It recommends measures, in the context of the proposed action, to protect and promote health and reduce health disparities. Most HIAs in the United States are therefore undertaken outside the formal decision-making process by organizations (such as nonprofit community-based groups), universities, or health departments that do not have decision-making authority over the proposals being addressed. Assessing the baseline health status of the affected population provides a reference point with which the predicted changes in health status may be compared; it identifies any groups that could be more vulnerable than the general population to the impacts of the proposal; and it provides an understanding of the factors that are responsible for determining health in the affected communities, and this, in turn, allows for a better understanding of how any changes in those factors may affect health. PDF Community Health Assessment: An Overview - Richard M. Fairbanks School Box 3-2 provides an example of scoping for the HIA of a proposed development in Atlanta. Public input while recommendations are being developed helps to ensure that proposed measures are locally relevant, address context-specific factors that might render them more or less effective, and address public concerns and hopes. Describes the baseline health status of the affected population with appropriate indicators, including prevalent health problems, health disparities, and social, economic, and environmental factors that affect health. However, many HIA reports are available from public agencies, universities, and nonprofit organizations, and the committee found few examples of HIAs led or commissioned by the private sector that were available. Would you like email updates of new search results? For example, the San Francisco Department of Public Health routinely screens major projects and plans to ensure adequate analysis and mitigation of environmental health impacts. Drafting measures that address identified public-health risks and that fulfill the requirements of the legal framework governing a decision will increase the chances that HIA recommendations are implemented. Consortia may wish to adopt consensus definitions of key terms such as population health, community health, and social needs vs. determinants of health, among others. Affordable Housing and Child Health: A Child Health Impact Assessment of the Massachusetts Rental Voucher Program. A statement of why the proposal was selected for screening. Elliott E, Francis S. Making effective links to decision-making: Key challenges for health impact assessment. Screening: HIA of a Residential Housing Program. A local community-based organization worked (more). Acknowledgement of plans for future outcome evaluation or discussion of limitations that prevent such an evaluation. 2005; Frank et al. Open communication is necessary to build trust and ensure mutual objectives. Several types of evaluation may be conducted on an HIA, including the following: In practice, most HIAs do not include process, impact, or outcome evaluation; this has been attributed to a lack of interest, time, and resources in the case of process and impact evaluation and to the length of time (often many years) required for observing changes related to implementation. 2007). 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. 2007). The process is analogous to the approach in the new risk-based decision- making framework proposed in Science and Decisions (NRC 2009), in which the primary objective of risk assessment is to help decision-makers choose among risk-management options by providing information on health risks that can be considered in the context of economic, social, and other factors. Lifetime Effects: The High/Scope Perry Preschool Study through Age 40. During scoping, the HIA team may produce an initial list, refine it on the basis of stakeholder input, and then make it final through research and analysis in the assessment phase. A preliminary opinion regarding the potential importance of the proposal for health. It is important for nonprofit hospitals to be knowledgeable about the Internal Revenue Services regulations for CHNAs. A variety of planning and zoning, funding, and environmental regulatory decisions were required for the BeltLines various components to be developed. HIA recommendations take various forms, and some examples are provided below. The specific methods used in assessment are discussed in depth in the next section. In practice, not all HIAs have conducted systematic literature reviews or documented review methods. Final Supplemental Environmental Impact Statement. According to effort, complexity, and duration, HIAs are often described as rapid, intermediate, or comprehensive. Although there are many potential benefits of undertaking an HIA, one common objective is to inform decisions to promote changes that support improvements in health determinants or health outcomes. 