health impact assessment training...hia steps screening determines the need and value of a hia time,...
TRANSCRIPT
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Transitional Jobs
Health Impact Assessment
Liz Feder, PhD
Paula Tran Inzeo, MPH
Penny Black, MS
Marjory Givens, PhD, MPH
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What is Health Impact
Assessment?
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Improving Health in the United States: The Role of Health Impact Assessment.
National Research Council, National Academies Press. Washington, D.C.; 2011
Health Impact Assessment 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 the effects within the population. HIA provides
recommendations on monitoring and managing
those effects.
HIA Definition
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Democracy
Equity
Sustainable Development
Ethical Use of Evidence
Comprehensive approach to health
Gothenburg Consensus Paper, 1999
HIA Core Values
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HIA Purpose
Through HIA report and communications
Project the health effects of a proposed project, plan or policy
Highlight health inequities
Provide recommendations
Shape public decisions & discourse
Make health impacts more explicit
Through the HIA process
Engage & empower community
Recognize lived experience
Build relationships & collaborations
Build consensus & promote transparency
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HIA Addresses
Determinants of Health
Democratic process
Housing
Air quality
Noise
Safety
Social networks
Nutrition
Parks and natural space
Private goods and services
Public services
Transportation
Social equity
Livelihood
Water quality
Education
How does the proposed
project, plan, policy affect
and lead to health outcomes
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Incorporating Health into
Decision-Making
The world could look different
Development
Immigration
Farm Policy
Ports
Incarceration
Education
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HIA Steps
Screening Determines the need and value of a HIA time, added value, engaged “deciders”, resources
Scoping Determines which health impacts to evaluate, methods
for analysis, and a workplan
Assessment Provides:
1) a profile of existing health conditions
2) evaluation of potential health impacts
Recommendations Provide strategies to manage identified adverse health
impacts or promote health benefits
Reporting Includes:
1) development of the HIA report
2) communication of findings & recommendations
Monitoring /
Evaluation
Tracks:
1) impacts on decision-making processes and the decision
2) impacts of the decision on health determinants and outcomes
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HIA : US and Abroad
International Finance Corporation requires HIAs for
large resource development projects
European countries require more explicit health
consideration (HIA) in land use and planning decisions
Some of application in developing countries
HIA is well-established in international arenas
HIA is emerging in the US
West coast
California, Alaska, Oregon, Washington
East coast
Massachusetts, D.C. metro area
Midwest
Wisconsin, Minnesota, Illinois
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Criticisms of HIA
Criticism Response
HIA is costly Not as costly as treatment of health impacts in
the long run
HIA is time-
consuming and
will slow
decision-making
processes
Conducting the HIA early will bring issues to
the front of the decision-making process,
potentially speeding approval processes, and
preventing costly litigation that delays projects
HIA will stop
economic
development
The role of HIA is to identify mitigations and
recommendations, not to say “don’t do that”
HIA is not
scientific
Role of HIA is to pull together disparate pieces
of the best available evidence to make a broad
statement about impacts
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HIAs Completed or In Progress
AK 7
CA
47
CO 4
FL
1
MA 4
NJ 1
MN 6
GA 8
WA 8
OR
12
OH
1
PA 2
MD 2
MT 3
Map Courtesy of A. Dannenberg, A. Wendel,
CDC NCEH
NM
1 TN 1
HI 1
IL 1
KY 1 MO
1
NH 2
TX 1
ME 1
WI 1
Total N=119
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12
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Funding
Pew Charitable Trusts
Robert Wood Johnson Foundation
Center for Disease Control and Prevention
Association of State and Territorial Health Officials
National Association of City and County Health Officials
California Endowment
Kresge Foundation
Blue Cross Blue Shield of Minnesota
Kansas Health Foundation
National Network of Public Health Institutes
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Goal: build a multi-sector HIA collaborative
Based on the San Francisco Bay Area Health Impact
Assessment Collaborative model
Government
Non-Profit
Academia
WI HIA Collaborative
Business
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Wisconsin Div. of Public Health, Dept. of Health Services
Bureau of Environmental and Occupational Health
2009 – 1 of 4 states awarded 2 years ASTHO funding
Website
HIA network
Outreach, Training, Technical assistance
Webinars, Workshops, Lectures
Implementation: Mini grants/pilots (5)
Healthiest Wisconsin 2020 - State Health Plan
State Government
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The University of Wisconsin - Madison
Population Health Institute (National Network of Public
Health Institutes and Morgridge Center Grant)
Global Health Institute
Health In All Policies
Seed money from Worldwide Universities Network and newly renewed EU Center for Excellence grant
Classroom Curricula
Academic
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Wisconsin Public Health Association
HIA section
HIA resolution
Training infrastructure
Policy actions
Wisconsin Center for Health Equity (WCHE)
Reaching non-traditional partners
Health equity lens
Civic capacity building
Focus on social determinants of health
Non-Profit/Community
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Transitional Jobs
Health Impact Assessment
Project
Background
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Demonstration Project Grant
“Increasing National Capacity for HIAs:
Utilizing the Nation’s Public Health Institutes” A project of NNPHI and the Health Impact Project, a
collaboration of the Robert Wood Johnson Foundation and The
Pew Charitable Trusts
To promote and support the growth of the
field of HIA nationwide by increasing the
capacity of public health institutes (PHIs) to
conduct HIAs in their respective regions.
