key elements of a community health assessment key elements of a community health assessment

Federal government websites often end in .gov or .mil. and transmitted securely. The committee recommends that HIAs be publicly released and disseminated. Box 3-3 provides an example of an assessment step that was based on interviews with people who were likely to be affected by a decision and that considered their impressions of the effects that industrial activities were having and were likely to continue to have on individual, family, and community life. EC (European Communities). The wide array of evidence includes public testimony on local conditions and concerns, interviews with key informants, surveys, epidemiologic analysis (for example, observational cross-sectional surveys, longitudinal studies, and intervention or experimental studies), measurement of physical environmental conditions and modeling (for example, modeling of infectious-disease propagation or dispersion of noise and air pollutants), and expert opinion. official website and that any information you provide is encrypted The potential for the HIA to be completed in the time allotted and with the resources available. Rethinking human health impact assessment. Questions that are important from a public-health perspective might include the severity of the health effect, the size and likelihood of the effect, and the potential of the effect to exacerbate health disparities. Participatory approaches that actively engage stakeholders in the process can yield rich information and provide opportunities for stakeholdersincluding community membersto influence the questions asked and to participate in the interpretation of findings. o Who is ultimate decision maker if the event needs to be cancelled, postponed or similar? A plan is typically updated every three to five years. Possible Elements of a Community Team. The site is secure. HIA is meant to assist decision-makers, so although the act of reporting is a formal step in the HIA process, it is also in the interest of decision-makers and the HIA team to keep in constant communication throughout the HIA process so that emerging results can be incorporated into the policy, plan, program, or project. In some cases, collaboration between a health department and other agencies has resulted in the identification of appropriate proposals for screening. Would you like email updates of new search results? Parry JM, Kemm JR. The HIA study area was divided into five planning areas, and census (2000) and mortality data were used to analyze the population profiles. [accessed May 24, 2011]. The committee notes that outcome evaluation considers the effects of the whole decision, including changes made as a result of HIA recommendations. Past Projects: Vehicle Miles Traveled Legislation. The first is to create a profile of the population affected, which includes information on the demographics, baseline health status, and social, economic, and environmental conditions that are important to health. The committee concludes that when alternatives to the proposal being assessed are under consideration, the HIA team should assess the impacts of each alternative. 8600 Rockville Pike The reader will notice that some of the committees descriptions and characterizations overlap with those of other guides; the similarities highlight the consistencies in the field. Others have proposed categorizing HIAs as participatory (emphasizing shared governance, public participation, and a focus on socioeconomic and environmental determinants), quantitative or analytic (concentrating on the methods and rigor of the analysis), or procedural (drawing on elements of the other two approaches but emphasizing the procedural steps required and often undertaken within a specified administrative or regulatory context) (Cole and Fielding 2007). Recommendations identify specific actions that could be taken to avoid, minimize, or mitigate harmful effects identified during the course of the HIA or to take maximal advantage of opportunities for a proposal to improve health. Good Practice Guidance on Health Impact Assessment. UPH (Upstream Public Health). A decision-making bodysuch as a department of planning or transportation can conduct an HIA to inform its own decision. 4321-4347 [1970]; EC 2001). In other cases, the initial scope is generated by stakeholders and then refined through research and input from advisory or steering committees. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. For that reason, it is important for the field to define the circumstances under which outcome evaluation may be practicable. Within several of these components, we discuss characteristics that are critical to improving community health. A plan for continuous monitoring, adaptation of mitigation measures, and verification of performancealthough not currently a uniform aspect of HIA practice helps to ensure that measures are carried out and achieving their objectives. 2007; Bhatia 2010). Another issue that should be addressed in scoping is identifying alternatives to the proposed action. Notwithstanding those considerations, the committee considers the public disclosure of HIAs to be an important ideal of practice but recognizes that it may not be realistic to expect widespread disclosure in the absence of requirements or incentives for it. Thus, it is generally not possible to attribute outcomes specifically to HIA recommendations because they are implemented with the decision. 