Oral

The National Environmental Policy Act (NEPA) of 1969 established the foundations of U.S. environmental policy, directing federal agencies to consider the impact of major federal actions on the “human environment,” and creating the Environmental Impact Statement (EIS) process. NEPA’s fundamental purposes include stimulating “the health and welfare of man,” yet implementation of this far-reaching legislation typically addresses human health marginally if at all. Because of their scale, projects undergoing an EIS involve not only environmental effects, but also predictable changes in local economies, employment, the built environment, and social organization – factors recognized as fundamental determinants of health and health disparity. Under NEPA, agencies must consider reasonable alternatives to the proposed action, and must show efforts to minimize, or “mitigate,” potential adverse effects, which offers a largely unused avenue to protect and promote community health. We will briefly review NEPA and related laws as they apply to public health. We will then describe the methodology of Health Impact Assessment (HIA), review current applications in the U.S., and discuss legal and practical challenges involved in expanding the scope of environmental impact assessment to include public health. The remainder of the session will examine 3 case studies of U.S. efforts to apply HIA within the environmental regulatory process, including a community-based effort undertaken in parallel with an EIS; an academic-CDC partnership examining a major urban redevelopment plan before the formal environmental review process; and a formally integrated HIA/EIS for oil and gas development in the National Petroleum Reserve in Alaska.

Session Objectives: 1. Discuss the legal leverage that NEPA, Executive order 12898 on Environmental Justice, and state and local environmental laws may provide for efforts to protect and promote public health. 2. Understand the basic principles and methodology of HIA. 3. Develop strategies for working both within and in parallel with the environmental planning and regulatory process through applying health impact assessment. 4. Recognize the significance of environmental regulation and planning efforts to public health. 5. List case examples of current applications of HIA in the U.S. 6. Discuss the legal and practical challenges involved in integrating public health concerns into environmental impact assessment.

CE Credits: CME, Health Education (CHES), Nursing