Health Impact Assessments: Q&A with the Alaska Department of Health’s Paul Anderson
At the recent 2nd Annual National Heath Impact Assessment Meeting held in Washington, D.C.,Paul Anderson, MD, MPH, manager of the HIA Program at the Alaska Department of Health, spoke about his state’s HIA efforts and successes. NewPublicHealth caught up with Anderson following the meeting to ask about lessons learned that can benefit other public health officials considering and conducting health impact assessments.
NewPublicHealth: Tell us about the HIA program in Alaska and how the health department has made HIA a routine part of decision making.
Paul Anderson: HIA in Alaska started with a couple of health impact assessments done in conjunction with natural resource development permitting and environmental impact statements (EISs) in the north of the state. These studies generated increased interest in the human health concerns that arise during project permitting. The Department of Natural Resources (DNR) contacted the Alaska Division of Public Health, asking us if we could get involved with this new idea—called health impact assessment—as it related to natural resource development permitting.
After some deliberation, we realized the importance of being involved with this work, and so we developed an HIA working group. That working group met for about three years and developed an HIA Toolkit, which is our guidance document for performing HIA in Alaska. Out of that working group came a realization that Alaska needed an institutionalized HIA program in order to lead this process forward effectively. So the group eventually decided to create an HIA Program in the Division of Public Health under the Section of Epidemiology.
NPH: Have you worked collaboratively in Alaska on HIAs?
Anderson: When our program was new, we wanted to conduct field work because we needed additional health information regarding a specific region of rural Alaska. This field work involved utilizing surveys, which can be very tiring for rural communities because they are surveyed frequently. There are several agencies in Alaska that already do surveys as a routine part of their work, and one of those is the Alaska Department of Fish and Game. They go house-to-house and community-to-community and use a very well-designed survey tool to learn about subsistence foods. They worked with us to integrate some important questions about food consumption onto their survey form. This turned out to be an effective cooperative relationship that benefitted both agencies and reduced the strain on rural communities.
In addition, we work collaboratively with many tribal health organizations in Alaska. One such organization is the Yukon-Kuskokwim Health Corporation, which is working with us on a proposed large-scale mining project in their region. They have helped us develop a community survey, which is being administered door-to-door in selected communities. Many other partners have assisted on other HIA projects.
NPH: What suggestions do you have for other states to help make HIAs a regular part of their critical decision making?
Anderson: My primary suggestion would be for states to explore starting an institutionalized HIA program in their respective health departments. Such a program can take various forms, and it need not emulate the one we have here in Alaska, though ours provides a number of advantages for states that wish to include health in their natural resource development decision-making processes. Health departments are typically well-connected in a state, and they often have existing technical expertise that can be readily applied to HIA work. Epidemiology is a prominent component of an HIA, so epidemiologists already employed at health departments can quickly develop the expertise necessary to develop and manage HIA programs. I would encourage other states that might be interested in developing an HIA program to visit our HIA Program website for additional resources and to contact us with questions.
- Anderson and colleagues from the HIA Program in Alaska recently published an article in the International Journal of Circumpolar Health on the institutionalization of HIA in Alaska, which provides detailed information on developing and conducting HIAs.
- The HIA program in Alaska has a detailed resource page, including contact information for the HIA principals, that public health officials considering and conducting HIAs should find very useful.