HIA Blog

Oregon Health Authority HIA Program Position (Closes soon!)

2013-05-16T11:05:00.002+10:00

From the position announcement:

OHA's HIA Program envisions an Oregon where human health and the distribution of health impacts are actively considered in relevant projects, policies, and plans across sectors. The Program is focused on catalyzing change in three key areas: promoting health impact assessment (HIA) among decision-makers and community partners; institutionalizing HIA practice into existing mechanisms; and expanding support for practitioners. We are seeking an epidemiologist/public health scientist to join our team to provide technical leadership on HIA projects and advance the consideration of health in Oregon.

The position closes on May 20. Click below to view the announcement:

http://agency.governmentjobs.com/oregon/default.cfm?action=viewjob&JobID=647683

U.S.A. Southeast Regional HIA Summit

2013-05-16T10:58:00.003+10:00

From the organisers:

Registration is now open for the first ever Southeast Regional HIA Summit! July 31 – August 2, Davidson, NC.

This is NOT your typical conference. Let’s face facts…HIA practitioners are a special breed of people who are creative enough to bridge the gap between multiple fields and operate outside of the box on a daily basis. Whenever we get together the atmosphere is more like a family reunion than a meeting. Add in the small-town charm of Davidson, NC and southern hospitality and you just know you are in store for a good time.

Here’s what the first Southeast Regional HIA Summit has to offer:

Opportunities to LISTEN: Hear from Dr. John Santopietro, M.D., Carolinas HealthCare System, on The State of Mental Health in the U.S. and Mitchell Silver, AICP, Past President of the American Planning Association on Building Healthy Communities.

Chances to LEARN: From each other during small group discussions− HIA Speed Dating, HIA Tool Exchange, Troubleshooting your HIA, Developing the HIA Message, Sustaining an HIA Program, and HIA and Health Equity.

Time to HAVE FUN: Networking during community activities including bicycling on Davidson’s greenway, paddling on Lake Davidson and viewing the Davidson Design for Life Documentary at Our Town Cinema.

And much, much more!

Likely participants include: HIA practitioners, researchers, and funders; professionals and educators from the fields of planning, policy, and public health; and interested government officials and not-for-profit leaders. To get the most out of the Summit, you should have direct experience in conducting HIA; be currently involved in conducting your first HIA; or at least have a basic understanding of the process and principles of HIA.

Everything you need to know about the Summit may be found on our web page:

Preliminary schedule-of-events

Hotel information

Online registration or a printable registration form (Early Bird Registration Deadline is June 15)

Travel scholarship

How to get to Davidson, NC

For more information and questions, please contact Courtney Spear, Summit Conference Planner at 704.400.0880 or courtneyhspear@gmail.com

Impact Assessment: The Next Generation, the program of #iaia13 is available

2013-05-03T21:20:00.001+10:00

Focus on Health - 14 May

The diversity of HIA practice worldwide is both a challenge and an asset, and the IAIA 2013 Health Day presents an ideal opportunity to facilitate dialogue across HIA practice globally. The Health Day and the other health-related activities will explore the importance of health within the Impact Assessment process, will enable IA practitioners to reflect on key lessons learned through the application of HIA, and will conclude with an examination of how HIA needs to evolve to be a better fit for the challenges ahead.

The one below is just a short summary, check the whole event program and the details of the presentations on the final program. At page 20 you find the details of the Health Day

6.1 Integrating health in impact assessments: Opportunities not to be missed

6.2 The science and art of international: HIA practice: Reflecting the range of HIA practitioners

6.3 The science and art of international: HIA practice: Old issues and new applications

6.4 The science and art of international: HIA practice: Let’s discuss

6.5 The science and art of international: HIA practice: Example from the industry

6.6 Using health impact assessment to achieve sustainable goals

14.6 Community responses to the next generation of energy technologies

See you in Calgary!

HIA Gateway Updates

2013-05-03T10:44:00.001+10:00

The HIA Bibliography has recently been updated, April 2013, and 50 new references were added. It is updated quarterly. If you have any relevant published papers you think should be on this list please forward to HIA Gateway We are now part of Public Health England. Public Health England will use use your information (as registered on the HIA Gateway) in the same way as we previously used your information and will not use it for any other purposes. We will ensure these details remain secure. If you no longer wish to continue receiving this monthly email and remain registered with the HIA Gateway, please contact the HIA Gateway: bwh-tr.hia@nhs.net .

