b4 thursday planners using hia

Planners Using Health Impact Assessments

Frank Robinson PhD, Executive Director Partners for a Healthier Community

Molly Goren-Watts Principal Planner/Manager Regional Information & Policy Center PVPC

Sang Cho, Junior Planner Intern HGSD

Peter Lowitt FAICP, Director Devens Enterprise Commission

Planners Using Health Impact Assessments

A Tool in Developing Public Policy

Thursday, October 23, 2104

Frank Robinson, PhD, Executive Director

Partners for a Healthier Community, Inc

Molly Goren-Watts, Principal Planner

Pioneer Valley Planning Commission

Western Massachusetts Casino

Health Impact Assessment

Overview and Context

Health Impact Assessment (HIA)

HIAs are NOT

Key Values that shape the HIA process

What is a HIA

….

2

HIAs are NOT!

• How is HIA different from other types of assessments?

• It’s not used to make the case for why a policy, program or

project should be proposed.

• It’s not an assessment to understand the impacts of a program or

policy once it has been implemented.

• It’s not a community assessment tool (i.e., MAPP, CHIP, CHA),

but those are used during assessment stage of HIA.

3

Key Principles & Values of a HIA • Democracy - allows participation in policy development

and implementation

• Equity - consider distribution of health impacts, pay

attention to vulnerable groups and recommend ways to

improve proposed decisions for affected groups

• Sustainable development - judge short- and long-term

impacts of a proposal

• Ethical use of evidence - Use evidence to judge impacts

and inform recommendations, not set to support or

refute a proposal; be rigorous and transparent.

• Holistic approach to health - Be guided by the wider

determinants of health

4

What is an HIA? • HIAs are different from other

assessments?

• It’s proactive! It’s meant to inform a proposed policy, program or project currently under consideration

• It’s predictive! It uses data and scientific literature to predict potential health outcomes (evidence – e.g. scientific literature, reports, etc.)

• It’s translational! HIA is the framework that translates data and evidence into well-informed policies.

The Sweet Spot!

Implementation of the Expanded

Gaming Act Legislation

Developing the process for

casino licensure

Developing regulatory

requirements for casino

development and operation

Oversee licensing process and

selection of Casino operators

5

HIA Methods Six-Step Process

7

1. Screening

2. Scoping

3. Assessment

4.Recommendations

5. Reporting

6. Monitoring &

Evaluation

Assess value of HIA.

Define scope of assessment (e.g., which health impacts

to evaluate).

Determine how will decisions impact selected health

determinates and health outcomes

Determine how will decisions impact selected

health determinates and health outcomes

Communicate findings &

recommendations

Track impact of HIA and

decision

Western Massachusetts Casino Health Impact

Assessment (WMCHIA) - How will a casino impact

health in Western MA?

November 2011 - Chapter 194 “An Act Establishing Expanded

Gaming in the Commonwealth” Allows “up to 3 destination resort casinos located in 3 geographically diverse regions”

8

Background Proposed Casino Locations

Springfield

South End - MGM

Springfield

North End - Penn

W. Springfield-

Hard Rock Cafe

Palmer –

Mohegan Sun

• Springfield – urban, gateway city (pop 153,000)

• Palmer – rural (pop 12,000)

• West Springfield – suburban and rural (pop 28,000) 9

Background Proposed Casino - Springfield

- Gateway city

- Struggling economy

- Majority community of

color

- Residents face numerous

socioeconomic challenges

and experience health

inequities

- Opportunity for economic

redevelopment

10

About WMCHIA Conducted Spring 2013 – Fall 2013

Lead partners

Partners for a Healthier Community

Springfield Dept. of Health &

Human Services

UMass School of Public Health

Step 1: Screen Determines value and need of HIA

Questions include…

Is HIA likely to add value?

Is it feasible?

Does decision-making process

allow for input from HIA?

