Health impact assessments (HIAs) gauge the impact that a policy, program, or law could have on a population’s health. HIAs have been applied to a range of decisions including those addressing transportation, housing, social and economic policy, natural resources and energy, and education. They aim to provide policymakers with information and recommendations informed by qualitative and quantitative data from multiple sources, including input from community members and other stakeholders, in order to improve decision-making.
The Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts, was established in 2009 to promote and support the use of health impact assessment in the United States. To date, the project has invested more than $20 million in advancing the field –funding more than 100 assessments, supporting training for more than 1,300 individuals, and serving as a convener for practitioners.
Part of the de Beaumont Foundation’s mission is to strengthen the public health system. With that in mind, in 2014 the Foundation partnered with the Health Impact Project to encourage urban health departments to perform HIAs–Boston, Chicago, and Maricopa County (Phoenix) were funded to conduct HIAs in their respective cities.
Boston chose to focus specifically on a measure that would propose changes to the city’s living wage ordinance. Evidence shows that there is a direct tie between income and health outcomes, and the work in Boston demonstrates the impact that raising wages can have on individuals and their families.
In 2016, Boston’s Mayor lauded the Boston Public Health Commission’s health impact assessment, saying, “This Health Impact Assessment is another step in the process we’re taking to make all of our city’s labor and wage laws work for our residents. I thank all of our partners and the Boston Public Health Commission for their work on this report and look forward to our important work ahead to provide our residents with the tools and services they need to become financially empowered.” Read the full report.
Chicago examined a particular decision about the built environment. There is a two-mile corridor in the city that is currently overgrown and vacant; this team looked at the impact of a proposed greenway trail and urban agriculture zone on the local community. The result was the Eastside Greenway Health Impact Assessment, which provided practical recommendations for using the proposed greenway to address fear of crime, the need for public exercise areas, and social cohesion in underserved neighborhoods.
Maricopa County, AZ took a slightly different approach. In this video, produced by the Maricopa County Department of Public Health, the participants of this HIA talk about the benefits of a shared-use agreement with the local public school system. As described by the Maricopa County Department of Health, a shared-use agreement can be defined as “opening school buildings and grounds during non-school hours for community use.” This will allow community members to access and use school-owned property for things like exercising, community gardening, and other activities that can lead to better health. Read the full report or executive summary.
HIAs are one tool in the toolbox. For these three communities, the process has been a powerful mechanism for informing decision-makers and engaging community members. It will be interesting to see if the skills learned by the local public health practitioners will translate into wider use of health impact assessments in these three urban areas, and serve as a model for other jurisdictions.