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Transitional Jobs
Provide immediate wage-paid employment and supportive services to those who have difficulty finding and keeping employment
Provide an opportunity to develop skills and experience in local labor markets and a positive work history.
Research suggests that participants in TJ programs may increase job security, increase wages over time, and decrease reliance on public benefits.
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Wisconsin TJ-Demonstration Project
2009 – WI Act 28 Original Project
up to 2,500 participants in key counties
(Milwaukee, Dane, Racine, Kenosha, Rock,
Brown)
2009 – WI Act 333 Enhanced Demonstration
TANF emergency funds (ARRA)
Removed ceiling – program statewide
Sunset when funds gone – June 2013
WI Legislative Fiscal Bureau, Paper #215, May 31, 2011
http://legis.wisconsin.gov/lfb/publications/budget/2011-13-
Budget/documents/Budget%20Papers/215.pdf
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Current Law
Eligibility: 21-64 yrs, AND TANF eligibility: >age 24 limited to
parents (or primary caregiver) of minor children
not W-2 or UI eligible,
Unemployed at least last 4 weeks
FPL <150%
Employment: 20-40 hours/week
At least minimum wage
Employer reimbursed for wages at min. wage, federal and state taxes, workers’ comp insurance premiums
Education and training may be provided during subsidized work, participants paid
Contractors required to help participants secure unsubsidized work for 3 mos. post subsidized job phase; monitor and support for 6 mos.
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Implementation
2 year contracts with administering agencies
17 Project Contractors
~700 businesses have committed to hiring program participants
~3,300 participants
~1,000 secured unsubsidized work
Contracts ended June 30, 2012
Last participants placed in Dec 2011 to allow for
6-mos service period
In practice: some continuing
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Decision Timeline
In the upcoming budget cycle, the decision to
end, continue, expand or modify the project will
be made in the following steps:
The Department of Children and Families and
the Department of Workforce Development
will submit budget requests by September 15,
2012;
The Governor releases his budget in January
2013;
The Legislature will debate the budget
through the session and pass a budget in
June 2013, operational on July 1, 2013.
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How does TJ HIA improve decision making?
Specific health impacts of the jobs program –
work permit policymakers to consider
whether jobs programs provide additional
benefits beyond alternative methods of
income support.
Health very broadly defined
i.e.: mental health, violence, and
community health
Model health outcomes for different target populations to inform possible program designs
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Research Process
Steering Committee
DCF, DWD, legislators, community
organizations, technical experts
Still seeking business representation
Lit Reviews
Departmental data?
Projections / forecasting
Focus groups and key informant interviews
Participants and policymakers
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What constitutes
evidence?
(EBHP is) an approach that “helps people make
well-informed decisions about policies,
programmes and projects by putting the best
available evidence from research at the heart
of policy development and implementation”
(Huw Davies, 2004)
Questions. “what works?” AND “what is the nature of the problem?” “why does the problem occur?”
and “what are different ways the problem might
be addressed?”
Evidence. Research and evaluation studies AND
monitoring data, expert knowledge, and
information from stakeholder consultations. State
Studies, Case Studies, Best-Practice Reports.
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Transitional Jobs
Health Impact Assessment
What this
means for the
Institute
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Beyond this Project
Grant provides national visibility for UWPHI as
a leader in HIA
Morgridge Challenge Grant for service
learning course to develop capacity for
emerging professionals
Advantage of PHIs as administrative homes
Shifting political winds leave HIA vulnerable
PHIs consistent, sustainable, non-partisan,
credible
Broad intellectual resources
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“To translate public health and health policy
research into policy and practice”
Engagement with “real-world” problems Timely and relevant
Community Engagement: Bridge to public health and health policy practitioners Promotes partnerships / breaks down barriers between
research producers and users; academia and community
Supports community health improvements Community identified Builds community capacity
Develops cross-sector collaborations Demonstrate how broad social, physical, economic
determinants of health operate Improve evidence base for programs/policies that improve
health (data collection, evaluation opportunities, analysis)
UWPHI Mission
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Example
Natural fit
Opportunity to create evaluation standards
Process
Outcome
Impact
Match
Policy
Evaluation
PHI
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How does HIA fit into your
work?
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Transitional Jobs
Health Impact Assessment
Thank you!