The State of Health Impact Assessment in Planning

By Anna Ricklin, AICP, Michelle Madeley, Elizabeth Whitton, AICP, Angelica Carey



Where people live, work, and play can directly and indirectly influence behaviors, individual health, and collectively, community health. In fact, the planning profession is deeply rooted in public health; planning was initially established to limit the spread of disease and increase sanitation in urban areas by creating standards for development and separating land uses. The 20th century marked a divergence between these fields, but the 21st century witnessed a renewed focus on uniting the two professions.

The International Association for Impact Assessment defines HIA as “a systematic process that uses an array of data sources and analytic methods and considers input from stakeholders to determine the potential effects of a proposed policy, plan, program, or project on the health of a population and the distribution of those effects within the population” (IAIA 2014). HIA is a tool that brings together scientific data, health expertise, and public input to understand how a proposed plan, policy, program, project, or action could affect the public's health.

HIAs are used by the planning profession to better understand the health impacts of proposed plans, policies, and projects on neighborhoods and communities. Between 2004 and 2014, 134 HIAs were conducted in the United States on decisions that meet this report's definition of planning ("planning HIAs"), representing more than a third of the total HIAs conducted or in progress in the country during that time. The State of Health Impact Assessment in Planning analyzes these HIAs and the use of HIAs within planning practice. The analysis in this report is the first to look at the current state of HIAs within the planning practice.


Page Count
Date Published
July 1, 2016
Adobe PDF
American Planning Association

About the Authors

Anna Ricklin, AICP
Anna Ricklin, AICP is a passionate advocate for healthy communities and is the first Health in All Policies Manager for the Fairfax County. In that role, she acts as a health ambassador across county agencies, promoting the integration of public health objectives into county plans, policies, and building projects. Formerly, Anna oversaw applied research and place-based initiatives to advance healthy planning practice at the American Planning Association, and began her career at the Baltimore City Department of Transportation. Anna has a background in health impact assessment, active transportation planning, and cross-sector collaboration, as well as recent work establishing metrics for healthy planning. Anna holds a Master of Health Sciences from the Johns Hopkins Bloomberg School of Public Health and lives in Falls Church, VA.

Michelle Madeley

Elizabeth Whitton, AICP
Elizabeth Whitton, AICP is a Transportation Planner at MetroPlan Orlando where she leads the regional transportation planning agency’s transit, health, and strategic planning initiatives. She works with federal, state, and local partners to ensure Central Florida’s transportation system supports healthy, inclusive, and economically vibrant communities. Prior to joining the MetroPlan Orlando team, Elizabeth worked in Washington, DC conducting policy research related to the built environment’s impact on public health. She has a Bachelors degree from the University of Alabama, a Masters degree from Florida State University, and was a Peace Corps volunteer in Morocco.

Angelica Carey

Table of Contents



Key Terms
Planning terms
Public health terms

1. Introduction
What did we learn?

2. Overview of HIAs in Planning

3. HIA Review
HIA process
Types of HIAs

4. Analysis and Conclusions
HIA and planning share best practices and core values
HIA illustrates connections between health and planning
HIA catalyzes and fosters cross-sector collaboration
HIA is evolving


Appendix 1. Methodology
Appendix 2. Introduction to In-Depth Case Studies
Appendix 3. In-Depth Case Studies
Appendix 4. References