1. Making Healthy Community Development Choices Richard Kreutzer California Department of Public Health, USA 5 th ICEOM Dujiangyan, China April 7-10, 2010

2. Presentation Overview 概要  What is a Healthy Community  General Plans- The Framework  National Environmental Policy Act (NEPA), California Environmental Quality Act (CEQA)- The Policies  Environmental Assessments, Environmental Impact Statements, and Health Impact Assessments- The Methods  Changes in Practice- The Need

3. Hooker Chemical Plant, Love Canal, NY

4. Freeway Interchange, Milwaukee

6. The Three ‘E’s of Healthy Places 健康住地的三个 ‘ E ’ Equity 平等 Economy 经济 Environment 环境

7. Healthy Community Defined A healthy community is one that –meets the basic needs of all residents, –ensures quality and sustainability of the environment, –provides for adequate levels of economic and social development; and –assures social relationships that are supportive and respectful.

8. The Framework

9. 9 The General Plan... 综合规划 Is a long-range policy document 长 远政策 Provides a framework for decision-making 为决 策提供框架 Includes seven required ‘elements’ 七 个必要因素 Is developed by the community 由 社区制定 Requires extensive environmental review 要 求广泛的环境考虑

10. General Plan Structure 综合规划结构

11. 11 Community Outreach 联系社区 Community Workshops... 社区研讨会

12. The Policies

13. The National Environmental Policy Act (NEPA) of 1969 is the basic national charter for protection of the environment. NEPA Overview

14. Overview NEPA was necessary to ensure that Federal agencies would consider environmental concerns when making decisions, because often the statutes that created the agencies did not include an environmental mandate. Many states, like California, have similar policies at the state level.

15. –Promote efforts that will prevent or eliminate damage to the environment and biosphere and stimulate the health and welfare of man –Enrich the understanding of the ecological systems and natural resources important to the Nation –Establish the Council for Environmental Quality (CEQ) Objectives

16. NEPA Documentation The NEPA processes and documents required by CEQ regulations are as follows: –Categorical Exclusion (CX) –Environmental Assessment (EA) –Environmental Impact Statement (EIS) NEPA GUIDELINES

17. Title I Section 101 Section 101(a) declares NEPA’s general policy: It is the continuing policy... to use all practicable means and measures... to create and maintain conditions under which man and nature can exist in productive harmony, and fulfill the social, economic, and other requirements of... Americans.

18. Title I Section 101 Section 101(b) sets forth NEPA’s six goals: –Fulfill the responsibilities of each generation as trustee of the environment for succeeding generations –Assure for all Americans safe, healthful, productive, and esthetically and culturally pleasing surroundings

19. Title I Section 101 –Attain a wide range of beneficial environmental uses without degradation, risk to health or safety, or other undesirable and unintended consequences

20. Title I Section 101 –Preserve important historic, cultural, and natural aspects of our national heritage... and maintain... an environment that supports diversity, and variety of individual choices

21. Title I Section 101 –Enhance the quality of renewable resources and approach the maximum attainable recycling of depletable resources –Achieve a balance between population and resource use that will permit high standards of living and a wide sharing of life’s amenities

22. The Methods

23. Environmental Impact Statement –The EIS ensures that the policies and goals defined in NEPA are introduced into the programs and actions of the Federal Government –The EIS is to be used by Federal officials (with other relevant material) to plan actions and make decisions

24. Environmental Impact Statement An EIS should include the following: –Cover sheet –Summary –Table of Contents –Purpose of and need for action –Alternatives (including proposed action) –Affected environment

25. Environmental Impact Statement –Environmental impacts (effects) –List of preparers –List of agencies, organizations, and persons to whom copies of the statement are sent –Appendices (if any)

26. The Threshold Decision: Do we need to prepare an EIS? Environmental Assessment: Does the proposed action have the potential to significantly affect the quality of the human environment? If YES, do an EIS! If NO, you’re free to go! (Well, not quite. You have to do a FONSI first). Environmental Assessment: Does the proposed action have the potential to significantly affect the quality of the human environment?

27. EIS Analysis Succinctly describe affected environmentSuccinctly describe affected environment Baseline: description at a fixed point in timeBaseline: description at a fixed point in time Analyze direct, indirect, cumulative impactsAnalyze direct, indirect, cumulative impacts Mitigation measuresMitigation measures Adverse effects that can’t be avoidedAdverse effects that can’t be avoided

28. NEPA Integration With Other Laws and Regulations The CEQ regulations state that agencies shall integrate NEPA requirements with other planning and environmental review procedures required by law so that the procedures run concurrently rather than consecutively.

29. Health Impact Assessment (HIA) has a simple and common sense purpose—to make visible the potentially significant human health consequences of public decisions; helps to ensure the accountability of public policies and decisions to the needs of health; is a systematic process to make evidence-based judgments on the health impacts of public decisions (Quigley 2006); two primary outputs of HIA include findings with regards to health impacts as well as strategies for policy design and implementation to ensure decisions protect and promote health.

30. Promotes Healthy Public Decision- Making Identifying harms and benefits before decisions are made Identifying strategies for decisions to protect and promote health Supporting inclusive and democratic decision-making Protecting Social Equity and Justice Planning health and public health service delivery Catalyzing social and institutional learning

31. Steps in the HIA Process Screening involves determining whether or not an HIA would be valuable and feasible. Scoping involves determining health issues for analysis, the temporal and spatial boundaries for analysis, and research methods. Assessment involves using data, expertise, and qualitative and quantitative research methods to judge the magnitude and likelihood of potential health impacts, their significance, and identifying appropriate mitigations and design alternatives. Reporting involves synthesizing the assessment findings and communicating the results. This can take many forms including written reports, fact sheets, comment letters, and public testimony. Monitoring describes the process of tracking the decision and implementation effect on health determinants and health status.

32. The Need

33. Changes to Framework Regionalization Cross sectoral collaboration Better measures/indicators

34. Changes to Methods Legal opinions CEQ regulations Public health and environmental health practice Combine Environmental Impact Statements (health risk assessments) with Health Impact Assessments

35. This is How We Can Achieve Healthy Communities Equity 平等 Economy 经济 Environment 环境

36. For More Information NEPA –www.epa.gov/compliance/basics/nepa.htmlwww.epa.gov/compliance/basics/nepa.html Health Impact Assessment –www.cdc.gov/healthyplaces/hia.htmwww.cdc.gov/healthyplaces/hia.htm –www.healthimpactproject.orgwww.healthimpactproject.org –www.ph.ucla.edu.hs.hiaclic/www.ph.ucla.edu.hs.hiaclic/ –www.health.nsw.gov.auwww.health.nsw.gov.au

37. Acknowledgements 致谢 Vikrant Sood John Petterson Health Impact Partners