United States
Environmental Protection
Agency
EPA/600/R-14/400
April 2015
www.epa.gov/ord
Proctor Creek's Boone Boulevard Green
Street Project Health Impact Assessment
(HIA)
Atlanta, Georgia
PROCTOR
CREEK
Office of Research and Development and Region 4
U.S. Environmental Protection Agency
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Proctor Creek's Boone Boulevard Green
Street Project Health Impact Assessment
(HIA)
Authors (in alphabetical order)
Lauren Adkins1, Thomas Baugh2, David Egetter3, Florence Fulk4, Isabel Garcia de Quevedo Landa5,
Alexander Hall1, Michelle Marcus-Rushing6, Na'Taki Osborne Jelks7, Amy Prues1, Justicia Rhodus1,
Monica Robinson8, Candace Rutt5, Tami Thomas-Burton9
1 CSS-Dynamac c/o U.S. Environmental Protection Agency, Cincinnati, OH 45268
2 U.S. Environmental Protection Agency, Region 4 Office of the Regional Administrator and Deputy
Regional Administrator, Energy and Climate Change Program, Atlanta, GA 30303
3 U.S. Environmental Protection Agency, Region 4 Resource Conservation and Recovery Act Division,
Brownfields Program, Atlanta, GA 30303
4 U.S. Environmental Protection Agency, Office of Research and Development, National Exposure
Research Laboratory, Cincinnati, OH 45268
5 Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and
Health Promotion, Atlanta, GA 30333
6 Georgia State University, Georgia Health Policy Center, Atlanta, GA 30302
7 Georgia State University, Atlanta, GA 30302; West Atlanta Watershed Alliance, Atlanta, GA 30302
8 Fulton County Department of Health and Wellness, Atlanta, GA 30303
9 U.S. Environmental Protection Agency, Region 4 Office of the Regional Administrator and Deputy
Regional Administrator, Environmental Justice and Sustainability, Atlanta, GA 30303
Suggested Citation:
U.S. EPA. 2014. Proctor Creek's Boone Boulevard Green Street Project Health Impact Assessment
(HIA). U.S. Environmental Protection Agency, Office of Research and Development and Region 4,
Washington, D.C.
Office of Research and Development and Region 4
U.S. Environmental Protection Agency
Washington, DC
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Notice
The U.S. Environmental Protection Agency (EPA) through its Office of Research and Development
(ORD) partially funded and collaborated in the research described here under the Regional Sustainable
Environmental Science (RESES) research program. It has been subjected to the Agency's review and
external peer-review and has been approved for publication as an EPA document. Proctor Creek's Boone
Boulevard Green Street Project Health Impact Assessment (HIA) was led by EPA staff and contractors
with technical assistance from the Georgia Health Policy Center (GHPC) through a cooperative
agreement with the Centers for Disease Control and Prevention (CDC). Members of the City of Atlanta,
GA; non-government organizations; and community residents in the headwaters of Proctor Creek in
Atlanta, Georgia also provided input for this report. The contents of this report are solely the
responsibility of the authors and do not necessarily represent the views or policies of the EPA, GHPC, or
CDC.
HIA Participants
HIA Core Project Team
Lauren Adkins [CSS-Dynamac], Thomas Baugh [EPA Region 4 Office of the Regional Administrator
and Deputy Regional Administrator (ORA)], Mary Jo Bragan [EPA Region 4 Water Protection Division],
Neil Burns [EPA Region 4 Office of Policy and Management (OPM)], David Egetter [EPA Region 4
Resource Conservation and Recovery Act (RCRA) Brownfields], Florence Fulk [EPA National Exposure
Research Laboratory (NERL)], Gregg Furie [EPA Sustainable and Healthy Communities (SHC) Research
Program], Isabel Garcia de Quevedo Landa [Centers for Disease Control and Prevention (CDC) Fellow],
Alexander Hall [CSS-Dynamac], Michelle Marcus-Rushing [GHPC, Georgia State University], Na'Taki
Osborne-Jelks [West Atlanta Watershed Alliance (WAWA), Georgia State University], Amy Prues [CSS-
Dynamac], Justicia Rhodus [CSS-Dynamac], Monica Robinson [Fulton County Department of Health and
Wellness (FC-DHW)], Candace Rutt [CDC], Denise Tennessee [EPA Region 4 Office of Environmental
Justice and Sustainability], Tami Thomas-Burton [EPA Region 4 Office of Environmental Justice and
Sustainability], Paul Wagner [EPA Region 4 Air Program], Camilla Warren [EPA Region 4 RCRA
Brownfields], Daphne Wilson [EPA Region 4 Office of Environmental Justice and Sustainability]
City of Atlanta Department of Watershed Management (DWM)
Todd Hill, Julie Owens, Susan Rutherford
HIA Advisory Group
Nikel Bailey [U.S. Department of Housing and Urban Development (HUD)—Atlanta Regional Office],
Daniel Deocampo [Georgia State University], Michael Dobbins [Georgia Tech College of Architecture],
Debra Edelson [Trust for Public Lands— Georgia], Michael Elliott [Georgia Tech— Center for Quality
Growth and Regional Development], Stacy Funderburk [The Conservation Fund— Georgia], Darryl
Haddock [WAWA], Lee Harrop [Atlanta Beltline, Inc.], Dudley Hartel [U.S. Department of Agriculture
(USDA)— Forest Service (Southern Research)], Tamaya Huff [Georgia Department of Transportation
(GA-DOT)], Na'Taki Osborne-Jelks [WAWA, Georgia State University], Cassandra Johnson [USDA-
Forest Service (Southern Research)], Yvonne Jones [Neighborhood Planning Unit (NPU)— L], Jewelle
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Kennedy [City of Atlanta— Department of Planning], Eloisa Klementich [Invest Atlanta], Eric Kuehler
[USDA—Forest Service (Urban Forestry South)], Stephanie Madson [Federal Emergency Management
Agency (FEMA)— Region IV Environmental Planning and Historic Preservation], Kevin Moody [Federal
Highway Administration (FHWA)— Office of Technical Services], Yomi Noibi [Environmental
Community Action Inc.], Mark Patterson [Kennesaw State University Department of Geography and
Anthropology], Demarcus Peters [English Avenue Neighborhood Association], Neela Ram [Atlanta
Regional Commission (ARC)], Walt Ray [Park Pride], Monica Robinson [FC-DHW], Catherine Ross
[Georgia Tech— Center for Quality Growth and Regional Development], Jonette Simmons [HUD—
Atlanta Regional Office], Julie Owens [City of Atlanta— DWM], Tony Torrence [Community
Improvement Association, Inc.], Jason Ulseth [Chattahoochee Riverkeeper], Latoria Whitehead [CDC—
Office of Minority Health and Health Equity], Ellen Wickersham [Invest Atlanta— Parks and Greenspace
Acquisition], Fatemeh Shafiei [Spelman University], Bruce Battle [Georgia Tech— School of City and
Regional Planning], Candace Rutt [CDC— Division of Nutrition, Physical Activity and Obesity], Isabel
Garcia de Quevedo Landa [CDC Fellow], Carolyn Aidman [Emory University— School of Medicine],
Brandy Crawford [City of Atlanta— Office of Planning], Chris Faulkner [Atlanta Regional Commission],
James Shelby [City of Atlanta— Department of Planning and Community Development], Jane Perry
[Georgia Department of Public Health (GA-DPH)], Julia Campbell [GA-DPH], Chris Rustin
[GA—DPH], Shuranda Buchanan [CDC— Division of Emergency and Environmental Health Services],
Abena Ajanaku [Georgia Environmental Protection Division (GA—EPD)]
HIA Community Informants
Al Bartell, Shaheed Dubois, Pamela Flores, Darryl Haddock [WAWA], Yvonne Jones [NPU- L], Yomi
Noibi [Environmental Community Action, Inc.], Na'Taki Osborne-Jelks [WAWA, Georgia State
University], Demarcus Peters [English Avenue Neighborhood Association], Debra Scott, Tony Torrence
[Community Improvement Association, Inc.]
For more information about this HIA, please contact:
Florence Fulk, U.S. EPA, NERL
Phone:513-569-7379
Email: fulk.florence@epa.gov
Tami Thomas-Burton, U.S. EPA, Region 4
Phone: 404-562-8027
Email: thomas-burton.tami@epa.gov
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Ackn o wledgem ents
The work described in this report is a product of a partnership between the U.S. Environmental Protection
Agency (EPA) Office of Research and Development (ORD) and Region 4, under the Regional
Sustainable Environmental Science (RESES) research program. Participation was leveraged from the
Urban Waters Federal Partnership, for which the success of this HIA would not have been possible. In
addition, we would like to acknowledge the following organizations and individuals for their continued
support and contributions throughout the HIA process:
Atlanta Beltline, Inc.
Atlanta Regional Commission (ARC)
Centers for Disease Control and Prevention (CDC)
Office of Minority Health and Health Equity
Chattahoochee Riverkeeper
City of Atlanta Department of Watershed
Management (DWM)
City of Atlanta Office of Planning
City of Atlanta Department of Planning and
Community Development
Community Improvement Association, Inc.
English Avenue Neighborhood Association
Environmental Community Action, Inc
Environmental Planning and Historic Preservation
Federal Emergency Management Agency (FEMA)
Federal Highway Administration (FHWA)
Office of Technical Services and Region 4
Emory University, School of Medicine
Fulton County Department of Health and Wellness
(FC-DHW)
Georgia Department of Natural Resources
(GA-DNR)
Georgia Environmental Protection Division
(GA-EPD)
Georgia Department of Public Health (GA-DPH)
Georgia Department of Transportation (GA—DOT)
Georgia Health Policy Center (GHPC)
Georgia State University
Georgia Tech College of Architecture, School of
City and Regional Planning
Georgia Tech Center for Quality Growth &
Regional Development
H.E.L.P.
Invest Atlanta
Kennesaw State University Department of
Geography and Anthropology
Neighborhood Planning Unit (NPU) L
Park Pride
Spelman University
The Conservation Fund - Georgia
Trust for Public Lands - Georgia
U.S. Department of Agriculture (USD A) Forest
Service— Southern Research Station
Urban Forestry South
U.S. Department of Housing and Urban
Development (HUD) - Atlanta Regional Office
Vine City Civic Association
West Atlanta Land Trust
West Atlanta Watershed Alliance (WAWA)
Critical review of this report was provided by Jonathan Heller (Human Impact Partners), Kitty Richards
(Green Health Consulting) and Mandy Green (Bernalillo County Place Matters).
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Table of Contents
Executive Summary 1
Chapter 1. Introduction 5
1.1. HIA: A Tool for Sustainable and Healthy Communities 5
1.2. The City of Atlanta, GA and Stormwater Management 7
Chapter 2. Screening the HIA 14
2.1. The Decision to Conduct the HIA 14
2.2. The Proposed Decision: Implementing the Green Street Project 16
Chapter 3. Scoping 20
3.1. HIA Timeline 20
3.2. HIA Participants, Roles, and Responsibilities 21
3.3. HIA Main Goals 24
3.4. HIA Quality Assurance 25
3.5. Settingthe Scope of the HIA 26
3.6 HIA Assessment Work Plan 33
Chapter 4. Assessment 50
4.1. Profile of the Population in the Community 50
4.2. Existing Conditions and Health Impacts Related to the Physical Environment 54
4.4. Existing Conditions and Health Impacts Related to the Social Environment 96
4.5. Existing Conditions and Health Impacts Related to the Economic Environment 109
Chapter 5. Recommendations 122
6. Reporting 131
6.1. HIA Reporting Activities 131
6.2. Stakeholder Input from Reporting Activities 135
7. Monitoring and Evaluation 140
7.1. Monitoring, Impact and Outcome Evaluation 140
7.2. Process Evaluation- Evaluating the HIA Design and Implementation 146
References 154
Appendix A. Tetra Tech's Conceptual Design of Boone Boulevard Green Street Project 162
Appendix B. Original HIA Timeline 163
Appendix C. Stakeholder Engagement Meeting Documentation 164
Documentation of First Community Engagement Meeting, March 22, 2013 164
Documentation of First HIA Advisory Group Meeting, April 30, 2013 171
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Documentation of HIA Training Workshop, May 23, 2013 180
Documentation of the Second HIA Advisory Group Meeting, July 23, 2013 183
Documentation of the Second Community Engagement Meeting, March 22, 2014 199
Documentation of the Final Stakeholder Engagement Meeting, June 5, 2014 205
HIA Recommendations Identified by Stakeholders 228
Appendix D. HIA Work Plan 231
Tasks and Timeframe for Completion of the HIA post-Scoping 231
Literature Review Guidelines 233
Literature Review Worksheet 236
Appendix E. Process Evaluation Results from External Peer-Reviewers 237
List of Figures
Figure 1. Combined sewer system function during dry and wet weather. (Source: (U.S. EPA 2003a)) 7
Figure 2. Aerial view overlooking the Proctor Creek Watershed (Source: EPA Region 4) 9
Figure 3. Examples of green infrastructure (U.S. EPA, 2014b) 10
Figure 4. Park Pride's PNA Vision Master Plan (Source: Park Pride 2010) 11
Figure 5. Park Pride Demonstration Site C: Boone Street East (Source: Park Pride 2010) 12
Figure 6. Cross-section of Boone Street if DWM implements the proposed project as planned. (Source:
www.streetmix.net 2013) 16
Figure 7. Cross-section of Joseph E. Boone Street (at the intersections of Brawley Drive, Sunset Avenue,
and Vine Street) if DWM implements the proposed project as planned. (Source: www.streetmix.net 2013)
17
Figure 8. The Final HIA Timeline 20
Figure 9. The HIA study area. The green line represents the half-mile radius around the proposed Green
Street Project site 26
Figure 10. The modeled area of Proctor Creek Watershed with stormwater flow lines 27
Figure 11. The modeled area upstream of the proposed project site with modeled stormwater flow lines.27
Figure 12. Community stakeholders voting on interests and/or concerns at the first community
engagement meeting 31
Figure 13. Results of the voting to prioritize categories of concern/need from the first Community
meeting 32
Figure 14. Results of the voting to prioritize categories of concern/need from the first HIA Advisory
Group meeting 32
Figure 15. Final health determinants included in the assessment step 35
Figure 16. (Right) Population density in the HIA study area 50
Figure 17. Diversity in the HIA study area 51
Figure 18. Top causes for ER visits in Fulton County, Georgia from 2008 to 2012. (Source: GA DPH
2013b) 52
Figure 19. Top causes of Death for African Americans in Fulton County, 2008 to 2012. (Source: GA
DPH2013b) 53
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Figure 20. Map of underground storm pipes around the proposed project site. (Source: Tetra Tech 2013)
58
Figure 21. Choropleth map of the 2006-2010 aggregate number of ER visits for all digestive system
diseases, by Census tract. (Source: GA-DPH 2013; 2000 Census) 60
Figure 22. Choropleth map of the 2006-2010 aggregate number of ER visits for all digestive system
diseases, by Census tract, for children aged one to fourteen years. (Source: GA—DPH 2013; 2000
Census) 60
Figure 23. Choropleth map of the 2006-2010 aggregate number of ER visits for all digestive system
diseases, by Census tract among adults over 65 years. (GA—DPH 2013; 2000 Census) 61
Figure 24. Choropleth map of the 2006-20 lOaggregate number of ER visits for all digestive system
diseases, by Census tract among Medicaid patients. (Source: GA—DPH, 2013; 2000 Census) 61
Figure 25. A map displaying the percent of impervious surfaces in the community for every 30 square
meters of land surface 66
Figure 26. Maps of the predicted wet areas (TWI) and the modeled stormwater flow lines 67
Figure 27. Vacant and derelict residential properties within a half-mile of the Green Street Project site.. 68
Figure 28. Vacant and derelict non-residential properties within 1/2 mile of the Green Street Project site.
69
Figure 29. A map of the impervious surfaces in the Proctor Creek Watershed and the area that drains to
the proposed Green Street Project. Modeled flow lines also show from where runoff comes from in the
area upstream of Boone Street 70
Figure 30. A Map of the 2006 NLCD Land Use Cover data for Proctor Creek Watershed and the
designated community 71
Figure 31. Graph of the recorded rainfall events by size and duration, from the three surrounding
precitipations stations, over the past five years. (Source: NCDC Mapper) 72
Figure 32. A map of the FEMA Special Flood Hazard Zones in the Proctor Creek Watershed. Source:
(FEMA2013) 73
Figure 33. PRISM monthly temperature and precipitation averages plotted with Atlanta regional averages.
77
Figure 34. A map of the impervious surfaces in the HIA study area 78
Figure 35. Choropleth map of the 2006-2010 aggregate number of ER visits for all respiratory diseases,
by Census tract. (Source: GA-DPH 2013; 2000 Census) 82
Figure 36. Choropleth map of the 2006-2010 aggregate number of ER visits for chronic lower respiratory
disease, by Census tract. (Source: GA-DPH 2013; 2000 Census) 83
Figure 37. Choropleth map of the 2006 to 2010 aggregate number of ER visits for all asthma, by Census
tract. (Source: GA-DPH 2013; 2000 Census) 83
Figure 38. GIS generated map of traffic data showing AADT in Atlanta. (Source: GA—DOT 2013) 86
Figure 39. A map of the vegetation-covered surfaces and impervious surfaces in the HIA study area.
