Building Capacity for HIA in the United States: Current Status and Future Directions Andrew L. Dannenberg, MD, MPH National Center for Environmental Health U.S. Centers for Disease Control and Prevention 9 th International HIA Conference Liverpool, October 9, 2008

HIA Demand and Supply HIA is slowly becoming more widely adopted in the United States Building demand for HIA must be accompanied by an increased supply of persons and organizations with the skills needed to conduct HIAs

Why Build Capacity to Conduct HIAs? Respond to community interest in improving public health Increase awareness of other sectors in health impacts of their decisions Improve the health of the public and reduce health care costs

AK 4 CA 16 CO 1 FL 1 MA 2 NJ 1 Completed HIAs in the United States 1999–2008 (N = 38) MN 4 GA 3 WA 3 OR 1 OH 1 PA 1

Training of Current HIA Practitioners in U.S. Some HIAs practitioners received formal training in HIA methods –NACCHO / APA / CDC courses –California courses –Alaska courses –Liverpool courses Other HIA practitioners were self-taught through the experience of conducting HIAs

Organizations that Conducted 38 HIAs in the US, Local health department N =16 Academic group; CDC N =15 Tribal council/health agency N = 4 Private consultants N = 3

Who Needs Training to Conduct HIAs Public health practitioners in local and state health departments Transportation planners Public health and planning students Private consultants University faculty Urban planners Others

U.S. HIA Training Materials Available On-line UCLA: American Planning Association: Human Impact Partners, California: UC Berkeley: San Francisco Department of Public Health

HIA Training Courses in the U.S. HIA Practitioner Mini-Course, San Francisco Health Department, July 2008, 4 days, expected to be offered annually – HIA graduate course, 3 units, UC Berkeley School of Public Health, offered annually – _cd=PB+HLTH&p_title=&p_number=267Dhttp://osoc.berkeley.edu/catalog/gcc_search_sends_request?p_dept_name=PUBLIC+HEALTH&p_dept _cd=PB+HLTH&p_title=&p_number=267D NACCHO / APA / CDC HIA training workshops, 1-2 days, offered sporadically Custom courses taught by various HIA practitioners sporadically

Options for Building Capacity for Conducting HIAs Short courses in classrooms –Multi-day courses to build HIA skills; modeled on Liverpool courses –One day courses to raise awareness of HIA –HIA included in workshops on health and built environment Web-based courses –Best done with faculty interactions synchronously or asynchronously –Examples include Scotland and APA courses, others? Train the trainers model –Develop courses specifically to train persons who can train others –No current models related to HIA

Options for Building Capacity for Conducting HIAs (continued) Websites with HIA background information to raise awareness, and potential for self-teaching - CDC, UCLA, WHO, etc Incorporate HIA training into training courses on Environmental Impact Assessment, Urban Planning, or Environmental Planning and Management Incorporate HIA into curricula of schools of public health and of planning, such as in health and built environment courses Interdisciplinary masters level courses on HIA –Model course now taught by Rajiv Bhatia and Edmund Seto at UC Berkeley includes HIA concepts, methods and hands-on project

Building Capacity for Conducting HIAs: Issues to Consider Identify resources to pay for courses (tuition?) Support practitioners outside of academic institutions to teach course in partnership with faculty Target courses to public health and planning professionals most likely to conduct HIAs Introduce HIA to all public health, urban planning, and transportation planning students

Building Capacity for Conducting HIAs: Issues to Consider (cont.) Build database of completed HIAs and available methods as a resource (e.g., UCLA database, London HIA Gateway) Create constituencies for HIA through education and outreach to various organizations Identify sources of technical assistance on local or state level, especially for new HIA practitioners Develop U.S. guidance document for HIA and possibly minimum standards of practice

Conclusions Efforts to build constituency for HIAs need to be balanced with capacity to conduct HIAs Training should include increased awareness of HIA for broader audiences and specific skills to conduct HIAs for smaller numbers of practitioners Further work needed to identify optimal methods and materials for HIA training

References – – Acknowledgements –Rajiv Bhatia –Aaron Wernham