An Introduction to Health Impact Assessment Paul J. Anderson, MD, MPH HIA Program Manager Section of Epidemiology Division of Public Health Department of Health and Social Services

What is HIA? Preventive health report Anticipates human health effects New or current Projects Policies Programs Minimize adverse health effects Maximize health benefits

Definition “HIA is 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” World Health Organization (WHO), 1999

HIA and NEPA

Federal Lead Agency Federal Cooperating Agencies EPA MMS BLM USACE Others Produces EIS State Cooperating Agencies DNR (LEAD) DHSS* DEC ADF&G DOT Others NEPA Local Cooperating Entities Municipalities Tribal Governments Boroughs Cities Counties Others Proponents Corporations State Government Cities Boroughs Others Contractors Environmental Socioeconomic Human health NEPA specific Others Who does the HIA?

Project Timeline and HIA Permit Application Project Permit Intent to File Permit Phase 1: BaselinePhase 2: NEPA/EISPhase 3: Operation

Project Timeline and HIA Permit Application Project Permit Intent to File Permit Phase 1: BaselinePhase 2: NEPA/EISPhase 3: Operation Screening Scoping meetings Site visits Existing data gathered New data collected Literature review Summary Report Data synthesis Data Analysis Updated site visits Risk Assessment Health Action Plan Standalone HIA Ongoing monitoring Evaluate Action Plan

Participating in HIA Permit Application Project Permit Intent to File Permit Phase 1: BaselinePhase 2: NEPA/EISPhase 3: Operation Scoping meetings Formal comments Draft reviews Study participation Help suggest mitigation Assist monitoring Request an HIA Educational meetings Letters of invitation Host HIA team visits Share information Participate in studies Community comments

HIA Concepts

Mitigation Types in HIA RegulatoryNegotiatedVoluntary Low Control (Indirect Impacts) High Control (Direct Impacts)

Respect, Protect, Remedy Corporation/ApplicantRespect Do no harm Do good when able Protect autonomy Seek justice GovernmentsProtect PeopleRemedy ~John Ruggie – UN Secretary General’s Special Representative on Human Rights

Health Effects Categories Social Determinants of Health Accidents and Injuries Hazardous Substances Food, Nutrition, Subsistence Infectious Diseases Chronic Diseases Water and Sanitation Health Care Delivery

Key Activities Ask for an HIA Participate in scoping meetings Give health comments Share local and traditional information

HIA Elements

Project Features and Health Linear features (roads, pipelines) Construction camps (size, location) Influx (worker housing) Resettlement or relocation Large projects, rural settings Engineering footprints Health footprint

HIA Funding under NEPA Federal Agency APPLICANT Federal agency requests HIA

HIA Funding under NEPA Federal Agency Department of Natural Resources (OPMP/LMPT) HIA Contractor APPLICANT Federal agency requests HIA Applicant asks OPMP for HIA OR Applicant hires contractor $ $

HIA Funding under NEPA Federal Agency AK HIA Program Department of Natural Resources (OPMP/LMPT) HIA Contractor APPLICANT Federal agency requests HIA Applicant asks OPMP for HIA OR Applicant hires contractor OPMP uses state HIA program OPMP provides contract help to HIA program $ $ $

HIA Funding under NEPA Federal Agency State HIA AK HIA Program Department of Natural Resources (OPMP/LMPT) HIA Contractor APPLICANT Independent HIA Federal agency requests HIA Applicant asks OPMP for HIA OR Applicant hires contractor OPMP uses state HIA program OPMP provides contract help to HIA program $ $ $ $