Bringing Health Into Decisions Across Sectors: HIA on Potential Coal Plant Closure

May 7, 2013, 12:16 PM

file The Rise of HIAs in the United States infographic courtesy of the Health Impact Project. View the full infographic below.

The Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts, recently announced eight new grant recipients that will receive funding to conduct health impact assessments (HIAs). The projects will bring health considerations into upcoming decisions on topics including education, sanitation infrastructure, and energy.

“Our new grantees will use health impact assessments to uncover opportunities to improve health in a wide range of policy decisions, as well as to identify and avoid potential unintended consequences,” said Aaron Wernham, MD, director of the Health Impact Project. “These eight HIAs are the latest in a fast-growing field, as more cities and states find them a useful way to bring health into decisions in other sectors.”

By the end of 2007, there were 27 completed HIAs in the United States. There are now more than 225 completed or in progress, according to the Health Impact Project map of HIA activity in the United States.

Funding for some of the new proposals was also provided by the Blue Cross and Blue Shield of Minnesota Foundation and The California Endowment.

Some of the new HIAs that have received funding include:

  • Partners for a Healthier Community, Inc. will undertake an HIA to inform decisions about a proposed casino in western Massachusetts. Decision-makers—including the state gaming commission, local government officials, and voters—will consider siting options as well as licensing, regulation, design and development of the casino. The HIA will examine health risks that might be linked to gambling—including substance abuse, mental health, and injury—and potential health benefits related to employment opportunity, access to health insurance, and community revenues. 
  • The University of Texas at El Paso, will conduct an HIA on the impacts of proposed water and sanitation improvement projects on the town of Vinton, Texas. Vinton primarily relies on failing septic tanks and cesspools for wastewater removal and domestic wells with poor water quality. Poor water and sanitation are associated with gastrointestinal illnesses and other serious health conditions such as hepatitis, dysentery, and dehydration. Improved systems could not only improve public health but also support economic development and long-term sustainability of local businesses and industry. 
  • An HIA by the Kentucky Environmental Foundation, in collaboration with the Purchase District Health Department, will examine the potential health benefits and risks of the retrofit or retirement of the Shawnee coal plant in Paducah, KY, operated by the Tennessee Valley Authority. The HIA will analyze environmental health concerns associated with air and water pollution from the plant and the effects of its closure on the community including employment, individual income, and revenue for local services important to health.

NewPublicHealth recently spoke with two of the researchers conducting the Shawnee coal plant HIA, Elizabeth Crowe, executive director of the Kentucky Environmental Foundation, and Deborah Payne, energy and health coordinator for the Foundation.

NewPublicHealth: What is the scope of the HIA you’re conducting? 

Elizabeth Crowe: The HIA is going to be focused on the Shawnee coal-fired power plant, which is in western Kentucky, near the city of Paducah. It is a power plant that is run by the Tennessee Valley Authority (TVA) has been operational since the late 1950s.  It’s definitely one of the older power plants in the state. 

The question is whether to eliminate a source of pollution in the community, but with the elimination of that source, you’re also looking at the economic impact.

It has been connected to a uranium enrichment facility managed by the Department of Energy, which will be closing down, and so a lot of the electricity produced by Shawnee may no longer be needed. So whether Shawnee is going to continue to operate or not is a huge question for the community. 

TVA regularly revisits the question of how its power plants are performing and whether they are able to meet federal standards and how much it costs to operate the facilities. So the HIA is focused on whether or not the Shawnee power plant should be retrofitted with pollution controls and other changes in order to allow it to operate, cost-effectively, within federal regulations or if the plant should be retired.

NPH: What are the key questions for the HIA to answer??

Elizabeth Crowe: The question that I think is going to be most critical, not just for Paducah, but really for the country, is: how are we able to consider the health impacts of our decisions around coal, coal plants and by extension, other fossil fuel decisions that are interwoven with considerations about jobs and the economy. Traditionally, those are the issues that tend to make the decision and there is very seldom a consideration of the health impact either alongside or as part of the jobs and economic decisions or as something that could be equally weighted. 

We know that for communities that have been dependent on a facility like Shawnee for decades, change does not come easily. But those changes are coming. In fact, they’re here, and this conversation can really help center the discussion in the community.

NPH: What are the next steps, and about how long will it take to conduct the HIA?

Elizabeth Crowe: We’re in the scoping phase of this process and we’re at the point of inviting community members and health professionals and business leaders to join the conversation. 

I would anticipate the HIA will take about 12 months and that we’d complete it around the beginning of 2014.

NPH: In addition to the community conversations, how will the HIA be conducted?

Deborah Payne: We have different components of the HIA. The District Health Department will be helping to conduct a community health survey in order to gather some background and they will be helping to conduct some listening circles for the qualitative side of the health assessment. We will also be doing an economic analysis to look at that impact. We’ll do presentations before stakeholders and get feedback from community members and organizations on the concerns of the community.

NPH: Who do you need input from?

Deborah Payne: We need input from all of the stakeholders that are in this process. When we’re addressing air quality concerns, for example, we’ll want the input from physicians who are dealing firsthand with ears, nose and throat issues in the community, as well as physicians who are dealing with cardiac health problems. When it comes to economic developments, we want to make sure that we have a thriving set of recommendations from those that work in business and in tourism and the community. So, it’s an opportunity and a forum for them to come together and not only address jobs, but also address health in the bigger scheme.

NPH: Are there any decisions that need to be made before a year from now? 

Elizabeth Crowe: Well, right now the TVA is constantly reviewing what plants they keep in operation and sources of energy they use for powering their production. The CEO of TVA has said they are very agnostic about where they get their energy. Their primary goal is to provide low-cost energy. And right now, there seems to be a transition towards gas as well as towards some more renewable energy such as wind. The Shawnee plant will be under consideration this year, but no decisions have been made. They have to retrofit in order to meet new standards that will be coming online in a couple of years.  This is a financial factor they’ll have to keep in mind about how much they want to be investing in keeping a plant open that is already over 50 years old.

NPH: Who do you expect will be informed by this HIA, in addition to your own community? 

Deborah Payne: We are hoping that this HIA can serve as a model for communities in transition all across the country. The transition from coal to other cleaner sources of energy is happening. It’s a challenge because while it does improve the quality of air and water in a community, it also has an impact on income and jobs and this has been a very strong pushback all along. So we hope this will be a useful HIA for any community that is in this kind of industrial transition.

>>Learn about the rise of Health Impact Assessments in the United States in an infographic from the Health Impact Project:

Rise of HIAs in the United State

This commentary originally appeared on the RWJF New Public Health blog.