What is a Health Impact Assessment (HIA)?

A Health Impact Assessment (HIA) is a type of report that uses data, research, and stakeholder input to understand how a policy or project would impact the health of a population. HIAs take place before a decision is made, so that recommendations can be made on how the policy or project could better promote health. In practice, HIA is a useful way to:

  • Include health issues in decision-making; and
  • involve stakeholders in the process.
What is the purpose of an HIA?

HIAs advocate for good health; they do not advocate for, or against, a project or policy. Instead, they look at how a project or policy would affect the health of a population impacted by the project or policy and develop recommendations that would lesson negative health impacts while maximizing positive impacts. In this way, HIAs help decision-makers understand possible health impacts that may result from a project or policy and address them, before the project or policy starts. 

What type of health factors does an HIA look at?

HIAs focus on how a policy or project will affect individual or population health outcomes, including physical and mental health. Oftentimes, HIAs examine how the social, economic, and physical environments impacted by policies or projects would affect health. By looking at these “health determinants”, an HIA creates pathways of how those changes will impact people’s health. 

What are the major steps in an HIA?

There are six major steps in an HIA:

  • Screening: Determines whether an HIA would be useful for the proposed policy or project
  • Scoping: Identifies which health impacts to evaluate, methods for analysis, and work plan for completing the assessment
  • Assessment: Establishes a profile of existing health conditions and evaluates potential positive and negative impacts of the proposed project or policy on those conditions
  • Recommendation: Provides strategies to manage identified health impacts of the proposed project or policy
  • Reporting: Communicates the development of the HIA report, findings, and recommendations to stakeholders
  • Monitoring: Tracks how the project or policy affects the identified health areas and establishes a way for decision-makers to be accountable for reducing those impacts
Who usually does an HIA?

Health focused foundations and public agencies are increasingly funding and leading HIAs. They are seen as a way to reduce negative health outcomes that may result from a proposed policy or project.

Will a casino be built in Western Massachusetts?

In November 2011, Governor Deval Patrick signed into law the Expanded Gaming Act. This law makes Western Massachusetts one of three regions in the state eligible to be the site of a destination resort casino. Two casino operators have filed initial applications and are actively negotiating with communities to build a casino: Mohegan Sun in Palmer and MGM Resorts International in Springfield. In September 2013, voters in West Springfield rejected Hard Rock International's plan. 

Who will decide if a casino is built or not?

The Massachusetts Gaming Commission makes that decision. Casinos must file a Phase 2 application for licensure by December 31, 2013 to be considered by the Commission. Only one license will be granted for Western Massachusetts. The casino applicant also needs to:

  • Negotiate an agreement with the host community; and
  • Win a referendum in the host community where a majority of voters agree to have a casino within their community.

Just because a casino may win a referendum does not mean they get a license to build a casino; the Gaming Commission will make that decision.The Commission anticipates issuing a license for a Western Massachusetts casino by April of 2014. To learn more about the Casino Licensing process, visit the Massachusetts Gaming Commission.

What is the Western Massachusetts Casino Health Impact Assessment looking at?

The Western Massachusetts Casino Health Impact Assessment is looking at the potential health impacts of a casino in Palmer or Springfield. Rather than conduct an HIA for each community, the Casino Health Impact Assessment combines them into one HIA. The Casino HIA began in March 2013 and will finish by December 2013. If possible, the Casino HIA will provide some information to decision-makers prior to December 2013.

Is the Gaming Commission leading the Casino HIA?

No.  The Public Health Institute of Western MA (PHIWM), a nonprofit public health organization based in Springfield, Massachusetts, is leading the Casino HIA.  PHIWM received a grant from the Health Impact Project (a collaboration between the Robert Wood Johnson Foundation and Pew Charitable Trusts) to conduct the Casino HIA. 

How are the two communities involved in the Casino HIA?

They are involved in two ways:

  • Residents and leaders from the two communities have directly participated in meetings, workshops, and online surveys; and
  • Through a large, diverse Advisory Committee consisting of representatives from professional businesses, community-based organizations, municipal and government offices, health centers, colleges and universities, faith-based organizations, social services, and employment agencies from Palmer and Springfield. The Gaming Commission is also a member.
Will the Casino HIA inform decision-makers about potential health impacts of a casino?

Yes. Both municipal leaders and the Gaming Commission are part of the Advisory Committee and interested in Casino HIA findings. Part of the goal of the Casino HIA is to assist the Massachusetts Gaming Commission, host community elected leaders and residents, and casino operators in understanding the potential health impacts of a casino being located here in Western Massachusetts. Periodic updates are given to municipal leaders and the final report will be ready in December so the Gaming Commission can take it into consideration for its licensing decision.

Do other communities do casino HIAs? Could those answer our health questions?

Yes, an HIA was conducted for a casino in Kansas. The Casino HIA team has looked at it, but communities are all different with different environmental, economic, and social factors that make it impossible to draw the same health conclusions. 

How can I learn more about the Casino HIA?

You can read the latest updates on the Casino HIA and provide feedback through our Contact Us page.

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