11

Arise for Social Justice Massachusetts Department of Public Health Springfield Police Department (retired

chief)

Behavioral Health Network Massachusetts Gaming Commission Town of Palmer, Health Department

City of West Springfield, Health

Department

New North Citizens' Council Town of Palmer, Planning Department

Develop Springfield Palmer Town Council United Council of Churches of Greater

Springfield

Greater Springfield Chamber of

Commerce

Partners for Community/United Farm Workers United Way of Pioneer Valley

Holyoke Community College Pioneer Valley Planning Commission University of Massachusetts, Amherst

Irene E. And George A. Davis

Foundation

Regional Employment Board of Hampden

County

Western MassCOSH

Lutheran Social Services Springfield City Council Casino Site

Committee

WMCHIA Methods Screening & Stakeholder Engagement

Advisory Committee • Cross-sector stakeholders, HIA experts, casino/gambling experts, decision-makers

host community municipalities, state and local public health, social justice, planning

organizations, non-profit, faith community, police/public safety, immigrant services,

development, academics

12

WMCHIA Methods

Step 1: Screening & Stakeholder

Engagement

Introductory HIA workshop

Community forums

Online Survey

Stakeholder interviews & community contacts

Media

WMCHIA web page

WMCHIA email list

Presentations to stakeholders

13

WMCHIA Goals

Step 1: Screening & Stakeholder

Engagement

1. Promote consideration of potential health impacts in decision-making related to the

licensing, site selection and development of a casino in Western MA, particularly

Host community agreement negotiations (if possible) and implementation

Casino operator applications

Host community public hearing

MA Gaming Commission licensing decisions and casino regulations

Planning for development of licensed casino

2. Recommend possible health or health-related indicators for the Gaming Commission’s

casino monitoring and evaluation plan

14

Casino Licensing Timeline

15

WMCHIA Methods

Step 2: Determining the Scope of WMCHIA

Interest from community in assessing impact on a range

of areas

Process for choosing health determinants and outcomes

in assessment

16

WMCHIA Focus Areas Step 2: Determining the Scope of WMCHIA

• Topic areas

• Jobs and employment

• Access to local casino

gambling

• Traffic

• Crime and Public Safety

• Geographic location

• Focused on host community

impact and in some cases

region

• Other important concerns

not included

• Public safety capacity &

city infrastructure

• Economic development

• City/town revenue

• Housing

17

Step 2: Determining the Scope:

Jobs & Employment Pathway

Casino Opens Resort casino jobs

Shiftwork

Income

Social cohesion w/family

Quality and access to health insurance

Smoking, gambling, alcohol (risk behaviors)**

Sleep disturbance

Life expectancy

Mental health

Chronic disease

Cancer

* Assessment focus is on impact of employment on unemployed ** Relates specifically to casino employees

Health ImpactsDecision

Initial Impact Pathway Impact

Pathway Impact

Employment (resort casino jobs)*

18


Access to Local Casino Gambling Pathway

Casino Opens

Access to gambling Problem or

pathological gambling

Life expectancy

Family health/well-being

Job loss and financial resources

Chronic disease

Mental health


Injuries

Cancer

Access to health-promoting resources

Suicide


Pathway Impact

Financial resources

19


Traffic Pathway

Casino OpensTraffic

Motor vehicle and pedestrian accidents

Air pollution

Motor vehicle & pedestrian injuries and mortality

Asthma, CVD, cancer



20


Crime & Public Safety Pathway

Casino Opens

Alcohol use Driving under the influence

Injury and mortality

Crime (actual and perceived)

Mental health

Chronic Disease


Initial Impact

Pathway Impact

21

WMCHIA Methods Step 3: Assessment

Assessment process is characterized by:

Expert input

Existing reports

Impacts - some quantitative but primarily

qualitative

Recommendations

Expert and stakeholder input

Based on best practice and local needs

22

WMCHIA Methods

Step 3: Assessment

Provides baseline data profile of health determinants and

conditions being evaluated

Evaluates potential health impacts

Uses scientific literature and other types of evidence to

identify potential impacts

What does literature say?

What is the strength of the evidence

Uses analytic methods and baseline data to predict

impact of decision on target population

23

WMCHIA Methods Step 3: Assessment

24

WMCHIA Methods

Step 4: Recommendations

The Western Massachusetts Casino Health Impact Assessment identified a number of potential positive and negative effects, but its focus was on solutions and recommended actions to strengthen the positives and mitigate the negatives of casino development in Springfield.

