Do Health Impact Assessments Help Promote Equity Over the Long Term?

The 2020 COVID-19 pandemic and the rise of social movements to advance racial justice have highlighted the wide disparities in health outcomes between White people and Americans of color, particularly Black and Indigenous populations. These disproportional outcomes can be linked to inequities in determinants of health—environmental, social, and economic factors, such as housing, income, employment, and education, that shape health and well-being.

To begin to mitigate health disparities and improve public health broadly, policymakers will need to implement and then evaluate interventions across diverse sectors. However, they face a challenging task in identifying specific policies that can promote health equity—the guiding principle that disparities in health outcomes caused by factors such as race, income, or geography should be addressed and prevented, providing opportunities for all people to be as healthy as possible.

Health impact assessments (HIAs) are one tool that can help. HIAs use a standardized six-step process to investigate how decisions—such as whether to develop a transit system, build a park, or construct a natural gas plant—could affect a community’s health and to promote the consideration of health factors as variables in decision-making. They also present recommendations on how to boost the benefits and mitigate the risks of any potential health effects.