1. www.designforhealth.net Design for Health August 13, 2007 Health Impact Assessment Kevin Krizek Design for Health

2. www.designforhealth.net Design for Health August 13, 2007 Health Impact Assessment Agenda (Image centered left to right, 2.5 up from bottom, 2.0 from top) I.What is a Health Impact Assessment (HIA)? II.What is special about the Design For Health HIA series? III.What are the types of HIAs? IV.What type(s) of HIA is best for your community? Ann Forsyth

3. www.designforhealth.net Design for Health August 13, 2007 Health Impact Assessment What is a Health Impact Assessment? (Image centered left to right, 2.5 up from bottom, 2.0 from top) Identifies and evaluates the effects of policies, plans, programs, and designs on the health of a population. Health impact = changes in health of an individual or group due to a project, program, policy, or plan Typically done before, during, or after the preparation of a project of plan Comes in a variety of forms Ann Forsyth

4. www.designforhealth.net Design for Health August 13, 2007 Health Impact Assessment What is different about our HIA series? (Image centered left to right, 2.5 up from bottom, 2.0 from top) Characteristics of traditional HIAs: Led by public health experts Focus on the social environment crime, economic development, affordable housing, etc. Most are very general, linked to broad health outcomes Ann Forsyth

5. www.designforhealth.net Design for Health August 13, 2007 Health Impact Assessment What is different about our HIA series? Design for Health HIA: Targets urban planners Comprehensive planning Plan implementation Development review Focuses on areas of the built environment of relevance to planners. Addresses a wide range of health issues, but only those where there is evidence of a health effect. Ann Forsyth

6. www.designforhealth.net Design for Health August 13, 2007 Health Impact Assessment What are the different types of HIAs? (Image centered left to right, 2.5 up from bottom, 2.0 from top) 1.Preliminary Checklist (also called an audit) 2.Rapid Assessment 3.HIA Threshold Analysis (a form of “intermediate” HIA) 4.Comprehensive HIA Ann Forsyth

7. www.designforhealth.net Design for Health August 13, 2007 Preliminary Checklist Overview First step in HIA process Checklist/survey of health issues Determine if further assessment is needed Quick Point-based Carissa Schively

8. www.designforhealth.net Design for Health August 13, 2007 Preliminary Checklist Overview Assesses significance of project, plan, or policy in terms of its size and scope Is it significant enough to assess? Does the plan or proposal meet some initial thresholds for a healthy community? Initial scan of impacts Helps determine whether additional analysis is needed Carissa Schively

9. www.designforhealth.net Design for Health August 13, 2007 Preliminary Checklist (Image centered left to right, 2.5 up from bottom, 2.0 from top) Part I: Is it significant enough to assess? 1.Geographic extent 2.Reversibility 3.Population or workforce increase 4.Cumulative impact 5.People affected 6.Land use change 7.Institutional capacity Carissa Schively

10. www.designforhealth.net Design for Health August 13, 2007 Preliminary Checklist Part 1: Is it significant enough to assess? Key QuestionsNoUncertain Yes Geographic extent: Does it apply to a geographic area of a full city block or larger? 01 2 Cumulative impact: Is it occurring in a place where specific local health problems have been identified (e.g. traffic safety, air quality, lack of health foods, contaminated brownfields)? 01 2 People affected: Does the project or plan affect vulnerable groups (e.g. children, older people, people with lower incomes)? 01 2 Total+ += If total score is 11 or greater, HIA may be needed, less than 7, move to Part 2. If total score is 7-10, a HIA is potentially needed, moving to Part 2 recommended. If total score is 6 or less, no HIA required. You may wish to do one on a targeted area or problem.

11. www.designforhealth.net Design for Health August 13, 2007 Preliminary Checklist (Image centered left to right, 2.5 up from bottom, 2.0 from top) Part 2: Does the plan/policy/project meet thresholds? 1.Accessibility 2.Physical Activity 3.Social capital 4.Air Quality 5.Water Quality 6.Food 7.Safety Carissa Schively

12. www.designforhealth.net Design for Health August 13, 2007 Preliminary Checklist Key QuestionsNoUncertain Yes Accessibility: Is there regularly scheduled transit service within ¾ miles of all residential and employment areas? 21 0 Air quality: Are there any residential areas or schools within 200 meters of a major auto- related transportation corridor such as a freeway or road with six or more lanes? 01 2 Food: Are there supermarkets or fruit and vegetable stores located within a mile of each home? 21 0 Total+ += If total score is 13 or greater, it is recommended that you conduct an HIA. If total score is 8-12, an HIA is potentially needed. If total score is 7 or less, no HIA required. You may wish to do an HIA on a targeted area or problem. Part 2: Does the plan or proposal meet some initial thresholds for a health community?

