Health Impact Assessment (HIA)

The World Health Organization defines HIA 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." Click here to learn more about HIA.

 

NACCHO and APA Resources

Fact sheets

• Public Health in Land Use Planning & Community Design Fact Sheet provides an overview of the connections between land use planning and public health, including the role of NACCHO and local health officials.
• NACCHO and the American Planning Association (APA) have compiled a fact sheet that highlights terms common to local planners that local public health practitioners may be unfamiliar with, and vice versa. This Jargon fact sheet can facilitate communication between health officials and planners and allow them to "speak the same language." Further, the Working with Elected Officials to Promote Healthy Land Use Planning and Community Design Fact Sheet will help health and planning agencies to broaden their partnerships to include other city and county officials who can work to progress the plan to create healthier communities.

Guides and Tools

• APA's Growing Smart Legislative Guidebook, with tools to help local governments combat urban sprawl, protect farmland, promote affordable housing, and encourage redevelopment.
• The Tri-County (CO) Health Department has developed an environmental health checklist for planners and health officials, which may serve as a comprehensive assessment tool for review of land use plans and an educational tool. The checklist can be modified to be more appropriate for your jurisdiction. Click on the PDF version for links to health data or other related resources.
• This Land Use and Public Health Collaborations Flowchart details typical steps that local planning agencies may undertake when drafting a comprehensive plan for their jurisdictions as well as specific strategies and actions that local public health agencies can use to involve themselves in the comprehensive planning process to ensure that health considerations are taken into account.

NACCHO Webcasts

• Living Healthy: Innovative Partnerships to Connect Public Health and the Built Environment Webcast May 2006

This NACCHO and APA webcast focuses on the efforts of two health departments, Lincoln-Lancaster County Health Department and Riverside County Department of Public Health, as they address the impact of the built environment on public health. Click here and enter the password wN9Wv3eP to view the webcast.

• HIA Webcast May 2005

This NACCHO and APA webcast focuses on what HIA is and provides examples of implementation. Click here to view the webcast.

 

University Level HIA Course Syllabus

• UC Berkeley offered a course on HIA to expose students to the practice and potential of HIA in the context of California’s land use and transportation policy making. The University of California at Berkeley Health Impact Group conducted an HIA. Click here for the results.

Articles

• NACCHO Exchange, Spring 2003

 

Walkability Resources

• This worksheet from the Robert Wood Johnson Foundation will help you determine if your community is walkable and suggest what steps to take if it is not. 
• The UNC Pedestrian and Bicycle Information Center developed a Neighborhood Walkability Checklist to determine the level of walkability in your community and offer tips and resources to improve walkability. Also available is a Bikeability Checklist.
• The Community Health Research Unit's guide Active Independent Aging: A Community Guide for Falls Prevention and Active Living contains a number of resources related to active living, including a Walkability Checklist with a focus on walking for health aging. This checklist ranks the level of walkability and recommends immediate and longer-term steps to mitigate walkability problems.
• California's Walk to School program encourages students to fill out a worksheet that helps to determine the walkability of their particular route to school. 
• Walkable Communities was organized to help communities, both large and small, to become more walkable and pedestrian friendly.

 

Other Tools and Resources

• A Public Health Professional's Guide to Key Land Use and Transportation Planning Policies and Processes, introduces the major policies and processes in land use and transportation planning and how LHDs can get involved.
• EPA's Database on Smart Growth Policies provides information and examples of smart growth policies implemented by varying levels of government, including state and local, to advance smart growth efforts. The database can be searched by state, smart growth principle, or keyword (such as "environmental health" or "physical activity").
• ICMA's consumer guide, Creating a Regulatory Blueprint for Healthy Community Design, is a road map for local government officials and their staff as they consider reforming zoning and development codes to encourage more physical activity in their areas. The guide is especially useful now as more and more jurisdictions focus on modernization of zoning and land development codes to encourage the design of more livable neighborhoods.
• Pedestrian Injury Prevention Web site from CDC’s National Center for Injury Prevention and Control.
• The Leadership for Active Living provides A Primer on Active Living for Government Officials.
• Promoting Active Living Communities, a marketing and communications guide from Active Living by Design, helps you “sell” the values of active living to your community.
• The report Measuring the Health Effects of Sprawl: A National Analysis of Physical Activity, Obesity and Chronic Disease from Smart Growth America and Surface Transportation Policy Project, provides research and analysis on the connection between urban sprawl and chronic disease.
• The Addressing Water and Natural Resource Education (AWARE) program in Colorado is a statewide effort to educate local decision makers about the impacts of land use choices on water quality. AWARE's Web site provides tools and resources related to water quality, land use planning, and smart growth. 
• Click here for resources from the Regional Plan Association, an independent, non-profit organization that improves the quality of life and the economic competitiveness in the New York-New Jersey-Connecticut region through research, planning, and advocacy. Resources include summaries and reports on findings of the School and Healthy Communities Project, Stamford Westside Healthy Communities Project, Regional Assessment Project, and the RPA's Healthy Communities Initiative and The New Jersey Mayors’ Institute on Community Design June 2003.
• HERS-ST v2.0 Highway Economic Requirements System—State Version is a technical report from the U.S. Department of Transportation's Federal Highway Administration from 2002 about a computerized model that is designed to simulate improvement selection decisions based on benefit-cost merits of alternate improvement options.
• The Considerate Constructors Scheme is a non-profit organization whose  initiative is promoting a voluntary code of considerate practice for construction companies to give high priority to health and safety, the environment, and sensitivity to the communities where they are located.
• The New Zealand Urban Design Protocol has been prepared by the Ministry for the Environment in conjunction with an Urban Design Advisory Group. The Protocol is a key part of the Government's Sustainable Development Programme of Action and the Urban Affairs Portfolio.
• Here are the publications from the London Health Commission.
• This Environmental Impact Assessment: Preliminary Index of Useful Internet Web Sites is a list of sites related to environmental assessment to be used as a guide to information on EIA.
• San Francisco's Program on Health, Equity, and Sustainability supports the integration of local government and community effort to work together for advancements in urban health, social justice, and environmental justice.
• The Wales Center For Health has funded 349 Healthy Living Centres (HLCs) in the UK, all running a diverse range of project within different settings.
• The Metropolitan Atlanta Rapid Transit Authority has been serving the community not only through transportation and environmental challenges but through community and charitable efforts.
• Project for Public Spaces (PPS) is a non-profit organization dedicated to creating and sustaining public places that build communities.
• The Shasta County Public Health department has created an internal Public Health Development Checklist for LHDs to evaluate development proposals, which would then be shared with the local land use planning staff. This example was not intended for a wider audience.

