Tag Archives: Democracy

We Thought it was Good, but not THIS Good: Community Participation in HIA

When we started this evaluation of how the field of HIA is doing at encouraging community participation in HIA, we have to admit, we had low expectations. But the results are in, and they are much more encouraging then we thought they might be.

At HIP, we have focused on community participation as a key way to reach international HIA goals of democracy and equity. We strive in our work to authentically and intentionally encourage community members who are impacted by public decisions to be involved in the HIA process. But, to be honest, we didn’t know for sure if community participation would lead to greater democracy and equity, or how strong the connection would be. So we set out to study it.

How do you measure how much a community participated in an HIA? How do you measure how that participation impacted democracy and equity? We started by diving into the literature and looking for resources to help us figure that out. First, we found the International Association of Public Participation’s Spectrum of Participation, and we adapted it to be more specific to HIA.

Table 1_ spectrum comm parti

Then, we had long discussions about what the ultimate outcome of democracy might be, on an individual and collective level, and we decided it was captured best by the concept of civic agency. We defined civic agency as: a community’s ability to organize and undertake collective action in its own self-interest. We measured civic agency by creating survey questions that lined up with the ways civic agency was discussed in the literature. We asked questions about community members taking action, increasing contact with decision makers, strengthening skills to influence future decisions, and if community voices about the HIA topic were heard.

Once we had our questions ready, we sent out our survey to HIA team members and to the community members that participated in their HIAs. We got nearly 100 respondents (63 HIA team members and 30 community members), representing 47 HIAs across the US. We followed this up with an in-depth study of four HIAs that we followed from beginning to end, to better understand the context of our findings and see if there was anything we missed.

Turns out, the field is doing a better job at incorporating community participation in HIAs than we thought. Most respondents reported that the level of community participation in their HIA fell in the middle of the spectrum, at the “involve” level. Perhaps even more encouraging, community members ranked their HIAs as higher in community participation than HIA practitioners did.

Figure 1. Level of Community Participation as reported by HIA team members (N = 59) and community members (N = 28).

Figure 1

Another finding that was stronger than we expected – no one feels like the community participation has a negative impact on the success of their HIA. In fact, a whopping 84% said they thought it had a positive impact.

Figure 2. Impact of Community Participation on the Success of the HIA

Figure 2

In fact, further analysis showed that HIAs that had higher levels of community participation had better odds of successfully impacting the HIA decision point (this is how we defined success). In other words – it’s not just having the community participate that improves the success of an HIA, it’s having the community participate at high levels of participation.

Finally, HIAs are doing a good job at supporting democracy through civic agency. With responses ranging from 63% to 85%, the majority of respondents reported that each measure of civic agency was achieved through the community participation in their HIA. This is great news. While we always suspected this would be the case – it makes intuitive sense that involving people more in the decision-making process that impacts their lives increases democracy – it is very encouraging to see this documented.

Figure 3. Civic agency outcomes (N = 88)

Figure 3

So overall, this study was able to contribute to the field of HIA by helping to define levels of community participation and impact on democracy through civic agency. We were able to show that the field of HIA is already doing a decent job of community participation in HIA, and community participation is contributing to civic agency and to the success of HIAs. Higher levels of participation led to even more successful HIAs.

But there’s still room for improvement. Less than one-third of the respondents indicated that community participation in their HIA was at one of the top two levels on the spectrum – where the most benefit comes. The findings from this study give us even more reason to keep striving for these higher levels of participation. We thought this was true, and now we know it is. Good news, indeed.

Check out our full report for more information on recommendations to enhance community participation in HIAs.

What is a ‘sustainable’ neighborhood?

This week’s guest blogger is former HIP intern, Dan Huynh. 

If you asked me what comes to mind when I think of a sustainable community, I’d say it’s a place that offers green alternatives to lessen our impact on the environment – things like transit-oriented development, urban density or solar panels. Through innovative design and technology, they would reduce system inefficiencies and make neighborhoods sustainable.

However, this is an incomplete picture of sustainability. After reading Making EcoDistricts, a white paper published by EcoDistricts (formerly the Portland Sustainability Institute), I realized this view makes strong assumptions: that identical choices are available to everyone and that everyone gains the same level of benefits from selecting them. Not everyone in a neighborhood can access or benefit from the same choices. For example:

  • While transit-oriented development aims to maximize public transit access, it can also drive up property values and rents, pricing out or displacing low-income families.
  • Limiting housing developments can lower the community’s impact on the environment, but it can also increase housing demand, which makes housing more expensive, again furthering gentrification.
  •  Solar panels may help a city reach its sustainability goal, but installing them costs too much up front for many low-income households.

