Transcript Document

Health Impact Assessment and Housing
Presentation to
HUD Office of Healthy Homes and Lead Housing Control
Aaron Wernham, M.D., M.S.
Director | The Health Impact Project
901 E Street, NW, Washington, D.C. 2004
p: 202.540.6346
e: [email protected]
www.healthimpactproject.org
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By RWJF and University of
Wisconsin Madison, County
Health Rankings program:
www.countyhealthrankings.or
g/about-project/background
Definitions
2. IAIA
A combination of procedures, methods and tools that
systematically judges the potential effects of a policy,
programme or project on the health of a population and the
distribution of those effects within the population. HIA identifies
appropriate actions to manage those effects.
(IAIA, 2006)
A practical approach for collaboration between health and other
sectors, translating public health research into predictions and
reasonable recommendations that policy makers can use to
ensure that new public decisions contribute to healthier
communities.
Analytical Framework
Proposed policy,
project, program
Determinants of
health
Health outcomes
• Broad framework: considers multiple determinants and
dimensions of health
• Considers direct, indirect, and cumulative pathways
• Both qualitative and quantitative methods used
• Focus: predicting outcomes or pathways/linkages, in order
to manage effects
HIA is NOT…
• Evaluation: not best for looking at effects of an existing policy or
program, or evaluating the impacts of a past action
• Risk assessment: HIA should not be used to look at one narrow
subset of issues. Best when it starts by asking “what are the
potential direct and indirect impacts on health”
• Exhaustive: despite it’s breadth, HIA should not catalogue every
theoretical risk, but should instead focus on the effect pathways
that appear to be the most important, of greatest concern to the
impacted community, and best supported by evidence
• Focused on quantifying risk: the most important task is to use
reasoned judgment about risk to promote sound management
strategies
The HIA Process
1. Screening –is HIA feasible and likely to add value?
2. Scoping – determine the important health effects, affected
populations, available evidence, etc
3. Assessment – analyze baseline conditions and the direct,
indirect, and cumulative pathways through which health
can be affected.
4. Recommendations, Implementation and Advocacy
5. Reporting – disseminate the report to the public,
stakeholders, solicit input
6. Monitoring and Evaluation
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Important points to clarify in developing an
HIA proposal
1.Timing:
• HIA should be done early enough to inform design & decisionmaking
• Developers may prefer to have health criteria available at the
outset of their planning.
2. Stakeholder engagement and participation (see next slide)
• Engaging stakeholders (project proponents, affected
communities, and decision-makers) is essential
• Clear plan for how input will be solicited, and how the HIA will
respond to input
3. Recommendations: effective recommendations must take into
consideration the political, regulatory, practical, and economic
context, not only health concerns.
Examples of Housing HIAs
Jack London Gateway (JLG) Senior Housing Project
Authors: Human Impact Partners and
SFDPH
Decision: Plan for 61 new senior housing
units close to 2 freeways & Port of
Oakland.
Outcomes:
Impacts: indoor & outdoor air quality,
•Many recommendations
noise, safety, retail planning
adopted.
•Additional HIA projects were
Recommendations: AQ monitoring;
installation of ventilation systems; noise- funded.
insulating windows; pedestrian protection •Healthy Development
medians; traffic calming measures; and checklist adopted by the
Development Committee.
many others.
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Trinity Plaza Apartments
Author: SFDPH
Decision: A developer proposed to
demolish 360 unit rent-controlled apartments to build 1400
condominiums
Impacts: related to displacement, risk of homelessness,
decreased social cohesion, and a range of related health
impacts
Recommendations/Outcome:
Developer agreed to provide 360 replacement units, at current
rents
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Examples of Housing HIAs:
Accessory Dwelling Units (HIA in progress)
Authors: Benton County Health Department, CO
Decision: Benton County currently prohibits all rural
residents from building ADUs on their properties. The
Benton County Planning Department receives
frequent complaints from the public concerning the
ordinance banning the construction of ADUs and has
a strong interest in addressing the issue to better serve the residents of
rural Benton County.
The HIA project aims to inform the Benton County Planning Department on
how proposed changes to the ordinance will affect residents of rural Benton
County.
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Examples of Housing HIAs
“Child Health Impact Assessment” of the Massachusetts
Rental Voucher Program
Decision: Modifications to the Massachusetts
Rental Voucher Program (MRVP), which provides
low-income families with rental subsidies.
Impacts: asthma, injuries, access to healthcare,
mental health conditions, and developmental & educational attainment.
Key Findings:
• Time limits for housing subsidies puts children's health at risk due to
budget trade-offs between housing expenses and other basic needs.
• Instituting work requirements will likely result in MRVP disenrollments
for some families.
• Increasing the frequency of eligibility re-determinations may increase
the number of families who disenroll from the program.
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Additional Housing-related HIAs
1. HOPE SF – an HIA to inform SF’s new public housing
policies. http://www.humanimpact.org/SF_Housing_HIA_Poster.pdf
2. 29th St/San Pedro LA – 450 affordable housing units
http://www.humanimpact.org/LA_29thSt_HIA_ExecSummary.pdf
3. Pittsburg Railroad Ave, CA – TOD sector plan: 1,590
units, 15% affordable
4. (proposed) County Board of Health would do HIA to inform
CDBG renewal
5. Good Poster on Housing HIAs:
http://www.who.int/hia/conference/poster_gilhuly.pdf
“HIA 2.0” – beyond project-specific applications
• Should a new HIA be done for each new project or
program?
• Can HIA be a formative learning tool that results in
adoption of new “healthy by design” principles that
obviate the need for HIA on every projects?
“HIA 2.0” – beyond project-specific applications
The Healthy Development Measurement Tool
Ingram County, MI
(Lansing):
Local health dept now
using “HIA Checklist”
This Website has case
study and link to the
checklist:
http://www.cacvoices.org/h
ealthylifestyles/environmen
tal/HIA/
Tradeoffs between HIA and Checklist
approaches:
Checklist
HIA
• Influence project design at an • Public engagement
earlier phase
process
• Take time to develop, but may • Requires interagency
reduce time demands in the
collaboration, with many
long run
benefits: insight into the
• Developers may favor a static
project, public education,
checklist approach for
new collaborative
predictability
relationships, building
public trust, etc
• But…may sacrifice projectspecific detail
Discussion?
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