Setting the Stage
In the early part of the 20th century, the neighborhood of North Omaha, Nebraska, birthplace of Malcolm X, was a thriving African American community. It was well-known for its jazz, swing, and blues music and as a stop for leading artists when they toured the Midwest. Although North Omaha is rich in history and culture, it has also struggled with the same issues as other large African American communities, including poverty and declining economy, housing options, and jobs.
In 2007, a group of business and community leaders came together to help return this previously bustling neighborhood to its former glory. They established a coalition composed of Omaha City agencies and residents of North Omaha to create a plan to revitalize the area.
In 2011, the coalition decided to focus on improving Adams Park, a 68-acre green space located next to the Malcolm X Birthsite. Their goal was to create a “Central Park” for North Omaha that would encourage residential housing growth in surrounding neighborhoods—partly through the creation of an urban farming and community gardening center within the park.
The Douglas County Health Department (DCHD) was already on board. In fact, DCHD had been working on a project that fit right in with the community garden plan. Thanks to a grant from the federal “Communities Putting Prevention to Work Program,” DCHD was focusing on reducing health problems caused by obesity in North Omaha.
“Volunteers had surveyed every grocery and convenience store in the county, rating them based on their healthy food options,” says Andy Wessel, a community health planner with DCHD. “Full-service grocery stores ranked the highest, but in North Omaha, they were few and far between. Our data on heart disease, diabetes, and other health issues also pinpointed North Omaha as an area where improving access to healthy food could make a big difference.”
Where Do We Start?
A health impact assessment (HIA) is a process that helps a community determine the health impact of a proposed policy, program, or project. HIA evaluates community demographic and health data and public input to recommend actions that will promote good physical and psychological health as well as general well-being.
HIA stages include:
• Assessing risks and benefits
• Developing recommendations
• Monitoring and evaluating
Although HIA began in Europe and Australia in the 1990s, it is still relatively new in the United States. In April 2012, CDC helped to organize and lead the first HIA conference in the United States, with at-capacity attendance. By then, more than 170 documented HIAs had been conducted or were underway in the United States.
The plan was gaining momentum, but DCHD and the coalition needed support to accomplish it. To get funding, they had to show that renovating the park and adding community gardens was possible and would be a good investment in the North Omaha community.
Cities and communities around the country, similar to North Omaha, are using a relatively new tool to help urban planners make such critical decisions about their communities. The tool, known as Health Impact Assessment (HIA), evaluates city planning, building, and transportation projects based on the effect they will have on people’s health. CDC’s Healthy Community Design Initiative provides funding and training to communities to conduct HIAs, and DCHD was one of only 6 communities to receive a grant in 2011.
“We saw the opportunity to bring health and health equity into the revitalization effort around Adams Park,” says Wessel. “In the beginning, a lot of people were skeptical about HIA because they felt it would slow down the process. At the end of the day, the Adams Park HIA showed how including health and community concerns was a real benefit for decision-makers. I credit a lot of that success to CDC’s Healthy Community Design Initiative for their funding, training, and hard work in helping us implement an HIA.”
Adams Park Health Impact Assessment
DCHD collected and analyzed data on health, demographics, food access, crime, traffic crashes, and land use in this neighborhood of North Omaha.
They interviewed experts and reviewed scientific research on how changes in Adams Park could affect health. Among other conclusions, their data showed how community gardens, urban farms, and park improvements would help improve residents’ health.
Getting input from area residents is an essential step in HIA. DCHD’s partners, the African American Empowerment Network and the North Omaha Neighborhood Alliance, provided valuable insight on community priorities.
Health and Health Equity: A Seat at the Table
Andy Wessel believes that in addition to answering questions about health impacts, HIA supports basic human rights. “Two of the values that HIAs promote are democracy and equity. That means making sure that decision makers ask questions like, ‘What are the hopes and concerns of the people most affected by this decision?’ and ‘How is this decision likely to affect the lives of those who are already struggling?’. Perhaps more important, HIA makes sure that groups that often go unheard are involved with determining the answers to those questions.”