Planned strategies (e.g. MGC, casino operator) that community stakeholders thought was important to show support for

Enhancement on planned strategy

Add-in new focus areas where no current plans

Recommendations are targeted to variety of stakeholders e.g. MGC, casino operator, host community, state agencies

25

Step 4: Recommendations:

Predicted Impacts - Jobs and Employment

Casino would bring needed

local jobs given high

unemployment rate

Estimated 3,000 new jobs,

2,200 FT

~65% of casino jobs will require

H.S. diploma/GED

Casino Careers Training Institute

will train for new positions

Local hiring goals

Diversity goals

New jobs locally

-> improved health

61%

26

Step 4: Recommendations: Predicted Impacts - Jobs and Employment

Challenges to meeting goals to improve local unemployment

Anticipated turnover rates of ~40%

Local and regional barriers to obtaining and retaining entry-level

positions prevent most in need of new jobs from obtaining

Workforce readiness capacity

Access to needed ABE and EOSL

Public transit service capacity

27


Category of Position Average per capita wage Annual Cash Tips

and/or Casino Tokes

Total Average Per

Capita Wage

Executive/Director $189,331 -- $189,331

Management $67,418 -- $67,418

Skilled Salary & Supervisory $53,583 -- $53,583

Hourly, Casino Tokes $17,374 $31,124 $48,498

Hourly, Cash Tips $18,388 $21,856 $40,244

Line Level and Administrative $29,806 -- $29,806

• Wages touted as high may not allow for self-sufficiency Foxwoods Crossroads Casino Report - Average Wage by Category

• 28% would be estimated to be line level and administrative support – this does not meet family economic self-sufficiency standards – 2 parents family (1 parent working full-time) with 2 kids residing in Greater Springfield

28


Casino employees may experience negative health impacts

Casino employees found to have higher prevalence of health risk

behaviors

Shift-work found to negatively impact health

Gaming Employees Non-Gaming Employees

Hours Percent Hours Percent

5:00 a.m. – 1:00 p.m. 20% 8:00 a.m. – 4:00 p.m. 20%

1:00 p.m. – 9:00 p.m. 40% 4:00 p.m. – 12:00 p.m. 60%

9:00 p.m. – 5:00 a.m. 40% 12:00 p.m. – 8:00 a.m. 20%

Source: Casino Careers Training Institute

29


Casino operator plan to reach targeted local hiring levels given

documented regional workforce barriers

Infrastructure funding for regional cross-sector collaboration to

address workforce barriers

Casino operator

Health and wellness programs

Best practices to reduce impacts of shiftwork

Employment indicator monitoring and reporting – diversity/equity,

where hired from, etc.

30

Step 4: Recommendations: Predicted Impacts - Access to Local Casino Gambling &

Disordered Gambling

Likely increase problem

gambling prevalence with

casino (estimated 30%)

Many vulnerable populations

in Springfield would be at

increased risk

Young people

Communities of color

Low-income individuals

Limited community capacity

to prevent/address problem

gambling

Problem and Pathological Gamblers

Geography Current After Casino

Opens - Initial

(~1 year)

After Casino Opens -

Over Time

(~5 years)

Springfield 3,993 5,191 3,993

Hampden

County

12,114 15,748 12,114

31

Step 4: Recommendations: Predicted Impacts - Access to Local Casino Gambling &

Disordered Gambling

Public Health Trust Fund funding to create infrastructure for

regional cross-sector collaboration to address increases in

problem gambling

Public awareness campaign

Targeted campaigns and strategies to vulnerable populations that

are accessible (e.g. culturally competent, appropriate literacy

level)

Casino implement responsible gambling framework

32

Step 4: Recommendations Predicted Impacts – Traffic

Estimated 15-30,000 new vehicle

trips per day

Potential adversely affect the City’s

many residents living in EJ areas

High hospitalization rates for

diseases affected by air pollution –

asthma, CVD, COPD

Large racial/ethnic disparities

33


• Greatest health impact likely due to near roadway air pollution

– Latinos experiencing disparities and live along likely casino routes and most likely to be impacted

• May be impact in traffic related collisions due to traffic increase

34


Funding to create infrastructure for regional cross-sector

collaboration to address increases in traffic

Promote use of public transportation and alternative methods of

transport

Assess impact of near roadway pollution on vulnerable

populations and develop strategies to mitigate harms

35

Step 4: Recommendations Predicted Impacts – Crime & Safety

• Uncertain the extent crime will increase – Literature conflicting

– Factors impacting • Community preparedness

• Community design

• DUIs and alcohol-related fatalities may increase with accessibility to free alcohol at casinos – Expanded Gaming Act allows for free alcohol on gaming floor b/t

8:00 a.m. – 2:00 a.m.

