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Health Impact    Health ImpactAssessment in CAFO     Permitting Imagining h lth i CAFOI   i i health in CAFO        permit...
Health in all policies . . .    “(The) toxic combination of bad policies (The) toxic combination of bad policies,   econom...
Industrial Agriculture            g
Some characteristics     • Size (chickens 125,000; dairy 700 or more)  • D it    Density  • Concentration of facilities, r...
Impact on communities & environmentPositive           Lower costs for meat, milk & eggs due to             more efficient ...
Quality of life‐social impactsStressPower imbalanceChanges to community activities/social  cohesion h               i     ...
Connecting health to CAFO policy – a few hurdles? The  EPA, DEQ, Agriculture Department, etc., are NOT  health agencies  D...
Building on the role of community healthAssessment:  Assessment:       Collecting and tracking public complaints        In...
Bridging the gap with health impact assessmentWhat is a health impact assessment?    Set of procedures, methods, and tools...
Goals   Primary Goals    Achieve changes in policies and proposals so that they support better health     and reduce healt...
Key elements   Screening:           Determines the need and value of a HIA Scoping : Scoping :             Determines what...
Screening Worksheet  Project and Timing    Has a project, plan or policy been proposed?    Is there sufficient time to con...
Screening Worksheet  Stakeholder Interest and Capacity     Have public concerns about the health impacts of the decision b...
Screening Worksheet Potential Impact of HIA Findings     Is health already being considered in the proposal or as part of ...
Screening Worksheet Potential Impact of the HIA Process on secondary goals?    What are the potential impacts of the HIA p...
Starting at the beginning Document baseline conditions, including –Population health vulnerabilities based on the populati...
What is a significant health impact?   direction magnitude likelihood distribution within the population permanence
Using the best available evidence  Assessments of health impacts should be based on a synthesis of the best available evid...
Community data collection Water quality monitoringAir quality monitoring Ai     li      i iOSHA complaints Journals/web‐ba...
Recommendations The HIA should include specific recommendations to manage the health impacts identified, including:Alterna...
CriteriaDeveloping recommendations and mitigation –Responsive to predicted impactsSpecific Technical feasible Enforceable ...
Using HIA process  HIA identified (self) in the U.S.          100 – 120 HIAs in process or completed in U.S.          15 i...
Using HIA to move up the ladder      Can health impact assessment       help rural communities “move up       the ladder?A...
ResourcesHealth Impact ProjectRobert Wood Johnson Foundation and The Pew Charitable TrustsNational initiative designed to ...
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Health Impact Assesment in Permitting for "Factory Farms"

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"Health Impact Assesment in Confirmed Animal Feeding Operations (CAFO) Permitting" presented by Ellen Mee, JD, at the Ohio Clean Water Conference 2011.

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Health Impact Assesment in Permitting for "Factory Farms"

  1. 1. Health Impact  Health ImpactAssessment in CAFO  Permitting Imagining h lth i CAFOI i i health in CAFO  permitting Ellen Mee, JD  Director of Environmental  Health Policy Ohio Environmental Council August 5, 2011 A t 5 2011
  2. 2. Health in all policies . . .    “(The) toxic combination of bad policies (The) toxic combination of bad policies,  economics, and politics is, in large  measure, responsible for the fact that a  ibl f th f t th t majority of people in the world do not  enjoy the good health that is  biologically possible.”  g yp – Who  Commission on Social Determinants of  Health (2009) Health (2009)
  3. 3. Industrial Agriculture g
  4. 4. Some characteristics    • Size (chickens 125,000; dairy 700 or more) • D it Density • Concentration of facilities, related industry • Vertical integration • Corporate ownerships or control • Technology/breeding/animal specialization Technology/breeding/animal specialization  • Mechanization • Pharmaceutical practice 
