However, Science and Decisions (NRC 2009) emphasizes that a detailed understanding of the decision context is necessary for analyses to be scoped appropriately and that the conceptual distinction between assessment and management should not be interpreted as a firewall that prevents communication between parties. Acknowledgments To address that concern, monitoring of concentrations of selected contaminants in local fish was proposed as a mitigation measure. 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. 2010). In 1998, the Bureau of Land Management (BLM) completed a Northeast National Petroleum Reserve-Alaska Integrated Activity Plan/Environmental Impact Statement (EIS). Past Projects: Paid Sick Days Legislation. A smaller set of related indicators was endorsed for use in monitoring key elements of community health status (CDC, 1991). The baseline profile characterizes the health status of affected populations and includes trends and factors (social, economic, and environmental) known to affect health. Process evaluation assesses the design and execution of the HIA in light of its intended purpose and plan of action and applicable practice standards. The effectiveness of Health Impact Assessment: Scope and Limitations of Supporting Decision-Making in Europe. These cookies may also be used for advertising purposes by these third parties. Thank you for taking the time to confirm your preferences. 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. The committee notes that outcome evaluation considers the effects of the whole decision, including changes made as a result of HIA recommendations. Menu labeling as a potential strategy for combating the obesity epidemic: A health impact assessment. HIAs conducted as part of a formal government process are generally subject to disclosure and freedom-of-information requirements. Observing and documenting the HIA processsuch as methods of engaging stakeholders and interacting with decision-makers and approaches to addressing analytic challenges and interviewing participants and stakeholders are the main methods of process evaluation. Catholic Health Association, Guide to Assessing and Addressing Community Health Needs [PDF-1.5MB], June 2013. Paper No. Elements of a Health Impact Assessment - Improving Health in the United An HIA does not have to accept community concern uncritically. Any logic models or scoping tables that were completed should also be included. The discussion below briefly provides definitions and key features of HIA monitoring and evaluation. This review outlines the epidemiology of suicide and suicidal behavior in young people. 3, Elements of a Health Impact Assessment. 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. 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. Science and Decisions: Advancing Risk Assessment. Links to nonfederal materials are provided as a public service and do not constitute an endorsement of the materials by CDC or the federal government, and none should be inferred. The use of various types of evidence and approaches used to make predictions are discussed below. Data and results are measured consistently across participants. Step 7: Plan Implementation Strategies | ACHI This list can then be used to set priorities. Affected populations: As the TAD constituted only a portion of the city that would be directly affected, the HIA team created the HIA study area by placing a 0.5-mile buffer around the BeltLine TAD. However, the committee notes that there are several benefits of disclosure for industry, policy-makers, and the affected communities. Activities directly or indirectly associated with oil and gasincluding aircraft traffic, seismic exploration, influx of nonresident workers, and emissions and dischargeswere identified, and pathways were analyzed to consider their impacts on such problems as diet-related chronic illnesses (for example, diabetes and hypertension), food insecurity, and social pathology (for example, assault, alcohol and drug abuse, and violence). A description of the HIAs impact on decision-making (to the extent that salient decisions have occurred by that time) as measured by an accounting of HIA recommendations that were adopted and an evaluation of available evidence that suggests whether and how the HIA played a role in decisions or contributed to changes in decision-makers knowledge, attitudes, or positions. The committee notes three considerations that may be particularly important for producing effective, actionable recommendations. The World Bank Policy on Access to Information. The process of implementing recommendations should be transparent and should include opportunities for public participation in the decision process and clear mechanisms of accountability. National Research Council (US) Committee on Health Impact Assessment. The committee selected a six-step framework as a clear way to organize and describe the critical elements of an HIA. Community Health Assessment Toolkit | ACHI The committee finds that an HIA report should at least describe the proposal and alternatives that are the subject of the HIA, the data sources and analytic methods used, the groups and individuals that were consulted in the course of the HIA, the process and findings of each step of the HIA, and the overall conclusions and recommendations. Epub 2018 Jun 19. Although deviation from the criteria may occur, a valid and clearly articulated rationale for such deviation should be described when the HIA is reported. For example, although rapid HIAs are small-scale, low-cost investigations, comprehensive HIAs that require new primary data collection can take longer than a year to complete and require substantially more resources. 2009; Castro et al. On the basis of its review, the committee synthesized the information from guidance, practice, and literature to propose criteria that define an HIA and draw several conclusions regarding HIA practice. In most cases, influencing decisions to protect or promote health is a central objective but by no means the sole outcome of value. 7 Components of a CHNA | Community Health Needs Assessment The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. 2019 Feb;22(1):25-31. doi: 10.1089/pop.2018.0049. The recommendations should be provided in the final HIA report and should document available supporting evidence, stakeholder input, and a health-management plan, which should do the following: If no recommendations are made in the HIA report, an explicit rationale should be provided for the decision not to include them. Cook WK, Heller J, Bhatia R, Farhang L. A Health Impact Assessment of the Healthy Families Act of 2009. That issue is discussed at greater length in Chapter 4. A major alternative to a proposal (for example, routing a proposed highway away from a vulnerable population or building a light-rail line rather than widening a road). In contrast, the effect of decisions on some health outcomes (such as cancer or obesity) may take years to occur and may have multiple contributing factors. 2006). Process evaluation can range from a simple self-assessment that is undertaken at the end of an HIA and focuses on a few variables that are relatively simple to describe, track, or measuresuch as the methods used, degree of certainty of predictions, and approach to stakeholder engagementto a more comprehensive case study that seeks to evaluate the HIA process holistically. A variety of screening tools and algorithms are commonly used (Cole et al. Sources: Veerman et al. That explanation is particularly important when public funds are to be used for an HIA because the public may want to understand the basis for allocating sparse public resources. Human Impact Partners then worked with groups in other states to extrapolate the findings of the national report to local jurisdictions to analyze the health effects of paid sick days. A variety of tools and processes may be used to conduct a community health assessment; the essential ingredients are community engagement and collaborative participation. The quality of the report can be a criterion by which the quality of the process is judged; that is, How clearly does the final document present the results of the analysis? While CHNAs are a recent requirement, community health assessments (CHAs) have long been used as a tool by hospitals, public health departments and other social service agencies to identify key community health concerns. It is also highly likely to lead to improved compliance with public-health guidance regarding seasonal influenza and community mitigation strategies for pandemic influenza. In contrast, effects that are likely but less well supported include increased ambulatory or preventive primary care, fewer emergency-room visits by workers who are insured, and greater compliance with infection-control policies. As part of the assessment phase, a set of specific indicators that can be used to describe the baseline and potential changes in health status or health determinants should be developed. The committee does not intend that the definition and criteria proposed in this chapter be considered rigid requirements but rather that they reflect an ideal of practice, deviation from which may occur but should be based on clear and well-articulated needs and rationale. Simply producing and disseminating a report may not be sufficient to secure adoption and implementation of HIA recommendations. The committee is referring here to HIAs sponsored or led by private-sector entities that are not part of any formal government process, such as a permitting or regulatory requirement. Cole BL, Wilhelm M, Long PV, Fielding JE, Kominski G, Morgenstern H. Prospects for health impact assessment in the United States: New and improved environmental impact assessment or something different? Although rapid or desktop HIAs may not involve stakeholders or consider their input, this often (although not uniformly) reflects a pragmatic response to limitations, such as the timeframe for the decision or resources available to the HIA team, rather than an optimal practice.
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