The bulleted list below provides examples in which some health impacts or behavioral outcomes have been quantified. Miranda ML, Keating MH, Edwards SE. The ultimate goal of a community health assessment is to develop strategies to address the communitys health needs and identified issues. Sources of information used in a baseline profile might include census data, hospital-discharge records, disease registries, and population and behavior surveys, such as the Behavioral Risk Factor Surveillance Survey, in which information is collected on different geographic scales. Different HIA guides vary somewhat as to the specific descriptors that should be used, and practice is highly variable. For example, U.S. priorities for improving public health are expressed in the Healthy People 2020 Program of the U.S. Department of Health and Human Services (DHHS 2010). Integrates stakeholder input into the analysis of effects. First, disclosure informs affected communities and individuals and possibly other stakeholders, such as government agencies and officials, of possible effects on their health and well-being, a core objective of HIA. Chapter 2 established the rationale for examining the potential effects of decisions on health and health disparities and highlighted health impact assessment (HIA) as a potential tool for assessing the health implications of various decisions. A complete nursing health assessment requires a health professional to examine a patient in a systematic fashion, from head to toe. Ensuring that the public has accurate and complete information on adverse and beneficial effects. Parry JM, Kemm JR. The assessment also highlighted several potential benefits, such as funding for infrastructure and health care; increased employment and income; and continued funding of existing infrastructure (BLM 2007, p. 500). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services. The HIA study area was divided into five planning areas, and census (2000) and mortality data were used to analyze the population profiles. Although less common to date, HIAs are also sometimes conducted by a decision-making agency, such as a metropolitan planning organization or a federal agency complying with NEPA. 2007). Sources: Adapted from Cook et al. National Public Health Performance Standards Program, National Center for State, Tribal, Local, and Territorial Public Health Infrastructure and Workforce, SDOH Research by CDC Authors: Frequently Asked Questions, Examples of How the SDOH Can Be Addressed Through the 10 Essential Public Health Services, Performance Management & Quality Improvement, National Public Health Improvement Initiative, National Public Health Performance Standards, Public Health Finance and Infrastructure Support, Competencies for Public Health Professionals, National Leadership Academy for the Public's Health, Supporting the Performance Improvement Workforce, Alerts About Current & Projected Funding Opportunities, Cooperative Agreements, Grants & Partnerships, Strengthening Public Health Systems & Services, USAPI Strengthening Public Health Systems & Services, Integrity & Accountability Review Offices, National Health Initiatives, Strategies & Action Plans, State & Territorial Health Department Websites, US Territories & Freely Associated States, Style for Referring to US Territories & Freely Associated States, About the Public Health Infrastructure Center, Implementing the Community Health Needs Assessment Process, U.S. Department of Health & Human Services, Multisector collaborations that support shared ownership of all phases of community health improvement, including assessment, planning, investment, implementation, and evaluation, Proactive, broad, and diverse community engagement to improve results, A definition of community that encompasses both a significant enough area to allow for population-wide interventions and measurable results, and includes a targeted focus to address disparities among subpopulations, Maximum transparency to improve community engagement and accountability, Use of evidence-based interventions and encouragement of innovative practices with thorough evaluation, Evaluation to inform a continuous improvement process, Use of the highest quality data pooled from, and shared among, diverse public and private sources, Improved organizational and community coordination and collaboration, Increased knowledge about public health and the interconnectedness of activities, Strengthened partnerships within state and local public health systems, Identified strengths and weaknesses to address in quality improvement efforts, Baselines on performance to use in preparing for accreditation, Benchmarks for public health practice improvements. Evaluation of whether a decision has changed specific health outcomes may often be difficult or impossible because of the complex and multifactorial causal pathways involved in many health outcomes, the length of time from implementation of a decision to observable changes in health indicators, and the lack of suitable comparison groups (Quigley and Taylor 2004; Parry and Kemm 2005). An HIA, however, might not provide any recommendations; this could occur if the HIA failed to reveal any important health effects. The Atlanta Development Authoritys BeltLine Redevelopment Plan (November 2005) was identified as a coherent and publicly accepted vision that had been approved by local elected officials (ADA 2005). Castro A, Chen L, Edison B, Huang J, Mitha K, Orkin M, Tejani Z, Tu D, Wells L, Yeh