Suicide is the fourth leading cause of death among young people worldwide and the third leading cause of death among those in the US. Moreover, disease rates in small populations can vary substantially, and it may not be possible to calculate them reliably. Epub 2018 Jun 19. 1999; Roscam Abbing 2004). Castro A, Chen L, Edison B, Huang J, Mitha K, Orkin M, Tejani Z, Tu D, Wells L, Yeh J. Cave B, Curtis S. Developing a practical guide to assess the potential health impact of urban regeneration schemes. Key health effects: Issues were identified through analysis of newspaper coverage; outreach to such groups as local officials, members of the public, and businesses; development of a logic framework; and a survey of people living, working, or attending school near the BeltLine. But few data may be available on the geographic scale of some decisions addressed in an HIA, such as decisions related to projects that would affect a rural area or a single neighborhood. 2006). This is the key link between a health profile and a health plan. Recommendations may be implemented through regulatory mandates or voluntary actions by stakeholders. Cookies used to track the effectiveness of CDC public health campaigns through clickthrough data. In contrast, independent evaluation can yield unbiased insights about an HIA from the perspectives of stakeholders and decision-makers, can contribute to a more robust external peer review, and can provide rich information regarding the strengths, weaknesses, and most effective methods and approaches in the field. 2004). Characteristics unique to the affected community may not be obvious to HIA practitioners who are outside the community. However the literature review is conducted, the methods should be clearly described in the report, and any studies with conflicting results acknowledged. Wernham A. Inupiat health and proposed Alaskan oil development: Results of the first Integrated Health Impact Assessment/Environmental Impact Statement of proposed oil development on Alaskas North Slope. Frank DA, Neault NB, Skalicky A, Cook JT, Wilson JD, Levenson S, Meyers AF, Heeren T, Cutts DB, Casey PH, Black MM, Berkowitz C. Heat or eat: The Low Income Home Energy Assistance Program and nutritional and health risks among children less than 3 years of age. Thomson H. HIA forecast: Cloudy with sunny spells later? Community input during the development of recommendations can ensure that they address specific aspects of living conditions and community design that may not be obvious to an outside researcher, and it provides an opportunity to ensure that the recommendations address high-priority issues in a manner that is acceptable to the affected community. If the HIA is based on a thorough analysis, provides complete information so that community members are able to critique the analysis, and is conducted openly, it may provide reassurance to affected communities even if the conclusions do not support the communitys concerns. HIV-AIDS infection risk associated with oil-pipeline construction. Click on the icon for each step to read about that part of the process. A growing population of families that have children. Another method of scoping is to develop a table that facilitates a systematic and rapid appraisal of all the potential ways in which a proposal might affect health (see Table 3-1). The committee notes that public involvement is important in screening; information provided by stakeholders may provide insight into the potential effects of a proposal under consideration that contribute to the final determination of whether an HIA is warranted and likely to be useful. Chapter 2. Other Models for Promoting Community Health and Development This information can help develop a community health improvement plan by justifying how and where resources should be allocated to best meet community needs. Collaboration with decision-makers or consultation with experts familiar with the legal or regulatory context may be the most effective way to ensure that recommendations are pragmatic and can be practically incorporated into the decision-making process. Characterization of health effects in HIA relies on qualitative and quantitative evidence. The potential for health effects to place a disproportionate burden on or substantially benefit vulnerable populations. Recommendations form the core of a health-management plan, but the plan also determines authority for and assigns responsibility for implementing each recommendation, establishes a monitoring plan, and creates or suggests mechanisms to verify that assigned responsibilities are being met. It develops the scope of health effects for analysis through systematic consideration of all factors associated with the proposed action that have a potential to influence health, and it narrows the scope to effects that are judged most important for health. Influences on practice include the timeline, resources and skills available to the HIA team, the factors being considered and the data available for analysis, and the legal and regulatory context of the decision-making process. It is also common for local, state, or tribal health departments to undertake an HIA to inform another agencys decision-making. For those reasons, the committee concludes that HIAs including, to the extent practical, the data used for the analysis, analytic methods, assumptions, findings, uncertainties, data gaps, and recommendations should be made public. HIA guidance often points out the need for monitoring and continuing management and verification that mitigation measures are being implemented. Sources: Veerman et al. However, where practical, the HIA team should aim to evaluate a variety of alternatives or, minimally, to identify the characteristics of proposed actions that would be health-protective or detrimental to health. The results of the HIA were presented in different formats; the full report was accompanied by a summary and fact sheets. HIAs are also done by private consultants who are hired by a project proponent or decision-maker or by private-industry stakeholders. 