HIA in Transportation Planning

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Health impact assessment (HIA) has emerged in the U.S. as a promising way to increase social and environmental justice by addressing health equity within transportation planning. HIA seeks to augment the information base upon which public decisions are made. It does so through a multi-disciplinary analysis of how the project or plan impacts various social determinants of health. It also augments community and stakeholder engagement by providing a forum - usually through an advisory committee - where stakeholders can identify and deliberate about health interests related to the target plan. While HIA advisory committees are diverse by design, those managing HIA processes are often surprised at the differences between and within both the planning and transportation fields.

This webinar reviews stakeholder engagement strategies common to HIA. It compares and contrasts the values, expectations, and methodologies that various types of planning and public health professionals often bring to the table. Finally, it identifies best practices for stakeholder engagement in HIA to maximize the collaborative nature of HIA.

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HIA in Transportation Planning

  1. 1. HIA in Transportation Planning: What to expect from transportation & public health stakeholders Nicole Iroz-Elardo, PhD irozelardo@yahoo.com July 16, 2014
  2. 2. Outline   •  Overview  of  HIA   •  Survey  of  the  Field   •  Why  Engage  Stakeholders   •  Who  Par=cipates   •  Types  of  HIA/Cases   •  Lessons  Learned   •  Best  Prac=ces  
  3. 3. Systematic process Data & analysis Input from stakeholders Potential effects on health Distribution within a population Recommendations and mitigations Inputs Outputs Conclusions What  is  Health  Impact  Assessment?  
  4. 4. Screening Scoping Recommending Reporting Monitoring Evaluation Assessment (Multiple) The  HIA  Procedure  
  5. 5. HIA  as  Health  in  All  Policies   How  can  we  ensure  considera=on  of   health  in  decisions  made  in  non-­‐ health  sectors?    
  6. 6. Social and Environmental Determinants of Health
  7. 7. Survey  of  the  HIA  Field   Source:  hIp://www.healthimpactproject.org/hia/us#status:Complete  on  7/4/2014  
  8. 8. Survey  of  the  HIA  Field   Source:  hIp://www.healthimpactproject.org/hia/us#status:Complete  on  7/4/2014  
  9. 9. WHY  ENGAGE  STAKEHOLDERS    IN  HIA?  
  10. 10. •  “right  of  people  to  par>cipate  in  a   transparent  process  for  the  formula=on,   implementa=on,  and  evalua=on  of  policies   that  affect  their  life  both  directly  and  through   elected  decision  makers”     –  Gothenburg  Consensus   •  Generally  interpreted  to  include  par=cipatory   elements,  although  par=cipatory  nature  is   overstated.     Founda=onal  Value:  Democracy  
  11. 11. •  Norma=ve      Reflect  democra=c  ideals   • Empowerment   •  Substan=ve    Improve  informa=on     •  Instrumental    Generate  legi=macy   • Reduce  conflict   • Increase  odds  of  smooth  implementa=on   Ra=onales  for  Par=cipa=on       Glucker,  (2013).  Public  Par=cipa=on  in  Environmental  Impact  Assessment:  Why,  Who,   and  How?  EIAR  .  
  12. 12. WHO  PARTICIPATES  IN  HIA?    
  13. 13. Everyone!   •  Public  Health   •  Target  Sector  (Transporta=on)   •  Government   •  Advocacy  Organiza=ons   •  Decision  Makers  (hopefully)   •  Public(?)   HOW?       HIA  Advisory   Group  
  14. 14. Differences  in  Language   •  Mortality  vs  Fatality   •  Morbidity  vs  Injury   •  Access   – To  highway/road  system   – To  (health  promo=ng)  services   •  Safety   – Real  vs  Perceived  
  15. 15. Planning  and  Public  Health:     Diverse  Fields   •  Land  Use  (zoning,  codes)   •  Transporta=on/Infrastructure   •  Environment     •  Design   •  Preserva=on     •  Community  Development  (Housing,  Social)   •  Economic  Development  (Real  Estate)   •  Regulatory  (NEPA)   •  Toxicology   •  Engineering  
