A community health assessment gives organizations comprehensive information about the community's current health status, needs, and issues. 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, which would guarantee workers access to paid sick leave. It follows a systematic process that includes screening, scoping, assessment, recommendations, reporting, and monitoring and evaluation. Screening should result in a simple statement that includes the following: Screening is essential for high-quality HIA. 2017 Jul/Aug;23 Suppl 4 Suppl, Community Health Status Assessment:S14-S21. The bulleted list below provides examples in which some health impacts or behavioral outcomes have been quantified. Mindell J, Biddulph J, Taylor L, Lock K, Boaz A, Joffe M, Curtis S. Improving the use of evidence in health impact assessment. FOIA A matrix can be a useful way to organize a qualitative analysis and to convey results in a manner that is easy to understand, but a matrix may also be misinterpreted as being more objective than a simple description. Reprinted with permission; copyright 2010, International Council on Mining and Metals. For example, rather than providing an estimate of lung-cancer rates in a small community, an HIA might identify smoking rates and important sources of airborne pollutants in the communitys airshed. Completing A Health Assessment In Nursing | NurseJournal.org Davenport C, Mathers J, Parry J. Similarly, HIA recommendations concern measures that can be taken to protect or improve health, but ultimately the decision-makers must weigh those recommendations with the political, economic, social, and technical factors that are relevant to the decision. In contrast, the effect of decisions on some health outcomes (such as cancer or obesity) may take years to occur and may have multiple contributing factors. The approaches taken for stakeholder involvement vary widely. In some cases, the lack of a recommendation may reflect a desire to avoid a perception that the HIA is a one-sided advocacy exercise, particularly when options for recommendations would involve adopting a position wholly supportive of or opposed to the proposal being assessed. That description is consistent with the earlier characterizations of HIA as a combination of procedures, methods, and tools (WHO 1999; Quigley et al. Federal government websites often end in .gov or .mil. Although a wide variety of excellent resources on community health assessment and CQI currently exist, those materials generally do not link assessment and CQI concepts and techniques in the way that is envisioned for . 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. Use of health impact assessment in incorporating health considerations in decision making. Lester C, Hayes S, Griffiths S, Lowe G, Hopkins S. Implementing a strategy to address health inequalities: A health authority approach. With clear language in mind, partners should come to agreement on the Knowing Your Community: Community Health Assessment as a Powerful Tool Bender, Kaye PhD, RN, FAAN Author Information Journal of Public Health Management and Practice: doi: 10.1097/PHH.0000000000000599 2017 Wolters Kluwer Health, Inc. All rights reserved. The HIA report states that scoping was done by the HIA team and involved desk-based research and a web and postal survey. It identified which areas and villages were most likely to be affected and when. Although deviation from the criteria may occur, a valid and clearly articulated rationale for such deviation should be described when the HIA is reported. Community Health, Safety and Security. Industrial proponents, government decision-making agencies, local health departments, and independent organizations (such as universities and nongovernment organizations) may all be in a position to implement measures recommended in the HIA. Rethinking human health impact assessment. World Bank. The impacts of right-to-know: Information disclosure and the violation of drinking water standards. A logic framework was produced to guide the assessment. Kuo T, Jarosz CJ, Simon P, Fielding JE. EC (European Communities). New surveys to address data gaps or questions specific to the proposal in question are also common in comprehensive HIAs. 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. In the absence of mandates or formal procedures, topics for screening are often chosen on the basis of the interests of a group wishing to use HIA as opposed to a structured, strategic selection process. However, where practical, the HIA team should aim to evaluate a variety of alternatives or, minimally, to identify the characteristics of proposed actions that would be health-protective or detrimental to health. This toolkit was partially supported by funding from the Centers for Disease Control and Prevention through Cooperative Agreement Number 5U38OT000211-03 with the Public Health Foundation. Mindell J, Ison E, Joffe M. A glossary for health impact assessment. Northeast National Petroleum Reserve-Alaska (NPR-A) Draft Supplemental Integrated Activity Plan/Environmental Impact Statement (IAP/EIS). 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. Disclaimer. sharing sensitive information, make sure youre on a federal Quantitative evidence can include routinely collected information, such as mortality and census data, that can inform the baseline assessment. It is not reasonable to expect decision-makers to adopt HIA widely in the absence of evidence of its effectiveness and value. 