Click for next page ( 186


The National Academies | 500 Fifth St. N.W. | Washington, D.C. 20001
Copyright © National Academy of Sciences. All rights reserved.
Terms of Use and Privacy Statement



Below are the first 10 and last 10 pages of uncorrected machine-read text (when available) of this chapter, followed by the top 30 algorithmically extracted key phrases from the chapter as a whole.
Intended to provide our own search engines and external engines with highly rich, chapter-representative searchable text on the opening pages of each chapter. Because it is UNCORRECTED material, please consider the following text as a useful but insufficient proxy for the authoritative book pages.

Do not use for reproduction, copying, pasting, or reading; exclusively for search engines.

OCR for page 185
Appendix D Glossary Capacity building: The process by which skills and competence are built for understanding the use for and carrying out a health impact assessment. It may include “policy seminars to sensitise senior managers and advocate change; training courses to build knowledge of method and procedure; dissemination; institutionalisation to enable self-sustaining training in institutions…;[and]case studies and research to build specialist skills.”1 Community: In the context of this report, the committee uses this term to de- scribe “groups of people who live in the same geographical area; groups of peo- ple with a shared history, culture, language; [or] citizens for whom governments are responsible and to whom governments are accountable.”2 Comprehensive plans: “A legal document that states the goals, principles, poli- cies, and strategies to regulate the growth and development of a particular com- munity… The main characteristics are comprehensiveness, long-range time frame, and holistic territorial coverage. They include elements on land use, eco- nomic development, housing, circulation and transportation infrastructures, rec- reation and open space, community facilities, and community design, among many other possible elements.”3 1 Birley, M.H. 2001. Annex 3: HIA Guidelines and capacity building. Pp. 39-56 in Health Impact Assessment. WHO/SDE/WSH/01.07. Geneva: World Health Organization [online]. Available: http://hia.anamai.moph.go.th/nwha/pdf/thai62e.pdf [accessed June 8, 2011]. 2 AIDA (Australian Indigenous Doctors’ Association). 2010. HIA Connect [online]. Available: http://www.hiaconnect.edu.au/reports/AIDA_HIA.pdf [accessed June 13, 2011]. 3 Hutchinson, E.R., ed. 2010. Pp. 304-305 in Encyclopedia of Urban Studies. Thou- sand Oaks, CA: Sage Publications. Examples of how comprehensive plans have ad- dressed public health concerns can be found at http://www.planning.org/research/public health/pdf/surveyreport.pdf. 185

OCR for page 185
186 Improving Health in the U.S.: The Role of Health Impact Assessment Consultation: “The dynamic process of dialogue between individuals or groups, based upon a genuine exchange of views, and normally with the objective of influencing decisions, policies, or programs of action.”4 Cost-benefit analysis: A method of considering the advantages and disadvan- tages of alternative policies or programs by converting all outcomes into mone- tary values.5 Cost-effectiveness analysis: An analysis that compares two or more policies or programs on at least two attributes, for example, costs and benefits. The analysis is done at the margin—that is, to determine the incremental cost effectiveness of one policy or program compared with another, the analyst determines the addi- tional cost required to achieve an additional unit of benefit.6 Council on Environmental Quality: An agency in the Executive Office of the President that “coordinates federal environmental efforts and works closely with agencies and other White House offices in the development of environmental policies and initiatives. CEQ was established…by Congress as part of the Na- tional Environmental Policy Act of 1969 and additional responsibilities were provided by the Environmental Quality Improvement Act of 1970.”7 Determinants of health: Many factors contribute to the health of individuals or communities. “Whether people are healthy or not, is determined by their cir- cumstances and environment. To a large extent, factors such as where we live, the state of our environment, genetics, our income and education level, and our relationships with friends and family all have considerable impacts on health, whereas the more commonly considered factors such as access and use of health care services often have less of an impact. The determinants of health include: 4 RTPI (Royal Town Planning Institute). 2005. Guidelines on Effective Community Involvement and Consultation. Royal Town Planning Institute [online]. Available: http://www.rtpi.org.uk/download/385/Guidlelines-on-effective-community- involvement.pdf [accessed June 8, 2011]. 5 Bergus, G.R., S.B. Cantor, M.H. Ebell, T.G. Ganiats, P.P. Glasziou, M.D. Hagen, R.M. Hamm, F.H. Lawler, and J.F. Murray. 1995. A glossary of medical decision-making terms. Prim. Care 22(2):385-393. 6 Bergus, G.R., S.B. Cantor, M.H. Ebell, T.G. Ganiats, P.P. Glasziou, M.D. Hagen, R.M. Hamm, F.H. Lawler, and J.F. Murray. 1995. A glossary of medical decision-making terms. Prim. Care 22(2):385-393. 7 CEQ (Council on Environmental Quality). 2010. The Council on Environmental Qual- ity – About. Council on Environmental Quality [online]. Available: http://www.whitehouse. gov/administration/eop/ceq/about [accessed Nov. 22, 2010].

