hia in transportation planning
DESCRIPTION
Health impact assessment (HIA) has emerged in the U.S. as a promising way to increase social and environmental justice by addressing health equity within transportation planning. HIA seeks to augment the information base upon which public decisions are made. It does so through a multi-disciplinary analysis of how the project or plan impacts various social determinants of health. It also augments community and stakeholder engagement by providing a forum - usually through an advisory committee - where stakeholders can identify and deliberate about health interests related to the target plan. While HIA advisory committees are diverse by design, those managing HIA processes are often surprised at the differences between and within both the planning and transportation fields. This webinar reviews stakeholder engagement strategies common to HIA. It compares and contrasts the values, expectations, and methodologies that various types of planning and public health professionals often bring to the table. Finally, it identifies best practices for stakeholder engagement in HIA to maximize the collaborative nature of HIA.TRANSCRIPT
HIA in Transportation Planning: What to expect from transportation & public health stakeholders
Nicole Iroz-Elardo, PhD [email protected] July 16, 2014
Outline
• Overview of HIA • Survey of the Field • Why Engage Stakeholders
• Who Par=cipates
• Types of HIA/Cases • Lessons Learned • Best Prac=ces
Systematic process
Data & analysis
Input from
stakeholders
Potential effects on
health
Distribution within a
population
Recommendations and mitigations
Inputs Outputs Conclusions
What is Health Impact Assessment?
Screening Scoping
Recommending Reporting
Monitoring
Evaluation
Assessment (Multiple)
The HIA Procedure
HIA as Health in All Policies
How can we ensure considera=on of health in decisions made in non-‐health sectors?
Social and Environmental Determinants of Health
Survey of the HIA Field
Source: hIp://www.healthimpactproject.org/hia/us#status:Complete on 7/4/2014
Survey of the HIA Field
Source: hIp://www.healthimpactproject.org/hia/us#status:Complete on 7/4/2014
WHY ENGAGE STAKEHOLDERS IN HIA?
• “right of people to par>cipate in a transparent process for the formula=on, implementa=on, and evalua=on of policies that affect their life both directly and through elected decision makers”
– Gothenburg Consensus
• Generally interpreted to include par=cipatory elements, although par=cipatory nature is overstated.
Founda=onal Value: Democracy
• Norma=ve Reflect democra=c ideals • Empowerment
• Substan=ve Improve informa=on
• Instrumental Generate legi=macy • Reduce conflict • Increase odds of smooth implementa=on
Ra=onales for Par=cipa=on
Glucker, (2013). Public Par=cipa=on in Environmental Impact Assessment: Why, Who, and How? EIAR .
WHO PARTICIPATES IN HIA?
Everyone!
• Public Health • Target Sector (Transporta=on) • Government
• Advocacy Organiza=ons • Decision Makers (hopefully)
• Public(?)
HOW?
HIA Advisory Group
Differences in Language
• Mortality vs Fatality • Morbidity vs Injury • Access
– To highway/road system – To (health promo=ng) services
• Safety – Real vs Perceived
Planning and Public Health: Diverse Fields
• Land Use (zoning, codes) • Transporta=on/Infrastructure • Environment
• Design • Preserva=on • Community Development (Housing, Social) • Economic Development (Real Estate)
• Regulatory (NEPA) • Toxicology • Engineering
Planning and Public Health: Diverse Fields
• Biostats • Epidemiology • Environmental • Occupa=onal • Toxicology (allied)
• Health Services/Primary/ Clinical Care
• Health Management/Policy/Admin
• Community/Health Promo=on
• Health Behavior/Educa=on
• Child & Women’s/Maternal
• Infec=ous Disease • Interna=onal
Types of HIA Harris-‐Roxas & Harris (2011). Differing Forms, Differing Purposes. EIAR.
Mandated Decision-‐Support
Advocacy Community-‐Led
Voluntary No Yes Yes Yes
Purpose? Meet Regula=ons Inform the Decision
Change the decision
Increase Community Control
A Spectrum of HIAs…
I-‐710 Corridor HIA
Clark County Bike-‐Ped HIA
Lake MerriI BART HIA
Types of HIA Harris-‐Roxas & Harris (2011). Differing Forms, Differing Purposes. EIAR.
Mandated Decision-‐Support
Advocacy Community-‐Led
Voluntary No Yes Yes Yes
Purpose? Meet Regula=ons Inform the Decision
Change the decision
Increase Community Control
Health Purpose
Minimize nega=ve impacts
HIA Author? Consultant for Government Agency
Informed by Environmental Health
Role of Stakeholders
Technical Info
Case: I-‐710 Corridor
Differences in Expecta=ons
Transporta>on -‐ AQAP
• Regulatory -‐ Risk Analysis with Toxicology
• Air Quality, Safety, Noise
• NEPA process à – Timing / Data Confiden=ality – Defined Alterna=ves
• AQAP Advisory CommiIee
Public Health -‐ HIP
• Social Determinants of Health Analysis (Epidemiology) & Equity
• Air Quality, Safety, Noise PLUS bike-‐ped, access, etc
• Wai=ng on modeled data, but then
no =me for health models
• No control • Used to working with public
including advocacy groups
Types of HIA Harris-‐Roxas & Harris (2011). Differing Forms, Differing Purposes. EIAR.