(Source: ArcMap, 2011 NAIP 1-meter) 90
Figure 40. Choropleth map of the 2006-2010 aggregate number of emergency room visits for all mental
and behavioral disorders, by Census tract. (Source: GA—DPH, 2013a; 2000 Census) 91
Figure 41. Joseph E. Boone Street, facing east towards downtown Atlanta. (Source: David Egetter 2014)
99
Figure 42. (Left) Crimes committed in the study area from August 2012 to August 2013. (Source: Atlanta
Police Department 2013) 103
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Figure 43. A map of the Uniform Crime Reporting numbers for felonies committed near the project site
from August 2012 to August 2013. The locations of significantly higher crimes reported are circled in
blue. (Source: Atlanta Police Department 2013) 104
Figure 44. Map of community assets where social capital can be influenced. (Source: Google Maps 2014)
107
Figure 45. Graphical analysis of occupied housing units by household income. It should be noted that the
margin of error for percentage of occupied housing units by income never went above +/-0.06%. (Source:
2006-2010 ACS 5-Year Estimates, Housing by Financial Characteristics dataset (S2503)) 114
Figure 46. Graphical analysis of the percentage of occupied housing units paying more than 30% of
income for monthly housing costs by housing type. It should be noted that the margin of error for
percentage of occupied housing units by income never went above +/-0.03%. (Source: 2006-2010 ACS
5-Year Estimates, Housing by Financial Characteristics dataset (S2503)) 114
Figure 47. Appraised value of residential parcel units within one half mile of the Green Street Project. 115
Figure 48. Appraised value of non-residential parcel units within one half mile of the Green Street Project
(City of Atlanta 2013) 120
List of Tables
Table 1. The Six Major Steps of HIA 6
Table 2. Expected Points of HIA Influence in the Decision-making Process 19
Table 3. HIA Roles and Related Levels of Commitment and Responsibilities 21
Table 4. Stakeholder Engagement during the Screening Step 23
Table 5. Stakeholder Engagement during the Scoping Step 23
Table 6. Stakeholder Engagement during the Assessment Step 23
Table 7. Stakeholder Engagement during the Recommendations Step 24
Table 8. Stakeholder Engagement during the Reporting Step 24
Table 9. Stakeholder Engagement during the Monitoring and Evaluation Step 24
Table 10. Interests and/or Concerns Identified by Stakeholders 29
Table 11. Assessment Step Tasks in the HIA Work Plan 34
Table 12. Impact Characterization Criteria and Rating Scale 38
Table 13. HIA Scoping Worksheet for Water Quality 39
Table 14. HIA Scoping Worksheet for Flood Management 39
Table 15. HIA Scoping Worksheet for Climate and Temperature 41
Table 16. HIA Scoping Worksheet for Air Quality 41
Table 17. HIA Scoping Worksheet for Traffic Safety 42
Table 18. HIA Scoping Worksheet for Exposure to Greenness 43
Table 19. HIA Scoping Worksheet for Exposure to Urban Noise 44
Table 20. HIA Scoping Worksheet for Access to Goods and Services, Greenspace, and Healthcare 45
Table 21. HIA Scoping Worksheet for Crime (Perceived and Actual) 46
Table 22. HIA Scoping Worksheet for Social Capital (Cognitive and Structural) 46
Table 23. HIA Scoping Worksheet for Household Economics (Costs of Living and Employment) 47
Table 24. HIA Scoping Worksheet for Community Economics (Business Performance) 48
Table 25. Educational Attainment of Residents In The Study Area 52
Table 26. Capture and Treatment Efficiencies of Storm water Form Low Intensity Development/Green
Infrastructure Elements 57
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Table 27. Potential Health Impacts from Changes in Water Quality and Management Strategies 62
Table 28. Stormwater Runoff Related Measurements of Proposed Project Site 69
Table 29. Expected Impacts of the Proposed Green Street Project 74
Table 30. Potential Health Impacts from Changes in Flood Management and Management Strategies.... 75
Table 31. Potential Health Impacts from Changes in Climate and Temperature and Management
Strategies 79
Table 32. Potential Health Impacts from Changes in Air Quality and Management Strategies 84
Table 33. Potential Health Impacts from Changes in Traffic Safety 87
Table 34. Potential Health Impacts from Changes in Exposure to Greenness and Management Strategies
92
Table 35. Potential Health Impacts from Changes in Exposure to Urban Noise and Management
Strategies 96
Table 36. Potential Health Impacts from Changes in Access to Goods, Services, Greenspace, and
Healthcare and Management Strategies 100
Table 37. Potential Health Impacts from Changes in Crime (Perceived and Actual) and Management
Strategies 105
Table 38. Potential Health Impacts from Changes in Social Capital (Cognitive and Structural) and
Management Strategies 108
Table 39. Employment Status by Educational Attainment among Population 25 to 64 Years Old 112
Table 40. Differences between 2000 and 2010 Census Housing Occupancy Indicators 113
Table 41. Potential Health Impacts from Changes in Household Economics (Cost of Living and
Employment) and Management Strategies 117
Table 42. Business Establishments within One Half-Mile Radius of the Green Street Project in 2010 .. 119
Table 43. Potential Health Impacts from Changes in Community Economics (Business Performance) and
Management Strategies 121
Table 44. Framework for Prioritizing Recommendations 122
Table 45. Short-term HIA Recommendations That Should Be Implemented Immediately (Before
Construction) 123
Table 46. Short-term HIA Recommendations That Should Be Implemented During Construction 126
Table 47. Short-term HIA Recommendations That Should Be Implemented After Construction 127
Table 48. Long-term HIA Recommendations That Should Be Implemented In The Next Several Years 128
Table 49. Summary of Key HIA Reporting Activities 132
Table 50. List of Stakeholder Comments to Assessment Findings 135
Table 51. List of Stakeholder Comments to the Initial HIA Recommendations 138
Table 52. Proposed Plan for Monitoring Health Impacts Post-decision 142
Table 53. Evaluation of HIA Goal Achievement 146
Table 54. Valuable Roles and Skills in the HIA Process 149
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Acronyms
Acronym Description Acronym
AADT Annual Average Daily Traffic HIA
ACS American Community Survey HIA-
ADD Attention deficit disorder CLIC
ADHD Attention deficit hyperactivity
disorder HIPAA
APD Atlanta Police Department
ARC Atlanta Regional Commission HIV
BLS U.S. Bureau of Labor Statistics HUC
BMP Best management practices HUD
CDC Centers for Disease Control and
Prevention IAIA
CO Carbon monoxide
CPTED Crime Prevention Through IRB
Environmental Design LiDAR
CSO Combined sewer overflow
dB(A) A-weighted decibels MARTA
DNA Deoxyribonucleic acid
DOE U.S. Department of Energy MPH
DOT U.S. Department of Transportation MVC
DWM Department of Watershed NACCHO
Management
EPA U.S. Environmental Protection NAAQS
Agency
EJ Environmental justice NAICS
ER Emergency room
FC-DHW Fulton County Department of Health NCDC
and Wellness NERL
FEMA Federal Emergency Management
Agency NHD
FHWA Federal Highway Administration NHTS
GA State of Georgia NHTSA
GA—DNR Georgia Department of Natural
Resources NLCD
GA—DOT Georgia Department of NO2
Transportation NOAA
GA—DPH Georgia Department of Public
Health NPU
GA—EPD Georgia Environmental Protection NRC
Division NY
GIS Geographic Information System Os
GHPC Georgia Health Policy Center
Description
Health impact assessment
Health impact assessment
clearinghouse learning and
information center
Health Information Portability and
Accountability Act
Human immunodeficiency virus
Hydrologic unit code
U.S. Department of Housing and
Urban Devleopment
International Association of Impact
Assessment
Internal Review Board
Light Detection and Ranging
(satellite)
Metropolitan Atlanta Rapid Transit
Authority
Miles per hour
Motor vehicle crashes
National Association of County and
City Health Officials
National Ambient Air Quality
Standards
North American Industry
Classification System
National Climatic Data Center
National Exposure Research
Laboratory
National Hydrography Dataset
National Household Travel Survey
National Highway Traffic Safety
Administration
National Land Cover Database
Nitrogen dioxide
National Oceanic and Atmospheric
Administration
Neighborhood planning unit
National Research Council
State of New York
Ozone
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Acronym Description
OASIS Online Analytical Statistical
Information System
OE J Office of Environmental Justice and
Sustainability
OPM Office of Policy and Management
ORA Office of the Regional Administrator
and Deputy Regional Administrator
ORD Office of Research and Development
PM Particulate matter
PNA Proctor Creek/North Avenue
POS Public, open space
RCRA Resource Conservation and
Recovery Act Division
RESES Regional Sustainable Environmental
Science Research Program
SCI Strategic Community Investment
SHC Sustainable and Healthy
Communities Research Program
SO2 Sulfur dioxide
SoVI Social Vulnerability Index
SSO Sanitary sewer overflow
STARS Sustainable Transportation Analysis
and Rating System
TMDL Total Maximum Daily Load
TRB Transportation Research Board
TWI Topographic Wetness Index
UCLA University of California, Los
Angeles
UHI Urban heat island
UN United Nations
USDA U.S. Department of Agriculture
USGS U.S. Geological Survey
VMT Vehicle miles traveled
VOC Volatile organic compounds
WAWA West Atlanta Watershed Alliance
WERF Water Environment Research
Foundation
WHO World Health Organization
WNV West Nile Virus
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Executive Summary
About the Health Impact Assessment (HIA)
Most areas within the City of Atlanta, Georgia use a combined sewer system in which stormwater and
sanitary sewer discharge flows together, through an underground conveyance system, to a treatment
facility. During periods of heavy rainfall or snow, however, these systems bypass the treatment facility
and discharge directly into a nearby waterbody. This event is called a combined sewer overflow (CSO)
event. Many rivers and streams in the Atlanta metropolitan area are on the state's impaired waters list
due to CSO events and stormwater runoff from urban areas [1]. Proctor Creek is one of the most
impaired waters in metro-Atlanta and drains a watershed of approximately 10,198 acres of urban area
before discharging into the Chattahoochee River. A watershed is the area of land where all of the water
that is under it or drains off it goes into the same place.
The U.S. Environmental Protection Agency (EPA) is evaluating tools and technologies that support
communities becoming more sustainable. Implementing green infrastructure, an EPA-supported
technology, is an example of using sustainable solutions to an array of environmental issues. In 2012,
EPA awarded funding to the City of Atlanta Department of Watershed Management (DWM) for technical
assistance to develop a conceptual plan to implement green infrastructure in a distressed neighborhood.
The purpose of the technical assistance was to provide support for water quality and revitalization
improvement efforts. Tetra Tech, a contractor to the EPA, developed a conceptual plan, titled the Boone
Boulevard Green Infrastructure Conceptual Design (i.e., Green Street Project), located in an at-risk
community in the headwaters of Proctor Creek [2]. As a demonstration project, the proposed project will
convert underutilized roadway into in-ground planter boxes and permeable pavement along Boone Street
and redirect stormwater runoff from the roadway into rain gardens prior to entering the combined sewer
system.
Why was a Health Impact Assessment performed?
EPA's Office of Research and Development (ORD) is considering health impact assessment (HIA) as one
of the many tools to provide science-based resources and information for community-driven initiatives.
This HIA is informing DWM's decision on implementing the proposed Green Street Project as they move
forward in the planning process.
Who performed this HIA?
Staff in EPA ORD and Region 4 (Southeast) partnered to lead the HIA. These partners established the
HIA Core Project Team, which was made of EPA staff and contractors, an HIA advisor, a staff member
from the Fulton County Department of Health and Wellness, two researchers from the Centers for Disease
Control and Prevention, and a university student who was also a resident in the community. The HIA
Core Project Team conducted the HIA with input and guidance from community residents and an HIA
Technical Advisory Group, which was made up of representatives from several stakeholder groups.
What methods were used in this HIA
Proctor Creek's Boone Boulevard Green Street Project HIA Page | 1
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HIA is "a systematic process that uses an array of data sources and analytical methods and considers input
from stakeholders to determine the potential effects of a proposed policy, plan, program or project on
health of a population and the distribution of those impacts within the population. HIA provides
recommendations on monitoring and managing those effects" [3]. HIAs follow a systematic, six-step
process- Screening, Scoping, Assessment, Recommendations, Reporting, and Monitoring and Evaluation.
The assessment utilized:
S Pre-existing and publically available data (e.g., Census data, crime data, reports, etc.)
>^ Standardized and rigorous analysis methods
>^ Geographic information systems (GIS) support for modeling, mapping and performing spatial
analyses
>^ Review of empirical, science-based literature
>^ Expertise from local public health professionals, researchers and other stakeholders
>^ Measureable (quantitative) and relative (qualitative) characterization of impacts
What was the scope of this HIA?
This HIA evaluated how the proposed project would influence twelve determinants of health (i.e., factors
that affect health), including water quality; flood management; climate and (surface) temperature; air
quality; traffic safety; exposure to greenness; exposure to urban noise; accessibility to goods and services,
greenspace and healthcare; crime, including both perceived and actual security; social capital, including
both cognitive and structural capital; household economics, specifically cost of living and employment;
and community economics, specifically business performance. A half-mile radius around the proposed
project site represented the study area in which the health impacts were appraised.
Main Findings and Recommendations of the HIA
Who would be affected by the proposed project?
According to the 2010 Census, there were 13,194 people living within a half-mile radius of the proposed
project site- a 15.6% decrease from a decade earlier, indicating movement out of the community. The
population was almost exclusively African American (82.3%), with Caucasian being the second most
populous (12.4%) [4]. Information on the health status of this population was only available at the county
level. According to the Community Health Needs Assessment Dashboard [5], the most common reasons
for emergency room visits in Fulton County, Georgia (2008-2012) were related to mental and behavioral
disorders (#1), asthma (#2), and assault (#3). For children, ages one to nineteen years, the most common
cause for emergency room visits was unintentional injury. The most common causes of death among
African Americans in Fulton County were hypertension and related chronic disease (#1), mental and
behavior health disorders (#2), and human immunodeficiency virus (HIV; #3). The leading causes of
death among African American children in Fulton County were assault and injury from motor vehicle
crashes. The leading causes of death among Caucasians in Fulton County were mental health and
behavioral disorders (#1), Parkinson's disease (#2), and HIV (#3). The most common causes of death for
Caucasian children were motor-vehicle crashes, congenial disease, cancer (i.e., malignant neoplasm of the
nervous system), and HIV.
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How would the proposed project affect health in the community?
The twelve health determinants included in the HIA scope were organized by their sector of impact— the
physical (natural and/or built) environment, social environment, or economic environment. Once the
potential impacts were identified, the extent of the effects was evaluated based on six criteria— likelihood,
direction, magnitude, permanence, distribution, and strength of evidence. The likelihood that the impact
would occur because of the project was evaluated. Whether the impact would improve, detract, or have
no net effect on health outcomes was described by the direction of impact. How many people the impact
would affect and its distribution among sub-groups in the population were described by the magnitude
and distribution of the impact, respectively. Permanence was used to refer to how long the effects were
expected to be experienced or observed. Lastly, the strength of evidence upon which the impact
characterization was made was also identified. The following table provides a summary of the potential
health impacts of the proposed project.
Health
Determinant
Water Quality
Flood
Management
Climate and
Temperature
Air Quality
Traffic Safety
Exposure to
Greenness
Exposure to Urban
Noise
Access to Goods
and Services,
Greenspace, and
Healthcare
Crime (Perceived
and Actual)
Social Capital
(Cognitive and
Structural)
Household
Economics (Costs
of Living and
Employment)
Community
Economics
(Business
Performance)
Likelihood
Highly
Likely
Highly
Likely
Highly
Likely
Highly
Likely
Highly
Likely
Highly
Likely
Plausible
Highly
Likely
Plausible
Plausible
Plausible
Plausible
Direction
Positive
Positive
Positive
Positive
Positive
Positive
Positive
Positive
Positive
Positive
Both
Positive and
Negative
Positive
Magnitude
Low
Moderate
Moderate
Moderate
High
Moderate
Moderate
Moderate
Moderate
Moderate
Moderate
(Positive)
Low
(Negative)
Moderate
Permanence
Quickly and
Easily
Reversed
Moderate
Long Lasting
Long Lasting
Long Lasting
Long Lasting
Long Lasting
Long Lasting
Quickly and
Easily
Reversed
Moderate
Quickly and
Easily
Reversed
Quickly and
Easily
Reversed
Distribution
Vulnerable
Populations Benefit
Vulnerable
Populations Benefit
Vulnerable
Populations Benefit
Vulnerable
Populations Benefit
Vulnerable
Populations Benefit
Vulnerable
Populations Benefit
Vulnerable
Populations Benefit
Vulnerable
Populations Benefit
Vulnerable
Populations Benefit
Vulnerable
Populations Benefit
Both Benefits and
Harms for Vulnerable
Populations
Vulnerable
Populations Benefit
Evidence
Limited
Limited
Strong
Limited
Limited
Limited
Strong
Strong
Limited
Limited
Limited
Limited
What should DWM do to manage these impacts?
The HIA Core Project Team and community stakeholders identified short-term and long-term
recommendations to maximize the potential positive health impacts and mitigate and/or avoid the
potential negative health impacts identified in the assessment. There were two overarching themes that
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came from stakeholder-identified recommendations: a) keeping the community engaged in the planning,
implementation, and monitoring phases of the project; and b) helping support community advocacy
groups in addressing the community's needs.
Conclusion
The HIA Core Project Team and community stakeholders strongly supported the implementation of the
project, due to the numerous co-benefits that could be realized as a result of the project's implementation.
However, the group warned that these co-benefits would be of little magnitude due to the project's small
size. Expanding the project and/or replicating the project throughout the watershed would allow DWM
and the community to increase the magnitude of impact and get the most out of those benefits. The HIA
Core Project Team strongly encouraged DWM's commitment to follow the HIA's recommendations as
they move forward in the decision-making process.
References
[1] GA-EPD. (2014, August 20). Georgia 305(b)/303(d) List Documents. Retrieved from Georgia Environmental Protection
Division: https://epd.georgia.gov/sites/epd.georgia.gov/files/related_files/site_page/303d_Draft_Streams_Y2014.pdf.
[2] Tetra Tech. (2013). Draft Boone Boulevard Green Infrastructure Conceptual Design. Atlanta, GA: Tetra Tech, Inc.
Released February 21, 2013.
[3] NRC. (2011). Improving Health in the United States: The Role of Health Impact Assessment. Washington, D.C.: The
National Academies Press.
[4] U.S. Census Bureau. (2010). 2010 Census Survey.
[5] GA—DPH. (2013, June 3). Community Health Needs Assessment Dashboard. Atlanta, Georgia, U.S. Retrieved August 18,
2014, from http://oasis.state.ga.us/CHNADashboard/Default.aspx.
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Introduction
Chapter 1. Introduction
Many communities across the United States are facing issues related to aging infrastructure, limited
financial resources, and impaired surface and ground waters. The growing population can mean a
growing need for development and businesses. However, the accelerated development of land can put a
strain on the local ecosystem and surrounding natural resources. Decisions are often resulting in trade-
offs between the needs of people and the needs of the environment in which they live. Such trade-offs
may yield short-term benefits, but also long-term adverse consequences.
Leaders worldwide are becoming more aware of the need to develop more comprehensive, sustainable
solutions to the complex issues facing their communities. At the 1992 Conference on Environment and
Development, the United Nations (UN) declared a more comprehensive approach was needed to address
development issues to ensure that today's actions do not endanger tomorrow's needs, thus promoting
sustainability. In 2005, the UN reaffirmed the commitment to consider all aspects of sustainability—the
environment, society, and economy (United Nations 1992, 2005). Solutions that allow for an equal
balance of benefits between these "three pillars" provide a pathway for communities to achieve
sustainability.
The U.S. Environmental Protection Agency (EPA) is working to test models, tools, and best practices that
enable the shift from trade-off to mutual benefit so that communities can move towards more sustainabile
and healthy states. Sustainability is achieved by "creating and maintaining the conditions under which
humans and nature can exist in productive harmony, that permit the fulfilling of social, economic and
other requirements of present and future generations" (U.S. EPA 2014a). EPA's Sustainable and Healthy
Communities (SHC) Research Program, in the Office of Research and Development (ORD), is
considering health impact assessment (HIA) as one of the many decision-support tools for providing
science-based resources and information to decision-makers.
1.1. HIA: A Tool for Sustainable and Healthy Communities
The pursuit of more sustainable solutions has steered public health professionals to promote the use of
more comprehensive and integrated approaches to address public health challenges. HIA is one of the
many tools used to consider health into traditionally non-health related decision-making processes. HIA
has been used to manage potential impacts of a proposed decision to protect the health of individuals and
the community.
1.1.1. Definition of HIA
The U.S. EPA uses the definition of HIA developed by the National Research Council (NRC) Committee
on HIA. The NRC 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 the effects within the
population. HIAs provide recommendations on monitoring and managing those effects" (NRC 2011).
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Introduction
1.1.2. HIA Process
There are six major steps in the HIA process— Screening, Scoping, Assessment, Recommendations,
Reporting and Monitoring and Evaluation— each of which have several tasks involved (North American
HIA Practice Standards Working Group 2010, Human Impact Partners 2011, 2012, NRC 2011, R. Bhatia
2011). Table 1 lists the six steps of HIA and provides a brief description for each step.
Table 1. The Six Major Steps of HIA
HIA Step
Screening
Scoping
Assessment
Recommendations
Reporting
Monitoring and
Evaluation
Description
Determines whether HIA is an appropriate approach to evaluate the pending
decision and whether the HIA will provide information useful to the
stakeholders and decision-makers. The proposal, any decision alternatives and
the anticipated added value of the HIA are explicitly identified.
Establishes the purpose, goals and team that will perform the HIA. Boundaries
of the assessment are defined, including the geographic area, timeframe the
HIA will be completed, health impacts that will be appraised and the population
and vulnerable sub-groups that will be impacted by the proposal.
Involves a two-part process that a) describes the existing (baseline) status of
health and related factors, and b) forecasts potential impacts that may result
from the decision. A variety of data sources and analytical methods are used.
Identifies actions or strategies to manage the health impacts of the decision, if
any are predicted. Recommendations are developed to maximize potential
benefits and minimize or avoid potential adverse impacts.
Documents the HIA activities, materials developed and communicates the
findings and recommendations of the HIA to stakeholders and the public.
Involves (or provides a plan for) follow-up activities that track how the HIA
was implemented, the result of the decision and impacts of the decision.
Evaluations should be included that assess the HIA's impact on the decision
and/or decision-making process (i.e., impact evaluation), whether the HIA met
its intended goals/objectives and practice standards (i.e., process evaluation),
and whether decision affected health (i.e., outcome evaluation).
1.1.3. HIA Core Values
There are five core values of HIA, which guide the implementation of the process:
1. A comprehensive approach to health and well-being
2. Sustainable development for short-term and long-term gain
3. Equity in the opportunity for healthy living
4. Democracy in the decision-making process
5. Ethical use of evidence that ensures transparent and rigorous methods are used
The HIA approach was developed based on the increasing understanding of the variety of conditions that
serve as predictors of health and well-being (i.e., health determinants) and uses a more comprehensive
approach to evaluating impacts to health (CDC 2009). Domains in which impacts may occur include, but
are not limited to housing, employment and livelihood, quality of the surrounding environment, access to
public services, individual behaviors and attitudes, and policy (R. Bhatia 2011). Using a broader
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Introduction
approach maximizes the ability to discover potentially harmful impacts and/or benefits that may not have
been considered otherwise in the decision-making process. HIAs take into consideration short-term and
long-term impacts of a proposal to promote sustainable solutions.
Furthermore, the HIA process allows for the consideration of how proposals may affect populations more
sensitive to changes in conditions where they live, work and play. Without considering the distribution of
impacts, a decision may unintentionally result in an unequal distribution of benefits and/or burdens. HIA
practitioners recognize the importance of identifying vulnerable populations and develop
recommendations to promote equity. Involving these groups in the process can help raise awareness of
how decisions can lead to health impacts and prevent exclusion of certain stakeholder groups. HIA
promotes meaningful involvement of a variety of stakeholders in the HIA process, promoting democratic
principles, and helping communities build capacity to influence future decision-making.
The HIA process allows for the integration of science-based methods and input from the population
affected by the decision so that pragmatic solutions can be developed to address common issues. Often,
decision-makers must pass judgment using the information at-hand, even when the evidence is limited or
lacking. A lack of openness and transparency in the decision-making process can lead to confusion
and/or distrust among stakeholders. The information collected during the HIA may come from a variety
of sources and levels of certainty. HIA practitioners use the best available evidence and science-based
methods to manage and present the information in an ethical and transparent manner.
