Air pollution contributes to asthma, allergies, lung function impairment, cardiovascular disease, and premature mortality. Transit-oriented development, roadway expansion, new residential and commercial development, and pollution mitigation projects impact local and regional air quality. This article discusses the use of Health Impact Assessment (HIA) by community advocates, public health and city planning departments, and regulatory agencies to ensure health impacts are considered in decision-making processes that affect air quality. HIAs encourage collaboration among diverse stakeholders, including communities facing health inequities. HIAs also use data and analysis to predict health outcomes of proposed planning and policy decisions. This article describes the collaborations, empirical assessment tools, communication and advocacy strategies, findings, recommendations, and outcomes of the following HIAs: a transit-oriented station area plan in Pittsburg, CA, grade separations funded through a policy to levy a fee on all port containers passing through major ports in California, and a freeway expansion in Los Angeles, CA.
The San Francisco Bay Area has experienced a rapid rise in homelessness over the past decade. There is a critical need for quantitative analysis to help determine how to increase the amount of housing to meet the needs of people experiencing homelessness. Noting that the shortage of housing available through the homelessness response system can be modeled as a queue, we propose a discrete-event simulation to model the long-term flow of people through the homelessness response system. The model takes as input the rate of additional housing and shelter available each year and delivers as output the predicted number of people housed, sheltered, or unsheltered in the system. We worked with a team of stakeholders to analyze the data and processes for Alameda County in California and use this information to build and calibrate two simulation models. One model looks at aggregate need for housing, while the other differentiates the housing needs of the population into eight different types. The model suggests that a large investment in permanent housing and an initial ramp up of shelter is needed to solve unsheltered homelessness and accommodate future inflow to the system.
There has been a surge of interest in Health Impact Assessment (HIA) in the United States, contributing to a range of practices that vary in their effort, duration, and complexity. HIA is a systematic but flexible process used to increase discussion of impacts to human health in decisions, such as in planning, which traditionally would not consider mental, social, or physical health and well-being but can affect them. Stakeholder participation is a core element of HIA practice, yet research suggests a gap between the intention of including meaningful participation and its implementation. This is particularly true in what are known as rapid HIAs due to their especially short timelines and the resource-intensiveness of meaningful community participation. We sought to address that gap, drawing on standard HIA practice and a Consensus Conference approach from Denmark to develop a rapid Health Impact Assessment model that includes meaningful participation and fosters empowerment among impacted residents using limited resources and within a short decision-making timeline. This paper describes a 2012 piloting of the rapid HIA model on a proposed stadium development project and findings about the HIA's impact, based on interviews with project stakeholders and a review of project outcomes. Findings indicated that the new model was successful: it contributed to a broader strategy that won a variety of health benefits and measures for the community; residents were engaged and felt empowered by the process; the rapid HIA helped organizations meet their goals; and the project contributed to changes in the stadium proposal that benefit health. The findings suggest that the model helps address a potential conflict practitioners and planners face between conducting a project with a short timeline and more fully engaging community stakeholders in the process.
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