Health Impact Assessment Blog: June 2012

15 June 2012

Anglo American releases updates version of award-winning Socio-Economic Assessment Toolbox (SEAT)

In 2012, Anglo American received the International Association for Impact Assessment (IAIA)'s 2012 Corporate Initiative Award. Stephen Lintner, IAIA president, commented on the selection: “The IAIA Board of Directors selected SEAT as the recipient of this new award because we believe Anglo American has made a unique attempt to incorporate impact assessment into the way it manages its operations on a day-to-day basis. We also wanted to recognize the fact that Anglo American is sharing its knowledge and experience in impact assessment by making SEAT available to the public.”

"The seven key steps of SEAT are:

Profiling our own operations and our host community.
Identifying and engaging with key stakeholders.
Assessing the impacts of our operations - both positive and negative - and the community's key socio-economic development needs.
Improving the management of socio-economic impact and issues during operation and closure.
Working with stakeholders and communities to help address some of their broader development challenges they would face even without our presence.
Developing a management and monitoring plan to mitigate any negative aspects of our presence and to make the most of the benefits our operations bring.
Producing a report with stakeholders to form the basis for ongoing engagement with and support for the community.

In line with SEAT best practice, each of our significant operations now runs a new assessment every three years.

SEAT plays a central role in our programmes to meet the requirements of the International Council on Mining and Metals (ICMM) sustainability principle 9 (i.e. to contribute to the social, economic and institutional development of the communities in which the Company operates).

All senior and site-based personnel who are responsible for community relations are trained in the use of the SEAT process, which includes a human rights screening exercise. For country-entry, mergers and acquisitions activity and for new projects, human rights impact assessments or due diligence are undertaken. A human rights scoping is undertaken in every case, with further investigation as required."

Click here to download the SEAT Toolbox.

Extracts from the International Council on Mining and Metals and Anglo American websites.

12 June 2012

The Role of HIA in Promoting Healthy Urban Development

I'll be live blogging a workshop on HIA and healthy planning, which is being held in Sydney and organised by the Public Health Association of Australia, the Australian Health Promotion Association and the UNSW Research Centre for a primary Health Care and Equity. I'll update this post as we go along.
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HIA In the USA
Dr Andrew Dannenberg, formerly of the US CDC, gave an overview of the inks between the built environment and public health. He then moved on to detailing the history of HIA in the US. The first HIA in the US was conducted in 1999 - around 160 have been completed in the USA as of 2012.

In the US, as elsewhere, most HIAs have been voluntary. The regulatory ones are less common and tend to be more contested, though they are still being done. Quantification and modelling ends to be more speculative but is important for reasonable cost-benefit models, which have been important to get traction in major decision-making processes in the US.

Community involvement in HIAs remains a thorny issue, as it does virtually everywhere. Vulnerabilities are important differential impacts to consider but practically challenging (as elsewhere).

There's an interesting distribution in the use of HIAs in the US. Most states have done one or are doing one, but most of the experience is on the west and east coast states. The majority have been conducted on built environment and transport proposals. San Francisco has been a leader in HIA and that work has largely been done using existing resources, i.e. not using special funds. Interesting examples room San Francisco and Boston were discussed. He gave some good examples of where good HIAs were conducted but they didn't change decisions - timing and other factors matter. "Getting the health information into the discussion is the primary purpose of HIAs" - I wonder if many would agree. That seems to be *a* purpose but is it the *only* purpose? And is it enough to justify HIA's use?

Andy mentioned a number of high-level govt documents that mention and support HIA's use. He also mentioned Health in All Policies and the work done to explore this in California. Massachusetts has introduced a requirement that HIA screening has to be done on all transport proposals, but the practicalities of this has still got to be figured out.

Andy mentioned the National Environmental Policy Act and how HIA might be integrated into that requirement (500 national NEPA-mandated EIAs are conducted every year, many more under state "mini-NEPAs"). Alaska has done a lot of work on health in EIA under their regulatory impact assessment procedures.

