integrating a health impact assessment into district-wide school travel planning

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Health Impact Assessment and Safe Routes to School Brian Butler, MPH Epidemiologist

DESCRIPTION

Integrating a Health Impact Assessment into District-Wide School Travel Planning Track: Prosper Format: 60 minute panel Abstract: Learn about how a Health Impact Assessment (HIA) was used for the first time to guide the formulation of the Safe Routes to School (SRTS) Columbus City Schools District-Wide School Travel Plan, which focused on schools and neighborhoods with health inequities. Presenters: Presenter: Brian Butler Columbus Public Health Co-Presenter: Kate Moening Safe Routes to School National Partnership Co-Presenter: Alex Smith Columbus Public Health Co-Presenter: Julie Walcoff Ohio DOT

TRANSCRIPT

Page 1: Integrating a Health Impact Assessment into District-Wide School Travel Planning

Health Impact Assessment

and Safe Routes to

School

Brian Butler, MPH

Epidemiologist

Page 2: Integrating a Health Impact Assessment into District-Wide School Travel Planning

What is Health Impact Assessment?

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. HIA provides recommendations on monitoring and managing those effects.

National Research Council of the National Academies, 2011

Page 3: Integrating a Health Impact Assessment into District-Wide School Travel Planning

HIA Purpose

Through HIA report and communications

• Judge health effects of a proposed project, plan or policy

• Highlight health disparities

• Provide recommendations

• Raise awareness among decision makers and the public

• Make health impacts more explicit Human Impact Partners

Page 4: Integrating a Health Impact Assessment into District-Wide School Travel Planning

HIA Purpose

Through the HIA process

• Engage & empower community

• Recognize lived experience

• Build relationships & collaborations

• Improve the evidence

• Improve transparency in decision making

Human Impact Partners

Page 5: Integrating a Health Impact Assessment into District-Wide School Travel Planning

6 Steps of an HIA

1. Screening – Determines the need and value of an HIA

2. Scoping – Determines which health impacts to evaluate, methods for analysis, and a workplan

3. Assessment – Provides a profile of existing health conditions and an evaluation of potential health impacts

Page 6: Integrating a Health Impact Assessment into District-Wide School Travel Planning

6 Steps of an HIA

4. Recommendations – Provides strategies to manage identified adverse health impacts and maximize benefits to health

5. Reporting – Includes the development of the HIA report and communication of findings and recommendations

6. Monitoring – Tracks and evaluates the process of conducting the HIA, impacts on decisions-making processes and implementation of the decision, and impacts on health outcomes

Page 7: Integrating a Health Impact Assessment into District-Wide School Travel Planning

7

Planning Intervention Points

Vision, goals &

priorities developed Starting an HIA

Typical Points in a Planning Process

Existing conditions

profiled

Alternatives drafted

Plan proposed

Plan approved

Plan implemented

(Rapid HIA)

(Comprehensive HIA)

Using HIA findings

/recommendations

Page 8: Integrating a Health Impact Assessment into District-Wide School Travel Planning

HIA and Columbus Public Health

• Healthy Places program has been conducting (mostly rapid) HIA’s since 2006

• Traditionally focused on accessibility of new development

• Safe Routes to School HIA work began in August 2013

• HIA report and additional products are currently being drafted and edited

Page 9: Integrating a Health Impact Assessment into District-Wide School Travel Planning

Health Equity In SRTS

• Inequities in health exist along the lines of race, ethnicity, income, education levels, and other variables

• Focus SRTS interventions on schools and neighborhoods with health inequities

• Recommendations to improve health outcomes in disadvantaged and vulnerable populations

Page 10: Integrating a Health Impact Assessment into District-Wide School Travel Planning

Δ obesity

Income Race/ethnicity

Eng Language Learner Educ attainment Marriage status

School test scores School performance

Columbus STP: Engineering Education

Encouragement Enforcement

Δ walking environment

Δ social cohesion/civic engagement

Δ traffic safety environment

Δ chronic diseases (heart disease,

diabetes, cancer)

Δ mental health

Δ crime safety environment

Δ physical activity

Δ ped/bike/auto collisions

Childhood obesity Physical activity Traffic collisions

Crime/fear of crime

Δ stress

Δ injuries

Columbus STP – Research Approach Prioritizing

recommendations: 1st Equity lens

Policy, Project, or Program

Environment & Behavior Health Outcomes

Δ biking environment

Income Race/ethnicity

Eng Language Learner Educ attainment Marriage status

School test scores School performance

2nd Equity lens

Page 11: Integrating a Health Impact Assessment into District-Wide School Travel Planning

A Key Research Question

How do you quantify or measure

health inequity?