36

Step 4: Recommendations Predicted Impacts – Crime & Safety

Community design strategies to prevent crime and enhance

perception of safety

City should support and complement casino operator proposed

design elements

Strategies to prevent DUIs

Public health campaign

Expanded sobriety checks, etc.

37

Step 4: Recommendations General Findings

Integrating resort casino plans with those of other initiatives has the

best potential to address existing regional needs

Large existing health inequities in Hampden County and Springfield

could be reduced or exacerbated by impacts of a casino depending on

strategies implemented

Data-driven evaluation and modification of activities to ensure that

stated goals are achieved, including

1. Publicly available casino impact data

2. Periodic evaluation of impact on identified existing regional needs and health

equity areas by multi-sector stakeholder groups

3. Modifications of strategies and plans as needed

4. Reallocation of money to fund modified strategies

38

Step 5: WMCHIA Report

39

WMCHIA Reporting Involved key stakeholders in review

process

MGC, SEIGMA, MGM, etc.

General dissemination

Email blast, press release, etc.

Presentations

Key decision-makers: MGC, MGC staff, Springfield Mayor

Other key stakeholders Problem-gambling groups (WMCGA,

MA Council Compulsive Gambling, local problem gambling panel)

Local outreach worker group

Others MAPC – examining surrounding

community impacts

MPHA Policy Subcommittee- deciding whether to take position on upcoming ballot questions

40

Step 6: WMCHIA Impacts

MA Gaming Commission and University of Massachusetts, School of Public Health and Health Sciences (SEIGMA - Social and Economic Impacts of Gaming in Massachusetts ) Health Equity lens for evidence-based research that includes community voice; Support for implementation activities – e.g. responsible gaming framework information on certain indicators

Springfield Mayor - considering adoption of recommendations and using it to advocate for funding to implement recommendations

Community residents and organizations Local neighborhood council reviewed report to understand impacts and identify

recs for advocacy Gardening the Community used info in WMCHIA to successfully apply for

funding WMCHIA recs used to support advocacy for MGM to purchase from local small

farmer cooperative

41

Step 6: Monitoring Impacts (Context –

Uncertainty)

• Impacts on decision-

making processes and

decision

• Impacts of decision on

health determinants

42

Devens Grant Road Redevelopment Regulations Health Impact Assessment

Peter Lowitt, FAICP Sang Cho

Neil Angus, AICP, LEED AP SNEAPA

October, 2014

Introduction

• Regional Context & Devens Redevelopment

• Grant Road HIA

• Recommendations

Regional Background • Neighboring towns:

Harvard, Shirley, Lancaster and Ayer

• Fort Devens located on Route 2, just outside Boston’s second beltway ring – I-495

• Rural character typical of Massachusetts outside Boston influence still exists in this area

• Excellent transportation access including Heavy Rail and Commuter Rail

1994 Reuse Plan

Grant Road

The purpose/function of HIA is to:

• Inform and influence the decision maker

• Help address inequalities in health

• Place public health on the agenda

• Reduce conflict between stakeholders

• Encourage sustainable development

HIA is an approach that gets people to think about what they are doing and how it may alter people’s health. It promotes health-and in the long term contributes to the health of local population.

HIA Methodology

• Screening

• Scoping

• Assessment 1. How will it be done?

