Katherine Hebert, MCRP<br />August 19, 2011<br />Health Impact Assessments: Bringing Public Health Back to the Decision Ta...
Quick History and Future Direction of Planning, Policy, and Public Health<br />Introduction to the Social Determinants of ...
Not New Concept- Over Correcting<br />
Social Determinants of Health<br />Source: http://www.pharmacymeetspublichealth.org.uk/publichealthbackground_determinants...
Policy &<br />Planning<br />Source: Frieden, A Framework for Public Health Action: The Health Impact Pyramid, AJPM<br />
Health Impact Assessments<br />HIA<br />HIA<br />
Planning + Policy + Public Health<br />Healthy Communities<br />Health Impact Assessments<br />Healthier Population<br />
What HIA IS<br />An HIA is a combination of procedures, methods and tools that systematically and prospectively judges the...
Process and Product<br />
Transportation Projects<br />Land Use Decisions<br />Housing<br />Agriculture/ Food Security/ Food Supply<br />Sustainabil...
Health Impact Assessments Steps<br />
Health Impact Assessments Steps<br />
Health Impact Assessments Steps<br />
Health Impact Assessments Steps<br />
Who Are the Players- U.S.<br />Funding<br />PEW<br />RWJF- ALR<br />NCEH-HCDI<br />ASTHO<br />Training<br />5 Universities...
Completed HIAs in the United States<br />1999–2010: 79<br />WA 4<br />ME 1 <br />MT 3<br />MN 5<br />OR 6<br />WI 1<br />N...
Completed and in Progress HIAs in the United States<br />1999–2010: 119<br />WA 8<br />ME 1 <br />MT 3<br />MN 6<br />OR 1...
Community Profile<br />Baseline of Current Community Conditions<br />Help Identify Health Concerns <br />Characterize Popu...
Join the HIA <br />Community of Practice!<br />Go to www.phconnect.org to become a member and find the HIA Community of Pr...
www. cdc.gov/healthyplaces/hia.htm<br />
www.healthimpactproject.org/project/opportunities<br />
www.hiaguide.org/<br />
Resources on HIA<br />NACCHO, HIA Quick Guide http://www.apho.org.uk/resource/item.aspx?RID=82413<br />Human Impact Partne...
Katherine Hebert, MCRP<br />Community Planner and Researcher<br />Centers for Disease Control and Prevention<br />Division...
 Health Impact Assessment (HIA)Project<br />Kentucky Worksite Wellness Tax Credit <br />Teresa Lovely MS CHES<br />Elaine ...
Kentucky Receives ASTHO HIA Grant <br /><ul><li>One of three states
$15,000
Build capacity to conduct HIAs
Conduct first HIA project
Collaborate with partners
Share findings and recommendations
Produce a final report
Monitor the outcome of the target project </li></ul>Cabinet for Health and Family Services<br />
HIA of  Kentucky Worksite Wellness Tax Credit<br />
Kentucky Worksite Wellness Tax Credit Proposed House Bill  HB 74 AN ACT relating to encourage  healthy lifestyles.<br />Or...
Goal of the HIA<br /><ul><li>Research the impact of the tax credit on:
Childhood obesity
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Health Impact Assessment: Bringing Public Health Back to the Decision Table

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  • Image Source: http://www.pharmacymeetspublichealth.org.uk/publichealthbackground_determinants.html“Social determinants of health are life-enhancing resources, such as food supply, housing, economic and social relationships, transportation, education, and health care, whose distribution across populations effectively determines length and quality of life.”James S. Social determinants of health: implications for intervening on racial and ethnic health disparities. Paper presented at: Minority Health Conference, 2002; University of North Carolina.
