Although Health Impact Assessments are great tools for analyzing the health impacts of development and other urban planning initiatives, they can be long and resource-intensive. HIA is not always the best tool, especially when project proponents and public health practitioners participate early on or arrive very late in the planning process. So among planning departments there has been a lot of recent interest in healthy development checklists as alternative approaches to data collection and analysis to ensure health and equity are considered in decision-making.
A healthy development checklist includes a list of indicators of health and well-being tied to development, and a set of associated criteria meant to evaluate proposed policies, plans, and projects. Many jurisdictions have created indicator systems – measures that can be used to capture the status of social and environmental conditions – but not all of these have criteria against which specific development proposals can be evaluated. So a checklist is an indicator system, but not all indicator systems are checklists.
The San Francisco Department of Public Health has applied a healthy development checklist to planning activities such as public housing redevelopment, pedestrian and bicycle planning, and several specific area plans. Examples of outcomes of these checklist applications include greater community involvement in plan development, potential mitigations and design strategies, and policy and implementation recommendations to better account for health.
Before jumping in, jurisdictions considering developing a checklist should also consider the process, benefits, and challenges of creating an indicator system. HIP produced this resource for the San Diego Association of Governments. It provides a review of several jurisdictions’ experiences with indicator systems and offers some approaches that may prove useful for those considering developing a healthy development checklist.
There are, however, additional considerations that checklist developers and users need to be aware of. In theory, a checklist can be a useful collaboration tool for public health and planning practitioners to ensure health goals are included in development, but keep the following questions in mind:
- Who develops the checklist? Is the process collaborative? Which priorities are reflected in the checklist? The development of a checklist involves selecting domains of interest, ways of measuring these domains via indicators, determining the health and equity objectives that the indicators reflect, and criteria to gauge whether an indicator will meet stated objectives. Who is involved in the checklist decision-making process will influence the objectives and criteria expressed by the checklist – and ultimately, what value they have to the larger community.
- Which domains and indicators should be included? To be inclusive, a range of perspectives should be sought. But ultimately, the priorities should reflect human needs – an underlying set of values determined by collaborators. Resist the urge to include the easiest indicators, or all indicators you can think of, in the checklist. Some of the most important things to include relate to what people need to live and be productive members of society – a living wage, education, and freedom from injustice and violence.
- Will data be available for all the important indicators? There is a good chance that for at least some indicators, data will be hard to come by, which will affect your budget, process, and analysis or interpretation. A collaborative process can help to overcome this challenge because affected communities can be included in data collection and interpretation. Be creative and, wherever possible, make plans to accommodate additional data collection efforts for hard-to-reach but important indicators.
- What is the process for applying the checklist to proposals? Who will be included? Will the community have input into in the process of interpreting the data, deciding whether criteria and objectives are met, and what should be done if they are not? Make these decisions up front and include them in instructions that accompany the checklist – otherwise, its value as a tool will be limited.
Most importantly, uphold the values of HIA – equity, democracy, sustainable development, ethical use of evidence, and a comprehensive approach to health – in developing and applying a healthy development checklist. Using these values will help ensure that the checklist and its application advance not just the technical goal of considering health, but the ethical and just goal of creating healthy communities.