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Tools to Build Health

Staff Perspective Jessica Garner

Where we live, work, play and learn have an impact on our health—the availability and accessibility of public transit, safe places for us to walk or bike, our incomes, and even how much we spend to live in our communities affects the quality and length of our lives. Each of the above considerations is a choice we make every day, yet the health of a community is not always factored in by policymakers from the local to federal levels. 

Before joining Get Healthy SMC, I was a local planner working for a city in Colorado where a significant part of my work required me to evaluate proposed developments based on the health, safety and welfare of the public. I relied on data and resources from a variety of agencies and partners to help guide my analysis, but I often didn’t have tools available to objectively determine a project’s impact on the public’s health, unless there were obvious environmental (and therefore I could extrapolate the human impact) or ecological concerns. 

One great exception to this happened on a revitalization project I worked on, where our local health department partnered with the city to develop a Health Impact Assessment (HIA) for the historic portion of town.  We were able to rely upon a structured process for screening, scoping, assessing, making recommendations, reporting, and ultimately evaluating the health impacts from the project before policies were decided by the local City Council. We brought a highly diverse set of community members into the process early and listened to their interests in creating safe and attractive walking and bicycling routes, more economic diversity and commercial choices, protection against gentrification, and safe parks and open spaces.  I was then able to incorporate their needs into the plan, which was approved that year. 

HIAs are one of many resources that bring data-driven information to the public and to policymakers when they are considering changes in policy or practice to land use, transportation, parks and open space, housing, schools, even wages, all of which have an impact on peoples’ health.  An HIA is formally defined by the National Research Council as, “A combination of procedures, methods and tools that systematically judges the potential, and sometimes unintended, effects of a policy, plan, or project on the health of a population and the distribution of those effects within the population. HIA identifies appropriate actions to manage those effects.”  Another important aspect of HIA is the opportunity they afford to invite deeper community engagement and dialogue, which can in turn create more opportunities for transparency in the decision making processes at each level of government.

HIA can be integrated into the practice of community development to examine the effects of projects or policies, and can also be used to evaluate if there are health disparities or inequalities between different groups of people if those policies or projects are or aren’t implemented.   These types of tools can raise awareness about health, and by utilizing the evidence emerging in the field, can help the public understand how a project or policy affects health. 

Using data and evidence-based information to evaluate a project or policy’s potential impacts on health can help a community understand and even measure the less obvious or tangible impacts of community development, and in doing so, ensures the voices of the people who are often being directly impacted are heard and incorporated into the planning process.

An HIA is one of many effective tools to evaluate project impacts, and we have very experienced local partners in the Bay Area who have been developing and engaging in conducting HIAs around the country and sharing their knowledge broadly.  For more information about how HIA has been used in our region and what kinds of projects have been analyzed, check out Human Impact Partners, and you can also see how the San Francisco Department of Public Health has utilized HIA within the past decade.

If you are interested in exploring how HIAs can be used in your community to strengthen the planning process or partnering with us to conduct an HIA for an upcoming plan or project, please contact me at