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HIAs follow a structured process that brings together public health expertise, scientific data, and stakeholder input to 1 identify potential health effects of a proposed policy, project, or plan, and 2 offer recommendations based on any possible risks or benefits identified in the study.
HIAs have been used by legislators, public agency officials, academics, non-governmental organizations, and industry to objectively evaluate a project or policy before it is built or implemented so that policy changes, design modifications, or other measures can be taken to optimize the health effects and mitigate health risks.
Through this project, NCSL examined state legislation and state statutes identifying and addressing health impact assessments.
Most states did not seek to implement a comprehensive Health Impact Assessment program, but many aspects of HIAs have been adopted by state governments. NCSL, in consultation with the Health Impact Project, reviewed state statutes, policies and legislation as far back as to identify how state policy makers perceived the concept, how the concept was being addressed in state legislation and policy, and what results have occurred from the adoption of such legislation and policy.
NCSL conducted personal interviews with state legislators who sponsored HIAs, with state legislative staff providing legislative and fiscal analysis, and with state agency personnel responsible for implementing HIA policy, to gain insight into the variety of approaches and impressions of HIAs.
HIA provides recommendations on monitoring and managing those effects. State legislators are exploring how to incorporate HIAs into state laws and policies. The Massachusetts state legislature included HIAs in their transportation modernization act.
Legislatures have discussed using HIAs to determine the impact a hospital closure will have on a community, how expanding an airport will affect the surrounding neighborhoods and the impacts of pending legislation on health disparities in vulnerable populations.
Some states have explored combining health impacts with environmental impacts via their environmental laws or policies. What criteria to use when determining if an HIA should be done; How to determine the scope of health issues that will be included; Whether to create mandates or incentives for using HIAs; and How the studies will be funded.
When has an HIA been useful? For certain topics, an HIA will provide scant new information, or the health concerns may have been addressed in another study. Considerations that may be important in determining when an HIA would be helpful include: The decision has the potential to affect important health risks or benefits; These health effects would not otherwise be clearly identified and addressed by another study that is already planned or underway; and There are adequate resources and time to conduct the HIA within the timeline for the decision at hand.
Health Effects Studied An HIA determines the scope of health effects that will be considered through a systematic consideration of all potential health factors associated with the proposed action. Prioritizing the study to focus on health effects limits the analysis, which saves both time and resources.
Mandatory or Voluntary HIAs Legislators have proposed that HIAs either be mandated required for a specific project or situation or encouraged through incentives providing funding or technical assistance to communities for an HIA.
For certain projects, the HIA is incorporated into the project budget. In other instances, if a community requests an HIA, funding to support the effort comes from state agency sources dedicated to HIAs.
In at least one case, legislators have included a screening provision to allow the implementing agency to consider whether adequate staff and resources are available in reaching a decision regarding whether or not to conduct an HIA. However, this approach might result in decisions not to conduct an HIA even where the information would be valuable to policy makers.
The Future of HIAs Decision makers at all levels in the United States are using the fast-growing field of HIA to take health into account when making decisions in a broad range of sectors.
Given that health care consumes a substantial percentage of many state budgets, HIAs offer a data-based approach to addressing pressing health issues and leveraging investments in other areas of policy that impact health, such as transportation and urban planning, natural resource management, housing, and social policies.
HIAs provide a cost-efficient method to ascertain the health-related implications of proposed policy and planning decisions, and to make recommendations that ameliorate community concerns, mitigate potential problems, and stave off unintended consequences. It is rare for HIAs to put forward an overall judgment regarding whether a proposal is good or bad for health, or to make recommendations for or against a proposal.
Rather, the purpose of an HIA is to: HIAs are conducted within the timeframe of the decision-making processes at hand. Rather than requiring extensive new data collection, most HIAs primarily rely on existing data.
The complexity of HIAs and the time and resources required to carry them out vary considerably. Smaller-scale assessments — often described as rapid HIAs — can be accomplished in weeks.
More in-depth, comprehensive HIAs may take longer than one year. A spectrum from rapid to comprehensive studies To function as a practical tool, HIAs must be flexible.
When data are needed quickly—for example, to inform a legislative vote anticipated to take place in a matter of weeks—the HIA will, by necessity, be a less detailed assessment. In other cases that are not time sensitive, such as a multi-year planning process for a major new highway, a comprehensive assessment may be more appropriate for planners and decision-makers involved.
Various types of HIA analysis include: Rapid HIAs may involve no direct stakeholder engagement, or they may involve circumscribed efforts to engage stakeholders through, for example, a single community meeting, a limited number of focus groups, or participation on an advisory committee.
The analysis may be simpler—often involving a brief summary of available published literature, but without more complex modeling or analytic methods.Only 27 countries, representing less than 8% of the world’s population, have tobacco tax rates greater than 75% of the retail price. Tobacco tax revenues are on average times higher than spending on tobacco control, based on available data.
Updated May 13, The statutory chart below summarizes the state laws in three categories: open container or consumption of alcohol within motor vehicles, patrons removing partially consumed containers or bottles from restaurants and open containers or consumption of alcohol in public.
An average of , foreigners a day in arrive the United States. This group includes 3, who have received immigrant visas that allow them to settle and become naturalized citizens after five years, and 99, tourists and business and student visitors.
Alcohol and tobacco 1 are among the top causes of preventable deaths in the United States (1). Moreover, these substances often are used together: Studies have found that people who smoke are much more likely to drink, and people who drink are much more likely to smoke (2). Summary. This national report summarizes key findings from the National Survey on Drug Use and Health (NSDUH) for indicators of substance use and mental health among people aged 12 years old or older in the civilian, noninstitutionalized population of the United States.
Nov 30, · The Office of Public Affairs (OPA) is the single point of contact for all inquiries about the Central Intelligence Agency (CIA). We read every letter, fax, or e-mail we receive, and we will convey your comments to CIA officials outside OPA as appropriate.