There's a lot of discussion on the legislative mechanisms that exist in the US, eg laws that are compatible with HIA's use. I wonder if this is a necessary but not sufficient condition for HIA's use, or maybe even not even necessary. Australia has had a lot of policy support for HIA that hasn't converted to activity. An imponderable.

Questions
Evaluation in HIA? Andy says that evaluation of HIA is useful but focusing on the predictive efficacy of HIA can be misguided/difficult. A lot of the evaluations that have been done have been conducted that the case level - there aren't many cross-sites studies of effectiveness (he mentioned the major Australian Research Council-funded study of HIA effectiveness that UNSW is currently completing, which I'm involved in and this is why Andy is here). Also most decisions have many factors that influence them, so it's hard to attribute change solely to HIAs.

Qualitative evidence for HIAs - can they ever give insights into the magnitude of potential impacts? Andy sort of flipped it around, there are lots of limitations to what we can quantitatively model. His point is essentially that we should quantify what we can. "My feeling is that the recommendations from an HIA would be the same without quantitative predictions, though the decision might not be." Well said.

What factors help enhance the uptake of recommendations? Relationships with decision-makers, that you're a known, credible group. Also that recommendations be actionable - where they lead to clear activities and not be motherhood statements.

We're many of the HIAs required by regulation? No, the vast majority are voluntary.

Have you seen many HIAs that are just done to tick a box? No, because most are done voluntarily that means that someone usually wants them done. (my view is that this is a major strength of HIA rather than a limitation - Ben)

Can you comment on the state of the art in qualitative research in HIA? Yes, it's difficult. Is air quality more important than physical activity? Difficulties in trying to prioritise between behaviours/environments/risks. It's hard.

Commentary from Australia: A planning perspective - Susan Thompson and a public health perspective - Peter Sainsbury.

They echoed many of Andy's points. Both identified the need for dedicated resources.

My iPad ran out of charge so I wasn't able to do justice to Susan and Peter's presentations. I'll add their presentations and the recording to this post in the next few days.

New on the HIA Gateway

8 June 2012

Lancet on Sustainable Development

The latest issue of the Lancet is on sustainable development and is available for free http://t.co/mNf4IIvH

1 June 2012

Closing Plenary - saying thank you and, reluctantly, goodbye

Obrigado/a and Adeus Porto and IAIA Porto Committee, new friends and old, and everyone involved in making this a excellent conference!

Lovely venue, great food, and beautiful city

Emerging themes:

Free, prior informed consent
Public participation
Performance based contracts in construction
Proactive government
Capability building in impact and benefit management
Conflict resolution and management
Community acceptance of renewables
Social investment, local content (long before IA starts)
Social Investment Management Plan (stakeholder is my partner)
Art of communication
Difference between SEA and EIA
Climate change research into practice
Gendered nature of impacts
Institutional capacity building
Regulation for ESHIA
Consensus building
Each context is different
Environmental impacts have social implications
Public participation is difficult
How big a success were the laminated almonds at the Banquet?
Assessing significance
Involving citizens in monitoring
Resettlement and livelihood practices
Workforce health and safety
Strategic thinking in ESHIA
Dependence on/of ecosystem services
Denial of individual's access to rights rather than impacts
Link between E&S management and value of investment
Link between IAIA and industry associations
Regional economic development

Pictures of Porto to follow...

Social Media and Public Participation in IA - Discussion

Need to use traditional approaches because in Afghanistan and Iran, where people are illiterate and there is a digital divide that social media can't be used.

How can we filter and analyse and compare data sets given how much there is?

How can we ensure the legitimacy of the system? What governance systems a needed?

Do we need to work with stakeholders to ensure

Can we use a photo website as a way of monitoring environmental change during construction and operation?

Are people really expressing their own opinion or feeling lonely and wanting to be part of a group, want to make friends, etc.?

People can get a link to petition on a issue from a friend and they can just added their name without reading the petition because that friends 'knows me'.

Can be a means of seeking out stakeholders and finding people who are affected.

Social Media and Public Participation in IA - Presentation 3

Embracing Social Media to Enhance Public Participation

Used to live in a world where knowledge is power, now we live in a flat world, a wiki world a democratised knowledge world.