  5. 5. Impact on communities & environmentPositive Lower costs for meat, milk & eggs due to   more efficient feeding,  housing  Larger facilities requiring less land Increased employment Increased tax revenue Increased demand for local commoditiesNegative Excess manure stored or applied locally (3‐20  times human waste in U.S.) Environmental impacts to water resources,  aquatic life Health impacts due to  release of agricultural  lh d l f l l chemicals, pathogens, pharmaceuticals into air,  water and soil
  6. 6. Quality of life‐social impactsStressPower imbalanceChanges to community activities/social  cohesion h i i ii / i l h iInterference with daily activities, life‐styleLoss of local political control/authorityIncreased large truck trafficInfrastructure damage (roads, bridges) costs paid by local tax revenue
  7. 7. Connecting health to CAFO policy – a few hurdles? The  EPA, DEQ, Agriculture Department, etc., are NOT  health agencies  Deeply entrenched notions of independence of  farming activities Deeply entrenched notions of independence of “farming” activities Power politics! Industry v. rural community Weak regulatory systems at both state and local levels, few (no?) formalized  requirements for consideration of health impacts Little understanding of  health impacts (as opposed to nuisance) Little understanding of “health” impacts (as opposed to nuisance) Public health agencies largely removed from jurisdiction No funding for health studies f f Disconnect between health (science‐driven) and policy (economics, politics,  public choice public choice Right‐to‐farm laws
  8. 8. Building on the role of community healthAssessment:  Assessment: Collecting and tracking public complaints  Investigation Assistance with monitoring (rodents, flies, well water) Monitor ER visits related to work environments Monitor ER visits related to work environmentsPolicy development: Some HDs may adopt limited health‐based regulations (but, Iowa  regulations overturned) regulations overturned)Advocacy & Education: Convene public meetings Educate agency personnel on public health impacts Educate agency personnel on public health impacts Educate facility owners/managers Promulgate recommendations  and regulations (limited) Work with producers/agency to promote mitigation strategies
  9. 9. Bridging the gap with health impact assessmentWhat is a health impact assessment? Set of procedures, methods, and tools p , , Systematically judges the potential effects of a policy or project  on the health  of a population and distribution of those effects within the populationGoals? Achieve changes in policies and proposals so that they support better health  and reduce health inequalities.  The recommendations of an HIA can include suggestions for enhancing positive  aspects of proposals, as well as recommendations to mitigate any potentially  negative aspects.  negative aspects Many HIAs therefore overtly aim to influence the decision‐making process. Make health impacts (broadly defined)  more explicit
  10. 10. Goals   Primary Goals Achieve changes in policies and proposals so that they support better health  and reduce health inequalities and reduce health inequalities Recommendations for enhancing positive aspects of proposals or mitigating  potentially negative aspects Influence the decision‐making process (promote voluntary actions) Make health impacts (broadly defined)  more explicit p ( y ) pSecondary Goals Engage & empower community Emphasize everyday experience Build consensus Build relationships & collaborations
  11. 11. Key elements   Screening:  Determines the need and value of a HIA Scoping : Scoping : Determines what impacts to evaluate, methods for analysis, work plan Assessment Provides: A profile of existing health conditions An evaluation of potential health impacts Strategies to manage identified adverse health impacts Reporting Includes: Development of the HIA report Communication of findings & recommendations Monitoring Tracks: Impacts on decision‐making processes and the decision Impacts of the decision on health determinants p
  12. 12. Screening Worksheet  Project and Timing Has a project, plan or policy been proposed? Is there sufficient time to conduct an analysis before the final  decision is made?Health ImpactsHealth Impacts Does the decision have the potential to affect environmental or social  determinants that impact health outcomes?   If so, which determinants  and which health outcomes? Would health inequities be impacted? In what ways? Are the proposal s impacts to health likely to be significant in terms of the  Are the proposal’s impacts to health likely to be significant in terms of the number of people impacted, the magnitude, breadth and/or immediacy of  impacts? Do evidence, expertise, and/or research methods exist to analyze health  impacts of the decision?
