29 October 2010

11th International HIA Conference - Abstract Submissions Deadline 15th Dec 2010

"In times of crisis, healthier ways"

The XIth International HIA Conference will take place on 14th-15th April 2011 in Granada, Spain at the Andalusian School of Public Health.

Abstracts are now being accepted, so if you have an interesting HIA story to tell whether at local, regional, national or international levels then get writing and submit you 300 word abstract for an oral or poster presentation.

Submissions are online from the conference website at:

Abstracts are welcomed in the four main conference topics:  
Topic 1. The role of HIA in times of crisis
How HIA can help reconsider the foundation of the prevailing development model, to include health as a core value for the wellbeing of the population wellbeing in  public policies, and to effectively address health equity. 
Topic 2. Embedding HIA in the decision making process to promote HiAP
How HIA can be mainstreamed to promote healthier public policies, as well as the opportunities that emerge from the new public health laws currently being developed in many countries at a national and regional levels. 
Topic 3. HIA methodology
What methodologies alongside solid evidence-based knowledge can facilitate the effective integration of HIA into policy-making processes whilst having a strong community perspective.

Topic 4. Sectorial experiences. HIA is being increasingly used in a variety of sectors and activities
Current HIA practice in urban planning, transport, regeneration projects, etc. and new emerging areas for HIA development.  

24 October 2010

Miniature Stoke: a cool way of showing a community profile

The purpose of mini Stoke is to bring to life a number of important ‘facts’ about peoples health and well-being in Stoke-on-Trent. It describes a moment in time, and aims to tell the story of what Stoke-on-Trent would be like if it was made up of one hundred people.

It is hoped that Miniature Stoke-on-Trent will be used by a whole range of people from community groups, local councillors, schools, colleges, universities and local employers to spark conversations about life in Stoke-on-Trent and to share people’s experiences of living, working and visiting the city.

Check out the Miniature Stoke website at: www.miniaturestoke.co.uk

Check out the Stoke-on-Trent Healthy City website at: www.healthycity-stoke.co.uk

Check out the Miniature Glasgow website at: www.miniatureglasgow.com

22 October 2010

HIA: conjecture, editorializing, data gaps and assumptions

All the above words have been used to describe the recent draft HIA report for the Garfield County Battlement Mesa natural gas extraction project.

Check out the Glenwood Springs Post Independent article.

Most experienced HIA practitioners will have come across similar statements on their HIAs (from all kinds of stakeholders including communities and proponents). Making judgements under uncertainty and trying to quality assure these judgements is one of the most difficult aspects of doing good HIAs.

There are no easy answers but peer review both internal to the organisation doing the HIA as well as from external HIA practitioners and scientists  (something suggested for this HIA) and having an explicit and detailed report can both help.

It will be interesting to see how this plays out.

Click here to download the draft Battlement Mesa HIA Report.

Four new US HIAs looking at transit, energy & nutrition policies

From a Health Impact Project Press Release

WASHINGTON — The Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts, today announced nearly $400,000 in grants to four organizations to conduct health impact assessments (HIAs). The assessments will identify and address potential and often overlooked health implications of policy proposals including farm-to-school food legislation, energy development, smart-metering technology for electric utilities and urban transportation plans.

The projects, to be conducted in Georgia, Illinois, Kentucky and Oregon, are at the leading edge of a growing movement in the United States in which governments, non-profit groups and other organizations use HIAs to help ensure that decision makers craft public policies and projects that avoid unintended consequences and unanticipated costs. These four awards bring the Health Impact Project’s investments in this field to more than $1.5 million for 2010.

“An HIA identifies the benefits and consequences of government decisions that fall outside the traditional scope of public health,” said Aaron Wernham, M.D., director of the Health Impact Project. “These grants will give policy makers powerful tools to weigh the pros and cons of a proposal, identify health opportunities and tradeoffs and ensure that their decisions achieve the greatest benefits for people in affected communities.”

The newly-funded HIAs are part of a diverse portfolio of projects occurring across the country. Currently, through funding from the Health Impact Project, HIAs are being conducted on proposals for public transit systems; a county agricultural plan; a land-use plan to redevelop an abandoned factory site; proposed state “cap-and-trade” regulations and a state budget process. It is expected that a second round of funding and call for proposals will be released in early 2011.

