文章基本信息

标题：Growing the Field of Health Impact Assessment in the United States: An Agenda for Research and Practice
本地全文：下载
作者：Andrew L. Dannenberg ; Rajiv Bhatia ; Brian L. Cole 等
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2006
卷号：96
期号：2
页码：262-270
DOI：10.2105/AJPH.2005.069880
语种：English
出版社：American Public Health Association
摘要：Health impact assessment (HIA) methods are used to evaluate the impact on health of policies and projects in community design, transportation planning, and other areas outside traditional public health concerns. At an October 2004 workshop, domestic and international experts explored issues associated with advancing the use of HIA methods by local health departments, planning commissions, and other decisionmakers in the United States. Workshop participants recommended conducting pilot tests of existing HIA tools, developing a database of health impacts of common projects and policies, developing resources for HIA use, building workforce capacity to conduct HIAs, and evaluating HIAs. HIA methods can influence decisionmakers to adjust policies and projects to maximize benefits and minimize harm to the public’s health. IN RECENT YEARS, AWARENESS that community design, land use, transportation systems, and other environmental and social factors affect the health of the public has increased. 1 ^– 4 But few health officials or urban planners have training or experience in each other’s fields. A health impact assessment (HIA) is commonly defined as “a combination of procedures, methods, and tools by which a policy, program, or project may be judged in terms of its potential effects on the health of a population, and the distribution of those effects within the population.” 5 An HIA can be used to improve communication between local health departments and community decisionmakers, enabling the latter to consider improved designs to favor health promotion or minimize adverse effects on health. For example, an HIA of a proposed airport in England focused on noise, air pollution, traffic congestion, and local employment and led to health-promoting changes in the developer’s plans. 6 The development of HIAs in recent years has grown in part out of assessments of the environmental and social impacts of large projects. 7 Environmental impact assessments (EIAs) focus on air and water quality and other environmental consequences of proposals with little attention to health impacts. 8 HIAs and EIAs both promote public accountability for the consequences of decisions that affect communities; they differ in the scope of impacts analyzed and the implementation process. 8 Interest in HIA at the Centers for Disease Control and Prevention (CDC) developed out of discussions at a 2002 workshop that led to a research agenda on issues to advance the field of public health in relation to community design. 9 Numerous HIAs have been conducted in Europe and elsewhere, 10 ^, 11 but few have been done in the United States. 12 In October 2004, the Robert Wood Johnson Foundation and CDC hosted discussions about HIA with invited experts at a 2-day workshop in Princeton, NJ. The workshop objectives were to explore key research questions regarding HIA methods and to advance the development of HIA instruments for use by community decisionmakers in the United States. Five workshop participants from the United Kingdom, Canada, and the World Health Organization had extensive expertise with HIA. US participants came from local health departments; transportation, environmental health, and urban planning groups; academia; the Robert Wood Johnson Foundation; and the CDC. Before the workshop, a planning committee developed a set of research questions regarding HIA methods. The workshop invitees helped revise these questions and then provided brief answers to the 12 questions that were used to initiate the discussions at the workshop. Although not representing a consensus of all persons involved, this article includes ideas from workshop participants and other interested individuals listed in the acknowledgments. Key findings and recommendations for further research from the workshop are summarized in the box on page 263.