Conference: From local to global – Health Impact Assessment to face new challenges

2013-04-09T14:14:00.003+10:00

From the organisers:

The 13th International Conference on Health Impact Assessment (HIA) will take place on 2-4 October 2013 in Geneva, Switzerland.
Please download the guiding document for the conference, which gives a first taste of the various tracks which are planned. The call for papers will be sent out in a few days. At the same time, the information about the abstract submission will become available on the conference website.
Key dates to remember:

Abstract submission deadline: 31 May 2013

Date of the conference: 2-4 October 2013

Mental Health Impact Assessment Report

2013-04-05T10:00:00.000+11:00

From Lynn Todman at the Adler Institute on Social Exclusion:

Our report “U.S. Equal Employment Opportunity Commission Policy Guidance: A Mental Health Impact Assessment” has been completed and is available to you at adler.edu/MHIA

This report is the culmination of our 18-month study examining how changes in federal law regarding the use of arrest records in employment decisions would affect Chicago’s underserved Englewood neighborhood. The report also details the Mental Health Impact Assessment (MHIA) process that we employed at the Institute on Social Exclusion at the Adler School of Professional Psychology, constituting an important advance and contribution to the practice of Health Impact Assessment (HIA).

As you know, it is common for U.S. policy makers to consider factors like the natural environment, human physical health, and economic impact in their decision-making processes. Environmental Impact Assessments, Health Impact Assessments, and Economic Impact Assessment are increasingly common. However, assessments that evaluate psychological or mental health impacts are rare, despite the fact that mental health is an essential element of healthy communities.

The MHIA process is intended help policy makers assess how changes in public policy may help or harm the mental health of communities, especially the most vulnerable. It is also a useful tool in helping to narrow health inequities, and will become increasingly important in light of dwindling mental health resources and support. Conducting an MHIA can help ensure that policies that are implemented will help reduce health inequities, and improve the health and wellbeing of communities and the nation.

Thank you for your interest in our work. If we can answer questions or provide more information for you, please contact us at ISE@adler.edu

Support HIA Research in East Africa

2013-04-04T08:19:00.000+11:00

CIHR Project Page

Kevin Pottie from the University of Ottawa and his colleagues in Canada have submitted a CIHR grant application to support the use of HIA by social entrepreneurs in East Africa. You can support their application by visiting the project page and clicking the like button, which is one of the factors CIHR considers.

The Rise of HIAs in the United States

2013-04-03T12:11:00.000+11:00

The Health Impact Project has put out a nice infographic about the use of HIA across the U.S.:

Source

The untapped potential of health impact assessment

2013-04-02T09:52:00.002+11:00

A fascinating paper by Mirko Winkler and colleagues has been published in the WHO Bulletin:

Countries and regions that are promoting HIA's use or have produced HIA guidance. Source

A paper on the “untapped potential of health impact assessment” has been published in the current issue of the Bulletin of the World Health Organization. In this policy and practice piece, current health impact assessment (HIA) practice is summarized, the potential of HIA to become a critical player with the major drivers of global change (e.g. population growth and urbanization, growing pressure on natural resources and global climate change) is outlined, and it is discussed where and how HIA can become fully integrated into the impact assessment suite. HIA has an important role to play in of the unfolding 21st century’s sustainable development agenda, and if the Rio+20 agenda is to genuinely benefit vulnerable populations, then “health” must be an equal participant and partner at the table.

Link to article

HIA Gateway moving and changing but still staying the same

2013-03-28T23:13:00.000+11:00

Fro Dr Sue Wright, HIA Gateway Manager:

The HIA Gateway is moving. It is part The Network of Public Health Observatories group (this was previously known as the Association of Public Health Observatories) but from 1^st April the website (including myself) is moving into an executive agency of the Department of Health, called Public Health England (PHE). The HIA Gateway will become part of the PHE portal (website) and this in turn will be accessed from the English Government Domain website: www.gov.uk . This means that the HIA Gateway is now secure for the foreseeable future.

The term "HIA Gateway" will remain but may become "PHE HIA Gateway" or Public Health England HIA Gateway and existing URLs for the HIA Gateway will still be operational and you will be redirected to the HIA Gateway landing page on the PHE portal.

I am unclear at this stage if the monthly emails will still be sent out nor if and how people will be able to register with the HIA Gateway alone. Registration with the HIA Gateway has ensured you receive a monthly email listing recent resources added to the website.

I will also be contacting those people on the People’s Directory and Contractor’s Directory in the near future to check if they wish to remain on the HIA Gateway now it has moved into PHE.

Thank you for your continuing support and if you have any HIAs or other resources you think relevant to the practice of HIA, MWIA or any other health related Impact Assessment, do please forward these on to me (or if you prefer links to these).

*********************************************************************************

Take home key points:

The HIA Gateway will become a formalised part of the new national public health agency of England.
www.hiagateway.org.uk will still direct you to the HIA Gateway site as it currently does.
Those using the existing actual URL should check to ensure that they have updated the URL to the new one generated when the site becomes a micro-site of the larger Public Health England website or use www.hiagateway.org.uk.
Please continue to email Sue with your HIAs and other resources so she can put them on the site.