  • Traditional relationship (at least since the 1950s- period of disconnect/rationalization/ suburbanization)HIA as a tool that joins planning, public health, policymakers and other fields to form a more effective relationship
  • I feel comfortable talking about this
  • I feel comfortable talking about this
  • Process- six steps various tools to help you walk through this process
  • Missing any? Prefer you to talk about slides 6-12
  • Although we know of 64 HIA-type projects, only 48 have been totally completed. As for the others:6 HIAs are in progress4 are not actually HIAs (yet, but could eventually be so we are tracking them)2 are HIA “checklists” and not HIA projects/programs/policies2 HIAs were cancelled2 HIAs have an unknown status- we have abstracts for the “Injury Liability Protection for Physical Activity” out of Los Angeles, but there have been no reports published. The status of the Tacoma/Pierce County South Hill Neighborhood Plan HIA is also unknown. The contact information we have for people associated with the project (Rick Porso and Beth Glynn) no longer work. Arthur or Andy, do you know anything about these two projects? Also, Andy, I only have 3 HIAs in Minnesota and Alaska, but your map listed 4…
  • Although we know of 64 HIA-type projects, only 48 have been totally completed. As for the others:6 HIAs are in progress4 are not actually HIAs (yet, but could eventually be so we are tracking them)2 are HIA “checklists” and not HIA projects/programs/policies2 HIAs were cancelled2 HIAs have an unknown status- we have abstracts for the “Injury Liability Protection for Physical Activity” out of Los Angeles, but there have been no reports published. The status of the Tacoma/Pierce County South Hill Neighborhood Plan HIA is also unknown. The contact information we have for people associated with the project (Rick Porso and Beth Glynn) no longer work. Arthur or Andy, do you know anything about these two projects? Also, Andy, I only have 3 HIAs in Minnesota and Alaska, but your map listed 4…
  • Health Impact Assessment: Bringing Public Health Back to the Decision Table

    1. 1. Katherine Hebert, MCRP<br />August 19, 2011<br />Health Impact Assessments: Bringing Public Health Back to the Decision Table<br />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.<br />
    2. 2. Quick History and Future Direction of Planning, Policy, and Public Health<br />Introduction to the Social Determinants of Health<br />HIA Definition and Purpose<br />HIA Process<br />The Current State of HIA in the United States<br />Resources<br />Agenda<br />
    3. 3. Not New Concept- Over Correcting<br />
    4. 4. Social Determinants of Health<br />Source: http://www.pharmacymeetspublichealth.org.uk/publichealthbackground_determinants.html <br />
    5. 5. Policy &<br />Planning<br />Source: Frieden, A Framework for Public Health Action: The Health Impact Pyramid, AJPM<br />
    6. 6. Health Impact Assessments<br />HIA<br />HIA<br />
    7. 7. Planning + Policy + Public Health<br />Healthy Communities<br />Health Impact Assessments<br />Healthier Population<br />
    8. 8. What HIA IS<br />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. <br />Adapted from the WHO Gothenberg Consensus Paper, 1999<br />
    9. 9. Process and Product<br />
    10. 10. Transportation Projects<br />Land Use Decisions<br />Housing<br />Agriculture/ Food Security/ Food Supply<br />Sustainability Efforts<br />Comprehensive Plans<br />Energy<br />Water/ Sewer/ Waste Management<br />Economic/ Employment<br />Budget<br />Topics HIA Have Been Applied To<br />
    11. 11. Health Impact Assessments Steps<br />
    12. 12. Health Impact Assessments Steps<br />
    13. 13. Health Impact Assessments Steps<br />
    14. 14. Health Impact Assessments Steps<br />
    15. 15. Who Are the Players- U.S.<br />Funding<br />PEW<br />RWJF- ALR<br />NCEH-HCDI<br />ASTHO<br />Training<br />5 Universities<br />APA/NACCHO Webcourse<br />San Francisco Course<br />Guides/Readings<br />Conferences <br />Practitioners <br />Human Impact Partners<br />San Francisco Health Department<br />SOPHIA<br />State & Local Health Officials<br />CPPW States<br />Universities<br />Healthy Design Professionals<br />
