Health Impact Assessments and Healthy Schools

Abstract

Defining healthy schools remains largely discipline specific. Design disciplines ground discussions in a “green building” framework. Public health approaches healthy schools through programmatic interventions for physical activity and nutrition. This article presents a more systemic approach to healthy schools via health impact assessment (HIA). It reviews literature on health determinants in school environments, focusing on physical design. Existing school HIAs are reviewed with other decision support tools that provide guidance on the operation and design of healthy schools. The paper examines current use of HIAs in schools and develops a screening matrix for using HIA in creating healthy schools.

Review of Education‐Focused Health Impact Assessments Conducted in the United States

“…These HIAs considered the potential impacts of education‐related decisions on a range of short‐ and long‐term outcomes including academics and education, school dynamics, health behaviors and health status, and psychosocial factors. By conceptualizing youth, family, and community well‐being in this type of holistic framework, HIAs have the potential to influence policies, plans, programs, and projects in ways that benefit health and education sector partners . Health impact assessment provides a mechanism for schools and education agencies to examine their data through another lens—to identify promising approaches to achieve academic and health goals and to improve understanding of the contexts in which positive change may occur.…”

“…Evaluations of HIAs conducted in the United States suggest that they can influence decisions, help build consensus and relationships among decision makers and their constituents, and give community members a stronger voice in decisions . Preliminary work suggests education‐focused HIAs can highlight the potential health impacts of decisions made by schools and provide a framework for educators to consider a more comprehensive range of factors that influence well‐being . Despite the potential utility of HIAs in advancing health‐promoting policies and enhancing collaboration, little work has been done to describe the scope and value of HIAs conducted on education‐focused decisions.…”

Green Health

“…Another resource helpful in making HIA assessments in a relatively short time frame is the Decision Support Tool (DST), a graphical, spreadsheet-based tool. Rao and Ross (2014) discuss HIA and DST in greater detail in their article that follows. Resources and tools for HIA are available through the American Planning Association (https://www.planning.org), Built Environment and Public Health Clearinghouse (http://www.bephc.gatech.edu), Centers for Disease Control and Prevention (http://www.cdc.gov/healthyplaces/hia.htm), Health Impact Project (http://www.healthimpactproject.org/), and the World Health Organization (http://www.who.int/hia/en/).…”

“…First, Banerjee (2014) paints a picture of an urban school system, similar to others across the country yet benefited by the perspective of the children who travel through difficult neighborhoods to their school, offering suggestions for similar evaluations across the country. Rao and Ross (2014) and Vincent (2014) then offer strategies for improved siting and use of K–12 school facilities through Health Impact Assessment (HIA), Decision Support Tools and Joint Use Agreements. McDonald and colleagues (2014) offer a policy analysis of state guidelines on minimum acreage for schools and its impact on closing of historic schools and resulting district-level school planning processes related to walking and biking to school across four states.…”

Characteristics of Joint Use Agreements in School Districts in the United States: Findings From the School Health Policies and Practices Study, 2012

“…Community use of schools takes advantage of existing infrastructure (1,3–7,9) and can promote support for education and educational facilities among community members without school-age children (approximately 55% of households) because they see evidence that tax revenues benefit them (4,7,10). Common barriers to establishing a formal JUA include insufficient partnerships between school districts and potential collaborating parties (6,7), inadequate institutional capacity to support coordination of joint use (7,11), exaggerated concerns about liability (12,13), and costs associated with increased use of facilities (1,3,6,7,14).…”