*********************************************************************************

Extracting the facts: an investor guide to disclosing risks from hydraulic fracturing operations

2013-03-26T02:44:00.000+11:00

This guide by the Investor Environmental health network offers best practice recommendations to energy companies for reporting and reducing risks and impacts from natural gas operations in shale relying on hydraulic fracturing (commonly referred to as "fracking"). The guide can be a resource for companies responding to the Securities and Exchange Commission's growing interest in the environmental risks from fracturing operations, especially chemical and water management, and assists companies seeking to implement a November 2011 US Department of Energy advisory panel recommendation that companies "adopt a more visible commitment to using quantitative measures as a means of achieving best practice". The guide suggests goals, practices and indicators, providing existing examples from numerous companies.

Synopsis

The guide is organized around 12 core goals and supporting practices and indicators. These include:

1. Manage risks transparently and at Board level
2. Reduce surface footprint
3. Assure well integrity
4. Reduce and disclose all toxic chemicals
5. Protect water quality by rigorous monitoring
6. Minimize fresh water use
7. Prevent contamination from waste water
8. Minimize and disclose air emissions
9. Prevent contamination from solid waste and sludge residuals
10. Assure best in class contractor performance
11. Secure community consent
12. Disclose fines, penalties and litigation

Report webpage link

Report link

In alphabetical order, the full list of the 55 investors, investment management and institutional investor firms supporting the “best practices” guidelines for fracking are as follows: Adrian Dominican Sisters (USA); Adveq Real Assets, Adveq Management AG (Switzerland); APG All Pensions Group (Netherlands); As You Sow (USA); Australian Council of Superannuation Investors (Australia); Bon Secours Health System, Inc. (USA); Boston Common Asset Management, LLC (USA); Calvert Investments, Inc. (USA); Catholic Health East (USA); Catholic Health Partners (USA); Catholic Super (Australia); Ceres (USA); Christian Brothers Investment Services, Inc. (USA); Christopher Reynolds Foundation (USA); Compton Foundation (USA); Congregation Sisters of St. Agnes General Council (Fond du Lac, WI) (USA); Dexia Asset Management (Belgium); Dignity Health (USA); Domini Social Investments LLC (USA); Dominican Sisters of Hope (USA); Dominican Sisters of Mission San Jose (USA); Ethos (Switzerland); Everence Financial (USA); First Affirmative Financial Network (USA); Governance for Owners (United Kingdom); Green Century Capital Management (USA); Local Government Super (Australia); Maryknoll Sisters (USA); Mercy Investment Services (USA); Miller/Howard Investments, Inc. (USA); NEI Investments (Canada); Northwest Coalition for Responsible Investment (USA); Park Foundation (USA); Parnassus Investments (USA); Pax World Funds (USA); Portfolio 21 Investments (USA); Qube Investment Management Inc. (Canada); Regnan - Governance Research & Engagement Pty Ltd (Australia); Religious of the Sacred Heart of Mary, Western American Province (USA); Rose Foundation for Communities and the Environment (USA); Shareholder Association for Research and Education (SHARE) (Canada); Sisters of Charity of Saint Elizabeth (USA); Sisters of St. Dominic, Congregation of the Most Holy Name, San Rafael (USA); Sisters of St. Francis of Penance and Christian Charity, St. Francis Province (USA); Sisters of St. Francis of Philadelphia (USA); Sisters of St. Joseph of Orange (USA); Sisters of St. Louis, California Region (USA); Sisters of the Holy Family (USA); Socially Responsible Investment Coalition (SRIC) (USA); Swift Foundation (USA); The Sustainability Group at Loring, Wolcott & Coolidge Trust, LLC (USA); Trillium Asset Management LLC (USA); Ursuline Sisters of Tildonk, U.S. Province (USA); Walden Asset Management, a division of Boston Trust & Investment Management (USA); and Zevin Asset Management (USA).

Talking about windfarm health problems may make people more likely to feel they are suffer from them

2013-03-22T02:11:00.000+11:00

Interesting Guardian article and research study:

The Guardian article link "Windfarm sickness spreads by word of mouth, Australian study finds"

The study pre-print article "Spatio-temporal differences in the history of health and noise complaints about Australian wind farms: evidence for the psychogenic, "communicated disease" hypothesis" link

NEW TERM: communicated disease
TERM NEW TO ME (UPDATED): Nocebo (Placebo, is a non-medicinal substance that has positive and beneficial effect on health, a nocebo is a substance that has negative and harmful effect on health)

Guardian Extract:

Sickness being attributed to wind turbines is more likely to have been caused by people getting alarmed at the health warnings circulated by activists, an Australian study has found.

Complaints of illness were far more prevalent in communities targeted by anti-windfarm groups, said the report's author, Simon Chapman, professor of public health at Sydney University. His report concludes that illnesses being blamed on windfarms are more than likely caused by the psychological effect of suggestions that the turbines make people ill, rather than by the turbines themselves.

