WHO Urban HEART Consultation Day 3

I've been invited to participate in a WHO Consultation on Urban HEART in Kobe. This is a post on Day 3 of the Consultation, there are also posts on Day 1 and Day 2.

Workshop 3: Review of Urban HEART guidance

There was a widespread view that the current Urban HEART guidance works quite well but that there are a few areas where it might be enhanced. There was discussion about the selection of interventions and responses being difficult in practice, and that it involves considerable negotiation. There wasn't agreement about the best ways to reflect this in the guidance but it was a recurrent theme, and one that's familiar in the context of HIA and negotiating recommendations.

Community participation is another aspect of Urban HEART that has been difficult to provide guidance on. Participatory rapid assessments, health assemblies, surveys, workshops, and the use of mobile and electronic engagement tools were all discussed as ways to involve communities in Urban HEART processes, though these were all recognised as having limitations.

There was quite a lot of discussion about the extent to which HIA might be integrated into Urban HEART, though it was agreed that Urban HEART and HIA are complementary rather than being processes that could be integrated. This is because Urban HEART helps to identify needs and areas for action at the city level, whereas HIA is most useful where there is a proposal or a limited set of options to assess. So whilst there are procedural similarities they serve quite different purposes and integrating them might complicate things rather than helping. The diagram below from the Urban HEART User Guide shows how WHO conceptualises Urban HEART's role in local planning cycles. Some related procedures like multi-criteria decision analysis and equity lenses were also discussed, and how they might be integrated into Urban HEART.

WHO Urban HEART Consultation Day 2

I've been invited to participate in a WHO Consultation on Urban HEART in Kobe. This is a post on Day 2 of the Consultation, there are also posts on Day 1 and Day 3.

Workshop 1: Review of Urban HEART concepts

The first workshop focused on factors affecting health equity that might be missing from or not sufficiently emphasised in Urban HEART. These include things like gender, food and nutrition, emergency preparedness, conflict and security, universal health coverage and environmental sustainability.

The issue of within-neighbourhood disaggregation was discussed, particularly in terms of age and gender, but there was a broad recognition that this data simply isn't available for most indicators and that this may add a layer complexity to an already imposing process. There was also a recognition that many indicators of health equity might not be sensitive enough, or may reflect structural or systemic inequalities, to change at the local or city level. These issues will be very familiar to those who have looked at equity and vulnerability within impact assessments.

There was quite a bit of discussion about the degree to which Urban HEART needs to be regarded as a standardised, readily-comprehensible approach or something that can be adapted to local needs. This is a debate I've encountered several times in relation to HIA and the answer seems to lie somewhere between those two extremes.

City case presentations

A presentation from Dr Oyelaran-Oyeyinka from UN-HABITAT emphasised the important role cities play as the engine rooms of economic development, though the challenge is to ensure that's inclusive development. Internationally the urban-rural divide is diminishing but the rich-poor divide is increasing.

Kelly Murphy from St Michael's Hospital in Toronto presented on her work adapting Urban HEART for use in developed countries. The City of Toronto has adopted Urban HEART as a mechanism to guide funding of Neighbourhood Improvement Areas and Issue to 2020.

WHO Urban HEART Consultation Day 1

I've been invited to participate in a WHO Consultation on Urban HEART in Kobe. This is a post on some of the issues discussed on Day 1, with some of my thoughts and reflections scattered throughout. There are also posts on Day 2 and Day 3.

Urban HEART grew out of the Commission on the Social Determinants of Health's work and dates back to 2007. Early activity on piloting and developing a tool were led by a few countries, notably Iran. The final report from the CSDOH gave further impetus and led to more piloting of Urban HEART in more cities. After piloting Urban HEART was extensively reviewed and Version 1 was published in 2010.