1.2. The City of Atlanta, GA and Stormwater Management
Stormwater management involves both the prevention and mitigation of both the quantity and quality of
Stormwater runoff and its impacts through a variety of methods and mechanisms (ARC and GA-DNR
2001). Most areas within the City of Atlanta, Georgia use a combined sewer system in which Stormwater
and sanitary sewer discharge flows together, through an underground conveyance system, to a treatment
facility. During periods of heavy rainfall or snow, however, these systems bypass the treatment facility
and discharge directly into a nearby waterbody. When the system discharges into a nearby waterbody, the
event is called a combined sewer overflow (CSO) event. Figure 1 demonstrates the difference between
combined sewer system functions during dry weather and wet weather.
Figure 1. Combined sewer system function during dry and wet weather. (Source: (U.S. EPA 2003a))
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Introduction
Many streams and rivers in the Atlanta metropolitan area are on the state's list of impaired waters. In
1998, the City of Atlanta, GA settled a lawsuit with the U.S. EPA, Georgia Environmental Protection
Division (GA—EPD), Upper Chattahoochee Riverkeeper Fund, Upper Chattahoochee Riverkeeper, Inc.,
and a private citizen through a consent decree aimed at improving water quality in the city's streams,
headwaters and surrounding river basins1. The consent decree required the City of Atlanta to develop and
implement activities to eliminate violations to water quality standards that resulted from CSO events (it
was amended in 1999 to include sanitary sewer overflow (SSO) events). These affirmations resulted in a
comprehensive and long-term plan to ensure clean water in metro-Atlanta, aptly named "Clean Water
Atlanta," and the creation of the Department of Watershed Management (DWM)2. The DWM manages
the city's drinking water, wastewater and stormwater utilities and systems. Since its formation in 2002,
the DWM has made vast improvements in utility performance, reduced CSO and SSO events, increased
repairs to conveyance systems, and implemented programs and projects aimed at preventing CSO and
SSO events.
1.2.1. Proctor Creek Watershed
Proctor Creek is one of the most impaired waters in metro-Atlanta and has been on the state's 303(d)
impaired waters list since 2002, for not meeting water quality standards to support its designated use -
fishing (GA-EPD 2014). Proctor Creek is located entirely within the City of Atlanta and drains a
watershed of approximately 10,198 acres of primarily residential and commercial properties to where it
discharges into the Chattahoochee River. Stormwater runoff from urban areas (i.e., urban runoff) and
CSO events are the suspected causes of the stream's impairment.
Neighborhoods within the Proctor Creek Watershed have experienced multiple environmental and public
health issues, including an overburden of blighted and abandoned properties, ageing infrastructure, illegal
dumping, persistent flash flooding, impaired water quality, and Brownfields (i.e., a property in which the
expansion, redevelopment, or reuse may be complicated by the presence or potential presence of a
hazardous substance, pollutant, or contaminant). Communities in the headwaters of Proctor Creek are
especially vulnerable to flash flooding due to the considerably large area of impervious surfaces known as
the "Gulch," which includes the Georgia Dome (Atlanta Falcons Stadium), Georgia World Congress
Center, Atlanta Federal Center and CNN Headquarters. The amount of blighted and abandoned
properties, as well as crime and insecurity in the area, has contributed to disinvestment and movement out
of the area. In addition, neighborhoods in the headwaters face other unique challenges with noise and
sporadic traffic congestion as a "stadium community."
EPA's Region 4 (Southeast) Resource Conservation and Recovery Act (RCRA) Division designated the
Vine City and Proctor Creek area as an environmental justice (EJ) community of concern, which is
defined as a geographic area with a largely minority and/or low-income population that faces a
disproportionately high burden of adverse environmental conditions (U.S. EPA 2010). Efforts to
revitalize this area have been ongoing for over a decade at the grassroots, city, state, and federal-level. In
1 The City of Atlanta Consent Decree issued May 26, 1998 by Kilpatrick Stockton, LLP is available on the DWM
website at: http://docs.atlantawatershed.org/.
2 The Clean Water Atlanta, Program Overview is available at:
http://www.cleanwateratlanta.org/ConsentDecree/Overview.htm
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Introduction
May 2013, the Proctor Creek Urban Waters Federal Partnership (i.e., the "Partnership"), which includes
the U.S. EPA, U.S. ACE Mobile District, Federal Emergency Management Agency (FEMA), U.S.
Department of Housing and Urban Development (HUD), and U.S. Department of Transportation (DOT),
was established to collaborate, advocate, and support improvements in the watershed. An aerial view of
the watershed is provided in Figure 2.
Figure 2. Aerial view overlooking the Proctor Creek Watershed (Source: EPA Region 4).
1.2.2. Green Infrastructure as a Sustainable Solution
The City of Atlanta adopted green infrastructure as one of many approaches to help address issues with
Atlanta's impaired waters. In February 2013, the City Council adopted an amendment to the City of
Atlanta Code of Ordinances (Chapter 7, Article 10) aimed at promoting green infrastructure and runoff
reduction practices for all new and redevelopment projects in the city3.
Green infrastructure is an example of EPA-supported technology that is used as an alternative to grey
infrastructure (e.g., impervious pavement, concrete and metal) in promoting sustainable solutions to an
array of issues (U.S. EPA 2014b). Design elements of green infrastructure include using soil, vegetation,
and natural processes to capture and filter stormwater as it moves through a system. Using elements of
green infrastructure has been shown to reduce capacity burden on existing infrastructure, improve urban
ecosystems, and provide energy and maintenance savings. Examples of green infrastructure include, but
are not limited to, rain gardens (i.e., bioretention or biofiltration cells), planter boxes, bioswales, and
permeable pavement, just to name a few (Figure 3).
3 For more information, refer to the "Implementing Green Infrastructure: Atlanta's Post Development Stormwater
Management Ordinance Factsheet," available at: http://www.atlantawatershed.org/greeninfrastructure/.
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Introduction
P
I Urban Trees
Pernionhie P;i> vine nt
£ Bioswale ^HPP*
• ;; ",^- •»--• •" ..•.-'-•,;••;
Figure 3. Examples of green infrastructure (U.S. EPA, 2014b).
1.2.3. Planning for Green Infrastructure in the Proctor Creek Watershed
In 2010, Park Pride led a coalition of community residents and other locally based organizations and
developed a plan for implementing green infrastructure in the headwaters of Proctor Creek. The Proctor
Creek/North Avenue (PNA) Watershed Basin: A Green Infrastructure Plan (i.e., PNA Vision) proposed a
series of green infrastructure demonstration projects in the urban watershed immediately west of
downtown Atlanta where communities face an overburden of economic, social, and environmental
challenges (Figure 4 is an illustration of the master plan in the PNA Vision) (Park Pride 2010). The
Prince's Foundation for the Built Environment performed a similar study earlier in 2010, but funding was
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Introduction
not available at the time to develop that plan further. The City of Atlanta has adopted the PNA Vision as
the master plan for implementing green infrastructure in the Proctor Creek Watershed.
^^^^v^r.^
*s
m*JJ ' «1
1123 Activity Node or
Corridor
BeMine Route
>—*.—Study Area Limits
Figure 4. Park Pride's PNA Vision Master Plan (Source: Park Pride 2010).
In 2012, EPA strengthened its commitment towards helping communities implement green infrastructure
by providing funding and technical assistance through its Community Partners Program. The City of
Atlanta was one of the seventeen communities awarded funding and technical assistance from EPA to
develop a conceptual design for implementing green infrastructure in a distressed neighborhood to help
reduce pervasive flooding and prevent CSOs. Tetra Tech, a contractor to the EPA, provided the technical
assistance to develop the conceptual design for DWM (EPA contract EP-C-11-009). Tetra Tech
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Introduction
performed a forensic review of historic reports, including the PNA Vision, to identify needs of the
watershed. Accompanied by Park Pride staff, Tetra Tech conducted a field assessment and held
stakeholder meetings to collect additional information about community priorities. Tetra Tech scored and
ranked the proposed sites based on the input from stakeholders (Tetra Tech 2013). DWM could not
secure funding at that time to implement the PNA Vision (in its entirety) and for that reason selected the
Boone Street site as a starting point to build more support for implementing the rest of the PNA Vision
(Figure 5 outlines the Boone Street demonstration project identified in the PNA Vision).
- Green Street
• Demonstration
Project
NOTE: The two park parcels shown
are oivned by the City's Oea-artment
fo Watershed Management
wnhomes(TH) >
Mixed-Use (MU)
Single Family Residential (SF)
Town Homes (TH)
Commercial Use (COMM)
Civic Use
Proposed Green Infrastructure
Proposed Water Infrastructure
Figure 5. Park Pride Demonstration Site C: Boone Street East (Source: Park Pride 2010).
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Introduction
1.2.4. About the Boone Street Corridor
Joseph E. Boone Street NW (previously named Simpson Road) is located northwest of downtown
Atlanta. The city renamed Simpson Road to Joseph E. Boone Street in 2008 after Joseph E. Boone, a
prominent civil rights activist. Boone Street connects two major urban corridors: Northside Drive NW
(Highway 19/41/29) to Hamilton E. Holmes Drive NW (Highway 280). Boone Street separates English
Avenue neighborhood from Vine City neighborhood. In the early 20th century, Vine City and English
Avenue were vibrant neighborhoods with a mix of many small businesses and single-family residences.
Currently, the neighborhoods experience high rates of poverty, crime, and boarded up businesses and
residences. Residents in this area have raised concerns related to illegal dumping of garbage, flash
flooding, mosquitoes, and unhealthy housing conditions.
There are several plans to redevelop along the Boone Street corridor. In 2004, then-mayor Shirley
Franklin identified Boone Street as one of six (6) underserved areas in the city that needed physical
redevelopment and economic revitalization and called for collaboration between the City Departments
and other public agencies to develop an updated plan for the identified areas. The Simpson Road
Corridor Redevelopment Plan (updated in 2006) outlines the long-term vision and guidelines for future
decision-making and investment in the area over the next 25 years.4 The Federal Highway
Administration (FHWA), through the Regional Transportation Referendum - Local Investment
Framework: 2013-2018, also recommended several transportation projects along Boone Street corridor.
One of those projects includes a road diet, which simply means a reduction of travel lanes. The Cycle
Atlanta Phase 1 Study, led by the Atlanta Regional Commission (ARC) Livable Centers Initiative, plans
to convert some of the unused area (left over from the road diet) into designated bike lanes.
4 The 2006 Update builds on the previously approved 1995 Simpson Redevelopment Plan, Beltline Redevelopment
Plan (December 2005), Vine City Redevelopment Plan (2004), Northside Drive Corridor Plan (2005), and Bankhead
Metropolitan Atlanta Rapid Transit Authority (MART A) Station LCI (2005), and the Study of Revitalization
Incentives for Underserved Areas (December 2005).
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Screening
Chapter 2. Screening the HIA
Screening is the first step in the HIA process in which the proposed decision is clearly defined, including
any alternative scenarios, and stakeholders consider whether performing an HIA would add value to the
decision-making process.
2.1. The Decision to Conduct the HIA
Prior to the conception of this HIA, EPA's ORD sent an invitation to the ten regional offices calling for
proposals to conduct an HIA. EPA had been assessing the value of using HIA as a tool to support local
decision-making and promote sustainable and healthy communities. ORD would provide funding for the
HIA through the Regional Sustainable Environmental Sciences (RESES) program5 as part of a nation-
wide group of HIA case studies led by the EPA.
At that time, Tetra Tech was evaluating the PNA Vision and ranking sites for implementing green
infrastructure in the headwaters of Proctor Creek. Because EPA's Region 4 (Southeast) classified the
area around Proctor Creek was classified as an EJ community of concern, staff in the Office of
Environmental Justice and Sustainability (OEJ) met with an HIA practitioner in ORD and discussed the
opportunity to perform an HIA. The purpose of the HIA was to bring health considerations into
evaluating the proposed sites for implementing green infrastructure in the watershed. Those individuals
also met with staff in DWM and other EPA offices to decide if performing an HIA would help inform the
decision-making and help the community. DWM and EPA agreed the HIA would bring valuable
information to the decision and supported the HIA moving forward. The following sections document the
considerations in screening the HIA.
2.1.1. Considerations for Community Health
The primary intent of implementing green infrastructure in the headwaters of Proctor Creek was to
address water quality issues and relieve the burden on existing stormwater infrastructure (i.e., address
storm water management needs). In addition to addressing stormwater management needs, there are other
potential impacts of implementing green infrastructure. There are an increasing number of studies linking
green infrastructure to increased property values and aesthetic value of nearby parcels, higher enjoyment
of surroundings, improved safety and sense of well-being and reduced crime (Hastie 2003, Kuo 2003,
Wolf 1998, Kuo and Sullivan 2001a, 200Ib). These potential impacts may help support revitalization
efforts in this community. The neighborhoods in the headwaters of Proctor Creek are experiencing social
and economic challenges, which have direct and indirect consequences to health. Thus, the need to
investigate a broader scope of consequences, especially to health, was warranted.
The HIA process would bring valuable information and recommendations with a public health focus, to
inform the efforts regarding green infrastructure approaches to stormwater management, ecosystem
restoration, and community revitalization in an environmental justice community of concern. The HIA
would further investigate changes to the physical environment, socio-economic conditions, and other
5More information about the RESES program is available at http://www.epa.gov/nerlesdl/reses/reses.html.
Proctor Creek's Boone Boulevard Green Street Project HIA Page 14
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Screening
environmental factors that influence community and individual health outcomes, a consideration
otherwise not accounted for in the decision. In addition, the HIA would identify and recommend
strategies that the City could take to maximize benefits and minimize potentially adverse impacts.
Furthermore, the educational materials that typically come from performing an HIA would provide
another outlet for raising awareness of environmental factors that influence health.
2.1.2. Considerations for Stakeholder Engagement and Neutrality
The challenges facing the communities in the Proctor Creek Watershed have been ongoing for many
years, as have efforts to address these issues. Many different stakeholder groups have an invested interest
in what transpires in the area. Residents in the headwaters of Proctor Creek have repeatedly expressed
concerns to EPA about the environmental issues experienced and the lack of involvement in the decision-
making regarding efforts in their community. As a federal agency, EPA would provide a neutral platform
for different stakeholder groups (e.g., the decision-makers, community residents, investors, etc.) to come
together and discuss their interests and/or concerns. The HIA would uphold Agency policies and HIA
practice standards for transparency and defensibility of the process by documenting the decisions made,
methods used, findings and recommendations. Furthermore, the HIA process could help build
community capacity to advocate for and address needs.
2.1.3. Considerations for Benefits to EPA and HIA Field of Practice
This HIA would provide another vehicle for EPA to understand community-level decisions, create new
partnerships with local community-based groups and improve the awareness of sustainable alternatives.
The HIA would provide further insight for EPA's SHC research program on HIA as a tool for promoting
sustainability through comprehensive approaches to address local issues and decision-making in an EJ
community of concern. As a federal agency, EPA would provide the HIA field of practice with a unique
perspective on implementation, challenges and lessons learned while performing a HIA. Adequate
personnel and data analysis methods, accessible through EPA could be leveraged to expand the science-
based tools and resources used in the HIA community of practice and inform practitioners of tools and
methods being developed.
2.1.4. Considerations for Resources Available
Between the ORD, its contractors and Region 4, there was sufficient personnel available to conduct the
HIA. In addition, EPA has led several initiatives and projects in the area that provided connections to
persons with local knowledge about the communities/populations affected, data and sources available,
and tools/models that could be used to analyze information. Staff in EPA's ORD and Region 4
(Southeast) OEJ partnered to lead the HIA and submitted a RESES proposal for funding to ORD. In
August 2012, ORD approved and awarded funding for the HIA.
NOTE: While waiting for a response from ORD, DWM informed EPA that funding could not be secured
for implementing the PNA Vision in its entirety. However, DWM could support one demonstration
project that would serve as a catalyst for gaining support for future efforts to implement green
infrastructure in the watershed. DWM selected the Boone Street demonstration project and Tetra Tech
began developing the conceptual design. EPA staff met with key stakeholders, including DWM, to decide
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Screening
whether the HIA should proceed, considering the downsized project area. EPA and DWM agreed the
HIA would still provide the benefits discussed above and would inform DWM's decision on implementing
the proposed Green Street Project as they move forward in the planning process.
2.2. The Proposed Decision: Implementing the Green Street Project
Currently, Boone Street exists as a 44-foot road right-of-way between the inside edge of the sidewalk on
either side of the street with four 10-foot travel lanes. The overall vision of the Boone Boulevard Green
Infrastructure Conceptual Design (from now on referred to as the proposed Green Street Project) is to
implement green infrastructure, specifically stormwater best management practices (BMPs), in
collaboration with the planned road diet. Guidance from the City's Transportation Planning Division
governed most of the project's layout, considering most of the green street features must fit within the
roadway corridor.
The proposed Green Street Project will span 2,200 feet of Boone Street, from Maple Street to James P.
Brawl ey Drive (refer to Appendix A for the complete layout of the proposed Green Street Project). After
completion, this section of Boone Street will consist of two, 10-foot travel lanes, a 5-foot bike lane on
each side of the street, and a 12-foot row of in-ground, planter boxes (Figure 6). A 12-foot left-turn lane
will replace the planter boxes at required intersections (i.e., at Boone Street and intersections with
Brawl ey Dr., Sunset Avenue and Vine Street; Figure 7). Bio retention cells (rain gardens) and grass
spillways will be placed at the entrance of the planned 16-acre Historic Mims Park (i.e., between Vine
Street and Elm Street) to capture and treat stormwater runoff coming from the street before it enters the
sewer system.
Boone Boulevard Green Street Project
:: I
Jt I
_• "i~ _• i
Figure 6. Cross-section of Boone Street if DWM implements the proposed project as planned.
(Source: www.streetmix.net 2013)
Proctor Creek's Boone Boulevard Green Street Project HIA
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Screening
Boone Boulevard Green Street Project
a I
tf ? =
Figure 7. Cross-section of Joseph E. Boone Street (at the intersections of Brawley Drive, Sunset
Avenue, and Vine Street) if DWM implements the proposed project as planned. (Source:
www.streetmix.net 2013)
2.1.1. Alternative Decision Scenarios
There are four possible alternative decision scenarios:
1. DWM implements the Green Street Project in conjunction with the planned road diet.
2. The planned road diet is implemented, but the proposed Green Street Project is not.
3. The Green Street Project is implemented, but the planned road diet is not.
4. Neither the Green Street Project nor the road diet are implemented.
The first scenario is the most possible and most expected outcome to occur. DWM has already received
some funding for the project through the Clean Water Act Section 319(h) appropriations. Section 319(h)
grants are awarded to designated state and tribal agencies to implement their approved nonpoint source
water pollution management programs (U.S. EPA 2014c). ARC Livable Centers Initiative also awarded
funds to implement projects in the Cycle Atlanta Phase 1 study, which includes resurfacing and restriping
Boone Street to include a bike path. The FHWA had already established that Boone Street was serving
well below its original planned traffic volume and the cost of maintaining roads is increasing.
Implementing the road diet may improve transportation safety along Boone Street and reduce the cost to
maintain the road (Highway Safety Information System 2004). The engagement of community residents
in the PNA Vision study and other community improvement projects has increased awareness and
support among stakeholders to implement green infrastructure in this area.
The second scenario is unlikely, given that the City has already acquired partial funding to implement the
project and has expressed its commitment to improve the corridor. Implementing just the road diet fails
to address other needs, such as the aesthetic appeal of the corridor, overburden of stormwater on the
combined sewer system running under the street, and flash flooding experienced in the area. If support
for the proposed project wanes and/or the project become a controversial issue, the City may decide to
postpone implementation until the issues can be resolved. Thus, buy-in from community residents and
other stakeholders is necessary to ensure the project moves forward.
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Screening
The third scenario is impractical, considering a large portion of the project is located in the unused space
left over from the road diet. If the road diet did not occur, the proposed 12-foot wide planter boxes and
designated bike lanes would not be achievable without creating space elsewhere. Other parts of the
proposed project, such as converting the road surface into permeable pavement and adding the green
infrastructure elements adjacent to Minis Park, could be achieved even if the road diet did not occur.
The last scenario is possible, but very unlikely. Both projects do face the potential for being delayed or
postponed. Delays may be inevitable if funding is not sufficient to complete implementation in its
entirety and/or other unforeseen challenges arise. Both projects could be postponed if there is enough
public opposition to the projects.
2.1.2. Expected Benefits of the Proposed Green Street Project
DWM does expect the project to solve issues of flooding in the immediate area surrounding the project
site or significantly improve water quality of Proctor Creek. The primary purpose of the project is to
demonstrate the use of alternative solutions to stormwater-related issues and help reduce the burden to
infrastructure already in place. Reducing the volume and flow of runoff going into the combined sewer
system will help prevent further infrastructure damage and CSO events. Furthermore, improved
stormwater runoff capture will reduce pooling of water on the street thereby preventing road hazards (i.e.,
reduce localized or flash flooding).
