Table 2. Reported Impacts of Health Impact Assessments (HIAs) in Case Study Sample (N = 23), With Illustrative Quotes and Examples, Community Health and Evaluation HIA Evaluation Study, 2011–2014.
| Impact on Decision Making | No. of HIAs (N = 23) | Illustrative Quote or Example |
|---|---|---|
| Direct impacts | ||
| Decision maker reported HIA shaped their decision making | 11 | “Recommendations helped shape how we proceeded about land acquisition and project prioritization . . . and over the last couple years we kicked off a health initiative where we connect the built environment to the health of community and HIA recommendations have been huge in that.” — Local decision maker |
| Direct and concrete contributions from the recommendations to the decision-making process | 11 | A state decision maker indicated that the HIA shaped the direction of his decision to include urban forests in carbon emissions plans. |
| Incorporation of health objectives into plans, policies, and programs of nonhealth-related agencies | 14 | A federal decision maker reported that after the HIA he now raises the issue of health analysis with every plan he is involved in at his nonhealth-related agency. “I raise this every time I’m on the periphery of another plan. I ask, ‘Are you going to do a public health analysis? Is this an issue? If so, you should do an analysis.’” |
| Longer-term outcomes beyond initial decision targets | 8 | One federal agency is now incorporating public health considerations in environmental impact statements. |
| Other impacts | ||
| Institutionalized or strengthened existing relationships between individuals and organizations, or created new and enduring relationships between public health and other agencies such as transportation or planning departments | 17 | One HIA resulted in a shared staff position between county public health and planning departments. |
| Helped decision makers and stakeholders see how health is connected to seemingly unconnected issues | 16 | “It made policymakers like myself understand that you pay one way or another.” – Former state representative |
| Built consensus around controversial topics | 9 | “Before there was hatred, now there is tolerance.” — HIA practitioner |
| Amplified community member voices in the decision-making process | 9 | “Now when I go talk at a DOT or local transportation meeting, I can say, ‘According to the HIA . . .’ rather than just being an angry mom.” — Community stakeholder |
Abbreviations: DOT, Department of Transportation.