1. Recommendations Steve White, MURP Oregon Public Health Institute

2. RECOMMENDATIONS 1.Threads 2.What makes a good recommendation? 3.What types of recommendations are often made in an HIA? 4.Recommendations outcomes 5.Small group exercises

3. Stakeholder Engagement Which stakeholders to involve in the development and prioritization of recommendations How to involve stakeholders as recommendations are developed Equity How to involve affected populations in the development of recommendations in order to ensure that the recommendations address their concerns Whether recommendations that address health inequities should be prioritized THREADS

4. Evaluation How to develop recommendations whose effectiveness can be assessed Communications How to communicate the credibility of recommendations and their ability to effectively achieve their desired outcomes THREADS

5. Good Recommendations Are… 1.Responsive to predicted impacts 2.Specific and actionable 3.Experience-based and effective 4.Enforceable 5.Able to be monitored 6.Technically feasible 7.Politically feasible 8.Cost-effective 9.Unaccompanied by additional negative consequences 10.Implementable within the regulatory, administrative, or legislative framework of the proposal being considered

6. A Tale of Two Recommendations… Lake Oswego to Portland Transit HIA Findings: Construction activities related to infrastructure development would result in temporarily elevated levels of certain hazardous air pollutants. Amounts of air toxics produced during construction can vary greatly depending on the age and condition of the construction equipment.

7. A Tale of Two Recommendations… The Recommendations Metro (the planning agency) should encourage contractors to use better equipment. TriMet (the contracting agency) should work with the State DEQ Clean Diesel program to develop more stringent emissions-based equipment fleet requirements or incentives for contractors and sub-contractors working on the project. Responsive to predicted impacts Specific and actionable Experience-based and effective Enforceable Able to be monitored

8. A Tale of Two Recommendations… The Recommendations Metro (the planning agency) should encourage contractors to use better equipment TriMet (the contracting agency) should work with the State DEQ Clean Diesel program to develop more stringent emissions-based equipment fleet requirements or incentives for contractors and sub-contractors working on the project Technically feasible Politically feasible Cost-effective Do not introduce additional negative consequences Implementable within the regulatory, administrative, or legislative framework of the proposal being considered

9. Common Types of HIA Recommendations 1.Mitigation: Actions intended to mitigate adverse health impacts identified during assessment 2.Enhancement: Actions intended to improve health by amending the policy, plan, or project under question 3.Adoption: Actions for the decision-makers regarding whether or not to adopt one of the proposed scenarios

10. Outcomes Each recommendation in the HIA should be accompanied by a brief statement that includes: The intent of the recommendation Which organization can and should implement the associated action(s) Indicators useful for monitoring effectiveness of recommendations in achieving their intent The scientific basis for its effectiveness If the HIA contains no recommendations, then it should contain a statement explaining this decision.

11. Why Think About Recommendations at the Outset? Help identify who to involve Help enlist key stakeholders Help determine scope of HIA