Health Impact Assessment: Fit for more than one purpose

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Ben Harris-Roxas

Slides for my keynote address at the HIA20120 Conference in Quebec http://www.hia2012.ca/

Health & Medicine Technology

Fit for More Than One Purpose
Typologies, Theory and Evaluation in Health Impact Assessment

Centre for Primary Health Care and Equity

Ben Harris-Roxas
Consultant, Harris-Roxas Health
Conjoint Lecturer, University of New South Wales, Sydney
Health Section Co-Chair, International Association for Impact Assessment

Protect health
Promote health
Reduce health inequities

Mandated
Decision Support
Advocacy
Community Led
Harris-Roxas B, Harris E (2011) Differing Forms, Differing Purposes: A Typology of Health Impact
Assessment, Environmental Impact Assessment Review, 31(4):396-403. doi:10.1016/j.eiar.2010.03.003

Harris E, Baum F, Harris-Roxas B, Kemp L, Spickett J, Keleher H, HarrisM, Morgan R, Dannenberg A, Sukkumnoed
D, Wendel A. The effectiveness of health impact assessments conducted in Australia and New Zealand; Australian
Research Council Discovery Project Grants; 2010-2011. [DP1096211]

Protect health
Promote health
Reduce health inequities
Improve governance & public decision-making
Learning

Technical
Conceptual
Social

Glasbergen P. Learning to manage the environment. In: Lafferty W, Meadowcroft J, (eds). Democracy and the
environment: problems and prospects. Cheltenham: Edward Elgar; 1999. p. 175–93.

Take away messages
• Typology - there’s more than one form of HIA and they have
different purposes

• Learning from HIAs takes different forms – technical, conceptual
and social

• It’s important to examine both purpose and types of learning
when evaluating HIAs

Acknowledgements
• The HIA2012 organisers
• The International Association for Impact Assessment’s Health
Section for their ongoing support and ideas
• The University of New South Wales Centre for Primary Health
Care and Equity for their ongoing collaboration

These slides are available at

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ben@harrisroxashealth.com

@ben_hr or @hiablog

healthimpactassessment.blogspot.com

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376 Evaluation of Community Action Against Asthma: A Community Health Worker Intervention to Improve Children’s Asthma-Related Health by Reducing Household Environmental Triggers for Asthma Edith A. Parker, DrPH, MPH Barbara A. Israel, DrPH, MPH Thomas G. Robins, MD, MPH Graciela Mentz, PhD Xihong Lin, PhD Wilma Brakefield-Caldwell Erminia Ramirez, MSW Katherine K. Edgren, MSW Maria Salinas Toby C. Lewis, MD, MPH This article describes the evaluation of a community-based participatory research (CBPR) community health worker (CHW) intervention to improve children’s asthma-related health by reducing household environmental triggers for asthma. After randomization to an intervention or control group, 298 households in Detroit, Michigan, with a child, aged 7 to 11, with persistent asthma symptoms participated. The intervention was effective in increasing some of the measures of lung function (daily nadir Forced Expiratory Volume at one second [p = .03] and daily nadir Peak Flow [p = .02]), reducing the frequency of two symptoms (“cough that won’t go away,” “coughing with exercise”), reducing the proportion of children requiring unscheduled medical visits and reporting inadequate use of asthma controller medication, reducing caregiver report of depressive symptoms, reducing concentrations of dog allergen in the dust, and increasing some behaviors related to reducing indoor environmental triggers. The results suggest a CHW environmental intervention can improve children’s asthma-related health, although the pathway for improvement is complex. Keywords: asthma intervention; community partnership; environmental triggers Ethnic minority children residing in urban areas with high concentrations of poverty disproportionately suffer the burden of asthma (American Lung Association, 2003; Mannino et al., 2002). Exposure to indoor allergens often plays a key role in asthma exac- erbation (Custovic, Murray, Gore, & Woodcock 2002; Gold, 2000). Because children Health Education & Behavior, Vol. 35 (3): 376-395 (June 2008) DOI: 10.1177/1090198106290622 © 2008 by SOPHE Parker et al. / Community Action Against Asthma 377 with allergic asthma tend to be sensitive to more than one allergen (Eggleston & Bush, 2001), interventions to reduce indoor allergens are beginning to focus on multiple triggers for asthma. Although there are reports of the success of home-visiting interventions involving professionals focusing on reducing multiple indoor environmental triggers (Carter, Perzanowski, Raymond, & Platts-Mills, 2001; Evans et al., 1999; Morgan et al., 2004), evidence about the effectiveness of such interventions using community health workers (CHWs) instead of trained professionals is just beginning to emerge (Krieger, Song, Takaro, & Weaver, 2005). CHWs, who are often from the community in which they work, may be particularly effective in working with underserved populations because of their knowledge of both the cultural context for health and il ...

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Running Head: ENVIRONMENTAL HEALTH 1 ENVIRONMENTAL HEALTH 8 Environmental Health Student Name: Kusum Syangbo Instructor Name: Elizabeth Wachira Course no: HHPH- 382-01W Date: April 5, 2020 Texas A&M University, Commerce Abstract Environmental health is both a public health and social justice issue. This paper will describe how environmental health is both a public health and social injustice issue and some of the environmental injustices in the United States. It will also explain the functions of environmental health movements in the US. Finally, the paper will describe some of the intervention opportunities in curbing environmental injustices including health education, advocacy, policy, leadership opportunities, and community focus and give my future leadership role as far as environmental health is concerned. Keywords Environmental health, public health, social injustice, minority groups Section 1: Topic Description The topic that I chose is Environmental Health. This topic is a public health issue because the environment in which we live in shapes our health every moment of every day. Our health can be affected by what we eat, where we live, and how we interact with the world around us. That is where environmental health professionals, programs and policies, all come into play. Environmental health is a large field in public health because of the numerous ways exterior factors can impact how we live, grow and, even eat. These factors concern how we address our natural environment like sanitation and clean water, but they are also the consequences of our actions as human beings (Krometis et al, 2017). Environmental Health is also a social justice issue because all the conversations about protecting habitats, mitigating climate change and recycling are not just about saving and protecting the earth, they are more about the struggle for protecting and providing basic human rights to good health. Every human being is entitled to quality air, clean water, and sanitation (Marmot, 2017). Section 2: Social Injustice Two Environmental Social Injustices One major environmental social injustice is the disproportional placing of dangerous waste amenities in poor and largely ethnic and racial minority localities. Research shows that there are ethnic and racial discrepancies in the locations of dangerous waste across the United States. As a result of these injustices people living in such an environment have developed diseases like cancer. Another social injustice is the environmental influence on healthy eating, physical activity, and obesity in ethnic and racial minority communities with low income. The principal concern here is the deprivation amplification such that in locations where have little individual resources, the local amenities that help people to live healthily, are poorer than those in non-socially and non-impoverished deprived places. Research has shown that t.

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