Creating a Community that is Healthy by Design by Using a Health Impact Assessment

Using a health impact assessment as an advocacy tool to make Billings, Mont., a community that is healthy by design

In 2005, given fast-paced development in the region, Montana's Yellowstone City–County Health Department worked with two local hospitals to conduct a community health assessment, which identified the area's most pressing health needs. Based on the results, the agency aimed to create a community that is "healthy by design."

To fulfill that goal, from 2007 to 2009, the Yellowstone City–County Health Department in Billings, Mont.—now known as RiverStone Health—engaged and guided communities and leaders in using health impact assessments to make decisions that affect public health.

A health impact assessment is a set of procedures and tools used to evaluate the effects of a proposed policy or project on the public’s health. With some 60 assessments completed in the United States from 1999 to 2009, public officials and researchers are working to integrate the approach into planning and policy-making.

The Billings project included hiring a grassroots organizer to work with local and state partners to consider the health consequences of proposed policies and projects.