A Short Review of Community Health Impact Assessments
Community-led HIAs are not a new thing, they have history and precedence. Based on desktop research it has been clear to us that a higher proportion of community-led/-driven HIA work has taken place in North America.
Researcher Maureen Coady examined the Community-Driven form of Health Impact Assessment (CHIA) practised in rural Nova Scotia, Canada between 1997 and 2014 and noted:
“informal learning in these processes is often transformative; ordinary citizens learn to identify factors that influence their health, to think beyond the illness problems of individuals, and to consider how programs and policies can weaken or support community health. They learn that they can identify directions for future action that will safeguard the health of their community.”
One of the projects analysed was on the community-driven health impact assessment of the Keppoch-Beaver Mountain Project. A report from 2009 about this project titled Influencing Healthy Public Policy with Community Health Impact Assessment summarised their findings that it “has resulted in a new level of legitimacy for PATH [People Assessing Their Health Network] and HIA within the municipal government sector, school boards, and other community organizations.”
Other Examples
There are several examples of community-led health impact assessments (HIAs) where communities take an active role in assessing how proposed policies, projects, or developments might impact their health and well-being. These assessments often involve local residents, community organisations, and other stakeholders working together to identify potential health impacts and advocate for changes to protect or improve public health.
San Francisco, California: Eastern Neighborhoods HIA
Background: This HIA was conducted to assess the potential health impacts of a large-scale land-use and redevelopment plan in the Eastern Neighbourhoods of San Francisco. The area faced issues related to housing, transportation, and environmental justice.
Process: Community organisations, residents, and public health professionals collaborated to identify key health concerns, such as access to affordable housing, safe transportation, and pollution exposure. The HIA included workshops, surveys, and public meetings to gather input from local residents.
Outcome: The HIA influenced the planning process by highlighting the need for affordable housing, improved public transportation, and measures to reduce exposure to industrial pollution. The findings were used to advocate for policies that better aligned with the health needs of the community.
Wales, UK: Merthyr Tydfil Health Impact Assessment
Background: In Merthyr Tydfil, Wales, a community-led HIA was conducted in response to a proposed opencast coal mine development. The community was concerned about the potential health impacts of air pollution, noise, and other environmental factors associated with the mining project.
Process: Local residents, health professionals, and environmental organisations came together to conduct the HIA. The assessment included community surveys, health data analysis, and discussions with experts. The community played a central role in defining the scope of the assessment and identifying potential health impacts.
Outcome: The HIA provided evidence of the potential negative health impacts of the coal mine, which was used to challenge the development proposal. The community's efforts contributed to greater scrutiny of the project and raised awareness of the health risks associated with such developments.
Los Angeles, California: South Central Farm HIA
Background: The South Central Farm, a 14-acre urban farm in Los Angeles, was threatened with closure and redevelopment. The farm served as an important source of fresh food and a community gathering space in a low-income, predominantly Latino neighbourhood.
Process: Community members and activists conducted an HIA to assess the potential health impacts of losing the farm. The assessment involved community surveys, focus groups, and health data analysis to document the farm's role in promoting physical and mental health, food security, and community cohesion.
Outcome: The HIA findings highlighted the critical role of the farm in supporting community health and were used to advocate for its preservation. Although the farm was eventually closed, the HIA helped raise awareness of the importance of urban agriculture in promoting public health.
Dundee Central Waterfront Redevelopment HIA, Scotland
Context: The redevelopment of the Dundee Central Waterfront was a major urban regeneration project aimed at transforming the city’s waterfront area.
Process: The HIA was community-led, with local residents and community organisations playing a significant role in identifying potential health impacts and shaping the redevelopment plan. The assessment focused on issues such as accessibility, the quality of public spaces, and the potential for increased physical activity.
Outcome: The HIA helped influence the final design of the waterfront area, ensuring that it promoted physical and mental health by enhancing walkability, creating green spaces, and improving public transport options. The community's involvement ensured that the redevelopment met local needs and priorities.
Luton Airport Expansion HIA, Bedfordshire
Context: The expansion of Luton Airport in Bedfordshire prompted concerns about the potential health impacts on local communities, particularly related to noise pollution, air quality, and traffic congestion.
Process: Local residents, supported by community organisations and public health experts, conducted an HIA to assess the health implications of the airport's expansion. They used a combination of community surveys, health data analysis, and public consultations.
Outcome: The HIA findings were used to advocate for measures to mitigate the negative health impacts, such as improved noise insulation for homes, enhanced air quality monitoring, and better transportation planning. The process also helped to raise public awareness and put pressure on decision-makers to consider health impacts more seriously.
Conclusion
Community-led health impact assessments are powerful tools for empowering communities to shape decisions that affect their health and well-being. These examples demonstrate how by actively participating in the assessment process, communities have been able to highlight health risks, advocate for necessary changes, and influence policy and planning decisions in ways that promote healthier, more equitable environments.
Reading the Marie Michael Library of the Coady Institute at St. Francis Xavier University shows that community driven/led HIA shows that this is not something new. There is precedence for participatory research, impact, and change. Yet, for the most part in the United Kingdom this has not been an institutionalised approach. Perhaps that’s because it gets in the way of building more homes by any means necessary, and that rhetoric has gone well over the past 20 years, hasn’t it?