During the Fukushima disaster there was a huge spike in google searches on the disaster and the issues around it.

Huge amount of information being generated every day - words, images, video.

Hong Kong has 7.1 million and the os ov 2 phones per person, and broadband in homes is nearly 90%.

3.7 million HK residents are on Facebook

There is consumptive sharing telling people what they are doing, eating, watching, playing, thinking

An Internet activit in a the space of 3 hours mobilised 3000 people to go and encircle the Parliament.

Social media can be an opposition multiplier
Opinion amplifier
Immediate
Chaotic
Governments and proponents can't control it
Catalytic accelerator

Proponents don't like complaints but complaints should be seen as a gift, free consultancy to improve you project
People are also workshopped out, engagement fatigue
Proponents want monologue while communities/opponents want a dialogue

Conclusion

Addition to face to face
Complementary and synergistic
Quite a powerful force

Q&A

How do you combat misunderstandings emerging as tweets and messages are passed on from one person to another - 'Chinese whispers'?

If we see stuff that's wrong then we try and contact the person directly and point them to the true information
Can't just put something into the debate or populate a debate

Where does this take us, proponents have got to be using social media?

There is a generational shift and this will mean that young and upcoming IA practitioners will get it
Social media is a tool and how effective it is depends on the person and can still use traditional media to get their message across, getting hits does not mean that change can be brought about

Given the network effects whe opposition develops and gains momentum how do you respond when you don't get friends or likes or hits or retweets?

It's an IA practitioners social network, we need to be extremely well connected, from all sides that are sharing information with you

"Social media is word of mouth marketing on steroids"

Social Media and Public Participation in IA - Presentation 4

WIKI WEB GIS for SEA on Google Maps in Action

Go to Qcumber website to see how it works

Getting people involved in making planning applications...

Local municipalities are calling us to be involved and want to promote it to their communities.

Main topics currently going on:

EIA, SEA, sustainable development, health, energy...

When people post then an alert will be sent to all registered users in the area, people raise awareness of the problem and also feedback that the problem has been resolved.

Welcome feedback on how to take the project forward.

Functionalities:

Institutions get a free service, can load GIS data...
Consultants get a huge environmental database, help model impacts, web GIS, support EIA/SEA
People don't trust public institutions data but trust our database, Qcumber, makes people proactive, helps communicate on environmental issues and to create new communities around an issue or idea.

Q&A

Have you accessed and uploaded EuroStat data.

Ensuring accurate information is critical in this project, need to quality assure the data.

Have a team and software involved in quality assuring
Users use nicknames but giving their correct address

Social Media and Public Participation in IA - Presentation 2

Social Media: Friend or Foe in Public Consultation Program?

What are the best tools we can use to inform people and then to get them engaged, that the key question?

Keep in mind:

Developing relationships and connections that lead to trust
Word of mouth is amplified by social media
"Authentic" messaging builds credibility

Online "lurkers"

90% online communications are lurkers they passively participate by reading material themselves but don't post comments themselves
9% occasionally post comments
1% provide majority of feedback

Social media a friend?

Potential for enhanced connectedness with broader and larger range of community members than traditional tools
Increased potential to engage with stakeholders outside of the community
Opportunity to respond quickly to false information
Opportunity to provide factual information from other credible/independent sources

Interests groups know:

Social media is valuable in expanding and amplifying your effort with limited resources

Social media, an enemy?

Loss of control of messaging
Information can spread quickly
No accountability due to anonymity
Human resources required to monitor and manage throughout the project life

Some challenges:

Google makes everyone an expert - responding to endless stream of info available on the Internet, providing credible sources online
Space/size restrictions (e.g. 140 character for twitter) force concise messaging - are we losing th meaning
Be prepared to listen to your community

Conclusion:

Develop a meaningful consultation plan with a range of tools including traditional consultation tools
Social media can be an effective consultation tools
Track and respond in a timely manner
Utilise a variety of social media
Monitor the chatter

Q&A

Proponents like order, a line to talk and keep points to monologue out, social media increase the risk of information they don't want to get out getting out at a time they don't want it to.

