What's the impact on health? Experts explore issues in using health impact assessments to find out

A short summary of the 2004 workshop in the US funded by the Robert Wood Johnson Foundation has just been published and it outlines the key recommendations from the workshop.

Key recommendations of the workshop included:

• Conduct pilot tests of existing health impact assessment tools, ranging from simple checklists to complex collaborative processes. Pilot tests should be designed to provide information on:
  • The usefulness of health impact assessment methods in US settings.
  • The availability of needed health impact data.
  • The acceptability of the process to local decision-makers.
• Develop a database of health impacts of common projects and policies. Such a searchable database should contain:
  • An inventory of tools for conducting health impact assessments.
  • Guidelines for choosing tools used in health impact assessments.
  • Systematic reviews of health impacts for a range of policies and projects.
  • Links to completed health impact assessments on numerous topics.
  • Lists of experts in the field of health impact assessment.
• Develop resources for the use of health impact assessment, which may vary according to scope of the project, depth of analysis, time available and processes employed.
• Build workforce capacity to conduct health impact assessments, including:
  • Health impact assessment professionals, whose training curriculum should include skills to:
    • Understand the health impact assessment process.
    • Identify stakeholders.
    • Analyze policies.
    • Identify and quantify health impacts.
    • Communicate results.
    • Understand land use and transportation planning.
  • Planners and decision-makers, who would be more likely to request and use health impact assessment processes if trained to understand their value. Health impact assessment training for this group should be interdisciplinary, problem-based and not overly technical.
• Evaluate health impact assessments. Such assessment have the potential to:
  • Advance the field.
  • Demonstrate value.
  • Document influence on decisions.
  • Improve quality.
  • Facilitate training.
  • Enhance institutional relationships.
  • Raise awareness of health impacts for decision-makers.
  • Examine adherence of processes to underlying values.
  
  Three types of health impact assessment evaluations would apply, depending on the needs:
  • Process evaluations examining how the health impact assessment was planned and implemented.
  • Impact evaluations assessing the effect of the health impact assessment on the decision-making process.
  • Outcome evaluations comparing the health outcomes after implementation with those predicted by the health impact assessment.

External link: http://www.rwjf.org/pr/product.jsp?catid=17&id=32231

Use of HIA in the US - 27 case studies 1999-2007

This article documents the growing use in the United States of health impact assessment (HIA) methods to help planners and others consider the health consequences of their decisions.

It used multiple search strategies to identify 27 HIAs that were completed in the U.S. during 1999 –2007 and key characteristics of each HIA were abstracted from published and unpublished sources.

• The areas examined in these HIAs ranged from policies about living wages and after-school programs to projects about power plants and public transit.
  
• Most HIAs were funded by local health departments, foundations, or federal agencies.
  
• Concerns about health disparities were especially important in HIAs on housing, urban redevelopment, home energy subsidies, and wage policy.
  
• The use of quantitative and nonquantitative methods varied among HIAs.
  
• Most HIAs presented recommendations for policy or project changes to improve health. Impacts of the HIAs were infrequently documented.
  

These completed HIAs are useful for helping conduct future HIAs and for training public health officials and others about HIAs. More work is needed to document the impact of HIAs and thereby increase their value in decision-making processes.

The article can be found at the CDC website at http://www.cdc.gov/healthyplaces/publications/AJPM_HIAcasestudies_March2008.pdf

HIA in Progress: Hume Power Station (Australian Capital Territory)

A health impact assessment is being carried out on a proposed power plant to be built near Hume in the Australian Capital Territory. The 28MW power plant will provide electricity for a major data centre hub being built by a consortium that includes ActewAGL, Technical Real Estate and CB Richard Ellis.

The proposal has been contentious, with substantial local opposition and has even led to a vote of no confidence in the ACT Chief Minister John Stanhope. Opponents are concerned about the proximity of the power station to residential areas in Macarthur and Tuggeranong, particularly in relation to potential impacts on air quality.

You can find out more about the HIA in the videos (inclduing videos of the consultation forum and technical workshop), media stories and links below.

Update 10 August 2008
ABC Online is reporting that the ACT Minister for Health, Katy Gallagher, has disbanded the health impact assessment steering committee and that an environmental impact study that includes an investigation of health effects will be undertaken instead. Further reports and commentary on the decision here, here and here.

Update 17 November 2008
The environmental impact assessment on the data centre has now been released.

Videos

Canberrans for Powerstation Relocation Protest
25 June 2008


Power Station Health Impact Assessment Community Forum
16 July 2008


Power Station Health Impact Assessment Technical Workshop Part 1
22 July 2008


Power Station Health Impact Assessment Technical Workshop Part 2
22 July 2008


Media Stories
May 16 - Power station consultation flawed: Foskey (ABC Online)
May 25 - Details of power station unveiled (ABC Online)
June 17 - Health committee to examine impact of power station (ABC Online)
June 17 - Stanhope faces no confidence motion (ABC Online)
June 25 - Stanhope survives Tuggeranong station no confidence motion (ABC Online)
July 2 - 600 weigh into gas power plant argument (Cenberra Times)
July 3 - Power station health report due next month (ABC Online)
July 3 - Gas power station steering committee named (Canberra Times)
July 14 - Residents maintain power station opposition (ABC Online Video)
Jul 14 - Campaign against Tuggeranong power station stepped up (ABC Online)
July 17 - Regaining Trust (ACT Greens)
July 17 - Probe into power station health impacts (Canberra Times)
Jul 17 - ACT Govt 'committed' to public health on power station (ABC Online)
July 26 - Stanhope fends off no confidence motion (ABC Online Video)

Links
Preliminary Assessment
Canberrans for Power Station Relocation

US Environmental Protection Agency Report on the Health Impacts of Climate Change in the USA

The US EPA has recently published its final report on the human health impacts of climate change in the USA entitled, "Synthesis and Assessment Product 4.6: Analyses and Effects of Global Change on Human Health and Welfare and Human Systems".