2009; Human Impact Partners 2009a,b; AECF 2011. Cole BL, Shimkhada R, Fielding JE, Kominski G, Morgenstern H. Methodologies for realizing the potential of health impact assessment. Since there are different models to guide assessment and planning, as well as a variety of organizations and agencies that carry out these activities, there may be confusion in choosing among approaches. HIA guidance often points out the need for monitoring and continuing management and verification that mitigation measures are being implemented. First, community input is essential especially for proposals that will affect the local community primarily. It solicits and responds to input from stakeholders throughout all stages of the process and includes publicly available and accessible documentation of processes, products, and sponsors. Evaluating health impact assessment. The baseline should be focused on the issues that are likely to be affected by the proposal. Fehr R. Environmental health impact assessment: Evaluation of a 10 step model. What Is a Community Health Improvement Plan? The final HIA report describes each factor (see below) and presents the results of the scoping. Available studies suggest that efforts to involve and inform decision- makers throughout the HIA process and a strong relationship between the HIA team and decision-makers are often critical for the HIAs effectiveness (Veerman et al. HHS Vulnerability Disclosure, Help DHHS (U.S. Department of Health and Human Services). Chapter 2 established the rationale for examining the potential effects of decisions on health and health disparities and highlighted health impact assessment (HIA) as a potential tool for assessing the health implications of various decisions. In practice, some HIAs have focused on a specific health end point, such as obesity, or health concerns related to a single impact of the proposal, such as the health effects of air pollutants, most likely without using a systematic approach that considered and eliminated other impacts (see, for example, Kuo et al. Community Health, Safety and Security. It can also assess whether the HIA had other important effects, such as building new collaborations among agencies, ensuring that stakeholder perspectives were considered, and increasing awareness of previously unrecognized health considerations. Environmental, Social and Health Impact Assessment (ESHIA) Process. Health impact Assessment: Concepts, Theory, Techniques and Applications. The World Bank Policy on Access to Information. As discussed above, additional benefits may include, for example (Wismar et al. Cancer risk and changes in life expectancy associated with tobacco taxes. Community Health Assessment aNd Group Evaluation (CHANGE): Building a Foundation of Knowledge to . The committee notes that each approach for gathering and interpreting data may be conducted in ways that are more or less participatory, engaging stakeholders in shaping the research questions, interpreting the findings, and developing recommendations on the basis of the findings. Establishing a foundation for appropriate monitoring. Saving Lives, Protecting People. Issues surrounding uncertainty, literature review, and reliability and validity of predictions are discussed in greater depth in Chapter 4. Second, it allows findings to be reviewed and improved. For example, the chair of the California Assembly Labor Committee referred to the HIA and asked the opposition to the bill if they condoned the spread of disease through restaurant workers.. Bhatia R, Wernham A. Catholic Healthcare West Guidelines for Community Health Assessment This document is meant to help CHW hospitals identify and evaluate community health issues, and capacities for dealing with them. As described in Appendix A, there are few laws in the United States that specifically require HIA, although manysuch as the National Environmental Policy Act (NEPA)require a consideration of health that can be accomplished through HIA. Identification of apparent data gaps and of data collection that could be undertaken to address the gaps or a rationale for not undertaking data collection. Collaboration with decision-makers or consultation with experts familiar with the legal or regulatory context may be the most effective way to ensure that recommendations are pragmatic and can be practically incorporated into the decision-making process. The most vulnerable populations were identified as people of low economic status, children, older adults, renters, and the carless. Health Impact Assessment for Regeneration Projects. The development of recommendations should be guided by a consideration of any available evidence regarding effectiveness. There could also be concerns that disclosure of such information would lead to litigation. Health Impact Assessment: SEIC (Sakhalin Energy Investment Company) Phase 2 Development. Additional modeling approaches, such as system-dynamic modeling and agent-based models, are also promising and emerging tools that could have applications to health. That explanation is particularly important when public funds are to be used for an HIA because the public may want to understand the basis for allocating sparse public resources. Bookshelf However, because few studies have directly assessed the impact of the implementation of policies, plans, programs, or projects on health outcomes, there may be little direct evidence available with which to predict a given measures effectiveness. In some cases, the HIA process allows a period for formal public comment on a draft of the HIA report. Acknowledgement of plans for future outcome evaluation or discussion of limitations that prevent such an evaluation. Public-health professionals reviewed the results