J. Cave B, Curtis S. Developing a practical guide to assess the potential health impact of urban regeneration schemes. In this report, HIA practitioner refers to the person (or people) involved in conducting an HIA. It includes the production and dissemination of written materials that document the HIA process, methods, findings, recommendations, and limitations of the analysis; and it includes the public dissemination of results through other channels, such as meetings with the public, decision-makers, and other stakeholders. An HIA would identify health assets, health liabilities, and health-promoting mitigations related to the proposed development project. Recommendations identify specific actions that could be taken to avoid, minimize, or mitigate harmful effects identified during the course of the HIA or to take maximal advantage of opportunities for a proposal to improve health. 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. A review of health impact assessment frameworks. A smaller set of related indicators was endorsed for use in monitoring key elements of community health status (CDC, 1991). Another consideration is whether the proposal is likely to place a disproportionate burden of risk on vulnerable populations in the affected community; screening proposals on this basis helps to ensure that the HIA addresses the risk factors that underlie observed disparities in the rates of illness among various populations. It identified which areas and villages were most likely to be affected and when. official website and that any information you provide is encrypted Those pathways and others were evaluated by using public-health data, literature on analogous populations, knowledge about accepted mechanisms of health and disease, witness testimony, and the effects analysis of other resources. Community Health, Safety and Security. Quantitative evidence can include routinely collected information, such as mortality and census data, that can inform the baseline assessment. As discussed at the beginning of this chapter, HIAs in the United States are often conducted without a formal legal mandate and by an agency or organization that does not have decision- making authority. The committee notes that some guides consider evaluation not as a step of HIA but rather as an independent practice that supports the development of the field (see Appendix E). Thus, HIA teams may include not only health experts but professionals in other related disciplines, such as air or water quality or traffic modeling. Efforts to support health-based recommendations must be carefully distinguished from biased efforts to promote a specific outcome or measure on the basis of an incomplete or inaccurately weighted comparison of favorable and unfavorable aspects of a proposal or of a predetermined political agenda. The development of recommendations should be guided by a consideration of any available evidence regarding effectiveness. 2006; World Bank 2010). Assessment and Plans - Community Health Assessment - STLT Gateway - CDC The diversity of practice owes partly to the fact that HIAs are undertaken for a wide array of policy-making that spans many sectors, levels of government, types of proposal (policies, plans, programs, and projects), and degrees of complexity. CDC - Home - Community Health Assessment - STLT Gateway 2009; Bhatia et al. Second, recommendations are effective only if they are adopted and implemented. Using Community Health Assessments to Understand the Social Health Impact Assessment: Main Concepts and Suggested Approaches-the Gothenburg Consensus Paper. Evaluation is important for the quality of individual HIAs and for the success of the HIA field as a whole. For example, in Oregon, an independent health-oriented nonprofit organization conducted an HIA of a series of proposals to reduce vehicle miles traveled in a bill intended to reduce greenhouse- gas emissions (UPH 2009). Assessing the baseline health status of the affected population provides a reference point with which the predicted changes in health status may be compared; it identifies any groups that could be more vulnerable than the general population to the impacts of the proposal; and it provides an understanding of the factors that are responsible for determining health in the affected communities, and this, in turn, allows for a better understanding of how any changes in those factors may affect health. The discussion below briefly provides definitions and key features of HIA monitoring and evaluation. A plan for continuous monitoring, adaptation of mitigation measures, and verification of performancealthough not currently a uniform aspect of HIA practice helps to ensure that measures are carried out and achieving their objectives. 4321-4347 [1970]; EC 2001). McHugh S, Maruca S, Lilien J, Manning A. Red Dog Mine Extension Aqqaluk Project. Wolf S. Fear and loathing about the public right to know: The surprising success of the emergency planning and community Right-to-Know Act. For example, in the Alaskan oil and gas HIA mentioned in Box 3-3, the HIA team drafted recommendations in collaboration with the decision-maker, the Bureau of Land Management, which formally adopted the recommendations as mitigation measures. It also shows how HIA results can be disseminated widely in different formats through a number of channels. In practice, the categories are rarely used consistently, and a single HIA often encompasses a blend of various approaches to stakeholder engagement and participation, analytic methods, and interactions with the formal decision-making process. There could also be concerns that disclosure of such information would lead to litigation. Process evaluation assesses the design and execution of the HIA in light of its intended purpose and plan of action and applicable practice standards. 