BOX 3-5HIA Recommendations

HIA recommendations take various forms, and some examples are provided below. The committee is not endorsing the HIAs or the recommendations, but simply providing examples.

  • Alternative to a proposal. As described in Box 3-3, the HIA of oil and gas leasing in the National Petroleum Reserve-Alaska raised concerns regarding the potential for adverse effects on the culture, well-being, and health of local residents because of the risk of disrupting the local fish and game on which the community depends for food. All three leasing alternatives presented in the environmental impact statement raised similar concerns. To address the concerns, the North Slope Borough suggested restrictions on leasing in a small percentage of the area. The final decision by the Bureau of Land Management reflected a consideration of those concerns and deferred leasing in the most critical fishing and hunting areas, which represented a small percentage of the total area available for leasing (BLM 2008).
  • Mitigation measures. An HIA of rezoning from industrial to residential use in San Francisco—a plan that would add 30,000 households—identified health-related noise and air-quality issues for the proposed residential units. It recommended new standards for ventilation and acoustical protection for new development. As a result, the city adopted performance-based regulations to ensure indoor-air quality and noise protections for all new residential development (Bhatia and Wernham 2008).
  • Mitigation and health-supportive measures. An HIA of proposed oil development in Sakhalin Island, Russia, concluded that a large influx of oil and gas workers from outside the region could increase the risk of sexually transmitted illnesses in workers and the community. The HIA proposed mitigation measures (such as restricting access to the work camp by local residents) and health-supportive measures (such as “supporting the health community in improving STD programme management”) (Balint et al. 2003).
  • Adopting a position for or against a proposal. An HIA of proposed restrictions in the funding for the Massachusetts rental-voucher program for low-income residents found that the restrictions could be harmful to health and recommended against them (Child Health Impact Working Group 2005).

From: 3, Elements of a Health Impact Assessment

Cover of Improving Health in the United States
Improving Health in the United States: The Role of Health Impact Assessment.
National Research Council (US) Committee on Health Impact Assessment.
Washington (DC): National Academies Press (US); 2011.
Copyright © 2011, National Academy of Sciences.

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