Equity is a core value of Health Impact Assessment (HIA). Many HIA practitioners engage in this work to address systemic, avoidable, unjust, and unfair differences between population groups in factors important to health. There are many compelling moral, economic, and health arguments for prioritizing and incorporating equity into HIA practice. To support the consideration of equity in HIA practice, the SOPHIA Equity Working Group reviewed and updated the original Equity Metrics for Health Impact Assessment resource. We have organized the framework into four equity-related components: Ensuring the HIA process and products focus on equity. Ensuring the HIA process builds the capacity of communities facing health inequities to engage in future HIAs and in decision-making more generally. Using the HIA process to shift power to the benefit of communities facing inequities. Using the HIA to reduced health inequities and inequities in the social and environmental determinants of health. The following tools can help you plan and evaluate an HIA with these four components in mind from beginning to end. This resource was developed with funding from the Health Impact Project—a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts.
We at Human Impact Partners have been working on a Health Impact Assessment to evaluate the health and equity impacts of youth being charged as adults through direct file. This policy—which allows prosecutors to charge someone as young as 14 as an adult without a judge’s review—is up for reform in Proposition 57 of the California ballot this November. To help inform California voters about this issue, we are excited to release a research brief that highlights our findings on direct file—mainly that it is a biased and harmful policy, especially for youth of color and their families. In collaboration with our partners, we’ve also produced an infographic (see below) on 5 Reasons to End Direct File. We’re also collaborating to produce three short videos highlighting personal experiences with this policy. Thank you to our partners in this work: The California Alliance for Youth and Community Justice, Communities United for Restorative Youth Justice, Fathers & Families of San Joaquin, Human Rights Watch, Impact Justice, the National Center for Youth Law, the National Council on Crime and Delinquency, Silicon Valley De-Bug, Urban Peace Movement, United Roots, and Youth Justice Coalition. Stay tuned for the final HIA report to be released in January 2017!
HIP and our partners with the AMOS Project are excited to release The Health and Equity Impacts of Expanded Access to Preschool: Cincinnati’s Fork in the Road. The report set out to answer the question: How will expanding access to preschool affect the health and well-being of children, families, and other residents of Cincinnati? Currently nearly half of Cincinnati’s children are starting from a disadvantage on their first day of kindergarten. But our study shows that children who have access to preschool could experience fewer challenges in school, leading to higher graduation rates and decreased crime rates; families could experience decreased parenting stress, child abuse, and neglect; and Cincinnati could benefit from more workers who are able to find employment at higher wages. Our conclusion is that expanding access to preschool would improve the health of Cincinnati’s children and families, making Cincinnati a healthier, wealthier and more equitable city. See here for the Executive Summary, Infographic, Full Report, and Appendices.
Public Health Departments in California and Criminal Justice System Reform: Successes, Barriers, and Recommendations for Action
Incarceration and involvement with the criminal justice system are intricately tied to physical and mental health outcomes, and social determinants like access to jobs and housing. Criminalization of health issues such as mental illness, substance use disorder, and homelessness has led to deep health inequities. While creating the conditions for better health is the mission of public health, it is an open question what role public health departments could and should play in reforming the criminal justice system in ways that improve health and decrease inequities. To better understand this, Human Impact Partners had discussions with health departments across California. We heard about successes health departments have had in making change and barriers that they have in getting involved in criminal justice system change. We then developed a set of recommendations for how health departments can get further involved in criminal justice policy reform. While this report focuses on California, it is relevant for public health agencies across the country. See the report here.
Human Impact Partners, The Center for Popular Democracy, and Working Washington are excited to release Scheduling Away Our Health: How Unpredictable Work Hours Affect Health and Well-being, a research report analyzing how unpredictable work schedules affect the physical and mental health of workers and their families. For many low-wage workers, every week looks different from the next. Receiving a work schedule with little advance notice, fluctuating shift times and working an inconsistent number of hours from week-to-week is the rule rather than the exception. These precarious work hours lead to income instability and make it difficult or impossible to arrange childcare, schooling, or a second job, or for a worker to manage his or her own serious medical condition. As momentum builds for fair workweek policies, the human costs are important to understand as policymakers weigh solutions. Our findings indicate that unpredictable work schedules directly and indirectly contribute to a host of health and well-being impacts, including stress, depression, anxiety, disrupted sleep, food insecurity, and numerous physical health problems, including high blood pressure. See here for the Executive Summary and Full Report.