"If windfarms were intrinsically unhealthy or dangerous in some way, we would expect to see complaints applying to all of them, but in fact there is a large number where there have been no complaints at all," Chapman said.

The report, which is the first study of the history of complaints about windfarms in Australia, found that 63% had never been subject to noise or health complaints. In the state of Western Australia, where there are 13 windfarms, there have been no complaints.

The study shows that the majority of complaints (68%) have come from residents near five windfarms that have been heavily targeted by opponent groups. The report says more than 80% of complaints about health and noise began after 2009 when the groups "began to add health concerns to their wider opposition".

Study Abstract:

Background and objectives

With often florid allegations about health problems arising from wind turbine exposure now widespread in parts of rural Australia and on the internet, nocebo effects potentially confound any future investigation of turbine health impact. Historical audits of health complaints across periods when such claims were rare are therefore important. We test 4 hypotheses relevant to psychogenic explanations of the variable timing and distribution of health and noise complaints about wind farms in Australia. Setting All Australian 49 wind farms (with 1471 turbines) operating from 1993–2012.

Methods

Records of complaints about noise or health obtained from wind farm companies regarding residents living near 47 Australian wind farms, expressed as proportions of estimated populations residing within 5km of wind farms, and corroborated with complaints in submissions to 3 government public enquiries and news media records.

Results

There are large spatio-temporal variations in wind farm noise and health complaints. 31/49 (63%) of Australian wind farms including 17/34 (50%) with turbine size >1MW have never been subject to noise or health complaints. Western Australia has seen no complaints. Only 120 individuals across Australia representing approximately 1 in 272 residents living within 5km of wind farms appear to have complained, with 81 (68%) of these being residents near 5 wind farms which have been heavily targeted by anti wind farm groups. About 1 in 107 of those living near turbines >1MW have ever complained. The large majority (82%) of health and noise complaints commenced after 2009 when anti wind farm groups began to add health concerns to their wider opposition. In the preceding years, health or noise complaints were rare despite large and small turbined wind farms having operated for many years.

Conclusions

In view of scientific consensus that the evidence for wind turbine noise and infrasound causing health problems is poor, the reported spatio-temporal variations in complaints are consistent with psychogenic hypotheses that health problems arising are “communicated diseases” with nocebo effects likely to play an important role in the aetiology of complaints.

"There are already mechanisms in place": same old arguments against health impact assessment?

2013-03-21T12:18:00.004+11:00

The Australian Senate

The Australian Senate Standing Committees on Community Affairs released a report on Australia's domestic response to the World Health Organization's (WHO) Commission on Social Determinants of Health report "Closing the gap within a generation" last night. The response to the report seems lukewarm to me, though that may be coloured by my personal sense that this represents another missed opportunities for intersectoral action for health in Australia. The Social Determinants of Health Alliance released a fairly upbeat press release.

From an HIA and Health in All Policies perspective there are a few interesting sections. I'll post two reasonable lengthy excerpts below so you can make up your own mind. This is from the Government response section:

Adopting a Health in All Policies approach
4.46 The pre-eminent idea put to the committee to address the social determinants of health in Australia was for the Commonwealth government to adopt a similar mechanism as the South Australian 'Health in All Policies' (HiAP) approach to government action. HiAP is a horizontal health policy strategy that incorporates health as a shared goal across all parts of Government and addresses complex health challenges through an integrated policy response across portfolio boundaries.[54] As explained by representatives from the South Australian Government:

Health in All Policies is essentially an approach to working collaboratively on policy issues across government to enable joined up policy responses to complex, so-called wicked, policy goblins. The problems faced by the health department results from these wicked problems, such as obesity, chronic disease and health inequities. All of these have serious impact on health services and health financing and budgets, but health departments do not actually have the policy levers to address them. Other sectors and departments do have the policy levers—such as transport, agriculture, employment and education—however many of these agencies that are able to take action on these determinants of health and wellbeing do not see health as their business...Our version of Health in All Policies looks at how we can assist other agencies in meeting their goals, in a way that supports health and wellbeing...In South Australia the Health in All Policies approach is applied in the internal government policy process, focusing strongly on Health being a partner rather than a director in the public policy process.[55]

4.47 Under the South Australian model, in order to ensure that policies have considered potential health impacts, health impact assessments are used. Health impact assessments consider the potential health consequences of a policy.

4.48 A large number of stakeholders called for the Commonwealth to adopt HiAP approach similar to the one used by the South Australian government.[56]

Later in the chapter:

4.54 One argument put forward for the adoption of a health impact or equity assessment framework was that it would 'create a little bit more awareness and consciousness around how decisions we make in every government department impact on people's health and equity issues.'[62] The actions already taken by a number of state governments point towards some jurisdictions being well ahead of the Commonwealth when it comes to ensuring that there is a sufficient understanding of the social determinants of health within government programs. Improving the awareness of health in areas outside the traditional health field is to be encouraged.

