Advancing policy change and health equity through health impact assessment and a health lens: A local health department's experience

In Alameda County, health outcomes vary by place, race, and income. An African American child born in West Oakland can expect to live 15 years less than a White child born in the Oakland Hills. The Alameda County Public Health Department (ACPHD) recognizes these disparate life chances are caused by differences in social, economic, and environmental conditions and that what shapes these unequal conditions is policy. To advocate for policies that increase health equity, ACPHD has adopted health impact assessment (HIA) as a tool in its collaborative work across multiple sectors and in partnership with community.

ACPHD has participated in HIAs on public school and bus transit funding, Port of Oakland operations, and Transit-Oriented Design near a subway station. ACPHD has also utilized HIA approaches to enter into policy discussions about foreclosure, public housing, and local planning processes. This session will highlight the spectrum of HIA-related work that ACPHD has been engaged in, including outcomes, lessons learned, and challenges.

HIA findings have been used in public testimonies, letters to decision-makers, media statements, and meetings with legislators and agency heads. Outcomes have included advocating for more equitable public school and transit funding, cleaner Port trucks and healthier work conditions, and registration and maintenance of foreclosed properties.

ACPHD demonstrates that local health departments can effectively use HIA and a health lens to promote increased equity in education, transportation, housing, and land use policies and decision-making. Such policy changes address inequities that accumulate over people's lives and diminish quality and length of life.