2001). These common components included preplanning; developing partnerships; developing vision and scope; collecting, analyzing, and interpreting data; identifying community assets; identifying priorities; developing and implementing an intervention plan; developing and implementing an evaluation plan; communicating and receiving feedback on the assessment findings and/or the plan; planning for sustainability; and celebrating success. Acknowledgement of plans for future outcome evaluation or discussion of limitations that prevent such an evaluation. Key elements that make up a health assessment at the - Course Hero The success of recommendations ultimately depends on the publics trust in and support of them. Open communication is necessary to build trust and ensure mutual objectives. PDF From Common Ground to Shared Action - American Hospital Association Johnson BL. Thank you for taking the time to confirm your preferences. A community health assessment gives organizations comprehensive information about the communitys current health status, needs, and issues. Process evaluation assesses the design and execution of the HIA in light of its intended purpose and plan of action and applicable practice standards. Thank you also to the ACHI Community Health Assessment Toolkit Workgroup for ongoing insight and contributions. 4321-4347 [1970]; EC 2001). Outcome evaluation should be undertaken when available resources and data will allow reasonable judgments regarding the association between the implementation of decisions and observed changes in health outcomes or health determinants. Behavioral Risk Factor Surveillance System data were used for the county and the state and stratified by race. Morgan RK. Although completed HIA reports are readily available, peer-reviewed or gray literature that discusses the impacts of specific HIAs is still rare. Because the assessment of health effects depends on an in-depth understanding of changes that may affect healthsuch as changes in traffic flow, roadway design, air quality, or community revenue sourcesHIAs are inherently multidisciplinary; public-health experts may lead the effort but must draw on resources and expertise from other disciplines. 2010). 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. Adopting a position for or against a proposal (for example, support for or opposition to a legislative proposal). Catholic Health Association of the United States. 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. The nature of the proposal being assessed, including alternatives that were included in the analysis. Iteration during scoping and between scoping and assessment often results in additional changes in the final list of issues included in the HIA. It uses the best available evidence to analyze effects on health and health disparities. Scoping also determines who will be part of the HIA team and establishes a plan for technical oversight and review, stakeholder participation and involvement, and involvement of and interaction with decision-makers. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the Centers for Disease Control and Prevention or the Department of Health and Human Services. It characterizes health effects according to their nature, direction, intensity, magnitude, distribution, timing and duration, and likelihood. In others, scoping may identify studies that can be carried out by the HIA team or studies that can be carried out by experts involved in some other aspect of the planning, permitting, or review process (such as air-quality or traffic-safety analysis). DOC CHW_Guidelines - Catholic Health Association of the United States 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). 2006; World Bank 2010). Chapter 2. Other Models for Promoting Community Health and Development Integrates stakeholder input into the analysis of effects. Health impact assessment: A tool to help policy makers understand health beyond health care. 54873. Indicators may be health outcomes in some cases, whereas health determinants may be more appropriate in others. For private corporations undertaking an HIA, the decision of whether to make an HIA public and what to disclose may be governed by internal corporate policies, by the standards of lenders supporting the project, or by a government that has jurisdiction over the project (McHugh et al. The Importance of Common Metrics for Community, Social - Health Leads Evaluation is important for the quality of individual HIAs and for the success of the HIA field as a whole. 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. Characterization of health effects in HIA relies on qualitative and quantitative evidence. 