San Francisco Department of Public Health
The purpose of the San Francisco Department of Public Health’s (SFDPH) Health Impact Assessment (HIA) project is to inform and support health-aware decision making at all levels of government and to increase both local level capacity and internal departmental capacity to use HIA. This will be done by using a multidisciplinary and collaborative approach to address health inequalities and demonstrate health as an intrinsic value in transportation, land use, and community design decisions.
2014–2016 HIA Accomplishments
Climate Change Preparedness Tool
This activity will create an HIA tool for evaluating climate interventions and informing the development of a public health climate adaptation plan. The tool will measure potential health impacts, address equity, and determine the co-benefits and costs of climate change interventions.
Food Safety and Restaurant Inspection
This HIA will assess the use of data and predictive analytics to evaluate the policies and strategies that the SFDPH Food Safety Program implements to ensure food safety practices are followed in new and existing establishments. The goals of this HIA are to better understand how inspection processes affect food safety and to guide SFDPH’s Food Safety Program as it updates its restaurant permitting and licensing process. Findings from this HIA will also inform policy recommendations to improve food safety practices in eating establishments.
Potrero Hill Health Center (PHHC) Transportation Access: Implications for Health
This HIA examined the relationship between public transit conditions and access to healthcare services and the implications it has on the health of Potrero Hill Health Center (PHHC) patients, who are disproportionately low income. Approximately 40% of PHHC’s patients are African Americans, 35% Spanish-speaking patients, and a minority of Asian and Caucasian patients. The HIA summarized existing literature and quantitative and qualitative data on local geographic conditions and patient experiences. The findings suggest that PHHC patients face transportation barriers to accessing health care services, which could negatively impact their health. The report provided policy recommendations and identified opportunities for public health and transportation professionals to work together to meet the needs of patients. SFDPH is using the HIA findings to advance collaboration with the city and county transportation agencies.
Retail Tobacco Permit Density Cap Ordinance
In January 2015, the San Francisco Health Code was amended to set a density cap on retail tobacco permits and to restrict permits for new tobacco retailers located near schools or in areas with existing tobacco retailers. The purpose of this HIA was to assess the impact of the density cap and land use ordinance on city residents and businesses, with an emphasis on vulnerable populations. The retrospective approach combined findings from the public health literature and data on neighborhood conditions and retailer locations in San Francisco. The analysis found that the overall number of tobacco retailers dropped city-wide in the 10 months following the implementation of the ordinance and that these declines occurred in neighborhoods with higher levels of vulnerable populations and retailer density. The HIA report recommended approaches to further reduce tobacco retailer density among vulnerable groups, such as youth, and next steps for monitoring the impact of the ordinance on tobacco use among city residents.
Tenderloin-Central Market HIA Tool
This HIA activity will develop a collective impact evaluation tool that captures the work of two major neighborhood-based initiatives by measuring shared outcomes and mapping areas of current or planned investments related to: safe and clean shared spaces, housing/demographic stability, and other healthy community design elements (e.g., pedestrian safety). The web-based tool will help simplify tracking and communication around shared outcomes and guide the implementation of neighborhood investment activities that support revitalization while minimizing displacement of long-time residents and businesses. SFDPH plans to expand the tool for use in other neighborhood economic development activities.
Vision Zero SF
Vision Zero SF is San Francisco’s road safety policy that has a goal of zero traffic deaths in the city by 2024. This HIA examined a comprehensive range of health and equity impacts of implementing potential Vision Zero policy strategies, including their impact on traffic-related injuries and deaths among pedestrians, cyclists, and motorists. The health-based recommendations in the HIA report will inform the next version of San Francisco’s Vision Zero Two-Year Action Strategy for 2017–2018.