“Some of the decisions that have the greatest impact on our ability to be healthy are made by leaders outside the fields of health and health care,” said Michelle A. Larkin, J.D., M.S., R.N., senior program officer and director of the public health team at the Robert Wood Johnson Foundation. “HIAs give leaders outside the health sector the information they need to factor health into a decision and can help them create safer, healthier communities throughout the United States.”

The four projects announced today by the Health Impact Project include:

  • The first-ever HIA on a major metropolitan transportation and comprehensive growth plan will be led by the Center for Quality Growth and Regional Development (CQGRD) at the Georgia Institute of Technology's College of Architecture. The Center will examine how PLAN 2040—which is being conducted by the Atlanta Regional Commission, the local intergovernmental coordination agency—will impact a range of health issues, such as injury and asthma rates, and the risks of obesity and diabetes. PLAN 2040 integrates multiple aspects of regional planning, including transportation and land use; housing; greenspace; and water and air quality through the year 2040. A final HIA is expected in September 2011.
  • The study by the Green River District Health Department in Owensboro, KY, is the first to address the overall health impacts that may result from a coal gasification project. Rather than burning coal, gasification techniques utilize a technology that converts coal into a substitute or synthetic natural gas. Together, the proposed plants—Cash Creek, Kentucky NewGas and Indiana Gasification—have the potential to affect nearly 500,000 people living nearby. The HIA will examine important health tradeoffs that could be associated with the planned projects. These include the benefits they could bring to the health of area residents as a result of employment opportunities and subsequent increase in income, health care access and local tax revenue, as well as the risks posed by any emissions produced. This HIA will provide practical recommendations for actions that could be taken to maximize the benefits and minimize any potential harm from these projects. The HIA’s recommendations will be included in a final report scheduled to be completed by February 2011, and can inform lawmaker’s decisions concerning these plants.
  • “Smart meters” may help electric utilities improve the reliability of the power grid and encourage conservation during peak-demand periods, but the health risks and benefits of this technology have not yet been studied. That is why the National Center for Medical-Legal Partnership at Boston Medical Center plans to produce a unique HIA of a pilot program run by Illinois’ largest electric utility, Commonwealth Edison. The assessment will measure the health effects of this technology in western metropolitan Chicago, in particular how these innovations could protect customers from potentially life-threatening exposure to heat or cold. The HIA also will look at the impact of energy prices on vulnerable populations such as the elderly, low-income or disabled, and the potential for this technology to increase or decrease the utility’s quality of service. The findings, expected in mid-2011, will become a model for understanding the potential impacts of widespread implementation. The grantee and Chicago’s non-profit Citizens Utility Board will collaborate on the HIA, disseminate the findings and make recommendations based on what was learned from the assessment to the Illinois Commerce Commission, the regulatory body monitoring the pilot program.
  • Upstream Public Health, a public policy non-profit based in Portland, OR, will conduct a novel HIA of proposed legislation in Oregon that would provide state funds to purchase locally-grown foods for schools and set up school teaching gardens. The lessons learned from this project could be applied to other food and agricultural policies being considered by states across the nation. The goal of the HIA is to inform state lawmakers and examine how the proposed law would impact child nutrition in public schools and the economic health of rural communities. The analysis will examine how new purchases of local foods, especially fruits and vegetables, will impact a variety of diet-related diseases such as diabetes and obesity. In addition, the HIA will consider how increased local food purchasing could best benefit the health and well-being of economically-depressed rural communities. The full report is expected to be available in March 2011.

To learn more about HIAs, how they work, previously funded projects and the goals of the Health Impact Project, please visit www.healthimpactproject.org.

20 October 2010

A Heavy Burden: the individual costs of being overweight and obese in the USA

This is an interesting research report on some key financial costs of being overweight and obese. A summary is presented below:

More than 60% of the United States population is overweight or obese, and if the current trajectory continues, 50% of the population will be obese by 2030. There is no question that being obese or overweight, is more costly than being of normal weight. Using existing literature, we have detailed the costs incurred due to overweight and obesity that affect working-age adults at the individual level.

