There is increasing acknowledgment that many health issues such as health disparities and preventive health care are profoundly influenced by factors outside the traditional realm of health and health care. Factors such as literacy, poverty, employment, crime, and racism contribute to disparities in life expectancy as well as to health-related quality of life. Concerns about how to address these factors have led to a focus on “health in all policies,” in which policies in non-traditional sectors such as transportation, housing, employment, and agriculture ideally would contribute to health and health equity.
A Health Impact Assessment (HIA) offers a vehicle to make possible health effects known. For example, although air pollution and injury prevention are often considered in major transportation projects, the influence of road design on physical activity and obesity is not. An HIA that recommends the addition of pedestrian and bicycle facilities (“complete streets”) to a transportation plan would contribute to a built environment that promotes the public’s health. The agriculture sector seeks to maximize productivity, meet consumer demand, and sustain livelihoods. From a health perspective, agricultural policy determines food quantity, quality, and prices that directly affect consumption patterns and therefore health. HIAs could be used to examine the health effects of proposed food policies, such as ones that enhance production of energy-dense, nutrient- poor foods that contribute to the increasing obesity epidemic. HIAs of proposed zoning plans, which would contribute to decreased density of fast-food and liquor stores or increased density of restaurants and full-service grocery stores, especially in low-income areas, could result in changes that better promote health.
The potential applications of HIA are expansive, and increasing evidence of the positive effects of HIAs on decision-making is compelling. HIAs can make an important contribution to social equity and the elimination of health disparities, especially when community input is incorporated into the planning, conduct, and communications processes of HIAs.
Using HIAs as the catalyst to improve health outcomes, the Health Planning Council is poised to work with members of your community, including cross-sector public and private stakeholders and the non-profit community to introduce health, well-being, and equity into the development and implementation of policies in all sectors of a community— Every Policy is a Health Policy.