2007; Harris-Roxas and Harris 2011). As noted above, the iterative process is known as adaptive management in the field of environmental management. Program on Health Equity and Sustainability, San Francisco Department of Public Health. Suicide is the fourth leading cause of death among young people worldwide and the third leading cause of death among those in the US. The HIA team identified the following critical issues that could affect the health of the study area population: access and social equity, physical activity, safety, social capital, and environment (including air quality, noise, and water management). Needs assessments serve as incredibly powerful tools for decision making, resource allocation, and ultimately reaching programmatic goals. In this approach, the aspects of a proposal that may affect health are listed and considered in major categories of health and illness. Scoping identifies those likely to be affected by the proposed policy, project, program, or plan. HIA should not be assumed to be the best approach to every health-policy question but should instead be seen as part of a spectrum of public-health and policy-oriented approaches, some of which will be more appropriate than others, depending on the specific application. Findings of each stage of the HIA and a summary of outputs at the end of each stage. It was not possible to derive mortality rates for demographic subgroups. National Public Health Performance Standards Program, National Center for State, Tribal, Local, and Territorial Public Health Infrastructure and Workforce, SDOH Research by CDC Authors: Frequently Asked Questions, Examples of How the SDOH Can Be Addressed Through the 10 Essential Public Health Services, Performance Management & Quality Improvement, National Public Health Improvement Initiative, National Public Health Performance Standards, Public Health Finance and Infrastructure Support, Competencies for Public Health Professionals, National Leadership Academy for the Public's Health, Supporting the Performance Improvement Workforce, Alerts About Current & Projected Funding Opportunities, Cooperative Agreements, Grants & Partnerships, Strengthening Public Health Systems & Services, USAPI Strengthening Public Health Systems & Services, Integrity & Accountability Review Offices, National Health Initiatives, Strategies & Action Plans, State & Territorial Health Department Websites, US Territories & Freely Associated States, Style for Referring to US Territories & Freely Associated States, About the Public Health Infrastructure Center, Implementing the Community Health Needs Assessment Process, U.S. Department of Health & Human Services, Multisector collaborations that support shared ownership of all phases of community health improvement, including assessment, planning, investment, implementation, and evaluation, Proactive, broad, and diverse community engagement to improve results, A definition of community that encompasses both a significant enough area to allow for population-wide interventions and measurable results, and includes a targeted focus to address disparities among subpopulations, Maximum transparency to improve community engagement and accountability, Use of evidence-based interventions and encouragement of innovative practices with thorough evaluation, Evaluation to inform a continuous improvement process, Use of the highest quality data pooled from, and shared among, diverse public and private sources, Improved organizational and community coordination and collaboration, Increased knowledge about public health and the interconnectedness of activities, Strengthened partnerships within state and local public health systems, Identified strengths and weaknesses to address in quality improvement efforts, Baselines on performance to use in preparing for accreditation, Benchmarks for public health practice improvements. In practice, however, there is some inconsistency in how HIAs are conductedfor example, how stakeholders are engaged and how data are collected and analyzedand in the structure and content of the final work products of an HIA. Improving Health in the United States: The Role of Health Impact Assessment. The American Hospital Associations review of the IRSs final rules for CHNAs and implementation strategies can be foundhere. Because any actions taken on the basis of HIA recommendations need to be implemented within a specific legal and policy context, screening needs to establish a clear description of the decision-making process and context. Criteria for use in the evaluation of health impact assessments. (2015). Health Impact Assessment: International Best Practice Principles. The Public Health Accreditation board defines community health assessment as a systematic examination of the health status indicators for a given population that is used to identify key problems and assets in a community. Because the degree to which the proposed action affects public health or safety is one factor considered, this process could be considered the equivalent of the screening step of an HIA. National Research Council (US) Committee on Health Impact Assessment. In 2005, an HIA was conducted by a multidisciplinary team. Identification of the population and vulnerable groupssuch as children, the elderly, racial or ethnic minorities, low-income people, and communities that are likely to be affected. . Harris P, Harris-Roxas B, Harris E, Kemp L. Harris-Roxas B, Harris E. Differing forms, differing purposes: A typology of health impact assessment. A Guide to Health Impact Assessments in the Oil and Gas Industry. Wernham A. The potential for health effects to place a disproportionate burden on or substantially benefit vulnerable populations. The toolkit presents the key elements of HRC development. 7 Components of a CHNA | Community Health Needs Assessment Source: ICMM 2010. Health Impact Assessment: SEIC (Sakhalin Energy Investment Company) Phase 2 Development. Because HIA in the United States is often undertaken outside a formal legal mandate, it has not consistently included alternatives assessment. 