Health Impact Assessments Can Connect Community Development and Public Health

Health Impact Assessments Can Connect Community Development and Public Health

This piece was originally published at Building Healthy Places Network in December 2014.

Some people might find it unusual for a gathering of community development finance institutions (CDFIs) to feature a panel with a doctor, a public health funder, and a representative from the Federal Reserve.

But, along with the head of a CDFI, these panelists at the Opportunity Finance Network’s annual meeting in Denver last month provided a rich picture of how community development and public health professionals can work together to improve the quality of life in low-income communities.

In fact, CDFIs invest in the very resources that play an important role in determining health outcomes: affordable housing, public transit, child care and education, access to healthy foods, and opportunities for employment and economic stability. The Build Healthy Places Network is helping to connect organizations and individuals working at this intersection of community development and public health by providing tools, resources, and a forum to share lessons learned.

One tool to incorporate health in other sectors is health impact assessment, or HIA. The Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts, supports the HIA to facilitate such cross-sector collaboration and identify the potential health implications of proposed projects, policies, program, and plans. Use of HIAs is growing rapidly. Nationwide, more than 300 assessments have been completed or are underway as of October, up from just 27 in 2007. A recent evaluation found that federal, state, local, and tribal legislators; public agency officials; and many others are using HIAs to craft smarter policies that promote safer, healthier communities. 

HIAs can be used to inform a variety of community development initiatives, including those that work to improve public transit systems, support small businesses, and increase access to affordable housing, education, and physical activity programs. And while many community developers already link new affordable housing units or new employment opportunities with health benefits, a HIA can ground these connections in data and evidence.

HIAs use a flexible approach that brings together public health expertise, scientific data, and input from community and other stakeholders. These assessments identify the health benefits and unintended health risks that proposed decisions would bring to affected communities, and they provide practical recommendations to improve community health and minimize potential health risks before it’s too late to correct them. HIAs are often effective in bringing to the table people who might not otherwise have had a voice. The assessment process includes creation of monitoring and evaluation plans to make sure that, once implemented, a project is having the intended health effects on the target population.

One example occurred recently in Phoenix. A local community development corporation used an assessment to identify ways to improve the health of residents of Coffelt-Lamoreaux, the oldest public housing development in Maricopa County. Coffelt was annexed by the city of Phoenix in 1959, but its streets never officially became part of the city street plan. As a result, commercial and industrial development was allowed in neighborhoods intended for residential living. When plans to redevelop the housing complex were announced, Phoenix Revitalization Corp., Catalyze Research and Consulting, and Local Initiatives Support Corp. launched an HIA to examine how residents’ well-being could be affected by improvements in landscaping, streets, and housing conditions.

The HIA’s final report revealed the serious challenges faced by Coffelt residents and made practical and evidence-based recommendations for updating the neighborhood’s infrastructure to increase access to healthy food, physical activity, transportation, and higher-quality housing. The local housing authority and involved developers responded positively to the HIA’s findings, and a group of city and county officials and community stakeholders is coming together to implement the recommendations. Most importantly, the HIA engaged community residents from the beginning and left many feeling empowered to make their homes and neighborhood safer and healthier.

This fall, several other organizations released HIAs related to community development. An HIA in Hartford, Connecticut, incorporated health considerations into the development of a neighborhood plan that addresses land use, utilities, housing conditions, and access to transportation and healthy food. The lead organization, Community Solutions, will serve in a “quarterback” capacity to help mobilize community partners to implement the plan to revitalize vacant lots, increase pedestrian safety, and improve a large neighborhood park. And in Massachusetts, government and nonprofit partners collaborated on an HIA to inform how funding for a new statewide grant program could best support community development corporations and improve health. These are just a few examples of how HIAs have been integrated into community development decisions.

As the use of HIAs continues to grow in the U.S., there will be more opportunities for community development and public health professionals to work together to support vibrant, healthy neighborhoods. Through the use of such public health tools as HIAs, developers, financers, policymakers, and communities can leverage the power of the development and public health sectors to ensure better health for all.

Moving forward, it will be critical for community developers and public health workers to share success stories, challenges, and resources. Fortunately, the Build Healthy Places Network focuses on spurring and solidifying partnerships among these sectors. The network will provide an important space for collecting and disseminating best practices, identifying synergies, and connecting with other organizations across fields.

-Kara Blankner and Bethany Rogerson
The Health Impact Project