Thanks, Nicole. I'm confused by this:  "HIA augments the current planning process" and this: "HIA - particularly when it is outside the regulatory planning/environmental process."  There seems to be a contradiction.  Is HIA within or outside the planning process?  I also haven't observed this, "HIA may point out mitigation measures for factors, design features," but I'm hoping you have some examples of where HIAs have pointed out mitigation factors.  Mitigation, of course, is a concept that grows out of NEPA.  A civil rights violation cannot be mitigated, but the actions that caused the violation must be stopped, remedies crafted, and the adversely affected parties made whole. 

Here you make a good point: "EJ sometimes struggles when addressing spatially diffuse issues."  We call these environmental insults over time and place "cumulative impacts."  They are routinely ignored in NEPA analyses.  Are you saying that they are included in HIAs, and that such inclusion prevents the creation or perpetuation of "sacrifice zones," neighborhoods that repeatedly are adversely affected by big, stinky, and toxic projects?  If so, I'd be curious to hear some HIA success stories of this type.  The HIAs that I've read have been of the advisory or study type, with no compliance or enforcement power whatsoever.  In other words, no power to force change in a positive direction.  This is a major difference between HIAs and legal compliance work under Title VI and the Clean Air Act, for example.  Again, I hope you've got some counter-examples. 
Marc



From: "Nicole Iroz Elardo" <irozelardo@yahoo.com>
To: "marcomcast" <mbrenman001@comcast.net>, h+t--friends@chrispy.net
Sent: Wednesday, June 11, 2014 3:25:42 PM
Subject: Re: [H+T--Friends] HIA Webinar

Marc,

Sure.  (And yes, exploited was an ironic choice given the civil rights angle, but not particularly intentional word.) Although I will say it is unclear to me if you are asking how *I* personally know or how the field knows.  I'll assume it is the latter - that you are asking "what does HIA add to a planning process that is not already there and how do we know it helps vulnerable communities." 

HIA is far from perfect and not appropriate for every situation, but it has a valid claim that and HIA augments the current planning process to allow for more informed decisions.  Public health professionals generally view planning as inadequately addressing human health or health equity even though disparities in human health are well-documented as are both social and built-environment factors leading to those disparities.  HIA uses this population-based health evidence to identify intended and unintended health consequences of proposed plans/projects/policies.  It aims to maximize health overall and decrease health disparities for vulnerable communities - a decision-making frame that planners do not necessarily use as they are balancing all sorts of interests in addition to health.  But it is a useful frame, particularly in a social justice situation.  

Transportation planners believe that they protect human health through NEPA, but the reality is that NEPA has been institutionalized to identify exposure concentrations in the physical environment and rarely makes it all the way to human health or to addressing some of the more indirect health pathways.  I believe that the humanizing factor is a pretty big deal.  Additionally, HIA - particularly when it is outside the regulatory planning/environmental process - starts from a place of identifying ALL possible paths to human health.  All paths means even things outside of the defined alternatives - very similar to some traditional EJ work.  So an HIA may point out mitigation measures for factors, design features, or the lack thereof that planners have dismissed as impractical or too expensive, etc.  In some cases, it might suggest that planners need to go back to the alternatives definitions and rework.
 
One place where HIA may augment traditional EJ for advocating for justice is in its ability to provide a stakeholder/decision-making framework to deliberate about competing health concerns.  An example from my dissertation is the Lake Merritt BART Station Area plan.  When planning for zoning for transit-oriented development, what health consideration is the very-low-income Asian community most concerned about?  affordable housing? losing the park used for Tai Chi?  air pollution?  culturally specific food? culturally specific public space? all of it?  If the community has to choose, then what?  Where to put advocacy efforts?  HIA, by tracing those pathways organizes and provides communities an evidence-base by which to deliberate the various pathways and which has the most impact on health.  It can then guide/augment EJ efforts.

Finally, HIA has health equity as one of a handful of explicit values.  This is completely congruent with EJ values and efforts.  What is different, however, is the ability of public health professionals to articulate that value using professional/academic knowledge and increasingly modeled information.  I'd also argue that HIA, with its flexibility, may be more useful than a traditional EJ approach to health equity in the policy arena because EJ sometimes struggles when addressing spatially diffuse issues.

