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Improving Health in the United States: The Role of Health Impact Assessment (2011)

Chapter: Appendix E: Summary of Health Impact Assessment Guides

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Suggested Citation:"Appendix E: Summary of Health Impact Assessment Guides." National Research Council. 2011. Improving Health in the United States: The Role of Health Impact Assessment. Washington, DC: The National Academies Press. doi: 10.17226/13229.
×

Appendix E

Summary of Health Impact Assessment Guides

Tables E-1 and E-2 provide a summary of health impact assessment (HIA) guides for each stage of the HIA process. Specifically, Table E-1 examines how HIA guides conceptualize the stages of an HIA. It does not review emerging approaches—such as practice standards (Bhatia et al. 2009, 2010)—or review criteria (Fredsgaard et al. 2009). Table E-2 provides an overview of HIA guides for policies and plans.

Suggested Citation:"Appendix E: Summary of Health Impact Assessment Guides." National Research Council. 2011. Improving Health in the United States: The Role of Health Impact Assessment. Washington, DC: The National Academies Press. doi: 10.17226/13229.
×

TABLE E-1 A Review of Health Impact Assessment Guidesa

Screening Scoping Assessment Reporting Recommendations Monitoring and Evaluation
Development Lending (Pfeiffer and Dora, unpublished material, 2010)b

• Screening

• Scoping

• Stakeholder engagement

——

• Reviewing HIA report

• Reviewing community health action plan

——

• Monitoring community health performance of project

ICMM (International Council on Mining and Metal 2010)

• Screening

• Scoping

• Community profiling and baseline studies

• Stakeholder and community involvement

• Health impact evidence gathering

• Analysis of health impacts

• Development of mitigation and enhancement measures

• HIA reporting

——

• Developing health management plan and follow up (monitoring and evaluation)

IFC (International Finance Corporation 2009)

• Screening

• Scoping

• Risk assessment

——

• Health action plan

• Implementation and monitoring

• Evaluation and verification of performance and effectiveness

UCLA (Fielding and Cole 2008)

• Screening

• Scoping

• Profiling

• Assessment

• Reporting and monitoring

—— ——
Suggested Citation:"Appendix E: Summary of Health Impact Assessment Guides." National Research Council. 2011. Improving Health in the United States: The Role of Health Impact Assessment. Washington, DC: The National Academies Press. doi: 10.17226/13229.
×
Screening Scoping Assessment Reporting Recommendations Monitoring and Evaluation
MWIA (Coggins et al. 2008)

• Screening

• Evidence based assessment

• Scoping

• Appraisal process

• Community profiling

• Stakeholder and key informant

• Research such as literature search

• Identification of potential beneficial or adverse impacts

• Identification of recommendations and writing of report

• Identification of indicators for monitoring impacts of proposal on mental well-being and implementation of recommendations

CHETRE (Harris et al. 2007)

• Screening

• Scoping

• Identification

• Assessment

——

• Decision-making and recommendations

• Evaluation and follow-up

Greenspace (Greenspace Scotland 2008)

• Screening

• Set up a team to do HIA

• Scoping

• Local profile

• Involve stakeholders

• Identification and assessment of impacts

——

• Make recommendations

• Monitor impacts

IAIA (Quigley et al. 2006)

• Screening

• Scoping

• Full-scale HIA

• Public engagement and dialogue

• Appraisal of HIA report

• Establishment of framework for intersectoral action

• Negotiation of resource allocations for health safeguard measures

• Monitoring of compliance

IPIECA (IPIECA/OGP 2005)

• Screening

• Scoping

• Risk assessment; impact assessment

• Decision-making; establishing priorities; reporting

——

• Implementation and monitoring

• Evaluation

Suggested Citation:"Appendix E: Summary of Health Impact Assessment Guides." National Research Council. 2011. Improving Health in the United States: The Role of Health Impact Assessment. Washington, DC: The National Academies Press. doi: 10.17226/13229.
×
EFHIA (Mahoney et al. 2004)

• Screening

• Scoping

• Impact identification

• Assessment of impacts

——

• Recommendations

• Evaluation and monitoring

Merseyside (Scott-Samuel et al. 2001)

• Screening

• Establish steering group

• Agree on terms of reference for assessment

• Select assessor

——

• Conduct assessmentc

• Appraise assessment

• Negotiate favored options

• Implement and monitor

• Evaluate and document

EHIA (Fehr 1999)