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. Articles in Google Scholar by Kaye Bender, PhD, RN, FAAN Guidance Note 4. The ultimate goal of a community health assessment is to develop strategies to address the communitys health needs and identified issues. Advisory, steering, and technical oversight committees are also commonly convened during scoping. The baseline profile characterizes the health status of affected populations and includes trends and factors (social, economic, and environmental) known to affect health. Management of the health effects of a proposal as it moves from planning into implementation should be a dynamic process in which monitoring results may drive continued adaptation of the health-management plan. Variations were found in race, age, employment status, poverty, car ownership, and mortality. First, disclosure informs affected communities and individuals and possibly other stakeholders, such as government agencies and officials, of possible effects on their health and well-being, a core objective of HIA. The cornerstone of an assessment that is conducted to comply with NEPA is the presentation of a set of reasonable alternatives to the proposed action; the assessment then considers the impacts of the proposed action and the alternatives. Morgan RK. A description of the research questions, data sources, methods to be used, and any alternatives to be assessed. 2006). Cook WK, Heller J, Bhatia R, Farhang L. A Health Impact Assessment of the Healthy Families Act of 2009. The health issues were identified by determining the populations that would be affected and then considering how they would be affected. The core issues that are commonly addressed are as follows: Some HIA guides recommend using a matrix, such as those shown in Tables 3-2 and 3-3, to characterize effects (Harris et al. BLM later considered amending the EIS to make additional public lands available for oil and gas leasing in the original 4.6-million-acre planning area. The process may include identifying communities and geographic regions; demographic, economic, racial, and ethnic groups; and vulnerable populations, such as children, elderly people, disabled people, low-income people, racial and ethnic minorities, and people who have pre-existing health conditions. With clear language in mind, partners should come to agreement on the Assessing the baseline health status of the affected population provides a reference point with which the predicted changes in health status may be compared; it identifies any groups that could be more vulnerable than the general population to the impacts of the proposal; and it provides an understanding of the factors that are responsible for determining health in the affected communities, and this, in turn, allows for a better understanding of how any changes in those factors may affect health. Paper No. The potential for irreversible or catastrophic effects (including effects of low likelihood). This toolkit was partially supported by funding from the Centers for Disease Control and Prevention through Cooperative Agreement Number 5U38OT000211-03 with the Public Health Foundation. Such a plan is often referred to as a public-health management plan or a health-action plan (Quigley et al. The Atlanta Development Authoritys BeltLine Redevelopment Plan (November 2005) was identified as a coherent and publicly accepted vision that had been approved by local elected officials (ADA 2005). It can also include information from social-science and epidemiologic studies regarding the strength of associations between the social and physical environment (such as air and water quality and economic impacts) and health outcomesinformation essential in the quantitative prediction of health effects. It is important to note that a matrix does not explain how evidence was used to reach conclusions. These common components included preplanning; developing partnerships; developing vision and scope; collecting, analyzing, and interpreting data; identifying community assets; identifying priorities; developing and implementing an intervention plan; developing and implementing an evaluation plan; communicating and receiving feedback on the A plan is typically updated every three to five years. The Catholic Health Association defines a community health needs assessment as a systematic process involving the community to identify and analyze community health needs and assets in order to prioritize these needs, and to plan and act upon unmet community health needs. 3Elements of a Health Impact Assessment Chapter 2established the rationale for examining the potential effects of decisions on health and health disparities and highlighted health impact assessment (HIA) as a potential tool for assessing the health implications of various decisions. HIA recommendations take various forms, and some examples are provided below. Kemm J. The health effects that are included, the data sources and methods that are used, and the recommendations that are made are therefore determined by the HIA practitioners rather than according to a legal or regulatory standard (Wernham 2011). In some cases, recommendations are developed by a decision-maker in response to an HIA report (Quigley et al. It is not reasonable to expect decision-makers to adopt HIA widely in the absence of evidence of its effectiveness and value. The decision-maker must ultimately balance health considerations with the many technical, social, political, and economic concerns that bear on the proposal. The HIA team was assisted by an advisory committee, but it appears that the committee was not involved in the scoping. The local North Slope Borough governmentan agency that participated in preparing the EISconducted an HIA, which was integrated into the EIS report. PDF Community Health Resource Centers: A Toolkit - Episcopal Health Foundation Making community health care culturally correct - American Nurse Good Practice Guidance on Health Impact Assessment. Since there are different models to guide assessment and planning, as well as a variety of organizations and agencies that carry out these activities, there may be confusion in choosing among approaches. Community Health Assessment Toolkit | ACHI For example, if a traffic-calming infrastructure was installed on a street that had a high rate of pedestrian injury, it may be appropriate to monitor injury rates directly because changes would be expected as soon as the installation was complete. Criteria for use in the evaluation of health impact assessments. Step 9: Evaluate Progress | ACHI The World Bank and International Finance Corporation have policies governing the disclosure of information, and although the policies differ, both provide for withholding or excluding documents that might contain proprietary information or information whose disclosure could damage a client or lenders financial, political, or legal interests (Halifax Initiative Coalition 2006; IFC 2006, 2010; McHugh et al. The committee recommends that HIAs be publicly released and disseminated. Becoming culturally competent is an ongoing process. The research was funded by the Annie E. Casey Foundation as an initiative with the potential to encourage long-term strategies and partnerships to strengthen families and communities. Furthermore, impact assessments, including HIAs, may rely on proprietary