OCR for page 185
187 Appendix D the social and economic environment, the physical environment, and the per- son’s individual characteristics and behaviours.”8 Environmental assessment (EA): In the context of the National Environmental Policy Act, an environmental assessment is a public document that briefly dis- cusses a proposed action and alternatives to it, including the need for the action and the direct, indirect, and cumulative ecologic, cultural, historical, social, or health impacts of the proposed action and the alternatives. It may be the basis for determining whether the proponent agency has a responsibility for preparing a more comprehensive environmental impact statement or whether it can exe- cute a finding of “no significant impact.” It also aids in an agency’s compliance with the statute when an environmental impact statement is not necessary.9 Environmental impact assessment (EIA): “The process of identifying, pre- dicting, evaluating and mitigating the biophysical, social, and other relevant effects of development proposals prior to major decisions being taken and com- mitments made.”10 It is a process mandated by law in countries around the world, including the United States, and is also used by multilateral development banks. Environmental impact statement (EIS): The “detailed statement” required by the National Environmental Policy Act for proposed major federal actions “significantly affecting the quality of the human environment.”11 It is prepared prior to a federal agency making a decision on the proposed action and must include an analysis of the effects of the proposed action and reasonable alterna- tives to it.12 Environmental, social, and health impact assessment (ESHIA): An inte- grated process by which the impacts of a project on the environment, society, and the health of individuals and the surrounding community are assessed. These assessments are currently carried out more often in the oil, gas, and min- ing industries.13, 14, 15 8 WHO (World Health Organization). 2011. The Determinants of Health. Health Im- pact Assessment. World Health Organization [online]. Available: http://www.who.int/ hia/evidence/doh/en/ [accessed Feb. 10, 2011]. 9 40 C.F.R. §1508.9. 10 International Association for Impact Assessment. 1999. Principles of Environmental Impact Assessment Best Practice. International Association for Impact Assessment [on- line]. Available: http://www.iaia.org/publicdocuments/special-publications/Principles%2 0of%20IA_web.pdf [accessed Nov. 22, 2010]. 11 74 Fed. Reg. 63765 [2009]. 12 42 U.S.C. Section 4332 (1969). 13 IPIECA/OGP (International Petroleum Industry Environmental Conservation Asso- ciation and International Association of Oil and Gas Producers). 2007. Health Perform-