• Project analysis

• Regional analysis

• Population analysis

• Background situation

• Prognosis of future pollution

• Summary assessment of impacts

——

• Recommendations

• Communication

• Evaluation

aThis table examines how HIA guides conceptualize the stages of an HIA. It does not review emerging approaches, such as practice standards (Bhatia et al. 2009, 2010), or review criteria (Fredsgaard et al. 2009).

bThis is not strictly a guide, and there is no assessment stage. The document assists lenders in following and reviewing health assessments.

cThis stage includes seven steps and covers scoping and assessment. Abbreviations: CHETRE, Centre for Health Equity Training, Research and Evaluation; EFHIA, equity-focused health impact assessment; EHIA, environmental health impact assessment; IAIA, International Association for Impact Assessment; ICMM, International Council on Mining and Metals; IFC, International Finance Corporation; IPIECA, International Petroleum Industry Environmental Conservation Association; MWIA, mental well-being impact assessment; and UCLA, University of California, Los Angeles.

Suggested Citation:"Appendix E: Summary of Health Impact Assessment Guides." National Research Council. 2011. Improving Health in the United States: The Role of Health Impact Assessment. Washington, DC: The National Academies Press. doi: 10.17226/13229.
×

TABLE E-2 Health Impact Assessment Guides for Policies or Plans

SEA EPHIA
(EP/Council 2001; ODPM 2005) (Abrahams et al. 2004)
Screening—2.5 under Article 2(a), the plans and programs subject to the directive are those which are:
Screening

•   Subject to preparation or adoption by an authority at national, regional, or local level or prepared by an authority for adoption through a legislative procedure by Parliament or government.

•   Required by legislative, regulatory, or administrative provisions.

Screening
Scoping Stage A—Setting the context and objectives, establishing the baseline, deciding on scope

A1: Identifying relevant plans, programs, and environmental protection objectives.

A2: Collecting baseline data.

A3: Identifying environmental problems.

A4: Developing SEA objectives, indicators, and targets.

A5: Consulting on the scope of SEA.

Scoping
Assessment Stage B—Alternatives and assessment

B1: Testing the plan or program objectives against the SEA objectives.

B2: Developing strategic alternatives.

B3: Predicting the effects of the draft plan or program, including alternatives.

B4: Evaluating the effects of the draft plan or program, including alternatives.

B5: Considering ways to mitigate adverse effects.

Suggested Citation:"Appendix E: Summary of Health Impact Assessment Guides." National Research Council. 2011. Improving Health in the United States: The Role of Health Impact Assessment. Washington, DC: The National Academies Press. doi: 10.17226/13229.
×

B6: Proposing measures to monitor the environmental effects of plan or program implementation.

•   Conduct assessment

•   Policy analysis

•   Qualitative and quantitative data collection

•   Impact analysis

•   Setting priorities among impacts

•   Recommendations developed

•   Profiling

•   Process evaluation

Reporting Stage C—Preparing the environmental report Report on health impacts and policy options

Stage D—Consultation and decision-making Responsible authorities will

Recommendations

•   Consult on the draft plan or programme and the environmental report.

•   Assess significant changes.

Monitoring and evaluation Stage E—Monitoring implementation of the plan or program

•   Developing aims of and methods for monitoring.

•   Monitoring

•   Impact and outcome evaluation

Abbreviations: EPHIA, European policy health impact assessment; and SEA, strategic environmental assessment.

Suggested Citation:"Appendix E: Summary of Health Impact Assessment Guides." National Research Council. 2011. Improving Health in the United States: The Role of Health Impact Assessment. Washington, DC: The National Academies Press. doi: 10.17226/13229.
×

REFERENCES

Abrahams, D., A. Pennington, A. Scott-Samuel, C. Doyle, O. Metcalfe, L. den Broeder, F. Haigh, O. Mekel, and R. Fehr. 2004. European Policy Health Impact Assessment: A Guide, University of Liverpool, England; RIVM, Netherlands; Institute of Public Health, Ireland; loegd, Institute of Public Health, NRW Bielefeld, Germany. Prepared for the Health and Consumer Protection Directorate General, European Commission. May 2004 [online]. Available: http://ec.europa.eu/health/ph_projects/2001/monitoring/fp_monitoring_2001_a6_frep_11_en.pdf [accessed May 16, 2011].