2011–2014 HIA Accomplishments
Assessment of Cyclist Safety Conditions in San Francisco
San Francisco is working to eliminate traffic deaths, improve safety conditions for cyclists and all road users, and increase cycling as a safe, sustainable, and healthy mode of travel. This HIA analyzed cyclist injury trends and patterns in the City and made recommendations for improving cyclist safety. It incorporated qualitative data from resident focus groups and quantitative injury and environmental data from SFDPH’s TransBASE, a database of over 200 spatially referenced variables. The HIA found that increased cycling in San Francisco has also resulted in increased cyclist injuries and deaths. To protect cyclists and promote public health, the report recommended implementing the “Es” of traffic safety best practice: education, enforcement, engineering, and evaluation. Future reports can use SFDPH’s modeling methodology, and the HIA findings can help prioritize cyclist safety engineering improvements in San Francisco and provide a baseline for future evaluation of safety interventions.
Central Corridor Project
The San Francisco Planning Department asked SFDPH to conduct an HIA on a proposed plan to encourage mixed-use, higher density, pedestrian-friendly development in the Central Corridor area, an area transitioning from industrial to residential. SFDPH used the Sustainable Communities Index (SCI) to assess the health-related social and environmental conditions in the area— such as air and noise pollution; pedestrian and bicycle safety; high traffic density; a lack of trees, parks, and open spaces; school and housing issues; and unemployment—that could be addressed in the plan. The HIA supported the use of health protective language in the Planning Department’s final Central Corridor Plan (now called the Central SoMa Plan), which guides neighborhood development. The Planning Department has also used the HIA’s findings and recommendations in the Central SoMa planning processes to align future benefit programs with resident health needs. Read more about this HIA here.
Enhancing Health Benefits of Residential Energy Efficiency Programs
This HIA assessed opportunities to leverage residential energy efficiency investments for health by incorporating design elements to protect or improve indoor air quality (IAQ) and reduce noise from outdoors. It also examined the health impacts of targeting these residential design improvements in areas with higher levels of ambient noise and air pollution. The HIA estimated that incorporating specific residential design elements can improve health by reducing premature death associated with fine particulate matter exposure and decreasing exposure to noise. Based on these findings, the HIA recommended that residential energy efficiency programs incorporate IAQ and noise protective design elements and target subsidies in high-risk areas. Following the HIA, SFDPH conducted a pilot program to improve the IAQ of homes in areas disproportionately burdened by poor air quality.
Climate Smart Strategy
This HIA was the final of three that OHA conducted to support Metro in developing a regional greenhouse gas reduction strategy focused on reducing vehicle miles traveled by gasoline-powered, light-duty vehicles. The HIA examined the final preferred Climate Smart Strategy that emerged from the first two phases of Metro’s analyses, which included findings from the previous HIAs. OHA used the Integrated Transport and Health Impact Model (ITHIM) to estimate the annual health and economic impacts of the final strategy based on changes to physical activity, traffic collisions, and air quality in the region. The model estimated that implementing the final strategy would prevent 126 deaths and reduce related illnesses by 1.6% in 2035 compared to 2010, accounting for population growth. The HIA findings helped Metro and its partners adopt the strategy for the region and develop an action plan and tool kit for implementing the new policy framework.
Jewish Home Pedestrian Infrastructure
This HIA analyzed pedestrian safety around the proposed Jewish Home of San Francisco, a senior housing and retail development along Mission Street. The HIA used the pedestrian safety geodatabase to assess public transit, transportation, neighborhood demographics, and pedestrian injury factors along the corridor. It also incorporated data from an audit of streets near the site using the Pedestrian Environmental Quality Index (PEQI) and reviewed data from other recent city analyses. The HIA identified several areas in need of improved pedestrian infrastructure and recommended site-specific and area-wide approaches to protect pedestrian safety. These recommendations were used to help improve the walking environment for seniors living at or adjacent to the Jewish Home of San Francisco. SFDPH now routinely works with the San Francisco Planning Department to address pedestrian safety issues in new developments.