What is the cost of being obese in America?
The overall, tangible, annual costs of being obese are $4,879 for an obese woman and $2,646 for an obese man. The overall annual costs of being overweight are $524 and $432 for women and men, respectively. For both genders, the incremental costs of obesity are much higher than the incremental costs of being overweight.

Adding the value of lost life to these annual costs produces even more dramatic results. Average annualized costs, including value of lost life, are $8,365 for obese women and $6,518 for obese men.
We only have a partial approximation of the cost of obesity for individuals.

The picture we have created is only a partial look at the individual costs related to obesity. Existing literature provides information on health- and work-related costs, but with the exception of fuel costs, there is no published academic research that gives us insight into consumer-related costs, such as clothing, air travel, automobile size or furniture. Anecdotal evidence suggests these costs could be significant.
How obese you are matters.

Where it was possible to break down the costs by degrees of obesity, it is clear the incremental costs of morbid obesity are much higher than those of moderate obesity. Total incremental costs for obese women are more than nine times higher than those for overweight women. For obese men, the incremental costs are six times higher than for overweight men.

The cost drivers are different for the overweight and the obese.

  • For those who are overweight, the main cost drivers are direct medical costs – 66% for women and 80% for men. 
  • Conversely, while direct medical cost is the primary driver of costs for obese men, only one-third of the overall costs for obese women are medical costs.
  • Obese women are disproportionately affected by job-related costs.
  • The overall, annual, incremental costs are significantly higher for obese women than for obese men. The difference is mostly the result of lost wages for obese women.

18 October 2010

Lifestyle versus socio-economic causes of the rise in obesity

In HIA we have tended to focus on the physical environmental factors that have reduced physical activity and access to fresh fruit and vegetables - the so-called 'obesogenic environment'. We generally focus much less on the way society is structured and how that might affect levels of obesity and the often subconscious worldviews embedded in the advocacy of certain forms of health interventions.

Farming Pathogens has an interesting article titled 'How Mayor Bloomberg causes obesity'.

The article argues that lifestyle focused interventions e.g. the focus on making welfare recipients eat healthily by not allowing them to buy 'junk' food using food vouchers ignores the socio-economic context within which health choices are made and how 'stressful environments' create the conditions for people to almost be 'self-medicating' on sugar and salt.

16 October 2010

The Contribution of HTA, HNA, and HIA to the Assessment and Translation of Technologies in the Field of Public Health Genomics

The European Union has named genomics as one of the promising research fields for the development of new health technologies.

Major concerns with regard to these fields are, on the one hand, the rather slow and limited translation of new knowledge and, on the other hand, missing insights into the impact on public health and health care practice of those technologies that are actually introduced.

This paper aims to give an overview of the major assessment instruments in public health [health technology assessment (HTA), health needs assessment (HNA) and health impact assessment (HIA)] which could contribute to the systematic translation and assessment of genomic health applications by focussing at population level and on public health policy making. It is shown to what extent HTA, HNA and HIA contribute to translational research by using the continuum of translational research (T1–T4) in genomic medicine as an analytic framework. The selected assessment methodologies predominantly cover 2 to 4 phases within the T1–T4 system. HTA delivers the most complete set of methodologies when assessing health applications. HNA can be used to prioritize areas where genomic health applications are needed or to identify infrastructural needs. HIA delivers information on the impact of technologies in a wider scope and promotes informed decision making. HTA, HNA and HIA provide a partly overlapping and partly unique set of methodologies and infrastructure for the translation and assessment of genomic health applications. They are broad in scope and go beyond the continuum of T1–T4 translational research regarding policy translation.

To go to the pay-per-view article click here.

14 October 2010

Evidence-based health impact assessment (EBHIA): a situation report (from the UK)

This research was carried out to ascertain the different types and sources of evidence commonly applied to the Health Impact Assessment (HIA) process in the United Kingdom; and to also examine the factors that influence the derivation and usage of the different types of evidence.

A questionnaire survey of 52 HIA practitioners who had conducted a total of 103 HIAs over a 3-year period was carried out, followed by semi-structured interviews of 11 practitioners to gain deeper insights into the questionnaire findings.