2.1.3. The Decision-makers and Decision-making Process
There are three general planning stages for public projects. The first of which involves developing the
overall concept of the project, including its purpose, goals, and general vision. The first stage results in a
30% conceptual design that is submitted to the public for feedback, usually through a series of public
hearings. The next planning stage usually involves performing the traditional environmental assessments
and testing from engineers/architects, etc. The evaluation findings and recommendations are used to
refine the design, yielding a 60% completed plan. Community input received during the open comment
period is used to further refine the project plan into the final (90%) project plan.
The DWM contracted Tetra Tech to complete the 30% conceptual design, which was published in March
2014.6 DWM will present the proposed conceptual design project to the public, followed by an open
comment period. Once DWM receives the community input and assessment findings and
recommendations, DWM will decide whether to present the project plan to the Mayor for final approval.
If the Mayor approves the proposed project, DWM will then initiate the contractor bidding process,
solidify a funding vehicle, and choose who will implement the project plan. Once the project is
completed, the City will be responsible for maintaining the corridor, which will require annual
appropriations approved by the Mayor through the annual budget process. Any additional capital
required to complete the project will also require approval from City Council.
6 The Boone Boulevard Green Infrastructure Conceptual Design is available online at
http://water.epa.gov/infrastructure/greeninfrastructure/upload/Boone-Blvd-Report-508-Report.pdf.
Proctor Creek's Boone Boulevard Green Street Project HIA Page 18
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Screening
As planning for the proposed project moves forward, there are opportunities for the HIA to provide
science-based and stakeholder input. This input would inform DWM's decisions as they move forward in
the planning process for the proposed Green Street Project. Table 2 lists several points that the HIA could
inform the decision-making process.
Table 2. Expected Points of HIA Influence in the Decision-making Process
Time Frame
November 2012
to January
2013
February 2013
April 2013 to
March 2014
April 2014 to
December 2014
Spring 2015
Summer 2015
Decision Points HIA Step
The 30% conceptual Screening
design is developed.
DWM informs Scoping
community members
and other
stakeholders about
the proposed project
and shares the
conceptual plan.
The proposed project Assessment
plan is assessed by
architects, engineers,
etc. DWM
incorporates
assessment findings
and recommendations
into project plan (i.e.,
60% design).
DWM incorporates Recommendations
community input into
the final design of the
project (i.e., 90%
design).
DWM presents Reporting
project plan to the
Mayor for final
approval.
If approved and Monitoring and
funding is received, Evaluation
DWM will initiate
the implementation
phase for the project.
HIA's Intended Influence
The screening process would inform
DWM that there is an opportunity to
assess the proposed Green Street
Project for other potential impacts,
apart from stormwater management
and traditional cost analysis.
Scoping would help stakeholders
identify priority issues and/or needs of
the community, build consensus
around shared values, and outline
expectations for the proposed Green
Street Project.
The HIA would assess the proposed
project from a public health
perspective and provide input on the
potential co-benefits and adverse
impacts that may result from
implementing the proposed Green
Street Project (as planned). The HIA
process would also help stakeholders
structure responses to the proposed
plan and provide feedback.
HIA recommendations would provide
science-based and stakeholder-
supported strategies that would
manage predicted impacts from the
proposed Green Street Project.
Information from the HIA could be
used to inform the Mayor's decision
and/or influence the priority level of
the project.
DWM and stakeholders could follow
the HIA's monitoring plan to follow up
on the decision and predicted changes
in health and the environment, and
make changes (if needed).
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Scoping
Chapter 3. Scoping
Scoping in HIA means to determine to what extent a subject matter will be evaluated and defines what is
relevant and what is not relevant pertaining to that subject matter. In scoping, the main goals of the HIA
are established, along with the timeline for completing the HIA; the population included in the HIA and
the study area are determined; investigators elicit stakeholder input and professional expertise to identify
all of the potential impacts that may occur as a result of the decision and prioritize which pathways the
HIA will investigate further and to what extent.
3.1. HIA Timeline
The HIA timeline was first drafted in the Screening step, as part of the requirements of the RESES grant
proposal (refer to Appendix B for the original HIA timeline); further refined in the Scoping step; and
then updated as the process progressed through the last steps. Figure 8 provides the final HIA timeline.
6/3/2013 - V 30/201'!
Recommendations
Reportlrvg
Monitoring (continuous) and Evaluation
EPA ORO solicited regional offices to
participate In RESES research program.
^ focusing on HIA
•5/2/2012
HIA Project Leads submit
±. RESES proposal to EPA ORO
for funding the HIA
6/1/20 1 1
^ EPA ORD accepted HIA
RESES proposal
7/2//OU
^ EPA ORO approved
and released
funding for HIA
i«ra
K for Boi
2/21/21
*w Rr
Tetra Tech releases draft conceptual plan
for Boon* Boulevard Green Street Project
7201 a
First HIA community stakeholder meeting
First HIA Advisory Group stakeholder
- meeting
Full day HIA Training Workshop for
^•stakeholders and HIA project team
S/22/2013
Second HIA Advisory Group
y stakeholder meeting
Tetra Tech releases final conceptual plan
~^ for Boon* Boulevard Green Street Project
^ Second HIA community stakeholder meeting
J/TV/2Q14
^ Final HIA stakeholder meeting (combined) with
community stakeholders and Advisory Group
"
2012
2/1/2013 5/19/201S
warn
Final HIA meeting with
£ PA Region 4 Regional
Administrator and Deputy
Administrator to report
HIA results and snare final
HIA Report
Final HIA meeting
with City of Atlanta
to report HIA results
" and share final HIA
Report
2015
Today
Figure 8. The Final HIA Timeline.
NOTE: There were unforeseen challenges and delays that arose during the HIA that resulted in extending
the HIA timeline pas the original completion date. Although the project timeline appears continuous,
there were periods when HIA work was delayed or ceased for a short period. For example, all HIA work
ceased during the sixteen-day shutdown of the U.S. Federal Government. For more discussion of this
issue, see 7.2.3 Challenges Identified by the HIA Core Project Team. It is important to note that the
changes to the timeline did not affect the HIA 's ability to inform the decision.
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Scoping
3.2. HIA Participants, Roles, and Responsibilities
This HIA was led by staff in EPA's ORD and Region 4 (Southeast) OEJ. Other HIA participants were
recruited from the Proctor Creek Urban Waters Federal Partnership and other stakeholder groups.
Stakeholders are individuals or groups that would be affected by and/or have an invested interest in the
result of the decision. Stakeholder groups invited to participate in this HIA included residents of the
study area and representatives from community-based organizations, local universities, local businesses,
the City of Atlanta, land and homeowners, and future businesses and investors.
The team leading the HIA recognized that not all HIA participants could be involved to the same extent
(e.g., due to scheduling conflicts, time and financial constraints, availability to travel to meetings, etc.).
The team leading the HIA outlined a set of roles and their respective responsibilities needed to complete
the HIA (see Table 3 for a list of the HIA participant roles and responsibilities). Stakeholders who
wanted to actively participate in the HIA and were available to fulfill the responsibilities outlined, were
invited to participate on the HIA Core Project Team. Stakeholders who wanted to participate in the HIA,
but had limited availability, were invited to serve as a member of the HIA Advisory Group. Stakeholders
not wanting to serve in a formal role, but wanted to provide input, were invited to participate in the
public, community meetings as a Community Informant.
NOTE: Some participants served more than one role. For example, the HIA Project Leads were also
members of the HIA Core Project Team. Furthermore, some Community Informants were also members
of the HIA Advisory Group.
Table 3. HIA Roles and Related Levels of Commitment and Responsibilities
HIA Role
HIA Project
Leads
Level of
Commitment
Intense
Responsibilities
Initiated and managed the HIA process;
Provided strategic oversight for completing tasks and ensuring
forward progress of the HIA;
Communicated directly with decision-makers, the community,
and other stakeholders;
Initiated, and moderated HIA meetings; and
Acquired personnel and funding resources for the HIA to be
completed.
HIA Core
Project Team
Intense
Conducted the HIA, including data collection and analysis,
synthesis of information, recommendation development, and
documentation of the HIA process; and
Performed the day-to-day HIA project tasks, including
attending project meetings and participating in group
discussions.
HIA Advisor Intense
Provided HIA expertise, including best practices, and
facilitated interactive HIA training workshop;
Advised and consulted on the selection of relevant scoping
pathways, data collection and synthesis of health information;
Guided tasks related to each step and engaging stakeholders.
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Scoping
HIA Role
Level of
Commitment
HIA Advisory Moderate
Group
Responsibilities
Provided technical expertise and local knowledge, as well as
feedback on the HIA process;
Attended and participated in three (3) HIA Advisory Group
meetings and discussions; and
Increased collaboration among agencies and organizations.
Community
Informant(s)
Low
Acted as a liaison between the HIA Core Project Leads and
community residents; and
Provided bi-directional feedback between the groups.
Decision- Moderate • Informed the HIA regarding the decision and decision-making
Maker(s) process;
• Provided feedback on the assessment findings and HIA
recommendations.
3.2.1. Stakeholder Communication and Engagement
Stakeholders were invited to participate in the HIA process via email, phone, and public flyer (refer to
Appendix C for invitations to participate in the HIA). The primary form of communication between the
HIA Core Project Team and other stakeholders was by phone and/or email. The regional HIA Project
Lead (Tami Thomas-Burton) acted as the gatekeeper for information sharing and communicating with all
stakeholders and HIA Core Project Team members.
The HIA Core Project Team developed many communications materials to support this HIA, including
meeting invitations, post-meeting summaries, PowerPoint presentations, factsheets, and documents. At
the beginning of the scoping step, the HIA Core Project Team began using a standardized format or
"brand," for HIA communication materials. The use of branding helped increase recognition and
consistency of HIA materials. Before materials were shared outside the team, several steps had to be
followed. First, there had to be consensus among the HIA Core Project Team regarding the content,
presentation, and dissemination point for each product. Second, the materials were sent to the Technical
Writer/Editor for review. Once comments and edit suggestions were addressed, HIA materials were sent
to the project co-leads for final approval before being shared.
The team leading the HIA outlined a plan for engaging stakeholders for each step of the process. The
planned stakeholder engagement activities, participants involved, and purpose for each step are outlined
in Table 4 to Table 9. The HIA Core Project Team would host two stakeholder meetings (one for the
HIA Advisory Group and one for the general public) during the Scoping and Assessment steps. The third
stakeholder meeting would be a joint meeting held with the HIA Advisory Group, public, and decision-
makers, during the Recommendations step. Hosting a joint meeting provides a forum for
recommendations to be discussed openly as a group, with representation from each interested party. A
final meeting would be held with the decision-makers to report the HIA main findings and
recommendations.
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Scoping
Table 4. Stakeholder Engagement during the Screening Step
Participants Involved
HIA Project Leads
Activities
Review stakeholder
input from previous
reports documenting
engagement.
Purpose
Identify community needs and issues
related to health in the Proctor Creek
Watershed.
• HIA Project Leads
• Decision-makers
Meet with DWM to
discuss opportunity for
the HIA to add value to
and affect the decision.
Establish benefits and other rationale for
conducting HIA.
Table 5. Stakeholder Engagement during the Scoping Step
Participants Involved
HIA Project Leads
HIA Core Project Team
Community Informants
Activities
1st public, community
meeting (March 22,
2013)
Purpose
Share information about the HIA and the
proposed project and gather input from the
community on what the HIA should
address.
HIA Project Leads
HIA Core Project Team
HIA Advisor
HIA Advisory Group
Decision-makers
1st HIA Advisory
Group meeting (April
30,2013)
Elicit feedback from stakeholders
regarding potential impacts of the proposed
project on health and stakeholder
viewpoints and opinions on which impacts
should be included in the HIA scope.
HIA Project Leads
HIA Core Project Team
HIA Advisor
HIA Advisory Group
Decision-makers
Community Informants
Full-day HIA training
(May 23, 2013)
Help building capacity for performing HIA
locally and provide HIA participants with
more knowledge and experience with the
process. Exercises were designed to teach
participants how to develop theoretical
pathways of impact, characterize the
impacts predicted, and develop
recommendations.
• HIA Project Leads
• HIA Core Project Team
HIA Core Project Team
meetings (periodic)
Develop and refine the HIA scope.
HIA Advisor
Table 6. Stakeholder Engagement during the Assessment Step
Participants Involved
• HIA Project Leads
• HIA Core Project Team
• HIA Advisor
• HIA Advisory Group
• Decision-makers
Activities (Date)
2nd HIA Advisory
Group meeting (July
23,2013)
Purpose
Gather information on potential data
sources and tools available to support the
assessment.
• HIA Project Leads
• HIA Core Project Team
• Community Informants
2nd public, community
meeting (March 22,
2014)
Present the initial findings and provide
stakeholders an opportunity to express
their opinions regarding the findings and
discuss any residual issues/concerns left
unaddressed.
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Scoping
Participants Involved
HIA Project Leads
Decision-m akers
Activities (Date)
HIA meeting with the
City of Atlanta (April
15,2014)
Present the initial findings from the
assessment and elicit feedback.
HIA Project Leads
HIA Core Project Team
HIA Advisor
HIA Core Project Team
meetings (periodic)
Conduct the assessment.
Table 7. Stakeholder Engagement during the Recommendations Step
Participants Involved
HIA Project Leads
HIA Core Project Team
HIA Advisor
Decision-m akers
HIA Advisory Group
Community Informants
Activities
Final HIA stakeholder
engagement meeting
(combined) (June 5,
2014)
Purpose
Present all the information gathered as part
of the HIA process, including assessment
findings and initial recommendations.
Discuss together potential solutions to
unresolved issues and identified
opportunities for improving the proposed
project so that stakeholder benefits were
maximized.
• HIA Project Leads
• HIA Core Project Team
• HIA Advisor
HIA Core Project Team
meetings (periodic)
Develop recommendations and establish
priorities.
Table 8. Stakeholder Engagement during the Reporting Step
Participants Involved
• HIA Project Leads
• Decision-makers
Activities
Final meeting with
DWM (March 2015)
Purpose
Present the main findings from the HIA
and the final recommendations to the City.
• HIA Project Leads
• HIA Core Project Team
HIA Core Project Team
meetings (periodic)
Develop the HIA report, Executive
Summary, factsheets, and any other
communication materials for sharing
information about the HIA.
Table 9. Stakeholder Engagement during the Monitoring and Evaluation Step
Participants Involved
HIA Project Leads
HIA Core Project Team
Activities
HIA Core Project Team
meetings (periodic)
Purpose
Develop a monitoring plan to follow-up on
the decision and health impacts of interest.
HIA Project Leads
Evaluation of the HIA
Use stakeholder feedback, feedback on the
HIA report to evaluate the HIA (i.e.,
process evaluation).
3.3. HIA Main Goals
Goals serve as the foundation for guiding the direction and implementation of the HIA. The HIA Core
Project Team established a set of goals early in the Scoping step to help guide the HIA. These goals
would serve as the criteria for judging the success of the HIA. The HIA goals are as followed:
1. Add a vehicle for equitable inclusion of all stakeholders in the decision-making process;
Proctor Creek's Boone Boulevard Green Street Project HIA
Page 24
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Scoping
2. Assess the effectiveness of the proposed green infrastructure project and raise awareness of the
environmental, economic, and societal impacts of implementing green infrastructure in the
designated community;
3. Provide recommendations to the proposed project that incorporate approaches to storm water
management, ecosystem restoration, and community revitalization; and
4. Increase transparency, local accountability, community empowerment, and ownership of the
proposed plan through meaningful stakeholder engagement.
Note: After the Reporting step was completed, the HIA Core Project Team evaluated whether the HIA
achieved its stated goals. Section 7.2 Process Evaluation - Evaluating the HIA Design and
Implementation provides more discussion on this topic.
3.4. HIA Quality Assurance
Prior to conducting this HIA, EPA conducted a review of over 80 existing HIAs to determine the current
state-of-science and to identify best practices and areas for improving HIA implementation (U.S. EPA
2013a). The findings from EPA's review, along with several HIA practice documents, were used to guide
the HIA process and quality assurance. The HIA practice documents reviewed included:
• North American Practice Standards Working Group. (2010). Minimum Elements and Practice
Standards for Health Impact Assessment, Version 2. Oakland, CA.
• Bhatia, R. (2011). Health Impact Assessment; A Guide for Practice. Oakland, CA: Human Impact
Partners.
• National Research Council. (2011). Improving Health in the United States; The Role of Health
Impact Assessment. Washington, B.C.: The National Academies Press.
• NACCHO. (2008). Health Impact Assessment: Quick Guide. Washington, D.C.: National
Association of City and County Health Officials (NACCHO).
• Quigley, R, et al. (2006). Health Impact Assessment; International Best Practice Principles, Special
Series No. 5. Fargo, USA: International Association for Health Impact Assessment (IAIA).
• UCLA. (2008). HIA Training Manual. Los Angeles, CA: University of California (UCLA).
• WHO. (1999). Health Impact Assessment; Main Concepts and Suggested Approach. Gothenburg
Consensus Paper. Brussels (Belgium): World Health Organization (WHO), Regional Office for
Europe, European Center for Health Policy.
The HIA Core Project Team used these documents to guide the implementation of the HIA. Furthermore,
the HIA Advisor continuously monitored and guided the process to ensure the HIA followed the
minimum elements and practice standards set forth by the North American HIA Practice Standards
Working Group and best practices in the field based on professional expertise.
Note: This HIA report underwent an external peer-review by three HIA practitioners and an internal
administrative review by the EPA. Section 7.2 Process Evaluation - Evaluating the HIA Design and
Implementation provides further discussion of the review process and its findings.
Proctor Creek's Boone Boulevard Green Street Project HIA Page 25
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Scoping
3.5. Setting the Scope of the HIA
3.5.1. Defining the HIA Study Area
One task in setting the scope of an HIA is to determine the study area where the impacts of the proposed
decision will be appraised. Previous HIAs have used proximity (or distance) measures from a quarter-
mile to one-mile to define the potential area of impact for different health determinants. For example, a
distance of one half-mile was used by many HIAs to determine health impacts related to access to parks,
recreational facilities, grocery stores, public transit stops, schools, etc. Due to the scale of the proposed
Green Street Project, the HIA Core Project Team decided that a half-mile radius was optimal for
designating the potentially impacted community (Figure 9). A quarter-mile radius would not include all
of the population affected by the proposed project, and the one-mile radius would not provide a sufficient
resolution at which to describe the population affected.
ArcHydro Generated Drainage
— Proposed Project Area
' Neighborhood Planning Units
Neighborhoods
1'2 mile Study Site Buffer
Procter Ck Watershed
Streets
•Source: 2006 NLCQ MCmeter Impervious Surface raster
Figure 9. The HIA study area. The green line represents the half-mile radius around the proposed
Green Street Project site.
The HIA Core Project Team wanted to assess how the changes in the HIA study area would translate to
changes in the larger watershed. The geographic information system (GIS) specialists obtained the
Proctor Creek Hydrologic Unit Code (HUC; HUC 12 = 031300020101) from the U.S. Geological Survey
(USGS 2013) and modified it in ArcHydro (ESRI, Redlands, CA) using topography, elevation, and
surface and groundwater flows to generate the watershed boundary. Figure 10 identifies the modeled
areas where stormwater would flow across surfaces from the headwaters to a single discharge point in the
Chattahoochee River. The HIA Core Project Team also defined the area (upstream) where stormwater
would flow to the proposed project site (Figure 11).
Proctor Creek's Boone Boulevard Green Street Project HIA
Page 26
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Scoping
Point bf discharge into the
ChaUahoochH ki
ArcHydrc Grrii?r
Proctor Ck Watershed
Interstate*
Boone Blvd Study Site
Figure 10. The modeled area of Proctor Creek Watershed with stormwater flow lines.
N
A
DrainageLme 1500
Watershed Upstream Boone Blvd
Proctor Ck Watershed
Interstate?
Boone Blvd Study Site
I
0 5 Miles
Figure 11. The modeled area upstream of the proposed project site with modeled stormwater flow
lines.
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Scoping
3.5.2. Vulnerable Populations Affected
HIAs assess the distribution of potential impacts within the population affected. This practice helps to
determine if there may be unequal sharing of burdens and/or benefits that may result from the proposed
decision. Vulnerable populations refers to sub-groups within the population that may be more sensitive to
or more affected by changes in the physical and natural environment, social environment, and/or
economic environment. The HIA Core Project Team discussed and determined that individuals in low-
income households (i.e., at or below the federal poverty level), young children, the elderly and/or
physically disabled, and households that are cost-burdened (i.e., spend more than 30% of their income on
housing costs) would be more vulnerable to the consequences of the proposed Green Street Project.
Individuals and households that are economically disadvantaged (e.g., low-income, fixed-income,
unemployed, etc.) are going to be more sensitive to changes in the economic environment. Housing costs,
costs of groceries, and transportation costs are types of living expenses that shape the economic
conditions of a community and can predispose vulnerable populations to disproportionate impacts. For
example, if housing costs (e.g., rent or property taxes) increase due to community-level improvements,
those living in the community at the lower end of the income spectrum would be less likely to be able to
accommodate those increased costs and may be obligated to move away. Displacement from
gentrification describes the movement of low-income residents out of an area due to an inability to adapt
to increases in cost of living.
