Twin Cities light rail project presents both opportunities and risks for health, according to report

An HIA is a study that helps policy makers identify the likely health impacts of a decision in a field outside of health—in this case, the assessment is informing the rezoning process for a billion-dollar light rail line connecting the downtowns of Minneapolis and St. Paul. The HIA has been successful in incorporating health issues into the policy discussion, and helping policy makers and community members see how issues like employment and access to transit affect health.

"The health impact assessment of the light rail line in the Twin Cities shows the value of planning ahead. The HIA identifies benefits as well as unintended consequences, like the risk of displacing low-income residents along the corridor while there is still time to do something about them," said Aaron Wernham, M.D., director of the Health Impact Project. "For a decision like this, HIA can serve as a road map for decision makers who have to balance issues such as health and affordable housing with economic opportunities that come with transit and land-use planning."

The HIA highlighted the health benefits the light rail offers through increased access to transit, which connects people to grocery stores, doctors' offices, and other services. It would also facilitate access to jobs and bring customers to the many small and minority-owned businesses that line the corridor. Employment benefits health by allowing people to afford food, safe housing, and medical care. This HIA offered practical recommendations, such as making additional parking available during construction to help small businesses attract and retain shoppers.

The HIA also identified that when redevelopment occurs in the corridor, housing costs would likely rise and lead to health risks if lower-income residents struggle to afford necessities such as rent, food, heat, and medicine. The transit line passes through some of the region's most diverse and lowest-income communities.

If people moved because of rising prices, the cultural and social aspects of the communities would change dramatically. Research shows that when people are more actively engaged in a community, they are more likely to walk and shop in the neighborhood, to know their neighbors, and to look out for one another. These benefits translate into lower crime and violence, and better health outcomes.

The HIA study identified affordable housing as a community priority, and as a result of the report's recommendation, the St. Paul city council created a work group to identify ways to preserve and enhance access to housing for low-income residents. The council also commissioned feasibility analyses on two proposals prioritized by a community steering committee representing a wide range of organizations and interests. One program would expand the incentives to developers who provide affordable housing in new residential and mixed-use development projects and a pilot that would help cover the cost of reserving some of the housing close to proposed light rail stations for lower-income households.

Although all HIAs include a stakeholder engagement portion to guide the study, this project's level of engagement, particularly with low-income people and communities of color, was unprecedented in the city of St. Paul, according to the report. The project created a community steering committee of more than 20 organizations representing diverse constituents and interests, including labor, faith, housing, and neighborhood groups.

Health impact assessment is a fast-growing field in the United States. Transportation projects and planning are frequent HIA subjects, with at least two dozen HIAs conducted to inform decisions in that sector in the U.S. Other HIAs informing transit-oriented development include projects in Houston, in Pittsburg, CA, and in Los Angeles.

Provided by Pew Health Group