LAUSR

Abstract Health impact assessment (HIA) is a method of analyzing and communicating the potential health-related outcomes of policies and projects in a variety of fields, including transportation. The transportation policy process already has formal routines to incorporate information about air quality, noise, safety, and other health issues. However, the HIA method could broaden the set of issues under consideration (e.g., physical activity), the types of decisions assessed, and the actors involved. In theory, HIA seeks to influence transportation decisions and serve as a platform for public participation, but the literature is not clear about how HIAs in practice influence decisions and support participation. We used the Health Impact Project (HIP) archive to analyze 59 HIAs on transportation issues conducted between 2005 and 2016 in the United States. We critically reviewed each HIA, and developed a categorization strategy to create a typology of HIAs according to the transportation decisions they sought to influence, the partnerships it created, and the types of participation it used. We found that HIA has predominantly been a point of entry for the public health profession to be active in transportation, rather than a learning process originating with transportation professionals or grassroots initiatives. Our typology revealed that HIAs have been conducted for diverse purposes including influencing decisions, but the majority, instead, framed their purpose as providing information, expressing community support, building capacity, or serving as a planning tool. Participation in HIAs drew from government agencies across multiple sectors, but its reach seldom included grassroots community groups. The future of HIA practice in public health and transportation could build on the HIA’s adaptability to the local decision-making context, and embrace its various forms of informal policy influence. In addition, future practice could increase public participation among members of general public and organized grassroots groups.