Today the Internet talks back, and proponents don't realise how fast and hard they talk back, people aren't just interested in knowing what information you want to tell them but they want a debate.

If you are monitoring, do you have a reaction plan, how do you react to what emerges from monitoring?

Monitoring is about responding to the questions an disses that are being discussed, particularly useful where rumours and false information that create public fear to reassure communities

In areas like South Africa where you have highly rural and highly urbanised areas, you can have a wider group of people who are not affected who object and protest but the people who are affected are mostly happy about a development, how do you handle that?

This is an important issue, regulators and decisionmakers need to take that into account.

Social Media and Public Participation in IA - Presentation 1

Social Media to Facilitate Public Particpation in IA

"Twitter provides teeth to the masses" - Arab Spring, Bank of America and JP Morgan withdrew rise in service fees, #stopknoy2012

What are the implications for IA, land use planning and policy making?

Are these new communication services/devices are the cause or the tools for change?

Mobilization:

Ubiquitous networked and mobile communications.
Can organise a protest in a few hours and politicians can't react in that short time.
Earthquake in China whe school buildings crumbled, the story got out even though govnment tried to suppress it because of these new tools.

Contested expertise:

Vaccination for cervical cancer in girls 12-15 years failed because rumours about chips being embedded, that it was a surveillance programme, Medical Lead complained that his expertise was being contested by people who did not have knowledge of the issues.

Citizen governance through crowd sourcing:

'Wisdom of the crowd'
Self-organising publics
How to get useful information from the general public
Open ended approaches can lead to reduced involvement

What will be the impact of new media and the phenomenon of self organising publics on impact assesment and the policy process?

creates new publics, don't know who the new publics are

New media:

Help organise public and spreading information
Help to monitor and follow up by inviting the public to act as monitor and feedback
But called to self organising publics that demand greater change

Who is participating and who needs to participate?

Is it a matter of constructing the right public?

Q&A

Proponent can use new media to spread their own rumours that support their case but it seems to be more a force for protest and opposition?

Politician that engage do get 1000s of followers so that they can create influence.
Companies are also using these tools spreading both information and rumours - overt and covert information spreading

Is this new media a benefit or a curse, leading to greater manipulation, good if it can lead to informed publics, often the media are selective, and what is the role of IA in this context?

New media are products being sold to us e.g. Facebook and LinkedIn
We are also being tracked by these products and services
We cannot evade them and avoid them so we have to engage with them
I don't know as yet what the role of IA is in this, need to understand how we might be manipulated through them

There is now conscious opposition to opposition, groups react by responding to for example a letter in a newspaper where people are paid to respond.
People can also pretend that they are someone else or some other organisation.
More chaotic management of information dissemination

Health Baseline within Different IAs - Discussion

Why is lead poisoning still happening given what we know and the many national bans and international bans?

There are many incidences of lead poisoning Nigeria as well as Peru and happening around the world.

Should the baseline collection occur at scoping or after the scoping, I.e. that scoping should develop the key questions on baseline and Terms of Reference? Often authorities do the scoping an dthen tell the IA team what baseline to collect.

Need to start thinking about baseline early, even sometimes before scoping to get the necessary permits.
HIA team need to be involved in the scoping, most often imy experience IA practitioner tend to draft the terms of reference and these are sent to the regulatory agency.

How doe she data collection contribute to the project development process?

We need to be selective about the type of indicators you collect
We look at the feasibility studies e.g. Geotechnical to see if there is heavy metals in the soil and water and whether they might have health implication in local communities
There is an overlap between the phases of screening, scoping and analysis
It's also important to create a picture of the area to go beyond the obvious issues to enable less obvious impacts to be considered later in the IA

Inform analysis of impacts and to provide baseline for monitoring and comparing before and after health status. Third purpose is that it can inform the social investment programme, baseline can inform the health needs assessment that is needed to develop the health projects within the social investment programme?

