Health Impact Assessment and/of City Council Policy: Opportunities to Address Social Determinants of Health in Baltimore

The World Health Organization recognizes that “the social determinants of health are mostly responsible for health inequities” (WHO, 2008). As such, achieving health equity cannot happen without deliberate and sustained action on the social determinants of health (SDoH). The distribution of SDoH is largely determined by policy decisions, and experts emphasize the importance of understanding that “every aspect of government and the economy has the potential to affect health and health equity” (WHO, 2008). A core feature of Health Impact Assessment (HIA) is that it can be used to assess any and every type of policy/program, including zoning, transportation, education, finance, and housing. Thus, by its very nature, HIA is a tool designed to address the underlying SDoH. However, local public health entities (and governments) have been slow to adopt the formal use of HIAs or incorporate the application of its core components and principles in the policy development process.

This presentation will discuss results of a review conducted of all policies introduced into Baltimore City Council in calendar year 2008. The review was an initial effort to ascertain the extent to which “non-health” policies may impact health and to explore the potential vitality of HIA in Baltimore as a tool to address SDoH and promote health equity. This work has resulted in the first and on-going dialogue around HIA with key City Council member and staff, with continuing discussions on how to incorporate the principles and core philosophy of HIA into the policy development process. Data will be presented.