What is a Health Impact Assessment? Why does it matter? To fans of wolf reintroduction: put your money where your mouth is.
What is a Health Impact Assessment? Why does it matter?
I came across the Health Impact Assessment, a government report on the Denver neighborhoods of Globeville and Elyria Swansea** recently while following links back in a CPR story.
It caught my eye and I thought I would share. It's worth looking at these things because the claims made are interesting to read in their own right, they are paid for with your tax money, and they often end up as the foundation/rationale of the policy that we Coloradans see.
In fact, if you look at screenshot 2 attached, you'll see that very language from the authors themselves.
There are multiple ways to take reports like this, but if I had to pick one idea, one theme, from the report that stood out to me the most it's summed up pretty well in the quote below.
"The health of an individual or population is only partlydetermined by genetics. The environment in which onelives – including housing, parks, schools, transportation,access to health care, environmental quality, jobs, healthyfood, and the resulting daily choices that are available– all have a far greater impact on one’s health. Healthinequality results when factors outside of individualgenetics and personal choice affect peoples’ health."
I chose this quote and found it notable not so much of a complete disagreement with the report, but more because it hints at what you'll NOT see in the report; that is, statements such as "resulting daily choices that are available" which make it clear just how much the study's authors (and presumably those who would thoughtlessly use this report) weigh both the role of personal choice/responsibility and also that of conditions over which both the community AND government have control.
Let me illustrate what I mean with two examples.
Take, for example screenshot 3 from p 14 of the report. Read the text in blue then note the size of the genetics slice in the pie chart. This is nature and nothing can change that. You're born how you're born. Look above that at the slice in black. You could make arguments as to how to parse out personal choice in the other slices of the pie (except the genetics) but the slice highlighted in black is pure choice. Knowing that, and revisiting the text in red, what do you think is played up here? What is downplayed?
I.e. look at the slice of that pie and keep its relative size in mind while you read the report. I daresay that nowhere near 20% of the discussion here centers on personal health choices.
Turn now to the discussion about services on p 46 of the report. A commonly reported dynamic in papers such as the Health Impact Assessment (and others, especially in public health literature) is the effect on neighborhoods of the lack of local businesses and services.
I don't disagree. Imagine living in a neighborhood where, as you can see in the quote at the bottom of p 47, there are more marijuana stores than grocery stores (from personal experience living next to or moving around in neighborhoods like these that one could just as easily replace marijuana with liquor and have it be as accurate).
The thing we must remember, however, is that this is not entirely due to outside, malignant influences.
Those stores are there because customers are there. I don't just mean that everyone in this neighborhood is on drugs and doesn't care about quality food. Just as frequently absent from the discussion is the fact that people's choices as to where to go affect where businesses locate.
Take a look at the second link below. Businesses want to be where people will go and see them. If people fear crime and don't go to local stores, there will soon not be local stores.
Compounding this effect is the fact that businesses do not want to invest in neighborhoods where there is crime. See the third link below for a reference. Even if they know there are customers, even if they assume the customers would venture over, why would they locate in an area where they'd have huge risks from theft, destruction of property, and the like?
The outcomes that people have in their life are an interplay.
It is not nature vs. nurture. It's both. At the same time. Playing off each other. I have seen children from unsafe homes who lived in poverty show more resilience than ones who come from privilege. I have seen children who showed great promise sink back in to the habits that landed their parents in bad situations.
Any attempt to assess and therefore to figure out ways to help people must (repeat MUST) reckon with the fact that we are indeed embedded in our environments but we also have choices to make in those environments. It also must reckon with the fact that choices that the government makes play into this.
If we are to help people live better, if we are to help people improve their lives, we need to look beyond a simple "return to the well" of blaming only societal and structural problems. We need to turn inward and help others do the same.
Unfortunately, this report and those of its ilk fall short in that regard and thus the policy made from it will almost certainly do the same.
** If you're not familiar, see the map attached as screenshot 1--neighborhood's outlined in red and I highlighted I-25 and I-70 in blue.
https://www.denvergov.org/content/dam/denvergov/Portals/746/documents/HIA/HIA%20Composite%20Report_9-18-14.pdf
https://www.sciencedirect.com/science/article/pii/S0094119022000250
https://scholars.unh.edu/cgi/viewcontent.cgi?article=1676&context=honors
Fan of wolves? Did you vote for their reintroduction (particularly into parts of the state where you wouldn't face a direct conflict)?
Now's your chance to put your money where your vote is and help give some of the benefit you feel from having wolves (that warm, snuggly feeling while viewing them from across the mountains knowing you'll never have to deal with the problems yourself) back to those that will be harmed.
CSU, through their carnivore coexistence team, has set up a donation site for those that want to help defray the costs of reintroducing wolves.
Quoting from the page itself, this fund is to support "...the efforts of Colorado State University and partners to implement on-the-ground, nonlethal tools to assist livestock producers and local communities in regions with wolves. Your contributions will support research, education, and outreach efforts to reduce conflict with wolves, benefiting both wolves and people."
The link to donate is below. You might consider donating even if you voted no as a way to help ranchers with the burden the Front Range imposed on them.
https://advancing.colostate.edu/WOLFCONFLICTREDUCTION