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Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June 13, 2014

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Page 1: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

Health Impact Assessment Training

Kelly Muellman, AICPMN Climate & Health Principal Planner

Linden WeiswerdaMN Climate & Health Principal Planner

June 13, 2014

Page 2: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

Acknowledgements

This webinar/videoconference is supported by a grant from the Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts.

The opinions expressed are those of the author(s) and do not necessarily reflect the views of the Health Impact Project, Robert Wood Johnson Foundation or The Pew Charitable Trusts.

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Page 3: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

Outline

What is HIA?

Why conduct an HIA?

What value does HIA add?

When is HIA appropriate?

HIA Examples

HIA Resources

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Page 4: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

What is Health Impact Assessment (HIA)?

A systematic process that uses an array of data sources and analytic methods and considers input from stakeholders to determine the potential effects of a proposed policy, plan, program, or project on the health of a population and the distribution of those effects within the population. HIA provides recommendations on monitoring and managing those effects.

National Research Council, Improving Health in the United States: The Role of Health Impact Assessment, 2011.

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Page 5: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

2010 Avg Life Expectancy and Healthcare Spending

US ranked 42nd in life expectancy for 2010 and 1st in health spending per capita.

WHO and Global Health Expenditure Database

http://www.gapminder.org/

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Page 6: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

Health Determinants

Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.Source: World Health Organization

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Page 7: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

Why Conduct an HIA?

Identify harms and benefits before decisions are made

Identify evidence-based strategies and recommendations to promote health and prevent disease

Support inclusive and democratic decision-making and increase transparency in the decision-making process

Support community engagement in the decision-making process and foster community empowerment

Advance equity and justice

Note: There are many ways to insert health into decision-making. HIA is one way.

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Page 8: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

Types of Decisions Influenced by HIA

• Policy Decisions (bills by state legislature, city council decision, local school board on district-wide policy)

• Policy Implementation (weigh various implementation options for a policy once it is passed)

• Project Specific (siting, permitting, construction, design)

• Comprehensive Plans (neighborhood plan, regional growth plans, master planning documents)

Provided by Health Impact Projecthttp://www.healthimpactproject.org/

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Page 9: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

What topics have HIAs addressed?

Provided by Health Impact Projecthttp://www.healthimpactproject.org/

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Page 10: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

Value of HIA

HIAs directly contributed to decision outcomes—the way projects, plans, and policies were developed or implemented

HIAs influenced changes beyond the decision under consideration HIAs showed key stakeholders the health effects of non-health

policies and programs. HIAs built consensus HIAs amplified community member voices in the decision-making

process HIAs built cross-sector relationships

Bourcier, E., Charbonneau, D., Cahill, C., & Dannenberg, A. (2014). Do health impact assessments make a difference? A national evaluation of HIAs in the United States. Seattle: Center for Community Health and Evaluation.

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Page 11: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

Concerns about HIAConcern Response

HIA is costly Not as costly as treatment of health impacts in the long run

HIA is time-consuming and will slow decision-making process

Conducting the HIA early will bring issues to the front of the decision-making process, potentially speeding approval processes, and preventing costly litigation that delays projects

HIA will stop economic development

The role of HIA is to identify mitigations and recommendations, not to say “don’t do that”

HIA is not scientific Role of HIA is to pull together disparate pieces of the best available evidence to make a broad statement about impacts

Source: Wisconsin Department of Health Services, Health Impact Assessment: A Tool to Increase Health Equity in Decision-Making, Great Lakes Intertribal Council, April 23, 2012

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Page 12: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

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Six Steps of HIA

1. Screening - to determine if an HIA is useful for a specific project or policy

2. Scoping - identify which health effects to consider

3. Assessment - determine which people may be affected and how they may be affected

4. Recommendations - suggest changes to proposal to promote positive or mitigate adverse health effects

5. Reporting - present the results to decision-makers

6. Monitoring and evaluating - determine the affect of the HIA on the decision process

Page 13: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

When is HIA appropriate?

