Introduction to Health Impact Assessment

1. Monday, November 21, 2011 3:00 – 4:30 p.m. Introduction to Health Impact Assessment Mandy Green Oregon Public Health Division Andrea Hamberg Oregon Public Health Division Steve White Oregon Public Health Institute Muriel DeLaVergne-Brown Crook County Health Department

2. Agenda 3:00 Welcome 3:05 Introduction to HIA 3:20 Case study 1: Portland to Lake Oswego Transit 3:30 Q & A 3:35 The steps of HIA, focus on screening 4:00 Case study 2: Crook County Bicycle and Pedestrian Plan 4:15 Q & A; Discussion 4:25 HIA resources; Evaluation

3. WHO Definition of Health Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.

4. Health Determinants

5. What is Health Impact Assessment? The International Association of Impact Assessment defines HIA as: a combination of procedures, methods and tools that systematically judges the potential, and sometimes unintended, effects of a policy, plan, program or project on the health of a population and the distribution of those effects within the population. HIA identifies appropriate actions to manage those effects.

7. What happens in an HIA? affect Democratic process Housing Air quality Noise Safety Social networks Nutrition Parks and natural spaces Private goods and services Public services Transportation Social equity Livelihood Water quality Education How does the proposed project, plan, or policy, and lead to healthoutcomes?

8. Why do HIA? To minimize negative and maximize positive health impacts of future projects, plans and policies Raise the profile of health in other sectors Employ a truly preventive approach Promote a holistic definition of health Reconnect public health with urban planning Ensure involvement of the community Explicit focus on equity and social justice Health is a shared value!

9. Who Participates? Those who may be impacted Community members Those who can offer information and expertise Community organizations Advocacy organizations Public and regulatory agencies, like public health, planning, transportation, housing, EPA, schools Consultants Universities Decision makers Public and regulatory agencies Elected officials Local, regional government

10. HIA by any other name • Who does it now? • Nonprofits and advocacy groups • Local health department staff • Epidemiologists and researchers • Health care sector • Land use planners • Environmental agencies Similar Activities Community organizing Public participation Advocacy Policy Analysis Precautionary approaches Risk Assessment Community Assessment Environmental Impact Statements

11. 5 Steps of Health Impact Assessment STEP Screening Scoping Assessment Reporting Evaluation/ Monitoring Decide if a HIA is feasible, timely and adds value to the decision-making process Create a plan that defines priority issues, research questions and methods, and participant roles Provide profile of existing conditions, evaluation of potential health impacts, and evidence-based recommend-ations Develop HIA report and communicate findings and recommend-ations Track the impact of HIA on decision, decision-making process, and health determinants Objective

12. Questions?

13. Screening and Impact of OPHIs Recent HIAs Steve White steve@orphi.org Oregon Public Health Institute www.orphi.org Oregon Health Authority HIA Webinar November 21, 2011 Full reports available at: http://www.orphi.org/healthy-community-planning/health-impact-assessments

14. Screening: HIA Goals • Pick projects that… • Fulfill grant requirements • Transportation-related strategies for mitigating climate change • Complete in 2010 • Develop new assessment methodologies • Build on existing partnerships • Metro • Bureau of Planning and Sustainability • Develop OPHI’s HIA capacity • Educate multi-sectoral partners about HIA and about the links between their decisions and public health and the need for, and value of, considering health impacts when they make their decisions and develop their plans, policies, and projects

15. Screening: Process Solicited ideas from partners HIA Network Individual meetings with staff from agencies interested in partnering with us on an HIA Metro Bureau of Planning and Sustainability

16. Screening: Process • Developed our criteria…

17. Screening: Process • And made our selection!

18. Impact of our HIAs • Outcomes of findings and recommendations: • LOPT HIA cited in support of Portland’s decision to recommend the streetcar option (final decision by Metro yet to be made) • SE 122nd Ave HIA report helped support a broader effort to make healthy, pedestrian-focused neighborhood design a central goal of the Portland Plan and Comprehensive Plan Updates • “Healthy, Connected Neighborhoods” is one of four main goals of the Portland Plan

19. Impact of our HIAs • Outcomes of the process: • Relationships were strengthened and champions were cultivated • Both agencies continue to work with us to explore multiple ways to integrate health into their decision-making • Both agencies have staff that understand HIA and key public health concepts and concerns • OPHI has been contacted by other agencies interested in conducting HIAs.

20. 5 Steps of Health Impact Assessment STEP Screening Scoping Assessment Reporting Evaluation/ Monitoring Decide if a HIA is feasible, timely and adds value to the decision-making process Create a plan that defines priority issues, research questions and methods, and participant roles Provide profile of existing conditions, evaluation of potential health impacts, and evidence-based recommend-ations Develop HIA report and communicate findings and recommend-ations Track the impact of HIA on decision, decision-making process, and health determinants Objective

21. When do you conduct an HIA? The project, plan, or policy has been proposed, a final decision about whether to adopt the proposal has not been made, and there is sufficient time to conduct an analysis before the decision is made.

