Source: SFDPH 2011. The HIA team identified the pathways in which the expansion would affect the lives of the primarily Iupiat residents of the area. Jones and Bartlett, 2009, as adapted in Public Health Accreditation Board Acronyms and Glossary of Terms Version 1.0 [PDF 536KB], July 2011. The committee does not intend that the definition and criteria proposed in this chapter be considered rigid requirements but rather that they reflect an ideal of practice, deviation from which may occur but should be based on clear and well-articulated needs and rationale. 1999; Roscam Abbing 2004). Most HIAs in the United States are therefore undertaken outside the formal decision-making process by organizations (such as nonprofit community-based groups), universities, or health departments that do not have decision-making authority over the proposals being addressed. In selecting the analytic methods that will be used, the HIA practitioner should consider not only technical limitations but what type of information will be most useful to decision-makers. 2008; Fredsgaard et al. Adopting a position for or against a proposal (for example, support for or opposition to a legislative proposal). The key findings are provided in the opening section of the report, and they are categorized according to the strength of the evidence as highly likely, likely but less well-supported by the available evidence, and plausible, but not well-supported. For example, according to the report, a requirement for paid sick days is highly likely to lead to more workers taking leave to recuperate from an illness, to receive preventive care, or to care for ill children and dependents. Mapping out the timeline for the decision-making process can be helpful, and for large and complex programs and projects, identifying the agencies involved and their jurisdictions is important. Lester C, Hayes S, Griffiths S, Lowe G, Hopkins S. Implementing a strategy to address health inequalities: A health authority approach. Although completed HIA reports are readily available, peer-reviewed or gray literature that discusses the impacts of specific HIAs is still rare. The expected resource requirements of the HIA and the ability of the HIA team to meet them. In 2005, an HIA was conducted by a multidisciplinary team. Health impact Assessment: Concepts, Theory, Techniques and Applications. 2023 by the American Hospital Association. Directive 2001/42/EC of the European Parliament and of the Council of 27 June 2001 on the assessment of the effects of certain plans and programmes on the environment. Practice implications include better understanding of different models and requirements by health departments, hospitals, and others involved in assessment and planning to improve cross-sector collaboration, collective impact, and community health. The potential for health effects to place a disproportionate burden on or substantially benefit vulnerable populations. This plan is used by health and other governmental education and human service agencies, in collaboration with community partners, to set priorities and coordinate and target resources. Schweinhart LJ, Montie J, Xiang Z, Barnett WS, Belfield CR, Nores M. Scott-Samuel A. Outcome evaluation will continue to be challenging, but it can generate useful information in well-selected cases. In other cases, a draft may be submitted to an internal body, such as a steering group, whose comments are incorporated into a final public version. A variety of tools and processes may be used to conduct a community health assessment; the essential ingredients are community engagement and collaborative participation. By examining the various components of the different assessment and planning models, we are able to identify areas for coordination, ways to maximize collaboration, and strategies to further improve community health. Scoping also determines who will be part of the HIA team and establishes a plan for technical oversight and review, stakeholder participation and involvement, and involvement of and interaction with decision-makers. Key Elements of Community Health Improvement Planning: From Assessment to Action Planning Key Elements of Community Health Improvement Planning: From Assessment to Action Planning CHA-CHIP Demonstration Project Improvement www.assesstoolkit.org April 23, 2012 The lines are muted. Kuo T, Jarosz CJ, Simon P, Fielding JE. Suicide is the fourth leading cause of death among young people worldwide and the third leading cause of death among those in the US. It identifies a baseline that describes the health status of populations that will be affected by the decision. Metrics are key to providing a more holistic view of a community's health, and ultimately inform and drive action. 2009). Community Health Assessment & Planning Guidebook - nmhealth.org The committees may be convened for several purposes, including providing technical guidance or peer review, ensuring adequate and fair representation of diverse interests and priorities among stakeholders, communicating the results of the HIA to decision-makers, and developing recommendations that address community needs and are compatible with the specific legal requirements of the decision- making process. IPIECA/OGP (International Petroleum Industry Environmental Conservation Association and International Association of Oil and Gas Producers). The fact, however, that the team conducting the HIA is aware of the decision context allows the assessment to be decision-relevant. What Is a Community Health Improvement Plan? Reprinted with permission; copyright 2010, International Council on Mining and Metals. Steinemann A. Seventh, disclosure allows people to take voluntary actions to avoid risk (Neidell 2009). In the absence of mandates or formal procedures, topics for screening are often chosen on the basis of the interests of a group wishing to use HIA as opposed to a structured, strategic selection process. Scoping establishes the boundaries of the HIA and identifies the health effects to be evaluated, the populations affected, the HIA team, sources of data, methods to be used, and any alternatives to be assessed. Some decisions to conduct HIA may depend on a specific statutory requirement or mandated procedure. For each step, the committee describes the basic purpose, objectives, and practice elements; summarizes the main outputs; and presents conclusions regarding pertinent issues raised. Monitoring and evaluation are often, although variably, described as the final stage of HIA (see Appendix E). The approaches taken for stakeholder involvement vary widely. While CHNAs are a recent requirement, community health assessments (CHAs) have long been used as a tool by hospitals, public health departments and other social service agencies to identify key community health concerns. In: Kemm J, Parry J, Palmer S, editors. Bennear LS, Olmstead SM. Cole BL, Fielding JE. The bulleted list below provides examples in which some health impacts or behavioral outcomes have been quantified. Catholic Health Association of the United States. The second task is to analyze and characterize effects on health and its determinants for the proposal and for any alternatives under consideration relative to the baseline and to each other. Box 3-1 provides an example of how screening on a proposal for a residential housing program was conducted. