Improving Health in the United States

The Role of Health Impact Assessment

The National Research Council (NRC) issued a report that offers concrete guidance for decision-makers on ways to identify and address the potential impact on health of proposed projects or policies in sectors outside of health and health care at the federal, state, tribal and local levels, including the private sector. The report provides a framework, terminology, and guidance for conducting a health impact assessment (HIA) on a pending policy decision or project in a non-health field, like building a new transit system, developing an agricultural plan, planning a city’s growth or deciding where to locate a new school.

The NRC committee on HIA was funded by Robert Wood Johnson Foundation (RWJF), the National Institute of Environmental Health Sciences, the California Endowment, and the Centers for Disease Control and Prevention. Citing growing scientific evidence of the impact of social, economic and other factors on people’s health, the committee’s report recommends a comprehensive, six-step process for HIA and calls for increased education and training, more emphasis on stakeholder involvement and reducing health disparities, and collaboration at all levels of government to support the incorporation of health considerations into decision-making.

The NRC is the third national body to promote the use of HIA in 2011, following the National Prevention, Health Promotion and Public Health Council and the Institute of Medicine committee on Public Health Strategies to Improve Health. Several other national reports have recommended the use of HIA, including the U.S. Department of Health and Human Services Action Plan on Disparities and the White House Childhood Obesity Task Force Action Plan.

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