22. Does the HIA add value? The decision has the potential to affect, positively or negatively, environmental or social determinants of health that impact health outcomes of a population—and those health impacts are not being or likely to be considered without the HIA

23. Do you have the resources? • Expertise, evidence, and research methods, or access to experts • Capacity to influence decision-makers • Partners are available to participate in the HIA • Internal resources – staff time and skills

24. Resources Source: Harris et al., HIA: A practical guide, 2007.

25. 5 Steps of Health Impact Assessment STEP Screening Scoping Assessment Reporting Evaluation/ Monitoring Decide if a HIA is feasible, timely and adds value to the decision-making process Create a plan that defines priority issues, research questions and methods, and participant roles Provide profile of existing conditions, evaluation of potential health impacts, and evidence-based recommend-ations Develop HIA report and communicate findings and recommend-ations Track the impact of HIA on decision, decision-making process, and health determinants Objective

26. Size

27. Who will participate in the HIA? • Who are the stakeholders in the proposed project? • Who are the decision-makers? • Who are the people most likely to be impacted? • Are there any populations who are particularly vulnerable? • Will you have a working group conduct the HIA? • Will you have a steering committee? Advisory group? • What role(s) will all these people have in the HIA?

30. 5 Steps of Health Impact Assessment STEP Screening Scoping Assessment Reporting Evaluation/ Monitoring Decide if a HIA is feasible, timely and adds value to the decision-making process Create a plan that defines priority issues, research questions and methods, and participant roles Provide profile of existing conditions, evaluation of potential health impacts, and evidence-based recommend-ations Develop HIA report and communicate findings and recommend-ations Track the impact of HIA on decision, decision-making process, and health determinants Objective

36. 5 Steps of Health Impact Assessment STEP Screening Scoping Assessment Reporting Evaluation/ Monitoring Decide if a HIA is feasible, timely and adds value to the decision-making process Create a plan that defines priority issues, research questions and methods, and participant roles Provide profile of existing conditions, evaluation of potential health impacts, and evidence-based recommend-ations Develop HIA report and communicate findings and recommend-ations Track the impact of HIA on decision, decision-making process, and health determinants Objective

38. 5 Steps of Health Impact Assessment STEP Screening Scoping Assessment Reporting Evaluation/ Monitoring Decide if a HIA is feasible, timely and adds value to the decision-making process Create a plan that defines priority issues, research questions and methods, and participant roles Provide profile of existing conditions, evaluation of potential health impacts, and evidence-based recommend-ations Develop HIA report and communicate findings and recommend-ations Track the impact of HIA on decision, decision-making process, and health determinants Objective

39. Questions?

40. Case Study: Bike & pedestrian plan HIACrook County, Oregon

41. Case Study: Bike & pedestrian plan HIACrook County, Oregon HIA Overview: • Decision point: update to community plan to be approved by Prineville City Council • Physical activity • Pedestrian and bicycle safety • Accessibility to bike and pedestrian infrastructure

42. Case Study: Bike & pedestrian plan HIACrook County, Oregon HIA Process: • Screening • Listening sessions • Windshield survey • Literature review • Reporting and presentations • Follow-up to evaluate impacts

43. Case Study: Bike & pedestrian plan HIACrook County, Oregon Poor quality existing bike path

44. Case Study: Bike & pedestrian plan HIACrook County, Oregon Crosswalk near school: not lit in the evening; unsafe crossing

45. Case Study: Bike & pedestrian plan HIACrook County, Oregon Findings: • Improving the safety and accessibility of sidewalks and walking paths in Prineville: • • Increase current sidewalk connectivity (Harwood St., Elm St., Ochoco Creek Park, Lynn Blvd., Combs Flat Rd., etc.). • • Pursue “Rails to Trails” funding. • Improving the safety and accessibility of bicycle use in Prineville: • • Increase existence of bicycle lanes in Prineville / Crook County. • • Create connectivity of bicycle lanes. • • Reduce/eliminate parked cars in bicycle lanes. • • Bicycle safety education and enforcement. • • Increased bicycle parking facilities throughout Prineville. • Identifying key areas in our community for pedestrian safety: • • Develop a process for prioritizing pedestrian route improvements based on demand, existing conditions, and proximity to a designated Safe Route to School corridors. • • Signage to direct individuals to walking paths in the community. • • Develop a pedestrian education campaign. • • Implement traffic calming, including clear identification of school speed zones, specifically on Lynn Blvd for CCHS and CCCS. • • Improve sight distances for turning cars where needed. • • Create a safe crossing area for Highway 126 near (or under) Crooked River bridge • • Create strategic plan for student drop off and pick up around all school zones and educate students and parent regarding plan

46. Case Study: Bike & pedestrian plan HIACrook County, Oregon Impacts and next steps: • Report to Prineville City Council and community • Planning Department has implemented some recommendations • Evaluate project and outcomes • Continue the integration of HIA into future work

47. OHA: Lessons learned • In-person training is critical to success • Select assessment methods that meet your needs • Select appropriate reporting methods • The relationships built within the counties are the most beneficial impact from the program

48. Questions?

49. Oregon HIA Capacity Building Initiative Goal Build local and state capacity to evaluate the health effects of projects and policies, and to provide the information to decision makers Activities Conduct and support HIA projects in Oregon Provide training and technical assistance Identify, assess and share resources Raise awareness about HIA Build and maintain relationships that support HIA in Oregon, the Pacific Northwest, and nationally Funding 2009-2011 one of four states funded by ASTHO 2011: Awarded a 3-year capacity building grant by CDC

50. HIAs funded through Oregon’s Capacity Building Program Oregon county HIAs, funded by OHA Walkability/Safe Routes to School—Wasco County/North Central Health District Accessory Dwelling Units – Benton County Tumalo Community Plan—Deschutes Barrett Park Development—Hood River County Bicycle and Pedestrian Master Plan—Crook County OHA-led HIA Biomass Boilers – Statewide Wind Energy – Statewide (in assessment) Climate Smart Communities – Portland Metro Region (in screening) OHA-supported HIA Climate Action Plan – Eugene Lake Oswego Transportation Plan – Lake Oswego