Healthy Cities: Assessing Health Impacts of Policies and Plans

Assignments

Reflection Pieces

Students may choose any three classes’ reading lists as the subjects for their reflection pieces. Reflections must be short (approximately 300 words) and may touch upon any aspects of the readings that students found surprising, important, lacking, or otherwise notable. Full credit will be given for all submissions that reflect meaningful engagement with the material.

Rapid HIA Pathway Presentation

With a group, develop and present a pathway diagram demonstrating the links between the proposed policy, program or project, and health. These diagrams illustrate the potential steps from the proposed decision to changes in social, economic and environmental conditions that lead to changes in health.

Learning Objectives

The goal of this assignment is to demonstrate your understanding of the possible impacts of the proposed decision on health. Drawing these diagrams will help you to consider all the exposures and outcomes, as well as prioritize those that matter most for the HIA. You will later use these pathways and data to assess these effects of the proposed decision, by providing baseline health information about health status in the area of interest, or by predicting the effects from the decision.

Expectations

These diagrams are often complex and dynamic and often involve numerous exposures and outcomes. The pathways can have multiple “steps” connecting the planned decision to health. For example, a proposed fare increase and service cut for a train system may affect transportation mode choice, which in turn may affect physical activity and air pollution levels, which are both associated with changes in cardiovascular health.

The potential links should be based on evidence from relevant literature, the stakeholder process, and professional and expert opinion. A good pathway diagram does not include all possible effects of the planned decision, but only those with evidence behind them and plausible health connections. The diagram should visually show the connections you have identified, and you should be able defend those pathways during your presentation.

The diagrams do not need to follow a specific structure; please view pathway diagram examples from Human Impact Partners(PDF).

Critique of published HIA (individual assignment 500–700 words)

Read through several published HIAs from the Pew Charitable Trust website, and choose one to critique.

Learning Objectives

The goal of this assignment is to help you familiarize yourself with the structure, content and challenges of HIA, and to deepen your understanding of how HIA is practiced. Note that there is considerable diversity in the products and practice of HIA, due to the variety of topics assesses, contexts in which decisions take place, and resources available and invested in the product. There is not a singular correct way to practice and publish, and no rigid criteria for HIA exist, but a number of available documents provide basic guidance and best practices. Many of these resources are listed in the Syllabus. Comparing your chosen HIA to the guidance documents will enhance your understanding of different approaches to conducting HIAs, and help you determine how to approach the final assignment for the course.

Expectations

Briefly describe the HIA decision topic, stakeholders involved, projected health impacts, and major recommendations. Use the remainder of the response to critique the strengths and weaknesses of the HIA. You can approach this in various manners, though some suggested questions to consider are listed below

• Was the screening process documented? Can you tell what factors went into the decision to perform the HIA and what stakeholders were involved?
• In the scoping, was there documentation and details on the overall HIA plan (i.e. research questions, rationale for selecting specific pathways, etc.)? Was the literature search transparent?
• How deep and meaningful was the assessment? Did they collect baseline data and are the data sources appropriate?
• Were the recommendations supported by the assessment? Did they seem logical and feasible?
• Is there transparent documentation of plans for reporting and communicating the results of the HIA?
• Is there a monitoring plan and or impact and outcome evaluation?

Rapid HIA

With a group, conduct a rapid HIA on a local project, proposal or policy in collaboration with a community partner. HIA topics will be provided, and students will decide which topic they would like to work on.

Learning Objective

You will produce a full rapid HIA for this assignment. Reflecting HIA practice, you will work with the other students in your group r to review research, collect and analyze secondary data, develop recommendations based on assessments of the data, and write a report of your findings. Through the process of conducting the HIA you should become comfortable identifying connections between public decisions and health outcomes, and searching, reviewing and synthesizing academic health literature. The goal of this assignment is to become proficient in identifying decisions appropriate for HIA, apply skills and concepts learned during class to produce a full report, and demonstrate understanding of HIA practice.

Expectations

Rapid HIAs are generally shorter and less resources and time intensive than typical HIAs, but deliver impactful evidence on the connections between a proposed project, policy, or program and potential changes in health outcomes.

The HIA should include the following six sections:

1. Screening – determine whether an HIA is appropriate and describe the process of this determination.
2. Scoping – defines priority issues, research questions and methods, and participant roles.
3. Assessment – characterize the baseline rates of health conditions and create a population profile, and evaluate potential health impacts.
4. Recommendations – developed to improve the project, plan, or policy and / or to mitigate any negative health impacts.
5. Reporting and Communication – create a plan to share the results with stakeholders and decision makers.
6. Monitoring and Evaluation – create a plan to track the impacts of the HIA on the decision, and impact of the decision on health.

For the assignment, students are expected to use publically available datasets, but can enhance quantitative assessments with qualitative data including interviews and focus groups with stakeholders and / or those affected by the proposed decision. Students should meaningfully engage with the community partner throughout the process of developing the HIA, and this should be collaboration should be reflected in the final product.