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. Northeast National Petroleum Reserve-Alaska (NPR-A) Draft Supplemental Integrated Activity Plan/Environmental Impact Statement (IAP/EIS). A logic framework was produced to guide the assessment. The process of implementing recommendations should be transparent and should include opportunities for public participation in the decision process and clear mechanisms of accountability. Scoping also establishes a plan for the analytic methods that will be used during the assessment phase. A variety of information was used to inform the process, Scoping: Atlanta BeltLine HIA. Advisory, steering, and technical oversight committees are also commonly convened during scoping. Having transparency throughout the process and clearly delineating the roles and responsibilities among various parties will help to limit real and perceived bias. The final HIA report should document the following: In addition to a final report, stand-alone executive summaries or fact sheets can help to disseminate and communicate the findings and recommendations of an HIA to various key audiences. For example, in Alaska, one of the adverse impacts of a proposed mine expansion was the feared contamination of water and wildlife, and evidence suggested that a fear of contamination might lead communities to shy away from eating a traditional diet. For example, in the context of NEPA, the lead federal agency must consider the degree to which the proposed action affects public health or safety to determine whether a proposal is likely to have significant effects and therefore require an environmental impact statement (40 CFR 1508.27). Moving to opportunity: An experimental study of neighborhood effects on mental health. Remember, although this example uses boxes and arrows, you and your partners in change can use any format or imagery that communicates more effectively with your stakeholders. The World Bank Policy on Access to Information. However, the committee notes that there are several benefits of disclosure for industry, policy-makers, and the affected communities. Castro A, Chen L, Edison B, Huang J, Mitha K, Orkin M, Tejani Z, Tu D, Wells L, Yeh J. Cave B, Curtis S. Developing a practical guide to assess the potential health impact of urban regeneration schemes. It outlines a set of principles that inform an ensuing discussion of key elements of community assessment. Box 3-4 provides several examples of topics that have been addressed in HIA by using quantitative methods. It would then fall to the decision-makers to determine routes that met those criteria. Even when there is substantial uncertainty, an assessment can illuminate potential causal pathways thateven when there appear to be conflicting influences on a specific outcomecan point the way toward a flexible framework for monitoring and managing any impacts that might occur as the proposal is implemented. Using this generic model as a template, let's fill in the details with another example of a logic model, one that describes a community health effort to prevent tuberculosis. The HIA team was assisted by an advisory committee, but it appears that the committee was not involved in the scoping. Office of Disease Prevention and Health Promotion, US Department of Health and Human Services. It is important for event staff to know exactly who has final decision-making power to eliminate potential conflicts. Furthermore, some policies may focus on determinants of healthfor example, economic development, transportation, or housingrather than explicitly mentioning health. PDF Community Health Assessment and Group Evaluation (CHANGE) Presentation Vaccaro A, Madsen P. Corporate dynamic transparency: The new ICT-driven ethics. 2006; World Bank 2010). 2017 Jul/Aug;23 Suppl 4 Suppl, Community Health Status Assessment:S14-S21. Health impact assessments are needed in decision making about environmental and land-use policy. The committee notes three considerations that may be particularly important for producing effective, actionable recommendations. 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. The HIA report states that scoping was done by the HIA team and involved desk-based research and a web and postal survey. 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. To request permission to reproduce AHA content, please, https://www.chausa.org/communitybenefit/assessing-and-addressing-community-health-needs, Step 5: Prioritize Community Health Issues, Association for Community Health Improvement (ACHI). Santa Monica Airport Health Impact Assessment (HIA): A Health-Directed Summary of the Issues Facing the Community near the Santa Monica Airport. In the United States, HIAs have commonly been undertaken by people who have an MPH or equivalent degree and have attended a brief (2- to 5-day) training session. Because it will often not be practical or possible to address all direct and indirect health effects that appear theoretically possible, it is important to select issues carefully. Good Practice Guidance on Health Impact Assessment. The committee is not endorsing the HIAs or the recommendations, but simply providing examples. The population, subgroups, vulnerable populations, and stakeholders likely to be affected and how they were involved in the HIA process. However, Science and Decisions (NRC 2009) emphasizes that a detailed understanding of the decision context is necessary for analyses to be scoped appropriately and that the conceptual distinction between assessment and management should not be interpreted as a firewall that prevents communication between parties. Fifth, transparent reporting of possible environmental and health impacts has proved in many studies to lead to risk reduction because it motivates changes, such as improved pollution controls, on the part of industry and governments (Wolf 1996; Bennear and Olmstead 2008; Vaccaro and Madsen 2009). Paper No. 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. But few data may be available on the geographic scale of some decisions addressed in an HIA, such as decisions related to projects that would affect a rural area or a single neighborhood. HIAs are also differentiated according to whether they are integrated into an environmental impact assessment or done independently. A discussion of whether the HIA achieved its initial objectives. Example of a Table for Rating Importance of Health Effects. Chapter 4 discusses the extent to which an HIA can ensure the implementation of recommendations. 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.
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key elements of a community health assessment