GOVERNING magazine: Health Impact Assessments: Bringing Health to All Policies

April 26, 2012    ·    [ Health Impact Project Coverage ]

BY: Dylan Scott

Ever wondered what impact building a four-lane highway near a residential neighborhood could have on someone’s health? Perhaps not. But the national conversation is quickly shifting from how to react to health problems to how to prevent them. Wonks call it “health in all policies”. And as states and localities move toward that goal, they have a new tool at their disposal: health impact assessments (HIA’s).

Would that highway increase carbon emissions near family homes? Would the traffic pose a risk to pedestrian traffic? Is there an opportunity to add bike paths or walkways to encourage exercise? These are the kind of questions HIA's can try to answer.

They aren’t yet a common part of public policy: according to a review by the Health Impact Project (a joint venture by the Robert Wood Johnson Foundation and Pew Charitable Trusts) of 30 state and local jurisdictions (plus five American Indian tribes and the federal government for a total of 36), there were only four instances of HIA’s being required by law.

Still, the movement seems to be gaining steam: the inaugural National Health Impact Assessment Meeting was held in Washington, D.C., in early April. More than 400 people -- including public health officials, non-health policymakers and elected representatives -- attended the two-day conference at the Renaissance Hotel, according to the Health Impact Project, which coordinated the event.

Even with that level of interest, there might not need to be a sudden rash of HIA legislation. According to the project’s analysis, HIA’s could be used to satisfy already existing legal requirements in several areas: environmental and energy (22 jurisdictions out of 36); transportation (7); agriculture (7); and waste disposal and recycling (11). Many initial HIA efforts have also been voluntary, reducing the need for new governmental mandates that might be politically unpopular.

'The Healthiest Way Possible'

Transportation offers arguably the most intriguing application of HIA’s. Their use seems fairly intuitive for environmental or waste disposal projects, but the implications are vast if health considerations become a major factor when policymakers decide where to build a highway or how to design a traffic intersection.

“Our goal shouldn’t be to make all transportation projects primarily focused on improving health,” Aaron Wernham, director of the Health Impact Project, said. “Transportation has a different mission. It’s about moving people. But if we can do that in the healthiest way possible, then I think we have a win-win.”

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