Urban HEART is conceptualised by WHO as a tool for assessment and response to health equity issues at the city level. Urban HEART was designed to meet four criteria:

• ease of use
• comprehensive and inclusive
• feasible and sustainable
• links evidence to action

It's a stepwise process with a lot of similarities to HIA. In contrast to HIA it doesn't need a proposal (even a general one or options) to assess. Rather it allows municipalities to identify issues for action and responses at the city level, and in that way it's more like a needs assessment or planning activity. It's useful where some willingness to act on health already exists, so Healthy Cities is a useful basis for action. Higher-order support is always required (which may be less true for HIA?).

Data that informs Urban HEART is almost always spread across agencies - no single one holds or reports on even the core indicators. This means multiple permissions and interagency liaison is often required, which reiterates the need for higher-order permission and negotiation at the earliest stages. Whilst this is undoubtedly desirable for HIAs as well it hasn't always been possible in my experience and HIAs often fly under the radar, at least in the early stages. I'm not sure that would be possible for Urban HEART but I'm not sure that's a bad thing. The under-the-radar HIAs I've been involved in have often encountered resistance when their recommendations are presented. A clear, unambiguous mandate and imprimatur as a basis for proceeding isn't a bad thing.

A survey of Consultation participants that was conducted in advance found that most participants thought Urban HEART works well overall, is easy to use and successfully links evidence to action, but is less successful at being comprehensive and organisationally sustainable.

Case studies from the City of Paranaque in the Philippines, Tehran in Iran and Indore in India provided a range of useful, practical lessons on the use of Urban HEART (and they were quite inspirational). The Inore case in particular modified the indicators in a way to suit the local context, in their case by ensuring that the indicators were all meaningful and comprehensible to anyone, from residents to national bureaucrats. The case studies also highlighted the need for Urban HEART to not be a one-off activity but as an activity that needs to be revisited/undertaken semi-regularly.

New HIA reports from the National Collaborating Centre for Healthy Public Policy (NCCHPP). These documents are available in both English and in French on the NCCHPP's website:

Planning Knowledge Sharing in the Context of a Health Impact Assessment

http://www.ncchpp.ca/67/new-publications.ccnpps?id_article=950 (en)
http://www.ccnpps.ca/88/Nouvelles_publications.ccnpps?id_article=949 (fr)

Developing a Citizen-Participation Strategy for Health Impact Assessment: Practical Guide

http://www.ncchpp.ca/67/new-publications.ccnpps?id_article=944 (en)
http://www.ccnpps.ca/88/nouvelles-publications.ccnpps?id_article=943 (fr)

The 12th International Conference on Health Impact Assessment (HIA): New issues arising from the evolution of the practice - Summary of Discussions

http://www.ncchpp.ca/67/new-publications.ccnpps?id_article=968 (en)
http://www.ccnpps.ca/88/nouvelles-publications.ccnpps?id_article=967 (fr)

Janette Sadik-Khan: To revitalise planning try new things that are cheap

New York's Transportation Commissioner on what NYC has done to try to change street life, via Francesca in the LinkedIn group.

Bulletin politiques publiques et santé, le 7 octobre 2013

de l'Institut national de santé publique du Québec:

Événements

CAN - Health in All Policies. Taking Intersectoral Action for Equitable & Sustainable Health

L'Association de santé publique de la Colombie-Britannique tiendra cette conférence régionale, ainsi qu’une séance avec le Ministère de la Santé sur les priorités émergentes en santé, les 4 et 5 novembre 2013, à Victoria.

US - 141st APHA Annual Meeting and Exposition

Le programme de la réunion de l'American Public Health Association aborde les questions actuelles et émergentes en science, politique etpratique de la santé dans le but de prévenir les maladies et promouvoir la santé. L’événement aura lieu du 2 au 6 novembre 2013, à Boston.