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. The HIA notes that the area within which The Crossings is proposed to be built has the following characteristics: The HIA notes that the residential area is inhabited by a vulnerable population, that the built environment is of low quality, that the development will potentially have important health implications for residents in the local and surrounding communities, and that there is a strong commitment shown by the community and the developer to integrate health considerations into the planning process. Improving relationships and collaboration between stakeholders. L 91-190, 42 U.S.C. Not all HIAs will meet all proposed criteria, but the criteria are intended to describe typical practice. A gulf may exist between an intervention that is sound from a public-health perspective and one that is acceptable and can be acted on within the relevant regulatory or legal framework. The committee notes that some guides consider evaluation not as a step of HIA but rather as an independent practice that supports the development of the field (see Appendix E). For example, if a traffic-calming infrastructure was installed on a street that had a high rate of pedestrian injury, it may be appropriate to monitor injury rates directly because changes would be expected as soon as the installation was complete. A number of corporations and professional associations, such as the International Committee on Mining and Metals and the International Association of Oil and Gas Producers, have guidance for HIA, but relatively few completed industry-led HIAs or environmental, social, and health impact assessments are available on the Internet or on public Web sites that catalog HIA activity. Health-supportive measures that would generally support health but are not tied directly to a specific impact (for example, building a clinic in an underserved neighborhood that would be adversely affected by emissions from a new freeway). Parry JM, Kemm JR. Discuss what entity has the authority or ability to implement each measure and document any commitments to do so. Membership is variable but may include representatives of affected communities or community-based organizations, industrial proponents or business groups, public-health experts, officials involved in the decision- making process, and others who have a stake in the outcome. You can review and change the way we collect information below. The health-management plan suggests which stakeholder agency or entity could take responsibility for implementing each recommendation. For example, the planning of the Atlanta Beltline, as described later in this chapter, involved the regional planning commission, local legislative bodies, state and federal environmental regulators, and private developers. Well-executed scoping saves time, work, and resources in the later stages of the HIA (Harris et al. Lifetime Effects: The High/Scope Perry Preschool Study through Age 40. The assessment also highlighted several potential benefits, such as funding for infrastructure and health care; increased employment and income; and continued funding of existing infrastructure (BLM 2007, p. 500). Past Projects: Vehicle Miles Traveled Legislation. 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. Dialogue with IRS staff and leadership on elements of the Revised 990, Schedule H Identification and examination of areas where: -There is a need for clarification (e.g., what constitutes meaningful community engagement, how to define community) -Selected reporting requirements as framed may yield unanticipated (and undesired . The decision-maker must ultimately balance health considerations with the many technical, social, political, and economic concerns that bear on the proposal. Different HIA guides vary somewhat as to the specific descriptors that should be used, and practice is highly variable. 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. Quigley RJ, Taylor LC. Health impact assessment. Cole BL, Fielding JE. It is critical to arrange the information logically so that readers can navigate easily through the document, to provide a lay summary that accurately describes the main findings and conclusions of the study, and to reference all data and sources accurately (Fredsgaard et al. Expert judgment is central to HIA but must be grounded in a solid foundation of scientific neutrality and accepted public-health principles. . Mindell J, Boaz A, Joffe M, Curtis S, Birley M. Enhancing the evidence base for health impact assessment. In that case, a robust evaluation method, such as interviews conducted with decision-makers before and after the HIA, could provide the data needed to gauge the effect on decisions. Public concerns are a common trigger for a decision to screen, and the degree of concern or controversy about a proposal may be one of the factors weighed in the decision to undertake an HIA. 2006; Bhatia 2010; ICMM 2010). Create structural or process change. A local community-based organization worked (more). However, it appears to be increasingly accepted that HIA is carried out to inform the decision rather than to evaluate the impacts after the decision is made, and there is general agreement on the procedural steps of HIA (Harris-Roxas and Harris 2011). 