Lessons From San Francisco: Health Impact Assessments Have Advanced Political Conditions For Improving Population Health


Jason Corburn, Rajiv Bhatia


California, city planning, community development, government department collaboration, health determinants, Health Impact Assessments (HIAs), health policy, public health, public policy, San Francisco


Health Affairs

Year Published:


Policy Summary

Health Impact Assessments (HIAs) are increasingly being used as a public policy decision making tool because they estimate the positive and negative health effects of potential policies and thus inform decision makers. The authors analyzed years of HIAs done by the San Francisco Public Health Department to determine the role HIAs have on decision makers. They found that HIAs increase decision makers use of health evidence (particularily social determinants) and allow for community participation in the evidence gathering process, which strengthened assessment findings. HIAs increase organizations knowledge about health determinants and conducting a HIA often leads to discoveries of gaps in health protective regulations and laws. HIAs tend to generate conversation about the links between public health and public policy and foster collaboration between the public health department and other large city departments. HIAs influence policy decisions in complex ways, while uniting advocacy groups.

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