OCR for page 185
188 Improving Health in the U.S.: The Role of Health Impact Assessment European Union: In 2010, the European Union (EU) had 27 member states and four applicants for membership. The EU “is not a federation like the United States. Nor is it simply an organisation for the co-operation between govern- ments, like the United Nations. The countries that make up the EU (its ‘Member States’) remain independent sovereign nations but they pool their sover- eignty…and delegate some of their decision-making powers to shared institu- tions.”16 “The EU’s decision-making process in general and the co-decision pro- cedure in particular involve three main institutions: the European Parliament (EP), which represents the EU’s citizens and is directly elected by them; the Council of the European Union, which represents the individual member states; [and] the European Commission, which seeks to uphold interests of the Union as a whole.”17 The commission proposes new laws, which are debated and then adopted by the European Parliament and the council of the EU. The commission and the member states then implement the laws, and the commission ensures that the laws are properly carried out.18 Framework: A set of basic elements of a process for evaluating scientific and technical information; in the context of HIA, this process is conducted to under- stand the potential adverse and beneficial effects of proposed policies, plans, programs, and projects on health. Health: “A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”19 ance Indicators: A Guide for the Oil and Gas Industry. OGP Report No. 393. Interna- tional Petroleum Industry Environmental Conservation Association, and International Association of Oil and Gas Producers [online]. Available: http://www.ipieca.org/system/ files/publications/HPI.pdf [accessed June 2, 2011]. 14 ICMM (International Council on Mining and Metals). 2010. Good Practice Guid- ance on Health Impact Assessment. London, UK: International Council on Mining and Metals [online]. Available: http://www.icmm.com/page/35457/good-practice-guidance- on-health-impact-assessment [accessed May 16, 2011]. 15 Chevron. 2011. Stakeholder Engagement. Growing Successful Partnerships. High- lights [online]. Available: http://www.chevron.com/globalissues/corporateresponsibility/ 2007/stakeholderengagement/#b2 [accessed Feb. 10, 2011]. 16 EC (The European Commission). 2010. How the EU Works. The European Com- mission [online]. Available: http://ec.europa.eu/ireland/about_the_eu/how_the_eu_works/ index_en.htm [accessed February 11, 2011]. 17 EU (European Union). 2011. EU Institutions and Other Bodies. Europa [online]. Available: http://europa.eu/institutions/index_en.htm [accessed Feb. 11, 2011]. 18 EC (European Commission). 2007. How the European Works: Your Guide to the EU Institutions. European Commission. July 2007 [online]. Available: http://ec.europa. eu/publications/booklets/eu_glance/68/en.doc [accessed Feb. 11, 2011]. 19 WHO (World Health Organization). 2003. WHO Definition of Health. World Health Organization [online]. Available: http://www.who.int/about/definition/en/print.html [ac- cessed Nov. 22, 2010].

OCR for page 185
189 Appendix D Health disparities: “Systematic, plausibly avoidable health differences ad- versely affecting socially disadvantaged groups.”20 Health effect, health impact: In this report, these two terms are used inter- changeably and defined as any change in the health of a population or subpopu- lation or any change in the physical, natural, or cultural environment that has a bearing on public health. Health impact assessment: The most commonly cited definition of health im- pact assessment (HIA) is in the Gothenburg consensus paper: A combination of procedures, methods and tools by which a policy, pro- gram or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population.21 Other definitions have arisen over the decades, and several examples are pro- vided in Chapter 1, Table 1-1. As discussed in Chapter 3, the committee has chosen to adapt the International Association of Impact Assessment definition22 and define HIA as follows: HIA is a systematic process that uses an array of data sources and analytic methods and considers input from stakeholders to determine the potential effects of a proposed policy, plan, program, or project on the health of a population and the distribution of those effects within the population. HIA provides recommendations on monitoring and managing those effects. The committee has selected a six-step framework as the clearest way to organize and describe the critical elements of an HIA (see Chapter 3). Screening determines whether a proposal is likely to have health effects and whether the HIA will provide information useful to the stake- holders and decision-makers. 20 Braveman, P.A., S. Kumanyika, J. Fielding , T. LaVeist, L.N. Borrell, R. Mander- scheid, and A. Troutman. 2011. Health disparities and health equity: The issue is justice. American Journal of Public Health [online]. Available: http://ajph.aphapublications.org/ cgi/reprint/AJPH.2010.300062v1?view=long&pmid=21551385 [accessed July 6, 2011]. 21 WHO (World Health Organization). 1999. P. 4 in Health Impact Assessment: Main Concepts and Suggested Approach. The Gothenburg Consensus Paper. Brussels: Euro- pean Centre for Health Policy, WHO Regional Office for Europe, Brussels. 22 Quigley, R., L. den Broeder, P. Furu, A. Bond, B. Cave, and R. Bos. 2006. Health Impact Assessment: International Best Practice Principles. Special Publication Series No. 5. Fargo: International Association for Impact Assessment. September 2006 [online]. Available: http://www.iaia.org/publicdocuments/special-publications/SP5.pdf [accessed May 6, 2011].