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. Assessing the Health Impacts of Road Pricing Policy Proposals. Analyzes beneficial and adverse health effects and characterizes the changes in the indicators selected, to the extent possible, in terms of nature, direction, intensity, magnitude, distribution in the population, timing and duration, and likelihood. Any approach to determining which proposals will be screened should demonstrate a consistent rationale; should document the rationale in the HIA report; and should take account of public input. The various categories of HIAs, although useful for describing distinct themes in the field, do not necessarily represent consistently distinct strains of practice. 2006). Human Impact Partners then worked with groups in other states to extrapolate the findings of the national report to local jurisdictions to analyze the health effects of paid sick days. The variation partly reflects the wide array of applications of HIA; for example, it is not necessary or feasible to use the same approaches to involve stakeholders for a local project and for a high-level state or national policy. Example of a Table for Rating Importance of Health Effects. This list can then be used to set priorities. Developing new cross-disciplinary and interagency collaborations. Bookshelf Paper No. Knowing Your Community: Community Health Assessment as a Pow - LWW Sixth, because many established environmental risk factors are found at higher concentrations in vulnerable communities, disclosure of risks may be an important way to reduce health disparities and address concerns about environmental justice (Miranda et al. On the basis of its review, the committee synthesized the information from guidance, practice, and literature to propose criteria that define an HIA and draw several conclusions regarding HIA practice. Clipboard, Search History, and several other advanced features are temporarily unavailable. The HIA drew on public testimony, literature review, and accepted mechanisms of health and illness to establish the scope of health concerns that should be considered. Finally, effects that are plausible but are not supported by available evidence include fewer hospitalizations because workers are able to receive the preventive primary care needed to maintain good health. The health issues were identified by determining the populations that would be affected and then considering how they would be affected. Because HIAs can address decisions that range from small, localized programs or projects to national policies, screening ensures that HIA is used judiciously and when it is most likely to be valuable. The selection of analytic methods for HIA is driven by the complex pathways and the multiple, sometimes conflicting, influences on any given health outcome and is also affected by the decision-making context. The associations between expected disturbances and changes in health were then analyzed in more depth to look at the alternatives proposed for the expansion and at the cumulative effects of oil exploration and extraction. 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. Red Dog Mine Extension Aqqaluk Project. Health impact assessments are needed in decision making about environmental and land-use policy. Box 3-4 provides several examples of topics that have been addressed in HIA by using quantitative methods. Catholic Health Association, Guide to Assessing and Addressing Community Health Needs [PDF-1.5MB], June 2013. o Who is ultimate decision maker if the event needs to be cancelled, postponed or similar? A community health assessment, also known as community health needs assessment, refers to a state, tribal, local, or territorial health assessment that identifies key health needs and issues through systematic, comprehensive data collection and analysis. A major alternative to a proposal (for example, routing a proposed highway away from a vulnerable population or building a light-rail line rather than widening a road). 2006). 1 Upon completing the assessment, hospitals develop implementation strategies to address the significant community health needs identified in the CHA. 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. Community Health Assessment & Planning Guidebook - nmhealth.org Instead, the committee focused its review on the characterization of effects and the use of evidence, although several recommendations to improve the quality of analysis are discussed in Chapter 4. That definition reflects the committees finding that the involvement of stakeholdersalthough the approaches used vary from little or no involvement to robust engagement and participation at every stephas consistently been described as a core element of HIA practice and should be considered essential to it. A screening recommendationfor example, no further action required; no HIA, but health advice and input to be offered in an alternative way; or proceed with HIA. ADA (Atlanta Development Authority). In other cases, the initial scope is generated by stakeholders and then refined through research and input from advisory or steering committees. Another categorization is based on the breadth of the HIA and distinguishes HIAs that have a tight focussuch as ones that use a narrow definition of health and emphasize quantification from HIAs that have a broader, holistic focus shaped by the social determinants of health (Kemm 2001).
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