key elements of a community health assessment

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. Ibid. 2006; World Bank 2010). Selection of appropriate indicators will be discussed at greater length below in the section Monitoring and Evaluation.. In practice, therefore, the HIA team will be asking a decision-maker to consider the findings and recommendations. A decision-making bodysuch as a department of planning or transportation can conduct an HIA to inform its own decision. The success of recommendations ultimately depends on the publics trust in and support of them. Good Practice Guidance on Health Impact Assessment. An HIA does not have to accept community concern uncritically. More structured approaches have also been used. Example of a Table for Rating Importance of Health Effects. Different HIA guides vary somewhat as to the specific descriptors that should be used, and practice is highly variable. Monitoring should provide information that allows one to conduct the evaluations noted above. The HIA team was assisted by an advisory committee, but it appears that the committee was not involved in the scoping. HIA recommendations take various forms, and some examples are provided below. Neidell M. Information, avoidance behavior, and health: The effect of ozone on asthma hospitalizations. All information these cookies collect is aggregated and therefore anonymous. Since there are different models to guide assessment and planning, as well as a variety of organizations and agencies that carry out these activities, there may be confusion in choosing among approaches. 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. Fehr R. Environmental health impact assessment: Evaluation of a 10 step model. This assessment of needs then informs a project's overall plan and approaches by helping you identify targeted strategies and prioritize resources. 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). II, Selected Evidence Base Breaking the Cycle, East London and the City Health Action Zone and Queen Mary. Directive 2001/42/EC of the European Parliament and of the Council of 27 June 2001 on the assessment of the effects of certain plans and programmes on the environment. Source: Adapted from BLM 2007 and Wernham 2007. Seven Steps for Conducting a Successful Needs Assessment - NICHQ Affected populations: As the TAD constituted only a portion of the city that would be directly affected, the HIA team created the HIA study area by placing a 0.5-mile buffer around the BeltLine TAD. In 1998, the Bureau of Land Management (BLM) completed a Northeast National Petroleum Reserve-Alaska Integrated Activity Plan/Environmental Impact Statement (EIS). Simply producing and disseminating a report may not be sufficient to secure adoption and implementation of HIA recommendations. Cookies used to enable you to share pages and content that you find interesting on CDC.gov through third party social networking and other websites. Thomson H. HIA forecast: Cloudy with sunny spells later? Under NEPA, a federal agency must determine whether a federal environmental decision is likely to have significant effects, and if so, the level of analysis required (40 C.F.R. HHS Vulnerability Disclosure, Help Various sources of population-health statistics at the national, state, and local levels are available. Given the breadth of decisions that are likely to warrant consideration, the approach taken will vary on the basis of who is initiating the HIA, the capacity and authority of the agency or entity undertaking it, and the objectives for contemplating an HIA. University researchers have conducted HIAs, and community-based organizations have conducted HIAs with technical assistance from public-health experts to inform officials who are deliberating on a legislative or administrative proposal. The process mirrors the one set out by NEPA for an environmental impact statement, but the practice is far more variable for HIA. The American Hospital Associations review of the IRSs final rules for CHNAs and implementation strategies can be foundhere. 2004, 2010). Given that HIA led by the private sector appears to be a rapidly increasing practice, the issue of availability bears further consideration. The discussion recognizes that the practice of HIA varies because it is adapted for use in different decision-making contexts. Several approaches for scoping are available. Key Elements - Kent County, Michigan 98224-MS. SPE International Health, Safety & Environment Conference; 24 April 2006; Abu Dhabi, UAE. Retrieved fromhttps://www.chausa.org/communitybenefit/assessing-and-addressing-community-health-needs Community Health Assessment and Improvement Planning - NACCHO Skip to Main NavigationSkip to Content LHD Directory Virtual Communities Toolbox Contact Us Mobilizing for Action through Planning and Partnerships (MAPP) Jobs at NACCHO Education & Events MyNACCHO Login Mobilizing for Action through Planning and Partnerships (MAPP) Jobs at NACCHO Process evaluation assesses the design and execution of the HIA in light of its intended purpose and plan of action and applicable practice standards. In practice, however, explicit consideration of health has been rare (Steinemann 2000; Cole et al. 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. Although the reasons and objectives for HIA are often not articulated at the outset of screening, establishing well-defined objectives will focus the screening process on determining whether HIA is likely to be an effective approach for achieving them. For example, under Alternative A, diabetes and metabolic disorders would be expected to increase if impacts on subsistence led to declining subsistence harvests (through declining populations of subsistence resources, displacement of resources that made hunting less successful, or displacement of hunters by oil activity and infrastructure). In some cases, the timeline and available resources will prevent collection of new data to address gaps that are identified. Given the volume and breadth of decisions at the local, state, tribal, and federal levels that can potentially affect health in some way, one of the challenges for HIA practice is to determine which proposals to screen. 