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Health Impact AssessmentsNeal Kaufman, M.D.
I keep hearing about how we need a healthy ecosystem, we need a healthy environment. Well, we need healthy people and people are only as healthy as the families in which they live and the families are only as healthy as the communities in which they find themselves, the communities are only as healthy as the society in which they find themselves. We called that the ecological approach to child health. The question becomes how do you do that? We have to make a major transformation. During the first 50 years of this century, we focused on infectious diseases, did a lot of good there -- sanitation, immunizations. For the next 50 years we focused on chronic disease; NIH, Medicare, etc. Over the next 50 years we should think of health as a resource for living. Health is something that we all should be able to have so that we can do the things we want to do. The question is how do you make that happen? To me you have to start with a couple of simple rules. The first is that relationships are key -- relationships among individuals, communities, organizations. The next is information flow -- timely and accurate information, knowledge and wisdom need to flow between each of us. It's essential that service and support are integrated, coordinated, comprehensive, and that the built space supports all of those things.
Here's a quick example. There was a property that was going to be low income housing but the school district wanted it and they were just going to take it, through eminent domain. New Schools, Better Neighborhoods came in and now on that same site they're going to have as much low-income housing plus a school, a child development center and open space -- all in the middle of downtown Los Angeles because joint master planning was done.
Health impact assessment is designed to look at what's the impact on the health of the individuals, the population and the public relative to a policy or construction activity. It helps to identify a way to predict before hand and measure outcomes overtime.. It also helps to mitigate the mistakes you made and learn for the next one. There are best practices that tell you if you build things in certain ways people will be healthier and that there will be greater social connections. Social support is the wonder drug of the 21st century and if we can figure out how to get people to be better connected, our children won't be dying from lack of connections and instead they'll be much healthier and more productive members of society. |
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