of the analysis. Catholic Health Association of the United States. On the basis of its review of current guidance and practice, the committee recommends that scoping should result in a framework for the HIA and a written project plan that includes the following: The credibility and relevance of HIA to the decision-making process rest on a balanced and complete examination of the health risks, benefits, and tradeoffs presented by the project, policy, program, or plan being assessed. The HIA team identified the pathways in which the expansion would affect the lives of the primarily Iupiat residents of the area. 2009; Bhatia et al. Sources: Adapted from Cook et al. Thus, HIA teams may include not only health experts but professionals in other related disciplines, such as air or water quality or traffic modeling. Cole BL, Wilhelm M, Long PV, Fielding JE, Kominski G, Morgenstern H. Prospects for health impact assessment in the United States: New and improved environmental impact assessment or something different? Document No. Kuo T, Jarosz CJ, Simon P, Fielding JE. It is also common for local, state, or tribal health departments to undertake an HIA to inform another agencys decision-making. Rapid HIAs may be completed in a short time (weeks to months), are often focused on smaller and less complex proposals, and generally involve primarily literature review and descriptive or qualitative analysis. Focusing on Health: How Can the Health Impact of Policy Decisions be Assessed? The National Partnership for Women and Families commissioned Human Impact Partners and researchers at the San Francisco Department of Public Health to conduct an HIA of the federal Health Families Act of 2009, (more). Across the field, there is little uniformity in the content of written HIA reports. Human Impact Partners; 2010. Similarly, HIAs sponsored by private nonprofit organizations may not have requirements for disclosure inasmuch as most U.S. HIAs are not done under a legal mandate that requires disclosure. 2007; ICMM 2010). Gruber JB, Wang W, Quittner A, Salyakina D, McCafferty-Fernandez J. Popul Health Manag. Activities directly or indirectly associated with oil and gasincluding aircraft traffic, seismic exploration, influx of nonresident workers, and emissions and dischargeswere identified, and pathways were analyzed to consider their impacts on such problems as diet-related chronic illnesses (for example, diabetes and hypertension), food insecurity, and social pathology (for example, assault, alcohol and drug abuse, and violence). This plan is used by health and other governmental education and human service agencies, in collaboration with community partners, to set priorities and coordinate and target resources. Different HIA guides vary somewhat as to the specific descriptors that should be used, and practice is highly variable. 2023 by the American Hospital Association. Furthermore, impact assessments, including HIAs, may rely on proprietary business information whose disclosure is legally barred or could damage a proponents business edge or competitiveness. Various sources of population-health statistics at the national, state, and local levels are available. Wernham A. Inupiat health and proposed Alaskan oil development: Results of the first Integrated Health Impact Assessment/Environmental Impact Statement of proposed oil development on Alaskas North Slope. Mindell JS, Boltong A, Forde I. Because HIA in the United States is often undertaken outside a formal legal mandate, it has not consistently included alternatives assessment. Schweinhart LJ, Montie J, Xiang Z, Barnett WS, Belfield CR, Nores M. Scott-Samuel A. That permits recommendations to form the basis of effective implementation and management rather than merely providing a static system without the capacity to adapt. The diversity of practice owes partly to the fact that HIAs are undertaken for a wide array of policy-making that spans many sectors, levels of government, types of proposal (policies, plans, programs, and projects), and degrees of complexity. Although little has been written on the reasons for keeping HIA information confidential, the committee recognizes that there may be reasons for organizations conducting HIAs to decide not to disclose the results. Risk Assessment in the Federal Government: Managing the Process. Mindell J, Biddulph J, Taylor L, Lock K, Boaz A, Joffe M, Curtis S. Improving the use of evidence in health impact assessment. University researchers have conducted HIAs, and community-based organizations have conducted HIAs with technical assistance from public-health experts to inform officials who are deliberating on a legislative or administrative proposal. (2015). Citation for Toolkit The definition also notes that recommendations should incorporate monitoring, which is essential for effective continuing management as a decision is implemented. Finally, it is appropriate to include issues that are the subject of community concern even if they seem unlikely to be substantiated by further analysis. Action plans have mutually reinforcing activities. Some provide a checklist of factors to consider and often focus on health determinants that might be affected by the proposal. Such programs and projects involve many agencies and entities that have authority over some aspect of planning and implementation. Cookies used to make website functionality more relevant to you. 2006) as a technical definition of HIA: HIA is 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 and the distribution of the effects within the population. Describes data sources and analytic methods and