Bhatia, R., L. Farhang, M. Gaydos, K. Gilhuly, B. Harris-Roxas, J. Heller, M. Lee, J. McLaughlin, M. Orenstein, E. Seto, L. St. Pierre, A.L. Tamburrini, A. Wernham, and M. Wier. 2009. Practice Standards for Health Impact Assessment (HIA), Version 1. North American HIA Practice Standards Working Group, Oakland, CA. April 2009 [online]. Available: http://www.habitatcorp.com/whats_new/HIA_Practice_Standards_040709_V1.pdf [accessed May 17, 2011].

Bhatia, R., J. Branscomb, L. Farhang, M. Lee, M. Orenstein, and M. Richardson. 2010. Minimum Elements and Practice Standards for Health Impact Assessment (HIA), Version 2. North American HIA Practice Standards Working Group, Oakland, CA. November 2010 [online]. Available: http://www.sfphes.org/HIA_Tools/HIA_Practice_Standards.pdf [accessed May 23, 2011].

Coggins, T., A. Cooke, L. Friedli, J. Nicholls, A. Scott-Samuel, and J. Stansfield. 2008. Mental Well-Being Impact Assessment: A Toolkit, “A Living and Working Document”. Care Services Improvement Partnership, North West Development Centre [online]. Available: http://www.liv.ac.uk/ihia/IMPACT%20Reports/mwia-toolit1.pdf [accessed May 16, 2011].

EP/Council (European Parliament and Council of the European Union). 2001. Directive 2001/42/EC of the European Parliament and of the Council of 27 June 2001 on the assessment of the effects of certain plans and programmes on the environment. O.J. Eur. Comm. L 197:30-37.

Fehr, R. 1999. Environmental health impact assessment: Evaluation of a 10 step model. Epidemiology 10(5):618-625.

Fielding, J., and B.L. Cole. 2008. UCLA Training Manual. Health Impact Assessment Clearinghouse Learning and Information Center [online]. Available: http://www.ph.ucla.edu/hs/health-impact/training.htm#uclatraining [accessed May 19, 2011].

Fredsgaard, M.W., B. Cave, and A. Bond. 2009. A Review Package for Health Impact Assessment Reports of Development Projects. Leeds, UK: Ben Cave Associates Ltd [online]. Available: http://www.bcahealth.co.uk/pdf/hia_review_package.pdf.

Greenspace Scotland. 2008. Health Impact Assessment of Greenspace: A Guide. Health Scotland, Greenspace Scotland, Scottish Natural Heritage and Institute of Occupational Medicine. Stirling: Greenspace Scotland. June 2008 [online]. Available http://www.greenspacescotland.org.uk/upload/File/Greenspace%20HIA.pdf [accessed May 17, 2011].

Harris, P., B. Harris-Roxas, E. Harris, and L. Kemp. 2007. Health Impact Assessment: A Practical Guide. Sidney, Australia: Centre for Health Equity Training, Research and Evaluation, the University of New South Wales. August 2007 [online]. Available: http://www.hiaconnect.edu.au/files/Health_Impact_Assessment_A_Practical_Guide.pdf [accessed May 9, 2011].

Suggested Citation:"Appendix E: Summary of Health Impact Assessment Guides." National Research Council. 2011. Improving Health in the United States: The Role of Health Impact Assessment. Washington, DC: The National Academies Press. doi: 10.17226/13229.
×

ICMM (International Council on Mining and Metals). 2010. Good Practice Guidance 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].

IFC (International Finance Corporation). 2009. Introduction to Health Impact Assessment. Washington, DC: World Bank [online]. Available: http://www.ifc.org/ifcext/sustainability.nsf/AttachmentsByTitle/p_HealthImpactAssessment/$FILE/HealthImpact.pdf [accessed May 5, 2011].

IPIECA/OGP (International Petroleum Industry Environmental Conservation Association and International Association of Oil and Gas Producers). 2005. A Guide to Health Impact Assessments in the Oil and Gas Industry. International Petroleum Industry Environmental Conservation Association, and International Association of Oil and Gas Producers [online]. Available: http://www.hiaconnect.edu.au/files/HIA_in_OG.pdf [accessed May 17, 2011].

