Tools: What is a Rapid HIA?

On the face of it Rapid HIAs are quick, but that's not the whole story. A rapid HIA while faster than a full, environmental impact assessment-style HIA, still takes some time. It is also different to some other quick HIA types such as desktop screening or scoping exercises.

Students performing a practice health impact assessment
at the School of Planning and Architecture, Vijayawada

Fundamentally a rapid  HIA is an interactive workshop—taking half a day or a day--that brings together stakeholders to identify and assess health impacts. However, additional time is needed to engage stakeholders in identifying key concerns and interest groups, to prepare background docuemtns for the workshop, have participants read those docuemtns, and write up the results. The good news is that a lot of the background information is similar to typical analyses that are standard in many planning and public health processes. Background information on health is available from several sources. Examples of completed HIAs are online.

Several toolkits are also available.

Design for Health  has two versions. The most recent Rapid HIA toolkit was ublished in 2008 but will be updated over the coming year. It draws on a number of previous examples, including the famous Merseyside model.  In 2010 DFH conducted a rapid HIA, termed a Healthy City Planning Workshop. This took a more flexible approach than the 2008 toolkit and also adapted worksheets from a number of recent HIAs. The reports from the workshop include basically all the information used to run and report on the HIA workshop--the actual information packet provided to participants in advance; the agenda of the meeting, copies of handouts, worksheets, and presentations from the workshops; a series of photos keyed to parts of the agenda; and the workshop’s summary report. This makes the report usable as a toolkit.

The Merseyside Guidelines for Health Impact Assessment (2001) published by the International Health IMPACT Assessment Consortium, is often cited as the most widely used HIA model in England. 

Human Impact Partners, Oakland provides several relevant tools including a number of guides and worksheets: http://www.humanimpact.org/hips-hia-tools-and-resources. Be sure to scroll down the page because a lot of the more interesting material is at the bottom.

Resources: Health, Place, and Children

Children, because they are still growing and developing, often suffer from different or additional health risks compared with adults. There are many useful resources on this topic--I list a few below specifically tailored to health and places.

Feeding chickens. Photo: Heather Forsyth

• Children's Health Protection 
  Sponsored by the U.S. Environmental Protection Agency (EPA), this Web site has a terrific search feature for looking up publications related to where children live, learn, and play. Their Children’s Environmental Health section has additional resources:including a site on indicators called America’s Children and the Environment.
• Guide to Community Preventive Services
  This resource from the Centers for Disease Control and Prevention (CDC) provides a study titled “Community Interventions to Promote Healthy Social Environments: Early Childhood Development and Family Housing,” which gives recommendations from reviews of HUD Section 8 Housing Vouchers, Rental Vouchers and preschool programs based on early childhood development intervention success. There’s also a section on adolescent health, focused on broad health topics.
• Effective Interventions to Tackle Inequalities in Children's Health
  This London Health Commission report provides a summary of “what works” —or what appears to work—in relation to the aims and interventions proposed in the draft children and young people's strategy; examines other interventions with strong evidence of effectiveness in reducing inequalities in child health; and identifies where there are gaps in the evidence.

Some additional resources are available at http://www.designforhealth.net/resources/children.html

Resources: Planning and Active Living

Active living, the idea that it’s good to build exercise into daily life, has been big news in planning for a while but I still get questions about how to incorporate active living into plans. A decade ago, when it was a fairly new idea, there was the hope that if we built places where people were more prone to do activities like travel walking, that they’d keep exercising as well, increase their total activity, and reduce weight. It turns out to be a bit more complicated than this as I noted in my blog on high density and overweight adolescents in China. Research is quite mixed in its findings—there’s a lot of variation in how people respond to environments. Programs, policies, prices, education, and attitudes all shape how people use environments. But as a bottom line it is useful to provide options for people to be active in different ways so that when they want to do so they can. 

So how can you help provide options? Several web sites provide case studies of communities have done this work.

Mexico City Cycle Day, 2011

• Active Living by Design has been around since 2001 and has a useful web site. The group has worked with a number of cities and countied and provides case studies linked to an onsite map: http://www.activelivingbydesign.org/communities.
• The APA has a webinar with some practice examples: http://www.planning.org/nationalcenters/health/education/webinars/activecommunity.htm
• Design for Health also highlights some alternative transportation plans including ones by Bloomongton and St. Louis Park. Some of the questions in the DFH Comprehensive Plan Review checklists also target active living—noted in a column: http://www.designforhealth.net/resources/checklists.html

Tools for Conducting an HIA on a Comprehensive Plan

I’ve recently had a number of queries about how to conduct a health impact assessment on an existing comprehensive plan. This is a great thing to do because it can help prioritize changes in an update: http://healthymetropolis.blogspot.com/2010/12/when-in-planning-or-policy-process-does.html. How to conduct an HIA is a big topic, but fortunately there are a lot of resources available with more coming online over the next year.

One place to start is the set of Comprehensive Planning Checklists on the Design for Health web site: http://www.designforhealth.net/resources/checklists.html. They are based on evidence--though there is stronger evidence for the “essential for health” sections than the “good for health” ones. Each question has a column that explicitly states which area of research it is based on and these are described more fully in online research summaries (see next point). These checklist are also broken into standard categories for comprehensive or general plans in the United States. Two other resources, highlighted in an earlier blog, may be useful: the Australian Healthy Urban Development Checklist and British Delivering Healthier Communities in London.

Research Summaries that form the basis of the DFH checklists that are available for free: http://www.designforhealth.net/resources/researchsummaries.html. The current versions reperesent work up to about 2007 or 2008 and in fast developing areas--such as food--we’ll be preparing updates in the next year. For extra information in the interim you might look at the "pathways" section of HIA-CLIC http://www.hiaguide.org/sectors-and-causal-pathways/pathways.

Model of Downtown Tianjin in the
Tianjin planning museum.
Photo: Ann Forsyth.

For advice about what to do after you have used the checklist and done your evaluation, the Design for Health web site has Information Sheets linked to the research summary topics that have examples and cases:
http://www.designforhealth.net/
resources/planningissues.html

In addition, a course on Planning for Healthy
 Places with Health Impact Assessments by the American Planning Association in association with the National Association of County and City Health Officials, is also a good place to start: http://professional.captus.com/Planning/hia/default.aspx. It is currently being updated by a team including Christine Green and Kimberly Hodgson at APA, Nisha Botchwey from the University of Virginia, and myself, with advice from Dee Merriam of the CDC. The update will substantially expand the resources section so there will be lots more information than this brief note can provide.