Consider:

Decision-point

Potential health impacts

Timing

Resources (money, staff, expertise)

Political will

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Page 14: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

Types of HIAsType Desk Based Rapid Intermediate Comprehensive

Duration Up to 6 weeks 6-12 weeks 12 weeks – 6 months 6 months – 1 year or more

Effort 1 full time person 1 full time person 1 full time person, and supporting help

1 full time person, and supporting help

Complexity Provides a broad overview of potential health impacts

Provides a more detailed overview of potential health impacts

Provides a thorough assessment of potential health impacts & more detail on specific predicted impacts

Provides a comprehensive assessment of potential & predicted health impacts

Methods Involves collecting & analyzing existing data

Involves collecting & analyzing existing data with limited input from experts & key stakeholders

Involves collecting & analyzing existing data, gathering some new qualitative data from stakeholders & key informants

Involves collecting & analyzing data from qualitative & quantitative sources

LESS COMPLEXITY MORE COMPLEXITY

Modified from Harris et al. 2007. Health impact assessment: A practical guide, Centre for Health Equity, Training, Research and Evaluation (CHETRE), Part of the UNSW Research Centre for Primary Health Care and Equity, UNSW: (http://www.hiaconnect.edu.au/hia_a_practical_guide.htm)

Page 15: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

When not to do an HIA

No added value Chula Vista Plan to Improve Walkability

Plan was already considering health Health advocates involved in design Resources better focused elsewhere

No influence on decision Milwaukee Zoo Interchange Project

Insufficient time to complete HIA for drafts Stakeholders (DOT) not open to considering health

Source: Wisconsin Department of Health Services, Health Impact Assessment: A Tool to Increase Health Equity in Decision-Making, Great Lakes Intertribal Council, April 23, 2012

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Page 16: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

HIA Examples

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Page 17: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

Gary/New Duluth HIA

Small Area Plan

Parallel process

Health concerns: Social Cohesion Physical Activity Access to Healthy Food

Page 18: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

Healthy Corridor for All

Zoning ordinance (urban) Lead by ISAIAH, Take Action MN,

and PolicyLink Community driven 3 Areas of Assessment:

1. Healthy Economy2. Healthy, Affordable Housing3. Safe and Sustainable

Transportation

http://www.policylink.org/atf/cf/{97c6d565-bb43-406d-a6d5-eca3bbf35af0}/HEALTHYCORRIDOR_SUMMARY_FINAL_20120111.PDF

Page 19: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

Goodhue County Zoning Districts HIA

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Zoning ordinance (rural) Lead by Goodhue County Health

and Human Services and Land Use Management Department

Areas of Assessment: Housing; Living conditions; Air,

water, and soil quality changes; Access to natural resources, respiratory health, mental well being, physical activity; and Economic health.

Page 20: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

Farm to School and School Garden Policy

Oregon Bill 2800 (HB 2800), the Farm to School and School Garden legislation (2011)

Led by Upstream Public Health

Areas of Assessment:1. Employment

2. Diet & Nutrition

3. Farm to School & School Garden Education

4. Environmental Health

5. Social Capital

Source: Henderson, T., Rader, M., Sorte, B., Ratcliffe, M. M., Lawrence, A., Lucky, J., and Harris, C. (2011) Health Impact Assessment: Farm to School and School Garden Policy, HB 2800, Upstream Public Health and the Health Impact Project. http://www.upstreampublichealth.org/sites/default/files/F2SHIA_FINAL.pdf

Page 21: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

Additional HIA Examples

Paid Sick Days HIA (national, state, local)

Treatment Instead of Prison HIA (WI)

School Integration Strategies HIA (MN)

Federal Farm Bill HIA (national)

HIA for proposed coal mine at Wishbone Hill (AK)

Lower Duwamish Waterway Superfund Site (WA)

HIA for open burning enforcement in La Crosse county (WI)

Page 22: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

HIA Resources

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Page 23: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

Evaluations of HIA

• Quigley & Taylor. 2004. Evaluating health impact assessment. Public Health. 2004 Dec; 118(8):544-52.

• EPA. 2013. A Review of Health Impact Assessments in the U.S.: Current State-of-Science, Best Practices, and Areas for Improvement.

• Center for community Health and Evaluation (CCHE). 2014. Do health impact assessments make a difference? A national evaluation of HIAs in the United States.