  16. 16. Planning  and  Public  Health:     Diverse  Fields   •  Biostats   •  Epidemiology   •  Environmental   •  Occupa=onal   •  Toxicology  (allied)   •  Health  Services/Primary/   Clinical  Care   •  Health  Management/ Policy/Admin   •  Community/Health     Promo=on   •  Health  Behavior/ Educa=on   •  Child  &  Women’s/ Maternal     •  Infec=ous  Disease   •  Interna=onal      
  17. 17. Types  of  HIA   Harris-­‐Roxas  &  Harris  (2011).  Differing  Forms,  Differing  Purposes.  EIAR.     Mandated   Decision-­‐ Support   Advocacy   Community-­‐Led   Voluntary   No   Yes   Yes   Yes   Purpose?   Meet  Regula=ons   Inform  the   Decision   Change  the   decision   Increase   Community   Control  
  18. 18. A  Spectrum  of  HIAs…   I-­‐710   Corridor  HIA   Clark  County   Bike-­‐Ped  HIA   Lake  MerriI   BART  HIA  
  19. 19. Types  of  HIA   Harris-­‐Roxas  &  Harris  (2011).  Differing  Forms,  Differing  Purposes.  EIAR.     Mandated   Decision-­‐ Support   Advocacy   Community-­‐Led   Voluntary   No   Yes   Yes   Yes   Purpose?   Meet  Regula=ons   Inform  the   Decision   Change  the   decision   Increase   Community   Control   Health   Purpose   Minimize   nega=ve  impacts   HIA  Author?   Consultant  for   Government   Agency   Informed  by   Environmental   Health   Role  of   Stakeholders   Technical  Info  
  20. 20. Case:  I-­‐710  Corridor  
  21. 21. Differences  in  Expecta=ons   Transporta>on  -­‐  AQAP     •  Regulatory  -­‐  Risk  Analysis   with  Toxicology   •  Air  Quality,  Safety,  Noise     •  NEPA  process  à   –  Timing  /  Data  Confiden=ality   –  Defined  Alterna=ves   •  AQAP  Advisory  CommiIee     Public  Health  -­‐  HIP   •  Social  Determinants  of  Health   Analysis  (Epidemiology)  &  Equity   •  Air  Quality,  Safety,  Noise  PLUS  bike-­‐ ped,  access,  etc     •  Wai=ng  on  modeled  data,  but  then   no  =me  for  health  models   •  No  control     •  Used  to  working  with  public   including  advocacy  groups    
  22. 22. Types  of  HIA   Harris-­‐Roxas  &  Harris  (2011).  Differing  Forms,  Differing  Purposes.  EIAR.     Mandated   Decision-­‐ Support   Advocacy   Community-­‐Led   Voluntary   No   Yes   Yes   Yes   Purpose?   Meet  Regula=ons   Inform  the   Decision   Change  the   decision   Increase   Community   Control   Health   Purpose   Minimize   nega=ve  impacts   Maximize  Health   Min  Dispari=es   HIA  Author?   Consultant  for   Government   Agency   Government   Agency,  some   health  non-­‐ profits   Informed  by   Environmental   Health   *Env  Health     *Social     *Health  Equity   Role  of   Stakeholders   Technical  Info   Inform  
  23. 23. Founda=onal  Value:  Health  Equity   •  “HIA  is  not  only  interested  in  the  aggregate  impact   of  the  assessed  policy  on  the  health  of  a  popula=on,   but  also  on  the  distribu>on  of  the  impact  within   the  popula>on  in  terms  of  gender,  age,  ethnic   background,  and  socioeconomic  status.”   –  Gothenburg  Consensus   •  SES  à  Spa=al  Distribu=on   •  Vulnerable  Popula=ons  (young,  old,  minority,  sick)   •  Implies  Decision  Rule  =  Maximize  Health  &                        Minimize  Health  Dispari=es  
  24. 24. Case:  Clark  County   Clark County, WA Bicycle and Pedestrian Master Plan
  25. 25. Good  Collabora=on   •  Planning  and  Public  Health  had  a  decent   working  rela=onship   •  Integra=on  of  Advisory  CommiIee  worked   because  Planning  allowed  Public  Health   significant  =me  on  the  advisory  commiIee   •  Plan  was  not  terribly  conten=ous     – Health  Promo=ng   – Vision    
  26. 26. Types  of  HIA   Harris-­‐Roxas  &  Harris  (2011).  Differing  Forms,  Differing  Purposes.  EIAR.     Mandated   Decision-­‐ Support   Advocacy   Community-­‐Led   Voluntary   No   Yes   Yes   Yes   Purpose?   Meet  Regula=ons   Inform  the   Decision   Change  the   decision   Increase   Community   Control   Health   Purpose   Minimize   nega=ve  impacts   Maximize  Health   Min  Dispari=es   Max  Health   HIA  Author?   Consultant  for   Government   Agency   Government   Agency,  some   health  non-­‐ profits   Health  non-­‐ profits  in   partnership  with   CBO   Informed  by   Environmental   Health   *Env  Health     *Social     *Health  Equity   *Social   *Health  Equity   *Env  Health   Role  of   Stakeholders   Technical  Info   Inform   Guide  
