Health Impact Assessment: An underserved Miami community preserves the past while embracing the future Luther Brewster, PhD. Florida International University School of Public Health David Brown, MD. University of Miami School of Medicine Background Overtown is a predominately African American community in Southern Florida with a population speculated to be between 8,000-9,000 people. Several key transportation projects have contributed to Overtowns diminished social and economic standing. While currently a blighted area its proximity to vital economic engines has made it a redevelopment target for developers, economic agencies and public officials. A. Young (2006)Overtown Mens health Study COMMON GROUND The successful opposition of recent transportation proposal introduced the idea of assessing the communitys willingness and capacity for HIA. A steering committee was formed and while debriefing the events of the transport opposition it was revealed that several of the key steps of HIA were already being performed. Two tools were developed to assist in the introduction of HIA to Overtown (as well as the South Florida area): Common Ground video & Community Health Empowerment Toolkit Goals Educate community, officials and academics on the health related consequences of non-health related programs, projects and policies. Create an environment that fosters increased public participation in the planning process. Integrate stakeholders familiar language, protocols and systems into justifications for the use of HIA. Stakeholder Familiarity Public Health 1. Social determinants 2. Service Learning 3. Community Based Participatory Research 4. Environmental justice 5. Evaluation (process, outcome & impact) Grantmakers 1. Abandon top-down models 2. Collaboration/ Consortium 3. Community empowerment 4. Sustainability 5. Evaluation Community Health Empowerment Toolkit Target audience: community based organizations Purpose: Introduce concepts of HIA to community groups in a familiar format so they are prepared for more formal HIA. Development keys: Sound theoretical foundation, Reinforce preexisting community efforts, User- friendly. Start with Community Community residents are the owners of their community and thus have the right to define their own community as they perceive it. This may contradicts accepted geographic, statistical or behavioral measures, however, often times embedded within their definition are the nuances that traditional measures are unable to capture. EXAMPLE: Overtown residents define their community as a predominately pedestrian community that is under siege by private and public sector outsiders who initially saw Overtown as a dumping ground and now see Overtown as a catalyst for economic development. This definition belies much of the apprehension expressed by Overtown residents when opposing the 14th Street ramps project. Screening It is unlikely that a community will have the resources necessary to address all projects, programs and policies proposed for their community. It is important, therefore, to identify those issues that either impact the community the most or serve as the catalyst for a much larger agenda. The obvious threat to the youth as well as the infringement on Overtowns existence as a pedestrian community made the construction of highway ramps inappropriate for Overtown. Additionally, the construction of highway ramps did not address any of Overtowns long or short-term needs, served only the business interests of communities to the east and assigned a very low (if any) priority to the needs of Overtown. Relationship Mapping Community partnerships are relationships and thus they must be properly nurtured and understood. A comprehensive understanding of each partners investment in the community as well as what information and resources they maintain is crucial. This will facilitate the proper organization of advocacy efforts and ensure that an attempt is made to meet the needs of each partner as well as the group. Example: Divide and conquer was a standard tactic employed by the Florida Department of Transportation. They often attempted to schedule meetings, broker deals and negotiate alternatives with different partners in an effort to gain some form of community endorsement. The partnership, however, consistently communicated with one another and attended public meetings to make sure no deals were brokered without the sanction of the entire community. Additionally, the partnership expanded its knowledge- base and partners by appealing directly to local politicians and experts in the field of transportation. Research A thorough understanding of the facts that are supporting a proposed project, program or policy is essential. At this step in the process you will expand your understanding of the apparent risks as well as investigate concomitant risk that may not be as apparent. Additionally, it may be helpful to investigate the source of the proposal at the local, state and federal levels. Example: It was evident to Overtown residents that this project posed a significant risk to the youth in the area. It was also evident that the state agency was aware of Overtowns opposition to the project. What was not clearly understood is how the project could move forward without the support of the community and its advisory board. Upon investigating the matter further it was discovered that the federal agency responsible for approving all transportation projects was informed by the state agency proposing the road project that the mandate for public participation had been fulfilled, not that the community had opposed the project. Action Communicating your concerns to the community-at-large will enable you to stage this issue in the court of public opinion. Document your position so that your position becomes a statement of public record. It should be the aim of the partnership to mobilize and recruit as many allies and new partners as possible. Example: Booker T. Washington High School drafted a resolution opposing the road project and then used this resolution to recruit the support of public officials. The resolution was adopted by these officials and what initially was the voice of the high school had been transformed into the voice of the community, community advisory boards and ultimately the commissioner. Conclusions The toolkit is a tool for forming informal collaboration and aligning with existing community advocacy values. Community opposition to key economic development initiatives appears to be a key pathway to introducing HIA in South Florida. Next steps: Currently an additional transport proposal is seeking community support and we will test the practicality and effectiveness of this toolkit and its ability to promote community participation in assessment workshops.