A Review of Health Impact Assessments in the U.S.
A review was conducted of 81 HIAs from the U.S. to obtain a clear picture of how HIAs are being implemented nationally and to identify potential areas for improving the HIA community of practice. The review was focused on HIAs from four sectors that the U.S. Environmental Protection Agency’s (EPA’s) Sustainable and Healthy Communities Research Program has identified as target areas for empowering communities to move toward more sustainable states. These four sectors are Transportation, Housing/Buildings/Infrastructure, Land Use, and Waste Management/Site Revitalization.
The Minimum Elements and Practice Standards for Health Impact Assessment was chosen from the broad body of HIA guidance documents as the benchmark against which to review the HIAs. The HIA Review systematically documented organizations involved in conducting the HIAs; funding sources; the types of community-level decisions being made; data, tools, and models used; self-identified data needs/gaps; methods of stakeholder engagement; pathways and endpoints; characterization and prioritization of impacts; decision-making outcomes/recommendations; monitoring and follow-up measures; HIA defensibility and effectiveness; attainment of the Minimum Elements of HIA; areas for improvement; and identification of best practices.
The results of the HIA review were synthesized to identify the current state of the HIA practice in the U.S., best practices in HIA, and areas for improvement.