HIP and Ella Baker Center for Human Rights are excited to release The Long Road Home: Decreasing Barriers to Public Housing for People with Criminal Records. Using the Oakland Housing Authority (OHA) as a case study, the report examines how policies that exclude people with criminal records from public housing affects health and equity in communities. It finds that current practices, in particular how OHA considers the presentation of “mitigating circumstances” for people with a criminal history during the application process can have long-lasting, damaging impacts. Report findings include: Historical policies have created racial disparities in housing and health outcomes. Access to stable housing serves as a foundation for families to improve their health, employment and education opportunities, family reunification, and social networks. Allowing applicants to present mitigating circumstances in their initial public housing applications would likely result in fewer denials because of a criminal history. The report also offers recommendations to create more inclusive housing policies that would decrease racial disparities, improve health outcomes, and reunite families: Allow public housing applicants with criminal records to present mitigating circumstances at the beginning of the application process. Eliminate the practice of evicting public housing residents for having family members with criminal… Read More >>
Human Impact Partners collaborated with a panel of public health experts to conduct an independent study – An Assessment of the Health and Safety Implications of Coal Transport through Oakland – of the health and safety risk of transporting up to 10 million tons of coal per year through the proposed bulk export terminal at the former Oakland Army Base. The study found that coal trains significantly increase concentrations of fine particulate matter (PM2.5) in communities along rail lines due to emissions of both coal dust and diesel exhaust. PM2.5, even at levels already found in Oakland, is definitively associated with premature death and many severe medical problems including increases in lung cancer, hospitalization for heart and lung disease, emergency room visits, asthma attacks, adverse birth outcomes, school and work loss and respiratory symptoms. The study looked at other potential health impacts of the proposed project, including through explosions, climate change, and noise. It also reviewed the potential mitigations that have been proposed, including covering the rail cars carrying the coal and storing the coal indoors at the Army Base, and found that these mitigations are unproven and largely experimental. Click here for the press release.
Public health professionals nationwide have joined the call for a complete overhaul of the nation’s broken immigration system, arguing that the fear and anxiety it inflicts does irreparable harm to child growth and development, emotional stability, self-confidence, social skills and ability to learn. A robust body of research shows that this damage can last far into adult life. “Those of us working on the front lines in hospitals, clinics and community service organizations see every day the suffering caused by our broken immigration system,” said Lili Farhang, co-director of Human Impact Partners, a nonprofit that studies the health and equity impacts of public policy. HIP’s study, Family Unity, Family Health: How Family-Focused Immigration Reform Will Mean Better Health for Children and Families, documents the adverse health consequences of family instability, economic strain and toxic stress. The study found that without reforms that create a clear path to citizenship, each year hundreds of thousands of children of undocumented immigrants suffer poorer physical and mental health, lower educational achievement and increased poverty and hunger. “I see firsthand the toxic toll on children who are anxious and fearful that their parents could be taken away from them,” said Dr. Babak Ettekal, Site Medical… Read More >>
HIP and ISAIAH are excited to release Drowning in Debt: A Health Impact Assessment of How Payday Loan Reforms Improve the Health of Minnesota’s Most Vulnerable. The report looks at the compelling evidence of the harm caused by payday loans to the health and mental health of borrowers, their families, and their communities. It shows that reforms to payday lending – including elimination of the practice in the state – will help slow the wealth drain on individuals and the community, thereby reducing stress and preventing further harm to health and well-being. In 2014, Minnesota has 72 licensed storefronts, and along with Internet lenders, made more than 385,000 loans to about 50,000 borrowers. The cost of these loans is staggering: Totaling almost $150 million, the average loan amount was $390, with borrowers averaging 10 loan transactions a year. The average APR was 252%. The report describes the overall context for payday lending – including a changing economic climate and increased financial insecurity – and highlights how payday loans: Trap Minnesotans in a cycle of debt and increase inequities in income, wealth, and health Target and drain wealth from Minnesota’s most vulnerable communities Worsen financial insecurity and negatively affect employment Contribute… Read More >>
We are excited to share the release of Communicating about Equity in HIA: A Guide for Practitioners, which is authored by SOPHIA’s Equity Working Group. HIAs provide an opportunity to advance equity, but practitioners often struggle with how to effectively and strategically communicate about this core value of HIA. An effective approach to communication, including crafting a purposeful plan for the content and presentation of the HIA report and other materials, is fundamental to ensuring that HIAs can impact policies and support change. This guide intends to aid HIA practitioners in their efforts to communicate about equity as an essential step towards advancing equity through practice.