Readings, Week Six

The focus of this week’s shorter (phew!) list of readings was the “science and art” of impact assessment.

The first article by Brian Cole was a very nice overview of HIA definitions, the key elements of HIA, and the history of different HIA approaches both internationally and within the United States. Cole notes that there are different ways of distinguishing HIAs, but offers his own categories based on the disciplines that they drawn on:

Quantitative analytic HIA (epidemiology, risk analysis, EBP and evaluation)

  • “In practice, the quantitative/analytic approach to HIA can be highly time- and cost-intensive. Time, money, and data limitations often restrict its application to a consideration of single, unmixed, noncumulative exposures, and only one or a few outcomes”

Community-based health promotion (participatory approach)

  • “Most HIAs have some provision for soliciting stakeholder input, but this is particularly emphasized in this approach to HIA, as it is the main input for analysis; facilitating this participation is the primary rationale for conducting a HIA”
  • Evidence may not have as much cache in some social contexts, not replicable, no common metrics, therefore, “This approach to HIA is probably better suited for analyses of local projects, not broad policies and programs that affect larger geopolitical units”

Environmental impact analysis (procedural approach & EBP and evaluation)

  • “The primary strength of the procedural approach to HIA is that the assessment can be performed in a relatively transparent, reproducible manner with methods that are broadly disseminated and understood. In theory, it can be relatively quick and efficient, but in practice agency rules and regulations specifying content and methods in great detail may greatly increase resource requirements for this type of assessment”
  • “There is also some question as to whether these procedural assessments are really used in the decision-making process, or whether they are just conducted to fulfill a bureaucratic requirement.”

I skimmed the next three articles. Mindell and Joffe examined the literature on the health impacts of fine particulate matter—the key takeaway here was that there is no threshold effect for particulate matter impact on morbidity and mortality, and that the long-term effects on health are probably more substantial than the acute effects. The World Bank’s guide for institutional, policy, and social analysis included frameworks and cases studies on analysis in the developing world. The final reading was an article by Oakes & his colleagues—a longitudinal analysis of equity in the siting of hazardous waste facilities. The researchers found that hazardous waste facilities were sited in white, working class neighborhoods, not in low-income, minority neighborhoods, and that there was no white flight after the facilities were built.

The HIA case study this week was an analysis of an Oregon proposal to reduce VMT (vehicle miles traveled) in Oregon’s six Metropolitan Planning Organizations. Human Impact Partners and UpStream Public Health collaborated on the HIA. They focused on analyzing the proposals in Governor Kulongoski’s plan on three indicators: air quality, physical activity, and car accident rates. In their literature review, they found that parking fees are more effective and equitable than driver-related taxes (e.g. congestion taxes) in reducing VMT, and that there is a threshold effect in fuel taxes—the proposed tax was not high enough to have an effect on VMT.

I added this to my mental list of favorite HIAs because the scoping and analysis seemed much more robust than previous HIAs in the reading list. The UCLA menu-labeling HIA, for example, made multiple leaps in logic, and I felt uncomfortable with the results. (I learned at the conference that Arnie changed his mind about menu-labeling legislation when he read the HIA so perhaps I’m being too skeptical!).  I wonder if I feel more comfortable with the Oregon HIA because much of the HIA was based on a literature review, which is a familiar process to me and in the public health research context is an accepted way of assessing the evidence. Both HIAs were equally transparent about their methods and pathways, but in this instance, I felt more comfortable with the science than the art!

2 thoughts on “Readings, Week Six

  1. Hanna, can you share with me the “leaps in logic” that bothered you? As an observer, I’m trying to understand the process of conducting an HIA so I’d be curious as to what logical leaps and assumptions are “beyond the pale” in your mind. Also, do you mean that the Oregon HIA was based on a review of established literature whereas the menu labeline one was based on authors’ own calculations rather than literature review? I would imagine a literature review of evidence that could inform the inputs would be standard phase in the process, so I am curious what the alternative modes of assessing evidence might be. Which type of HIA that Cole identifies in his typology appealed to you the most?

  2. The reaon I felt uncomfortable with the menu labeling HIA was that it strung together a series of assumptions to come up with a dollar amount saved by introducing menu-labeling in CA. (Something like number of restaurants in CA x number of meals eaten outside of the home x data on the impact of menu-labeling x forecasts of chronic disease rates over 20 years). It seemed that each of those estimates probably had a margin of error, and stringing them all together meant compounding that error. They accounted for this in their calculations but it still seems like the possibility of error was pretty high. Based on the SHIP experience– where promises of cost savings have now been used to argue against the program because those savings hasn’t been demonstrated , calculating cost projections and messaging them to policymakers can be a tricky business. I think in this case, menu-labeling was an inexpensive policy that was implemented by businesss without much public expense, so it probably won’t be an issue.

    Cole’s community-based participatory approach appealed to me professionally as something I would want to be involved in and lend my skills and experience to, but also something that would be very valuable in the right circumstances. So it was useful for me to recognize that project-based HIAs would be the types of HIA where the community and stakeholder engagement would be the most useful.

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