4.55 Although the Department conceded that health impact assessments might be useful, it was argued that this needs to be considered alongside their time- and cost-heavy nature:

Health impact assessments have been promoted as a means of assessing the health impacts of policies, plans and projects using quantitative, quantitative and participatory techniques. While we think that they may be a useful tool, we believe that they have the potential to be expensive and time-consuming, and we believe that this needs to be taken into account in any further consideration of these.[63]

4.56 This point was expounded upon in the Department's supplementary submission:
In the case of both the South Australian Government and Tasmanian Health in All Policies Collaboration, key drivers have been established through legislation; in particular Public Health Acts, as well as state based strategic plans and/or targets. Duplication of such approaches at a national level could add further complexity to an already complicated environment without a clear mandate for action.[64]

4.57 The Australian Social Inclusion Board made a similar case against the use of a South Australian style approach:

The development of a more formally structured framework, such as the South Australian approach, could introduce ambiguity into existing Commonwealth mechanisms and therefore detract from the social inclusion narrative. It could also result in current measurement and reporting framework and social inclusion principles holding less currency.[65]

4.58 However, representatives from the Department argued that there was already adequate consideration given to health in public policy making:

An approach is taken, certainly by our department, that recognises the interconnectedness and complexity of the social determinants of health through integrated approaches to the development and implementation of social policy and programs, both at the Commonwealth level but also across all levels of government. Key aspects of the approach include a number of things: firstly, strong governance arrangements. Some examples of those are the Australian Social Inclusion Board, the Social Policy and Social Inclusion Committee of Cabinet and also COAG's standing committees that look into these issues...[W]e believe that other approaches can and are also being used to achieve coordination across sectors and levels of government.[66]

4.59 The committee did not receive any evidence in the form of improved health outcomes that the South Australian model is more effective than comparative systems. The diversity of international and domestic responses to rising awareness of the social determinants of health points to a field of practice undergoing rapid evolution of thought. As noted by the Chief Executive Officer of ANPHA:

We are not sure which approaches will work best. We have almost got a set of natural experiments going on in Australia, which we think ought to be evaluated before we come to a conclusion on that. The South Australian method is one way of doing it...We are not quite sure what will do the trick here. It is one of the reasons we looked at Canada so closely. They do a bundle of different things, and other countries have done different things as well.[67]

Committee view

4.60 The committee notes that the Department believes that it effectively takes a social determinants approach within its own policy making. However, the key point is that such an approach needs to be taken across government, and in particular in social, economic and employment policy decisions that affect social determinants (such as employment status, levels of welfare benefit, and access to education). The need for a social determinants approach lies not only within, but beyond, the health portfolio.

4.61 There are already mechanisms in place to ensure that important issues are considered across government when necessary, such as the requirements for inter-departmental consultation in the preparation of cabinet submissions, the requirement for Regulatory Impact Statements in conjunction with the introduction of legislation, and statements of compatibility with human rights.

4.62 Introducing a health in all policies approach of some sort would not therefore represent a completely new dimension to policy development. While the committee does not have a fixed view about how it should be done, the government's adoption of a social determinants approach should influence the policy development process, particularly in relevant areas such as education, employment, housing, family and social security.

There are a few familiar themes in this response that I've heard from government representatives over the years, from local health services to the World Health Organization:

HIA is expensive and time-consuming;
we're already doing addressing health in all our policy; and
HIA or HiAP would create duplication between levels of government and existing cross-sectoral policy initiatives.

All these assertions seem almost entirely without evidence to me. They may in fact be true but I haven't seen any empirical research that demonstrates them compellingly. Any discussions about expense and time investment should be in comparison to other interventions, rather than continuing to do nothing. HIA practitioners in many Federalist countries (e.g. Canada, U.S.A, Austria, Switzerland) have faced similar rationales to not develop an HIA or HiAP agenda at a federal level.

We need to be more assertive in calling out these kind of untested attitudes if we want to see further intersectoral action for health.

HIA 2013 - Geneva, Switzerland - 2-4 Oct 2013

2013-03-19T00:45:00.000+11:00

Date for your diary; the HIA International Conference is in Geneva, Switzerland and will take place between the 2-4 October 2013.

The website is at:

www.hianet2013.net [English]

www.eis2013.net [French]

Two HIA job opportunities in San Francisco

2013-03-14T11:38:00.000+11:00

Thanks to Tim Choi for letting us know about this.

The Program on Health, Equity and Sustainability is seeking a full-time Data Analyst and a Communications Specialist, who will be hired through the San Francisco Public Health Foundation, to support the San Francisco Department of Public Health's health impact assessment (HIA) work for a five month period.

The Data Analyst will support data collection, analysis and visualization used in HIA to inform public policy on housing and neighborhood conditions that impact health.