That said, HIA is a process and product that is centered around information.  HIA documents advocate for human health but will not advocate for a specific outcome/alternative.  That is left up to the actual community to use the HIA information to advocate in an inherently political planning process.   

In sum, a good HIA will augment EJ efforts by outlining where intentional and unintentional health effects and health disparities are likely to occur with a public decision.  This is a good thing and doesn't have to be an either/or.  HIA should tell you where the health problems are and identifies specific human health indicators that might be useful arguing for and monitoring the legal aspects of civil rights and EJ.  Again, a win for vulnerable communities. 

~Nicole

Nicole Iroz-Elardo, PhD
Portland State University
irozelardo@yahoo.com  

From: mbrenman001@comcast.net [mailto:mbrenman001@comcast.net] 
Sent: Wednesday, June 11, 2014 2:17 PM
To: TRB Health and Transportation; nicole.iroz-elardo@state.or.us
Subject: Re: [H+T--Friends] HIA Webinar
 
Thanks, Nicole, can you tell us more about this:  "HIA processes and products engage the notion of equity in ways that are currently not exploited in planning and EJ circles"?  How do you know what is "exploited" [an odd choice of words!] in planning and EJ circles? 
Marc Brenman
 

From: "Iroz-Elardo Nicole" <nicole.iroz-elardo@state.or.us>
To: "h+t--friends@chrispy.net" <h+t--friends@chrispy.net>
Sent: Wednesday, June 11, 2014 1:17:01 PM
Subject: Re: [H+T--Friends] HIA Webinar
 
Hi all.  I am the presenter of the HIA webinar being discussed.  It is hosted by IBPI which is associated with OTREC and Portland State University - my doctoral institution.  It is an offshoot of lessons learned from both my doctoral research and time as an HIA practitioner.  My doctoral research takes a broad look at transportation planning, so the webinar will not be bike/ped specific.  The webinar was initiated because OTREC provided some doctoral support for the research and this seemed like a good avenue to distribute practice-related findings.  This particular webinar will address the wide variation within and between disciplines about meaning, definitions, and methods associated with concepts such as health, equity, and engagement; this often result in conflicts between and within professions mid-HIA due to inappropriate expectations of HIA.
 
Regarding the statements about social and environmental justice... While my doctoral research does not address civil rights law directly, it is a critique of the extent to which HIA proclaims itself participatory and thus protective of community.  HIA assumes that there is value in stakeholder/collaborative engagement; it is an offshoot of what is currently termed "health in all policies" approach in public health which suggests any time you can bring public health evidence in for public consideration, decision-makers are more likely to make a more informed and thus healthier public decision.  But make no mistake, HIA is generally informed by a stakeholder process engaging in an even broader stakeholder process.  Because of that, all the caveats in the literature about power and stakeholder/collaborative processes apply; stakeholder processes are easily co-opted and are highly dependent on representation, timing, and good facilitation to address power structures.  HIA, while!
  committed in theory to good process, is still in its infancy in defining and bounding engagement.  And community driven HIAs are relatively rare in the U.S.  
 
My research shows that the social justice and community aspects of HIA practice are less a result of stakeholder/participation formats and more a function of explicit HIA values such as a commitment to health equity and broad determinants of health.  Through these values, public health professionals are able to identify and advocate for underserved or unorganized communities - particularly in spatially-based plans.  It is also important to realize that public health professionals engage in HIAs  because they do not see the current NEPA regulatory and federal/state legal structures do not go far enough to protect population health and health equity.  And HIA processes and products engage the notion of equity in ways that are currently not exploited in planning and EJ circles - a likely win for vulnerable communities.  So HIA may not explicitly address civil rights law (certainly true in most U.S. HIAs), but it engages in the notion of health disparities and thus health, socia!
 l, and environmental equity.  
 
