Plenary Session 1: USA - HiAP and HIA

 

LInda Rudolph, Consultant in HiAP and H earthy Communities

 

LIke to discuss our experience in California and some of the issues we've faced.

 

• Environments shape health and these environments are shaped by other sectors and these have had inequitable impacts on vulnerable communities.
  
• Initial focus was on obesity prevention and some climate change initiatives.
  
• HIA was used as part of this.
• Part of a long history of intersectional action in public health - seat belts...

 

HiAP came out of an Executive Order by Arnold Swarzenegger that explicitly talked about this as a policy aim. A HiAP Task Force was created. Defined as a collaboration to improve wellbeing.

 

First challenge was to get people working together and to generate enthusiasms and get people working together better. Met with a range of stakeholders and set up an Ad Hoc Advisory Group. We then developed a definition of Healthy Communities to guide our thinking and developed a vision of how each agency could health. The suggestions from meetings and public meetings was reduced to a set of 6 themes and 11 recommendations.

 

So what are my thoughts and questions on HiAP and HIA.

• Health Imperialism can be a charge made at us when we do HiAP
• We answered or attempted to answer the question What Is In It For Me?
• Needed to deal with the concerns of HIA from a administrative, regulatory and legal perspective
• We stayed away from using the term HIA and talked about tackling health equity and using a health lens and that HIA is one approach to incorporate health perspectives
• Not possible to do HIAs on all policies
• But we need to do HIAs and when and how more formal HIAs are the most appropriate method in HiAP
• How do we deal with conflicting policies - should not build housing within 500m of a freeway but there is also a transportation policy to reduce vehicle miles and reducing greenhouse gases. This also had an impact on reaching affordable housing goals.
• Active community engagement is very hard and their are agency concerns about this being an opportunity for advocacy groups to criticise government
• Really easy for us to focus on the immediate here and now risks and not the more important long term issues around climate change and greenhouse gas emissions
• How do we look at the health impacts of windfalls and smart energy grids a deters that does not undermine the longer term climate change interventions needed.
• Can we use HIA to deal with complex issues and can we do this with humility...maybe.