Making health a routine consideration in public policymaking: Health impact assessment of federal housing policy

Health impact assessments (HIA) have been used internationally for many years to help policymakers factor health more routinely into decision-making processes. HIA practice in the U.S., however, has focused mostly on state and local polices. Of the nearly 300 HIAs completed or underway nationally, fewer than 10 have targeted federal policy decisions. Stemming from the work of the National Prevention Council, and in collaboration with the U.S. Department of Housing and Urban Development (HUD), we conducted an HIA of how changes to existing federal regulations permitting the designation of public housing for seniors only, non-elderly persons with disabilities only, or a mix of seniors and non-elderly persons with disabilities could affect the health of these populations. Nearly 140 public housing authorities currently administer this rule, designating over 65,000 public housing units for occupancy by low-income seniors or non-elderly persons with disabilities. 

Presenters will begin the session with a brief introduction to HIA as an approach to bring together scientific data, health expertise, and public input to identify the potential—and often overlooked—health effects of proposed projects, policies, and programs. We will share HIA findings on the potential health implications of the proposed federal housing rule change highlighting data from key informant interviews and focus groups with public housing authority administrators, staff, and residents; and incorporating evidence from a systematic literature review, and quantitative analyses of housing data. We will also highlight lessons learned from applying HIA to a federal regulatory policy as part of the National Prevention Strategy.