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. EPA (U.S. Environmental Protection Agency). Thank you for taking the time to confirm your preferences. Scholars point to a remarkable consistency in the basic elements that are generally included in descriptions of HIA (Mindell et al. The tasks or elements that are described as part of an HIA are fairly consistent in the peer-reviewed literature and guides reviewed by the committee. Community health assessments use such principles as. The Association for Community Health ImprovementsCommunity Health Assessment Toolkitoffers a nine-step pathway for conducting a CHA and developing implementation strategies. Scoping should therefore entail a deliberative process that involves engagement of stakeholders. Improving relationships and collaboration between stakeholders. Participatory approaches that actively engage stakeholders in the process can yield rich information and provide opportunities for stakeholdersincluding community membersto influence the questions asked and to participate in the interpretation of findings. Clipboard, Search History, and several other advanced features are temporarily unavailable. Wernham A. Cole BL, Fielding JE. 2007). Mindell JS, Boltong A, Forde I. Shortened life expectancy associated with air pollution. That issue is addressed again in Chapter 4. Although rapid or desktop HIAs may not involve stakeholders or consider their input, this often (although not uniformly) reflects a pragmatic response to limitations, such as the timeframe for the decision or resources available to the HIA team, rather than an optimal practice. This is the key link between a health profile and a health plan. CDC is not responsible for the content of materials not generated by CDC. The steps can be described as follows: The following sections provide an overview of the process of conducting an HIA. A statement of why the proposal was selected for screening. Poorly selected proposals may result in HIAs that add little new information and consume considerable time and resources of the HIA team to complete and of recipients to review. 2010). It is common for mitigation measures and design alternatives to be considered during scoping, to be refined as the assessment phase further characterizes the impacts and identifies their importance, and to be made final during the recommendations phase. The Crossings is a proposed housing development in Los Angeles that will provide 450 units in a newly rezoned residential area that needs affordable housing. 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. As for any other research method, qualitative analysis in HIA should use appropriate methods and a clear, rigorous research design. Issues surrounding uncertainty, literature review, and reliability and validity of predictions are discussed in greater depth in Chapter 4. For that reason, it is important for the field to define the circumstances under which outcome evaluation may be practicable. Source: SFDPH 2011. A smaller set of related indicators was endorsed for use in monitoring key elements of community health status (CDC, 1991). The training and credentials of HIA practitioners are variable, and there is no universally accepted standard for a level of training necessary to lead an HIA. Some HIAs rely on proxy measures when rates of specific diseases are not available or are too small to calculate. This list can then be used to set priorities. Thank you also to the ACHI Community Health Assessment Toolkit Workgroup for ongoing insight and contributions. HIAs conducted as part of a formal government process are generally subject to disclosure and freedom-of-information requirements. Another method of scoping is to develop a table that facilitates a systematic and rapid appraisal of all the potential ways in which a proposal might affect health (see Table 3-1). 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. A summary of how stakeholders were engaged, the main issues that the stakeholders raised, and how they will be addressed or why they will not be addressed. 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. As noted above, the iterative process is known as adaptive management in the field of environmental management. It is also highly likely to lead to improved compliance with public-health guidance regarding seasonal influenza and community mitigation strategies for pandemic influenza. In contrast, effects that are likely but less well supported include increased ambulatory or preventive primary care, fewer emergency-room visits by workers who are insured, and greater compliance with infection-control policies. Discuss what entity has the authority or ability to implement each measure and document any commitments to do so. 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. The Atlanta Development Authoritys BeltLine Redevelopment Plan (November 2005) was identified as a coherent and publicly accepted vision that had been approved by local elected officials (ADA 2005). The process may include identifying communities and geographic regions; demographic, economic, racial, and ethnic groups; and vulnerable populations, such as children, elderly people, disabled people, low-income people, racial and ethnic minorities, and people who have pre-existing health conditions. Alcohol-consumption effects of alcohol taxes. The committee notes that outcome evaluation considers the effects of the whole decision, including changes made as a result of HIA recommendations. An evaluation plan should have been developed early in the HIA process to guide selection of the appropriate methods for conducting evaluations. PDF Community Health Assessment and Group Evaluation (CHANGE) Presentation Practice implications include better understanding of different models and requirements by health departments, hospitals, and others involved in assessment and planning to improve cross-sector collaboration, collective impact, and community health. This information can help develop a community health improvement plan by justifying how and where resources should be allocated to best meet community needs. Community health assessment and community health improvement planning are continuous, systematic processes for assessing and addressing health needs in a community. This chapter describes the types, structure, and content of HIAs and summarizes the HIA process, methodologic approaches, and variations in practice. The Catholic Health Association defines a community health needs assessment as a systematic process involving the community to identify and analyze community health needs and assets in order to prioritize these needs, and to plan and act upon unmet community health needs. Advisory, steering, and technical oversight committees are also commonly convened during scoping. 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. ADA (Atlanta Development Authority). Articles in Google Scholar by Kaye Bender, PhD, RN, FAAN Because developing an alternative (such as suggesting an alternate route for a proposed highway) involves many considerations that may be outside the purview and expertise of an HIA team, the committee recognizes that it may not be practical to expect the HIA team to develop alternatives independently. Scoping also establishes a plan for the analytic methods that will be used during the assessment phase. HIAs are also differentiated according to whether they are integrated into an environmental impact assessment or done independently. The HIA team needed an authoritative description on which to base its assessment. A variety of screening tools and algorithms are commonly used (Cole et al. Across the field, there is little uniformity in the content of written HIA reports. Some provide a checklist of factors to consider and often focus on health determinants that might be affected by the proposal.
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