Health Impact Assessment: A New Way to Look at EH

Date posted: 
Monday, July 18, 2016 - 11:45
Blog poster: 
Sandra Whitehead, PhD
Email of Blog Poster: 

If you work in a local health department (LHD), it probably comes as no surprise that shrinking budgets have forced cuts to many environmental health programs.

Shrinking budgets, compounded by the limited understanding about the value of the environmental health field and the roles of its practitioners are driving this trend. In fact, recent studies  have estimated that approximately 22 percent of state and local environmental health positions were removed since 2008. When faced with difficult funding choices, it is easier for LHDs, to cut a program that is seen as regulatory, like environmental health, rather than direct services like immunizations or diabetes management.  Until the environmental health community clearly articulates its mission, return on investment, and the value of their work, this trend will continue.

The first step is reframing the discussion about the role of environmental health professionals and their significance. It starts with expanding the definition of environmental health to include new tasks and frameworks, in other words, creating Environmental Health 2.0. This is a concept put forth by Dr. Dyjack to demonstrate how and why EH professionals need to partner with primary care. I argue that we need to extend our networks and our skills beyond just the health setting and find ways to address the social determinants of health through working with planners, parks and recreation professionals, economic developers and architects.

One powerful tool in particular that can move this process forward is the Health Impact Assessment (HIA).  HIA is   defined as a systematic process that uses an array of data sources and analytic methods and considers input from stakeholders to determine the potential effects of a proposed policy, plan, program, or project on the health of a population and the distribution of those effects within the population. HIA provides recommendations on monitoring and managing those effects. The knowledge, skills, and capabilities necessary to carry out an HIA can simultaneously grow the relevance and awareness of the environmental health profession. Not only does HIA foster cross-community collaboration, it also generates data-driven analysis, and the development of evidence based recommendations.

The recent Annual Educational Conference in San Antonio devoted an entire day’s worth of sessions highlighting HIA. A total of eight sessions featured diverse speakers representing federal, state and local agencies highlighting HIAs that examined the effects of a proposed light rail extension on community food access, challenges of starting a Built Environment Unit within a local health department, using data to inform an HIA on severe weather events, incorporating HIA into the brownfields redevelopment process, and more.

An important point to recognize in sharing these HIAs is that LHDs cannot, and should not solve community health issues in a vacuum. Instead, public health officials, particularly environmental health staff, should use HIA to inform decision-makers of the evidence-based value related to their efforts. As a result, the likelihood of funding and program cuts will decrease. In the wake of emergencies like Flint’s water contamination and the Zika Virus, environmental health capacity needs to grow, rather than disappear. Using HIA will support that growth.


Note: If you are interested in receiving copies of the PowerPoints presented at the AEC’s HIA Track, please go to: and apply the EH Impact Assessment filter by EHIA.






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Editor's Note: The opinions expressed here are those of the author. They do not reflect the policy, endorsement, or action of NEHA or the organization where the author is employed. NEHA does not verify the accuracy or science of the contents of the blog.  

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