An Introduction to Health Impact Assessment

Paul J. Anderson, MD, MPH

HIA Program Manager

Section of Epidemiology

Division of Public Health

Department of Health and Social Services

What is HIA?

• Preventive health report • Anticipates human health effects• New or current

• Projects• Policies• Programs

• Minimize adverse health effects• Maximize health benefits

Definition

“HIA is a combination of procedures, methods and tools by which a policy, program or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population”

World Health Organization (WHO), 1999

HIA and NEPA

Federal Lead Agency

Federal Cooperating Agencies•EPA•MMS•BLM•USACE•Others

Produces EIS

State Cooperating Agencies•DNR (LEAD)•DHSS*•DEC•ADF&G•DOT•Others

N E P ALocal Cooperating Entities•Municipalities•Tribal Governments•Boroughs•Cities•Counties•Others

Proponents•Corporations•State Government•Cities•Boroughs•Others

Contractors•Environmental•Socioeconomic•Human health•NEPA specific•Others

Who does the HIA?

Project Timeline and HIAPermit

ApplicationProject Permit

Intent to File Permit

Phase 1: Baseline Phase 2: NEPA/EIS Phase 3: Operation

Project Timeline and HIAPermit

ApplicationProject Permit

Intent to File Permit

Phase 1: Baseline Phase 2: NEPA/EIS Phase 3: Operation

•Screening•Scoping meetings•Site visits•Existing data gathered•New data collected•Literature review•Summary Report

•Data synthesis•Data Analysis•Updated site visits•Risk Assessment•Health Action Plan•Standalone HIA

•Ongoing monitoring•Evaluate Action Plan

Participating in HIAPermit

ApplicationProject Permit

Intent to File Permit

Phase 1: Baseline Phase 2: NEPA/EIS Phase 3: Operation

•Scoping meetings•Formal comments•Draft reviews•Study participation•Help suggest mitigation

•Assist monitoring•Request an HIA•Educational meetings•Letters of invitation•Host HIA team visits•Share information•Participate in studies•Community comments

HIA Concepts

Mitigation Types in HIA

Regulatory Negotiated Voluntary

Low Control(Indirect Impacts)

High Control(Direct Impacts)

Respect, Protect, Remedy

Corporation/Applicant RespectDo no harmDo good when ableProtect autonomySeek justice

Governments ProtectPeople Remedy

~John Ruggie – UN Secretary General’s Special Representative on Human Rights

Health Effects Categories

• Social Determinants of Health• Accidents and Injuries• Hazardous Substances• Food, Nutrition, Subsistence• Infectious Diseases• Chronic Diseases• Water and Sanitation• Health Care Delivery

Key Activities

• Ask for an HIA• Participate in scoping meetings• Give health comments• Share local and traditional information

HIA ElementsElement Phase Key ActionsScreening Phase 1 HIA needed?

Scoping Phase 1 Desktop HIA (No new data)Rapid Appraisal HIA (Some new data)Comprehensive HIA (Extensive new data/review)

Baseline Data Phase 1 Field studiesExisting data sourcesTraditional knowledge

Risk Assessment

Phase 2 Risk identification (Health Areas)Risk ranking

Action Plan Phase 2 Mitigation Approach

Monitoring & Evaluation

Phase 3 Key Performance Indicators (KPI)

Project Features and Health

• Linear features (roads, pipelines)• Construction camps (size, location)• Influx (worker housing)• Resettlement or relocation• Large projects, rural settings• Engineering footprints • Health footprint

HIA Funding under NEPA

Federal Agency

APPLICANT

•Federal agency requests HIA

HIA Funding under NEPA

Federal Agency

Department of Natural Resources

(OPMP/LMPT)

HIA ContractorAPPLICANT

•Federal agency requests HIA•Applicant asks OPMP for HIA OR Applicant hires contractor

$

$

HIA Funding under NEPA

Federal Agency

AK HIA Program

Department of Natural Resources

(OPMP/LMPT)

HIA ContractorAPPLICANT

•Federal agency requests HIA•Applicant asks OPMP for HIA•OR Applicant hires contractor•OPMP uses state HIA program•OPMP provides contract help to HIA program

$

$$

HIA Funding under NEPA

Federal Agency

State HIA

AK HIA Program

Department of Natural Resources

(OPMP/LMPT)

HIA ContractorAPPLICANT

Independent HIA

•Federal agency requests HIA•Applicant asks OPMP for HIA•OR Applicant hires contractor•OPMP uses state HIA program•OPMP provides contract help to HIA program

$

$

$

$