The dissertation employs a case-study approach; two of the three cases are HIAs that are centered around non-English EJ populations in the U.S. and thus might be of particular interest to some commenters.  It is a reasonably interesting read for a dissertation and publically available through OTREC at http://otrec.us/project/715.
 
Fun to see this being discussed!  Hope to have some of you on the webinar on July 16th.http://otrec.us/events/entry/health_impact_assessment_hia_in_transportation_planning
 
~Nicole
 
Nicole Iroz-Elardo, PhD
Portland State University
irozelardo@yahoo.com

 
-----Original Message-----
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Sent: Wednesday, June 11, 2014 10:00 AM
To: h+t--friends@chrispy.net
Subject: H+T--Friends Digest, Vol 38, Issue 5
 
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Today's Topics:
 
   1. Re: H+T--Friends Digest, Vol 38, Issue 4 - HIA (Mindell, Jenny)
   2. Re: H+T--Friends Digest, Vol 38, Issue 4 - HIA
      (mbrenman001@comcast.net)
   3. David Ragland Profiled for Robert Wood Johnson Foundation
      Safe Routes to Schools work (Phyllis ORRICK)
 

----------------------------------------------------------------------
 
Message: 1
Date: Tue, 10 Jun 2014 08:58:44 +0000
From: "Mindell, Jenny" <j.mindell@ucl.ac.uk>
Subject: Re: [H+T--Friends] H+T--Friends Digest, Vol 38, Issue 4 - HIA
To: "h+t--friends@chrispy.net" <h+t--friends@chrispy.net>
Message-ID:
        <7354587cd221478c8333e68518d1a139@DB3PR01MB331.eurprd01.prod.exchangelabs.com>
        
Content-Type: text/plain; charset="utf-8"
 
We may like the concept of evidence-based decision-making but  being realistic, political (including planning) decisions are based on a whole range of things.
So most people now aim for 'evidence-informed decision-making', for which HIA is well-suited.
It would be daft to think that planners (or others in local, regional or national government) consider only health when making their decisions.
But the more that the decision-makers are involved with the HIA process, the more likely they are to engage with the recommendations produced.
And I am very surprised by the statement that public health professionals are unaware of social equity or civil rights.  Certainly not the case in the UK.  And HIA, as accepted across Europe and I thought worldwide, considers both the health impacts and their distribution across the population.
 

Dr Jennifer Mindell
Clinical senior lecturer
Health and Social Surveys Research Group Research Department of Epidemiology and Public Health UCL
1-19 Torrington Place
London WC1E 6BT
 
Tel. 020 7679 1269 (Internal x41269)
Survey doctor: 07770-537238
Fax 020 7813 0242
Email: j.mindell@ucl.ac.uk
Web: IRIS web page
 
Journal of Transport and Health: www.elsevier.com/locate/jth
 

----------------------------------------------------------------------
 
Message: 1
Date: Sat, 7 Jun 2014 12:29:58 +0000 (UTC)
From: mbrenman001@comcast.net
Subject: Re: [H+T--Friends] webinar on Health Impact Assessment (HIA)
        in Transportation Planning
To: TRB Health and Transportation <h+t--friends@chrispy.net>
Message-ID:
        <648017716.8220462.1402144198106.JavaMail.root@comcast.net>
Content-Type: text/plain; charset="utf-8"
 
Who is putting on this webinar? It appears to be something called IBPI. "The Initiative for Bicycle and Pedestrian Innovation is an exciting center for research and learning that is focused on bicycle and pedestrian travel. IBPI?s aim is to advance bicycling and walking as integral elements of the transportation system in Oregon?s communities." Where's the neutrality and objectivity?
 
In regard to this statement, "Health impact assessment (HIA) has emerged in the U.S. as a promising way to increase social and environmental justice by addressing health equity within transportation planning," much HIA work does not adequately address social equity and EJ issues. For example, HIA's rarely address Title VI of the Civil Rights Act of 1964 or the environmental justice executive order. They rarely contain legal concepts at all. HIA's are usually conducted by public health people, who have no background in social equity or civil rights. They often perform with an environmentalist bias (see "bicycle innovation" above), which often is in tension with the needs of low income communities and communities of color.
 