The Communications Specialist will develop impactful "storytelling" and visualizations that can be used to support future HIA work and policy recommendations on healthy housing and/or other key healthy community design initiatives.

Both positions have an anticipated start date of April 1, 2013.

More details here

Request for Proposals: Greenways and Green Infrastructure Health Impact Assessment

2013-03-13T07:01:00.000+11:00

Shelby County Government (Tennessee) is seeking proposals from interested and qualified consultants or consultant teams to conduct an assessment of the impact on public health of greenways, green infrastructure, and other green spaces, including how existing and planned greenways and trails in the study area impact public health. The consultant or consultant team will develop an assessment tool that can be used by the community to consider the health impacts of greenways, green infrastructure, and green spaces as part of the Mid-South Regional Greenprint and Sustainability Plan process and beyond.

Bids will be accepted through March 28, 2013 at 4:00 p.m. Central Standard Time

For more information, please visit shelbycountytn.gov/bids.aspx?bidID=534 to download the full RFP and bidding instructions.

Via American Society of Landscape Architects

Health equity impact assessment - new journal article

2013-03-11T16:00:00.000+11:00

New journal article from Sue Povall, Fiona Haigh, Debbie Abrahams and Alex Scott-Samuel at IMPACT.

Abstract

The World Health Organization's Commission on Social Determinants of Health has called for ‘health equity impact assessments' of all economic agreements, market regulation and public policies. We carried out an international study to clarify if existing health impact assessment (HIA) methods are adequate for the task of global health equity assessments. We triangulated data from a scoping review of the international literature, in-depth interviews with health equity and HIA experts and an international stakeholder workshop. We found that equity is not addressed adequately in HIAs for a variety of reasons, including inadequate guidance, absence of definitions, poor data and evidence, perceived lack of methods and tools and practitioner unwillingness or inability to address values like fairness and social justice. Current methods can address immediate, ‘downstream’ factors, but not the root causes of inequity. Extending HIAs to cover macro policy and global equity issues will require new tools to address macroeconomic policies, historical roots of inequities and upstream causes like power imbalances. More sensitive, participatory methods are also required. There is, however, no need for the development of a completely new methodology.

More: heapro.oxfordjournals.org/content/early/.../heapro.dat012.shor...

Funding available to support health impact assessments (HIAs) in Minnesota, USA

2013-03-07T22:32:00.000+11:00

Three grants of up to US$100,000 is available for conducting HIAs in Minnesota.

Brief proposals are due by Wednesday, May 15 2013.

Who Can Apply

The primary purpose of this project is to develop the capacity of Minnesota organizations to conduct HIAs. Eligible applicant organizations must be located in Minnesota and include:

state, tribal, or local agencies;
tax-exempt educational institutions;
tax-exempt organizations described in Section 501(c)(3) of the Internal Revenue Code (including public charities and private foundations).

Applicants need not have experience with HIA to apply. They should have knowledge of the decision-making process that they aim to inform and the ability to communicate effectively with all of the stakeholders, including individuals and organizations that will be affected by the decision, elected officials, and agency staff. Grantees will receive training, mentoring, and technical assistance from the Health Impact Project and leading HIA experts.

Key Dates

Tuesday, March 26, 2013

Request for proposals announced

Wednesday, May 15, 2013, 5:00 p.m. CT

Brief proposals due

Friday, May 31, 2013

Notification of full proposal invitation

Monday, July 1, 2013, 5:00 p.m. CT

Full proposals due through online application system

August 2013

Anticipated start date for selected projects

September 23, 2013

Grantee meeting

September 24-25, 2013

National Health Impact Assessment Meeting

August 2014

Anticipated end date for selected projects

Selection Criteria

All full proposals will be screened for eligibility and then assessed by a committee composed of Health Impact Project staff, Blue Cross and Blue Shield of Minnesota Foundation staff, and expert, external reviewers.

Selection will be based on the following:

Whether the HIA will inform a decision for a proposed policy, program, or project that is under active consideration. The proposals must address decisions that can be reasonably anticipated within or shortly following the grant period;
Significance of the pending policy, program, or project decision to health and health equity;
A strong plan for engaging key stakeholders—community members and community-based organizations, decision-makers, relevant public agencies and leaders, and others—at each step of the HIA;
A clear outline for disseminating the findings and supporting the adoption and implementation of the HIA recommendations;
Potential for the HIA to add to the decision-making process by addressing health issues that are not already known or may not be immediately obvious, by analyzing and clarifying complex health effects, by identifying any differential impacts on vulnerable populations, and by generating health-based recommendations not already under consideration;
The potential for the HIA to build new and enduring partnerships between public health organizations and nonhealth sectors such that health will be more regularly factored into future decisions;
A well thought-out staffing plan with adequate staff time and commitment of senior leadership;
Reasonableness of proposed budget and project timeline.

For more information see:

Request for proposals document [Microsoft Word 2007-2010 docx format file].