Actualités

QC - Investir pour l'avenir : politiques publiques

Ce numéro d’octobre 2013 du bulletin « Investir pour l’avenir » porte sur les politiques publiques. On y présente notamment des outils pour promouvoir les saines habitudes de vie, des évaluations d’impact sur la santé pour soutenir les municipalités en Montérégie, des outils pratiques pour améliorer l’offre alimentaire dans les écoles dans le Centre-du-Québec, etc.

Health Impact Assessments in Australia and New Zealand 2005-2009

Overview of HIAs in Australia and New Zealand during the study period

I'm excited that several colleagues and I have published a paper on HIAs conducted in Australia and New Zealand between 2005 and 2009:

http://onlinelibrary.wiley.com/doi/10.1111/1753-6405.12102/full

This paper is essentially a census of practice. It's the first paper from an Australian Research Council-funded study of the impact and effectiveness of HIAs conducted in Australia and New Zealand. The best thing is it's an open access publication, so anyone can access the entire article for free.

The flow chart below gives an overview of how HIAs were selected for inclusion in the study. We don't think we included every HIA done - a number were not possible to find or were never publicly released - but the study represents one of the more systematic and comprehensive attempts to describe HIA practice internationally.

A total of 115 potentially eligible HIAs were identified; 55 met the study's inclusion criteria

Please let us know what you think in the comments.

The application of Equator Principles in high-income OECD countries

Map of the Ichthys LNG Project Area
in North West Australia

There's a very interesting post by Mehrdad Nazari about the use of the Equator Principles and related performance standards in an Australian setting:

The Equator Principles website highlights that “Designated Countries [such as Australia and other high income OECD countries] are those countries deemed to have robust environmental and social governance, legislation systems and institutional capacity designed to protect their people and the natural environment”. The EPIII also notes that for “Projects located in Designated Countries, the Assessment process evaluates compliance with relevant host country laws, regulations and permits that pertain to environmental and social issues”. In the preceding paragraph, the EPIII highlights that for “Projects located in Non-Designated Countries, the Assessment process evaluates compliance with the then applicable IFC Performance Standards on Environmental and Social Sustainability (Performance Standards) and the World Bank Group Environmental, Health and Safety Guidelines (EHS Guidelines) (Exhibit III).”

Despite the proponents in the Ichthys LNG Project reportedly used the EPIII performance standards in an Australian context. Read the post in full here.

Speaking in a purely personal capacity I'd like to see more use of the Equator Principles in developed countries. They're rigorous and well-understood internationally, and can help to allay international investor concerns and facilitate due diligence on a project. An excellent point is made in the comments for Mehrdad's piece:

Although Australia is a developed country, projects like this are usually situated in remote areas which have many of the same characteristics as developing nations: delicate & untouched environment, indigenous traditional landowners, etc. Local laws regulate these issues but, by hedging its bets, the bank does not have to due diligence local law to the same extent – and the syndicate’s lawyers don’t have to convince 41 credit committees.

Thanks to Martin Birley for alerting me to the piece.

New HIA Events and Courses

Mostly via the HIA Gateway update

Training Courses

• Health economic assessment tools (HEAT) for walking and cycling: online training dates 
• IMPACT HIA Course, 11-15 November 20123

Events

• 13th HIA 2013 International Conference – Geneva, Switzerland, 2-4 October 2013
• 2nd National HIA Meeting, 24-25th September, Washington D.C. 
• How districts tackle the wider determinants of poor health, 4th September, London 
• 11th International Conference on Urban Health, 4-7th March 2014

HIA Step by Step - A new online course by the NCCHPP

From the Canadian National Collaborating Centre for Healthy Public Policy:

Health Impact Assessment (HIA) is used to inform decision makers about the potential effects of a project, program or policy on the health of a population. HIA of public policies applies to any project, program or policy for which the decision maker is a governmental authority, either at the local, regional, provincial or federal level.

The NCCHPP will offer a new online continuing education course on HIA of public policies starting this fall.

This 12-hour online course will take place over a period of 3 weeks and will be offered both in French and in English.