As to this, "It also augments community and stakeholder engagement by providing a forum - usually through an advisory committee - where stakeholders can identify and deliberate about health interests related to the target plan. While HIA advisory committees are diverse by design," much HIA work is conducted solely in English, and the limited English proficiency needs of various demographic groups are not addressed. Another concern with "advisory committees" is that fact that they only provide "advice" which the "planning" entity is not obligated to pay any attention to. A colleague who leads an immigration advocacy group told me a couple of years ago, "I no longer serve on advisory committees because they don't make policy or control anything."
 
 
 
 

------------------------------
 
Message: 2
Date: Tue, 10 Jun 2014 18:08:33 +0000 (UTC)
From: mbrenman001@comcast.net
Subject: Re: [H+T--Friends] H+T--Friends Digest, Vol 38, Issue 4 - HIA
To: TRB Health and Transportation <h+t--friends@chrispy.net>
Cc: j.mindell@ucl.ac.uk
Message-ID:
        <1533380969.350750.1402423713482.JavaMail.root@comcast.net>
Content-Type: text/plain; charset="utf-8"
 
Here's what I said: "HIA's rarely address Title VI of the Civil Rights Act of 1964 or the environmental justice executive order. They rarely contain legal concepts at all. HIA's are usually conducted by public health people, who have no background in social equity or civil rights. They often perform with an environmentalist bias...much HIA work is conducted solely in English, and the limited English proficiency needs of various demographic groups are not addressed." My comments were focused on the US, where the webinar under discussion is occurring. But prove me wrong in the UK. Quote some HIAs in the UK that discuss the Equality Act (which is under fire in the UK by the Conservative Party) or the equivalent, and environmental justice, and use the languages preferred by demographic groups. This is more than "awareness," since awareness doesn't cure much of anything. I'll be happy to be proved wrong and would love to use those good HIA examples.
 
In recent work with The City Project in Los Angeles, as funded by the California Endowment, we observed that even those public health organizations and medical professionals who work with minority health disparities rarely engage civil rights law to help solve the challenges. Various professions just seem stuck in their silos. And don't get me started on trying to use epidemiologists as witnesses in environmental just cases. I've never found one who would testify that X environmental insult caused Y adverse effect on a given minority or low income community. They insist upon a scientific standard of proof, which is way higher than the administrative civil rights standard of proof of a preponderance of the evidence. 
Marc Brenman
mbrenman001@comcast.net

 
----- Original Message -----
 
From: "Jenny Mindell" <j.mindell@ucl.ac.uk>
To: h+t--friends@chrispy.net
Sent: Tuesday, June 10, 2014 1:58:44 AM
Subject: Re: [H+T--Friends] H+T--Friends Digest, Vol 38, Issue 4 - HIA
 
We may like the concept of evidence-based decision-making but being realistic, political (including planning) decisions are based on a whole range of things. 
So most people now aim for 'evidence-informed decision-making', for which HIA is well-suited. 
It would be daft to think that planners (or others in local, regional or national government) consider only health when making their decisions. 
But the more that the decision-makers are involved with the HIA process, the more likely they are to engage with the recommendations produced. 
And I am very surprised by the statement that public health professionals are unaware of social equity or civil rights. Certainly not the case in the UK. And HIA, as accepted across Europe and I thought worldwide, considers both the health impacts and their distribution across the population.
 

Dr Jennifer Mindell
Clinical senior lecturer
Health and Social Surveys Research Group Research Department of Epidemiology and Public Health UCL
1-19 Torrington Place
London WC1E 6BT
 
Tel. 020 7679 1269 (Internal x41269)
Survey doctor: 07770-537238
Fax 020 7813 0242
Email: j.mindell@ucl.ac.uk
Web: IRIS web page
 
Journal of Transport and Health: www.elsevier.com/locate/jth
 

----------------------------------------------------------------------
 
Message: 1
Date: Sat, 7 Jun 2014 12:29:58 +0000 (UTC)
From: mbrenman001@comcast.net
Subject: Re: [H+T--Friends] webinar on Health Impact Assessment (HIA) in Transportation Planning
To: TRB Health and Transportation <h+t--friends@chrispy.net>
Message-ID: 
<648017716.8220462.1402144198106.JavaMail.root@comcast.net>
Content-Type: text/plain; charset="utf-8"
 
Who is putting on this webinar? It appears to be something called IBPI. "The Initiative for Bicycle and Pedestrian Innovation is an exciting center for research and learning that is focused on bicycle and pedestrian travel. IBPI?s aim is to advance bicycling and walking as integral elements of the transportation system in Oregon?s communities." Where's the neutrality and objectivity?
 
