HIA Policy Reports

To date our project team has conducted in-depth health impact assessments of three government policies. As additional HIAs are completed reports and summaries will be posted on this website.

Los Angeles City Living Wage Ordinance
Since the mid 1990s over one hundred jurisdictions in the U.S. have passed "Living Wage" ordinances, including Baltimore, Boston, Detroit, Minneapolis, New York City, San Francisco and Los Angeles. While the provisions of these ordinances vary, they generally establish a minimum wage that must be paid to a specified group of workers. They often also require employers to provide either health insurance or additional monetary compensation in lieu of wages. We constructed a model to estimate potential reductions in mortality among the estimated 10,000 workers covered by the Los Angeles City Living Wage Ordinance.
summary | framework | interactive calculator | other websites
Full report available upon request. See contact page.


After-school Programs: California Ballot Proposition 49
Support for after-school programs has been rapidly growing across the U.S. because of their potential to improve education, reduce crime and benefit health. A major initiative in support of after-school programs has been California's Ballot Proposition 49, approved in November 2002, which will increase state funding for after-school programs from $117.5 million per year to $550 million per year. Extrapolating from the results of published evaluations of after-school programs, we examined the potential health impacts of this proposition in six areas affecting health: socio-economic changes linked to education, crime, substance abuse, physical activity, mental health and sexual activity.
comprehensive report | summary | framework | other websites
Full report available upon request. See contact page.


2002 Federal Farm Bill
Signed into law in May 2002, the Farm Security and Rural Investment Act of 2002 (the 2002 Farm Bill) includes a vast array of provisions from funding for crop subsidies to support for ethanol production to the definition of the term "catfish." It increases funding for these programs by $82.8 billion over the next ten years to $458.7 billion. Provisions in this vast piece of legislation will likely have a range of positive and negative impacts. We reviewed the evidence on the potential impacts for each of the ten major titles of the bill, with special attention given to impacts related to agricultural subsidies and support for adding ethanol to gasoline for use in automobiles.
summary | framework (agricultural subsidies) | framework (biofuels) | other websites
Full report available upon request. See contact page.


Sacramento Safe Routes to School
(currently being conducted in collaboration with U.S. Centers for Disease Control, Project MOVE)

With the goal of improving the health and safety of students by reducing traffic around school facilities and encouraging greater physical activity among students, Safe Routes to School programs have generated substantial interest as a mechanism to foster an active lifestyle among youth. The Sacramento Safe Routes to School Program, operating in the Natomas Unified School District, has established an on-going walk/bike to school program at two elementary schools and is beginning in one middle school. Based on a review of the relevant research literature we identified two major pathways through which the program could affect health, physical activity and pedestrian safety, and two minor pathways, violence/crime and exposure to air pollution. The health impacts stemming from each of these pathways will be analyzed based on existing research data. Most of the analysis will be descriptive and qualitative, but we will also create a simple predictive model to estimate changes in physical activity levels and body mass index.
summary | framework | other websites


NE Plaza/Buford Highway Redevelopment – Atlanta
(currently being conducted in collaboration with U.S. Centers for Disease Control, Project MOVE)

Buford Highway is a seven-lane arterial highway that connects downtown Atlanta to the suburbs. It is considered one of the most deadly highways in the country. The proposed changes to Buford Highway and the NE Plaza include: reducing the number of lanes; adding sidewalks, crosswalks, medians, bike lanes, and on-street parking; increasing the density, land-use and connectivity around the area immediately surrounding the highway and NE Plaza. The structural changes to Buford Highway and the NE Plaza are likely to improve pedestrian safety and increase walkability; thus, the prevention of fatal and non-fatal injuries and increased physical activity are the two major health outcomes of interest for the quantitative analysis.

           

summary | framework | other websites


Rapid HIA of proposed legislation to provide partial immunity from injury liability for entities providing access to facilities for recreational physical activity
(currently being prepared for the California Department of Health Services, Physical Activity Policy Action Team of the Nutrition Network)

This Rapid HIA attempts to identify policy options that will encourage physical activity in California by expanding access to existing recreational facilities in schools and businesses. More specifically this HIA examines the potential health effects of a proposed legislative initiative aimed at providing public and private organizations with protection against liability associated with the provision of facilities and services promoting physical activity. The proposed initiative will remove liability from small and medium-sized employers (50-200 employees) who make available gym equipment and space necessary for fitness activities in the work place and who encourage employees to utilize fitness and health programs. In addition the policy will extend to schools and churches that choose to open their exercise facilities and grounds to the public. The purpose of conducting this HIA is to investigate whether, and to what extent, removing this barrier will lead employers, school districts, and community centers to offer their grounds as affordable and convenient places where employees and community members can exercise thereby increasing physical activities levels in the general population.
summary | framework | other websites


Health Impact Assessment (HIA) of Potential Modifications to Physical Education Requirements in California

"As part of the California Endowment's Healthy Eating Active Communities (HEAC) Initiative, a comprehensive health impact assessment (HIA) was conducted using a quantitative model to compare policy options for by increasing the quality and quantity of physical education (P.E.) provided by their schools at every grade level. Targeting the percent time spent in moderate-to-vigorous physical activity (MVPA) during P.E. has the greatest potential for increasing health-inducing physical activity levels among secondary school students..."
summary | full report

Health Impact of the Los Angeles City Living Wage Ordinance
Cole BL, Shimkhada R, Morgenstern H, Kominski G, Fielding JE, Wu S.  2005.  The projected health impact of the Los Angeles City Living Wage Ordinance.  Journal of Epidemiology and Community Health.  59:645-650.
abstract

Growing Field of HIA
Dannenberg AL, Bhatia R, Cole BL, Dora C, Fielding JE, Kraft K, McClymont-Peace D, Mindell J, Onyekere C, Roberts JA, Ross CL, Rutt CD, Scott-Samuel A, Tilson HH. 2006.  Growing the field of health impact assessment in the United States: an agenda for research and practice. American Journal of Public Health. 2006 Feb;96(2):262-70.
abstract

Common Principles, Methodologies, and Approaches of HIA
Cole BL, Fielding JE.  2007.  Health impact assessment: A tool to help policy makers understand health beyond health care.  Annual Review of Public Health.  28:393-412.
abstract

Use of HIA in the United States
Dannenberg AL, Bhatia R, Cole BL, Heaton SK, Feldman JD, Rutt CD.  2008 (in press).  American Journal of Preventive Medicine. Use of Health Impact Assessment in the United States: 27 Case Studies, 1999-2007.
abstract