Community Health Innovation

Using Health Impact Assessment to Optimize Health Care Reform

By Stephen Horan, PhD

What will happen to our community under health care reform?  This is an important question for anyone concerned about the health of their community.  The answer is not simple to produce, but we can start by taking a systematic approach

Health impact assessment (HIA) is a systematic approach for evaluating the potential health effects of a policy or project.  It has been defined as "a flexible, data-driven approach that identifies the health consequences of new policies, and develops practical strategies to enhance their health benefits and minimize adverse effects." (The Health Impact Project).  HIA may involve a variety of research methods including demography, public health research, health services research, health policy research, economic impact analysis, and more.  HIA typically follows a six-step process:

1. Screening - Identify the projects or policies for which an HIA would be useful
2. Scoping - Identify which health effects to consider
3. Assessing Risks and Benefits - Identify which people may be affected, and how
4. Developing Recommendations - Suggest changes to proposals to promote positive impacts and mitigate negative impacts
5. Reporting - Present the results to decision makers
6. Evaluating- Determine the influence of the HIA on the decision process.

At its best, HIA is designed to produce practical answers to important questions posed by people with a stake in the policy or project under study.  If a community were to apply HIA to the health care reform legislation, the study could be designed to answer questions like:

1. Who in our community will be covered under health reform? Who will remain uninsured?
2. How might the health reform legislation affect the health status of our community population?
3. How might the health reform legislation affect peoples' access to health services?
4. How might the health reform legislation affect our local employers and employment?
5. What steps should we be taking at the community level to promote the positive impacts of health care reform, and mitigate any negative impacts?
6. What recommendations should we make to federal and state government to optimize the legislation and regulation?

Questions like these could be generated and refined by a single entity or by a coalition of community stakeholders.  The results could be used to inform policy and practice at the federal, state, and local level.  To learn more about the potential of health impact assessment, visit:

The Centers for Disease Control

The Health Impact Project

The UCLA Clearinghouse

Community Health Solutions

Six Questions for Strategic Leaders

By Steve Horan, Community Health Solutions

We all like to 'be strategic' in our work as leaders.  But what does being strategic really mean?

In our research to develop The Practical Leadership Model we identified six key factors that influence strategic achievement:

1. Long-term thinking
2. A return-on-investment perspective
3. Strategic investment in capacity
4. A focus on mission and goals throughout the organization or team 
5. Continuous attention to culture
6. Continuous attention to execution.

Whether we are leading an entire organization, an internal team, or an external partnership, we can use these six success factors to guide our leadership.  They key is to integrate these success factors into our leadership thinking by asking ourselves six questions every day:

1. Are we thinking long term?
2. Are we building return on investment for our stakeholders?
3. Are we developing the capacity we need for sustainable excellence?
4. Is everyone focused on the right intentions (mission, goals, etc.)?
5. Does our culture support the kind of innovation and collaboration we need to succeed?
6. Are we fully executing what we set our to do?

Ask yourself these questions whenever you are contemplating a significant decision or initiative.  Also engage your team in asking the same questions on a regular basis.  This will help you build a team of strategic thinkers who are ready to take your organization or initiative to the next level.  At the same time, you will be developing the next generation of leaders.

 

Jim Collins on Good to Great in the Social Sectors

 

Jim Collins is the author of Good to Great , Good to Great in the Social Sectors, and other best sellers on what works in leadership and strategy.  He has also compiled a series of free short videos and podcasts on Good to Great in the Social Sectors at JimCollins.com. 

Click here to access any of the following

• Greatness is Not a Business Idea | 02:07
• The Uber-Flywheel in the Social Sectors | 01:21
• A Conversation with a Church Leader About the Resource Engine | 01:58 | Download MP3
• "First Who, the Hedgehog Concept, and Your Personal Trajectory" | 02:58 | Download MP3
• Funding: Time-Telling Vs. Clock-Building | 01:51 | Download MP3
• Greatness Is a Matter of Conscious Choice and Discipline | 00:58 | Download MP3
• Harnessing the Flywheel | 00:40 | Download MP3
• A Hypothesis: Executive and Legislative Leadership | 01:07 | Download MP3
• "If We Only Have Great Companies, We Will Merely Have a Prosperous Society - Not a Great One" | 00:35 | Download MP3
• The Importance of Distinguishing Inputs from Outputs | 00:50 | Download MP3
• The Inverse Relationship of Leadership and Power | 03:12 | Download MP3
• Lack of Resources Is No Excuse for Lack of Rigor | 01:24 | Download MP3
• The Social Sectors' Compelling Advantage: The Desperate Craving for Meaning in Our Lives | 00:42 | Download MP3
• The Solution Is Not to Be More Like a Business | 00:35 | Download MP3
• The Three Circles and the Resource Engine | 00:40 | Download MP3