98224-MS. SPE International Health, Safety & Environment Conference; 24 April 2006; Abu Dhabi, UAE. Public Health Accreditation Board Acronyms and Glossary of Terms Version 1.0 [PDF 536KB], July 2011, as adapted from Healthy People 2010 and CDCs National Public Health Performance Standards Program. The selection of analytic methods for HIA is driven by the complex pathways and the multiple, sometimes conflicting, influences on any given health outcome and is also affected by the decision-making context. Seventh, disclosure allows people to take voluntary actions to avoid risk (Neidell 2009). You will be subject to the destination website's privacy policy when you follow the link. Mindell J, Ison E, Joffe M. A glossary for health impact assessment. Intermediate HIAs require more time and resources and involve more complex pathways, more stakeholder engagement, and a more detailed analysis but include little collection of new data. Key elements that make up a health assessment at the - Course Hero Fehr R. Environmental health impact assessment: Evaluation of a 10 step model. Document No. For example, in Alaska, one of the adverse impacts of a proposed mine expansion was the feared contamination of water and wildlife, and evidence suggested that a fear of contamination might lead communities to shy away from eating a traditional diet. A lack of access to needed goods and services. Because the biologists on the EIS team were uncertain of the degree to which subsistence harvests might be favorably or adversely affected, the HIA did not attempt to make quantitative estimates of the probability or intensity of the impact. Assignment of significance rests on the characterization of an effect as described above, but judgments regarding what constitutes a significant impact are ultimately determined partly on the basis of social and political values. Under NEPA, a federal agency must determine whether a federal environmental decision is likely to have significant effects, and if so, the level of analysis required (40 C.F.R. Quigley RJ, Taylor LC. To request permission to reproduce AHA content, please, https://www.chausa.org/communitybenefit/assessing-and-addressing-community-health-needs, Step 5: Prioritize Community Health Issues, Association for Community Health Improvement (ACHI). As previously described in the section on Recommendations, monitoring can refer to tracking changes in health indicators as a new project or policy is implemented and has been defined as outcome monitoring. The decision to initiate an HIA is often made ad hoc when public-health advocates recognize that the proposal may have important health implications that would not otherwise be recognized or addressed. The findings of the HIA were covered by newspapers and Web sites in California, Maine, Massachusetts, and New Hampshire; and the HIA researchers were interviewed on radio. The committee is not endorsing the HIAs or the recommendations, but simply providing examples. The potential for HIA-based information to alter a decision or help a decision-maker discriminate among decision options. Unauthorized use of these marks is strictly prohibited. Health Impact Assessment for Regeneration Projects. The potential for the HIA to be completed in the time allotted and with the resources available. In such cases, HIAs often rely on data on a larger region and consider whether the characteristics of the larger population can be generalized to the affected community. The first is to create a profile of the population affected, which includes information on the demographics, baseline health status, and social, economic, and environmental conditions that are important to health. Community Health Assessment aNd Group Evaluation (CHANGE): Building a Foundation of Knowledge to . In those cases, the HIA team may need to rely on established principles of health promotion and disease prevention to develop approaches to minimizing or mitigating the identified effects. It recommends measures, in the context of the proposed action, to protect and promote health and reduce health disparities. 2005; Bhatia and Seto 2011). The phrase desktop HIA has also been used to refer to a rapid HIA that entails little or no public engagement. Community health assessments use such principles as. A community health assessment (sometimes called a CHA), also known as community health needs assessment (sometimes called a CHNA), refers to a state, tribal, local, or territorial health assessment that identifies key health needs and issues through systematic, comprehensive data collection and analysis. Ibid. Even when there is substantial uncertainty, an assessment can illuminate potential causal pathways thateven when there appear to be conflicting influences on a specific outcomecan point the way toward a flexible framework for monitoring and managing any impacts that might occur as the proposal is implemented. Why Community Health Is Important for Public Health - Tulane University The approaches taken for stakeholder involvement vary widely. Northeast National Petroleum Reserve-Alaska, Supplemental Integrated Activity Plan, Record of Decision.
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