13. www.designforhealth.net Design for Health August 13, 2007 Preliminary Checklist Using the HIA Who is involved? City staff – planners, engineers, parks, public health, others Public Elected/appointed officials Other agencies/organizations What is required? Time varies Basic knowledge of the project, plan, or policy Carissa Schively

14. www.designforhealth.net Design for Health August 13, 2007 Preliminary Checklist Using the HIA What are the outcomes of a preliminary checklist? Knowledge about the connections between health and planning Additional HIA may be needed Key health concerns may emerge Need for scoring adjustments to reflect local values and conditions Carissa Schively

15. www.designforhealth.net Design for Health August 13, 2007 Rapid Health Impact Assessment 1. Big idea 2. Participants 3. Information 4. Agenda/workshop 5. Results Design for Health

16. www.designforhealth.net Design for Health August 13, 2007 Rapid Assessment Characteristics (Image centered left to right, 2.5 up from bottom, 2.0 from top) 1.More time intensive Few weeks to prepare One-half day to conduct Few weeks to write- up 2.Participatory focus group workshops 3.Prospective Ann Forsyth

17. www.designforhealth.net Design for Health August 13, 2007 Rapid Assessment Steps to Prepare for the HIA (Image centered left to right, 2.5 up from bottom, 2.0 from top) 1.Identify and gather participants Steering committee, stakeholders, etc 2.Gather information Inventory of existing plans/policies, creating an area profile, talking to those affected 3.Run the workshop 4.Write-up the results and move forward

18. www.designforhealth.net Design for Health August 13, 2007 Several Types of Results Report – introduction, information, results of the workshop, recommendations for changes Implementation e.g. results incorporated into plan Evaluation – Michigan Public Health Institute is doing a process and outcome/implementation evaluation Monitoring – of implementation Rapid Assessment Results

19. www.designforhealth.net Design for Health August 13, 2007 Rapid Assessment How can planners use the results? 1.Determine if a more detailed HIA is needed 2.Determine the financial and political risk 3.Use to make changes to plan, policy, or project 4.Identify methods to monitor and evaluate health outcomes 5.Educate city staff and stakeholders Metropolitan Design Center

20. www.designforhealth.net Design for Health August 13, 2007 Threshold Analysis Characteristics (Image centered left to right, 2.5 up from bottom, 2.0 from top) 1.Potentially time intensive for data preparation 2.Detailed 3.Lists thresholds 4.Requires evidence 5.Point-based Ann Forsyth

21. www.designforhealth.net Design for Health August 13, 2007 Where to use in the HIA process? Most rapidly evolving of the types of HIAs being developed Best used later in the planning process

22. www.designforhealth.net Design for Health August 13, 2007 Characteristics of the Threshold HIA Most specific in the suite of HIA tools provided by Design for Health. Informed by synthesizing and digesting available research. –What does the “research tells us” –How strong/clear is that research –How can it be applied to more specific projects or plan proposals

23. www.designforhealth.net Design for Health August 13, 2007 Structure of the Threshold HIA Uses same categories of public health categories as other tools in the Design for Health HIA suite Further breaks these areas down into 20 or so specific criteria Requires specific knowledge of the plan or project (e.g., specific information or characteristics about plan element or development proposal Scoring is based on sliding scale

24. www.designforhealth.net Design for Health August 13, 2007 Topic: Accessibility Threshold Analysis (Draft) IntentEnsure adequate transit service. RationaleTransit service not only provides alternatives to auto- travel, but provides means of mobility for the elderly, young and/or financially disadvantaged. RequirementsResidential components of the plan are built at an average of more than seven units per acre DefinitionsNeed to consider net density. SubmissionSite plan with density calculations. Possible Credits 1 for 7 units per residential acre; 2 for 7 units per gross acre Credits Awarded Transit Service (Threshold)

25. www.designforhealth.net Design for Health August 13, 2007 Types of HIAs How do you choose which type of HIA your community should use to inform plan, policy, or project decisions? Questions that planners should ask: Are there only very limited resources available to conduct a HIA? Is there only limited time to conduct an HIA? Will the HIA only have limited influence? Is the timeframe for the decision-making process set by external factors beyond your control? Is it relatively short?

26. www.designforhealth.net Design for Health August 13, 2007 Health Impact Assessment Agenda (Image centered left to right, 2.5 up from bottom, 2.0 from top) I.What is a Health Impact Assessment (HIA)? II.What is special about the Design For Health HIA series? III.What are the types of HIAs? IV.What type(s) of HIA is best for your community? Ann Forsyth

27. www.designforhealth.net Design for Health August 13, 2007 Health Impact Assessment For more information visit www.designforhealth.net Ann Forsyth