Legislative Health Notes: Preliminary Learnings From Piloting a New Policy Analysis Tool.

CONTEXT: In 2018, the Health Impact Project (the Project) developed and tested a new health in all policies (HiAP) tool called "legislative health notes" to provide state and local legislators with peer-reviewed evidence, public health data, and local data that illustrate potential positive and negative health and equity effects of proposed bills. OBJECTIVES: The Project sought to refine the health note methodology while piloting the tool in the Colorado and Indiana General Assemblies, and with the Council of the District of Columbia, and worked with affiliates to introduce them in North Carolina, Ohio, and California. DESIGN AND PARTICIPANTS: External partners solicited feedback on health notes via semistructured interviews and surveys from legislators, legislative staff, and expert reviewers who were familiar with health notes in each of these jurisdictions. RESULTS: Respondents shared that health notes were nonpartisan, were easy for nonexperts to understand, and would be more effective if delivered earlier in the legislative process. CONCLUSION: In response to informant feedback, practitioners can explore adding high-level summaries, increasing focus on health equity implications and the potential to work with legislators during the policy formulation phase. Data from this pilot suggest that legislative health notes are a promising nonpartisan and standardized tool to better understand the health and equity implications of proposed legislation.

Recent Advances in Health Impact Assessment and Health in All Policies Implementation: Lessons from an International Convening in Barcelona.

Health Impact Assessment (HIA) and Health in All Policies (HiAP) are policy tools used to include health considerations in decision-making processes across sectors such as transportation, education, and criminal justice that can play a role in improving health and equity. This article summarizes proceedings from an international convening of HIA and HiAP experts held in July 2019 in Barcelona, Spain. The presentations and panel discussions included different models, best practices, and lessons learned, including from government, international banks, think tanks, and academia. Participants discussed ideas from around the world for cross-sector collaboration to advance health. The convening covered the following topics: community engagement, building greater understanding of and support for HiAP, and exploring how mandates for HIA and HiAP approaches may advance health and equity.

Considering health and health disparities during state policy formulation: examining Washington state Health Impact Reviews.

BACKGROUND: As part of efforts to expand Health in All Policies (HiAP) in Washington State in the U.S., the Washington State Board of Health (BOH) received statutory authority in 2006 to conduct Health Impact Reviews (HIRs). HIRs analyze the potential impacts of proposed legislation and budget decisions on health and health disparities. Public health professionals who are aware of HIRs are interested in adopting a similar process in their states; however, there is limited information about HIRs, how they are perceived, and how they could advance HiAP. METHODS: This research involved a descriptive analysis of a sample of HIRs and semi-structured interviews with a purposive sample of 17 key informants. For the descriptive analysis, all HIRs requested or completed between January 1, 2007 and April 1, 2016 that had a request form submitted by a legislator or the governor that was available in the BOH's online database were reviewed. Information was collected on several variables including the bill number and title, sponsor and political affiliation, and the sector to which the bill or budgetary proposal pertained. A purposeful sample of legislators, staff, advocates, and lobbyists who were involved with HIRs during the study period were invited to participate in semi-structured interviews. Topic coding was used to identify key themes from the qualitative data. RESULTS: During the study period, 20 legislators requested 36 HIRs; 32 HIRs were completed. HIRs were requested for several bill topics, including education (11/36) and labor and employment (9/36). Legislators who requested HIRs felt they provided valuable data on health and health disparities for proposed bills. Individuals who were less supportive of HIRs perceived them as an advocacy or political tool. The main barrier to widespread use of HIRs in Washington was a lack of awareness among legislators. CONCLUSIONS: HIRs are one strategy to advance HiAP for state policy decisions. HIRs are a potentially effective tool for highlighting how legislative proposals and budgets positively and negatively impact health and health disparities. Future efforts should promote awareness and highlight shared benefits of HIRs among legislators and their staff, as well as their scientific integrity, methodological rigor, and objectivity.

Correction to: Avenues of Influence: the Relationship between Health Impact Assessment and Determinants of Health and Health Equity.

Please note that the correct name of the penultimate author of this article is "Arielle McInnis-Simoncelli", not "Arielle Mc-Innis Simoncelli" as presented in the article as originally published. The original article has been corrected.

Avenues of Influence: the Relationship between Health Impact Assessment and Determinants of Health and Health Equity.

This study aims to identify perceived impacts of Health Impact Assessment (HIA) on decision-making, determinants of health, and determinants of health equity and outline the mechanisms through which these impacts can occur. The research team conducted a mixed-methods study of HIAs in the USA. First, investigators collected data regarding perceived HIA impacts through an online questionnaire, which was completed by 149 stakeholders representing 126 unique HIAs. To explore in greater depth the themes that arose from the online survey, investigators conducted semi-structured interviews with 46 stakeholders involved with 27 HIAs related to the built environment. This preliminary study suggests that HIAs can strengthen relationships and build trust between community and government institutions. In addition, this study suggests that HIA recommendations can inform policy and decision-making systems that determine the distribution of health-promoting resources and health risks. HIA outcomes may in turn lead to more equitable access to health resources and reduce exposure to environmental harms among at-risk populations. Future research should further explore associations between HIAs and changes in determinants of health and health equity by corroborating findings with other data sources and documenting potential impacts and outcomes of HIAs in other sectors.

A simplified framework for incorporating health into community development initiatives.

Community development seeks to address the consequences of poverty through initiatives that improve housing, economic opportunity, service availability, and community capacity. There is growing recognition that the fields of community development and public health have much in common with regard to target populations, objectives, and challenges. Individual and neighborhood-level poverty are well-documented risk factors for illness and premature death. But relatively few developers systematically analyze how their projects could affect the health of the target community. Tools and metrics that facilitate incorporating health into planning, financing, and implementing new community development projects and programs will foster more widespread and productive collaboration between these two fields. We propose a simple framework to facilitate the identification and measurement of potential health effects, actions to optimize anticipated positive impacts, and strategies to mitigate potential negative impacts. The framework is drawn from an analysis of health impact assessments and includes four elements: identifying the health status of the population served, considering neighborhood-level influences on health, building design features important to health, and incorporating community engagement and capacity-building activities into the initiative.

Housing interventions at the neighborhood level and health: a review of the evidence.

A panel of subject matter experts systematically reviewed evidence linking neighborhood-level housing interventions, such as housing programs or policies, to health outcomes. One of the 10 interventions reviewed--the Housing Choice Voucher Program--had sufficient evidence for implementation or expansion. The evidence showed that voucher holders are less likely to suffer from overcrowding, malnutrition due to food insecurity, and concentrated neighborhood poverty than non-voucher holders. Of the other reviewed interventions, 2 needed more field evaluation and 7 needed more formative research. None were determined to be ineffective. Although many of the reviewed interventions lacked sufficient evidence for widespread implementation solely based on their health benefits, this evidence review shows that many interventions positively affect other areas of social, economic, and environmental well-being. Efforts to improve neighborhood environments and to maintain and increase the number of affordable housing units are critical to ensuring safe, healthy, and affordable housing for all people in the United States. Given that people of color disproportionately reside in high-poverty neighborhoods, neighborhood-level interventions may be particularly important in efforts to eliminate health disparities.