A Practical Guide to Health Impact Assessment and Housing

Many of the nation’s most pressing public health problems, such as asthma, depression, diabetes, and obesity, are influenced by the places where people live, work, and play.

Policy decisions that affect housing quality, affordability, and location as well as neighborhood characteristics can influence whether these places are supportive of or detrimental to community health and well-being. Such housing policies can also play important roles in reducing or even preventing diseases.

Unfortunately, public health professionals often are not part of the development decision-making process, which can result in a missed opportunity to ensure that health is effectively considered.

So the National Center for Healthy Housing, the Health Impact Project, and the Center for Housing Policy collaborated on a report after reviewing 40 housing health impact assessments (HIA) to provide guidance for future housing assessments, and offers a helpful tutorial on housing programs. The review was conducted in United States between 2002 and 2013.

The Link Between Housing Policy and Health

Professionals know that the health impacts of housing decisions can last decades. These decisions affect residents over their lifetimes and across generations. For example, a lack of affordable housing limits a person’s ability to acquire and maintain adequate shelter and meet other basic needs. Financial constraints can force families to choose between paying for rent, utilities, food, or medical care.

The design and quality of housing can affect health outcomes such as asthma, cardiovascular disease, cancer, and injury. The neighborhood can have implications for health through access to supportive resources, opportunities, and social networks and relationships.

HIAs provide an opportunity for these sectors to build strong partnerships dedicated to one shared goal—ensuring that housing projects, policies, and programs promote the best possible health and quality of life for residents.

HIAs help identify the potential health effects of policy, program, and project proposals, including those related to housing; offer practical options for maximizing health benefits and minimizing health risks; and leverage the resources, strengths, and expertise of each sector. By identifying key decision-makers and providing public health professionals with information about major housing programs and policies, health and housing decisions can become one.

Engaging Health and Housing Professionals

HIAs bring together scientific data, health expertise and public input. It becomes easier for decision makers to identify potential and overlooked positive and negative public health effects of proposed laws, regulations, projects, policies, and programs. Employing both qualitative and quantitative analyses, HIAs identify concerns and make the readily available to vulnerable groups such as seniors, children, and low-income families.

Public health professionals can engage housing experts and build awareness of the benefits of HIAs in a variety of ways:

• Offer training about housing and community issues
• Provide public health data and expertise
• Meet with political and housing decision-makers to discuss findings and recommendations
• Give public presentations to illustrate the benefits of using HIAs
• Learn common housing terminology because CDC might mean different in different context (in the health industry, it means the Centers for Disease Control and Prevention whereas in the housing industry, it stands for community development corporations)

Better Housing, Better Health

If public health professionals ensure that health is considered in housing decisions, then it can improve construction and design of buildings and neighborhoods as well as maximize positive health impacts.

Through the use of HIAs, the health and housing sectors can build collaborations that leverage their unique assets toward their shared goal of improving community health and quality of life.