The Five Steps in the Health Impact Assessment Process - Term Paper Example

Q1. Identify, explain and discuss the five (5) steps in the health impact assessment process. Your answer should reference and use examples from the community of Parramore in Orlando, Florida. Health Impact Assessment (HIA) is defined as a combination of procedures, methods and tools that judges the potential and at times the unintended effects of a plan, program or project on the health of a population and the distribution of those effects in the population (Dannenberg, Frumkin & Jackson, 2011, p. 309). HIA creates a framework for estimating the impact of a proposed program or policy on a selected environmental or health issue for a defined population. The main objective is to evaluate the positive and negative health impacts of proposed programs and making necessary recommendations. The HIA involves participation of public stakeholders and lays down a social model of health and well being with focus on equity, sustainability and social justice (Dora, 1999, p. 1686-1689). The procedure involves the following steps: a. Screening: Helps to determine the potential health implications of a policy under consideration to determine whether the HIA will likely to succeed and add value. It will define the domain of the specific project, program or policy decision that the HIA will address (“The HIA Process: Health Impact Project, 2011).The HIA specific for Parramore community should evaluate the impact of the community’s redevelopment and improvement on the health of its residents particularly in chronic health issues. At least one individual per family in the Parramore Community suffers from chronic diseases. Screening may also provide information of earlier unrecognized health issues and will predict the feasibility of available sources like money, stakeholder interests and political will. b. Scoping: The key health issues and public concerns are identified and considered in this step so the objectives and aims of the HIA are formulated. The health determinants must also include the environmental and social factors. The outcome will address the health effects that the HIA will address, the person/s that would be affected by the HIA policy, and in what way? c. Appraisal and Assessment: With respect to the defined scope all the available evidence gathered will be used to estimate the potential health gains or losses. This indicates there should be a description of the baseline health of people and groups affected by HIA and then predicting the potential health effects in them. The baseline analysis will not only evaluate the causes of illness but also the associated factors like local economy, environmental quality and food accessibility will all be in question. d. Recommendations: Formulation of the decisions based on the HIA analysis after thorough analysis of the potential risks, benefits, cost effectiveness and feasibility of the HIA program. Based on all a specific health management plan may be implemented. e. Reporting: The findings will be disseminated between decision makers of the HIA as a feedback system, so that necessary revision can be formulated. f. Monitoring: Measures to be taken to monitor the actual impacts on health of the intervention and enhance the evidence base. This is done through i. process evaluation, which evaluates the HIA’s quality to established standards, ii. Impact evaluation, which assesses the success versus the objectives planned during scoping and iii. Outcome evaluation which assesses the change in health status after decision is implemented. As 41% of Parramore households at least one child with chronic health needs, a HIA should be created to eliminate the disparities of health care to address health needs in diverse, racial ethnic and cultural backgrounds. Q2. Discuss the application of public health concepts and epidemiology to the development of healthy communities addressing the built environment and the natural environment. Environmental conditions are important in producing and maintaining health disparities which impact the epidemiological aspects based on various factors. Differential residential locations involve different health risks. Neighborhood stressors and pollution creates adverse health issues which itself counterbalanced by neighboring sources. The structural factors help to create the boundaries which determine the health promotion framework and contemporary sources and state of stressors, resources and pollution in a community. This structural factor acts as salutogens (factors that support health) or pathogens. Local economy is a salutogen which will impact community’s ability to reject undesirable changes and thus have an impact on the epidemiology and health in the local perspective. Segregation in the community is associated with increased infant and adult mortality, tuberculosis and other diseases. Segregation forms a critical link between race and environmental health of racial communities, which lead to different exposure to health risk factors (Gee and Devon, 2004, p. 1645-1653). In Epidemiology and Public health, built environment refers to those physical environments which are designed with health and wellness as integral parts of the community. This indicates the ways the neighborhoods are created can impact the physical activity and the mental health of the residents in that community. Neighborhoods with more walkability areas had lower rates of obesity, which also increases the physical activity of its residents. It also resulted in lower rates of depression, increased social capital and low alcohol abuse. Walkabilty includes safety in sidewalk constructions and destinations designed for walking. There are Global Information System mediated assessment tools to determine distances to grocery and other amenities and also the associated connectivity. Public health also addresses bikeability and healthy food accessibility issues and access to community gardens. As walkability and bikeability improves physical activity, a higher density of convenience stores has been associated with obesity. On the other hand, improved access to community supermarkets and farmers market is correlated with lower rates of obesity. Community gardens have positive social and psychological impact that reduces stress