Grant opportunity announcement.

More about HIA in the USA.

Does health impact assessment protect health? Is that the right question?

2013-03-07T12:14:00.002+11:00

There's a thought-provoking piece at ABC Environment on Does environmental impact assessment protect the environment? The piece quotes several well-known Australian EIA academics about how well EIA in Australia is performing in terms of environmental protection.

There's no consensus in the piece about whether EIA is successfully protecting the environment or not, though some different ways of thinking about it are discussed. I think that's because the article dances around the core issue: what is the purpose of EIA? This may seem axiomatic and uncontested but I wonder if it's an under-examined difference between the goals and purpose of impact assessments.

In a sense we're lucky in the HIA field. The yoke of regulatory requirement and government mandate hasn't weighed us down too much... yet. Practice is still evolving and hasn't been circumscribed by regulations and legal challenge to the same extent as EIA. Because of this, my impression is that there's more acceptance that an HIA will probably have a limited impacts on health outcomes in itself. The stated goals of HIA are to protect health, promote health and to reduce health inequalities (and possibly to improve governance and public decision-making, as well as learning). HIA seeks to influence decision-making and implementation in order to influence a range of determinants of health, which in turn will impact on health outcomes, as shown below:

This is an idealised representation of an HIA's influence. Other assessment processes, organisational considerations and even broader social conditions will play much larger roles. In fact the process depicted is never linear either. Health outcomes and determinants are constantly changing, and decisions are constantly revisited. The delay between an activity and eventual health outcomes can sometimes stretch to decades. At each step there are a multitude of other factors that exert influence, apart from the HIA.

Though HIA's goal is to protect health, like EIA's is to protect the environment, the practical purpose of an HIA is to change decisions and implementation - the first step in the process depicted above. We should think about the purpose of EIA the same way. It's not an environmental intervention, it's a decision-making intervention. Burdening it with expectations of environmental protection isn't realistic.

If we do acknowledge that it will be difficult if not impossible for an HIA to demonstrate its role in changing health outcomes, we should redouble our efforts to prove its effectiveness in influencing decisions and implementation. I made a related argument in a recent article:

In some ways the issue of effectiveness may have less currency in relation to other forms of IA [than HIA]. Impact assessment, in particular environmental impact assessment, is used in some form in almost every country. Its use is common, accepted, well understood and not usually actively compared to other interventions or activities. This is not necessarily true for health impact assessment though because of the resource constraints and associated health disciplinary and epistemological concerns... if HIA's use is to continue to be supported in increasingly resource-constrained health systems that demand evidence of the comparative effectiveness of interventions.

Source

The right question is not whether HIA changes health outcomes. Instead it's does HIA change decisions, implementation and ways of working?

The health impacts of diesel exhaust: Australian radio documentary

2013-03-05T08:30:00.000+11:00

Dangerous Diesel is an interesting radio documentary on the health impacts of diesel exhaust. The program is Western Australia-focused and some nuance about the evidence on health impacts is lost, nonetheless the program is worth listening to.

Program Link

Building Health and Equity Into Policy: Health Equity Impact Assessments

2013-03-04T11:38:00.000+11:00

Guest post by Dr Bob Gardner, Director of Policy at the Wellesley Institute

Addressing 'wicked' policy and social problems such as systemic health inequities and their underlying social determinants requires comprehensive and coordinated action across government and other sectors -- and that needs good planning. Health equity impact assessments have been emphasized here in Ontario and in many other jurisdictions as one key way to ensure equity is embedded in planning.

Wellesley has been undertaking more specifically policy orientated angles on health equity impact assessment (HEIA). When a Commission was established in Ontario to examine the reform of the social assistance system we worked with a broad collaborative of public health, Community Health Centres, hospitals and other health care organizations to provide input. The theme of our several briefs and meeting with the Commissioners was how to ensure that any reformed system took population health and health equity into account and we set out concrete recommendations on how to create a health enabling system.

We then developed a series of analyses that we explicitly framed as policy-orientated HEIAs. We called this series the Real Cost of ... because we were often unfortunately arguing that a particular policy or direction would have an adverse and inequitable impact on health, especially for particular vulnerable populations. These papers dissect the population health implications of the particular policy, review available evidence on the expected impact of implementation, identify health and equity consequences of implementation, and recommend ways to avoid or mitigate that adverse impact. We have done such Real Cost analyses of:

proposed Toronto budget cuts to social and community programs;
federal reductions in health care programs for refugees. Again, this came out of working with a broad collaboration of researchers, clinicians and community organizations, and we have subsequently set out action steps that various levels of government and providers need to undertake to address the consequences of the federal cuts. We have also continued to comment as the policy unfolded: for example, when the government released its list of designated safe countries -- which had drastic implications for the levels of services available to refuges categorized on this list. We presented to the Toronto Board of Health and to other committees on the health challenges facing refugees and undocumented people.
Ontario's proposed cuts to a particularly important and flexible social assistance program called Community Start-Up and Maintenance Benefits. This project subsequently led to developing a map-based on-line tracking tool to monitor the social impact of these changes in communities across the province.
Recent debates on whether a casino should be located in Toronto -- here also, we working collaboratively with public health and other partners, held a forum on the health equity implications of casinos and problem gambling, and presented to the Toronto Board of Health, which recommended not proceeding with a casino.

