HIA as Rosetta Stone: A Q&A with Cleveland Councilman Joe Cimperman
Oct 2, 2013, 11:24 AM
“[Health Impact Assessments have] taught people how to think and speak differently, clearly, objectively,” according to Cleveland Councilman Joe Cimperman. “Suddenly we are saying those words we don’t say often enough in government: Are you comfortable with the environmental and health impacts of this decision?”
NewPublicHealth caught up with Cimperman soon after his plenary address at the second annual National Health Impact Assessment meeting held in Washington, D.C., this week. He is an HIA supporter and enthusiast who is already engaged in health impact assessments for the city of Cleveland.
NewPublicHealth: What was your impression of the HIA meeting?
Joe Cimperman: I was blown away by so many different things—the geographic diversity of the people attending, and the many ideas they presented in questions and in private conversations after I spoke.
NPH: In your opinion, what is the intrinsic value of health impact assessments?
Cimperman: HIA has been a model for how to get things done right. But the tool also allows us to get closer to people and their specific needs by going through the process—which is such an important component—to find out how we help individuals when we make policy-level decisions. If we want to restore our cities, we need to ask what problems we’re solving.
NPH: What’s a strong example of an HIA in your community that was innovative and beneficial?
Cimperman: We have completed an HIA on the health implications of proposed legislation to expand agriculture into urban areas. Cities like ours have enough land that we can think about the different and best ways to use some of it—and urban agriculture is a means of helping people use the land themselves, and use it for something other than home and industrial construction. I think we’ve been able to do so much good by applying an HIA because we’re answering questions right up front. The Urban Agriculture overlay district is a proposed piece of legislation that would introduce intense farm uses in an urbanized environment, including livestock, community gardens and commercial gardens. While the uses are thought to have positive impacts on human health—such as access to fresh fruits and vegetables, community cohesion through the establishment of gardens, potential economic opportunities and a productive reuse of vacant land—unintended adverse impacts to human health include increased animal waste, potential exposure to carcinogens created by insecticides, and increases in noise and odor levels.
The legislature will hear the HIA findings later this month. The HIA’s recommendations include placing new city agricultural districts in locations with large tracks of vacant land, near underserved areas of the city that lack healthy food options and away from land previously used for industrial purposes (unless cleaned up). The HIA also recommends targeting nearby corner stores to encourage them to buy fresh fruits and vegetables from the new agricultural areas. This, among other things, reduces travel time for area residents to buy healthy foods and creates incentives for corner stores to purchase fresh produce from businesses within the district.
Long-term benefits of urban agriculture, according to the HIA, include increased nutrition; decreased obesity and chronic disease; and increased social cohesion.
NPH: What role do you think HIAs can play in helping to maximize the full potential of new projects, laws and regulations?
Cimperman: With an HIA, an idea goes out there and it’s not just about jamming it through but creating grass roots support. Often, the legislature thinks they have to carry the weight on their own. An HIA clears up questions and concerns for everyone and changes the power dynamic. When you take the time to find answers, it shows respect for the people asking the questions. It’s good to have that kind of absolute equality and the ability to ask questions of each other. I think it has a very positive effect on the democratic process.
NPH: What are your plans for applying an HIA to Cleveland’s budget?
Cimperman: What I would like to do is work with partners we’ve already worked with—such as the city planning commission, the county board of health, several area hospitals and Ohio State University, or other HIAs—to see what outcomes we need to know about, such as impact of the budget on public utilities, public services and economic development. That will help us see what we have to construct and what we have to fix. Over the next 14 months, we’ll be figuring out the questions a budget HIA needs to ask, such as: what are we spending money on? What should we be spending our money on? Does it make sense to have this many roads dedicated just to cars, or should some offer space for bikes and walking? And if we spent it on this, rather than on that, how would that impact health?
Our money should purchase more than just what we’re spending. We're going to save a lot of money with prevention. We're going to be able to close prisons, and prevent healthcare costs. I know an HIA is going to give us the facts to do that. An HIA will also guide us in terms of how to ask the better question.
NPH: Do you see see a potential for HIAs to lower health costs in Ohio?
Cimperman: Definitely. It’s just such a different way of looking at things. It’s almost like a different culture. Examples include the effort I described to foster urban agriculture, which offers the potential for both better health and income. Another is assessing the impact of reducing toxic environments, such as mitigating the lead in abandoned houses in Cleveland and figuring out how to move people into them, once safe, who are in need of housing, such as immigrants in need of low-cost housing.
NPH: What other ideas do you have for HIA in Cleveland?
Cimperman: I think we should do an HIA on how the police communicate with communities, so we can help find ways to reduce tension and improve wellbeing for the police force and residents.
An HIA is a Rosetta Stone. It’s a translator. When HIA is a part of all our lives, we’re asking what people think, we’re saying we care what they have to say and we’re making the effort to do it.
This commentary originally appeared on the RWJF New Public Health blog.