Ten different sources of evidence were seen to have been applied to the HIA process. Literature review was discovered to be the most commonly utilized source of evidence, having been used by 37 out of 52 practitioners (71.2%) and in 83.5% of the 103 HIAs. Engagement with local residents was second in terms of usage by practitioners (69.2%) and expert opinion was third, having been used by 67.3% of respondents. Other sources of evidence included completed HIA reports, survey, modelling and Delphi exercises. The findings point to efforts to ensure that predictions are grounded on robust sources of evidence, although several issues need to be addressed in the pursuit of evidence-based HIA (EBHIA).

To go to the pay-per-view article click here.

12 October 2010

Theory in a Nutshell

The use of theory in the planning and implementation of health promotion programs will more reliably produce positive outcomes. 

Following on from the success of the second edition, 'Theory in a Nutshell 3rd Ed' explores the main theoretical concepts and models in health promotion and explains the significance, practical application and impact of different theories on the individual, community and organization. 

This edition includes concise reviews of established theories, such as social cognitive theory and health belief model, as well as expanding on new developments in the field including evidence-based policy making and health impact assessment. Thoroughly revised and updated, the book maintains the accessible style suitable for public health practitioners, health promotion and health education specialists, epidemiologists and social policy makers, as well as students of public health and health promotion.

Original Source: http://www.healthypeople-betterpeople.info/

10 October 2010

Developmental milestones in children's environmental health

Interesting editorial in the latest issue of Environmental Health Perspectives. Below are the extracts that I liked that has relevance for HIA [emphasis added and phrases in square brackets]:

"...In the early 1900s, the environment was already well understood to  be an important contributor to health, and its importance was routinely taught to [medical and nursing] students. Think of Florence Nightingale’s 6 Ds of disease: dirt, drink (clean drinking water), diet, damp, drafts, and drains  (proper drainage and sewage systems). With the advent of high-tech  medicine, however, these fundamentals began to receive short shrift in  graduate education. At the same time, the house call - a home visit that  allowed the physician to view the environment in which the patient  lived - became increasingly rare, and doctors’ visits began to take place  in the confines of modern offices or hospitals, far removed from the  day-to-day surroundings of the family. Over time, the environment  became “invisible” to the medical practitioner.
...Why has it been so difficult to move from knowing to doing?  First, many of the decisions affecting children are made not by those  in the health sector, but by our professional colleagues in the agriculture, education, energy, housing, mining, and transportation sectors. Just as “men are from Mars and women are from Venus,” it seems  as if professionals in each of these sectors are from different planets.  Although we may speak the same language, we rarely have more  than a cursory understanding of the forces that shape one another’s decisions and other considerations...

Professionals in the health sciences may  work alongside professionals in other sectors, but we are absorbed in our own activities and usually have little interaction outside them. Instead of sitting at the table with urban planners, housing specialists, and energy experts when health professionals are planning an approach to a child health problem such as asthma, we usually move forward to design a study, implement it, analyze the results, and then present it as a fait accompli to our colleagues in other economic sectors, and hope that they will find it useful.

...This is not the ideal way to engage them. We medical professionals  need to fully engage with other sectors as we launch our attempts to  find solutions to child health problems. Major breakthroughs are likely  to occur in protecting children from hazards in the environment only  when we establish strong working relationships with those who haven’t  been trained as we have and who don’t think as we do. One tool that  helps different sectors to interact is Health Impact Assessment, pro- moted by the WHO (2010b) and by many countries including the  United States. Health Impact Assessment helps decision makers make  choices about alternatives and improvements to prevent disease/injury  and to actively promote health. A recent White House Task Force on  Childhood Obesity report recommends that communities consider  integrating Health Impact Assessment into local decision-making  processes before undertaking any major new development or planning  initiative (White House Task Force on Childhood Obesity 2010."

Click here to go to the October 2010 Table of Contents.

Click here to download the article as a PDF.

Image Source: Salim Vohra

7 October 2010

HIA sessions at the APHA Annual Meeting & Exposition - Nov' 6-10, 2010

The American Public Health Association (APHA) Annual Meeting and Exposition will host several sessions and talks related to health impact assessment.

These look very exciting and I'm very tempted to go! The only thing holding me back is the sustainability of flying to the US for a only a few days. What the examples below do show is the variety and depth of HIA work that is going on in the USA.