Agree an disagree, may fit with some clients but sometimes the structure of the health impact baseline can be different to a health needs and health service assessment.
There is a problem with attribution of impacts, but baseline indicators can inform the monitoring process and track the value of a project.
Can be an issue that the positive impacts can also lead to negative impacts e.g. Men working in the oil company and the children take on father's activity and this leads to negative impact.
We've been asked to do an IA and we've been given a baseline developed by an NGO and where they could invest is not what is needed for the IA.

The definition of children an be different in different countries, Children are under 16 years in a country but children in malaria programmes are seen as those under 5 years old; challenges in what data is collected?

Need to understand the context and the indicators can be comparable but need to understand whe the measure has come from.

How much data collection is enough too much and difficult to analyse and too little and don't have enough to understand the context?

Often don't have budget to do too much
There often a minimum amount that is considered statistically significant in primary surveys to ensure generalisibility.
Often want to have as much as you can get.

Drummed into you that you don't collect individual level data unless you know what you need it for. If you can't use it to monitor it then why should we be collecting it?

Collecting height and weight data, in a situation whe agricultural land is leased or taken then this can affect nutritional stays of children but by knowing that children are already stunted we know with the situation is getting worse.
Same is true for environmental data, offshore exploration wells, they had to collect air pollution but often the impact is a cumulative type of impact

Wind farm baseline is likely to be different from a chemical factory baseline in terms of the indicators or data collected. Similarly for whether the a rural or urban community is affected.

How do you deal with private data sets that only share if you pay them? Should companies pool and share the data? Same community can be accessed twice in a very short time.

Often the data shared with health agency, community and Ministry, yes.
Data on the website then no.
Sometimes you can ask the company who commissioned and they may share.
Often companies for commercial sensitivity reasons don't want to share.

In Thailand for information collected in an EIA and HIA after the data put in the report and the report approved by regulatory agency then this information is put in the public domain.

Health Baseline within Different IAs - Presentation 4

Lead Exposure in Native Children and Oil Activity in Peru

Case study in the Corrientes river basin where there are 36 communities of 8000 people. majority of them are poor, subsistence based economy.

Oil industry started in the 1970s and was linked to negative environmental impacts.

Heavy metal soil and water contamination as well as oil spills.

Community concerns led to a toxicological survey in 2005:

66% had high blood lead levels
No significant water or soil pollution

Another study in 2011 conducted to test lead levels in three communities two exposed to oil installations and one not.

Found that blood lead levels in children were at similar levels for both exposed and non exposed communities and environmental samples showed levels below reference levels (from international literature).

Undertook a further study with more communities, 6 communities studied, 2 highly exposed, 2 moderately exposed and two not exposed as judged by distance from oil facilities.

Data collection:

Blood lead levels
Heamoglobin levels
Risk factors questionnaies to head of families
Environmental sampling of water, soil and fish
Food sampling

Results:

346 people studied
27% had high lead levels
High levels in highly exposed communities, and age 7-17 years
Children playing with pieces of lead, chewing pieces of lead and fishing more than 3 times a week were lictors of high blood levels
Environmental levels were below defence levels

Conclusions

Contact with lead and exposure to oil facilities had high lead levels.
But why given no high levels in the environment
Because greater access to oil facilities waste, communities extracted lead from this waste informally, majority of men work for the oil companies, families keep scraps of lead in the home.
We recommended - improved control of industrial waste, public awareness program on preventing lead exposure, replacement of lead with other materials to construct fishing weights.

Health Baseline within Different IAs - Presentation 3

Baseline Health Surveys: challenges and opportunities

Areas of concern or gaps are identified during the scoping phase which may lead to further qualitative and quantitative research.

Helps to develop monitoring indicators - individual, household and community levels

Developed a set of modules and a methodology for conducting primary health surveys involving questionnaires and clinical tests.