OCR for page 185
190 Improving Health in the U.S.: The Role of Health Impact Assessment Scoping establishes the scope of health effects that will be included in the HIA, the populations affected, the HIA team, sources of data, meth- ods to be used, and alternatives to be considered. Assessment involves a two-step process that first describes the baseline health status of the affected population and then assesses potential im- pacts. Recommendations suggest design alternatives that could be imple- mented to improve health or actions that could be taken to manage the health effects, if any, that are identified. Reporting documents and presents the findings and recommendations to stakeholders and decision-makers. Monitoring and evaluation are variably grouped and described. Moni- toring can include monitoring of the adoption and implementation of HIA recommendations or monitoring of changes in health or health de- terminants. Evaluation can address the process, impact, or outcomes of an HIA. Health impact assessment (HIA) practitioner: One who conducts HIA as an individual or part of a team. Health in all policies: “An approach that looks at all public- and private-sector policy making through a health lens, with the objective of promoting and pro- tecting the health of the population by addressing the social and physical envi- ronment influences on health.”23 Human health risk assessment: A process used to incorporate the understand- ing of the health implications of exposures, often environmental, into the regula- tory decision-making process. See the description of “risk assessment” for more information. Indigenous: “An official definition of ‘indigenous’ has not been adopted by any UN-system body. Instead the system has developed a modern understanding of this term based on the following: self-identification as indigenous peoples at the individual level and accepted by the community as their member; historical con- tinuity with pre-colonial and/or pre-settler societies; strong link to territories and surrounding natural resources; distinct social, economic or political systems; 23 PHI (Public Health Institute). 2010. PHI statement on Health in all Policies Task Force, March 12, 2010 [online]. Available: http://www.phi.org/news_events/phi_state ments.html [accessed Feb. 10, 2011].

OCR for page 185
191 Appendix D distinct language, culture and beliefs; form non-dominant groups of society; [and] resolve to maintain and reproduce their ancestral environments and sys- tems as distinctive peoples and communities.”24 Land-use planning: Considers a “community’s vision for future development; the policies, goals, principles, and standards upon which the development of the community are based; the proposed location, extent, and intensity of future land usage; existing and anticipated future housing needs; the location and types of transportation required; the location of public and private utilities; and the loca- tion of educational, recreational, and cultural facilities including libraries, hospi- tals, and fire and police stations.”25 Life-cycle assessment (LCA): “A technique to assess the environmental aspects and potential impacts associated with a product, process, or service, by: compil- ing an inventory of relevant energy and material inputs and environmental re- leases; evaluating the potential environmental impacts associated with identified inputs and releases; [and] interpreting the results to help you make a more in- formed decision.”26 “The major stages in [a life-cycle assessment] study are raw material acquisition, materials manufacture, production, use/reuse/maintenance, and waste management.”27 National Environmental Policy Act: A U.S. federal law that requires federal agencies in the executive branch to “integrate environmental values into their decision-making processes by considering the environmental impacts of their proposed actions and reasonable alternatives to those actions.”28 It establishes U.S. environmental policy and the Council on Environmental Quality.29 24 United Nations Permanent Forum on Indigenous Issues. 2006. Indigenous Peoples and Identity. Fact Sheet 1. United Nations Permanent Forum on Indigenous Issues [on- line]. Available: http://www.un.org/esa/socdev/unpfii/documents/5session_factsheet1.pdf [accessed Jan. 4, 2011]. 25 Breslow, L. 2002. Pp. 677-678 in Encyclopedia of Public Health, Vol. 3. New York: Macmillan. 26 EPA (U.S. Environmental Protection Agency). 2011. Life-Cycle Assessment (LCA). U.S. Environmental Protection Agency [online]. Available: http://www.epa.gov/nrmrl/ lcaccess/ [accessed Feb. 10, 2011]. 27 EPA (U.S. Environmental Protection Agency). 2011. LCA 101. U.S. Environmental Protection Agency [online]. Available: http://www.epa.gov/nrmrl/lcaccess/lca101.html [accessed May 10, 2011]. 28 FedCenter. 2010. NEPA: General Description. FedCenter [online]. Available: http:// www.fedcenter.gov/assistance/facilitytour/construction/nepa/ [accessed June 13, 2011]. 29 42 U.S.C. § 4321 et seq.