Page 12: Integrating a Health Impact Assessment into District-Wide School Travel Planning

What does the literature tell us?

Conducted an extensive lit review to look at:

1. What are the characteristics of communities where health inequities exist?

2. How are things like physical activity and traffic safety different in these communities?

3. How might the uptake of interventions be different in these communities?

Page 13: Integrating a Health Impact Assessment into District-Wide School Travel Planning

• Socioeconomic Status (SES) Index – Crowding

– Home value

– Income

– High education

– Low education

– Unemployment

– Poverty

• Poverty

• Race

• Ethnicity

• Language other than English

• Single parent head of household

Level 1 Analysis

Analyzed and mapped indicators of Healthy Equity by Census Tract:

Page 14: Integrating a Health Impact Assessment into District-Wide School Travel Planning

School building datasets • Free and reduced lunch rates

• School Performance Indicators and Index

• ELL/ESL rates

• Overweight and obesity rates

Additional factors mapped to inform the HIA • Crime and perception/fear of crime

• Traffic collisions – pedestrians and bicycles

• Elementary/Middle school aged population

More Level 1 Analysis

Page 15: Integrating a Health Impact Assessment into District-Wide School Travel Planning

Focus School Profiles

List based on multiple indicators

• SES Index

• Race and Ethnicity

• Single parent households

• Language

• Population of children

• School Performance

Page 16: Integrating a Health Impact Assessment into District-Wide School Travel Planning

School CT or S Sullivant Trevitt Windsor STEM Lincoln Park Highland Ohio Avenue East Columbus Eakin

School Type Elem. Elem. Elem. Elem. Elem. Elem. Elem. Elem.

Census Tract 51 29 15 60 47 53 26 75.11

Neigh-borhood Franklinton Eastside Linden Southside Hilltop Old Town East Eastside Hilltop

SES Index rank CT 2 3 6 11 21 21 15 46

FARM rank S 1 12 49 5 24 30 51 8

% non-white rank

CT 67 5 1 97 80 38 55 89

% non-white rank

S 66 16 9 73 65 15 34 42

Lang. other than English rank

CT 44 249 128 270 204 211 31 9

ESL rank S 20 70 80 42 18 68 31 3

% single parent rank

CT 31 16 20 43 34 4 92 90

% pop. 5 to 14 years old rank

CT 12 1 28 114 16 31 67 75

% of students w/in 0.5 mi

42.8 64.6 37.2 41.5 60.8 27.9 51.6 76.1

% of students w/in 1.0 mi

69.2 81.4 65.1 63.6 71.4 57.7 57.3 81.8

% of students w/in 2.0 mi

79.8 86.7 87.2 71.5 84.2 78.1 71.6 87.5

% of ODE standards met

S 14.3 0 0 11.1 0 0 14.3 14.3

ODE Perf. Index percent

S 54.5 45.7 49.9 66.8 51 52.5 54.4 62.4

Page 17: Integrating a Health Impact Assessment into District-Wide School Travel Planning

School Sullivant Eakin

Type Elem Elem

Census Tract 51 75.11

Neighborhood Franklinton Hilltop

SES Index Rank 2 46

Free and Reduced Lunch Rank 1 8

Percent non-White Rank (CT) 67 89

Percent non-White Rank (Sch) 66 42

Language other than English Rank (CT) 44 9

English Language Leaner Rank (Sch) 20 3

Percent Single Parent Rank 31 90

Percent Population 5 to 14 Rank 12 75

Percent of Students with 0.5 Miles 42.8 76.1

Percent of Students with 1.0 Mile 69.2 81.8

Percent of Students with 2.0 Miles 79.8 87.5

Percent of ODE Standards Met 14.3 14.3

ODE Performance Index 54.5 62.4

Page 18: Integrating a Health Impact Assessment into District-Wide School Travel Planning

Questions?