Interview team - collects knowledge, attitude and practice information as well as some demographic and household info.
Clinical field unit - reception and anthropometrics (height, weight, anaemia, BP, etc),
Parasitological team - stool sampling, soil sampling
Services and infrastructure - access and quality of care
Essential services - test a glass of drinking water asked for from a household

challenges:

Hugh cost, what finances you have determines what indicators or baseline data can collect e.g. One urine sample can cost $50; can use data from the EA
Time - linked to cost, design of the surveys is critical, doing data entry into computer in the field can save time.
Ethical clearance - can take weeks and months, consult national and local authorities
Procuring materials to undertake the survey e.g. Team had to leave before material arrived.; only mobilise onece equipment is available and ready
Logistics - transportation problems, weather
Security - hostility in a community may require protected vehicles and not visiting some communities, sensitise and raise community awareness
Team skills - need to train and ensure that everyone understands how to do their tasks and issues
Cultural aspects - multicultural team, host country culture
Community expectations - need to engage with communities before you do the survey
Motivation and intra team challenges

Q&A

Confidentiality is important and binding to us and the company
Company does not get the actual questionnaire only the analysed and summarised and anonymised data.
Analysis also goes to health agencies
How do you capture seasonality given the survey happens only one point in time? We Recommed repeated surveys over time and different times of the year, also trying to give them indicators they can use for monitoring

Health Baseline within Different IAs - Presentation 2

Before the Beginning: "intelligent" health baselines

There is the project development process, the ESHIA process and we use also the business intelligence process.

BI refers to computer based techniques and analyses methodologies for identifying extracting and analysing ...

ESHIA tends to come in after concept design is almost complete and hence does not have as much influence as the project design related process.

BI aims to map technical, economic, logistics, health and social data that feed into the early phase of the project development process.

Case A already started and entered the concept phase:

Time and resource constraints
There is appraisal of the available data and identifying gaps in the data
Stakeholder availability was not ascertained
Led to much of the data being obsolete
The above biased the baseline data collected
Also made monitoring planning more difficult

Case B:

Data gathering: what and how

social and health risks
ecosystem services
...

Appraisal of data and gap identification

Classifying data as relevant to project or not
Is it accurate or not
Is it sufficient
Logistic, engineering, production, etc...

Data analysis

Identifying hotspots and criticalities
Classifying by how critical or not an aspect is e.g. Agricultural land,
Both risks to the project and risks of project to communities

Advantages:

Encourages communication ESP in IA teams
Truly avoidance first because it happens early rather than just mitigation and compensation
Two fold input base data to both project and ESHIA
two way identification of risks to project and communities
ID of critical gaps
...

Conclusion:

Time and resource constraints
Leads to win win situation
Can help to buil intelligent and effective baselines

Health Baseline within Different IAs - Presentation 1

Health Baseline for IA in Resource Poor Settings

Definitions:

It's about data and collection and there is a time component
Heath status and determinants of a given population wrt time, place and context.

Baseline as a snapshot

But what is it for, what is it supporting, what are we going to do with it?

Understand how the project might affect a population's health status.

Example: Malaria

WHO estimate 655,000 malaria deaths in 2010 but another agency says over 1 million
3 important issues - need to know number of deaths, within what size of population and what time period
Challenge that using secondary data which can lead to very different estimates of baseline health status
Health clinic data means nothing without knowing what population is using the clinic, how are people accessing the service, why are they accessing, etc.
Often many disease cases aren't recorded in clinics or elsewhere.
Lots of challenges using secondary data.

Therefore, need to be very clear about what we are reporting, is the data really measuring what we think we are measuring, is the whole population captured, are all cases of disease reported.

Are we using primary data or secondary sources. What are the weaknesses in the sources and data.

Doing a baseline should help to develop health indicators e.g. Anaemia, pregnant women have a different range of normal values than non-pregnant women, similarly with differents age groups of children.

What should we report?

For Dengue should we use annual incident rate or annual case fatality e.g annual incidence may be low but case fatality may be high, I.e. few people get it but those who do more likely to die of it.

Summarising

Describe health status
Estimate prevalence and distribution of main health outcomes and determinants
Contribute to understanding how project might affect population Wellbeing and equity
Use information to define an dmonitor recommendations and management plan
Need to be careful of using secondary data to infer meaningful conclusions
If local data is not available then the data used is not a baseline but perhaps should call it community profiling