Practice Standards for Health Impact Assessment (HIA), Version 1. An official website of the United States government. other key elements that will be important for the work moving forward. To address that concern, monitoring of concentrations of selected contaminants in local fish was proposed as a mitigation measure. First is screening that measure the health effects of a proposal and whether the health assessment will yield useful HEALTH ASSESSMENT AND COMMUNICATION 4 information to decision makers and stakeholders. The source of public funding for the project was the Tax Allocation District (TAD), and only within the districts boundaries could funding be collected and bond money spent. Harris P, Harris-Roxas B, Harris E, Kemp L. Harris-Roxas B, Harris E. Differing forms, differing purposes: A typology of health impact assessment. Public concern or controversy regarding health effects of the proposed decision. We identified 11 common assessment and planning components across 18 models and requirements, with a particular focus on health department, health system, and hospital models and requirements. However the literature review is conducted, the methods should be clearly described in the report, and any studies with conflicting results acknowledged. In other cases, all proposals in selected agencies or sectors have been screened by local governments (SFCC 1998; Lester et al. The committee notes that the diversity of approaches and decision contexts imposes challenges for determining the resources required for conducting an HIA. Community Health, Safety and Security. As discussed in greater depth in the section on scoping, it is common to convene advisory or steering committees, which can include both technical and policy experts and representatives from stakeholder groups that have an interest in the decision outcome. The committee proposes on the basis of its review the following adaptation of the current working definition of the International Association of Impact Assessment (Quigley et al. The potential for health effects to place a disproportionate burden on or substantially benefit vulnerable populations. Mapping out the timeline for the decision-making process can be helpful, and for large and complex programs and projects, identifying the agencies involved and their jurisdictions is important. The use of the information by the decision-maker is discussed at greater length in Chapter 4 in the section Managing Expectations.. The research was funded by the Annie E. Casey Foundation as an initiative with the potential to encourage long-term strategies and partnerships to strengthen families and communities. Unable to load your collection due to an error, Unable to load your delegates due to an error. HIV-AIDS infection risk associated with oil-pipeline construction. In many cases, a complete and accurate description of health and its determinants in the affected community may not be possible. National Public Health Performance Standards Program, National Center for State, Tribal, Local, and Territorial Public Health Infrastructure and Workforce, SDOH Research by CDC Authors: Frequently Asked Questions, Examples of How the SDOH Can Be Addressed Through the 10 Essential Public Health Services, Performance Management & Quality Improvement, National Public Health Improvement Initiative, National Public Health Performance Standards, Public Health Finance and Infrastructure Support, Competencies for Public Health Professionals, National Leadership Academy for the Public's Health, Supporting the Performance Improvement Workforce, Alerts About Current & Projected Funding Opportunities, Cooperative Agreements, Grants & Partnerships, Strengthening Public Health Systems & Services, USAPI Strengthening Public Health Systems & Services, Integrity & Accountability Review Offices, National Health Initiatives, Strategies & Action Plans, State & Territorial Health Department Websites, US Territories & Freely Associated States, Style for Referring to US Territories & Freely Associated States, About the Public Health Infrastructure Center, Implementing the Community Health Needs Assessment Process, U.S. Department of Health & Human Services, Multisector collaborations that support shared ownership of all phases of community health improvement, including assessment, planning, investment, implementation, and evaluation, Proactive, broad, and diverse community engagement to improve results, A definition of community that encompasses both a significant enough area to allow for population-wide interventions and measurable results, and includes a targeted focus to address disparities among subpopulations, Maximum transparency to improve community engagement and accountability, Use of evidence-based interventions and encouragement of innovative practices with thorough evaluation, Evaluation to inform a continuous improvement process, Use of the highest quality data pooled from, and shared among, diverse public and private sources, Improved organizational and community coordination and collaboration, Increased knowledge about public health and the interconnectedness of activities, Strengthened partnerships within state and local public health systems, Identified strengths and weaknesses to address in quality improvement efforts, Baselines on performance to use in preparing for accreditation, Benchmarks for public health practice improvements. This site needs JavaScript to work properly. In most cases, influencing decisions to protect or promote health is a central objective but by no means the sole outcome of value. Unauthorized use of these marks is strictly prohibited. Articles in Google Scholar by Kaye Bender, PhD, RN, FAAN Because any actions taken on the basis of HIA recommendations need to be implemented within a specific legal and policy context, screening needs to establish a clear description of the decision-making process and context. Improving community health starts with knowing the factors that impact people's health, both inside and outside of the clinic. Box 3-2 provides an example of scoping for the HIA of a proposed development in Atlanta. Public and stakeholder participation during scoping can serve several important purposes, such as providing local knowledge regarding existing conditions and potential impacts, introducing alternatives or mitigation measures that stakeholders would endorse as effective ways to address key concerns, and allowing representative participation in shaping the terms of the HIA by groups affected by the proposal. The American Hospital Associations review of the IRSs final rules for CHNAs and implementation strategies can be foundhere. 