Environmental justice implications of reduced reporting requirements of the Toxics Release Inventory Burden Reduction Rule. I and III, Breaking the Cycle, East London and the City Health Action Zone and Queen Mary. For those reasons, the committee concludes that HIAs including, to the extent practical, the data used for the analysis, analytic methods, assumptions, findings, uncertainties, data gaps, and recommendations should be made public. 3, Elements of a Health Impact Assessment. Example of a Matrix for Analyzing Health Effects. 2019 Feb;22(1):25-31. doi: 10.1089/pop.2018.0049. Turnock B. During scoping, the HIA team may produce an initial list, refine it on the basis of stakeholder input, and then make it final through research and analysis in the assessment phase. Elliott E, Francis S. Making effective links to decision-making: Key challenges for health impact assessment. They help us to know which pages are the most and least popular and see how visitors move around the site. Crossings at 29th St./San Pedro St. Area Health Impact Assessment. The Public Health Accreditation Board defines a community health improvement plan as a long-term, systematic effort to address public health problems on the basis of the results of community health assessment activities and the community health improvement process. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services. The core issues that are commonly addressed are as follows: Some HIA guides recommend using a matrix, such as those shown in Tables 3-2 and 3-3, to characterize effects (Harris et al. 8600 Rockville Pike An evaluation of the HIA process against the HIA plan and applicable standards and consideration of whether the process used was appropriate given the decision-making context, needs, objectives, and resources available (a process evaluation). Catholic Healthcare West Guidelines for Community Health Assessment This document is meant to help CHW hospitals identify and evaluate community health issues, and capacities for dealing with them. In many cases, a complete and accurate description of health and its determinants in the affected community may not be possible. In Alaska, all large natural-resources development proposals are now screened for the need for HIA in a new program begun by the state health department. In those cases, the HIA team may need to rely on established principles of health promotion and disease prevention to develop approaches to minimizing or mitigating the identified effects. Because the biologists on the EIS team were uncertain of the degree to which subsistence harvests might be favorably or adversely affected, the HIA did not attempt to make quantitative estimates of the probability or intensity of the impact. . Others have proposed categorizing HIAs as participatory (emphasizing shared governance, public participation, and a focus on socioeconomic and environmental determinants), quantitative or analytic (concentrating on the methods and rigor of the analysis), or procedural (drawing on elements of the other two approaches but emphasizing the procedural steps required and often undertaken within a specified administrative or regulatory context) (Cole and Fielding 2007). Second, recommendations are effective only if they are adopted and implemented. As a final note, it is important to remember the context in which HIAs are conducted when considering the recommendations phase. It is also highly likely to lead to improved compliance with public-health guidance regarding seasonal influenza and community mitigation strategies for pandemic influenza. In contrast, effects that are likely but less well supported include increased ambulatory or preventive primary care, fewer emergency-room visits by workers who are insured, and greater compliance with infection-control policies. An official website of the United States government. It was concluded during the screening phase that an HIA would add value to project outcomes. On the basis of its review, the committee synthesized the information from guidance, practice, and literature to propose criteria that define an HIA and draw several conclusions regarding HIA practice. Menu labeling as a potential strategy for combating the obesity epidemic: A health impact assessment. Or, in some cases, there may be unpublished evaluations of measures that have been implemented in similar scenarios. Cole BL, Wilhelm M, Long PV, Fielding JE, Kominski G, Morgenstern H. Prospects for health impact assessment in the United States: New and improved environmental impact assessment or something different? Box 3-6 shows how the results of an HIA of proposals to provide paid sick days to employees were presented clearly in a report with appropriate acknowledgement of the strengths and weaknesses of the evidence. For example, in the Alaskan oil and gas HIA mentioned in Box 3-3, the HIA team drafted recommendations in collaboration with the decision-maker, the Bureau of Land Management, which formally adopted the recommendations as mitigation measures. Such reviews of the existing literature are common. Because developing an alternative (such as suggesting an alternate route for a proposed highway) involves many considerations that may be outside the purview and expertise of an HIA team, the committee recognizes that it may not be practical to expect the HIA team to develop alternatives independently. Identification of the population and vulnerable groupssuch as children, the elderly, racial or ethnic minorities, low-income people, and communities that are likely to be affected. For each step, the committee describes the basic purpose, objectives, and practice elements; summarizes the main outputs; and presents conclusions regarding pertinent issues raised. For example, in Oregon, an independent health-oriented nonprofit organization conducted an HIA of a series of proposals to reduce vehicle miles traveled in a bill