and hypertension, and improves the sense of well being affecting the overall health of an individual. The intersection of public health with other disciplines becomes evident in the design process of built environments including land use planning, environmental planning and policy development. Research suggests that people are more physically active in mixed use communities. Q3. Develop a “healthy community plan” with a minimum of ten (10) strategies to improve the safety and health of residents in a struggling community, such as Parramore. Poverty stricken communities like Parramore have suffered tremendous neglect resulting in poor health due to crime and improper living conditions In order to address the health issues of a struggling community there should be a public initiative. The initiative should integrate traditional medical services with public health interventions which will improve the positive behavioral changes and built environmental changes to improve the health status. The various strategies would include: 1. Improvement in Living Condition and Communication: Encouraging fair, attainable and affordable housing facility with direct access to the LYNX Central and Church Street Stations and to the residents of the neighborhoods that make up the Parramore community should be initiated. The need to restablish the currently disjointed street grid and moving physical barriers to improve access from the Parramore neighborhoods to Sunrail and its connections to the employment centers and regional commerce must be initiated. 2. Improving Transportation Improving the multimodal (bike, pedestrian and transit) transportation facilities 3. Building on Sustainable Community Staging the transformation of neighborhoods of Parramore, into a sustainable community, at the same time preserving the community assets and characteristics by implementing the principles of Healthy Community Design. 4. Building a Farmers Market Struggling communities like Parramore have little access to nutritious foods, while they have access to those shops which results in poor health. This leads to diabetes, hypertension, obesity and other lifestyle disorders. So farmers market will not only address this issue but also improve physical activity in the locality. 5. Setting Community Schools Community school includes pre-school, provision of adult education and health services under one campus. 6. Community Garden Set Ups These gardens can rejuvenate an oppressed and depressed section of the Parrmore neighborhood. This helps in social interaction, improved quality of life , lower family food budgets, conservation , improved quality of life and even prevents crime (American Gardening Association). 7. Establishing Recycle Center This can reduce trash and reduce litter accumulation, improving conditions of living. 8. Health for All Each and every person of the community should get access to quality and competent healthcare 9. Awareness Programs There should be awareness program and education to make the community aware about the implications of chronic disease and its management. 10. Monitoring Tobacco Usage & Substance Abuse. The importance of maintaining a healthy environment should be stated and promoted. Infectious disease should be controlled at source and should be prevented from being communicable, with intervention measures. The community should be made prepared to combat any unexpected health exigency (Community Service Plan, Department of Health, New York). Q4. Discuss the number one condition (poverty) that impacts health negatively in any society, and identify and discuss a minimum of four (4) strategies that planners are able to utilize to minimize the impact of poverty and to improve the health of the community Poverty and in particular child poverty is a significant public health concern. Child during the early years of growth and development should be given the laying foundations for future health and development. Poverty also imposes a health concern in adult and geriatric populations. This is because poverty causes improper treatment and poor prognosis causing loss of man days and makes the elder population more vulnerable to life threatening diseases. An early experience in the life of an individual with poverty worsen key health outcomes like increased infant mortality, respiratory problems like asthma, low birth weight , issues of overweight and obesity, increase in injury proneness , mental health problems and learning difficulties. The aboriginals are more prone to such effects with regard to poverty (Lethbridge et al, 2005). Strategies 1. Each segment of health care should play an important role in advancing public policies that will identify and confront the socioeconomic conditions. 2. Key responsibility should include educating communities and governments at all levels regarding the potential health impact of policies and programs 3. Health care professionals and various organizations must engage in advocacy on an individual basis and also through collaborations and their professional networks to address poverty related health problems. 4. Public Health policies should strive to mitigate the negative health effects through programs and services that will support the lower income group, through assessment. Education and referral ( Sengupta et al, 2007). References Dora C. (1999) A Different Route to Health: Implications of Transport Policies , BMJ, 318:1686- 1689 Dannenberg, A. L., Frumkin, H., & Jackson, R. (2011). Making healthy places: Designing and building for health, well-being, and sustainability. Washington, D.C: Island Press. Gee,G and Devon,C.(2004) Environment Health Disparities: A framework integrating psychosocial and environmental concepts.Environ Health Perspect.  112(17): 1645–1653. Lethbridge LN, Phipps SA.(2005) Chronic poverty and childhood asthma in the Maritimes versus the rest of Canada. Can J Public Health; 96:18–23. Sengupta, R, Wit,M and Mckenow,D.(2007) Impact of poverty on current and future health status of children Paediatr Child Health.  October; 12(8): 667–672. The HIA Process | Health Impact Project. (2011). Retrieved from http://www.healthimpactproject.org/hia/process World Health Oranization, Health Impact Assessment, UNEP The impact of poverty on the current and future health status of children Read More