If our goal is to make sustainable neighborhoods, we need to ensure that choices are beneficial and available to all. EcoDistricts raises important questions about access to sustainable choice: How do we ensure a people-first perspective in the growth of neighborhoods? How do we create neighborhoods that are equitable, sustainable and healthy?

These are also questions HIP seeks to address in our Health Impact Assessments that focus on land use policy. Our HIAs on the Jack London Gateway and Pittsburg Railroad Avenue show how achieving equity, sustainability and health is possible when all stakeholders recognize the importance of these three values and cooperate to realize them.

A residential and retail complex for low-income seniors, the Jack London Gateway project was located just 1,000 feet from the Port of Oakland and Interstate 980 in Oakland, Calif. It was important to the residents’ health that air pollution and noise be controlled. HIP’s rapid HIA recommended ways to mitigate these impacts, and residents used it to persuade the developer to make changes including a central air ventilation system with high-efficiency filters, a noise-buffered courtyard, less-toxic paints, solar panels and low-flow toilets. As a result the building received the highest Greenpoint rating from Build It Green.

The Pittsburg Railroad Avenue project was a proposal for a new rapid transit station, with transit-oriented residential and commercial development, in a community in transition from industrial town to commuter suburb. Partnering with two community groups, HIP’s analysis focused on affordable housing, air quality and quality of community life. The final plan for the project incorporated our recommendations on affordable housing, noise and air pollution reduction techniques were recognized and connections were improved between rapid transit trains and city buses.

In all these examples, equity is an important consideration when imagining truly sustainable communities. Community development that focuses on both sustainability and equity makes for places where everyone can live healthier lives.

Dan Huynh is a recent graduate of the UCLA Fielding School of Public Health with an MPH in Environmental Health Sciences. She served as an intern at HIP during the summer of 2014.

Practitioner or Renaissance Woman?

I’m in the final stretch of completing a Health Impact Assessment, and I’m struck by how many different skills are needed to do it right. Our model at Human Impact Partners – combining rigorous research, evidence-based analysis, community participation and a strong focus on equity – requires HIA practitioners to master an array of roles:

  • Project manager. Every successful project has a strong manager. A typical HIA must be coordinated with a variety of stakeholders, cover a range of topics, and be done on time (often more quickly than you’d ideally like). As project manager, you outline the tasks, who’s responsible for them, and how long each task should take to stay on time and budget. You coordinate with all team members and partners so everyone is clear about the plan. Throw in a changing timeline and super-busy community partners, and your management skills are really tested.
  • Technical expert. HIA is inherently multidisciplinary, so you’ll need to learn about the subject of your study. You may be unfamiliar with your target, available policy options, your partners’ positions, or the broader political context. You may need to explore a social determinant of health you’ve never researched before, such as critical race theory, cross-race understanding, or parental deportation. By the end, after doing a literature review, sourcing and analyzing the data, and communicating to partners about what you found, you’ll be an expert in something new.
  • Meeting facilitator/public speaker. These skills come into play as you uphold the values of democracy and equity. Stakeholder engagement is critically important; to do this, you’ll need to communicate about your HIA, get people engaged in the process, and facilitate input from stakeholders in a public forum. You’ll need input and agreement on your scope, the impacts you’re predicting and the recommendations you are making. It helps if you’re comfortable in front of a group and have creative ways to keep people engaged.
  • Diplomat. One of the most difficult tasks is prioritizing and limiting your research while still responding to stakeholder and partner concerns. For many HIAs, you can’t examine everything, and to attempt too much means compromising depth for breadth. It takes diplomacy to be strategic with the most compelling findings and recommendations while striking a balance between what your partner wants and what the budget allows.
  • Research designer and analyst. To recognize and analyze the pathways through which your proposal may impact health requires an understanding both of how individuals respond to changes in their environment and how on a larger scale those changes influence an entire population’s behaviors, outcomes and inequities. You start by conceiving the impact pathways. Then you must identify indicators and measures of behavioral, social, and environmental factors. After you and others on the team collect and analyze the data, you still must visualize how you’re going to present it.
  •  Communications expert. Communications are the icing on the cake. The final report is a record of all your efforts, presented for the affected populations, collaborators, decision-makers, journalists and the public to see. As editor of the report you must be strategic about what you include, exclude, and highlight and how you disseminate the results so your HIA has an impact.