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Quigley RJ, Taylor LC. The most vulnerable populations were identified as people of low economic status, children, older adults, renters, and the carless. Office of Disease Prevention and Health Promotion, US Department of Health and Human Services. Qualitative evidence provides a context-specific view of peoples lives. The HIA team was assisted by an advisory committee, but it appears that the committee was not involved in the scoping. Public input while recommendations are being developed helps to ensure that proposed measures are locally relevant, address context-specific factors that might render them more or less effective, and address public concerns and hopes. First, community input is essential especially for proposals that will affect the local community primarily. Variations were found in race, age, employment status, poverty, car ownership, and mortality. Noncommercial use of original content on www.aha.org is granted to AHA Institutional Members, their employees and State, Regional and Metro Hospital Associations unless otherwise indicated. HIAs are also differentiated according to whether they are integrated into an environmental impact assessment or done independently. A community health assessment often yields a long list of public health needs, issues, and problems. It should define the vision for the health of the community through a collaborative process and should address the gamut of strengths, weaknesses, challenges, and opportunities that exist in the community to improve the health status of that community. 2005; Bhatia and Seto 2011). 2007). Quigley R, den Broeder L, Furu P, Bond A, Cave B, Bos R. Roscam Abbing EW. HIAs can be conducted by a variety of agencies, organizations, or individuals. Cancer risk associated with exposure to hazardous chemicals. 2005; PHAC 2005; Harris et al. 2009; Bhatia et al. There are six elements that make up a health assessment. Key elements of the model include: Disseminating surveys Conducting key informant interviews and focus groups Incorporating county-level data on health Small rural hospitals may lack the required resources to successfully address issues that may be identified as a result of a CHNA. Johnson BL. Evaluation can be thought of in two useful and complementary ways: self-evaluation of the HIA process and impacts and independent external evaluation. The facts that resources were available and that timelines were appropriate were also relevant to the decision to conduct an HIA. Because of the timeframe of proposal implementation and effects on health, outcome evaluation often requires a long-term research commitment. II, Selected Evidence Base Breaking the Cycle, East London and the City Health Action Zone and Queen Mary. The variability in the practice has evolved in the absence of widely accepted practice standards or formal regulatory or procedural requirements for HIA outside NEPA and related state laws (see Appendix A). Outcome evaluation should be undertaken when available resources and data will allow reasonable judgments regarding the association between the implementation of decisions and observed changes in health outcomes or health determinants. Funding Acknowledgement Mindell J, Boaz A, Joffe M, Curtis S, Birley M. Enhancing the evidence base for health impact assessment. This assessment of needs then informs a project's overall plan and approaches by helping you identify targeted strategies and prioritize resources. World Bank. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services. An HIA would identify health assets, health liabilities, and health-promoting mitigations related to the proposed development project. In practice, not all HIAs have conducted systematic literature reviews or documented review methods. 2006). Mindell J, Ison E, Joffe M. A glossary for health impact assessment. In many cases, the first course of action is to gather information from published literature, unpublished reports, administrative data gathered for routine monitoring purposes, and other available documents. All information these cookies collect is aggregated and therefore anonymous. For example, in Alaska, one of the adverse impacts of a proposed mine expansion was the feared contamination of water and wildlife, and evidence suggested that a fear of contamination might lead communities to shy away from eating a traditional diet. The dissemination strategy should be developed in a systematic manner, should consider what groups need or will rely on the information (including stakeholders and decision-makers), and should determine the most effective ways to present the information to these groups, taking into account any barriers or challenges. However, because few studies have directly assessed the impact of the implementation of policies, plans, programs, or projects on health outcomes, there may be little direct evidence available with which to predict a given measures effectiveness. Several types of evaluation may be conducted on an HIA, including the following: In practice, most HIAs do not include process, impact, or outcome evaluation; this has been attributed to a lack of interest, time, and resources in the case of process and impact evaluation and to the length of time (often many years) required for observing changes related to implementation. The committee finds that an HIA report should at least describe the proposal and alternatives that are the subject of the HIA, the data sources and analytic methods used, the groups and individuals that were consulted in the course of the HIA, the process and findings of each step of the HIA, and the overall conclusions and recommendations. An explicit statement of data sources, methods, assumptions, and uncertainty is essential, but uncertainty does not negate the value of the information. Citation for Toolkit Moreover, because there is generally no written record of HIAs that stop at screening, still less is known about the reasons that have led to decisions not to proceed with HIA.
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