This course will allow you to become familiar with the HIA process as applied to public policies, recognize its foundations, and reflect on the favorable conditions for successful HIA implementation.

Dates of the online course:

• in French from October 15 to November 1st 2013 
• in English from October 21 to November 8, 2013

Registration deadline: October 7, 2013. Places are limited.

For more information, and to register: click here. (http://www.ncchpp.ca/274/Online_Course.ccnpps?id_article=922) 

For any question concerning this new online course, please contact us at the following address: ncchpp_training@inspq.qc.ca or by phone at 514-864-1600 ext. 3637.

HIA and peer review satisfaction survey

Request below.

Please help move the practice of HIA and peer review forward with your feedback on this survey (5 minutes).

Survey link (google form): http://goo.gl/DN7Tg

We, a group of HIA practitioners, are interested in your experiences of the peer review process in Health Impact Assessment (HIA), as a reviewer and/or as a reviewee. Although HIA practice is not standardized, many HIA practitioners feel some form of peer review to be important in ensuring quality in the HIA process. Your responses to the survey will:

• help us understand the broad and multiple practices of peer review

• inform a paper featuring case studies of how practitioners have incorporated peer review within the HIA framework.

For this survey, peer review is defined broadly to include all purposeful activities that contribute to enhancing the quality of an HIA using peer review and feedback. This could range from an informal gathering of “experts” to review the HIA to a formalized double-blind review facilitated by an academic journal. 
Reviewers might be environmental exposure specialists, community leaders, public officials, or others.Please feel free to share with other colleagues who have been a part of the peer review process in HIA.Deadline for responses - August 1st, 2013
For more information, contact Tim Choi at tim.choi@sfdph.org

U.S.A. Southeast Regional HIA Summit

From the organisers:

Registration is now open for the first ever Southeast Regional HIA Summit! July 31 – August 2, Davidson, NC.

This is NOT your typical conference. Let’s face facts…HIA practitioners are a special breed of people who are creative enough to bridge the gap between multiple fields and operate outside of the box on a daily basis. Whenever we get together the atmosphere is more like a family reunion than a meeting. Add in the small-town charm of Davidson, NC and southern hospitality and you just know you are in store for a good time.

Here’s what the first Southeast Regional HIA Summit has to offer:

• Opportunities to LISTEN: Hear from Dr. John Santopietro, M.D., Carolinas HealthCare System, on The State of Mental Health in the U.S. and Mitchell Silver, AICP, Past President of the American Planning Association on Building Healthy Communities.
• Chances to LEARN: From each other during small group discussions− HIA Speed Dating, HIA Tool Exchange, Troubleshooting your HIA, Developing the HIA Message, Sustaining an HIA Program, and HIA and Health Equity.
• Time to HAVE FUN: Networking during community activities including bicycling on Davidson’s greenway, paddling on Lake Davidson and viewing the Davidson Design for Life Documentary at Our Town Cinema.
• And much, much more!
  
  

Likely participants include: HIA practitioners, researchers, and funders; professionals and educators from the fields of planning, policy, and public health; and interested government officials and not-for-profit leaders. To get the most out of the Summit, you should have direct experience in conducting HIA; be currently involved in conducting your first HIA; or at least have a basic understanding of the process and principles of HIA.

Everything you need to know about the Summit may be found on our web page:

• Preliminary schedule-of-events
• Hotel information
• Online registration or a printable registration form (Early Bird Registration Deadline is June 15)
• Travel scholarship
• How to get to Davidson, NC
  
  

For more information and questions, please contact Courtney Spear, Summit Conference Planner at 704.400.0880 or courtneyhspear@gmail.com

Impact Assessment: The Next Generation, the program of #iaia13 is available

Focus on Health - 14 May

The diversity of HIA practice worldwide is both a challenge and an asset, and the IAIA 2013 Health Day presents an ideal opportunity to facilitate dialogue across HIA practice globally. The Health Day and the other health-related activities will explore the importance of health within the Impact Assessment process, will enable IA practitioners to reflect on key lessons learned through the application of HIA, and will conclude with an examination of how HIA needs to evolve to be a better fit for the challenges ahead.

