This health impact assessment (HIA) of the City of Portland’s rental housing inspection program compared the program’s two current inspections models, the standard inspection model and the pilot enhanced model in East Portland, finding that both improve the health of rental housing residents but that the enhanced model has greater potential to contribute to improved health and health equity.
Practice Standards Checklist By reviewing the Practice Standards Checklist prior to the implementation of each stage of the HIA, it enabled the facilitation team to be proactive in addressing potential issues and barriers. Additionally, it ensured the development of a thorough process that has been certified by leaders in the HIA field.OPHI met every practice standard except those regarding the decision-makers’ concerns and input during the screening and scoping stage of the HIA. Input was solicited from decision-makers after the scoping stage. Stakeholder Survey Due to a low response rate (n=1), the OPHI staff was unable to determine whether stakeholders outside of the steering committee gained knowledge about and capacity to influence rental housing inspections.Steering Committee Survey After the release of the HIA, steering committee members were asked to complete a survey that retroactively assessed knowledge and opinions of the HIA. From the survey, there were three main findings:
The understanding of the survey participants regarding the Rental Housing Inspections program either stayed the same or increased due to the HIA.
The understanding of the survey participants regarding the Health Impacts that would stem from the Rental Housing Inspections program either stayed the same or increased due to the HIA.
The understanding of the survey participants regarding the impacts that the Rental Housing Inspections program would have on specific populations stayed the same.The understanding of the survey participants regarding how an HIA can improve decisions in non-health sectors either stayed the same or increased due to the HIA.
All survey participants either “agreed” or “strongly agreed” with each of the following statements:
Decision-Maker Interview Interviews were held with the two Portland City Councilor policy staff members (Matt Grumm from Commissioner Dan Saltzman’s office, and Sonja Schmanski from Commissioner Nick Fish’s office) who were most directly involved in discussions about the budget for the inspections program. There were three main findings that stemmed from the interviews:
The Health Impact Assessment helped support the City Council’s decision to maintain current funding levels for the inspections program instead of decreasing the program’s funding as earlier drafts of the budget had called for. Although the final HIA report was released after the budget was finalized, interim presentations and draft documents summarizing the HIA’s initial findings and recommendations were shared with City Council staff during the budget development process. City Council staff found this information valuable in convincing the Council to maintain current funding levels for the inspections program instead of decreasing the program’s funding as earlier drafts of the budget had called for.
The HIA will have a significant role in future budgetary discussions. Both interviewees agreed that the final HIA report is a very useful document that will play a significant role in upcoming discussions about how to improve and more adequately fund the inspections program. Indeed, since the formal evaluation was completed in late October, the Neighborhood Inspections Team Stakeholder Advisory Committee (NITSAC) decided to use the HIA recommendations as a starting point for future discussions about the design of the program and related budget needs. A sub-committee of NITSAC, including most of the HIA steering committee members and a couple of other NITSAC members, has since developed detailed cost estimates for each of the HIA recommendations and will be working with the Bureau of Development Services Budget Advisory Committee (BDS BAC) to identify potential funding streams and strategies for funding the implementation of the HIA recommendations in next year’s budget.
The decision-makers’ experience with the RHIP HIA has increased the likelihood that they will engage in future Health Impact Assessments. Both interviewees expressed enthusiasm in the possibility of engaging in future HIAs, in part because they are useful tools for providing and interpreting relevant data regarding impacts on health and health equity, but also because this process provided an effective means for engaging key stakeholders and developing a shared set of politically and technically feasible recommendations to be used by decision-makers.