Youths (ages 5 to 18 years) and young children (under age 5) are highly sensitive to the physical, social,
and economic conditions in the community because of their dependency on others. Children are also
more susceptible to illness and injury than adults. Environmental conditions, such as poor air quality,
greatly increase the risk for respiratory disease (e.g., asthma) among children. Poor social conditions,
such as overcrowding and crime, can lead to stress and harmful health behaviors that continue through
adulthood. Children living in poverty are more likely to live in crowded housing, have less access to
healthy food, and limited access to healthcare, than children not living in poverty.
Elderly and/or physically disabled individuals are more dependent on the accessibility of the built
environment, compared to those without physical restrictions. For example, the design and condition of
roadways in a neighborhood (e.g., level sidewalks, pedestrian crossings with counters, bicycle lanes, and
public transit stops) can either prevent or enable those with physical restrictions to reach destinations,
such as health clinics, parks, and recreational space, which affect health and wellness.
The HIA Core Project Team paid particular attention to whether or not the identified vulnerable
populations would disproportionally affected by the proposed project.
3.5.3. Identifying the Pathways of Impact
The HIA Core Project Team relied on stakeholder input to decide what the HIA would assess (i.e., what
health impacts would be included in the assessment). Documentation of the following scoping activities
can be found in Appendix C.
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Scoping
Stakeholder-identified Health Impacts
On March 22, 2013, the HIA Core Project Team held the first public, community meeting of the HIA.
There were eighteen community members who attended the meeting and eleven different organizations
represented. The HIA Core Project Team facilitated a group discussion among the meeting attendees to
identify what "health" meant to them. Physical well-being remained the most recognizable factor related
to health. Stakeholders also recognized overall well-being, including physical, mental, and social aspects,
as a contributing factor. Attendees were asked to name and describe concerns in the community and how
"quality of life" could be improved. There were ten pre-conceived categories of interest and/or concern
identified by the HIA Core Project Team prior to the meeting, and attendees came up with an additional
category, titled "Community engagement," which they felt also needed to be included. Community
members then identified ways to improve the quality of life in the community within these 11 categories.
This same exercise was conducted at the first HIA Advisory Group meeting on April 30, 2013. The HIA
Advisory Group identified additional ways to improve the quality of life in the community within the
eleven identified categories and added a twelfth category, titled "Total Investment." The premise of this
category was the concern that residents who lived in the community may not be able to stay in the
community after improvements were made because the area was no longer affordable (later identified as
"gentrification"). Table 10 documents the responses from the attendees at the public, community meeting
and HIA Advisory Group meeting.
Table 10. Interests and/or Concerns Identified by Stakeholders
Category of
Interest and/or
Concern
Community
Engagement
Ways to Improve Quality of Life
(Identified by the community)
Opportunities to participate in
decision-making
A safe/secure community
meeting space
Opportunities for community
outreach
Additional Ways to Improve Quality of
Life
(Identified by the HIA Advisory Group)
A "greater voice" or unified community
voice
(internal) institutions for community
engagement
Economy / Jobs
/ Poverty
Community-owned asset that is
an economic activity generator
Increased local jobs for
community residents
Increased "green jobs"
Develop grey-to-green job
training pilot
Increased tourism and other
economic opportunities
[No input provided.]
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Category of
Interest and/or
Concern
Education
Ways to Improve Quality of Life
(Identified by the community)
Capacity building for sustainable
jobs
Community outreach that
augments existing community
knowledge
Environmental health
education/training
Environmental
health/stewardship program that
targets youths
Historically Black College and
University (HBCU) kick-start
environmental academy
Additional Ways to Improve Quality of
Life
(Identified by the HIA Advisory Group)
Training for green infrastructure jobs
Education for 'healthier' living and
eating
Education on environmental risks
Environment • Improvements to stormwater
management
• Cleanup of contaminated
properties
• Restored creek beds and stream
health
• Invest in green infrastructure
• Increased beautification projects
• Implement sustainability projects
More green space
Address deficiencies in the 5
mechanisms of healthy communities
(transportation, telecommunications,
power, wastewater, water supply)
Improved balance between built
environment (development) and
environmental hazards
Broader view on green infrastructure
implementation
Reduce 'heat stress' (planting trees)
Health
Decrease in liquor stores •
Address health disparities and •
serious health threats, e.g., HIV, •
cardiovascular disease
Sustainable food
options/regenerate soils for urban •
agriculture
Access to healthy foods
A medical home
Assess and educate for risk factors to
health in community, e.g., lead
poisoning, asthma, etc.
Reduce disease transmission and
(improve) vector control
Housing
Reduced vacant buildings
Reduce and eliminate dilapidated
housing and flood-prone
properties
More affordable housing
Launch a housing status
inventory
Increase home/land ownership
(home-owners)
More suitable (healthy) housing
Increase replacement housing (for
dilapidated properties)
Politics /
Government
Equitable distribution of
resources (from city)
Change land-use policy
Influence public policy, agencies,
etc. with informed community
input
A step-wise approach that looks at short-
term, medium, and long-term impacts
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Category of
Interest and/or
Concern
Recreational
Ways to Improve Quality of Life
(Identified by the community)
Increase beauty (aesthetics)
Completed Mims Park to enhance
historic portion of
community/tourist attraction
A Recreation/community center
Additional Ways to Improve Quality of
Life
(Identified by the HIA Advisory Group)
(Added) recreational opportunities
Safety
Decrease drug sales and crime
(police enforcement)
Establish neighborhood watches
Implement beautification projects
(to improve social cohesion)
(Improve) built environment to support
safe/civil activities and deter crime
Social /
Cultural
• Talk to long-term residents,
address problems, and respond
• (Promote) multi-generational and
walk-able community
(Improve) relationships between
established community institutions and
educational institutions
(Address) social impacts of projects
(Add) opportunity for social/emotional
support
Different "branding" of community
(Improved) community cohesion
Transportation
(Improve) connectivity with
downtown
Add directional signage to lead
people to neighborhood
goods/services
(Improved) accessibility/walk -
ability/access to basic needs (e.g.,
laundry, healthy foods, employment,
etc.)
Total
Investment
[No input provided.]
Ensure affordability to live in the
community after improvements have
been implemented (avoid gentrification)
1 The HIA Core Proj ect Team developed the categories a priori with the exception of "Community Engagement" (added by the
community) and "Total Investment" (added by the HIA Advisory Group).
After identifying interests and/or concerns, the HIA Core Project Team asked participants at each of the
meetings to vote on which categories of interest/concern were most important and/or relevant to the
community; four votes were given to each participant. Figure 12 highlights community stakeholders
voting on which pathways were more important.
Figure 12. Community stakeholders voting on interests and/or concerns at the first community
engagement meeting.
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Votes were tallied at the end of the exercise and compared between the two groups. Figure 13 and Figure
14 identify the number of votes assigned to each category at the community meeting and HIA Advisory
Group meeting, respectively. Both groups identified the environment, economy/jobs/poverty, and
community engagement as the higher priority items. However, there were differences of opinion between
the two groups regarding categories of lesser priority. For example, transportation was considered a
higher priority by the HIA Advisory Group, but not among the residents who attended the community
meeting. Education and housing were important to community residents, but not as important to the HIA
Advisory Group.
Community Priorities
Categories
' Economy/ Jobs/ Poverty
• Environment
• Health
* Transportation
Education
Housing
Politics/ Government
Safety
Social/ Cultural
Recreational
Community Engagement
Figure 13.
meeting.
Results of the voting to prioritize categories of concern/need from the first Community
Advisory Group Priorities
• Economy/ Jobs/ Poverty
• Environment
• Health
• Transportation
Education
Housing
Politics/ Government
Safety
Social/ Cultural
Recreational
Community Engagement
Categories Total Investment in Community
Figure 14. Results of the voting to prioritize categories of concern/need from the first HIA Advisory
Group meeting.
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Using an HIA Training Workshop to Build Capacity for HIA and Identify Pathways of Impact
On Thursday, May 23, 2013, EPA's Region 4 OEJ, in partnership with CDC and GHPC, hosted a full-day
HIA training titled "An Introduction to Health Impact Assessment." Several stakeholders were invited to
attend the training. A total of 30 participants attended the training and included EPA staff (n=10) other
federal agencies (n=7), non-governmental organizations (n=l), universities (n=7), county (n=l) and
community organizations (n=4). The training was conducted using small group exercises and PowerPoint
presentations that discussed the steps of HIA, the Boone Boulevard Green Street Project case study,
health determinants, and information on how the "National Prevention Strategy" and "Health in All
Policies" initiative are new science-based tools for improving health outcomes throughout the U.S.
Participants were given scenarios related to the Green Street Project, and asked to step through the HIA
process using facilitated exercises. Exercises were designed to teach participants how to develop
theoretical pathways of impact, characterize the impacts predicted, and develop recommendations for the
different scenarios (results of those exercises are documented in Appendix C).
The HIA Core Project Team used the information gained from this training to start identifying pathways
in which the proposed project could influence health. Causal pathway diagrams are a tool often used in
HIA to frame or illustrate the relationships between actions and their consequences. Several health
determinants and health outcomes were identified in this exercise. As the pathways became more
complex, it became very evident that the health outcomes affected by the proposed project were not
linked to one factor alone, nor were they independent of one another. Thus, the HIA Core Project Team
put together an overarching theoretical impact pathway diagram that illustrated the various interconnected
pathways through which the proposed project could affect health. The handout with the overarching
theoretical impact pathway diagram can be found in Appendix C under Documentation of the Second
HIA Advisory Group Meeting, July 23, 2013.
Data Mining and Preliminary Literature Search to Inform Pathway Diagrams
The HIA Core Project Team took the information provided by stakeholders and compiled it into a list of
topics. Then, the team brainstormed what was known and unknown for each topic and where information
(i.e., data) could be obtained to fill in the unknowns or (i.e., data gaps). Investigators began mining for
information about each of the topics, using data and literature (e.g., peer-reviewed scientific journal
articles, agency reports, factsheets, etc.) already available to gather. The team identified commonly-used
terminology, key indicators of measurement, methods of analyses, and sources of data. A Master Data
Sheet (created in Excel) was used to document the information obtained from these efforts and was kept
in a Google Plus© share drive, so that each member of the team could view and/or add information to the
file as needed. As more information was gathered, the potential health impacts and their pathways were
further refined.
3.6 HIA Assessment Work Plan
The HIA Project Leads created a work plan that listed the tasks required to complete the HIA, starting
with Assessment (refer to Appendix D for the complete HIA Work Plan). Table 11 lists the tasks
identified for completing the Assessment Step.
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Table 11. Assessment Step Tasks in the HIA Work Plan
Description
Task 1. Access and
collect data on
existing conditions in
the community
Collect and analyze data on the current resident population, including
demographic, economic, social, and health outcome indicators.
Synthesize existing data on identified health determinants and outcomes
of interest.
Update/refine the research questions and pathway diagrams as needed.
Task 2. Evaluate and
weigh evidence of
causal relationships
Access and synthesize peer-reviewed literature and agency reports for
information explaining the relationships (or lack thereof) between the
decision, current conditions, determinants of health, and health outcomes.
Evaluate, based on certainty, whether the evidence demonstrates a cause
and effect relationship between factors and assess whether the
information gained (based on context and range) can be applied to this
project.
Update/refine the research questions and pathway diagrams as needed.
Task 3. Share
information gathered
with stakeholders and
elicit feedback
Present information found and data gaps to advisory group and discuss
initial findings of existing conditions and elicit stakeholder input to fill in
data gaps.
Present preliminary findings to community and elicit feedback.
Task 4. Forecast
health effects,
quantitatively where
feasible
Identify and use suitable prediction models (exposure-response,
regression equations, etc.), where appropriate, to predict estimated health
effects.
Estimate impacts to health and/or health determinants using predictive
models, where possible.
Task 4. Characterize
expected health effects
Characterize the direction of impact, likelihood, magnitude, permanence,
distribution, and strength of evidence for the impacts estimated, based on
the data/information collected and/or modeled.
Task 5. Evaluate the
level of confidence or
certainty in health
impact
characterization
Compile the evidence that supports the characterization of impacts and
evaluate the level of confidence or certainty. Prepare communication
materials that represent the information synthesized and impacts judged.
Present assessment findings to stakeholders and public to elicit input on
the predicted/estimated impacts and re-evaluate the confidence and
certainty of change based on their input.
3.6.1. Health Impacts Assessed
The proposed project was expected to affect, either directly or indirectly, several health-related factors.
For example, the proposed project would result in changes to roadway infrastructure (e.g., lane reductions
and restriping) that will directly affect traffic safety. Improving traffic safety may remove potential
barriers that limit access to goods and services. Improving accessibility can lead to more people traveling
through the area, which increases the opportunity for social interaction and building relationships.
Increased traffic to the area will affect the crime rates, either by increasing the number of potential crime
victims or by reducing the opportunities for crime by increasing the number of "eyes on the street."
Building social relationships is a key component of social capital, which is the presence and strength of
social bonds and ties (networks) in a community. Social capital also plays an important role in a
community's ability to control crime. Each determinant fits within a sector of sustainability -
environment, society, and economy. Thus, the extent to which the proposed project influences these
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factors could be used as a performance indicator for promoting sustainability. Figure 15 identifies the
twelve determinants of health included in the assessment, by sustainability sector, and the pathways
connecting them to the proposed project.
Boone Boulevard Green Street Project
A £iposu.~? tc
jraar halae
& "•::!••-•• to
G DQQV £ f«ICK.
Srfcmp»:c. and
Healthcare
4 Crime
|Psrt«i«J and
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""*• Direct pathway
~ "^Indirect pathway
A "Change in"
i Economy A Society
Figure 15. Final health determinants included in the assessment step.
3.6.2. HIA Study Questions and Data Collection and Analysis
Study questions were developed to address each health determinant in the identified pathways either by
providing insight on the existing conditions observed in the community (i.e., existing conditions study
questions) or how the proposed project may change those conditions and ultimately influence health (i.e.,
impact study questions). Once the study questions were identified, the HIA Core Project Team worked to
identify the most relevant, reliable data sources, indicators, and analysis methods available to answer
those questions. A scoping worksheet, developed by Human Impact Partners
(http://www.humanimpact.org/capacity-building/hia-tools-and-resources/), was used to document this
process. The study questions were refined as more information was collected.
Pre-existing, publically available data was the most commonly used data in assessment. Standardized and
scientifically-rigorous datasets, such as the 2010 Census data files and the 2006 National Land Cover
Dataset (NLCD), were given greater consideration. Finding data at the same resolution (i.e., level of data
collection) for some of the study questions proved to be difficult. For example, Census data was available
for all of the demographic and socio-economic indicators at the tract level, for some indicators at the
block group level, and for almost none at the block level. Therefore, the tract level was used for most
data analysis resolution.
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Note: As a federal agency, direct collection of information from individuals is restricted by the
Paperwork Reduction Act and Information Collection Policy (44 USC 3501 -3520) and requires approval
from an Agency Internal Review Board (IRB) prior to any direct data collection from the public. The
timeframefor this process did not fit within the HIA timeframe and thus restricted the ability to collect
information directly from the public.
Modeling and Quantitative Analysis
Data files from the U.S. Census Bureau were used to extract demographic, structural, and socioeconomic
conditions in the community. The HIA Core Research used both the 2000 and 2010 Census datasets (to
compare the population overtime), and data from the 2006-2010 American Community Survey (ACS)
five-year aggregated estimates. The use of aggregate numbers is common in public health, when looking
at community health profiles, because it normalizes potential outlier years (i.e., years of abnormally high
or low values). The Atlanta Department of Planning and Community Development and the Atlanta Police
Department (APD) provided additional social and economic data to conduct analyses related to property
values, vacant and derelict properties, and crime. Calculations and mapping of the population-based data
were performed using GIS software and methods.
A variety of data sources were used to obtain and analyze data related to the physical (natural and built)
environment, including the National Hydrography Dataset (NHD), the NLCD, PRISM Climate Group,
local climatological data sources, and www.weather.com. GIS-based mapping tools and analytical
models, such as ArcHydro, ArcMap, and EPA's Stormwater Calculator (Version 1.0.0.9) were used to
generate watershed boundaries, stormwater flow lines, sites of stormwater flow accumulation, wetness
indexes, land cover and land use types, average monthly temperatures and precipitation, and flood prone
zones.
Literature Review
The HIA Core Project Team performed literature reviews of the empirical evidence. Team members were
given a set of guidelines for conducting the literature review, a list of document types that were
acceptable to include in the review, and a worksheet developed to standardize the information collected
(provided in Appendix D).
The HIA Core Project Team reviewed over 200 articles and prepared literature review worksheets to track
the information collected. Databases, such as Google Scholar, JSTOR, and LexisNexis, EBESCO
Academic Search Complete, Web of Science, Science Direct, PubMed, Psychlnfo, ProQuest, Social
Science Research Network, and PAIS International, were used to search the literature articles. Identifying
key search terms (e.g., green infrastructure efficiency, human health, extreme heat event, etc.) and setting
exclusion parameters (e.g., sources published after 1995, in English, etc.) helped to expedite the review of
the literature. HIA clearinghouses, such as UCLA's HIA Clearinghouse Learning and information Center
(HIA-CLIC; http://www.hiaguide.org/) and the Health Impact Project HIA Clearinghouse
(http://www.healthimpactproject.org/hia/us) provide free access for searching previous HIA reports. The
data from the literature review worksheets were compiled in the Master Data Sheet.
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Stakeholder Input
There were instances where the data needed to effectively evaluate the potential impacts to health were
not available. The HIA Core Project Team held a second HIA Advisory Group meeting on July 23, 2013
to enlist stakeholders' assistance in identifying potential data, sources, and tools available to address
identified data gaps. The team presented the data sources and approaches they had identified for use in
the assessment and using posters showcasing each of the various categories (i.e., health determinant
groupings) and sub-topics to be addressed, and solicited input from stakeholders. The HIA Advisory
Group identified additional sources, contacts, and tools that could be used in the assessment (the input
provided by the HIA Advisory Group is documented in Appendix C under Documentation of the Second
HIA Advisory Group Meeting, July 23, 2013).
When data was not available or was lacking in reliability, the HIA Core Project Team relied on
professional expertise and best judgment. HIA as a "pragmatic exercise and reflects a balance between
scientific rigor and professional judgment" (NRC 2011). The HIA Core Project Team utilized the
expertise of local public health professionals, science research professionals, and stakeholders with local
knowledge to evaluate potential impacts of the Green Street Project. Caveats and cautions are made
explicit in this report to highlight limitations and uncertainties in the data and analysis methods used,
along with assumptions made in carrying out the assessment.
Characterization and Qualitative Analysis
Health status information for the community was almost non-existent, given the relatively small size of
the HIA study area. However, some health data was provided at the Census tract level by the Georgia
Department of Public Health Online Analytical and Statistical Information System (OASIS; available at
http://oasis.state.ga.us/oasis/). This information, however, was provided in a non-numeric format—
choropleth maps of quintile (i.e., data was arranged in five ranks equally distributed between the
minimum and maximum values) from lowest to highest. Health information was gathered on the
aggregate number of emergency room (ER) visits, by cause, for the years 2006 to 2010.
Note: The availability of health status information is often limited or unavailable due to the privacy
standards of the 1996 Health Insurance Portability and Accountability Act (HIPAA). These data gaps
can limit the scope of a study and hinder accurate forecasting of impacts in assessment. In this HIA, the
lack of health data at a finer resolution than county level made it difficult to forecast the probability and
magnitude of predicted health impacts. However, OASIS allowed the HIA Core Project Team to
qualitatively characterize health status for reported health outcomes. It is important to note that the
population boundaries in the OASIS mapping tool have not been updated and use the 2000 Census tract
boundaries.
Data-based evidence, empirical evidence, and professional expertise were used to characterize the
potential health impacts of the proposed project. Once the potential impacts were identified, the extent of
the impacts was evaluated based on six criteria - likelihood, direction, magnitude, permanence,
distribution, and strength of evidence. The likelihood that the impact would occur because of the project
was appraised. Whether the impact would improve, detract, or have no net effect on health outcomes was
described by the direction of impact. Magnitude described how many people would be affected by the
change. Permanence was used to refer to how long the changes to the health determinants were expected
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to last. The distribution of the impact was judged for how it would affect vulnerable populations. Lastly,
the strength of evidence upon which the impact characterization was made was also identified. Table 12
explains the rating scales for each criterion.