    16. 16. Completed HIAs in the United States<br />1999–2010: 79<br />WA 4<br />ME 1 <br />MT 3<br />MN 5<br />OR 6<br />WI 1<br />NH 1<br />MA 3<br />PA 2<br />OH 1<br />NJ 1<br />CO 3<br />CA 30<br />MD 1<br />TN 1<br />NM 1<br />GA 6<br />FL 1<br />AK 5<br />Map developed in collaboration with A. Wernham, Health Impact Project and A. Wendel and A. Dannenberg, National Center for Environmental Health<br />16<br />
    17. 17. Completed and in Progress HIAs in the United States<br />1999–2010: 119<br />WA 8<br />ME 1 <br />MT 3<br />MN 6<br />OR 12<br />WI 1<br />NH 2<br />MA 4<br />PA 2<br />OH 1<br />IL 1<br />NJ 1<br />CO 4<br />CA 47<br />MD 2<br />MO1<br />KY 1<br />TN 1<br />NM 1<br />GA 8<br />FL 1<br />TX 1<br />AK 7<br />Map developed in collaboration with A. Wernham, Health Impact Project and A. Wendel and A. Dannenberg, National Center for Environmental Health<br />HI 1<br />
    18. 18. Community Profile<br />Baseline of Current Community Conditions<br />Help Identify Health Concerns <br />Characterize Population <br />Pay Attention to Scale/ Challenge of Local Data<br />CDC Resources<br />Behavioral Risk Factor Surveillance System<br />Youth Risk Behavior Surveillance System<br />Social Determinants Maps<br />County Prevalence Data Maps<br />State Burden of Chronic Disease<br />State Cancer Rate Information<br />
    19. 19. Join the HIA <br />Community of Practice!<br />Go to www.phconnect.org to become a member and find the HIA Community of Practice<br />For more information contact Katherine Hebert at jsx3@cdc.gov<br />
    20. 20. www. cdc.gov/healthyplaces/hia.htm<br />
    21. 21. www.healthimpactproject.org/project/opportunities<br />
    22. 22. www.hiaguide.org/<br />
    23. 23. Resources on HIA<br />NACCHO, HIA Quick Guide http://www.apho.org.uk/resource/item.aspx?RID=82413<br />Human Impact Partners, HIA Toolkit http://www.humanimpact.org/component/jdownloads/finish/11/81<br />University of Minnesota, Rapid HIA Toolkithttp://www.designforhealth.net/pdfs/HIA/BCBS_Rapidassessment_011608.pdf<br />Websites: HIA Gateway, HIA CLIC, CDC HIA, WHO HIA, San Francisco Bay HIA Collaborative, phConnect<br />
    24. 24. Katherine Hebert, MCRP<br />Community Planner and Researcher<br />Centers for Disease Control and Prevention<br />Division of Nutrition, Physical Activity, and Obesity<br />jsx3@cdc.gov, 770-488-5247<br />
    25. 25. Health Impact Assessment (HIA)Project<br />Kentucky Worksite Wellness Tax Credit <br />Teresa Lovely MS CHES<br />Elaine Russell MS RD LD<br />Dr. Cecilia Watkins CHES<br />Cabinet for Health and Family Services<br />
    26. 26. Kentucky Receives ASTHO HIA Grant <br /><ul><li>One of three states
    27. 27. $15,000
    28. 28. Build capacity to conduct HIAs
    29. 29. Conduct first HIA project
    30. 30. Collaborate with partners
    31. 31. Share findings and recommendations
    32. 32. Produce a final report
    33. 33. Monitor the outcome of the target project </li></ul>Cabinet for Health and Family Services<br />
    34. 34. HIA of Kentucky Worksite Wellness Tax Credit<br />
    35. 35. Kentucky Worksite Wellness Tax Credit Proposed House Bill  HB 74 AN ACT relating to encourage healthy lifestyles.<br />Original bill introduced 2008<br />Total credit not to exceed $100 / number of employees annually<br />$3,000,000 cap<br />Kentucky Worksite Wellness Tax Credit<br />
    36. 36. Goal of the HIA<br /><ul><li>Research the impact of the tax credit on:
    37. 37. Childhood obesity
    38. 38. Jobs
    39. 39. Social cohesion in the workplace</li></ul>Cabinet for Health and Family Services<br />
    40. 40. Literature Review Conducted by <br />Western Kentucky University<br /><ul><li>Looked at obesity at national level
    41. 41. Kentucky’s obesity levels particularly for children
    42. 42. Need for an integrated approach
    43. 43. Workplace’s potential role – where parents are
    44. 44. Parent’s impact on children’s health (obesity)
    45. 45. The need to look at the environment and policy</li></ul>Cabinet for Health and Family Services<br />
    46. 46. Childhood Obesity Impact Findings<br /><ul><li>Parents are not receiving enough information, support, and guidance on childhood obesity.
