Health Impact Assessments

Health impact assessment (HIA) is a fast-growing field that helps policymakers to take advantage of opportunities by bringing together scientific data, health expertise, and public input to identify the potential—and often overlooked—health effects of proposed new laws, regulations, projects, and programs. It offers practical recommendations for ways to minimize risks and capitalize upon opportunities to improve health. HIA gives federal, tribal, state, and local legislators, public agencies, and other decision makers the information they need to advance smarter policies today to help build safe, thriving communities tomorrow (Health Impact Project).

Moving forward, we anticipate that the majority of our work on health impact assessment will center on housing.  HIA can be used in many contexts, but our focus will remain on housing because it is here that we may add unique value.

A Systematic Review of Health Impact Assessments on Housing Decisions and Guidance for Future Practice

The National Center for Healthy Housing and the National Housing Conference are pleased to announce the release of “A Systematic Review of Health Impact Assessments on Housing Decisions and Guidance for Future Practice.” This report provides a review of 40 housing HIAs conducted in the U.S. between 2002 and 2013. These housing HIAs have examined a wide array of decisions, including the impact of housing decisions on access to transportation, jobs, parks and open space, and healthy foods; housing quality; and the impact of housing polices on neighborhood segregation by race and socioeconomic status. Of the 40 HIAs, 11 focused directly on housing policies, codes, structural design, or energy delivery systems. The remaining 29 HIAs pertained to the broader built environment (e.g., community redevelopment, transportation, planning) with at least one component of the decision-making process focused on housing. The review revealed that a variety of agencies have led the HIAs, including nonprofit organizations, public health departments, and academic institutions.

This report begins by describing the connections between housing and health and then provides a systematic review of housing decisions that have been the subject of past HIAs. Next it provides guidance for conducting future housing HIAs. This information is organized by each of the six steps of the HIA process so that it is practical and actionable. Finally, it provides a tutorial on the major housing programs as a means of helping public health professionals understand the links between housing programs and public health. The six programs covered in the tutorial are public housing; housing choice vouchers; project-based rental assistance programs; the Low Income Housing Tax Credit program; code enforcement and inspection programs; and zoning and land use policies.

Nationwide, housing officials and community developers are at the forefront of efforts to address many of today’s most pressing public health challenges by building affordable housing and by supporting improvements in neighborhood infrastructure and social and economic opportunities. Understanding how to integrate public health considerations into housing decisions can positively impact the health of residents and ensure strong financial stewardship of public funds. Health impact assessment (HIA) is a rapidly growing field that can bring together housing officials and public health professionals, helping decision-makers make better choices by utilizing scientific data, health expertise, and public input to identify the potential and often overlooked effects on public health, both positive and negative, of proposed housing projects, policies, and programs.

This report is supported by a grant from the Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts with funding from The Kresge Foundation.

Click here to view the report.


A set of issue briefs from the Pew Charitable Trusts was also published in relation to this report.  As housing professionals can play an important role in improving health outcomes, and public health professionals can engage in the development decision-making process to ensure health outcomes are considered, the briefs provide guidance for both constituencies.

  • Guidance for Housing Professionals” introduces housing professionals and policymakers to the concept of health impact assessments (HIAs) and explains how these studies can improve decisions about projects, policies, and programs in the areas of housing and community development.
  • Guidance for the Public Health Sector” provides public health professionals with information about major housing programs and policies, identifies key decision-makers, and discusses how public health professionals can effectively integrate health into housing decisions.

Click here to access these briefs as well as additional resources.

Baltimore-Washington Rail Intermodal Facility Health Impact Assessment

NCHH’s first foray into Health Impact Assessment (HIA) was with the Baltimore-Washington Rail Intermodal Facility. Through a grant from the Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts with funding from The Kresge Foundation, NCHH compared the impacts of the proposed intermodal facility at several potential sites in the Baltimore-Washington region.

Click here for additional information on this project.

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