methods used to engage stakeholders. Program on Health Equity and Sustainability, San Francisco Department of Public Health. Recommendations form the core of a health-management plan, but the plan also determines authority for and assigns responsibility for implementing each recommendation, establishes a monitoring plan, and creates or suggests mechanisms to verify that assigned responsibilities are being met. Screening should result in a simple statement that includes the following: Screening is essential for high-quality HIA. HIA and national policy in the Netherlands. However the literature review is conducted, the methods should be clearly described in the report, and any studies with conflicting results acknowledged. Sources: Veerman et al. Assessing the Health Impacts of Road Pricing Policy Proposals. About the Annie E. Casey Foundation, Baltimore, Maryland. Regardless of whether effects are quantified, the assessment stage should include a characterization of each effect to the greatest extent. A description of the HIAs impact on decision-making (to the extent that salient decisions have occurred by that time) as measured by an accounting of HIA recommendations that were adopted and an evaluation of available evidence that suggests whether and how the HIA played a role in decisions or contributed to changes in decision-makers knowledge, attitudes, or positions. If it is not possible to undertake complete, systematic literature reviews for an effect analyzed in an HIA, HIA practitioners must be vigilant to avoid selective searching and consideration of only studies that confirm particular conclusions (Mindell et al. 98224-MS. SPE International Health, Safety & Environment Conference; 24 April 2006; Abu Dhabi, UAE. Section 1508.27). Moreover, disease rates in small populations can vary substantially, and it may not be possible to calculate them reliably. Red Dog Mine Extension Aqqaluk Project. The committee notes that a variety of qualitative and quantitative approaches are often used to generate predictions, but regardless of the methods used, most available guidance emphasizes the importance of considering diverse forms of evidence, a consistent and unbiased approach to selecting and interpreting evidence, and a clear and transparent description of the analytic approach (WHO 1999; Mindell et al. government site. Vol. Improving Health in the United States: The Role of Health Impact Assessment. 2004, 2010). Some have suggested that evaluation should be considered as outside the HIA process itself because of the need for an independent and objective perspective, particularly for impact evaluation (Bhatia et al. Before The grouping of the elements in discrete stages or steps of an HIA is less consistent; some guides list as few as five steps, and others describe as many as nine (Quigley et al. Ultimately, regardless of the specific tool used, the decision to conduct HIA in most cases relies on the practitioners or decision-makers judgment regarding the likelihood of impacts, the time and resources available, and the likelihood that the information produced by the HIA will be a valuable aid to decision-making. It follows a systematic process that includes screening, scoping, assessment, recommendations, reporting, and monitoring and evaluation. An HIA would identify health assets, health liabilities, and health-promoting mitigations related to the proposed development project. Scholars point to a remarkable consistency in the basic elements that are generally included in descriptions of HIA (Mindell et al. A community health assessment (sometimes called a CHA), also known as community health needs assessment (sometimes called a CHNA), refers to a state, tribal, local, or territorial health assessment that identifies key health needs and issues through systematic, comprehensive data collection and analysis. This data then informs the nursing care plan. Frank DA, Neault NB, Skalicky A, Cook JT, Wilson JD, Levenson S, Meyers AF, Heeren T, Cutts DB, Casey PH, Black MM, Berkowitz C. Heat or eat: The Low Income Home Energy Assistance Program and nutritional and health risks among children less than 3 years of age. Health Impact Assessment: A Practical Guide. HIAs in the private sector are increasingly common, pursuant to internal corporate guidelines or requirements of lending banks, such as the International Finance Corporation and World Bank (see Appendix A for further discussion) (Birley 2005; IPIECA/OGP 2005; McHugh et al 2006; ICMM 2010; IFC 2007, 2010).3 Few, however, are made public. If there is a causal relationship between variables, a valid estimate of effect size, and data on how a decision will change the prevalence of a health-related factor (exposure), it is possible to make quantitative predictions of effects (Fehr 1999; Veerman et al. Quigley RJ, Taylor LC. In those cases, it may be more appropriate to monitor exposuressuch as environmental concentrations of a carcinogen or the availability of safe walking corridorsthat are linked to the outcome of interest by public-health evidence. It is critical for the credibility of the HIA that the measures or outcomes being promoted are grounded in full and transparent consideration of the evidence that supports and does not support the issue in question. For example, under Alternative A, diabetes and metabolic disorders would be expected to increase if impacts on subsistence led to declining subsistence harvests (through declining populations of subsistence resources, displacement of resources that made hunting less successful, or displacement of hunters by oil activity and infrastructure).