business information whose disclosure is legally barred or could damage a proponents business edge or competitiveness. As in the realm of health risk assessment, there remains a need to distinguish between the assessment and management phases to avoid manipulation of analytic components by decision-makers. For example, although an HIA may not be able to incorporate engineering or economic specifications for alternate routes for a proposed highway, it could discuss factors that would influence health outcomes, such as indicating that a desirable route would be, for example, 100 m from any school or elderly facility or would not be proximate to high-population-density areas with a number of vulnerable people. This chapter has described HIA categories, defined HIA, discussed current HIA practice, noted variations in practice, and provided the committees conclusions regarding each step of the HIA process. In practice, the categories are rarely used consistently, and a single HIA often encompasses a blend of various approaches to stakeholder engagement and participation, analytic methods, and interactions with the formal decision-making process. A clear explanation should be provided with the characterization of effects that indicates the evidence used to develop the matrix and any limitations, data gaps, and uncertainties. Third, it informs government agencies and officials of potential changes in demand for services, such as health care, emergency response, and public safety; this can facilitate an appropriate response. IPIECA/OGP (International Petroleum Industry Environmental Conservation Association and International Association of Oil and Gas Producers). 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. As discussed above, additional benefits may include, for example (Wismar et al. For example, there may be concerns about risks to a proponents reputation or to the viability and public acceptance of a proposed project if a report discloses important unmitigated adverse impacts or potential impacts that are uncertain or for which strong evidence does not exist. CDC is not responsible for the content of materials not generated by CDC. Understanding Risk: Informing Decisions in a Democratic Society. Evaluation is important for the quality of individual HIAs and for the success of the HIA field as a whole. Public and stakeholder participation during scoping can serve several important purposes, such as providing local knowledge regarding existing conditions and potential impacts, introducing alternatives or mitigation measures that stakeholders would endorse as effective ways to address key concerns, and allowing representative participation in shaping the terms of the HIA by groups affected by the proposal. A smaller set of related indicators was endorsed for use in monitoring key elements of community health status (CDC, 1991). Acknowledgement of plans for future outcome evaluation or discussion of limitations that prevent such an evaluation. 2009; Castro et al. Another consideration is whether the proposal is likely to place a disproportionate burden of risk on vulnerable populations in the affected community; screening proposals on this basis helps to ensure that the HIA addresses the risk factors that underlie observed disparities in the rates of illness among various populations. Major issues and challenges for HIA development and practice are considered in Chapter 4. Because decision-makers must eventually translate health-based recommendations into actionable measures (for example, by modifying legislation, drafting regulations or permit conditions, instituting new zoning requirements, or encouraging voluntary activities), regular communication between the HIA team and the decision-makers is important for the success of a proposed recommendation (EPA 2009). Conversely, to have the greatest relevance as an informational and planning document and to ensure judicious use of resources, the HIA should ultimately focus on the health effects of greatest potential importance. 2009; Bhatia et al. The degree to which they are systematic varies, and some authors have suggested frameworks and guidance for conducting systematic reviews (Mindell et al. Scoping identifies appropriate data sources for the analysis and should also identify important data gaps. HIA provides recommendations on monitoring and managing those effects. In the United States, HIAs have commonly been undertaken by people who have an MPH or equivalent degree and have attended a brief (2- to 5-day) training session. The training and credentials of HIA practitioners are variable, and there is no universally accepted standard for a level of training necessary to lead an HIA. The committee proposes on the basis of its review the following adaptation of the current working definition of the International Association of Impact Assessment (Quigley et al. Not all HIAs will meet all proposed criteria, but the criteria are intended to describe typical practice. Parry JM, Kemm JR. Because of the timeframe of proposal implementation and effects on health, outcome evaluation often requires a long-term research commitment. A central tenet is that peoples experience offers an invaluable perspective on the potential effects of the proposal. 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. Describes the baseline health status of the affected population with appropriate indicators, including prevalent health problems, health disparities, and social, economic, and environmental factors that affect health. We identified 11 common assessment and planning components across 18 models and requirements, with a particular focus on health department, health system, and hospital models and requirements. 2017 Jul/Aug;23 Suppl 4 Suppl, Community Health Status Assessment:S14-S21. Membership is variable but may include representatives of affected communities or community-based organizations, industrial proponents or business groups, public-health experts, officials involved in the decision- making process, and others who have a stake in the outcome. Community Health Assessment & Planning Guidebook - nmhealth.org Given that HIA led by the private sector appears to be a rapidly increasing practice, the issue of availability bears further consideration. Even when there is substantial uncertainty, an assessment can illuminate potential causal pathways thateven when there appear to be conflicting influences on a specific outcomecan point the way toward a flexible framework for monitoring and managing any impacts that might occur as the proposal is implemented.
Newsletter
Cadastre-se para receber nossa newsletter e conhecer em primeira mão todos os shows, experiências e eventos do ALL Signature