Integrating a Health Impact Assessment into District-Wide School Travel Planning Track: Prosper Format: 60 minute panel Abstract: Learn about how a Health Impact Assessment (HIA) was used for the first time to guide the formulation of the Safe Routes to School (SRTS) Columbus City Schools District-Wide School Travel Plan, which focused on schools and neighborhoods with health inequities. Presenters: Presenter: Brian Butler Columbus Public Health Co-Presenter: Kate Moening Safe Routes to School National Partnership Co-Presenter: Alex Smith Columbus Public Health Co-Presenter: Julie Walcoff Ohio DOT

1. Health Impact Assessment and Safe Routes to School
Brian Butler, MPH
Epidemiologist

2. What is Health Impact Assessment?
A systematic process that uses an array of data sources and analytic methods and considers input from stakeholders to determine the potential effects of a proposed policy, plan, program or project on the health of a population. HIA provides recommendations on monitoring and managing those effects.
National Research Council of the National Academies, 2011

3. HIA Purpose
Through HIA report and communications
•Judge health effects of a proposed project, plan or policy
•Highlight health disparities
•Provide recommendations
•Raise awareness among decision makers and the public
•Make health impacts more explicit
Human Impact Partners

4. HIA Purpose
Through the HIA process
•Engage & empower community
•Recognize lived experience
•Build relationships & collaborations
•Improve the evidence
•Improve transparency in decision making
Human Impact Partners

5. 6 Steps of an HIA
1. Screening – Determines the need and value of an HIA
2. Scoping – Determines which health impacts to evaluate, methods for analysis, and a workplan
3. Assessment – Provides a profile of existing health conditions and an evaluation of potential health impacts

6. 6 Steps of an HIA
4. Recommendations – Provides strategies to manage identified adverse health impacts and maximize benefits to health
5. Reporting – Includes the development of the HIA report and communication of findings and recommendations
6. Monitoring – Tracks and evaluates the process of conducting the HIA, impacts on decisions-making processes and implementation of the decision, and impacts on health outcomes

7. 7
Planning Intervention Points
Vision, goals & priorities developed
Starting an HIA
Typical Points in a Planning Process
Existing conditions profiled
Alternatives drafted
Plan proposed
Plan approved
Plan implemented
(Rapid HIA)
(Comprehensive HIA)
Using HIA findings /recommendations

8. HIA and Columbus Public Health
•Healthy Places program has been conducting (mostly rapid) HIA’s since 2006
•Traditionally focused on accessibility of new development
•Safe Routes to School HIA work began in August 2013
•HIA report and additional products are currently being drafted and edited

9. Health Equity In SRTS
•Inequities in health exist along the lines of race, ethnicity, income, education levels, and other variables
•Focus SRTS interventions on schools and neighborhoods with health inequities
•Recommendations to improve health outcomes in disadvantaged and vulnerable populations

10. Δ obesity
Income
Race/ethnicity
Eng Language Learner
Educ attainment
Marriage status
School test scores
School performance
Columbus STP:
Engineering
Education
Encouragement
Enforcement
Δ walking environment
Δ social cohesion/civic engagement
Δ traffic safety environment
Δ chronic diseases (heart disease, diabetes, cancer)
Δ mental health
Δ crime safety environment
Δ physical activity
Δ ped/bike/auto collisions
Childhood obesity
Physical activity
Traffic collisions
Crime/fear of crime
Δ stress
Δ injuries
Columbus STP – Research Approach
Prioritizing recommendations:
1st Equity lens
Policy, Project, or Program
Environment & Behavior
Health Outcomes
Δ biking environment
Income
Race/ethnicity
Eng Language Learner
Educ attainment
Marriage status
School test scores
School performance
2nd Equity lens

11. A Key Research Question
How do you quantify or measure
health inequity?

12. What does the literature tell us?
Conducted an extensive lit review to look at:
1.What are the characteristics of communities where health inequities exist?
2.How are things like physical activity and traffic safety different in these communities?
3.How might the uptake of interventions be different in these communities?

13. •Socioeconomic Status (SES) Index
–Crowding
–Home value
–Income
–High education
–Low education
–Unemployment
–Poverty
•Poverty
•Race
•Ethnicity
•Language other than English
•Single parent head of household
Level 1 Analysis
Analyzed and mapped indicators of Healthy Equity by Census Tract:

14. School building datasets
•Free and reduced lunch rates
•School Performance Indicators and Index
•ELL/ESL rates
•Overweight and obesity rates
Additional factors mapped to inform the HIA
•Crime and perception/fear of crime
•Traffic collisions – pedestrians and bicycles
•Elementary/Middle school aged population
More Level 1 Analysis

15. Focus School Profiles
List based on multiple indicators
•SES Index
•Race and Ethnicity
•Single parent households
•Language
•Population of children
•School Performance

16. School
CT or S
Sullivant
Trevitt
Windsor STEM
Lincoln Park
Highland
Ohio Avenue
East Columbus
Eakin
School Type
Elem.
Elem.
Elem.
Elem.
Elem.
Elem.
Elem.
Elem.
Census Tract
51
29
15
60
47
53
26
75.11
Neigh-borhood
Franklinton
Eastside
Linden
Southside
Hilltop
Old Town East
Eastside
Hilltop
SES Index rank
CT
2
3
6
11
21
21
15
46
FARM rank
S
1
12
49
5
24
30
51
8
% non-white rank
CT
67
5
1
97
80
38
55
89
% non-white rank
S
66
16
9
73
65
15
34
42
Lang. other than English rank
CT
44
249
128
270
204
211
31
9
ESL rank
S
20
70
80
42
18
68
31
3
% single parent rank
CT
31
16
20
43
34
4
92
90
% pop. 5 to 14 years old rank
CT
12
1
28
114
16
31
67
75
% of students w/in 0.5 mi
42.8
64.6
37.2
41.5
60.8
27.9
51.6
76.1
% of students w/in 1.0 mi
69.2
81.4
65.1
63.6
71.4
57.7
57.3
81.8
% of students w/in 2.0 mi
79.8
86.7
87.2
71.5
84.2
78.1
71.6
87.5
% of ODE standards met
S
14.3
0
0
11.1
0
0
14.3
14.3
ODE Perf. Index percent
S
54.5
45.7
49.9
66.8
51
52.5
54.4
62.4

17. School
Sullivant
Eakin
Type
Elem
Elem
Census Tract
51
75.11
Neighborhood
Franklinton
Hilltop
SES Index Rank
2
46
Free and Reduced Lunch Rank
1
8
Percent non-White Rank (CT)
67
89
Percent non-White Rank (Sch)
66
42
Language other than English Rank (CT)
44
9
English Language Leaner Rank (Sch)
20
3
Percent Single Parent Rank
31
90
Percent Population 5 to 14 Rank
12
75
Percent of Students with 0.5 Miles
42.8
76.1
Percent of Students with 1.0 Mile
69.2
81.8
Percent of Students with 2.0 Miles
79.8
87.5
Percent of ODE Standards Met
14.3
14.3
ODE Performance Index
54.5
62.4

18. Questions?