key elements of a community health assessment

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. Steinemann A. Catholic Health Association of the United States. 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. 2008). Qualitative data can be gathered through, for example, focus groups, one-on-one interviews, surveys, individual meetings with stakeholder organizations, testimony in community meetings, Web-based or other written input, and running a stand or exhibition in a public place. There are often not clear lines of authority between the team conducting the HIA and the decision-maker. IPIECA/OGP (International Petroleum Industry Environmental Conservation Association and International Association of Oil and Gas Producers). A logic framework was produced to guide the assessment. The committee notes that qualitative social sciences and participatory-action research provide fertile ground for innovative methods for HIA. The final HIA report describes each factor (see below) and presents the results of the scoping. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. Instead, it appears that the specific methods and approaches used in a single HIA often evolve within the basic framework described above and develop as a pragmatic response to context. The potential for substantial adverse or beneficial health effects and the potential to make changes in the proposal that could result in an improved health risk-benefit profile. In other cases, it may not be possible to attribute a particular decision to the influence of an HIA (Wismar et al. Articles in Google Scholar by Kaye Bender, PhD, RN, FAAN Monitoring focuses on measures that are likely to be sensitive and early indicators of change. Click on the icon for each step to read about that part of the process. The reliability and validity of predictions made in HIAs have often been questioned (Thomson 2008). Failing to undertake a systematic review may mean overlooking evidence that would lead an assessor to a different conclusion. The top 10% of the census tracts within the study area were then identified as locations of the most vulnerable populations. 4 A Community Health Improvement Process - National Center for They can take longer than a year to complete. Key health effects: Issues were identified through analysis of newspaper coverage; outreach to such groups as local officials, members of the public, and businesses; development of a logic framework; and a survey of people living, working, or attending school near the BeltLine. What Is a Community Health Improvement Plan? 1. Shortened life expectancy associated with air pollution. 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. Consequently, the committee concludes that the lack of attention to evaluation is a barrier that will need to be overcome if HIA practice is to be advanced in the United States. For example, although an HIA may not be able to incorporate engineering or economic specifications for alternate routes for a proposed highway, it could discuss factors that would influence health outcomes, such as indicating that a desirable route would be, for example, 100 m from any school or elderly facility or would not be proximate to high-population-density areas with a number of vulnerable people. Past Projects: Paid Sick Days Legislation. Human Impact Partners; 2010. Unauthorized use of these marks is strictly prohibited. Furthermore, HIA teams commonly rely on analyses by such experts as traffic-safety engineers or air-quality analysts who provide information on the links between the proposal and changes in health determinants. Because HIA in the United States is often undertaken outside a formal legal mandate, it has not consistently included alternatives assessment. Improving relationships and collaboration between stakeholders. Cole BL, Shimkhada R, Fielding JE, Kominski G, Morgenstern H. Methodologies for realizing the potential of health impact assessment. Mindell J, Boaz A, Joffe M, Curtis S, Birley M. Enhancing the evidence base for health impact assessment. 2005). An explicit statement of data sources, methods, assumptions, and uncertainty is essential, but uncertainty does not negate the value of the information. The research was funded by the Annie E. Casey Foundation as an initiative with the potential to encourage long-term strategies and partnerships to strengthen families and communities. 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). The HIA conclusions and recommendations should be presented in a manner that is clear and easily understood. The potential for HIA-based information to alter a decision or help a decision-maker discriminate among decision options. Assessing alternatives in parallel with the proposal can aid decision-making by highlighting tradeoffs and actions that can be taken to achieve the desired outcome while minimizing harms. Qualitative evidence provides a context-specific view of peoples lives. The committee recognizes that undue bias in an HIA may compromise its credibility and efficacy. 2010). As described by Ross (2007, p. 9), the Atlanta BeltLine is a transit, trails, parks, and redevelopment project that uses a 22-mile loop of largely abandoned freight rail line that lies between two and four miles from the city center and affects about 45 neighborhoods. HIAs can be conducted by a variety of agencies, organizations, or individuals. PDF Key Elements of Community Health Improvement Planning: From Assessment I and III, Breaking the Cycle, East London and the City Health Action Zone and Queen Mary. However, the committee notes that there are several benefits of disclosure for industry, policy-makers, and the affected communities. It was not possible to derive mortality rates for demographic subgroups. It may lack the objectivity and rigor of an external evaluation conducted by an experienced evaluator, but it is important because it contributes to a database that informs other efforts in the field and provides basic information about the applications of HIA, the methods and strategies used by HIA practitioners, and the success of and challenges to its use. PDF Community Health Assessment and Group Evaluation (CHANGE) Presentation An HIA would identify health assets, health liabilities, and health-promoting mitigations related to the proposed development project. Cookies used to make website functionality more relevant to you. For example, desktop HIAs may consider indirect stakeholder input through review of public comments submitted outside the HIA process, comprehensive HIAs may have relatively little stakeholder engagement, and rapid-appraisal HIAs of smaller-scale proposals may involve collection of some new data to inform the analysis. Citation for Toolkit Selection of appropriate indicators will be discussed at greater length below in the section Monitoring and Evaluation.. The HIAs also changed the debate in such a way that providing paid sick days for employees began to be presented as a public-health issue rather than a labor issue. Human Impact Partners. Scoping also establishes a plan for stakeholder participation in later phases of the HIA. Third, it informs government agencies and officials of potential changes in demand for services, such as health care, emergency response, and public safety; this can facilitate an appropriate response. In this approach, the aspects of a proposal that may affect health are listed and considered in major categories of health and illness. This site needs JavaScript to work properly. Some decisions to conduct HIA may depend on a specific statutory requirement or mandated procedure. According to effort, complexity, and duration, HIAs are often described as rapid, intermediate, or comprehensive. Schweinhart LJ, Montie J, Xiang Z, Barnett WS, Belfield CR, Nores M. Scott-Samuel A. The committee does not intend that the definition and criteria proposed in this chapter be considered rigid requirements but rather that they reflect an ideal of practice, deviation from which may occur but should be based on clear and well-articulated needs and rationale. They expressed interest in developing The Crossings in a way that will address local community needs for affordable housing and for other community assets that are safe, healthy, and supportive (p. Intro-1). 