Mandated Decision-‐Support
Advocacy Community-‐Led
Voluntary No Yes Yes Yes
Purpose? Meet Regula=ons Inform the Decision
Change the decision
Increase Community Control
Health Purpose
Minimize nega=ve impacts
Maximize Health Min Dispari=es
HIA Author? Consultant for Government Agency
Government Agency, some health non-‐profits
Informed by Environmental Health
*Env Health *Social *Health Equity
Role of Stakeholders
Technical Info Inform
Founda=onal Value: Health Equity
• “HIA is not only interested in the aggregate impact of the assessed policy on the health of a popula=on, but also on the distribu>on of the impact within the popula>on in terms of gender, age, ethnic background, and socioeconomic status.”
– Gothenburg Consensus
• SES à Spa=al Distribu=on • Vulnerable Popula=ons (young, old, minority, sick) • Implies Decision Rule = Maximize Health & Minimize Health Dispari=es
Case: Clark County
PREPARED BY:Alta Planning + Design
October 2010
Clark County, WABicycle and Pedestrian Master Plan
Good Collabora=on
• Planning and Public Health had a decent working rela=onship
• Integra=on of Advisory CommiIee worked because Planning allowed Public Health significant =me on the advisory commiIee
• Plan was not terribly conten=ous – Health Promo=ng
– Vision
Types of HIA Harris-‐Roxas & Harris (2011). Differing Forms, Differing Purposes. EIAR.
Mandated Decision-‐Support
Advocacy Community-‐Led
Voluntary No Yes Yes Yes
Purpose? Meet Regula=ons Inform the Decision
Change the decision
Increase Community Control
Health Purpose
Minimize nega=ve impacts
Maximize Health Min Dispari=es Max Health
HIA Author? Consultant for Government Agency
Government Agency, some health non-‐profits
Health non-‐profits in partnership with CBO
Informed by Environmental Health
*Env Health *Social *Health Equity
*Social *Health Equity *Env Health
Role of Stakeholders
Technical Info Inform Guide
Types of HIA Harris-‐Roxas & Harris (2011). Differing Forms, Differing Purposes. EIAR.
Mandated Decision-‐Support
Advocacy Community-‐Led
Voluntary No Yes Yes Yes
Purpose? Meet Regula=ons Inform the Decision
Change the decision
Increase Community Control
Health Purpose
Minimize nega=ve impacts
Maximize Health Min Dispari=es Max Health
Min Dispari=es Max Health
HIA Author? Consultant for Government Agency
Government Agency, some health non-‐profits
Health non-‐profits in partnership with CBO
CBO’s in partnership with health non-‐profits
Informed by Environmental Health
*Env Health *Social *Health Equity
*Social *Health Equity *Env Health
*Social *Health Equity
Role of Stakeholders
Technical Info Inform Guide Control
LAKESIDEDR
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Peralta CommunityCollege DistrictAdministration
OaklandUni!edSchoolDistrict
LaneyCollege
OaklandMuseum ofCalifornia Kaiser
Auditorium
MTC/ABAG
LakeMerritt
BART
BARTParking
MadisonSq. Park
ChineseGarden
Park
LincolnSq.Park
Paci!cRenaissance
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LincolnElementary
PostO"ce
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PublicLibrary
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Oakland Uni!edSchool District
DowntownCampus
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Lake Merritt StationArea Planning Areas
BART Station Entrance
West Subarea
East Subarea
1/2 Mile Radius
1
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Existing Places in the Planning Area Case: Lake MerriI
BART
Sta=o
n Area Plan
Madison Square Park
Source: http://memorymap.oacc.cc/project-info/taichichats.html
Lessons Learned
• Conflict with HIAs onen aligns with – Type of plan: Health Promo=ng vs Risk Reduc=on
– Scale of the plan – Previous/ongoing rela=onships between planners and public health authors of HIA
• Good facilita=on can go a long way • Professionals misjudge other professionals, assuming uniform interests
Lessons Learned (con=nued)
• Transporta=on planners should try to… – Understand who is performing the HIA to hint at the type of HIA
– Learn about the social determinants of health and health equity
– Be clear about data =melines
– Offer GIS data if available, par=cularly for safety
Lessons Learned (Con=nued)
• HIA prac==oners should try to… – Understand regulatory constraints – Ask about past health partners – Be flexible about products – Scoping is the ideal =me for stakeholder engagement à budget enough =me
– Beware of giving up control of the HIA advisory commiIee
Best Prac=ces
• Stakeholder engagement plan • Meet with planners very early on
• Ask about the =ming of their process and when they would most appreciate input
• Ask/aIend each other’s advisory commiIee
• In advisory commiIees, do not assume one planner or one public health person can represent the en=re field
QUESTIONS?
Contact Info: Nicole Iroz-‐Elardo, PhD [email protected]