  27. 27. Types  of  HIA   Harris-­‐Roxas  &  Harris  (2011).  Differing  Forms,  Differing  Purposes.  EIAR.     Mandated   Decision-­‐ Support   Advocacy   Community-­‐Led   Voluntary   No   Yes   Yes   Yes   Purpose?   Meet  Regula=ons   Inform  the   Decision   Change  the   decision   Increase   Community   Control   Health   Purpose   Minimize   nega=ve  impacts   Maximize  Health   Min  Dispari=es   Max  Health   Min  Dispari=es   Max  Health   HIA  Author?   Consultant  for   Government   Agency   Government   Agency,  some   health  non-­‐ profits   Health  non-­‐ profits  in   partnership  with   CBO   CBO’s  in   partnership  with   health  non-­‐ profits   Informed  by   Environmental   Health   *Env  Health     *Social     *Health  Equity   *Social   *Health  Equity   *Env  Health   *Social   *Health  Equity   Role  of   Stakeholders   Technical  Info   Inform   Guide   Control  
  28. 28. LA KESIDE DR 11TH ST TUNNEL 14TH ST 13TH ST 12TH ST 11TH ST 10TH ST 9TH ST 8TH ST 7TH ST 6TH ST 5TH ST 4TH ST 3RD ST 2ND ST EMBARCADERO WEST 4TH ST 15TH ST 17TH ST MADISONST LAKESIDEDR LAKESHORE AVE E. 18TH ST ATHO L AVE FOOTHILL BLVD INTERNATIONAL BLVD E. 12TH ST E. 11TH ST E. 10TH ST E. 15TH ST 1STAVE 2NDAVE 3RDAVE 4THAVE 5THAVE E. 7TH ST JACKSONST ALICEST HARRISONST WEBSTERST BROADWAY WEBSTERST FRANKLINST BROADWAY HARRISONST JACKSONST ALICEST MADISONST OAKSTOAKST FALLONST WATER ST 1ST ST EMBARCADERO 19TH ST 880 WEBSTERPL VICTORY CT AMTRAK Laney Parking Peralta Community College District Administration Oakland Unified School District Laney College Oakland Museum of California Kaiser Auditorium MTC/ ABAG Lake Merritt BART BART Parking Madison Sq. Park Chinese Garden Park Lincoln Sq.Park Pacific Renaissance Plaza Lincoln Elementary Post Office County Court Public Library L a k e M e r r i t t Oakland Unified School District Downtown Campus 0 500 FEET 100 12th St BART FRANKLINST Lake Merritt Station Area Planning Areas BART Station Entrance West Subarea East Subarea 1/2 Mile Radius 1 2 3 4 5 6 8 7 1 2 3 4 5 6 6 7 8 9 9 Existing Places in the Planning Area Case:  Lake  MerriI     BART  Sta=on  Area  Plan  
  29. 29. Madison Square Park Source: http://memorymap.oacc.cc/project-info/taichichats.html
  30. 30. Lessons  Learned   •  Conflict  with  HIAs  onen  aligns  with   – Type  of  plan:  Health  Promo=ng  vs  Risk   Reduc=on   – Scale  of  the  plan   – Previous/ongoing  rela=onships  between   planners  and  public  health  authors  of  HIA   •  Good  facilita=on  can  go  a  long  way   •  Professionals  misjudge  other   professionals,  assuming  uniform  interests  
  31. 31. Lessons  Learned  (con=nued)   •  Transporta=on  planners  should  try  to…   – Understand  who  is  performing  the  HIA  to   hint  at  the  type  of  HIA   – Learn  about  the  social  determinants  of   health  and  health  equity   – Be  clear  about  data  =melines   – Offer  GIS  data  if  available,  par=cularly  for   safety    
  32. 32. Lessons  Learned  (Con=nued)   •  HIA  prac==oners  should  try  to…   – Understand  regulatory  constraints   – Ask  about  past  health  partners   – Be  flexible  about  products   – Scoping  is  the  ideal  =me  for  stakeholder   engagement  à    budget  enough  =me   – Beware  of  giving  up  control  of  the  HIA   advisory  commiIee  
  33. 33. Best  Prac=ces   •  Stakeholder  engagement  plan   •  Meet  with  planners  very  early  on   •  Ask  about  the  =ming  of  their  process  and   when  they  would  most  appreciate  input   •  Ask/aIend  each  other’s  advisory  commiIee   •  In  advisory  commiIees,  do  not  assume  one   planner  or  one  public  health  person  can   represent  the  en=re  field  
  34. 34. QUESTIONS?   Contact  Info:   Nicole  Iroz-­‐Elardo,  PhD   irozelardo@yahoo.com  

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