Health Impact Assessment: Bringing Public Health Back to the Decision Table
38
Katherine Hebert, MCRP August 19, 2011 Health Impact Assessments: Bringing Public Health Back to the Decision Table Presentation made possible through funding from the Oak Ridge Institute of Science and Education (ORISE). The findings and conclusions in this presentation have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.
-
Upload
hpcareernet-llc -
Category
Health & Medicine
-
view
2.793 -
download
1
Transcript of Health Impact Assessment: Bringing Public Health Back to the Decision Table
Katherine Hebert, MCRP
August 19, 2011
Health Impact Assessments: Bringing Public Health
Back to the Decision Table
Presentation made possible through funding from the Oak Ridge Institute of Science and Education (ORISE). The findings and conclusions in this presentation have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy.
Quick History and Future Direction of Planning, Policy, and Public Health
Introduction to the Social Determinants of Health
HIA Definition and PurposeHIA ProcessThe Current State of HIA in the United StatesResources
Agenda
Not New Concept- Over Correcting
Social Determinants of Health
Source: http://www.pharmacymeetspublichealth.org.uk/publichealthbackground_determinants.html
Source: Frieden, A Framework for Public Health Action: The Health Impact Pyramid, AJPM
Policy &Planning
Health Impact Assessments
Public Health
Built Environment
Planning and Policies
HIA
HIA
Planning + Policy + Public Health
Healthy Communities
Healthier Population
Health Impact Assessments
An HIA is a combination of procedures, methods and tools that systematically and prospectively judges the potential, and sometimes unintended, effects of a policy, plan, program, or project (commonly outside of the health sector) on the health of a population, and the distribution of those effects within the population. HIA identifies appropriate actions to manage those effects.
What HIA IS
Adapted from the WHO Gothenberg Consensus Paper, 1999
Process and Product
Process• Principles of democracy,
equity, sustainability, ethical use of data, comprehensive approach to health
• Fosters collaboration between planning, health, and policy making fields and community engagement
• Steps: screening, scoping, assessment, recommendations, report, evaluation
Product• A report (in multiple
formats for different audiences) that portrays the process, findings, and recommendations of the HIA
• Intended to be presented to decision makers prior to the decision being made
• Used as a model to other HIA practitioners and to supplement other tools/policies
Transportation ProjectsLand Use DecisionsHousingAgriculture/ Food Security/ Food SupplySustainability EffortsComprehensive PlansEnergyWater/ Sewer/ Waste ManagementEconomic/ EmploymentBudget
Topics HIA Have Been Applied To
Screening
Scoping
Assessment
Recommendations
Reporting
Evaluation
Health Impact Assessments Steps
Screening
•Whether or not to conduct a HIA on the proposal.
•Will a HIA add to the decision-making process?
•Are there potential health impacts?
Scoping
•How are we going to conduct the HIA? Setting an action plan.
•Identifying potential impacts to assess.
•Setting boundaries- temporal, geographic, population, etc.
Health Impact Assessments Steps
Assessment
•Collecting data and conducting a community profile.
•Estimating the potential impacts based on quantitative and qualitative data and processes.
•Combination of expert and community involvement.
Recom
mendations
•Develop suggestions to maximize the positive and minimize the negative health impacts.
•Prioritize recommendations and make them actionable and as specific as possible.
•Community involvement key for buy in and support of recommendations by decision makers.
Health Impact Assessments Steps
Reporting
•Provide public and decision makers with the process, findings, and recommendations of the HIA.
•Remember different report types for different audiences.
Evaluation
•How could the process be improved?
•What was the impact on the decision?
•What were the health outcomes of the decision made? Predictions accurate?
Health Impact Assessments Steps
Who Are the Players- U.S.Funding
PEWRWJF- ALRNCEH-HCDIASTHO
Training5 UniversitiesAPA/NACCHO
WebcourseSan Francisco
CourseGuides/Readings
Conferences Practitioners
Human Impact Partners
San Francisco Health Department
SOPHIAState & Local Health
OfficialsCPPW StatesUniversitiesHealthy Design
Professionals
AK 5
CA 30
CO 3
FL 1
MA 3
NJ 1
Completed HIAs in the United States1999–2010: 79
MN 5
GA 6
WA 4
OR 6
OH 1
PA 2
MD 1
MT 3
Map developed in collaboration with A. Wernham, Health Impact Project and
A. Wendel and A. Dannenberg, National Center for Environmental
Health
16
NM 1
TN 1
ME 1
WI 1 NH 1
AK 7
CA 47
CO 4
FL 1
MA 4
NJ 1
Completed and in Progress HIAs in the United States
1999–2010: 119MN 6
GA 8
WA 8
OR 12
OH 1
PA 2
MD 2
MT 3
Map developed in collaboration with A. Wernham, Health Impact Project and
A. Wendel and A. Dannenberg, National Center for Environmental
Health
NM 1
TN 1
ME 1
WI 1 NH 2
HI 1
TX 1
IL 1
MO1
KY 1
Community ProfileBaseline of Current Community ConditionsHelp Identify Health Concerns Characterize Population Pay Attention to Scale/ Challenge of Local
DataCDC Resources
Behavioral Risk Factor Surveillance SystemYouth Risk Behavior Surveillance SystemSocial Determinants MapsCounty Prevalence Data MapsState Burden of Chronic DiseaseState Cancer Rate Information
Join the HIA Community of
Practice!