2003; ICMM 2010). Evaluation can be thought of in two useful and complementary ways: self-evaluation of the HIA process and impacts and independent external evaluation. [online] Available: ICMM (International Council on Mining and Metals). Needs assessments serve as incredibly powerful tools for decision making, resource allocation, and ultimately reaching programmatic goals. Health Impact Assessment: A Practical Guide. Disclosure requirements and practices vary considerably among development lenders and private-sector proponents. . It is also useful to assess the political context of the proposal to be assessed and consider, for example, the major political drivers of the proposal, the arguments made by political supporters and those opposed to the proposal, and any economic or technical constraints that limit the alternatives that can be considered. Self-evaluation performed by the HIA teamfor example, against a set of process objectives or practice criteriaserves quality-assurance aims and can produce insights that will improve the field. Health impact Assessment: Concepts, Theory, Techniques and Applications. Bethesda, MD 20894, Web Policies Scholars point to a remarkable consistency in the basic elements that are generally included in descriptions of HIA (Mindell et al. McHugh S, Maruca S, Lilien J, Manning A. The committee is not endorsing the HIAs or the recommendations, but simply providing examples. Several approaches for scoping are available. 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. The discussion described pathways by which Iupiat health was likely to be affected. 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. Practice Standards for Health Impact Assessment (HIA), Version 1. Kuo T, Jarosz CJ, Simon P, Fielding JE. From Principles to Consider for the Implementation of a Community Health Needs Assessment Process [PDF 457KB] (June 2013), Sara Rosenbaum, JD, The George Washington University School of Public Health and Health Services, Department of Health Policy. 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. CDC twenty four seven. PDF Community Health Resource Centers: A Toolkit - Episcopal Health Foundation The second task is to analyze and characterize effects on health and its determinants for the proposal and for any alternatives under consideration relative to the baseline and to each other. Northeast National Petroleum Reserve-Alaska (NPR-A) Draft Supplemental Integrated Activity Plan/Environmental Impact Statement (IAP/EIS). Roles and responsibilities for key, onsite event personnel, e.g., Event Organizer, Security Manager, Police, Fire, EMS, etc. A community health assessment often yields a long list of public health needs, issues, and problems. In 1998, the Bureau of Land Management (BLM) completed a Northeast National Petroleum Reserve-Alaska Integrated Activity Plan/Environmental Impact Statement (EIS). 3, Elements of a Health Impact Assessment, Improving Health in the United States: The Role of Health Impact Assessment. 2023 by the American Hospital Association. Some use pertinent screening questions, such as the ones noted, and apply a sequential yes-no query to each (Cole et al. Prospective health impact assessment: Pitfalls, problems, and possible ways forward. 2001). Box 3-4 provides several examples of topics that have been addressed in HIA by using quantitative methods. 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. The nature of the proposal being assessed, including alternatives that were included in the analysis. The committee notes that effective dissemination requires consideration of barriersincluding those associated with language, availability of child care, disability, access to transportation, disenfranchisement, or literacyand that multiple approaches may be required for disseminating a single HIA so that all appropriate audiences can be reached. A community health assessment gives organizations comprehensive information about the communitys current health status, needs, and issues. Management of the health effects of a proposal as it moves from planning into implementation should be a dynamic process in which monitoring results may drive continued adaptation of the health-management plan. 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. An evaluation plan should have been developed early in the HIA process to guide selection of the appropriate methods for conducting evaluations. Key Elements of Community Health Improvement Planning: From Assessment to Action Planning Key Elements of Community Health Improvement Planning: From Assessment to Action Planning CHA-CHIP Demonstration Project Improvement www.assesstoolkit.org April 23, 2012 The lines are muted. Such evidence may come from a review of published literature on interventions to address the health outcomes of concern. 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. If you do not allow these cookies we will not know when you have visited our site, and will not be able to monitor its performance. 2 Setting priorities considers pathways that appear most important from a public-health perspective and considers issues that have been raised prominently by stakeholders. It includes the production and dissemination of written materials that document the HIA process, methods, findings, recommendations, and limitations of the analysis; and it includes the public dissemination of results through other channels, such as meetings with the public, decision-makers, and other stakeholders. 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. Document No. The assessment phase includes two tasks. 2010). DHHS (U.S. Department of Health and Human Services). Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. ADA (Atlanta Development Authority). Wernham A. 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. 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. Science and Decisions: Advancing Risk Assessment. It is important to note that a matrix does not explain how evidence was used to reach conclusions. Source: Adapted from BLM 2007 and Wernham 2007. Minimum Elements and Practice Standards for Health Impact Assessment (HIA), Version 2. 2010). Agreeing on a target population. Literature review provides much of the empiric evidence for most HIAs, and whenever possible, assessors should conduct a systematic review of the literature for any health effects and determinants identified as high-priority issues in scoping. As described by Ross (2007, p. 9), the Atlanta BeltLine is a transit, trails, parks, and redevelopment project that uses a 22-mile loop of largely abandoned freight rail line that lies between two and four miles (more).
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