intended to reduce greenhouse- gas emissions (UPH 2009). A discussion of whether the HIA achieved its initial objectives. Improving community health starts with knowing the factors that impact people's health, both inside and outside of the clinic. It is important for nonprofit hospitals to be knowledgeable about the Internal Revenue Services regulations for CHNAs. The scoping phase was used to identify the parameters of the assessment, the affected and most vulnerable populations, and potential key health effects. However, the committee notes that there are several benefits of disclosure for industry, policy-makers, and the affected communities. Potential health effects have been estimated by using established approaches for quantitative analysis, such as the calculation of the fraction of disease rates in a population that can be attributed to the risk being analyzed and the application of available exposure-response functions to quantify cancer risk associated with incremental changes in exposure to carcinogens. The diversity of practice owes partly to the fact that HIAs are undertaken for a wide array of policy-making that spans many sectors, levels of government, types of proposal (policies, plans, programs, and projects), and degrees of complexity. The local North Slope Borough governmentan agency that participated in preparing the EISconducted an HIA, which was integrated into the EIS report. Federal government websites often end in .gov or .mil. The approaches can provide useful information on how people view the proposal, that is, how it is expected to affect them and potentially improve or harm their quality of life. DHHS (U.S. Department of Health and Human Services). The facts that resources were available and that timelines were appropriate were also relevant to the decision to conduct an HIA. The expected resource requirements of the HIA and the ability of the HIA team to meet them. The dissemination strategy should be developed in a systematic manner, should consider what groups need or will rely on the information (including stakeholders and decision-makers), and should determine the most effective ways to present the information to these groups, taking into account any barriers or challenges. 2006). Unable to load your collection due to an error, Unable to load your delegates due to an error. Program on Health Equity and Sustainability, San Francisco Department of Public Health. 2 Setting priorities considers pathways that appear most important from a public-health perspective and considers issues that have been raised prominently by stakeholders. Key elements of community health include: Identifying top public health concerns within the specific geographic area, such as environmental and social factors that affect healthy life choices. Dialogue with IRS staff and leadership on elements of the Revised 990, Schedule H Identification and examination of areas where: -There is a need for clarification (e.g., what constitutes meaningful community engagement, how to define community) -Selected reporting requirements as framed may yield unanticipated (and undesired . In other cases, the initial scope is generated by stakeholders and then refined through research and input from advisory or steering committees. EC (European Communities). The final HIA report should document the following: In addition to a final report, stand-alone executive summaries or fact sheets can help to disseminate and communicate the findings and recommendations of an HIA to various key audiences. Noncommercial use of original content on www.aha.org is granted to AHA Institutional Members, their employees and State, Regional and Metro Hospital Associations unless otherwise indicated. In some cases, the lack of a recommendation may reflect a desire to avoid a perception that the HIA is a one-sided advocacy exercise, particularly when options for recommendations would involve adopting a position wholly supportive of or opposed to the proposal being assessed. Schweinhart LJ, Montie J, Xiang Z, Barnett WS, Belfield CR, Nores M. Scott-Samuel A. . As part of the assessment phase, a set of specific indicators that can be used to describe the baseline and potential changes in health status or health determinants should be developed. Decisions are often based on incomplete information and must often be made within a specified time rather than waiting for more complete information. CDC is not responsible for Section 508 compliance (accessibility) on other federal or private website. Practice implications include better understanding of different models and requirements by health departments, hospitals, and others involved in assessment and planning to improve cross-sector collaboration, collective impact, and community health. Depending on the nature of the proposal being assessed and the specific impacts, recommendations can take various forms (see Box 3-5), such as the following: HIA Recommendations. To provide this care as a community health nurse, you need to continually acquire knowledge, refine skills, and assess yourself. Because HIAs can address decisions that range from small, localized programs or projects to national policies, screening ensures that HIA is used judiciously and when it is most likely to be valuable. L 91-190, 42 U.S.C. Scoping identifies appropriate data sources for the analysis and should also identify important data gaps. Comprehensive HIAs are most commonly differentiated from rapid and intermediate HIAs by the scope of potential impacts and the need for collection of new primary data. There are, however, no current examples of HIAs in the United States that include outcome evaluation as described here. In other cases, a draft may be submitted to an internal body, such as a steering group, whose comments are incorporated into a final public version. Fehr R. Environmental health impact assessment: Evaluation of a 10 step model. and