Mahoney, M., S. Simpson, E. Harris, R. Aldrich, and J. Stewart-Williams. 2004. Equity Focused Health Impact Assessment Framework. The Australasian Collaboration for Health Equity Impact Assessment (ACHEIA). August 2004 [online]. Available: http://www.hiaconnect.edu.au/files/EFHIA_Framework.pdf [accessed May 17, 2011].

ODPM (Office of the Deputy Prime Minister). 2005. A Practical Guide to the Strategic Environmental Assessment Directive. Department for Communities and Local Governments [online]. Available: http://www.communities.gov.uk/documents/planningandbuilding/pdf/practicalguidesea.pdf [accessed June 10, 2011].

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].

Scott-Samuel, A., M. Birley, and K. Ardern. 2001. The Merseyside Guidelines for Health Impact Assessment, 2nd Ed. Liverpool: International Health Impact Assessment Consortium. May 2001 [online]. Available: http://www.hiaconnect.edu.au/files/Merseyside_Guidelines.pdf [accessed May 18, 2011].

Suggested Citation:"Appendix E: Summary of Health Impact Assessment Guides." National Research Council. 2011. Improving Health in the United States: The Role of Health Impact Assessment. Washington, DC: The National Academies Press. doi: 10.17226/13229.
×
Page 196
Suggested Citation:"Appendix E: Summary of Health Impact Assessment Guides." National Research Council. 2011. Improving Health in the United States: The Role of Health Impact Assessment. Washington, DC: The National Academies Press. doi: 10.17226/13229.
×
Page 197
Suggested Citation:"Appendix E: Summary of Health Impact Assessment Guides." National Research Council. 2011. Improving Health in the United States: The Role of Health Impact Assessment. Washington, DC: The National Academies Press. doi: 10.17226/13229.
×
Page 198
Suggested Citation:"Appendix E: Summary of Health Impact Assessment Guides." National Research Council. 2011. Improving Health in the United States: The Role of Health Impact Assessment. Washington, DC: The National Academies Press. doi: 10.17226/13229.
×
Page 199
Suggested Citation:"Appendix E: Summary of Health Impact Assessment Guides." National Research Council. 2011. Improving Health in the United States: The Role of Health Impact Assessment. Washington, DC: The National Academies Press. doi: 10.17226/13229.
×
Page 200
Suggested Citation:"Appendix E: Summary of Health Impact Assessment Guides." National Research Council. 2011. Improving Health in the United States: The Role of Health Impact Assessment. Washington, DC: The National Academies Press. doi: 10.17226/13229.
×
Page 201
Suggested Citation:"Appendix E: Summary of Health Impact Assessment Guides." National Research Council. 2011. Improving Health in the United States: The Role of Health Impact Assessment. Washington, DC: The National Academies Press. doi: 10.17226/13229.
×
Page 202
Suggested Citation:"Appendix E: Summary of Health Impact Assessment Guides." National Research Council. 2011. Improving Health in the United States: The Role of Health Impact Assessment. Washington, DC: The National Academies Press. doi: 10.17226/13229.
×
Page 203
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Factoring health and related costs into decision making is essential to confronting the nation's health problems and enhancing public well-being. Some policies and programs historically not recognized as relating to health are believed or known to have important health consequences. For example, public health has been linked to an array of policies that determine the quality and location of housing, availability of public transportation, land use and street connectivity, agricultural practices and the availability of various types of food, and development and location of businesses and industry.

Improving Health in the United States: The Role of Health Impact Assessment offers guidance to officials in the public and private sectors on conducting HIAs to evaluate public health consequences of proposed decisions -- such as those to build a major roadway, plan a city's growth, or develop national agricultural policies -- and suggests actions that could minimize adverse health impacts and optimize beneficial ones.

Several approaches could be used to incorporate aspects of health into decision making, but HIA holds particular promise because of its applicability to a broad array of programs, consideration of both adverse and beneficial health effects, ability to consider and incorporate various types of evidence, and engagement of communities and stakeholders in a deliberative process. The report notes that HIA should not be assumed to be the best approach to every health policy question but rather should be seen as part of a spectrum of public health and policy-oriented approaches.

The report presents a six-step framework for conducting HIA of proposed policies, programs, plans, and projects at federal, state, tribal, and local levels, including within the private sector. In addition, the report identifies several challenges to the successful use of HIA, such as balancing the need to provide timely information with the realities of varying data quality, producing quantitative estimates of health effects, and engaging stakeholders.

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