2. Community Participation

3. The Study Area

4. Behavior Risk Factor Surveillance System data

5. Analytic Method

• Reporting

Process

• Literature review

• Consultation with HGSD and HSPH faculty and graduate students

• Invitation to community and professionals to participate

• Development of background materials and two mock development scenarios, handouts, HIA checklist, and workshop schedule

120 Unit Development Scenario #1 (30 acres)

Housing Mix: 30 single family 16 single fam. cottage 16 two-family 28 – multi-family (#of units) 30 multi-family (9x 3-4 units) (4x 6-12 units)

Park

Park

Com Gdn

ComGdn

1

1

1

1

1

1

1

1

1

1

1

1 1

1 1

1

1 1 1

1

1

1

1

1

1

1

1

1 1

1

1 1

1

3

3

4

4

2 2

2 3

6

8

2

2

2

3 3

2

8

4

4

2

2 3

12

1c

1c

1c

1c

1c

1c

1c 1c 1c 1c

1c 1c 1c 1c

*

*Cedar Street – Neighborhood Road

120 Unit Development Scenario #2 (60 acres)

Housing Mix: 80 single family 22 two-family 12 – 3-4 family 6 multi-family (#of units) (1x6 unit)

1

1

1

1

1

1

1

1

1 1

1

1 1 1

1

1

1

1

1

1

1 1

1 1

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1 1

1

1 1 1

1

4

4

2

2

2

2

2

2

2

2

2

2 6

4

2

1 1

Proximity to Local Services

Homes Shops Schools Work Play

½ mile walk/bike distance

Key Features of Development Scenarios

Key Features of Development Scenarios cont…

Links between Housing and related factors and Health

Example Use of HIA checklist

HIA Checklist and Results

Recommendations

• Introduce traffic calming measures to reduce speeds • Install Rotary at intersection of Grant, Pine and Hospital Roads • Use architecture to assure privacy and access to green space is available

on all lots • Incentivize community gardens and have plots available for employees

and neighboring communities • Support measures to introduce shuttles to commuter rail line to support

increased transit use • Support existing food pantry serving healthy foods • Provide nutrition classes for residents and offer classes on gardening • Attract residents from surrounding communities onto Devens through

courses, programming and educational events • Organize community walks and other events that promote healthy

lifestyles

For more information:

• A pdf of the Grant Road Redevelopment Regulations HIA is available at www.devensec.com/news.html

• Contact: Peter Lowitt, FAICP, [email protected]

• [email protected]

• [email protected]

http://www.devensec.com/

mailto:[email protected]



Health Impact Assessments:Health Impact Assessments:Health Impact Assessments:Health Impact Assessments:What Roles Can a Regional What Roles Can a Regional Planning Agency Play?Planning Agency Play?Planning Agency Play?Planning Agency Play?

Presented at SNEAPA 2014Presented at SNEAPA 2014Thursday, October 23

Molly Goren-Watts, Principal Planner/Manager Regional Information & Policy Center

Pioneer Valley Planning Commission

Lead or ProvideLead or ProvideLead or ProvideLead or ProvideTechnical AssistanceTechnical Assistance

All HIAs need technical expertise, topic knowledge, and community connections and engagement.

Model 1 – Lead with technical expertise. Engage partners for topic knowledge and/or community connections as needed.

Model 2 – Provide technical expertise to community research partner (expert in specific field or community organization facing the question at hand)

Model 3 – Conduct HIA as partnership led by RPA and one or more topic or community-specific organizations.

PVPC Participation in PVPC Participation in PVPC Participation in PVPC Participation in Casino HIACasino HIA

•Partners for a Healthier Community was lead.

• As RPA to all three proposed host communities, PVPC had to remain neutral in fact and appearance to all communities involvedneutral in fact and appearance to all communities involved.

•PVPC provided:•Data collection and understanding data sources

•Mapping

•Topic area specialists – traffic, transit, land use, economic development (for analysis and proofing of recommendations)

•Networking/Connecting with other specialists in the region (city/town government, workforce development agencies (REB), police department, transit authority, others doing related work for stakeholder engagement) stakeholder engagement) •Analytical assistance such as review of pathway diagrams

PVPC Roles in Other HIAsPVPC Roles in Other HIAsPVPC Roles in Other HIAsPVPC Roles in Other HIAs

•Overall Management

•Literature review

•Analysis and writing

•Stakeholder engagement•Stakeholder engagement

Questions?Questions?Questions?Questions?

b4 thursday planners using hia

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hia different

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