Table 12. Impact Characterization Criteria and Rating Scale
Criteria Rating Scale
Direction Positive= the potential change to the health determinant will benefit health
Negative= the potential change to the health determinant will detract from health
Both Positive/Negative= Both positive and negative impacts are expected
None= no change in the health determinant is expected
Likelihood Highly Likely= it is highly likely that the change will occur because of the project
Plausible= it is plausible that the change will occur because of the project
Not Likely= it is not likely or not plausible that the change will occur because of the
project
Magnitude High= the change has the potential to impact many people, beyond those on the
street
Moderate= the change in the health determinant has the potential to impact a
moderate number of people, specifically those using the street
Low= the change in the health determinant has the potential to impact very few
people
Permanence Long Lasting= the change in health may be long-lasting (for many years)
Moderate= the change in the health may be medium-lasting (for a few years)
Quickly and Easily Reversed= the change in the health may be short-lasting or
easily and quickly reversible
Distribution Vulnerable Populations Benefit=the change in the health determinant has the
potential to benefit vulnerable populations, or restore equity in the opportunity for
healthy living
Vulnerable Populations Harmed= the change in the health determinant has the
potential to harm vulnerable populations
Equal Impact= the impact will be distributed equally throughout the population
Strength of Strong= causal evidence is strong, there are many consistent studies, or cause-effect
Evidence pathway is generally accepted
Limited= evidence is limited, there are a few good studies showing an association
between the factors, but some controversy exists (potential for
confounders/mediators)
Lacking= evidence is lacking, but the impact(s) predicted follow a logical
(theoretical) pathway
The following tables provide information from the HIA Scoping Worksheet for each of the health
determinants, including the study questions, data needed (i.e., indicators), whether the data was publically
available, data sources and tools available, and data analysis methods. Table 13 to Table 19 relate to the
health determinants in the environmental sustainability sector. Table 20 to Table 22 relate to the health
determinants in the social sustainability sector. Table 23 and Table 24 relate to the health determinants in
the economic sustainability sector.
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Table 13. HIA Scoping Worksheet for Water Quality
Study Questions
1. What influences water
quality?
2. How does water quality
influence public health?
3. How efficient is green
infrastructure in
improving water quality?
Data Needed
(Indicators)
• Exposure to water-
borne disease
• Percent efficiency of
stormwater best
management practices
(BMPs)
Publically Data Sources and/or Tools
Available?
Yes
• Empirical Literature
Review
Analysis Methods
Review empirical
literature to determine
factors that contribute to
water quality in urban
communities and how
water quality affects
health.
4. What is the status of water
quality in the Proctor
Creek Watershed?
5. What is the status of
health outcomes in the
community related to
water quality?
• Fecal coliform and/or Yes
E. coll monitoring data
• 305(b)/303(d) criterion
violated and identified
potential causes
• ER visits for digestive
system diseases
(GA-DPH OASIS
does not report
waterborne diseases)
• Water quality monitoring
reports and list of
305(b)/303(d) impaired
rivers and streams
(GA-EPD, DWM, and
ARC)
• GA-DPH, OASIS 2006-
2010dataset
Review previous reports
on water quality
surveillance and extract
relevant data.
Review available health
information related to
water-borne illness.
6. Will the elements of the
Green Street Project be
sufficient to affect water
quality and related health
outcomes?
[Blank]
[Blank] • Proposed project
conceptual design (Tetra
Tech 2013)
Review evidence and
(qualitatively) characterize
health impacts related to
water quality.
Table 14. HIA Scoping Worksheet for Flood Management
Study Questions
1. What are the risks to
human health associated
with flooding (i.e., injury
from slips/falls, damage to
Data Needed
(Indicators)
Exposure to injury
from flooding
Exposure to poor
housing
Publically
Available?
Yes
Data Sources and/or Tools
• Reports and available
data from GA-DPH
• Empirical Literature
Analysis Methods
Review literature to
determine pathways of
impact between flooding,
housing and infrastructure
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2.
3.
4.
5.
6.
7.
Study Questions
homes, contribution to pest
population, etc.)?
During or after a rain
event, where is stormwater
(that is not captured and
conveyed by the storm
sewers) most likely to
flow?
Do the areas in the
community more prone to
flooding also have derelict
or vacant properties?
How much stormwater
runoff reaches the storm
sewer inlets in the
proposed project site?
How are the areas
upstream, downstream,
and in the community
interrelated with respect to
flooding?
What is the risk of
flooding in the community
and in other areas of the
watershed?
Will the Green Street
Project affect flooding and
related public health
issues?
Data Needed Publically
(Indicators) Available?
• Exposure to vector-
borne disease (i.e.,
positive West Nile
Virus (WNV) sample
locations)
• Topographic Wetness Yes- but
Index (TWI) requires GIS
• Derelict and vacant expertise
properties (land and/or
structure)
• Percent of all rainfall
retained
• Days per year with
runoff
• Percent of wet days
retained
• Average annual runoff
O
• Land cover (land use)
• Plotted monthly
average precipitation
• Predicted annual peak
discharge by volume,
magnitude, and
reoccurrence intervals
• Predicted flood
.C j-
frequency percent
[Blank] [Blank]
Data Sources and/or Tools
-
• NLCD and NHD (2006) -
• Atlanta Department of
Planning and
Community
Development, Strategic
Community Investment
(SCI) Window Survey
data
• Geospatial analysis using
ArcGIS tools, including
ArcMap and ArcHydro
• Scenario modeling using
National Stormwater
Calculator (EPA Release
1.0.0.9)
• Computations in
Microsoft Excel
• Proposed project
conceptual design (Tetra
Tech 20 13)
Analysis Methods
damage, vector control,
and health.
Review literature to
identify contributing
factors to flooding in an
urban watershed.
Generate flood plains and
wetness index to identify
flood risk and flood prone
areas.
Estimate current and
predicted volumes of
stormwater runoff flowing
through the project area
before and after the Green
Street Project has been
implemented.
Use GIS support to
perform spatial analysis of
derelict and/or vacant
properties and anticipated
wet areas.
Calculate and plot average
daily precipitation values
to determine size and
frequency of 8 1 % of storm
events.
Review evidence and
(qualitatively) characterize
health impacts related to
flood management.
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Table 15. HIA Scoping Worksheet for Climate and Temperature
2.
Study Questions
What elements of the built
and natural environment
in an urban community
might predispose residents
to higher temperatures?
How does exposure to
higher temperatures affect
health and wellness?
Data Needed
(Indicators)
Exposure to extreme
heat events (heat-
related illness not
reported in GA—DPH
OASIS)
Publically Data Sources and/or Tools
Available?
Yes
Empirical Literature
Analysis Methods
Review the literature
evidence to identify
pathways of impact
between exposure to
extreme heat events,
health, and any mediating
factors.
3. What are the historic
temperatures experienced
in the community?
4. Are there areas in the
community that may
contribute to "hot spots"
or higher than average
surface temperatures?
Monthly average
temperatures
Infrared imaging of
impervious surfaces
Yes- but
requires GIS
expertise
www.weather.com
ArcGIS Mapping Tools
Geo spatially analyze
impervious surfaces and
use monthly average
temperatures to determine
areas of significantly
higher temperatures.
5. Is the Green Street
Project, as designed,
expected to change the
microclimate and influence
temperature and its
related health impacts?
[Blank]
[Blank]
Proposed project
conceptual design (Tetra
Tech 2013)
Review evidence and
(qualitatively) characterize
health impacts related to
climate and temperature.
Table 16. HIA Scoping Worksheet for Air Quality
Study Questions
1. How does air quality
influence health and
wellness?
2. How does the built and
natural environment
Data Needed
(Indicators)
• Exposure to ambient
air pollutants
• Traffic-related air
pollution
Publically
Available?
Yes
Data Sources and/or Tools
Empirical Literature
Analysis Methods
Review the literature
evidence to identify
pathways of impact
between exposure to air
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Study Questions
influence ambient air
pollutant concentrations,
especially in urban
communities?
Data Needed
(Indicators)
Ecological processes
of pollutant capture by
vegetation
Pollutant capture
efficiencies of BMPs
Publically
Available?
Data Sources and/or Tools
Analysis Methods
pollutants, health and any
mediating factors.
3. What is the existing status
of health outcomes related
to air quality in the
community?
ER visits for
respiratory diseases
ER Visits for chronic
lower respiratory
disease
ER Visits for asthma
Yes
• GA-DPH, OASIS 2006-
2010 health indicators
dataset
Use the OASIS mapping
tool to select and
download maps of ER
visits related to air quality
by Census tract.
4. Will the Green Street
Project, as designed, affect
local air quality and
related health outcomes?
[Blank]
[Blank]
Proposed project
conceptual design (Tetra
Tech 2013)
Review evidence and
(qualitatively) characterize
health impacts related to
air quality.
Table 17. HIA Scoping Worksheet for Traffic Safety
Study Questions
1. What characteristics of the
built and natural
environment contribute to
traffic safety?
2. Does implementing green
infrastructure along a
street (i.e., streetscaping)
improve traffic safety?
Data Needed
(Indicators)
Exposure to injury
from motor-vehicles
Publically
Available?
Yes
Data Sources and/or Tools
Empirical Literature
Analysis Methods
Use peer-reviewed
literature to qualitatively
assess impact of road diet
and streetscaping on traffic
safety and choosing active
modes of transportation
(i.e., walking and
bicycling).
3. What are the existing
traffic conditions and
traffic safety practices
present along the project
site?
Speed limit
Average annual daily
traffic (AADT)
Safety practices (e.g.,
speed bumps,
Yes
GA-DOT, Georgia State
Traffic and Report
Statistics (STARS)
GA-DPH, OASIS 2006-
2010 dataset
Use direct observations to
inventory the traffic safety
practices that exist along
the proposed project site.
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Study Questions
Data Needed
(Indicators)
pedestrian and cycling
infrastructure, etc.)
Publically
Available?
Data Sources and/or Tools
4. Is the Green Street Project [Blank]
designed to improve traffic
safety
Analysis Methods
Access traffic data and
calculate daily traffic
volumes.
Use the OASIS mapping
tool to select and
download maps of ER
visits related to motor-
vehicle crashes by Census
tract.
[Blank]
Proposed project
conceptual design (Tetra
Tech 2013)
Review evidence and
(qualitatively) characterize
health impacts related to
traffic safety.
Table 18. HIA Scoping Worksheet for Exposure to Greenness
Study Questions
1. How does the natural
environment or amount of
greenness in a
neighborhood affect
residents living in that
neighborhood?
Data Needed
(Indicators)
Publically
Available?
Exposure to greenness Yes
Data Sources and/or Tools
Empirical Literature
Analysis Methods
Review available literature
and identify mechanisms
by which greening of the
living environment (or
lack of) can impact public
health.
2. How green is the
community around the
proposed project site?
3. Is mental and behavioral
health a concern in the
community?
Infrared imaging of
vegetation (by type)
ER visits for mental
and behavioral
disorders
Hospitalizations for
mental and behavioral
disorders
Yes-GIS
expertise
required
2006 NLCD
GA-DPH, OASIS 2006-
2010dataset
Map the green and grey
areas in the community
and calculate spatial
differences.
Use the OASIS mapping
tool to select and
download maps of ER
visits related to mental and
behavioral disorders.
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Study Questions
4. Will the added greenness
of the Green Street Project
along Boone Street be
enough to impact health
outcomes related to mental
and behavioral health?
Data Needed
(Indicators)
[Blank]
Publically
Available?
[Blank]
Data Sources and/or Tools
Proposed project
conceptual design (Tetra
Tech 2013)
Analysis Methods
Review evidence and
(qualitatively) characterize
health impacts related to
greening the living
environment.
Table 19. HIA Scoping Worksheet for Exposure to Urban Noise
Study Questions
How does living near a
major urban corridor
affect resident health and
well-being?
How can the natural
environment influence the
adverse health impacts of
noise generated from an
urban street?
Data Needed
(Indicators)
Exposure to urban
(especially traffic-
related) noise
Publically
Available?
Yes
Data Sources and/or Tools
Empirical Literature
Analysis Methods
Review the available
literature to identify
sources of urban noise and
mechanisms in which
urban noise impacts public
health.
3. What are the current levels •
of ambient noise generated
from Boone Street?
4. What are the existing
conditions of health
outcomes that are most •
related to urban noise
exposure?
Modeled ambient
noise levels from
traffic or individual
sound level exposure
(if available)
Frequency of self-
reported annoyance
and/or sleep
disturbance (if
available)
Mortality and
morbidity by cause
Noise and
Health data
available, but
limited to
county level
Seongetal(2011)
modeled road traffic
noise
GA DPH OASIS 2006-
2010dataset
GA DPH Mortality Rate
Dashboard by cause
Collect available data on
road-source traffic and
related mortality and
morbidity data for Fulton
County, GA and infer
probable observations
experienced in the
community.
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Scoping
Study Questions
5. Will the Green Street
Project, as designed, be
enough to affect how noise
from the street travels
through the surrounding
community and related
health outcomes?
Data Needed
(Indicators)
[Blank]
Publically
Available?
[Blank]
Data Sources and/or Tools
Proposed project
conceptual design (Tetra
Tech 2013)
Analysis Methods
Review evidence and
(qualitatively) characterize
health impacts related to
(traffic-related) urban
noise.
Table 20. HIA Scoping Worksheet for Access to Goods and Services, Greenspace, and Healthcare
Study Questions
1. Does implementing green
infrastructure along a
street corridor influence
accessibility?
2. How does accessibility
affect health?
Data Needed
(Indicators)
• Accessibility
• Walk-ability
• Bike-ability
Publically
Available?
Yes
Data Sources and/or Tools
Empirical Literature
Analysis Methods
Review the literature
evidence available
regarding accessibility and
related health impacts.
3. How walkable and
bikeable is the area along
Boone Street?
• Walk Score®
• Bike Score®
• Transit Score®
Yes
• www.walkscore.com
Use the standardized Walk
Score® already generated
and supplement with
anecdotal and
observational information.
4. Is the Green Street
Project, as designed
capable of influencing
accessibility for residents
and visitors along Boone
Street?
[Blank]
[Blank]
Proposed project
conceptual design (Tetra
Tech 2013)
Review evidence and
(qualitatively) characterize
health impacts related to
accessibility.
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Table 21. HIA Scoping Worksheet for Crime (Perceived and Actual)
1.
2.
3.
Study Questions
How does crime influence
health?
How can implementing
green infrastructure
influence crime?
Data Needed
(Indicators)
• Perceived and actual
safety/security
Publically Data Sources and/or Tools
Available?
Yes
Empirical Literature
Analysis Methods
Review the available
evidence on crime and
health impacts of crime.
Does the area experience a
high crime rate?
Yearly crime count
(by type - aggravated
assault, auto theft,
homicide, larceny,
non-residential
burglary, residential
burglary, robbery,
vehicle larceny)
Yes- by
request
City of Atlanta, GA
Police Department Beat
102 and 103
ArcGIS Mapping Tools
Obtain and spatially
analyze crime data to see
where there are areas of
high crime.
4. Does the Green Street
Project have the potential
to influence crime in the
community?
[Blank]
[Blank] • Proposed project
conceptual design (Tetra
Tech 2013)
Review evidence and
(qualitatively) characterize
health impacts related to
perceived and actual
security/safety.
Table 22. HIA Scoping Worksheet for Social Capital (Cognitive and Structural)
Study Questions
1. How does streetscaping
and revitalization efforts
relate to social capital at
the neighborhood level?
Data Needed
(Indicators)
Cognitive social
capital
Structural social
capital
Publically
Available?
Yes
Data Sources and/or Tools
Empirical Literature
Analysis Methods
Review the available
literature on revitalization/
redevelopment,
streetscaping, and social
capital.
2. What assets are available
in the community that
provide space to build
social capital?
Location of public
facilities, greenspace,
churches, etc.
Yes-
• www.googlemaps.com
• ArcGIS
Identify and map the
facilities where social
capital can be influenced.
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Study Questions
3. Is the Green Street Project
expected to influence social
capital in the community
surrounding the proposed
project site?
Data Needed
(Indicators)
[Blank]
Publically
Available?
[Blank]
Data Sources and/or Tools
Proposed project
conceptual design (Tetra
Tech 2013)
Analysis Methods
Review evidence and
(qualitatively) characterize
health impacts related to
social capital.
Table 23. HIA Scoping Worksheet for Household Economics (Costs of Living and Employment)
Study Questions
1. How does streetscaping
affect living expenses (e.g.,
property taxes, rent, etc.,)
among nearby properties?
Data Needed
(Indicators)
Property values
Housing costs
Gentrification
Publically
Available?
Yes
Data Sources and/or Tools
Empirical Literature
Analysis Methods
Review the available
literature evidence on
green infrastructure
(especially green streets)
and individual economic
impacts.
2. What is the existing cost of
living in the community
and how much of a
person's income is going to
housing costs?
Household income
(median and mean by
owner-occupied and
renter-occupied)
Households on Fixed
income (by social
security income,
public assistance,
retirement income)
Monthly housing costs
(by owner-occupied
and renter-occupied)
Percent imputed of
monthly gross rent (by
renter-occupied
housing units)
Average property
value
Yes- GIS • U.S. Census Bureau,
expertise is 2010 Census data files
required . 2006-2010 ACS 5-Year
Estimates
• City of Atlanta, GA
Department of Planning
and Community
Development, Strategic
Community Investment
(SCI) Survey
• HUD Affordability Index
(http: //www .locationaffo
rdability.info/lai.aspx)
• 2013 Atlanta Tax Digest
data
• ArcGIS Mapping Tools
Collect and aggregate the
Census data regarding
housing costs
Map the residential
property values and
spatially analyze the
impact of distance from
the street on property
values in the community.
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Study Questions
Data Needed
(Indicators)
Persons living at or
below poverty level
(by age, race,
ethnicity, gender,
educational
attainment)
Location affordability
index
Residential property
values
Publically
Available?
Data Sources and/or Tools
Analysis Methods
3. Is the total investment in
the Green Street Project
expected to affect costs of
living?
[Blank]
[Blank] • Proposed project
conceptual design (Tetra
Tech 2013)
Review evidence and
(qualitatively) characterize
health impacts related to
cost of living.
4. How does green
infrastructure impact
employment or the
opportunity for
employment in
disadvantaged
communities?
5. How does employment
affect health?
Employment
Yes
Empirical Literature
Review the available
literature evidence on
green infrastructure
(especially green streets)
and individual economic
impacts.
6. What is the existing
employment level in the
community?
Population employed/
unemployed (by age,
gender, race, ethnicity,
educational
attainment)
Yes- GIS • U.S. Census Bureau,
expertise is 2010 Census data files
required . 2006-2010 ACS 5-Year
Estimates
Collect and aggregate the
Census data regarding
employment.
7. Is the total investment in
the Green Street Project
expected to affect
employment?
[Blank]
[Blank]
Proposed project
conceptual design (Tetra
Tech 2013)
Review evidence and
(qualitatively) characterize
health impacts related to
employment.
Table 24. HIA Scoping Worksheet for Community Economics (Business Performance)
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1.
Study Questions
How does streetscaping
influence business
performance?
Indicators
(Markers)
Data
Publically
Available?
• Demand for goods and
services
• Business performance
Yes
Data Sources and Tools
Empirical Literature
Analysis Methods
Review the literature
available on mechanisms
in which green
infrastructure can affect
local business
performance.
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^_
- Map and spatially analyze
non-residential property
values in the community.
2. What are the current
property values for
businesses in the
community?
Property costs of non-
residential properties
Yes-GIS • 2013 Atlanta Tax Digest
expertise is data
required . ArcGIS Mapping Tools
3. Does the Green Street
Project have the potential
to impact or influence
community-level business
performance?
[Blank]
[Blank]
Proposed project
conceptual design (Tetra
Tech 2013)
Review evidence and
(qualitatively)
characterize health
impacts related to
business performance.
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Chapter 4. Assessment
The assessment step involves two major tasks - 1) creating a profile of the population affected by the
decision, including health status and existing conditions in the community; and 2) characterizing the
potential health impacts of the decision. Assessment should utilize the best available evidence, including
quantitative (if available) and qualitative data from diverse sources, and should draw upon local
knowledge as part of the evidence base.
4.1. Profile of the Population in the Community
The HIA Core Project Team evaluated the potential impacts of the proposed project using a half-mile
radius around the proposed project site. This area constitutes of 1.25 square miles and intersects seven
Census tracts (i.e., Census tracts 21, 23, 24, 25, 26, 35, and 118). The City of Atlanta Department of
Planning and Community Development also refers to this area as neighborhood planning units (NPUs) K,
L, and M. Census data provides the most accurate representation of population counts and estimates in a
given geographic area.
4.1.1. Population Size and Density
The HIA Core Project Team first looked at the size and density of the population living in the community.
According to the 2010 Census, there were 13,914 people living in the HIA study area— 15.6% decrease
from a decade earlier, indicating movement out of the community. It is important to note that the large
decrease in population from 2000 to 2010 resulted in a change of Census tract boundaries (Census tracts
22 and 8 were combined into Census tract 118 for the 2010 Census).
ArcGIS was used to map
the population density data
by Census tract, which were
grouped into quintiles (i.e.,
ordinal groups of equal
distance between the
minimum value and the
maximum value).
Population density ranged
from 2,476 to 7,857 persons
per square mile and there
were no spatial patterns
observed among the Census
tracts (Figure 16).
Figure 16. (Right)
Population density in the
HIA study area.
