M. Mason, B. Wyatt, K. Chavez, L. Schott, K. Widomski

Funded by:Tri-County Health Departmentand Communities Putting Prevention to Work

American Public Health Association Annual Meeting

Wednesday, October 31, 2012

Presenter disclosures

No conflict of interest and relationships to disclose

Health Impact Assessment (HIA)

Systematically evaluates potential health effects of a project or policy before it is implemented.

Provides recommendations to increase positive health outcomes and minimize adverse health outcomes.

Source: Centers for Disease Control and Prevention, 2010

Systematically evaluates potential health effects of a project or policy before it is implemented.

Provides recommendations to increase positive health outcomes and minimize adverse health outcomes.

Source: Centers for Disease Control and Prevention, 2010

Six Step HIA Process:

1. Screening2. Scoping3. Assessing4. Recommending5. Reporting6. Monitoring and

Evaluating

Source: National Association of County and City Health Officials, 2008

Six Step HIA Process:

1. Screening2. Scoping3. Assessing4. Recommending5. Reporting6. Monitoring and

Evaluating

Source: National Association of County and City Health Officials, 2008

A call for more participatory HIAs

Simple, people-centered, low technology approaches to health impact assessment at the local level are needed (Mittlemark, 2001)

HIA screening & scoping

HIA of South Thornton Subarea Revitalizatin (STaR) Plan

STaR Plan advisory board informed the HIA process

Comprehensive HIA focused on healthy eating, active living (HEAL)

Funding provided by Tri County Health Department and Communities Putting Prevention to Work

Thornton, Colorado

Sustainable Communities Index (SCI)

HIA Indicators

Sustainable and safe transportation Social cohesion Public infrastructure/access to goods

and services Demographics Health outcomes• Healthy economy• Environmental stewardship• Adequate and healthy housing

= used in the STaR Plan HIA to address HEAL

HIA Indicators

Sustainable and safe transportation Social cohesion Public infrastructure/access to goods

and services Demographics Health outcomes• Healthy economy• Environmental stewardship• Adequate and healthy housing

= used in the STaR Plan HIA to address HEAL

Community-based participatory approach

Action-oriented community diagnosis (AOCD) Identify untapped resident

strengths and resources to address issues in community, especially as it relates to health and illness (Eng, 2006).

Asset-based community development (ABCD) Build on the skills of local

residents, the power of local associations, and the supportive functions of local institutions (ABCD Institute, 2012).

Assessing

What data exist or need to be collected?

How residents mightbe affected by the STaRPlan?

Neighborhood tours (car and bike)

Key informant interviews

Intercept surveys

Participatory assessment process

Walkability & bikeability assessments

Community mapping

Community forum

Participatory process continued

Participants and sessions by activityActivities in English & Spanish # of participants # of sessions

Neighborhood tours (car and bike)

6 2 tours

Intercept surveys 81 8

Key informant interviews 10 11

Walk & bike assessments 35 2

Planning Active Community Environments (PLACE) Training

18 1

Community mapping 18 3

Community forum 28 1

Community-driven recommendations and reporting

The key SCI indicators that emerged as contributors to HEAL include:– Access to good and services

(i.e., healthy foods)– Social connections and

communication (i.e., social cohesion)

– Public infrastructure and transportation (i.e., sustainable and safe options)

The STaR Plan goals and strategies support positive health outcomes for south Thornton community members.

Monitoring & evaluationShort-term Successes Built ongoing HEAL coalition

Received multi-year funding to address HEAL issues

HIA recommendations approved by resolution by City of Thornton City Council: April 10, 2012

Received the Colorado Chapter of the American Planning Association’s 2012 Merit Award in the Category of Sustainability

Strengths of utilizing participatory approaches during a HIA

Gained an “insiders view” about community dynamics

Inserted community voice in planning dialogue

Generated new learning and expanded social networks for everyone involved

Began the organizing process to address HEAL issues for sustainability

Challenges of utilizing participatory approaches during a HIA

Substantial investment of time 1yr.

Multiple obligations and timelines (e.g. stakeholders and seasonal)

Gaining trust with local agencies

Facilitating meetings with diverse community members and finding common ground

Lessoned learned

Be flexible in how you engage people in the HIA process

Find ways to keep people involved to maintain momentum

Remove as many barriers as possible (e.g., provide childcare, interpreters, dinner)

Increase organizational capacity to assist with community outreach (e.g., sufficient bilingual staff)

Thank you! ¡Gracias!For more information contact:

Community Enterprise ‐ (303) 288‐4783

or 

City of Thornton 

http://www.cityofthornton.net/Departments/CityDevelopment/LongRangePlanning/Pages/SustainabilityWellness.aspx

Some key STaR Plan HIA recommendations

Incentivize increasing access to nutritious food (e.g., Smart MealTM Program, zoning for urban farming and community garden) and physical activity.

Strengthen and expand partnerships with community residents and those with focus on HEAL (e.g., Bicycle Colorado).

Establish joint use agreements with school district for shared recreation and community facilities.

Build infrastructure to improve walkability and safety for people of all ages and abilities (e.g., lighting, landscaping, signage/wayfinding, traffic calming measures, shelter and seating at transit stops).