These policy-orientated HEIAs have proven useful in several ways:

as a solid analytical tool -- rapidly assessing issues within this framework can quickly provide evidence-based findings and recommendations to effectively intervene in current policy issues;

these Real Cost HEIAs have proven to be an important resources for health care and other partners in addressing the particular issues at both policy and program levels;

they have had some immediate success in contributing to shifts in the particular policies -- for example, the proposed Toronto budget cuts were significantly softened, the planned CSUMB cuts were reduced, and many municipal councillors and the Toronto Board of Health have opposed a casino in Toronto. Of course, these analyses were only one part of much wider mobilization that contributed to these changes, but they were arguably an important part.

finally, by highlighting concretely how population health, the social determinants of health and health equity need to be built into the development of many kinds of policy, across many spheres of government, these HEIAs can contribute to a reframing of how policy is developed -- and can help move towards really implementing comprehensive Health in All Policies approaches.

The Role of the World Health Organization in the International System

2013-02-18T04:47:00.000+11:00

Since the World Health Organization (WHO) was founded in 1948, the development of many new institutions in the field challenges its original vision as the 'directing and coordinating body on international health work'.
WHO evolved from a body principally aimed at the control of infectious diseases to a more holistic approach to the improvement of health characterized in the 1970s by the slogan 'Health for All'.
The entry of the World Bank as a major health funder in the 1980s and a proponent of market-based health policies challenged WHO's pre-eminent position in the field.
Under Director-General Dr Gro Harlem Brundtland in the 1990s a serious attempt was made to refocus WHO and raise its status as a player in the development policy arena, but with mixed success and limited sustainability.
More recently WHO's chronic financial problems, characterized by excessive dependence on voluntary short-term funding by donors, have precipitated another round of reform.
The question is whether WHO member states and its secretariat are asking sufficiently searching questions about WHO's place in the international system and what might need to be done to put its future on a more secure footing.

This is the first paper in a series related to the Chatham House Centre on Global Health Security which are aimed at improving global health security.

The series consists of papers prepared for the Centre’s Working Groups on Governance and Financing, which are aimed at improving global health security through examining the way global and national institutions related to health are governed and financed.

The publication is now available at the following link and the summary points can also be found below: http://www.chathamhouse.org/publications/papers/view/189351

Seminar and Webcast - Thu 7th Mar 2013: Life expectancy and healthy life expectancy on the island of Ireland

2013-02-15T03:22:00.000+11:00

What do we know about the gap between life expectancy and healthy life expectancy on the island of Ireland? Report Launch

The Institute of Public Health in Ireland (IPH) in association with the Centre for Ageing Research and Development in Ireland (CARDI) will launch a report which focuses on what we can learn from the data on the island of Ireland about health expectancies. Attendance is free and the launch will also be available as a live webcast.

Date:	7 March 2013
Time:	12pm-1pm
Venue:	Institute of Public Health in Ireland, Forestview, Belfast BT8 7ZX
Chair:	Professor Bob Stout

Programme:

*11.45am*	Registration with tea and coffee
*12.00pm*	Introduction Professor Bob Stout, Co-Chair of CARDI
*12.05pm*	Policy context with respect to healthy ageing Dr Roger O’Sullivan, CARDI
*12.10pm*	Presentation of results and findings Ms Lorraine Fahy, IPH
*12.30pm*	Discussion
*1.00pm*	End with light lunch.

Dublin:
Suzanne Kirk
The Institute of Public Health in Ireland
Telephone: +353 1 478 6300
Fax: + 353 1 478 6319
Email: suzanne.kirk@publichealth.ie

Belfast:
Leah Friend
The Institute of Public Health in Ireland
Telephone: +44 28 9064 8494
Fax: +44 28 9064 6604
Email: leah.friend@publichealth.ie

Click here to find us - http://www.publichealth.ie/belfastmap

Further information can be found on the websites www.thehealthwell.info and www.publichealth.ie

Video on the health impacts of the Minneapolis-St. Paul Light Rail Project

2013-01-29T13:56:00.001+11:00

From the Robert Wood Johnson Foundation, which funded a health impact assessment of the project in conjunction with the Pew Charitable Trusts as part of the Health Impact Project.

Great HIA job opportunity with the US Health Impact Project

2013-01-23T18:46:00.001+11:00

Senior Associate with the Health Impact Project based in Washington DC, job listing here. Looks like a good opportunity.