Population Density by Tract
Census 2010
C3 Procter Ck Watershed
Boone Blvd Study Site
<^5 1/2 mile Study Site Buffer
Source U S Ceraus 2010 Summary fit 1
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4.2.2 Population Demographics
Over two-thirds of the population (67.0%) are between the ages of 22 and 64 and over a quarter of the
population (26.7%) are under the age of 22 (U.S. Census Bureau 2010). Men outnumber women, but by a
very small margin (6.4%). In 2010, the population was almost exclusively African American (82.3%),
with Caucasian being the second most populous (12.4%) (U.S. Census Bureau 2010). Persons of
Hispanic ethnicity accounted for 3.4% of the population.
The HIA Core Project Team calculated the Diversity Index for the community study area, which gives a
probability that on any given day, two people chosen at random from the same area will belong to
different race or ethnic groups; the Index ranges from 0 (i.e., no diversity) to 100 (i.e., complete diversity)
(ESRI 2013). The diversity index for the community study area was 30.6, which is considerably lower
than the state average of 62.2. Figure 17 shows a distinct increase in diversity as one moves closer
towards downtown Atlanta (Census tract 35). This pattern was not seen in the data obtained from the
2000 Census.
Diversity Index by Tract
Census 2010
Diversity Index
| | 11% -12%
-31%
32% - 47%
48% . 55%
Boons Blvd Study Site
1/2 mJle Study Site Buffer
ArcHydro_Proctor_Waterahed
Figure 17. Diversity in the HIA study area.
4.2.3. Educational Attainment
According to the 2006-2010 ACS data, almost one-third (29.9%) of the individuals over 25 years of age
have a college degree. Table 25 indicates that most of the residents over the age of 25 years (83.6%) have
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at least a high school degree or general education development (GED) certificate, and very few residents
have less than high school education (i.e., less than 9th grade).7
Table 25. Educational Attainment of Residents In The Study Area
Level of Education Attained
Less than High School
Some High School, No Diploma
High School Graduate (or GED)
Some College, No Degree
Associate Degree, or Higher
Percentage of Residents Over 25 Years1
3.7%
12.7%
31.2%
22.5%
29.9%
1 Source: 2006-2010 ACS, Educational Attainment Estimates (S1501)
4.2.4. Health Status
As mentioned before, data on health status in the community was very limited. The most numerous
causes of death and emergency room visits in the county were used to infer about the status of health in
the study area. According to the Community Health Needs Assessment Dashboard, the most common
reasons for emergency room visits in Fulton County, Georgia were related to mental and behavioral
disorders (#1), asthma (#2), and assault (#3) (GA-DPH 2013b). In Figure 18, the number of emergency
room (ER) visits related to asthma and assault were well above the state average. The most common
cause of visiting the emergency room, between 2008 and 2012 among children ages one to nineteen, was
unintentional injury (GA-DPH 2013b).
Ranked Significantly High Causes and State/County Comparison, Emergency Room
Visit Rate, Fulton County, 2008 - 2012
All Other Mental and
Behavioral Disorders -
45,287
Asthma - 40.226
Assault (Homicide) -
20.552
Essential (Primary)
Hypertension and
Hypertensive Renal.
and Heart Disease •
16.666
Anemias-11.861
a I
Diabetes Mellitus •
11,726
#2
Certain Conditions
Originating in the
Perinatal Period -
2,706
#3
Legal Intervention •
1,191
#4 #5
Human
Immunodeficiency
Virus (HIV) Disease - Parkinsons Disease -
901 112
= 1,
= 7
#8
It 9
# 10
Figure 18. Top causes for ER visits in Fulton County, Georgia from 2008 to 2012. (Source: GA
DPH 2013b)
7 The margin of error was calculated for the aggregated Census tract data from the 5-year ACS (2006-2010)
population estimates for educational attainment. For all of the indicators, the margin of error was less than +/-
0.04%.
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The HIA Core Project Team extracted the top ranked age-adjusted mortality rates, by cause, among
African Americans and Caucasians in Fulton County, GA from the OASIS Community Health Needs
Assessment Dashboard. The most common causes of death among African Americans in Fulton County
from 2008 to 2012 were hypertension and related chronic disease (#1), mental and behavioral disorders
(#2), and human immunodeficiency virus (HIV; #3) (GA-DPH 2013b). Each of these health outcomes
were well above the state averages, as indicated in Figure 19. The most common cause of death among
African American children, ages one to four and ten to nineteen years, was assault (homicide); motor
vehicle crashes was the leading cause of death for ages five to nine years (GA-DPH 2013b).
Ranked Significantly High Causes and State/County Comparison, Age-Adjusted
Death Rate, Race: Black or African-American, Fulton County, 2008 - 2012
Essential (Primary)
Hypertension and
Hypertensive Renal,
and Heart Disease -
1,175
Human
All Other Mental and Immunodeficiency
Behavioral Disorders - Virus (HIV) Disease -
684 493
Assault (Homicide) -
434
Malignant Neoplasm
of the Breast -371
# 1
Accidental Poisoning
and Exposure to
Noxious Substances •
193
Falls -93
Georgia
#6
#3
Mental and Behavioral
Disorders due to
Psychoactive
Substance Use • 88
Georgia
#5
Figure 19. Top causes of Death for African Americans in Fulton County, 2008 to 2012. (Source: GA
DPH 2013b)
The leading causes of death among Caucasians in Fulton County were mental health and behavioral
disorders (#1), Parkinson's Disease (#2), and HIV (#3) (GA-DPH 2013b).8 Death rates for each of these
causes were higher than the state average. The most common causes of death among Caucasian children
were motor vehicle crashes (ages fifteen to nineteen years), HIV (ages ten to fourteen years), cancer
(malignant neoplasm of the meninges, brain and other parts of the nervous system; ages five to nine
years), and congenital disease (malformations, deformations and chromosomal abnormalities; ages one to
four years) (GA-DPH 2013b).
From this information, we can gleam that it is likely the health needs of residents in Fulton County,
including the study area, are related to reducing hypertension and related chronic disease, addressing
mental health and behavioral disorders, and preventing assault and motor vehicle crashes. Addressing
these needs may improve health and prevent deaths in Fulton County, GA.
8 Parkinson's Disease is a chronic degenerative disease of the nervous system. For more information about
Parkinson's disease, please visit http://www.parkinson.org/.
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4.2. Existing Conditions and Health Impacts Related to the Physical Environment
The physical environment includes both natural and built features that can shape the quality of life in a
community. Human health is dependent on the quality of the environment in which people live, work,
learn and play. There are co-benefits that can be realized when considerations for addressing
environmental issues are shared with efforts to improve healthy living. A healthy ecosystem and safely
designed community can provide basic health protection measures and move communities forward
towards sustainability.
4.3.1. Water Quality
Water quality, which was one of the most discussed topics among community residents and HIA
participants, was a contributing force behind ranking the physical environment as a top interest/concern in
the community. Stakeholders cited the conditions that contributed to the perceived poor water quality in
the Proctor Creek Watershed, including stormwater runoff, illegal dumping of trash and tires, and
impaired streams. Stakeholders charged the HIA Core Project Team with identifying and characterizing
how the proposed project could affect water quality in the community and determine whether the project
could significantly change the water quality of Proctor Creek. First, the HIA Core Project Team
determined the status of water quality in Proctor Creek and the conditions in the headwater communities
that contributed to its current state using previous sampling studies, water quality reports and peer-
reviewed literature. Second, the HIA Core Project reviewed the scientific literature on water quality as a
health determinant. Then, the HIA Core Project Team appraised the project's conceptual design for its
potential to influence water quality in the community and the conditions contributing to the impairment of
Proctor Creek.
Results of the Literature Review
What influences water quality?
Water quality is characterized by its physical, biological, and chemical properties, including the health of
organisms living in the water (U.S. EPA 2012b). Factors that influence these properties include
precipitation (e.g., volume, intensity, etc.), presence of pollutants, landscape (e.g., land cover, surface
permeability, land use, grade, etc.), presence of plants and animals and characteristics of the soil (e.g.,
composition, type, size and layering). These factors are discussed in more detail, below.
Water that falls from the atmosphere as precipitation (i.e., stormwater) has three general directions of
movement: 1) back into the air, via evapotranspiration, 2) into the ground, and 3) across surfaces as runoff
(U.S. EPA 2003a). The flow and volume of stormwater runoff can influence the quality of water on the
surface by mobilizing pollutants and/or diluting their concentration (Davis, Hunt, et al. 2009). As
stormwater runoff moves across a surface, it picks up any solids, chemicals, or organisms that can be
suspended in water (e.g., debris, trash, sediment, chemicals, and bacteria).
Sources of water pollution can come from materials used in or emitted from motor vehicles, illegal
dumping, and runoff from agriculture, gardening, roofs and other impervious surfaces. Harmful
pollutants from motor vehicles include engine oil, grease, rubber particles from tires, and emissions from
partial combustion processes. Dumping wastes (e.g., household garbage, furniture, appliances, carpets,
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and mattresses, tires, batteries, hazardous materials, etc.) in unpermitted locales can shock the ecosystem
by introducing toxic chemicals, pathogens, and other pollutants. Ambient air pollution from automobiles,
industry, agriculture, and natural sources can be carried by precipitation or (dry) deposited on the ground.
Fertilizers, mulch, compost materials, and pesticides and herbicides used in agriculture and gardening are
common sources of chemical contamination and nutrient overloading. Pollutants deposited on the
ground's surface from human activities are the leading cause for impairment of surface waters (U.S. EPA
2003b).
Impervious surfaces (e.g., concrete, metal roofs, pavement) reduce the ability for storm water to infiltrate
the ground. A natural event takes place underground where pollutants can be filtered out of stormwater
through physically, chemically, and biological processes (Hsieh and Davis 2005). Pollutants deposited on
impervious surfaces, however, bypass these processes and move with the stormwater runoff.
Vegetation influences water quality through slowing of surface water flow; trapping of sediment, organic
matter, and nutrients, such as phosphorous; absorption of water and heavy metals into the roots and
stems; carbon sequestration; and nitrogen fixation (via symbiotic relationships between plants and
microscopic organisms living on plant roots).
Characteristics of the soil can affect water quality through multiple mechanisms. Soil type and
composition (i.e., the percentage of sand, silt and clay) affects the ability of stormwater to infiltrate and
drain through the ground. Soil composition and layering affects the physical filtration of pollutants from
stormwater as it moves through the media (Kadam, et al. 2008, Wang, Gerba and Lance 1981). For
example, coarse-textured sand has relatively large particles with large spaces between particles (i.e.,
pores), which allows runoff to pass through easily while larger particles (e.g., oils, grease, suspended
solids) are captured (Hsieh and Davis 2005). Free standing phosphorous, a nutrient naturally present in
the soil, readily attaches to suspended solids. Thus, when the soil captures solids suspended in
stormwater, phosphorous is also captured.
How does water quality influence public health?
Water quality affects both environmental health and human health (U.S. EPA 2012b). Living and non-
living substances in the water, including pathogens (i.e., bacteria, viruses, parasites and other agents that
cause disease) and toxic substances (e.g., heavy metals, pesticides, chemicals, etc.) can cause illness in
humans via ingestion or contact with the skin.
Note: The need to protect human and environmental health through water quality control has led to
several legislatively controlled actions. At the federal level, Congress passed the Federal Water
Pollution Control Act of 1948 and the 1972 amended version, commonly known as the Clean Water Act.
These actions established maximum criteria for pollutant discharge (i.e., total maximum daily load
(TMDL)) and a framework for regulating the discharge of pollutants into surface waters.
When there is an introduction of a foreign pathogen or the population of naturally occurring bacteria
becomes abnormal, symptoms of illness can develop. Typical symptoms of a waterborne illness manifest
as changes in the gastro-intestinal tract (e.g., diarrhea, vomiting, and abdominal pain), but can become
more severe and even cause death. Toxic chemicals commonly found in surface water include oils,
rubber and hydrocarbons from automobiles, and heavy metals from building materials (e.g., zinc, lead,
Proctor Creek's Boone Boulevard Green Street Project HIA Page 55
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Assessment
copper, aluminum). Exposure to these chemicals usually occurs by ingesting contaminated water or
dermal contact through recreational or occupational activities, such as swimming and fishing (Craun,
Calderon and Wade 2006). Exposure to contaminated water or poor water quality does not guarantee
illness will occur. In some cases, there is a certain level or duration of exposure that must be reached to
induce symptoms (i.e., dose response). In other cases, there are factors that predispose an individual to
develop illness, which may include age, immune system function, recent surgery or illness, and nutrition
(Craun, Calderon and Wade 2006).
How efficient is green infrastructure in improving water quality?
The green infrastructure approach to water quality management utilizes natural processes to protect,
restore, and mimic the natural water cycle (American Rivers 2014). Green infrastructure affects water
quality by reducing stormwater runoff volume and flow and reducing nutrient and pollutant loading
through increased filtration and absorption. Stormwater best management practices (BMPs) includes
using elements of green infrastructure (e.g., rain gardens, planter boxes or strips, bioswales, and
permeable pavement).
An experimental study in Waterford, Connecticut found that designing a residential neighborhood with
several BMPs significantly reduced the volume of stormwater draining from that neighborhood compared
to a traditionally designed neighborhood (Bedan and Clausen 2009). A few good studies found that
BMPs were highly efficient at reducing the amount of heavy metals (e.g., copper, nickel, lead, etc,), oil,
and grease from stormwater runoff (Bedan and Clausen 2009, Davis, Field performance of bioretention:
water quality 2007, Hunt, et al. 2006, Hsieh and Davis 2005). The ability for BMPs to reduce solids and
nutrient loading, however, has shown mixed results. Researchers found a trade off in pollutant removal
and stormwater capture with regards to the selection and design of soil media in BMPs. Generally, BMPs
designed to capture stormwater were less effective at removing pollutants and vice versa. For example,
soil media chosen to support plant gowth to increase stormwater capture also had high levels of
phosphorous and nitrogen, which leached out of the soil causing higher nutrient loading. That being said,
streams fed by runoff from BMPs would still benefit from the increase in dissolved oxygen in the water,
which supports aquatic life (Kadam, et al. 2008). One thing to note was that newly constructed BMPS
sometimes added more suspended solids after a rain event from the loose soil, but removal efficiencies
improved overtime once the soil media settled.
There were several studies found that evaluated the effectiveness of BMPs to reduce stormwater runoff
capture and pollutant removal. Table 26 lists the results of six key studies that measured the efficiencies
of stormwater BMPs to reduce stormwater flow and pollutant loading. The results from the latest
National Pollutant Removal Performance Database (version 3, 2007), which statistically analyzed peer-
reviewed and published studies that measured the efficiencies of each major type of BMP to remove
pollutants and nutrients from stormwater runoff, are provided for the two types of BMPS used in the
project's conceptual design.
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Table 26. Capture and Treatment Efficiencies of Stormwater Form Low Intensity Development/Green Infrastructure Elements
Indicators1
Percent Change in Stormwater Effluent Post-Implementation2
Study
(Hunt, et
al. 2006)
(Bedan
and
Clausen
2009)
(Hsieh
and
Davis
2005)
Design
1
(Hsieh
and
Davis
2005)
Design
2
(Kadam, (Kadam,
et al. et al.
2008) 2008)
Site 1 Site 2
(Kadam, (Davis (Davis
et al. 2007) 2007)
2008) Cell A Cell B
SiteS
(Fraley-
McNeal,
Schueler
and Winer
2007)
Bioretenti
on Cell
(Fraley-
McNeal,
Schueler
and Winer
2007)
Permeable
Pavement
Storm Flow
(Volume; cm/wk)
N/A
-42%*** N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Peak Discharge
(m3/s/wk)
N/A
-26%
O/ N.S.
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
NO3N (mg/L)
-75%
+100%* -31%
-10%
N/A
N/A
N/A
-90%
-95%
-43%
0%
NH3N (mg/L)
+0.99% -50%* ->37% ->44%
N/A
N/A
N/A
N/A
N/A
N/A
N/A
TKN (mg/L)
+4,9% +44%**
N/A
N/A
N/A
N/A
N/A
N/A
N/A
-46%
-42%
TP (mg/L)
+240%
+939%
***
N/A
N/A
N/A
N/A
N/A
-79%
-77%
-5%
-65%
TSS (mg/L)
+170%
+197%
***
+103% -10%
-96%
-95%
-87%
-59%
-54%
-59%
-89%
BOD (mg/L)
N/A
-3%
O/ N.S.
N/A
N/A
-94%
-92%
-87%
N/A
N/A
N/A
N/A
Fecal coliform
(No/lOOmL)
N/A
-95%**
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
N/A
Cu (ug/L)
-99% -25%:
N/A
N/A
N/A
N/A
N/A
-83%** -77%**
-81%
-86%
Pb (ug/L)
-81% -67%*** ->94% ->95%
N/A
N/A
N/A
.84%**
N/A
N/A
Zn (ug/L)
-98% -77%*** N/A
N/A
N/A
N/A
N/A
-27%
-69%
-79%
-66%
DO
N/A
N/A
N/A
N/A
+586% +325% +400%
N/A
N/A
N/A
N/A
Oil/Grease (mg/L) N/A
N/A
- >99% - >99%
N/A
N/A
N/A
N/A
N/A
N/A
N/A
1NO3N - Nitrate nitrogen, NH3N - Ammonia nitrogen, TKN - Total kjeldahl nitrogen (ammonia, organic and reduced nitrogen), TP - Total phosphorous, TSS - Total suspended
solids, BOD - Biochemical oxygen demand, Cu - Copper , Pb - Lead, Zn - Zinc, DO - Dissolved oxygen
2 N.S. - not significant, N/A - data not available, (+) - added, (-) - removed, *p < 0.05, **p < 0.01, ***p < 0.001
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Existing Conditions Related to Water Quality
What is the status of water quality in the Proctor Creek Watershed?
In accordance with the Clean Water Act and state water quality regulations, Proctor Creek must meet the
water quality standards for its designated use - fishing (GA-EPD 2013). Since 2002, however, Proctor
Creek has not met the fecal coliform water quality standards established for water bodies used for fishing
(GA-EPD 2002)9. Fecal coliform are bacteria that reside in the intestines of humans and other warm-
blooded animals and excreted in feces (Whitlock, Jones and Harwood 2002). At high concentrations (i.e.,
number of matter by a measured volume), fecal coliform in surface and drinking water has been shown to
cause waterborne illness and the impairment of urban waters (Arnone and Walling 2007). While there is
not enough evidence to state that higher levels of fecal coliform in surface water is a direct cause of
enteric diseases (i.e., intestinal disease), the circumstantial evidence is enough to infer that high levels of
fecal coliform can also indicate that there are high levels of other potentially pathogenic organisms
present in the water.
There are two suspected causes for the impairment of Proctor Creek and its tributaries - urban storm water
runoff and CSO events (GA-EPD 2013). The stormwater drains located under the proposed project site
convey stormwater from Joseph E. Boone Street to the storm sewer main under Vine Street. Depending
on the volume of stormwater flowing through the pipe, the contents are either conveyed to the wastewater
treatment facility (i.e., during dry weather) or discharged into Proctor Creek at the Proctor Creek/North
Avenue combined sewer outflow (i.e., during wet weather). Figure 20 identifies the locations of the
underground storm pipes that collect and convey stormwater near the proposed project.
— -
Boone Boulevard
Green Infrastructure Design
TfIKA 1 «CM
Legend
—+— Storm Pipe*
Elevation Contour (2ft)
I I Green Street Catchment
Parcels
City of Atlanta
Figure 20. Map of underground storm pipes around the proposed project site. (Source: Tetra Tech
2013)
9 The standard for fecal coliform permissible in a river or stream used for fishing is 1,000 units per 100 mL (30-day
geometric mean) between November and April and 20 units per 100 mL from May to October (GA-EPD 2013).
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The inability of Proctor Creek and other urban streams in Atlanta to meet state water quality standards led
to the establishment of consent decrees that require the development and implementation of Water
Quality Improvement Plans for these streams. Beginning in 2010, the ARC, in a collaborative agreement
with EPA, conducted a targeted water quality monitoring study that looked at the presence of Escherichia
coli (E. coli) bacteria in Proctor Creek. E. coli is a specific coliform that is often monitored, in addition to
or in place of fecal coliform, due to increasing evidence that E. coli serves as a better indicator of
potentially harmful pathogens in surface water (ARC 2011, Simpson, Santo Domingo and Reasoner
2002). It is important to note that none of the sampled sites in this study was located in the HIA study
area. Monitoring activities found that at certain sites along Proctor Creek, levels of E. coli were well
above the EPA's recommended level in waters used for swimming. Water samples taken immediately
downstream of the Proctor Creek/North Avenue outflow stayed relatively low, except on August 19, 2010
when researchers saw values over five times the EPA's recommended limit for swimming.
What is the status of health outcomes in the community related to water quality?
