The Health-Impact Assessment (HIA): A Useful Tool

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The purpose of this quick guide is to introduce health-impact assessment—an exciting and relatively new analytic approach to planning healthier communities. “How are existing or planned land use, community design, and transportation policies, projects, or programs affecting or likely to affect public’s health?” (NACCHO). Recently endorsed by the nationwide health promotion plan Healthy People 2020, health-impact assessment is one method local communities can use to begin to address this question. In today’s society, media coverage of health topics such as smoking and obesity has become the norm. Issues that used to be thought of as individual problems have grown into public health concerns and are forcing society to rethink how choices made in various sectors affect health. Health-impact assessments (HIAs) are rapidly growing practices within the United States that can help decision-makers outside of the health sector evaluate the potential health effects of proposed projects and policies. An HIA can be defined as “a combination of procedures, methods and tools by which a policy, program or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population” (1999 Gothenburg consensus statement). It is becoming increasingly clear that many of the things that determine health, disease, or injury lie outside of the traditional health sector. Uncovering these determinants is imperative in restoring the nation’s health. Both revolutionary and surprisingly intuitive, the HIA methodology simply seeks to evaluate public-policy decisions on their likely human outcomes. With the central and sole assumption that peoples’ health, vitality, and longevity ought to guide significant policy decisions, HIAs can be used as a planning tool to confront the social determinants of health amid the growing consensus that there are many social, environmental, and economic factors that affect health. There are vast opportunities for the use of HIAs. They can be used to assess the health impacts of seemingly small plans to those of complex land-development efforts. For example, deciding where to place a playground may seem irrelevant, but the realization that children must cross a busy highway to get there could lead to plan revisions that make access more practical and lead to greater use and physical activity. Decisions made regarding community design, development and policy implementation have the potential to impact the health of surrounding populations. safely than when they have the perception of a “neighborhood expressway.”