Introduction to Health Impact Assessment

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What is a Health Impact Assessment?

A Health Impact Assessment is a systematic process that:

  1. Uses qualitative and quantitative methods and best available data sources;
  2. Considers input from stakeholders;
  3. Determines potential effects of a proposed policy, program or project across other sectors on health; and
  4. Provides recommendations to monitor and manage potential effects.

What are the Steps to Conduct a Health Impact Assessment?

Step Description
Screening Determines the need and value of an assessment.
Scoping Identifies which health impacts to evaluate, methods for analysis
and a work plan.
Assessment Provides:
    a) A profile of a current health status
    b) Evaluation of potential positive and negative health impacts
Recommendations Provide strategies to manage identifies adverse health impacts
and maximize benefits to health.
Reporting Includes:
    a) Development of a report
    b) Communication of findings & recommendations
Monitoring Tracks:
    a) Impacts on decision-making processes and the decision
    b) Impacts of the decision on health determinants

Health Impact Assessments in California and Los Angeles County

HIAs are a new and emerging public health tool. As of July 2019, a total of 84 assessments have been completed or are in progress across the state of California.1 As shown in Figure 1, most of these assessments focus on health impacts of policies or projects related to the built environment, transportation and housing.

Figure 1. Completed and In Progress Health Impact Assessments in California by Sector.

Pie chart of in progress and completed HIAs 

The Los Angeles County Department of Public Health (DPH) has completed 10 of these HIAs to date:

  • Menu Labeling 2,
  • Reducing Sodium in the County of Los Angeles 3,
  • Providing Free Public Transportation Passes to Students in Los Angeles County 4,
  • Parks After Dark 5,
  • Transit alternatives to Wilshire Corridor from mid-town Los Angeles to Santa Monica 6,
  • Second Chance Women's Re-Entry Court 7,
  • Affordable and Transit-Oriented Housing Policies for the City of Los Angeles 8,
  • Preventing and Reducing Homelessness in Los Angeles County 9,
  • Mobility Plan for the City of Los Angeles 10, and
  • Cannabis Regulation in Los Angeles County 11.

The Center for Health Impact Evaluation has also published a toolkit of best practices for rapid health impact assessments, which you can access.

References

  1. Health Impact Project. HIAs and Other Resources to Advance Health-Informed Decisions. The PEW Charitable Trusts. Accessed July 11, 2019. 
  2. Kuo T, Jarosz CJ, Simon P, Fielding JE. Menu Labeling as a Potential Strategy for Combating the Obesity Epidemic: A Health Impact Assessment. American Journal of Public Health. 2009;99(9):1680-1686. doi:10.2105/AJPH.2008.153023
  3. Kim GY, Cummings PL. The Potential Health Impact of Reducing Excess Sodium Consumption in Los Angeles County. Los Angeles County Department of Public Health; 2010.
  4. Gase LN, DeFosset A, Kuo T. The Potential Costs and Benefits of Providing Free Public Transportation Passes to Students in Los Angeles County. Los Angeles County Department of Public Health; 2013.
  5. Butler K, Fischer K. Potential Costs and Health Benefits of Parks After Dark: Rapid Health Impact Assessment. Los Angeles County Department of Public Health; 2014.
  6. Cole B, Fielding J, Jackson R, et al. Wilshire Corridor Transit Alternatives: Health Impact Assessment. University of California Los Angeles & Los Angeles County Department of Public Health; 2013.
  7. Butler K, Pourshaban D, Center for Health Impact Evaluation. Health and Public Safety Impacts of Sustaining a Women’s Jail Diversion Program in Los Angeles County: Rapid Health Impact Assessment. Los Angeles County Department of Public Health; 2015.
  8. Nicholas W, Mullholand Graves E. Initiative Ordinance JJJ: Affordable and Transit-Oriented Housing Policies for the City of Los Angeles. Los Angeles County Department of Public Health; 2016.
  9. Nicholas W. Measure H: Preventing and Reducing Homelessness in Los Angeles County. Los Angeles County Department of Public Health; 2017.
  10. Nicholas W, Vidyanti I, Caesar E, Maizlish N. Implementing the City of LA’s Mobility Plan 2035: Public Health Implications. Los Angeles County Department of Public Health; 2018.
  11. Nicholas W, Greenwell L, Washburn F, et al. Health Equity Implications of Retail Cannabis Regulation in Los Angeles County: Health Impact Assessment. Los Angeles County Department of Public Health; 2019.