North to the future: An evaluation of the two HIAs that led to the first statewide HIA program

The state of Alaska recently became the first state in the U.S. to formalize the use of health impact assessment (HIA) as part of its permitting and regulatory procedures for large projects. HIA is a decision-support tool: in the context of a proposed policy or project, it is used to systematically identify potential health risks, benefits, and tradeoffs, and to propose recommendations for alternatives or specific mitigation measures that would minimize any identified risks and maximize the potential benefits. We will present evaluations on two HIAs—one for an oil and gas leasing proposal and one for a proposed mine expansion—and describe how these pilot projects helped establish Alaska's HIA program. These HIAs addressed a range of health risks and benefits including exposure to air and water pollution; dietary change from impacts to fish and wildlife; demographic changes and the risk of drug and alcohol use, violence, and the spread of sexually transmitted illnesses; and individual and employment and regional economic changes. We will evaluate the process of conducting the HIAs, including how stakeholders were engaged; the methods used in the assessment of impacts; and the development and prioritization of recommendations; and the impact of each HIA on the final permitting decisions. The talk concludes with a description of the Alaska Department of Health and Social Service's new HIA program as a model for effective and sustainable collaboration between a health department and state, federal, and tribal regulatory agencies.