Health Impact Assessments: A Tool for Social Justice
  • Community Health Assessment via Social Determinants and GIS: Informing Policy for Community Health Equity
  • Incorporating Health Impact Assessment into the I-710 Freeway Expansion Decision-Making Process
  • "Impact" in Health Impact Assessments: Effectiveness of HIAs as a Decision-Making Tool (Presented by Aaron Wernham, director of the Health Impact Project)
  • Using Health Impact Assessment to Improve Health Outcomes Associated with Housing Development
Health Impact Assessment: A Decision Making Tool to Enhance Social Justice
  • Health Impact Assessment in the U.S.: Bridging research and policy to address the determinants of health and health disparities (Presented by Aaron Wernham, director of the Health Impact Project)
  • An Evaluation of Efforts to Raise Human Health Assessment in the Environmental Impact Assessment Process
  • Health Impact Assessment in the National Environmental Policy Act: Leveraging Resources across Federal Agencies for Environmental Health and Informed Decision Making
  • Use of Health Impact Assessment to Help Inform Decision Making Regard Natural Gas Drilling Permits in Colorado
  • Balancing equity, Assessing health impacts, Ensuring effectiveness
Strategies Towards Positive Health Outcomes Through Community Health Planning, Partnership, Advocacy , and Policy Change
  • Health Impact Assessment Capacity Building in Wisconsin
Everyone Gets Sick: A Rx for Policy Remedies Targeting the Workplace
  • Paid Sick Leave as Public Health Policy: A Health Impact Assessment of the California Healthy Families, Healthy Workplaces Act
Communities Shaping Policy
  • Building Policy Capacity Through a Community-Based Health Impact Assessment
Public Health Strategies for Health Promotion
  • Gambling on the Health of the Public: A Health Impact Assessment for an Urban Casino
  • Health Impact Assessment and/of City Council Policy: Opportunities to Address Social Determinants of Health in Baltimore
Environmental Contaminants and Public Health
  • Health Impact Assessment as a Tool for Assuring Social Justice Regarding Interventions Implemented on Populations
Global trade, local impacts, and environmental justice challenges
  • Public Health through Public Participation: Reducing Impacts from the Largest Freeway Expansion Project in the U.S.

Source: Health Impact Project

4 October 2010

Climate Change: a summary of the science

The UK's Royal Society has produced a new short summary guide to climate change. This updates an earlier guide and highlights key areas of debate as well as consensus on climate change.

The guide's key conclusions are [Bold emphasis added]:

"There is strong evidence that changes in greenhouse gas concentrations due to human  activity are the dominant cause of the global warming that has taken place over the last  half century. This warming trend is expected to continue as are changes in precipitation over the long term in many regions. Further and more rapid increases in sea level are likely which will have profound implications for coastal communities and ecosystems.

It is not possible to determine exactly how much the Earth will warm or exactly how the  climate will change in the future, but careful estimates of potential changes and  associated uncertainties have been made. Scientists continue to work to narrow these  areas of uncertainty. Uncertainty can work both ways, since the changes and their  impacts may be either smaller or larger than those projected.

Like many important decisions, policy choices about climate change have to be made in  the absence of perfect knowledge. Even if the remaining uncertainties were substantially resolved, the wide variety of interests, cultures and beliefs in society would  make consensus about such choices difficult to achieve. However, the potential impacts  of climate change are sufficiently serious that important decisions will need to be made.  Climate science – including the substantial body of knowledge that is already well  established, and the results of future research – is the essential basis for future climate  projections and planning, and must be a vital component of public reasoning in this  complex and challenging area."

More details of the guide can be found at http://royalsociety.org/climate-change-summary-of-science/

Download the guide directly by clicking here.

1 October 2010

Zotero: browser based citation manager soon supporting Firefox, Chrome, Safari and Internet Explorer

I tried Zotero a while back after Ben suggested it (I'm sure it was you Ben) but couldn't get into it. However, Zotero has launched 'Zotero Everywhere' and now supports all the major browsers (except Opera)

As with the majority of online services it follows a freemium model i.e. it is free to store 100MB after which it costs $20 a year for 1Gb, $60 per year for 5Gb and so on.

I think I will give it another go. There is also another similar online app called Mendeley which is also worth checking out.

Zotero can be found at www.zotero.org

Mendeley can be found at www.mendeley.com

If you use either of these let us know whether you have found them useful or not.