The one below is just a short summary, check the whole event program and the details of the presentations on the final program. At page 20 you find the details of the Health Day

6.1 Integrating health in impact assessments: Opportunities not to be missed

6.2 The science and art of international: HIA practice: Reflecting the range of HIA practitioners

6.3 The science and art of international: HIA practice: Old issues and new applications

6.4 The science and art of international: HIA practice: Let’s discuss

6.5 The science and art of international: HIA practice: Example from the industry

6.6 Using health impact assessment to achieve sustainable goals

14.6 Community responses to the next generation of energy technologies

 

See you in Calgary!

Mental Health Impact Assessment Report

From Lynn Todman at the Adler Institute on Social Exclusion:

Our report “U.S. Equal Employment Opportunity Commission Policy Guidance: A Mental Health Impact Assessment” has been completed and is available to you at adler.edu/MHIA

This report is the culmination of our 18-month study examining how changes in federal law regarding the use of arrest records in employment decisions would affect Chicago’s underserved Englewood neighborhood. The report also details the Mental Health Impact Assessment (MHIA) process that we employed at the Institute on Social Exclusion at the Adler School of Professional Psychology, constituting an important advance and contribution to the practice of Health Impact Assessment (HIA).

As you know, it is common for U.S. policy makers to consider factors like the natural environment, human physical health, and economic impact in their decision-making processes. Environmental Impact Assessments, Health Impact Assessments, and Economic Impact Assessment are increasingly common.  However, assessments that evaluate psychological or mental health impacts are rare, despite the fact that mental health is an essential element of healthy communities.

The MHIA process is intended help policy makers assess how changes in public policy may help or harm the mental health of communities, especially the most vulnerable. It is also a useful tool in helping to narrow health inequities, and will become increasingly important in light of dwindling mental health resources and support. Conducting an MHIA can help ensure that policies that are implemented will help reduce health inequities, and improve the health and wellbeing of communities and the nation.

Thank you for your interest in our work.  If we can answer questions or provide more information for you, please contact us at ISE@adler.edu

The Rise of HIAs in the United States

The Health Impact Project has put out a nice infographic about the use of HIA across the U.S.:

Source

The untapped potential of health impact assessment

A fascinating paper by Mirko Winkler and colleagues has been published in the WHO Bulletin:

Countries and regions that are promoting HIA's use or have produced HIA guidance. Source

A paper on the “untapped potential of health impact assessment” has been published in the current issue of the Bulletin of the World Health Organization. In this policy and practice piece, current health impact assessment (HIA) practice is summarized, the potential of HIA to become a critical player with the major drivers of global change (e.g. population growth and urbanization, growing pressure on natural resources and global climate change) is outlined, and it is discussed where and how HIA can become fully integrated into the impact assessment suite. HIA has an important role to play in of the unfolding 21st century’s sustainable development agenda, and if the Rio+20 agenda is to genuinely benefit vulnerable populations, then “health” must be an equal participant and partner at the table.

Link to article 

Does health impact assessment protect health? Is that the right question?

There's a thought-provoking piece at ABC Environment on Does environmental impact assessment protect the environment? The piece quotes several well-known Australian EIA academics about how well EIA in Australia is performing in terms of environmental protection.

There's no consensus in the piece about whether EIA is successfully protecting the environment or not, though some different ways of thinking about it are discussed. I think that's because the article dances around the core issue: what is the purpose of EIA? This may seem axiomatic and uncontested but I wonder if it's an under-examined difference between the goals and purpose of impact assessments.

Great HIA job opportunity with the US Health Impact Project

Senior Associate with the Health Impact Project based in Washington DC, job listing here. Looks like a good opportunity.