Health Impact Assessments (HIAs) are useful tools to promote public health because they raise awareness of health issues among decision-makers, according to a new paper from the Group Health Research Institute and the University of Washington School of Public Health.
Researchers from the Institute's Center for Community Health and Evaluation teamed with Andrew Dannenberg, affiliate professor of environmental and occupational health sciences at the UW School of Public Health. The evaluation team was led by Emily Bourcier (MHA '99, MPH '00) of Group Health.
Researchers examined results of 23 HIAs in 16 US states from 2005 through 2013. They reviewed literature and conducted site visits; interviewed stakeholders, investigators and decision-makers; and surveyed 144 HIA practitioners.
For 11 of the HIAs, decision-makers said their decisions would have been markedly different without the HIA. "This, in turn, altered the trajectory of a policy or plan in ways that were intended to improve health or mitigate potentially adverse health consequences," researchers wrote.
Additionally, 14 HIAs influenced changes beyond the decision under consideration, resulting in the incorporation of health objectives into plans, policies, and programs established by non-health agencies. HIAs contributed to other impacts, including creating new and enduring relationships between public health and other agencies such as transportation or planning departments.
"Sixteen HIAs helped decision-makers and stakeholders understand how health is connected to seemingly unconnected issues," the researchers said. Examples of changes attributed to the HIA included creating a shared staff position between the county health and planning departments, and adding urban forests to a state carbon emissions plan.
Researchers include success factors and challenges of HIAs. "Success factors included engaging key stakeholders and crafting clear recommendations, while challenges included underestimating the effort needed to conduct an HIA and ensuring follow-up on recommendations," Dannenberg said. The study was funded by the Robert Wood Johnson Foundation, a major funder of HIAs in the U.S.
Dannenberg also was lead author of a research paper on the uses of HIAs for transportation planning. That paper, published by the Transportation Research Board, identified 73 transportation-related HIAs for road developments, bridge replacements and development of trails and public transit. Five HIAs were examined as case studies that may serve as models for future transportation-related HIAs.
The UW School of Public Health recently took part in an HIA as part of a proposed cleanup plan for the lower Duwamish River in Seattle led by the U.S. Environmental Protection Agency.