Lane County Affordable Housing Strategic Plan
Lane County Public Health (LCPH) partnered with Eugene’s Planning and Development Department (PDD) and the Oregon Public Health Institute (OPHI) to assess the direct and indirect impacts of the Affordable Housing Strategic Plan on the health of children and youth (age 0-17). The housing plan was one of two strategic plans included in the Eugene-Springfield 2010 Consolidated Plan. The HIA provided health impact information to guide the Eugene-Springfield 2015 Consolidated Plan; as a result, public health professionals are now serving on two committees for the 2015 Consolidated Plan update.
Traffic Speed on South Third St. (Hwy 99W), South Corvallis
This HIA, conducted by Benton County Health Services, examined the potential health and safety impacts of lowering the speed limit from 35 to 25 mph on a one-mile stretch of S. Third Street (Hwy 99W) in south Corvallis. The City of Corvallis requested that Oregon Department of Transportation (ODOT), who sets speed limits for state-operated roads, conduct a speed study of this segment of Hwy 99W. The goal of the HIA was to provide complementary information on the impact of traffic speed on health outcomes and health equity (e.g., active transportation, traffic safety, social networks, and access to goods and services) that are not currently factored into the ODOT process for determining speed limits. Based on community input and analysis of these additional health and safety factors, the HIA recommended lowering the speed limit to 25 miles per hour and improving road and sidewalk conditions. After completing the speed study, ODOT decided to leave the speed limit on Hwy 99W through south Corvallis unchanged. Even though the HIA did not result in lowering the speed limit, the process provided Benton County Health Services the opportunity to build HIA capacity among new public health workers, strengthen existing relationships, and develop new relationships with local and state agencies.
Single Room Occupancy Hotels
Single room occupancy (SROs) hotels are a main source of low-cost and transitional housing in San Francisco. This HIA reviewed existing social and environmental issues that affect SRO resident health and potential policies to address these issues. SFDPH developed several recommendation to improve living conditions among SRO tenants, including mandatory training of SRO operators, culturally competent education materials for SRO operators, publication of housing inspection data, and analyzing data and creating a data sub-committee to improve coordination and operations. San Francisco’s Office of Economic and Workforce Development included these recommendations in its overall Central Market/Tenderloin Strategy. The HIA will guide future policies and programs to improve the health and living conditions of SRO residents.
Vehicle-Pedestrian Injury Collisions at Signalized Intersections
This HIA-like project used a predictive health modeling approach to forecast vehicle-pedestrian injury collisions at signalized intersections, where almost half of these collisions occur in San Francisco. The model developed by SFDPH revealed several environmental factors—including traffic volume, presence of bus stops and bus volume, and resident and employee population—that contribute to these collisions. The study found that identifying and modeling proposed changes to land use and transportation factors can help predict where pedestrian injuries are likely to increase. This information can be used to proactively incorporate pedestrian safety improvements at signalized intersections during the planning process. SFDPH’s methodology now guides modeling efforts for Vision Zero San Francisco’s work to eliminate traffic deaths in the city by 2024.
Tools and Resources for HIA Practitioners
The SFDPH Health Impact Assessment Program developed the following:
- Local community health indicators for local and regional HIA practice, including the San Francisco Indicator Project and Community Residency Indicators
- TransBASE—a relational database designed to access, manage, and apply spatial data to help solve transportation‐related health problems
- Methods to analyze impacts of changes in urban vehicle speeds
- Methods for inter‐disciplinary health impact and cost‐benefit analysis of transportation design alternatives
- Methodology for corridor‐level analysis of traffic injury patterns
- Impact analysis of residential energy efficiency upgrades on exposure to noise and air pollution exposure
- Screening matrix for HIA policy and project targets
- California Department of Public Health
- Golden Gate Restaurant Association
- Potrero Hill Health Center
- San Francisco City Transportation Authority
- San Francisco County Transportation Authority
- San Francisco Mayor’s Office of Housing and Community Development
- San Francisco Mayor’s Office of Innovation
- San Francisco Metro Planning Agency
- San Francisco Municipal Transportation Authority (SFMTA)
- San Francisco Office of Economic and Workforce Development
- San Francisco Planning Department
- Page last reviewed: March 28, 2017
- Page last updated: March 28, 2017
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