Go to www.phconnect.org to become a member and find the HIA Community of PracticeFor more information contact Katherine Hebert at [email protected]
www. cdc.gov/healthyplaces/hia.htm
www.healthimpactproject.org/project/opportunities
www.hiaguide.org/
Resources on HIANACCHO, HIA Quick Guide
http://www.apho.org.uk/resource/item.aspx?RID=82413
Human Impact Partners, HIA Toolkit http://www.humanimpact.org/component/jdownloads/finish/11/81
University of Minnesota, Rapid HIA Toolkithttp://www.designforhealth.net/pdfs/HIA/BCBS_Rapidassessment_011608.pdf
Websites: HIA Gateway, HIA CLIC, CDC HIA, WHO HIA, San Francisco Bay HIA Collaborative, phConnect
Katherine Hebert, MCRPCommunity Planner and Researcher
Centers for Disease Control and PreventionDivision of Nutrition, Physical Activity, and Obesity
[email protected], 770-488-5247
Cabinet for Health and Family Services
Teresa Lovely MS CHESElaine Russell MS RD LDDr. Cecilia Watkins CHES
Health Impact Assessment (HIA)Project
Kentucky Worksite Wellness Tax Credit
Kentucky Receives ASTHO HIA Grant One of three states$15,000Build capacity to conduct HIAsConduct first HIA projectCollaborate with partnersShare findings and recommendationsProduce a final reportMonitor the outcome of the target
project Cabinet for Health and Family Services
HIA of Kentucky Worksite Wellness Tax Credit
Kentucky Worksite Wellness Tax Credit Proposed House Bill HB 74 AN ACT relating to encourage healthy lifestyles.
Original bill introduced 2008
Total credit not to exceed $100 / number of employees annually
$3,000,000 cap
Kentucky Worksite Wellness Tax Credit
Goal of the HIA
Research the impact of the tax credit on:
Childhood obesity
Jobs
Social cohesion in the workplace
Cabinet for Health and Family Services
Cabinet for Health and Family Services
Literature Review Conducted by Western Kentucky University
•Looked at obesity at national level•Kentucky’s obesity levels particularly for children•Need for an integrated approach•Workplace’s potential role – where parents are•Parent’s impact on children’s health (obesity) •The need to look at the environment and policy
Parents are not receiving enough information, support, and guidance on childhood obesity.
A worksite wellness program would address teaching employees (parents) about diet and physical activity
The education and support that employees (parents) receive in the workplace can positively influence the family.
Programs would need to include children and families, focus on child behavior and environment
Parents can be advocates for their children’s environment whether at home, daycare or school.
Cabinet for Health and Family Services
Childhood Obesity Impact Findings
IBM’s Children Health Rebate Program
About 45 % of IBM’s employees have children covered on the health plan.
In 2008 launched this program to help parents assist their children in maintaining a healthy weight.
The 12-week web-based program includes a $150 cash rebate that rewards participation.
2/3 of employees who participated reported that their children were exercising
59% of children and 64% of adults improved body weight or maintained a healthy weight.
Parents and children improved in healthy eating and physical activity behaviors and a reduction in screen time
Source: Business Group on HealthCabinet for Health and Family Services
Jobs: Impact Findings
Lack of employment or underemployment affects ability to purchase healthy foods, maintain or improve health, and receive medical care
Reducing health care costs, improving productivity through wellness programs could lead to an increase in jobs in the state
A tax credit could lead to an increase in wellness jobs
Cabinet for Health and Family Services
Social Cohesion/Well-being: Impact Findings
Ky. Ranked 49 in Gallop Well –being Index Study
State’s Work Environment Index score fell from 48.3 in 2009 to 46.8 in 2010 leading to a drop in state ranking from 32 to 36 in this index
Specific populations such as urban areas and rural, particularly Appalachian reported less well-being in some factors.
Wellness programs have been shown to affect morale and improve the work environmentCabinet for Health and Family Services
Overall: Impact Findings
Number of companies that have wellness programs has increased from 34% in 2007 to 63% in 2010.
However most not comprehensive 94% of companies have less than 50
employeesFirms with less than 100 employees
accounted for 35 percent of total employment in Kentucky.
A worksite wellness tax credit would increase the number of worksite wellness programs particularly in smaller companies Cabinet for Health and Family Services
Worksite Wellness Programs: Impact Findings
Kentucky lacks much of the needed specific information on worksite wellness programsHow many work in the wellness service field?Turnover rates in companies in the state with
wellness programs ? How does the morale differ in companies that have
wellness programs? How does the productivity differ?Health outcomes associated with workplace
support
A state-wide detailed assessment of current worksite wellness program practices is needed.
Cabinet for Health and Family Services
Preliminary Recommendations
Enact the tax credit billConduct an in depth assessment of worksite
wellness programs in the stateRecognize the worksite venue as a means to
improve health of Kentucky residents – not just employees
Incorporate tax credit criteria to include programs to assist families improve health
Kentucky economy can be improved through worksite wellness programs
Cabinet for Health and Family Services
Cabinet for Health and Family Services
QUESTIONS?