OCR for page 185
192 Improving Health in the U.S.: The Role of Health Impact Assessment Participation: The overarching term that describes “the extent and nature of activities undertaken by those who take part in public or community involve- ment, [engagement, and consultation.]”30 Plan: In the context of this report, a document, often adopted by a government entity, that describes a future course of action for a community to achieve a de- sired vision or goal. A plan typically describes the vision and goals of a commu- nity or a problem that must be solved, includes a systematic synthesis of avail- able information to analyze the problem, and identifies future actions that must be taken and future investments that must be made to address the stated problem and achieve the desired vision. Plans are prepared and implemented by all levels of government but are especially common at local government levels. Plans in- clude general or comprehensive plans, land-use plans, economic-development plans, and transportation plans. Plans that are commonly subjected to health impact assessment include plans for land use, infrastructure, and natural- resource management. Policy: Generally, “an agreement or consensus on a range of issues, goals and objectives which need to be addressed….For example, ‘Saving Lives: Our Healthier Nation’ can be seen as a national health policy aimed at improving the health of the population of England, reducing health inequalities and setting objectives and targets which can be used to monitor progress towards the pol- icy’s overall goal or aims.”31 In the committee’s report, the use of the term is extended to refer to anything other than land-use plans or development and in- frastructure projects. In this context, policy includes formal and informal social rules, including legislation, regulation, budgets, guidelines, and practices. Program: “Usually refers to a group of activities which are designed to be im- plemented in order to reach policy objectives…. For example, many Single Re- generation Budget programmes and New Deal for Communities initiatives have a range of themes within their programmes—often including health, community safety (crime), education, employment and housing—and within these themes 30 RTPI (Royal Town Planning Institute). 2005. Guidelines on Effective Community Involvement and Consultation. Royal Town Planning Institute [online]. Available: http://www.rtpi.org.uk/download/385/Guidlelines-on-effective-community-involvement.pdf [accessed June 8, 2011]. 31 WHO (World Health Organization). 2011. Health Impact Assessment (HIA) Glos- sary of Terms Used [online]. Available: http://www.who.int/hia/about/glos/en/index1. html [accessed Feb. 11, 2011].

OCR for page 185
193 Appendix D are a number of specific projects which, together, make up the overall pro- gramme.”32 Project: “Usually a discrete piece of work addressing a single population group or health determinant, usually with a pre-set time limit.”33 “Usually (but not al- ways), the term refers to ‘bricks and mortar’ projects involving construction of a discrete structure or group of structures, such as a power plant, highway, or housing development.”34 Public (or community) engagement: Action taken to begin to “establish effec- tive relationships with individuals or groups so that more specific interactions can then take place.”35 Public health: The Institute of Medicine has defined public health as “what we, as a society, do collectively to assure the conditions in which people can be healthy.”36 However, the term used in the present report refers more generally to the health of the public. This use is synonymous with the emerging term popula- tion health.37 Implicit in both terms is the notion that health is affected by a wide array of factors that range from the societal to the biologic. Public (or community) involvement: “Effective interactions between planners, decision-makers, individual and representative stakeholders to identify issues and to exchange views on a continuous basis.”38 32 WHO (World Health Organization). 2011. Health Impact Assessment (HIA) Glos- sary of Terms Used [online]. Available: http://www.who.int/hia/about/glos/en/index1. html [accessed Feb. 11, 2011]. 33 WHO (World Health Organization). 2011. Health Impact Assessment (HIA) Glos- sary of Terms Used [online]. Available: http://www.who.int/hia/about/glos/en/index1. html [accessed Feb. 11, 2011]. 34 UCLA HI-CLIC (University of California, Los Angeles-Health Impact Assessment Clearinghouse Learning and Information Center). 2011. Glossary [online]. Available: http://www.hiaguide.org/glossary [accessed Feb. 11, 2011]. 35 RTPI (Royal Town Planning Institute). 2005. Guidelines on Effective Community Involvement and Consultation. Royal Town Planning Institute [online]. Available: http://www.rtpi.org.uk/download/385/Guidlelines-on-effective-community- involvement.pdf [accessed June 8, 2011]. 36 IOM (Institute of Medicine). 1988. The Future of Public Health. Washington, DC: National Academy Press. 37 Kindig, D.A. 2007. Understanding population health terminology. Milbank. Q 85 (1):139-161. 38 RTPI (Royal Town Planning Institute). 2005. Guidelines on Effective Community Involvement and Consultation. Royal Town Planning Institute [online]. Available: http://www.rtpi.org.uk/download/385/Guidlelines-on-effective-community-involvement.pdf [accessed June 8, 2011].

