1. Health Impact Assessment
A Presentation for the Health Disparities
Workgroup at NYAM
Prepared by Lindsey Realmuto &
Kimberly Libman

2. Outline
• What is Health Impact Assessment?
• What does it involve?
• How does it relate to health disparities
and health equity?
• Examples of health impact assessment
• Emerging Issues and Opportunities
• Resources to learn more

3. A systematic process that uses an array of data
sources and analytic methods and considers input
from stakeholders to determine the potential
effects of a proposed policy, plan, program or
project on the health of a population and the
distribution of those effects within the population.
HIA provides recommendations on monitoring and
managing those effects.
National Research Council of the National Academies, 2011
What is Health Impact Assessment (HIA)?

4. HIA:
• looks at health from a broad perspective;
• brings community members, business interests and other stakeholders
together;
• acknowledges the trade-offs of choices under consideration and offers
decision makers recommendations to maximize health gains and
minimize adverse effects;
• puts health concerns in the context of other important factors when
making a decision; and
• considers impacts on vulnerable groups.
Health Impact Project
http://www.pewtrusts.org/en/projects/health-impact-project/health-impact-assessment
What is Health Impact Assessment (HIA)?

5. What does HIA involve?
HIA Steps Description
Screening Determines the need and value of an HIA
Scoping Determines which health impacts to evaluate,
methods for analysis, and a work plan
Assessment Provides:
1) a profile of existing health conditions
2) evaluation of potential health impacts
Recommendations Provide strategies to manage identified adverse
health impacts and maximize benefits to health
Reporting Includes:
1) development of the HIA report
2) communication of findings & recommendations
Monitoring & Evaluation Tracks and evaluates:
1) the process of conducting the HIA
2) impacts on decision-making processes and
implementation of the decision
3) impacts of the decision on health outcomes

6. HIA practice is intended to
embody the following
principles and values:
1. Democracy
2. Equity
3. Sustainable Development
4. Ethical Use of Evidence
5. Comprehensive
Approach to Health
How does HIA relate to health disparities
and health equity?
A report published in 2013 (pictured above) explicitly describes how the use of HIA
can promote equity and provides examples of different HIAs that have exemplified
this value.
http://www.policylink.org/sites/default/files/PROMOTINGEQUITYHIA_FINAL.PDF

7. There are several ways that HIA practice can incorporate considerations
for health equity:
• Select proposals, policies or projects that are likely to have disproportionate,
either positive or negative, impacts on vulnerable populations.
• Authentically engage, involve, and develop leadership of stakeholders from
vulnerable populations at all stages of the HIA process.
• Ensure a goal of the HIA is to evaluate outcomes for vulnerable populations.
• Ask and prioritize questions about impacts on vulnerable populations.
• Disaggregate data and analysis by geography, race/ethnicity, income, gender,
and/or age when possible.
• Identify recommendations that maximize the health benefits for those already
facing adverse impacts/health disparities.
• Communicate the HIA results to vulnerable communities in culturally
appropriate ways.
How does HIA relate to health disparities
and health equity?

8. Examples of HIA
While it looks
like a lot have
been done in the
NE, only two
have been done
or are in process
in NYS!
Health Impact Project
http://www.pewtrusts.org/en/multimedia/data-visualizations/2014/hia-in-the-united-states

9. Examples of HIA
• California Domestic Worker Equality, Fairness
and Dignity Act
• Minnesota School Location and Design
• Massachusetts Rental Voucher Program

10. Examples of HIA
California Domestic
Worker Equality,
Fairness and Dignity Act
Addressed proposed
legislation in California that
would make a number of
labor protections enjoyed by
many other workers
applicable for domestic
workers.
http://www.sfhealthequity.org/co
mponent/jdownloads/finish/33/78
/0?Itemid=0

11. Examples of HIA
Minnesota School Location and Design
Examined the ways in which decisions about school location and
building design can affect health to inform revisions to the Minnesota
Department of Education’s school construction and siting guidelines.
http://www.publichealthlawcenter.org/buildinghealthyschools

12. Examples of HIA
Massachusetts Rental Voucher Program
Addressed the health implications of a housing assistance and
homelessness prevention program called the Massachusetts Rental
Voucher Program, as well as proposed changes to the program for
FY2006.
http://www.pewtrusts.org/en/~/media/Assets/External-Sites/Health-Impact-
Project/massachusettsrentalvoucherprogram.pdf

13. Emerging Issues and Opportunities
Opportunities Issues
Health Equity Impact
Assessments
 Gender equity in
developing world
Appropriate timing of
HIAs
 Relationships
Monitoring and
evaluation
Resources
 Funding
 Available evidence
for HIA modeling
Engaging appropriate
stakeholders and
building trust
Legal framework

14. • Health Impact Project
– http://www.pewtrusts.org/en/projects/health-impact-project
• Society for the Practitioners of Health Impact
Assessment (SOPHIA)
– http://www.hiasociety.org/index.php
• Human Impact Partners
– http://www.humanimpact.org/
• Upstream Public Health
– http://www.upstreampublichealth.org/
• San Francisco Department of Health Program on
Health, Equity, and Sustainability
– http://www.sfhealthequity.org/
• Policy Link
- http://www.policylink.org/
Additional Resources