    47. 47. A worksite wellness program would address teaching employees (parents) about diet and physical activity
    48. 48. The education and support that employees (parents) receive in the workplace can positively influence the family.
    49. 49. Programs would need to include children and families, focus on child behavior and environment
    50. 50. Parents can be advocates for their children’s environment whether at home, daycare or school. </li></ul>Cabinet for Health and Family Services<br />
    51. 51. IBM’s Children Health Rebate Program<br /><ul><li>About 45 % of  IBM’s employees have children covered on the health plan.
    52. 52. In 2008 launched  this program to help parents assist their children in maintaining a healthy weight.
    53. 53. The 12-week web-based program includes a $150 cash rebate that rewards participation.
    54. 54. 2/3 of employees who participated reported that their children were exercising
    55. 55. 59% of children and 64% of adults improved body weight or maintained a healthy weight.
    56. 56. Parents and children improved in healthy eating and physical activity behaviors and a reduction in screen time</li></ul>Source: Business Group on Health<br />Cabinet for Health and Family Services<br />
    57. 57. Jobs: Impact Findings<br /><ul><li>Lack of employment or underemployment affects ability to purchase healthy foods, maintain or improve health, and receive medical care
    58. 58. Reducing health care costs, improving productivity through wellness programs could lead to an increase in jobs in the state
    59. 59. A tax credit could lead to an increase in wellness jobs</li></ul>Cabinet for Health and Family Services<br />
    60. 60. Social Cohesion/Well-being: Impact Findings<br /><ul><li>Ky. Ranked 49 in Gallop Well –being Index Study
    61. 61. 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
    62. 62. Specific populations such as urban areas and rural, particularly Appalachian reported less well-being in some factors.
    63. 63. Wellness programs have been shown to affect morale and improve the work environment</li></ul>Cabinet for Health and Family Services<br />
    64. 64. Overall: Impact Findings <br /><ul><li>Number of companies that have wellness programs has increased from 34% in 2007 to 63% in 2010.
    65. 65. However most not comprehensive
    66. 66. 94% of companies have less than 50 employees
    67. 67. Firms with less than 100 employees accounted for 35 percent of total employment in Kentucky.
    68. 68. A worksite wellness tax credit would increase the number of worksite wellness programs particularly in smaller companies </li></ul>Cabinet for Health and Family Services<br />
    69. 69. Worksite Wellness Programs: Impact Findings<br />Kentucky lacks much of the needed specific information on worksite wellness programs<br />How many work in the wellness service field?<br />Turnover rates in companies in the state with wellness programs ? <br />How does the morale differ in companies that have wellness programs? <br />How does the productivity differ?<br />Health outcomes associated with workplace support<br /><ul><li> A state-wide detailed assessment of current worksite wellness program practices is needed.</li></ul>Cabinet for Health and Family Services<br />
    70. 70. Preliminary Recommendations<br /><ul><li>Enact the tax credit bill
    71. 71. Conduct an in depth assessment of worksite wellness programs in the state
    72. 72. Recognize the worksite venue as a means to improve health of Kentucky residents – not just employees
    73. 73. Incorporate tax credit criteria to include programs to assist families improve health
    74. 74. Kentucky economy can be improved through worksite wellness programs</li></ul>Cabinet for Health and Family Services<br />
    75. 75. QUESTIONS?<br />Teresa.Lovely@ky.gov<br />Cecilia.watkins@wku.edu<br />Elaine.russell@ky.gov<br />Cabinet for Health and Family Services<br />

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