1. Inclusion of Health and Wellbeing Impacts within Environmental Assessments for Major Land-Use Planning Projects in New South Wales, Australia Patrick Harris, Elizabeth Harris, Susan Thompson, Ben Harris-Roxas, Lynn kemp CHETRE, FBE, UNSW patrick.harris@unsw.edu.au Centre for Primary Health Care and Equity Research that makes a difference www.cphce.unsw.edu.au

2. Centre for Primary Health Care and Equity Research that makes a difference www.cphce.unsw.edu.au The Problem Since the inception of EIA in late ’60’s – health advocates have wanted health impacts included Work from the ’70’s on has shown that this has not happened – even from a ‘tight’ health risk perspective Australia is recognised as a world leader in including health within project based EIA but this is contested but has not been empirically tested

3. Retreat from Regulation Health is not clearly articulated as part of the environment in the legislation EIAs seen as cumbersome, expensive and too often uncritical: often presented in volumes of data that no one has time to read. In NSW Health Sector fear that HIA will follow this trend and block action. “Red tape” abolition committees have currency Regulatory approaches have limited support: but can we doo better?

4. What is Major Project Environmental Assessment in NSW? In 2005 the Department of Planning amended the land- use planning and assessment legislation to instigate a streamlined EA process for major infrastructure and state significant development proposals. Purpose of the reform to remove unnecessary red tape and confusion created by the original legislation, thereby facilitating the economic development of the state Under the amendment a particular development or development type may be declared by the Minister for Planning as a ‘major project’ to be assessed under the legislation.

5. Planning workshops Agreement there is a problem but not clear how to progress constructively Why not do some research?

6. Our approach Random selection of 22 (of 117) ‘Major Project’ EA applications approved by the Minister for Planning between July 2006 and December 2007 Created a reference group of relevant professionals Created a content analysis framework based on international EIA and HIA literature Applied to a sample of 22 EAs

7. Content analysis framework 1.explicit use of the terms ‘Health’ and ‘Wellbeing’ 2.determinants of health – across (triple bottom line): ‘physical environment’, ‘social’, ‘economic’, and ‘biological individual’ 3.‘Scope of impact’ – including distribution of impacts within and among different populations Also coded for: ‘Actions related to impacts’ (mitigation etc); ‘Reported impact’ (+ve, -ve); and ‘Type of evidence used’ (guidance, consultation)

8. Sample 22 Projects analysed across each of eight development types Range of projects including coal mines, brewery upgrade, cricket ground upgrade, boat storage facility, residential subdivision Major project triggers included: – Type of activity (mining, water infrastructure, remediation of contaminated land) – Site of activity (e.g. residential devt on coastal land) – Cost: range from > Aus. $30 million to $170 million

9. Explicit reference to health and wellbeing in EAs Health mentioned explicitly in 18 of the 22 EAs Wellbeing explicitly in 2 EAs Breakdown of different references across all EAs is:

10. But… ‘Health impacts, effects risks or hazards’ only average of twice per document References to health were single items or sentences and general rather than detailed, e.g. ‘The proposed upgrade is unlikely to increase the risk of exposure to contamination with respect to human health’ In the actual assessment section of the EAs, the number of total references to health impacts, effects, risks or hazards drops to 16 (mean per document = 0.73)

11. Link between EAs and requirements concerning inclusion of health When health mentioned in (six) requirements this translated into inclusion in corresponding EAs One requirement asked for an HIA to be undertaken, with this EA making the most references of all to health impacts, effects, risks or hazards Also this was the only EA to include an HIA section, but named ‘Air quality and Health Impact Assessment’, with no reference to health impacts, effects, risks or hazards!

12. Number of EAs and requirements referring to types of impact

13. Numbers of references to each type of impact across all EAs

14. Range of impacts per broad type Physical environment greatest range, focusing on traditional public health determinants, for example water, traffic, noise, and air quality. Social and economic impacts smaller in range, for example provision of services, infrastructure and capacity, and the importance of supporting the local community and economy. Biological individual impacts referred mainly to person safety, access and mobility and sleep disturbance.

15. General findings Coverage depends on definition of health – If broad, then EAs are covering determinants, but with emphasis on the physical environment – If tight, then coverage is poor Limited use of health data No demonstration of understanding of causal pathways Reference to populations potentially affected but no reference to vulnerability or differential impacts Range of impacts and depth of analysis could be better for social, economic, and biological individual – depends on guidance (not assessed), legislative requirements (appear limited), and involvement of health agencies across EA steps (poor)

16. Recommendations Department of Planning to improve requirements to include health impacts as stand alone and as part of bio-physical, social and economic impacts Department of Health should provide knowledge on these impacts, their pathways and distribution across and within populations and improved access to contextually relevant health data. Future research look at current guidance, legislation, and work with stakeholders to understand issues and build capacity

17. Centre for Primary Health Care and Equity Research that makes a difference www.cphce.unsw.edu.au HIA Connect & HIA Blog www.hiaconnect.edu.au