2010). Outcome evaluation should be undertaken when available resources and data will allow reasonable judgments regarding the association between the implementation of decisions and observed changes in health outcomes or health determinants. The process mirrors the one set out by NEPA for an environmental impact statement, but the practice is far more variable for HIA. Because it will often not be practical or possible to address all direct and indirect health effects that appear theoretically possible, it is important to select issues carefully. (2015). It is important to note that a matrix does not explain how evidence was used to reach conclusions. The nature of the proposal being assessed, including alternatives that were included in the analysis. The discussion described pathways by which Iupiat health was likely to be affected. Assessing alternatives in parallel with the proposal can aid decision-making by highlighting tradeoffs and actions that can be taken to achieve the desired outcome while minimizing harms. Expert judgment is central to HIA but must be grounded in a solid foundation of scientific neutrality and accepted public-health principles. Federal government websites often end in .gov or .mil. Assessing the baseline health status of the affected population provides a reference point with which the predicted changes in health status may be compared; it identifies any groups that could be more vulnerable than the general population to the impacts of the proposal; and it provides an understanding of the factors that are responsible for determining health in the affected communities, and this, in turn, allows for a better understanding of how any changes in those factors may affect health. Public concerns are a common trigger for a decision to screen, and the degree of concern or controversy about a proposal may be one of the factors weighed in the decision to undertake an HIA. The facts that resources were available and that timelines were appropriate were also relevant to the decision to conduct an HIA. 2005; Bhatia and Seto 2011). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. 54873. Mindell J, Ison E, Joffe M. A glossary for health impact assessment. Finally, it is appropriate to include issues that are the subject of community concern even if they seem unlikely to be substantiated by further analysis. Mitigation measures that address a specific impact identified in the HIA and are intended to minimize a potential harm (for example, a measure to reduce benzene emissions from gas wells near residential areas) or measures to maximize a potential benefit. It can also include information from social-science and epidemiologic studies regarding the strength of associations between the social and physical environment (such as air and water quality and economic impacts) and health outcomesinformation essential in the quantitative prediction of health effects. Health impact assessments are needed in decision making about environmental and land-use policy. The toolkit provides a foundation for meeting the relevant IRS requirements. SFCC (Federation of Swedish County Councils). Major issues and challenges for HIA development and practice are considered in Chapter 4. A description of the HIAs impact on decision-making (to the extent that salient decisions have occurred by that time) as measured by an accounting of HIA recommendations that were adopted and an evaluation of available evidence that suggests whether and how the HIA played a role in decisions or contributed to changes in decision-makers knowledge, attitudes, or positions. The HIA team identified the following critical issues that could affect the health of the study area population: access and social equity, physical activity, safety, social capital, and environment (including air quality, noise, and water management). Scholars point to a remarkable consistency in the basic elements that are generally included in descriptions of HIA (Mindell et al. Minimum Elements and Practice Standards for Health Impact Assessment (HIA), Version 2. In others, scoping may identify studies that can be carried out by the HIA team or studies that can be carried out by experts involved in some other aspect of the planning, permitting, or review process (such as air-quality or traffic-safety analysis). Wernham A. Inupiat health and proposed Alaskan oil development: Results of the first Integrated Health Impact Assessment/Environmental Impact Statement of proposed oil development on Alaskas North Slope. Behavioral Risk Factor Surveillance System data were used for the county and the state and stratified by race. Characteristics unique to the affected community may not be obvious to HIA practitioners who are outside the community. Finally, effects that are plausible but are not supported by available evidence include fewer hospitalizations because workers are able to receive the preventive primary care needed to maintain good health. This step suggests a modified version of CDC's evaluation guidelines, and may be used as a starting point to tailor an evaluation for a particular community health improvement effort, at . The HIA drew on public testimony, literature review, and accepted mechanisms of health and illness to establish the scope of health concerns that should be considered. Cole BL, Fielding JE. The report of the Healthy Families Act HIA provides a clear description of the steps in the analytic process. It characterizes health effects according to their nature, direction, intensity, magnitude, distribution, timing and duration, and likelihood. This is the key link between a health profile and a health plan. Scoping should therefore entail a deliberative process that involves engagement of