PowerPoint Presentations
The following PowerPoint presentations can help LHDs learn more about the links between planning and health and provide resources for LHD staff to educate others at the local level. Please download these resources and modify them to better address your local needs.

• The Built Environment and Injury Prevention from NACCHO-ASTHO Annual 2005. 
  • Susan Allan, MD, JD, MPH, Public Health Director, Oregon Department of Human Services
  • Marya Morris, AICP, Senior Research Associate, American Planning Association
  • Candace Rutt, PhD, Division of Nutrition and Physical Activity, CDC
• NACCHO and APA Health Impact Assessment Webcast from

  May 12, 2005.

  • Bob Glandon, Ingham County Health Department
  • Andy Dannenberg, Emergency and Environmental Health Services Branch, Natl. Center for Environmental Health, CDC
  • Candace Rutt, Division of Nutrition and Physical Activity, CDC
• Planning 101. Provides local health officials a planner’s perspective on how planning takes place at the local level. Developed by Marya Morris, Senior Research Associate with the American Planning Association (Download PowerPoint Presentation [2,562 KB])
• Addressing Public Health in Transportation & Land Use Policy (presented at the Environmental and Energy Study Institute briefingon Oct. 2, 2003)
  • Built Environment and Public Health. This PowerPoint explores the trends in obesity and physical activity and describes how the National Institute of Environmental Health Sciences (NIEHS) plans to address these issues (presented by Allen Dearry, Associate Director, NIEHS).
  • A Compelling Case for Addressing Public Health in Transportation and Land Use Policy. This PowerPoint was presented by Reid Ewing, National Center for Smart Growth, University of Maryland; principal author of the study, Relationship Between Urban Sprawl and Physical Activity, Obesity and Morbidity.
  • Designing the Physically Active Community. Presented by Jeffrey Soule, APA Policy Director, this PowerPoint addresses emerging policy regarding sprawl and health and APA’s Planning and Designing the Physically Active Community Project; it includes a survey of local planners regarding their knowledge on the links between land use and health.
• The following presentations were made at the 4th Annual Partners for Smart Growth Conference in January 2005: 
  • Integrating Health into Planning and Community Design, Part II, presented by the APA, details strategic points where planning and public health overlap. 
  • Integrating Health Into Community Design, presented by Safe and Healthy Communities Consulting, details efforts in California to create more active living environments through community design initiatives. 
  • Utilizing the PACE Methodology as a Tool for Improving the Quality of Life in Communities, presented by Julianne Renk of Indian River County (FL) Health Department, explores the use of a community assessment tool in addressing quality of life issues related to land use planning and community design. 
  • Building Bridges: Integrating the Work of Public Health and Urban Planning, presented by Rajiv Bhatia of the San Francisco Department of Public Health, looks at social equity concerns in San Francisco and explains the use of HIA currently underway by the health department. 
  • Current Efforts Related to Public Health and the Built Environment, presented by Federal Highway Administration, focuses on efforts to address the intersection of the fields by focusing on transportation planning and physical activity and assessing whether transportation facilities can be evaluated for health impacts. 

Healthy People 2010
NACCHO has developed action steps for those Healthy People 2010 objectives that relate most directly to land use planning. These tools assist LHDs to operationalize the HP2010 objectives by taking a community design approach to environmental health.

Objective 8-1: Reduce the proportion of persons exposed to air that does not meet the U.S. Environmental Protection Agency’s health-based standards for harmful air pollutants.

Objective 8-2: Increase use of alternative modes of transportation to reduce motor vehicle emissions and improve the Nation’s air quality.

Objective 8-4: Reduce air toxic emissions to decrease the risk of adverse health effects caused by airborne toxics.

Objective 8-6: Reduce waterborne disease outbreaks arising from water intended for drinking among persons served by community water systems.

Objective 8-9: (Developmental) Reduce the number of beach closings that result from the presence of harmful bacteria.

 

Using NACCHO Tools for Built Environment Work

NACCHO has a number of community-based needs assessment tools, as well as interagency collaboration tools and worksheets, which can be tailored to be used by communities/LHDs working on land use issues and particularly those who identified land use issues as a priority in a needs assessment process. Click here to find a description of each tool, specific recommendations about how to implement the tool for community design purposes, and links to downloadable worksheets and the tools themselves.