Harnessing the power of community in health impact assessments

Health Impact Assessments (HIAs) are an important tool for promoting health in all policies, and community stakeholders are becoming recognized as important partners in furthering the HIA methodology. An HIA was conducted on the multi-use development of a vacant parcel of land located in a low income, racially-diverse neighborhood in Boston, MA. The HIA examined the development's potential impacts on resident health and safety, specifically chronic disease, mental health, and injury. Stakeholder involvement is a key element of the HIA process, yet it does not consistently occur in the HIA process due to time and budget constraints. Community engagement was integral to the success of this HIA and helped to drive its scoping, assessment, and recommendations phases. HIAs frequently examine published health status data, but these data often lack the geographic and demographic specificity needed to understand how a particular neighborhood may be affected by a proposed project or plan. In order to address this limitation, the assessment phase was enhanced by the implementation of an innovative neighborhood survey to better gauge local residents' behaviors, perceptions and values, consequently indicating how they would perceive and use the new development. This critical information guided the formation of the predicted health impacts and recommendations for making the development healthier and safer, ultimately strengthening its value and utility for the neighborhood. The HIA process also built capacity among residents, helped solidify important partnerships between the community and public health partners, and fostered the creation of a healthy, safe space for local residents.