• John Hopkins School of Public Health (Keisha Pollack ), Health Impact Project and CDC, 2011

Page 24: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

HIA at the National Level

Two major national funders Centers for Disease Control & Prevention (CDC) (directly funds

grantees and professional organizations) Health Impact Project (PEW and RWJF)

SOPHIA (Society of Practitioners of HIA): http://www.hiasociety.org/

Two conferences: HIA of the Americas Workshop (Oakland, CA) National Health Impact Assessment Meeting (WDC)

Local Funder: Blue Cross Blue Shield of MN Foundation

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Page 25: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

Completed and in progress HIAs

Provided by Health Impact Project & CDChttp://www.healthimpactproject.org/hia/us

Page 26: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

Leading/performing HIAs: Douglas County Comprehensive Plan; St. Louis Park Comprehensive

Plan; Duluth 6th Ave Redesign Plan; Divine Mercy HIA; Gary/New Duluth Small Area Plan HIA; Winona County Active Living Plan HIA; Lincoln Park Small Area Plan HIA

Providing technical assistance: Healthy Corridor for All HIA; Bottineau Transitway HIA; HIA on the Fort

DuPont Redevelopment Project DE; Second Street Redevelopment Plan GA; Emerald Ash Borer HIA; MN School Location & Design HIA

Providing HIA training

MDH’s Role in Promoting HIA

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Page 27: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

MDH’s Role in Promoting HIA (II)

Promoting Health in All Policies EAW & Comprehensive

Plans Tool Development (EAW,

comp planning, brownfields, climate change)

Sharing information on HIA: website & listserv (500+)

Promoting HIA through Collaboration

(http://www.health.state.mn.us/divs/hia/)

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Page 28: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

Collaboration: Get Involved HIA Interagency Workgroup: (12 agencies)

MN HIA Coalition: (70+ members) (http://www.health.state.mn.us/divs/hia/coalition.html)

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Page 29: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

HIA Reports

Improving Health in the United States: The Role of Health Impact Assessment (http://www.nap.edu/catalog.php?record_id=13229)

Minimum Elements and Practice Standards for Health Impact Assessment (http://www.humanimpact.org/doc-lib/finish/11/9)

Guidance and Best Practices for Stakeholder Participation in Health Impact Assessments (http://www.hiasociety.org/documents/guide-for-stakeholder-participation.pdf)

Promoting Equity through the Practice of Health Impact Assessment: (http://www.policylink.org/atf/cf/%7B97c6d565-bb43-406d-a6d5-eca3bbf35af0%7D/PROMOTINGEQUITYHIA_FINAL.PDF)

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Page 30: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

Resources: HIA Websites

MDH HIA webpage (http://www.health.state.mn.us/divs/hia/)

CDC Healthy Places webpage (http://www.cdc.gov/healthyplaces/hia.htm)

World Health Organization HIA webpage (http://www.who.int/hia/en/)

HIA Gateway – Public Health England (http://www.apho.org.uk/default.aspx?QN=P_HIA)

UCLA – HIA Guide web (http://www.hiaguide.org/)

Health Impact Project website (http://www.healthimpactproject.org/)

Design for Health website (http://www.designforhealth.net/resources/healthimpact.html)

Healthy Development Measurement Tool website (http://www.thehdmt.org/) Source: http://www.policylink.org/atf/cf/%7B97c6d565-

bb43-406d-a6d5-eca3bbf35af0%7D/PROMOTINGEQUITYHIA_FINAL.PDF

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Page 31: Health Impact Assessment Training Kelly Muellman, AICP MN Climate & Health Principal Planner Linden Weiswerda MN Climate & Health Principal Planner June

Contact Information

Kelly Muellman, AICPPrincipal PlannerMN Climate & Health ProgramMinnesota Department of [email protected]

Linden WeiswerdaPrincipal PlannerMN Climate & Health ProgramMinnesota Department of [email protected]

Please complete the online evaluation:https://survey.vovici.com/se.ashx?s=56206EE33D67C4D2*We will send all participants links to today’s slides and the webinar evaluation*

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