stakeholders. In some cases, the team may draw on outside consultants who have expertise in a specific health issue or method. HIA practice is often defined in terms of several categories. In those cases, it may be more appropriate to monitor exposuressuch as environmental concentrations of a carcinogen or the availability of safe walking corridorsthat are linked to the outcome of interest by public-health evidence. Here are 7 common components of a successful Community Health Needs Assessment (CHNA): Information, Research, and Data Collection Stage Issues surrounding uncertainty, literature review, and reliability and validity of predictions are discussed in greater depth in Chapter 4. A comprehensive profile will include many indicators; those related to selected priorities Describes data sources and analytic methods and methods used to engage stakeholders. Calculations were conducted to develop a vulnerability score. Logic frameworks can be used as part of stakeholder engagement to develop a shared understanding of how a project will develop and the outcomes that can be expected (Cave and Curtis 2001a,b; Cave et al. The tasks or elements that are described as part of an HIA are fairly consistent in the peer-reviewed literature and guides reviewed by the committee. The scoping phase was used to identify the parameters of the assessment, the affected and most vulnerable populations, and potential key health effects. The World Bank and International Finance Corporation have policies governing the disclosure of information, and although the policies differ, both provide for withholding or excluding documents that might contain proprietary information or information whose disclosure could damage a client or lenders financial, political, or legal interests (Halifax Initiative Coalition 2006; IFC 2006, 2010; McHugh et al. Fourth, disclosure of potential impacts may benefit industry by reducing the risk of litigation and by reducing tort liability by fulfilling requirements to warn those potentially responsible and potentially affected before the effects occur. For example, HIA reports can be disseminated in hard copy, in electronic format, at public meetings, to focus groups, or at different stages in the HIA process or policy cycle. A community health assessment, also known as community health needs assessment, refers to a state, tribal, local, or territorial health assessment that identifies key health needs and issues through systematic, comprehensive data collection and analysis. Scoping considers input from many sources, including preliminary literature searches, public input, and professional or expert opinion in fields relevant to the proposal. Health and impact assessment: Are we seeing closer integration. A lack of access to needed goods and services. The quality of the report can be a criterion by which the quality of the process is judged; that is, How clearly does the final document present the results of the analysis? To request permission to reproduce AHA content, please, https://www.chausa.org/communitybenefit/assessing-and-addressing-community-health-needs, Step 5: Prioritize Community Health Issues, Association for Community Health Improvement (ACHI). However, in some cases, the relationships between the implemented decision and health determinants may be more direct and measurable. The success of recommendations ultimately depends on the publics trust in and support of them. Outcome evaluation will continue to be challenging, but it can generate useful information in well-selected cases. In selecting the analytic methods that will be used, the HIA practitioner should consider not only technical limitations but what type of information will be most useful to decision-makers. Key Elements of Community Health Improvement Planning: From Assessment to Action Planning Key Elements of Community Health Improvement Planning: From Assessment to Action Planning CHA-CHIP Demonstration Project Improvement www.assesstoolkit.org April 23, 2012 The lines are muted. However, where practical, the HIA team should aim to evaluate a variety of alternatives or, minimally, to identify the characteristics of proposed actions that would be health-protective or detrimental to health. Citation for Toolkit Furthermore, HIA teams commonly rely on analyses by such experts as traffic-safety engineers or air-quality analysts who provide information on the links between the proposal and changes in health determinants. MeSH The Crossings is a proposed housing development in Los Angeles that will provide 450 units in a newly rezoned residential area that needs affordable housing. 2010). 2006; World Bank 2010). Program on Health Equity and Sustainability, San Francisco Department of Public Health. 2007; ICMM 2010). Northeast National Petroleum Reserve-Alaska (NPR-A) Draft Supplemental Integrated Activity Plan/Environmental Impact Statement (IAP/EIS). As discussed later in this section, recommendations can also establish a foundation for monitoring, and the results of the monitoring may indicate that the management strategies need to be adapted to respond to the observed outcomesa process known as adaptive management (Johnson 1999). Questions that are important from a public-health perspective might include the severity of the health effect, the size and likelihood of the effect, and the potential of the effect to exacerbate health disparities. Parry JM, Kemm JR. This information can help develop a community health improvement plan by justifying how and where resources should be allocated to best meet community needs. Decision-making is rarely based solely on scientific evidence but instead takes into account an array of political, economic, technical, and practical considerations. Crossings at 29th St./San Pedro St. Area Health Impact Assessment. The committee finds that an HIA report should at least describe the proposal and alternatives that are the subject of the HIA, the data sources and analytic methods used, the groups and individuals that were consulted in the course of the HIA, the process and findings of each step of the HIA, and the overall conclusions and recommendations.
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