The Health Impact Assessment: Building Environmental Health Capacity

By Sandra Whitehead, PhD, Director of Program and Partnership Development, National Environmental Health Association 

More and more, local health departments (LHDs) are being forced to cut their environmental health programs. This pattern is caused by shrinking budgets and further compounded by limited understanding of the value of the environmental health field and the roles of its practitioners. According to the Association of State and Territorial Health Officials (ASTHO) and the National Association of County and City Health Officials (NACCHO), more than 50,600 state and local environmental health positions (approximately 22 percent) were removed since 2008. When faced with a choice, it is easier for LHDs to cut a program seen as regulatory, like environmental health, rather than one related to client-based services. Until the environmental health community clearly articulates its mission, return on investment, and the value of its work, this trend will continue.

The first step is reframing the discussion about the role of environmental health professionals and their significance. It starts with expanding the definition of environmental health to include new tasks and frameworks; in other words, creating Environmental Health 2.0. The Health Impact Assessment (HIA) is one tool in particular that can support moving this process forward. The knowledge, skills, and capabilities necessary to carry out an HIA can simultaneously grow the relevance and awareness of the environmental health profession. Not only does an HIA foster cross-community collaboration, it also generates data-driven analysis and the development of evidence-based recommendations.


The recent National Environmental Health Association (NEHA) Annual Educational Conference in San Antonio devoted an entire day’s worth of sessions to highlighting HIAs. A total of six sessions featured diverse speakers representing federal, state and local agencies who discussed the available tools, funding mechanisms and opportunities to conduct HIAs at the local level. Session highlights included:

  • The Environmental Protection Agency (EPA) presenting their HIA resources and examples of their current HIA work.
  • Kenneth Steel, pictured on the right*, and Jackie Ward of Maricopa County Department of Public Health sharing their experience of  conducting an HIA to examine the effects of a proposed light rail extension on community food access.
  • Patricia Cummings and other colleagues from Harris County Public Health and Environmental Services discussing the challenges of starting a Built Environment Unit within a local health department, providing key strategies to overcome limited funding and staffing.
  • Chris Duclos, from the Florida Department of Health, presenting on using Environmental Public Health
    Tracking data to inform an HIA on severe weather events.
  • NEHA staff giving two presentations highlighting the value of HIA for environmental health professionals and incorporating HIA into the brownfields redevelopment process.

NEHA’s efforts to promote HIAs and their use aimed to recognize that LHDs cannot, and should not, solve community health issues alone. Instead, public health officials, particularly environmental health staff, should use HIAs to inform decision-makers of the evidence-based value related to their efforts. Doing so will decrease the likelihood of funding and program cuts. In the wake of emergencies like Flint’s water contamination crisis and the Zika Virus, environmental health capacity needs to grow, not disappear. Putting HIAs into practice will definitively advance that growth.

Visit NACCHO’s HIA Quick Guide for more about the Health Impact Assessment and how it can empower LHDs to ensure public health is Incorporated into policy and decision making within the community they serve. For additional information, please contact the NACCHO Healthy Community Design team.

*Photo retrieved from Twitter (direct link), originally posted on June 15, 2016 by Sandra Whitehead (@sandrafw).

About Anastasia Sonneman

Anastasia Sonneman serves as a Communications Specialist at NACCHO. Her work includes promoting local health departments' best practices, as well as partner tools and resources, in environmental health, health and disability, and preparedness through NACCHO's communications channels, storytelling, and outreach to various audiences.

2 thoughts on “The Health Impact Assessment: Building Environmental Health Capacity

  1. Darryl Booth
    July 9, 2016 at 12:29 pm

    Thank you Dr. Whitehead for this important position. “Building Capacity” should be a component of every LHD planning and the HIA is a great model.

    1. July 11, 2016 at 12:03 pm

      Thanks, Darryl. We at NEHA are dedicated to helping EH professionals evolve and grow to build their capacity to meet emerging trends and to apply a prevention lens to our work.

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