This report focuses on impacts of global climate change, especially impacts on three broad dimensions of the human condition: human health, human settlements, and human welfare.

Climate change, interacting with changes in land use and demographics, will affect important human dimensions in the United States, especially those related to human health, settlements and welfare.

The challenges presented by population growth, an aging population, migration patterns, and urban and coastal development will be compounded by changes in temperature, precipitation, and extreme climate-related events. Climate change will affect where people choose to live, work, and play.

Among likely climate changes are:

• changes in the intensity and frequency of rainfall,
• more frequent heat waves, less frequent cold waves,
• more persistent and extreme drought conditions and associated water shortages,
• changes in minimum and maximum temperatures,
• potential increases in the intensity and frequency of extreme tropical storms,
• measurable sea-level rise and increases in the occurrence of coastal and riverine flooding.

In response to these anticipated changes, the United States may develop and deploy strategies for mitigating greenhouse gases and for adapting to unavoidable individual and collective impacts of climate change.

The report can be downloaded from

http://oaspub.epa.gov/eims/eimscomm.getfile?p_download_id=475107

ORISE Fellowship - USA

Application are invited for this fellowship which has a strong element of HIA.

It's at the CDC so if you're interested in broadening your horizons and spending some time doing HIA and public health work in the USA then this fellowship could be for you.

Title of Position: Physical Activity (PA) Fellow

This is a one-year position with possible future opportunities for longer-term full time employment.

Description:

The Physical Activity (PA) Fellow will work with the Centers for Disease Control and Prevention, Division of Nutrition, Physical Activity, and Obesity (DNPAO), Physical Activity and Health Branch on a variety of projects related to physical activity.

Responsibilities:

• Participates as a member of various project teams working on projects focused on how the built environment is related to various health outcomes, with an emphasis on physical activity.
• Analyze data from the Neighborhood Parks and Active Living study, a multi year study which examined physical activity in 12 parks in Atlanta.
• Write manuscripts and reports as needed
• Conduct Health Impact Assessments (HIA), commonly defined as “a combination of procedures, methods, and tools by which a policy, program, or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population.”
• Apply HIA to various projects and policies.
• Serve as a key member of the interdisciplinary HIA team learning and working on numerous aspects of performing a HIA.
• Develop partnerships and communicate effectively with non-traditional public health partners.
  
• Work closely with the primary supervisor in collaborating with external partners to help advance the field of HIA in the U.S.

Knowledge and Abilities:

• Demonstrated knowledge of data collection techniques and measurement tools.
• Demonstrated ability to interpret, synthesize and translate qualitative and quantitative research data.
• Demonstrated ability to write manuscripts and reports.

Qualifications

• Master’s degree, or equivalent in public health or relevant field and 2 years of related experience and completion of related coursework.
• Experience interpreting and translating research results.
• Experience writing about health related and/or nutrition, physical activity, or weight related topics.
• Ability to work tactfully and respectfully with a wide variety of individuals, including subject experts, internal and external partners.
• Ability to work independently.
• Ability to effectively organize a variety of complex tasks and complete them in a timely way.
• Knowledge of nutrition, physical activity, and/or weight maintenance and weight loss a plus.

Salary dependent on qualifications. Interested applicants are requested to submit a resume and cover letter to Candace Rutt, Ph.D. at - crutt(a)cdc.org - by August 29, 2008.

Good luck!

Good for Kids. Good for Life Equity Focused HIA Wins Minister's Award for Aboriginal Health

The Hunter New England Area Health Service's work on HIA has been recognised by receiving the 2008 New South Wales Health Minister's Award for Aboriginal Health. The Good for Kids, Good for Life Equity Focused Health Impact Assessment looked at potential health equity impacts of a $7.5 million childhood obesity prevention program, with specific reference to impact on Aboriginal children.

Minister Paul Lynch, NSW Minister for Aboriginal Affairs, presented the Award on behalf of the NSW Minister for Health. "This project brings together a variety of agencies, community groups and industry to provide practical information... to make it easier for Aboriginal children to be active and eat well," Mr Lynch said.

The HIA was undertaken as part of NSW HIA Project with the support of the Centre for Health Equity Training, Research and Evaluation (CHETRE).

The Minister's Award is the second HIA-related award for Hunter New England Area HEalth Service this year after they received the UNSW Research Centre for Primary Health Care and Equity's Health Impact Assessment Award in May.

About the Program
Good for Kids, Good for Life is Australia's largest ever population-based childhood obesity prevention trial. It brings together a variety of agencies, community groups and industry to provide practical information, as well as new programs and systems, to make it easier for children to be active and eat well. Good for Kids program undertook an equity-focused Health Impact Assessment (HIA) in order to improve the equity with which the program was delivered to Aboriginal children and non-Aboriginal children and ensure that its implementation did not exacerbate existing inequalities. The HIA produced over 80 recommendations. These recommendations were made to ensure Good for Kids strategies did not directly or indirectly exclude Aboriginal children and communities by failing to acknowledge and plan for differences in how health eating and physical activity is understood and approached in Aboriginal communities.

About the Award
The Minister's Award for Aboriginal Health is presented to the NSW Health Area Health Service or organisation that demonstrates the most outstanding commitment to improving Aboriginal health across a range of indices including excellence in program delivery, strengthening access to primary care, improved access to mainstream health services for Aboriginal people and collaborative partnership arrangement with Aboriginal people.

A full list of the 2008 New South Wales Aboriginal Health Award winners can be found on the NSW Health website. More information on equity focused HIA can be found on HIA Connect.