  13. 13. Screening Worksheet  Stakeholder Interest and Capacity Have public concerns about the health impacts of the decision been voiced or  documented? Who are the stakeholders and interest groups involved in the decision‐making  process? Do stakeholders have the interest to participate in the HIA? Do stakeholders have the capacity (resources, skills, etc.) to participate in the  Do stakeholders have the capacity (resources skills etc ) to participate in the HIA? Would stakeholders use the HIA to inform or influence the decision‐making  process? How?
  14. 14. Screening Worksheet Potential Impact of HIA Findings  Is health already being considered in the proposal or as part of the decision‐ Is health already being considered in the proposal or as part of the decision making process? Are the links between the proposal and health or health determinants clear? Is the decision‐making process open to the HIA and /or recommendations for  changes to design, mitigations and/or alternatives? If applied, would HIA findings and recommendations potentially improve the  impact that the proposal has on health?
  15. 15. Screening Worksheet Potential Impact of the HIA Process on secondary goals? What are the potential impacts of the HIA process? (e.g., building  What are the potential impacts of the HIA process? (e g building relationships, empowering community members, voluntary intervention,  demonstrating how health can be used in decision making)
  16. 16. Starting at the beginning Document baseline conditions, including –Population health vulnerabilities based on the population characteristicsInequalities in health outcomes/impacts among subpopulations or places.
  17. 17. What is a significant health impact?   direction magnitude likelihood distribution within the population permanence
  18. 18. Using the best available evidence  Assessments of health impacts should be based on a synthesis of the best available evidence. Existing data, empirical research, professional expertise, and the products of original investigationsWhen available, practitioners should utilize evidence from well‐designed andpeer‐reviewed systematic reviewsPreviously published evidence, both supporting and refuting particular health impactsThe expertise and experience of affected members of the public (localknowledge), whether obtained via the use of participatory methods, collected via formal qualitative research methods, or reflected in public testimony, is potential evidence.
  19. 19. Community data collection Water quality monitoringAir quality monitoring Ai li i iOSHA complaints Journals/web‐based reporting SurveysDocumented complaints
  20. 20. Recommendations The HIA should include specific recommendations to manage the health impacts identified, including:Alternatives to the decisionModifications to the proposed policy, program, or project Mitigation measuresMitigation measuresWhere needed, expert guidance should be utilized to ensure recommendations reflect current effective practices
  21. 21. CriteriaDeveloping recommendations and mitigation –Responsive to predicted impactsSpecific Technical feasible Enforceable  Within the authority of decision‐makers or Recommendations may include those for monitoring, reassessment, and adaptations to help manage uncertainty in impact assessment.
  22. 22. Using HIA process HIA identified (self) in the U.S. 100 – 120 HIAs in process or completed in U.S. 15 involved natural resources and the environment 15 involved natural resources and the environment 6 agriculture and food policy CAFO permitting/industrial agriculture:  0   (Michigan?) CAFO i i /i d i l i l 0 (Mi hi ?)
  23. 23. Using HIA to move up the ladder Can health impact assessment  help rural communities “move up  the ladder?Arnstein S. 1969. Ladder of citizen participation.JAIP 35 (4): 216‐224JAIP 35 (4) 216 224
  24. 24. ResourcesHealth Impact ProjectRobert Wood Johnson Foundation and The Pew Charitable TrustsNational initiative designed to promote the use of health impact assessments (HIAs) as a decision‐making tool for policymakers.http://www.healthimpactproject.orgHuman Impact Partners Offers policymakers, project leaders, public agencies, community groups and advocacy organizations the support they need to conduct HIAs and use the results to make informed choiceshttp://www.humanimpact.org/hips‐hia‐tools‐and‐resourcesInternational Association for Impact Assessment (IAIA)International Association for Impact Assessment (IAIA)organized in 1980 to bring together researchers, practitioners, and users of various types of impact assessment from all parts of the world. IAIA involves people from many disciplines and professions. http://www.iaia.org/h // i i /
  25. 25. Questions?

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