Applying a Health Lens to Decision Making in Non-Health Sectors Workshop Summary (2014) / Chapter Skim
Currently Skimming:
3 Highlights from the Work of Federal Agencies
3 Highlights from the Work of Federal Agencies
Pages 13-26
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discussed how the EPA is linking health impact assessments and community research to decision making. Beth Osborne, Deputy Assistant Secretary for Transportation Policy at the U.S.
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Based on input from communities about their needs, the program focuses on four sectors: transportation, infrastructure, land use, and waste management. Health Impact Assessments in Community Decision Making One approach to integrating health concerns into policy making is the health impact assessment (HIA)
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. As an example, Fulk described the HIA for the Proctor Creek Boone Boulevard Green Street Project, which is evaluating the potential positive and negative public health impacts of the project design.
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State DOTs oversee state highways, but some will also oversee transit programs, and some even ports and airports. State transportation planners and engineers are focused on transportation efficiency (generally long distance rural routes that are straight, clear, and fast)
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Concerns about the health of a family member also affect a service member's ability to focus on his or her mission. Operation Live Well is DoD's education, outreach, and behavior change initiative designed to improve the health and well-being of members of the defense community.
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Initially, the project will assess the physical environment, existing health and wellness initiatives, and current health behavior of the population. The focus will be on initiatives that improve nutritional choices, increase physical activity, promote healthy weights, and decrease tobacco use.
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HOUSING AND URBAN DEVELOPMENT Figure homeeditablewe live, it is a part of the community in which we Our 3-1, is where live, and everything that is going on in the community around us affects our health and our well-being, said Jennifer Ho. Housing is a means to health and well-being, and health comes into play in many of the activities of HUD.
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Regional planning grants, totaling $170 million in 2010 and 2011, were awarded to improve regional planning efforts that integrate housing, land use, economic and workforce development, and transportation and infrastructure investments to address economic competitiveness and revitalization; social equity, inclusion, and access to opportunity; energy use and climate change; and public health and environmental impact. Communities participating in the regional planning grant program complete the Fair Housing and Equity Assessment, which helps them assess where people live according to race and economic status, and integrate those data with data on access to community assets, to understand the potential effect of policies on community members.
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Ho referred participants to the Partnership for Sustainable Communities website for more information about the HUD, DOT, and EPA partnership.2 DISCUSSION In the discussion that followed the panel presentations, individual panelists and workshop attendees expanded upon a range of topics, with particular interest in how to foster revitalization without inadvertently furthering inequities, the cost of HIAs, the costs and benefits of intersectoral collaboration, the issue of livability initiatives beyond urban areas to rural areas, the role of communication, and an exploration of leverage points in the decision-making process. Fostering Revitalization Without Furthering Inequities Individual participants raised concerns about how revitalization in urban areas is leading to increased costs of rent, food, and other essentials, forcing out many long-time residents.
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Moderator Dawn Alley added that eliminating health disparities is one of the four strategic directions of the National Prevention Strategy, and the other three (promoting healthy and safe community environments, promoting empowered people, and increasing linkages between clinical and community preventive services) each have an equity dimension.
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For example, if housing provides a health impact and if, with Medicaid expansion, it has a significant federal dollar impact, it is not possible to work with the Office of Management and Budget or the Congressional Budget Office to justify an increased investment in housing based on a cost offset to Medicaid. In a state budget, however, these types of conversations can come into play.
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Elenberg stressed the importance of a good strategic communication campaign for helping to motivate people to participate in a public health initiative. Leverage Points at Different Levels Moderator Dawn Alley asked the panelists about approaches or leverage points to be considered at different levels of decision making.
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Performance Measures A participant asked whether the forthcoming federal MAP-214 performance measures consider transportation choice as a measure. Osborne responded that Congress prohibits DOT from defining any performance measure not specifically listed in MAP-21, but states are not limited in developing performance measures locally.
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