In regard to this statement, "Health impact assessment (HIA) has emerged in the U.S. as a promising way to increase social and environmental justice by addressing health equity within transportation planning," much HIA work does not adequately address social equity and EJ issues. For example, HIA's rarely address Title VI of the Civil Rights Act of 1964 or the environmental justice executive order. They rarely contain legal concepts at all. HIA's are usually conducted by public health people, who have no background in social equity or civil rights. They often perform with an environmentalist bias (see "bicycle innovation" above), which often is in tension with the needs of low income communities and communities of color.
 
As to this, "It also augments community and stakeholder engagement by providing a forum - usually through an advisory committee - where stakeholders can identify and deliberate about health interests related to the target plan. While HIA advisory committees are diverse by design," much HIA work is conducted solely in English, and the limited English proficiency needs of various demographic groups are not addressed. Another concern with "advisory committees" is that fact that they only provide "advice" which the "planning" entity is not obligated to pay any attention to. A colleague who leads an immigration advocacy group told me a couple of years ago, "I no longer serve on advisory committees because they don't make policy or control anything."
 
 

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Message: 3
Date: Tue, 10 Jun 2014 11:52:48 -0700
From: Phyllis ORRICK <phylliso@berkeley.edu>
Subject: [H+T--Friends] David Ragland Profiled for Robert Wood Johnson
        Foundation Safe Routes to Schools work
To: sph_faculty_open@berkeley.edu, sph_staff_open@berkeley.edu,
        "safetrec_staff@lists.berkeley.edu"
        <safetrec_staff@lists.berkeley.edu>,
        safetrec_students@lists.berkeley.edu, faculty@its.berkeley.edu,
        students@its.berkeley.edu, staff@its.berkeley.edu,
        h+t--friends@chrispy.net, phaa@berkeley.edu
Message-ID:
        <CALuXqV5Wo71QhhptTV_PG+u6FZohLp0oquAhT8c9vahVnE3YYg@mail.gmail.com>
Content-Type: text/plain; charset="utf-8"
 
Hi all,
 
Here is an item with link to a lengthy profile of SafeTREC Director David
Ragland and our team research on health and safety effects of Safe Routes
to School.
 
Best,
 
Phyllis
 
 
SafeTREC's David Ragland Profiled by RWJ's Active Living Program
 
In an article titled "Safe Routes to School Examined: How Structural
Changes Around Schools Affect Children's Mobility and Safety: A Profile of
Active Living Research Investigator David R. Ragland, PhD, MPH," the Robert
Wood Johnson Foundation's Active Living Research program discusses the
origins of SafeTREC director and founder David Ragland's work in traffic
safety in general and his and SafeTREC researchers' series of studies
evaluating various effects of Safe Routes to School projects, including:
 
   - Safe Routes to School Safety & Mobility Analysis
   <http://www.escholarship.org/uc/item/5455454c>
   - Ten Years Later: Examining the Long-Term Impact of the California Safe
   Routes to School Program
<http://www.escholarship.org/uc/item/8m59g6vx> (presented
   at TRB 2014 Annual Meeting)
 
Links
 
 
 
 
-- 
Phyllis Orrick
Communications Director
Safe Transportation Research and Education Center
<http://www.safetrec.berkeley.edu/> (SafeTREC)
2614 Dwight Way
UC Berkeley
Berkeley CA 94720-7374
510-643-1779
@transsafe <https://twitter.com/#%21/transsafe>
@trbhealth <https://twitter.com/#%21/trbhealth>
Skype: pmorrick
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