OCR for page 185
194 Improving Health in the U.S.: The Role of Health Impact Assessment Risk assessment: Traditionally, risk assessment is defined as “the characteriza- tion of the potential adverse health effects of human exposures to environmental hazards.” Risk assessment can be divided into four major steps: hazard identifi- cation (“the process of determining whether exposure to an agent can cause an increase in the incidence of a health condition”), dose-response assessment (“the process of characterizing the relation between the dose of an agent administered or received and the incidence of an adverse health effect in exposed populations and estimating the incidence of effect as a function of human exposure to the agent”), exposure assessment (“the process of measuring or estimating the inten- sity, frequency, and duration of human exposures to an agent”), and risk charac- terization (“the process of estimating the incidence of a health effect under the various conditions of human exposure described in exposure assessment”).39 Stakeholder: Any individual or group that will be affected by the outcome of a decision. Stakeholders may include the affected community or specific interest groups, individuals, or organizations that have an economic stake in the outcome and the proponents of a project.40 State environmental policy act: Legislation that “provides a way to identify pos- sible environmental impacts that may result from governmental decisions [at the state-level]. These decisions may be related to issuing permits for private projects, constructing public facilities, or adopting regulations, policies or plans.”41 Several states have state environmental policy acts, including California, Connecticut, North Carolina, Washington, and Wisconsin. Strategic environmental assessment (SEA): “A systematic and anticipatory process, undertaken to analyze the environmental effects of proposed govern- ment plans, programmes and other strategies, and to integrate the findings into decision-making. It involves the public and environmental and health authori- ties, giving them a say in government planning: the responsible authority has to arrange for informing the public and consulting the public concerned, and the decision-maker has to take due account of comments received from the public and from the environmental and health authorities. Such assessments are most commonly carried out for land-use planning at various levels of government, but 39 NRC (National Research Council). 1983. Risk Assessment in the Federal Govern- ment: Managing the Process. Washington, DC: National Academy Press. 40 Mindell, J., E. Ison, and M. Joffe. 2003. A glossary for health impact assessment. J. Epidemiol. Community Health. 57(9):674-651. 41 Washington State Department of Ecology. 2002. Washington State Environmental Policy Act. Publication No. 02-06-013. FOCUS Sheet May 2002 [online]. Available: http://www.ecy.wa.gov/pubs/0206013.pdf [accessed Mar. 22, 2011].

OCR for page 185
195 Appendix D are also applied to other sectoral plans, such as for energy, water, waste, trans- port, agriculture and industry.”42 Tribal environmental policy act: A model act that would establish an envi- ronmental impact assessment for actions proposed by tribal governments in the United States.43 Zoning ordinance (or bylaws): “Legislative regulations by which a municipal government seeks to control the use of buildings and land within the municipal- ity. It has become, in the United States, a widespread method of controlling ur- ban and suburban construction and removing congestion and other defects of existing plans.”44 42 UNECE (United Nations Economic Commission for Europe). 2010. New Interna- tional Treaty to Better Integrate Environmental and Health Concerns into Political Deci- sion-Making. United Nations Economic Commission for Europe. July 6, 2010[online]. Available: http://www.unece.org/press/pr2010/10env_p22e.htm [accessed Jan. 3, 2011]. 43 The Tulalip Tribes of Washington. 2000. Participating in the National Environ- mental Policy Act: Developing a Tribal Environmental Policy Act. A Comprehensive Guide for American Indian and Alaska Native Communities. The Tulalip Tribes of Washington [online]. Available: http://www.tulalip.nsn.us/pdf.docs/Tribal_EA_Handbo ok.pdf [accessed Nov. 22, 2010]. 44 Columbia University. 2007. The Columbia Electronic Encyclopedia, 6th Ed. New York: Columbia University Press.