transmitted securely. The committee notes that effective dissemination requires consideration of barriersincluding those associated with language, availability of child care, disability, access to transportation, disenfranchisement, or literacyand that multiple approaches may be required for disseminating a single HIA so that all appropriate audiences can be reached. As described by Ross (2007, p. 9), the Atlanta BeltLine is a transit, trails, parks, and redevelopment project that uses a 22-mile loop of largely abandoned freight rail line that lies between two and four miles from the city center and affects about 45 neighborhoods. Notwithstanding those considerations, the committee considers the public disclosure of HIAs to be an important ideal of practice but recognizes that it may not be realistic to expect widespread disclosure in the absence of requirements or incentives for it. McHugh S, Maruca S, Lilien J, Manning A. The committee notes three considerations that may be particularly important for producing effective, actionable recommendations. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Jagannathan R, Camasso MJ, Sambamoorthi U. 2009). Another issue that should be addressed in scoping is identifying alternatives to the proposed action. Paper No. HIAs in the private sector are increasingly common, pursuant to internal corporate guidelines or requirements of lending banks, such as the International Finance Corporation and World Bank (see Appendix A for further discussion) (Birley 2005; IPIECA/OGP 2005; McHugh et al 2006; ICMM 2010; IFC 2007, 2010).3 Few, however, are made public. It identifies a baseline that describes the health status of populations that will be affected by the decision. The https:// ensures that you are connecting to the For example, if a traffic-calming infrastructure was installed on a street that had a high rate of pedestrian injury, it may be appropriate to monitor injury rates directly because changes would be expected as soon as the installation was complete. A plan for continuous monitoring, adaptation of mitigation measures, and verification of performancealthough not currently a uniform aspect of HIA practice helps to ensure that measures are carried out and achieving their objectives. Suicide in young people: screening, risk assessment, and intervention A local community-based organization worked (more). Monitoring should provide information that allows one to conduct the evaluations noted above. o Who is ultimate decision maker if the event needs to be cancelled, postponed or similar? That definition reflects the committees finding that the involvement of stakeholdersalthough the approaches used vary from little or no involvement to robust engagement and participation at every stephas consistently been described as a core element of HIA practice and should be considered essential to it. A description of the political and policy context of the decision and an analysis of the opportunities to influence decision-making or otherwise make health-oriented changes. The second task is to analyze and characterize effects on health and its determinants for the proposal and for any alternatives under consideration relative to the baseline and to each other. For example, the planning of the Atlanta Beltline, as described later in this chapter, involved the regional planning commission, local legislative bodies, state and federal environmental regulators, and private developers. The HIA team needed an authoritative description on which to base its assessment. Management of the health effects of a proposal as it moves from planning into implementation should be a dynamic process in which monitoring results may drive continued adaptation of the health-management plan. 2003; ICMM 2010). A community health assessment gives organizations comprehensive information about the communitys current health status, needs, and issues. Advisory, steering, and technical oversight committees are also commonly convened during scoping. For private corporations undertaking an HIA, the decision of whether to make an HIA public and what to disclose may be governed by internal corporate policies, by the standards of lenders supporting the project, or by a government that has jurisdiction over the project (McHugh et al. In those cases, it may be more appropriate to monitor exposuressuch as environmental concentrations of a carcinogen or the availability of safe walking corridorsthat are linked to the outcome of interest by public-health evidence. Although HIA may not always include or provide resources for independent evaluation, more in-depth, independent evaluation will generate more robust conclusions about HIAs effectiveness and best practices in the field and should be given high priority. A variety of information was used to inform the process, Scoping: Atlanta BeltLine HIA. Box 3-1 provides an example of how screening on a proposal for a residential housing program was conducted. Health Impact Assessment: Main Concepts and Suggested Approaches-the Gothenburg Consensus Paper. HIAs conducted as part of a formal government process are generally subject to disclosure and freedom-of-information requirements. New surveys to address data gaps or questions specific to the proposal in question are also common in comprehensive HIAs. Health impact assessment: A tool for healthy public policy. First, disclosure informs affected communities and individuals and possibly other stakeholders, such as government agencies and officials, of possible effects on their health and well-being, a core objective of HIA. Community health assessments use such principles as. It is critical for the credibility of the HIA that the measures or outcomes being promoted are grounded in full and transparent consideration of the evidence that supports and does not support the issue in question.
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