www.designforhealth.net design for health august 13, 2007 health impact assessment kevin krizek...

www.designforhealth.net

Design for HealthAugust 13, 2007

Health Impact Assessment

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Design for Health



Health Impact AssessmentAgenda

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I. What is a Health Impact Assessment (HIA)?

II. What is special about the Design For Health HIA series?

III. What are the types of HIAs?

IV. What type(s) of HIA is best for your community?

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Health Impact AssessmentWhat is a Health Impact Assessment?


• Identifies and evaluates the effects of policies, plans, programs, and designs on the health of a population.

• Health impact = changes in health of an individual or group due to a project, program, policy, or plan

• Typically done before, during, or after the preparation of a project of plan

• Comes in a variety of forms

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Health Impact AssessmentWhat is different about our HIA series?


•Characteristics of traditional HIAs:

• Led by public health experts

• Focus on the social environment

• crime, economic development, affordable housing, etc.

• Most are very general, linked to broad health outcomes

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Health Impact AssessmentWhat is different about our HIA series?

Design for Health HIA:• Targets urban planners

• Comprehensive planning• Plan implementation• Development review

• Focuses on areas of the built environment of relevance to planners.

• Addresses a wide range of health issues, but only those where there is evidence of a health effect.

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Health Impact AssessmentWhat are the different types of HIAs?


1. Preliminary Checklist (also called an audit)

2. Rapid Assessment

3. HIA Threshold Analysis (a form of “intermediate” HIA)

4. Comprehensive HIA

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Preliminary ChecklistOverview

• First step in HIA process

• Checklist/survey of health issues

• Determine if further assessment is needed

• Quick

• Point-based Car

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Preliminary ChecklistOverview

• Assesses significance of project, plan, or policy in terms of its size and scope

• Is it significant enough to assess?

• Does the plan or proposal meet some initial thresholds for a healthy community?

• Initial scan of impacts

• Helps determine whether additional analysis is needed C

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Preliminary Checklist


Part I: Is it significant enough to assess?

1. Geographic extent

2. Reversibility

3. Population or workforce increase

4. Cumulative impact

5. People affected

6. Land use change

7. Institutional capacity

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Preliminary ChecklistPart 1: Is it significant enough to assess?

Key Questions No Uncertain Yes

Geographic extent: Does it apply to a geographic area of a full city block or larger?

0 1 2

Cumulative impact: Is it occurring in a place where specific local health problems have been identified (e.g. traffic safety, air quality, lack of health foods, contaminated brownfields)?

0 1 2

People affected: Does the project or plan affect vulnerable groups (e.g. children, older people, people with lower incomes)?

0 1 2

Total + + =

If total score is 11 or greater, HIA may be needed, less than 7, move to Part 2. If total score is 7-10, a HIA is potentially needed, moving to Part 2 recommended.If total score is 6 or less, no HIA required. You may wish to do one on a targeted area or problem.





Part 2: Does the plan/policy/project meet thresholds?

1. Accessibility

2. Physical Activity

3. Social capital

4. Air Quality

5. Water Quality

6. Food

7. Safety

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Key Questions No Uncertain Yes

Accessibility: Is there regularly scheduled transit service within ¾ miles of all residential and employment areas?

2 1 0

Air quality: Are there any residential areas or schools within 200 meters of a major auto-related transportation corridor such as a freeway or road with six or more lanes?

0 1 2

Food: Are there supermarkets or fruit and vegetable stores located within a mile of each home?

2 1 0

Total + + =

If total score is 13 or greater, it is recommended that you conduct an HIA.If total score is 8-12, an HIA is potentially needed.If total score is 7 or less, no HIA required. You may wish to do an HIA on a targeted area or problem.

Part 2: Does the plan or proposal meet some initial thresholds for a health community?



Preliminary ChecklistUsing the HIA

• Who is involved?

• City staff – planners, engineers, parks, public health, others

• Public

• Elected/appointed officials

• Other agencies/organizations

• What is required?

• Time varies

• Basic knowledge of the project, plan, or policy C

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Preliminary ChecklistUsing the HIA

• What are the outcomes of a preliminary checklist?

• Knowledge about the connections between health and planning

• Additional HIA may be needed

• Key health concerns may emerge

• Need for scoring adjustments to reflect local values and conditions

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Rapid Health Impact Assessment

1. Big idea2. Participants3. Information4. Agenda/workshop5. Results

Design for Health



Rapid AssessmentCharacteristics


1. More time intensive • Few weeks to prepare• One-half day to

conduct• Few weeks to write-

up

2. Participatory focus group workshops

3. Prospective

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Rapid AssessmentSteps to Prepare for the HIA


1. Identify and gather participants

• Steering committee, stakeholders, etc

2. Gather information

• Inventory of existing plans/policies, creating an area profile, talking to those affected

3. Run the workshop

4. Write-up the results and move forward



Several Types of Results• Report – introduction, information, results of the

workshop, recommendations for changes• Implementation e.g. results incorporated into plan• Evaluation – Michigan Public Health Institute is doing a

process and outcome/implementation evaluation• Monitoring – of implementation

Rapid Assessment

Results



Rapid AssessmentHow can planners use the results?

1. Determine if a more detailed HIA is needed

2. Determine the financial and political risk

3. Use to make changes to plan, policy, or project

4. Identify methods to monitor and evaluate health outcomes

5. Educate city staff and stakeholders

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Threshold AnalysisCharacteristics


1. Potentially time intensive for data preparation

2. Detailed

3. Lists thresholds

4. Requires evidence

5. Point-based

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Where to use in the HIA process?

• Most rapidly evolving of the types of HIAs being developed

• Best used later in the planning process



Characteristics of the Threshold HIA

• Most specific in the suite of HIA tools provided by Design for Health.

• Informed by synthesizing and digesting available research. – What does the “research

tells us”– How strong/clear is that

research– How can it be applied to

more specific projects or plan proposals



Structure of the Threshold HIA

• Uses same categories of public health categories as other tools in the Design for Health HIA suite

• Further breaks these areas down into 20 or so specific criteria

• Requires specific knowledge of the plan or project (e.g., specific information or characteristics about plan element or development proposal

• Scoring is based on sliding scale



Topic: Accessibility

Threshold Analysis (Draft)

Intent Ensure adequate transit service.

Rationale Transit service not only provides alternatives to auto-travel, but provides means of mobility for the elderly, young and/or financially disadvantaged.

Requirements Residential components of the plan are built at an average of more than seven units per acre

Definitions Need to consider net density.

Submission Site plan with density calculations.

Possible Credits

1 for 7 units per residential acre; 2 for 7 units per gross acre

Credits Awarded

Transit Service (Threshold)



Types of HIAsHow do you choose which type of HIA your community should use to inform plan, policy, or project decisions?

Questions that planners should ask:

Are there only very limited resources available to conduct a HIA?

Is there only limited time to conduct an HIA?

Will the HIA only have limited influence?

Is the timeframe for the decision-making process set by external factors beyond your control? Is it relatively short?



Health Impact AssessmentAgenda


I. What is a Health Impact Assessment (HIA)?

II. What is special about the Design For Health HIA series?

III. What are the types of HIAs?

IV. What type(s) of HIA is best for your community?

Ann

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rsyt

h



Health Impact Assessment For more information visit www.designforhealth.net

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