You may not be an expert in each of these skills, but being an HIA coordinator does require familiarity and some level of proficiency in all of them. This incredible variety is one of the reasons I love my job. It is never routine, you’re always learning, and you bring people together through the very important shared value of health.

Public Housing, Public Health and the Public Interest

This blog post was originally published at The Pump Handle on February 18, 2014.

The quality of public housing is a key determinant of health among low-income populations. Substandard housing – where mold, pest infestations, fire hazards, or other health risks are present – is associated with a wide range of health problems, including respiratory infections, asthma, lead poisoning and mental health issues. Nor is illness the only concern: Each year millions of Americans are injured, and tens of thousands killed, by accidents in and around their homes that may be linked to housing conditions. Access to safe and affordable housing is not just an economic issue, but a major public health issue.

However, much of the public housing in the United States is in disrepair – unhealthy, unsafe, even uninhabitable. The federal Department of Housing and Urban Development (HUD) has been working for many years to fix the problem, but with the cost of bringing public housing up to standard estimated at more than $20 billion nationwide, it’s a daunting task. (It doesn’t help that HUD’s budget, especially the portion for maintenance and renovation, which was inadequate in the first place, has been repeatedly slashed for the last 30 years.)

In 2011, Congress passed the Rental Assistance Demonstration Project (RAD), a pilot program providing for the purchase and renovation of some 60,000 units of public housing by nonprofit organizations or private entities. A linchpin of the program is the requirement that for 15 to 20 years the new owners must continue to make the housing available to the same populations that currently live there.

Public housing has received increasing attention from the field of Health Impact Assessment, which evaluates multiple health impacts of proposed policies and projects. HIAs have been conducted on housing inspections in Ohio and in Marin County, Calif., and on the HOPE VI program in San Francisco. Currently the Health Impact Project is in the midst of an HIA done in collaboration with HUD about changing the rules for elderly and disabled public housing.  In 2011, Human Impact Partners released an HIA of the RAD proposal.

Recently San Francisco, where soaring rents are forcing increasing numbers of low- and medium-income renters out of the city, was awarded a grant from HUD to rehabilitate its public housing stock – enough to renovate three-fourths of all units. In order to qualify for renovation, the units must be sold to private or nonprofit owners who get tax credits. The units then become Section 8 voucher properties (where low-income tenants pay 30 percent of their rent and vouchers make up the difference to the landlord), and the owners sign a contract to keep them as such for 20 years.

Human Impact Partners’ HIA of the RAD project predicted that the program would lead to improved housing quality, decreased stress among residents and decreased crime around renovated housing. But the devil is in the details. We also predicted that RAD, if not done well, could lead to poor health due to potential evictions, displacement, lack of authentic resident inclusion in decision-making, and stress from not knowing whether one’s housing is secure over the long term.

Here’s what we believe San Francisco must do to avoid those potential negative impacts:

  • Ensure that clear standards are set for protecting residents from evictions, displacement and changes in affordability.
  • Require new management to have a long-term plan to preserve the housing stock.
  • Create funding for services, support and protections for those typically hard to house, such as the elderly, large families, people with disabilities, those who have been arrested or incarcerated, and those with poor credit histories.
  • Create an oversight committee of leaders of resident organizations in the housing sites, housing advocates and elected officials.
  • Develop metrics that truly measure determinants of health to understand how RAD affects health over time.

Affordable housing is not only vital for low-income populations, but to the community at large. We’ve seen what happened when the mental health system that helped those who could not live without support was dismantled. Homelessness and incarceration shot through the roof. We don’t want that to happen if public housing goes away. The bottom line: We just aren’t sure that the RAD program offers enough protection to ensure that private interests wouldn’t eventually win out over the public good.

Think about it: You’re a developer who can afford to buy hundreds of units of public housing, get tax breaks from the government for improving them.  All you have to do is agree that for 15 to 20 years you will keep them available for low-income populations.  After that, you must consider keeping them available, but you’re free to sell them at market rates. In markets such as San Francisco, where even modest units have no shortage of takers eager to rent or buy at prices unthinkable until recently, would you think about public health, or your own opportunity to profit?

Policymakers must consider ways to require or incentivize the continued availability of affordable units. Policymakers who want to consider health and quality of life for their most vulnerable residents must assure that safe, well-maintained housing continues to be available for low-income residents.