Exposure to waterborne pathogens (i.e., disease causing organisms in the water) can come from multiple
sources, such as direct contact with surface water or consumption of contaminated food. Typical
symptoms of waterborne illness often take an enteric form (i.e., changes in digestive system). Less severe
cases can resolve on their own or can be masked with over-the-counter medications. The higher the
severity of the symptoms, the more likely a person will seek care at a clinic, doctor's office, or hospital
emergency room. The most severe cases involve admission into the hospital for an extended period.10
Reported cases of enteric disease caused by a waterborne pathogen are usually confirmed by
deoxyribonucleic acid (DNA) testing or culture screening, which is typically not cost efficient and may
not change the treatment plan. Less severe cases may be treated without a definitive cause.
Personal behaviors and predisposing factors can contribute to the risk for developing waterborne illness.
Individuals with suppressed immune systems, those that are undernourished and those that are more
frequently exposed are more likely to develop illness from pollutants or harmful organisms in the water
(Craun, Calderon and Wade 2006). Playing in unhealthy streams and washing or irrigating foods with
contaminated water will increase risk. Low-income or uninsured individuals may be limited financially
in options for treatment or relief and thus experience increased potential for symptoms to become more
severe leading to higher ER visits). Since directly surveying residents was not an available option,
investigators used ER visits to indicate heath status related to water quality.
The GA DPH does not list waterborne disease in the OASIS mapping tool. Instead, investigators used a
proximate diagnosis - digestive system disease -to interpret whether waterborne illness was a concern.
Based on the choropleth graph generated in OASIS, one can observe an overall pattern of increasing ER
visits for digestive system diseases among residents moving downstream of the headwaters and tributaries
(Figure 21).
10 Hospitals don't always code patients admitted from the ER as inpatient until after a grace period (usually two
days). If the patient comes into the ER for care and is discharged within the grace period, the services may be coded
as outpatient for billing purposes. Therefore, cases in which individuals sought emergency care, but were quickly
treated may not be captured in the hospital discharge data. Thus, using ER visit data may be a better indicator.
Proctor Creek's Boone Boulevard Green Street Project HIA Page 59
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Proposed
project site
h-gh«t
Figure 21. Choropleth map of the 2006-2010 aggregate number of ER visits for all digestive system
diseases, by Census tract. (Source: GA—DPH 2013; 2000 Census)
Note: The OASIS mapping tool has not been updated to use the current (2010) Census boundaries.
Instead, the 2000 Census tract boundaries are used.
The HIA Core Project Team looked at the cases of ER visits for digestive system diseases for those who
were perceived to be more likely to contact surface waters (i.e., youths under the age of 15), persons who
may be immune-compromised (i.e., adults over the age of 65 years), and persons who may have restricted
financial access to healthcare (i.e., used Medicaid as a payor). Digestive system disease among youths
and older adults were relatively low, except in areas where Proctor Creek flows (Figure 22 and Figure
23). The number of ER visits related to digestive diseases among Medicaid patients was relatively high in
the community and throughout the larger watershed (Figure 24).
1
Proposed
project site
Figure 22. Choropleth map of the 2006-2010 aggregate number of ER visits for all digestive system
diseases, by Census tract, for children aged one to fourteen years. (Source: GA—DPH 2013; 2000
Census)
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Proposed
project site
Figure 23. Choropleth map of the 2006-2010 aggregate number of ER visits for all digestive system
diseases, by Census tract among adults over 65 years. (GA—DPH 2013; 2000 Census)
Proposed
project site
Figure 24. Choropleth map of the 2006-2010aggregate number of ER visits for all digestive system
diseases, by Census tract among Medicaid patients. (Source: GA—DPH, 2013; 2000 Census)
There was a distinct pattern observed where ER visits increased as the Census tracts moved from the
headwaters to the lower watershed, especially among Medicaid patients. Based on this information, the
concern for water quality related disease among residents in the community is relatively low, but
moderate to high for residents living further downstream and in close proximity to Proctor Creek.
The perceived risk of exposure to waterborne pathogens or disease from poor water quality in the
community is low. Aboveground water is not always observed year-round in the headwaters, which
lowers the exposure to waterborne pathogens. The risk of exposure to waterborne pathogens increases
when a combined sewer overflow (CSO) event occurs. The combined sewer outlet is located outside the
designated community, so a CSO event will not affect the population in the community (i.e., half-mile
radius around the proposed project site). Overflowing manholes or if the storm and sanitary sewer system
breaks or leaks will affect health risk in the community. Populations living downstream of the CSO,
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however, have a higher risk of waterborne disease than those in the headwaters, due to the compounding
nature of untreated water being funneled into Proctor Creek.
How the Green Street Project May Impact Water Quality
Will the proposed Green Street Project be sufficient to affect water quality and related health outcomes?
It is highly likely that the proposed project will improve the quality of the storm water entering the
conveyance system. The proposed project will increase the capture and treatment of stormwater runoff
from the street before it enters the combined sewer system. The natural filtration processes of soil media
and plants will reduce the total pathogens and pollutants going into the combined sewer system.
Furthermore, this project will help prevent CSO events, which are known to impair urban streams. Poor
water quality can affect both ecosystem health and human health. The reduction in pathogens and
pollutants entering surface water lowers the risk of a developing waterborne illness, which will protect
health. Very few people are expected to be affected by the improvements in water quality, considering
the small size of the proposed project. Waterborne illness is more of a concern as one moves further
downstream from the Proctor Creek/North Avenue combined sewer outflow. Expanding the project area
will increase the potential magnitude of impact. The improvement in water quality can be quickly and
easily reversed if the underground pipes exceed capacity (i.e., a CSO event occurs) or if the green
infrastructure elements are damaged and/or not maintained properly. Improvements to water quality will
benefit vulnerable populations. Persons who are more susceptible to waterborne illness include young
children, the elderly, individuals with compromised immune systems (e.g., persons with HIV), and low-
income households. The evidence used to support the predicted pathway of impact is limited. There are
many strong studies that support the efficiency of stormwater best management practices in improving
water quality and the effect water quality has on health. However, the research does not show a cause-
effect relationship between implementing stormwater best management practices and the number of cases
of waterborne disease. This is partly due to the complex socio-economic factors that influence seeking
care and being diagnosed with waterborne illness. Table 27 summarizes the predicted health impacts of
the proposed project related to water quality and potential strategies to manage those impacts.
Table 27. Potential Health Impacts from Changes in Water Quality and Management Strategies
Criteria Scale Potential Impact Management Strategies
Likelihood Highly Expand BMPs (green infrastructure) throughout the community to help to
Likely maximize pollutant removal going into storm sewers. This will not only
provide capacity relief for the CSO, but may also reduce the number of
overflows, which is a major contributor to fecal coliform in surface
waters. Increase soil media height of planter boxes from 2 feet to at least
2.5 feet (30 in) to improve pollutant removal efficiency.
Direction
Positive None provided.
Magnitude Low
Utilize multiple strategies to increase the magnitude of the Green Street
Project's impact, such as increasing the community's awareness of urban
runoff and impacts on human and environmental health, increasing law
enforcement against illegal dumping, and expanding implementation of
BMPs throughout the community.
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Criteria
Permanence
Quickly
and Easily
Reversed
Potential Impact Management Strategies
Strictly adhere to the recommendations outlined in section 6.1 Common
Elements of the Green Infrastructure Technical Specifications of the
initial project design (Tetra Tech 2013). Selection of soil media, fertilizer,
and mulch should be driven by the need to reduce conditions favorable
for pathogen growth (i.e., prevention control). This includes selecting soil
media with low phosphorous and nitrogen content and avoiding mulch
that is manure or compost-based. Add restricted/limited use of fertilizers.
Distribution Vulnerable Improve water quality hazard warnings for water contact to raise
Populations awareness of health risks, especially for those who may be more
Benefit vulnerable to pathogens and/or toxic properties in the water.
Strength of Limited Recommend for the City and/or EPA to conduct soil sampling and water
Evidence quality testing further upstream in the headwaters of Proctor Creek,
starting in this community. Also, invite residents to participate in future
studies (e.g., community-participatory research) so that data related to
health outcomes and/or health determinants can be collected on
community level to fill gaps.
4.3.2. Flood Management
Flood management was arguably the second most important health determinant and environmental
improvement performance indicator. Stakeholders identified aspects of flood management at the first
public meeting and first meeting with the HIA Advisory Group. Residents in the Proctor Creek
Watershed were concerned about the pervasive, localized flooding in the area.
NOTE: It is important to note that this project was not intended to address flooding issues. The primary
purpose of the project was to help manage stormwater coming from the street and going into the
combined sewer system. However, the HIA Core Project Team believed that identifying the potential
impacts to flooding and flood management from the proposed project would at least provide some
informative benefit.
The absence of health data pertaining to flood events greatly limited the assessment's ability to evaluate
health risks related to flooding in the community. Hospitalizations and/or emergency room visit data do
not capture health data for this specific cause. Thus, human health risks were qualitatively inferred from
the theoretical pathways of impact and the identified floodplains.
Exposure to injury from flooding, housing damage from flooding (i.e., Housing Quality) and exposure to
vector-borne disease (i.e., Vector Control) were originally identified as stand-alone health determinants;
however, upon further review, it was decided that these impacts should be discussed in relation to
flooding. Therefore, all three were consolidated into the single health determinant-flood management.
Review of the Literature Review
What are the risks to human health associated with flooding?
Urban flooding is typically caused by stormwater runoff that is not captured as it moves across a surface
(Jha, Bloch and Amond 2012, Foody, Ghoneim and Arnell 2004). Flash flooding events occur when a
large volume of stormwater flows in a localized area over a short amount of time. Flash flooding
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increases the risk of injury by creating hazards for slips, falls, and injury from floating debris (Maantay
and Maroko 2009). Persons with physical restrictions can be more prone to slipping or falling during
flash flood events.
Flooding can damage homes, buildings and infrastructure. Flooding damage to sewer systems can lead to
sewer overflow events, which intensifies the release of organic material and pathogens into the ecosystem
(Plate 2002). A group of researchers in eastern Germany sampled for microbial pathogens in soil and
water after prolonged rains and subsequent flooding in 2002 that caused damage to local sewage systems,
resulting in the release of untreated water into the river system (Abraham and Wenderoth 2005). They
detected high levels of pathogenic bacteria in the cellars of flooded houses, as well as on playgrounds and
streets. High bacteria counts were not observed in samples of open water, suggesting that basements of
flooded homes may provide a "special niche for the survival of bacteria." The detection of antibiotic
resistant bacteria in homes damaged by flooding was a special concern.
Water damage to a building can permit mold and bacterial growth and make openings for pests that may
be harmful within the structure of the home (Taylor, et al. 2011). Rodent infestation can increase the risk
of exposure to harmful pathogens, such as Hantavirus and Salmonella. A number of different conditions,
including temperature and moisture, allow for biological organisms present in the water to grow and
survive in building materials. The growth of microbial pathogens in a household can affect the health of
the inhabitants either through direct contact or by inhaling them with the air. In 2005, the WHO
published a comprehensive review that identified bacteria, fungi and mold as common pollutants in
homes that cause or propagate health issues. The primary health effects associated with exposure to
indoor microbial pollutants were increased prevalence of respiratory symptoms, allergies, asthma, and
agitation of the immune defense system (WHO 2009a). The presence of mold or moisture in households
where children live is a special concern. Researchers in Finland assessed the presence of moisture and
mold in 110 Finnish homes. They concluded that exposure to moisture and/or mold was associated with
increased risk of upper and lower respiratory symptoms and an increased risk for nausea and difficulty
concentrating for both preschool and school-aged children living in the home (Koskinen, et al. 1999).
These studies highlighted the importance of the quality of the indoor environment with regard to health.
Severe cases of water damage to a home can cause displacement of persons living in the home, which can
lead vacancy or abandonment. The presence of blighted and vacant properties have been associated with
poorer perceived health and deteriorated mental health and social capital among residents. Pervasive
flooding and property damage can lower perceived safety in an area and increase stress (Few 2003).
Efforts to improve/restore vacant or derelict homes may reduce levels of distress among residents and
visitors to the area.
Pooling water after a flood event can create a habitat suited for insects and other animals that carry
diseases. Calhoun et al. (2007) found that water movement is associated with density of immature
mosquitoes, with significantly greater numbers of all stages (except egg rafts) being found in stagnant
compared with fast-moving water. In other studies, mosquito population density and mosquito body size
was significantly greater near side pools of water and stagnant water of a CSO-affected stream (Calhoun,
et al. 2007, Chaves, et al. 2011). A study conducted in Virginia found urban infrastructure was positively
correlated with the abundance of two mosquitos (Culex pipiens L. and Culex restuans) and CSO systems
were large contributors to Culex vector populations (Deichmeister and Telang 2009). In a study
Proctor Creek's Boone Boulevard Green Street Project HIA Page 64
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Assessment
conducted in Fulton County, GA, West Nile Virus (WNV) infection rates among humans and corvids
(i.e.; passerine birds) were positively linked with proximity to CSO-affected streams, the extent of tree
cover, and median household income (Vazquez-Prokopec, et al. 2010). In particular, distance to CSO-
affected streams was the best predictor of the abundance of house mosquitoes followed by tree canopy
coverage. Furthermore, they found that WNV infection in the southern house mosquito (Culexx
quinquefasciatus) was significantly higher in CSO-affected streams compared with non-CSO streams.
Although researchers found an association between median household income and WNV infection rates,
the association was not statistically significant.
Populations that live in highly dense, low lying areas (typically low income areas) where there are many
sources for insect habitation have an increased risk of exposure to vector borne diseases (e.g., WNV and
Hantavirus), compared to residents in less dense, higher elevated areas (typically high income areas).
Homes near illegally dumped scrap tires and garbage, which provide habitats for rodents and mosquitoes,
are less prevalent in high-income communities compared to low-income communities (Calhoun, et al.
2007, Vazquez-Prokopec, et al. 2010, LaDeau, et al. 2013). In more than one study, it was inferred that
people residing in low-income housing were found to be at increased risk of exposure to mosquitoes
compared with residents of high-income areas, where air conditioning and protective behaviors such as
the use of mosquito repellent or the active avoidance of mosquitoes may be higher.
Existing Conditions Related to Flood Management
The HIA Core Project Team used ground slope, topography, impervious surfaces, and precipitation data
to calculate the volume of stormwater runoff moving through the proposed project site and to model the
likeliest places for stormwater to flow and eventually pool. Analysis of this data was performed using
numerous GIS-based tools and datasets, such as ArcHydro, ArcGIS, NHD, and EPA's Stormwater
Calculator (released version 1.0.0.9).11
During or after a rain event, where is stormwater most likely to flow?
The HIA Core Project Team analyzed the permeability of the surfaces in the study area and found that
over half (53.6%) of the total surface area is impervious or impenetrable for stormwater. When
researchers mapped the impervious surface data in the watershed, they found that imperviousness
increases as the property moves closer to downtown (Figure 25).
11 The NHD is a digital vector dataset that represents the drainage network with features such as rivers, streams,
canals, lakes, ponds, coastline, dams, and stream gages. For more information, please visit http://nhd.usgs.gov/.
The Stormwater Calculator is a desktop application that estimates the annual amount of rainwater and frequency of
runoff from a specific site anywhere in the United States. For more information, please visit
http://www2.epa.gov/water-research/national-stormwater-calculator.
Proctor Creek's Boone Boulevard Green Street Project HIA Page 65
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Assessment
•
Percent Impervious*
•
100 0
English
Avenue'
Bank/lead
[Proposed Project Areal_
ArcHydro Gene
^~ Proposed Project Area
I -
t J Neighborhood Planning Units
Neighborhoods
V2 mile Study Site Buffer
Procter Ck Watershed
Streets
'Source: 2006 NLCr^,x£ 20 reflects persistently wet areas.
http://arcscripts.esri. co m/details.asp?dbid= 16750
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-
• *m * - _' :• ^<- * : *- H-^Hl1 ji ,- r«» '••<>• _-.". ' '. Ty >•< ; < ;
^•^'^^^^V ^ .-^:H
,' I .\.Joseph.E. Bobne Blv'd NW\ I-?•.. |'[-.. ' ••'.' ' .' ,.. .-^j-^^jj ^
Topographic Wetness Index .
Relative Wetness ' i*.. »p
kj^
-------
Assessment
of Housing 2012). In the neighborhood of English Avenue, only 12% of properties have curb appeal,
59% of properties are vacant and/or abandoned, 17% are blighted properties, and 17% have health code
issues (Atlanta Office of Housing 2012)Figure 27 and Figure 28 show the locations of vacant and derelict
residential properties and non-residential properties.
Sourca- City of Atlanta SCi Rffpon A
cnv dAoanu mn r»x ngest
WWr.hjWS. end tM CIS w»«f
Boone Blvd Green Street
Residential Property Conditions
Parcel ^^| Vacant Property Derelict Property
Figure 27. Vacant and derelict residential properties within a half-mile of the Green Street Project
site.
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Sourer Cfly of Atlanta SO R«pon *
Oty ol Arwnw t'01 :j Tax dgwt
and tto U15 v*e* communrty
Boone Blvd Green Street
Non Residential Property Conditions
Parcel H| Vacant Property Derelict Property
Figure 28. Vacant and derelict non-residential properties within 1/2 mile of the Green Street
Project site.
There are many derelict properties throughout the community. Although there was some overlap of
deteriorated and/or vacant homes and relatively wetter areas, these homes are so numerous that one
cannot conclude whether or not they are the result of flooding. Deteriorated and/or vacant non-residential
properties (i.e., commercial, industrial, public properties) do not appear to be located in areas predicted to
be wet and are scattered throughout the community.
How much stormwater runoff reaches the storm sewer inlets in the proposed project site?
The HIA Core Project Team calculated the amount of stormwater moving through the proposed site using
EPA's Stormwater Calculator. Table 28 shows the baseline calculations for the proposed project area.
Based on these calculations, the average amount of stormwater runoff coming from the proposed project
site is 45.6 inches per year, which goes into the storm sewer conveyance system. In a given year, the
expected number of days in which stormwater runoff will come from the site is 69.5 days.
Table 28. Stormwater Runoff Related Measurements of Proposed Project Site
Measurement
Total Area"
Impervious Surface Area"
Percent Impervious15
Description
Total area where changes are planned.
Total area that is impenetrable by water.
The percent of area that is impenetrable by water.
Finding
117,612ft2
63,040 ft2
53. 6% (63,040 ft2)
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Average Annual Runoff*
Percent of All Runoff
Retained15
Days Per Year with
Runoff
Percent of Wet Days
Retained15
Total runoff (in inches) produced by the site
divided by the number of years simulated.
Total rainfall that infiltrates, evaporates, and
becomes runoff minus the percent that becomes
runoff and evaporates.
The number of days with measurable runoff
divided by the number of years simulated.
The percentage of days with measurable rainfall
that do not have any measurable runoff generated.
45.6 inches
13.1%
69.5 days per year
17.2%
a Source: Tetra Tech (201 3)
b Source: EPA Stormwater Calculator release 1.0.0.9
How are the areas upstream, downstream, and in the community interrelated with respect to flooding?
The HIA Core Project Team found that 67.9% of area that drains to Boone Street is impervious or does
not allow water to infiltrate the ground. Figure 29 shows the area upstream of Boone Street and the
proposed project site relative to the rest of the watershed.
Percent Impervious
N
A
©
Value
CSOs
Pr°cter Ck Watershed
Upstream Boone Blvd
Proctor Ck
Boone Blvd Study Site
High 100
Figure 29. A map of the impervious surfaces in the Proctor Creek Watershed and the area that
drains to the proposed Green Street Project. Modeled flow lines also show from where runoff
comes from in the area upstream of Boone Street.
Impervious headwaters predisposes the areas downstream of the headwaters to flash flooding (i.e., events
where a short duration but high volume of water can cause a flood event). Flash flooding is an event of
extremely high precipitation (i.e., sustained, extremely high rainfall rate) that causes rapid stream rise or
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stormwater flow volume above the usual measurement in a given area (Carpenter, et al. 1999, NOAA
2014a, Doswell, Brooks and Maddox 1996). Even when there is a small rain event, vast impervious areas
allow water to increase in volume quickly (i.e., cumulate), which can lead to flash flooding and CSO
events. Thus, it takes less time and less volume of stormwater in a more developed area to change an
urban stream system (e.g., produce a flood, erode stream banks, etc.) compared to a less developed area
(Walsh, et al. 2005, Sheeder, Ross and Carlson 2002). Land use, therefore, can play an intricate role in
how an urban stream system may respond to a rain event.
The HIA Core Project Team looked at land use throughout the watershed to gain a better understanding of
land use in the Proctor Creek Watershed. Most of Proctor Creek's headwaters are highly developed, with
high percentages of developed land and corresponding impervious surfaces (Figure 30). The community,
within a half-mile radius of the proposed Green Street Project, is a moderately developed urban area, with
43.5% low intensity development, 33.8% medium intensity development, and 18.2% high intensity
development (Multi-Resolution Land Characteristics Consortium 2006). This means that even during a
short or small rain event, the stormwater from this area may contribute largely to flooding in the
downstream or low-land areas.
2006 NLCD Land Use
Land
EH
EH
Use
Open Water
Developed, Open Space
Developed, Low Intensity
Developed, Medium Intensity
Developed, High Intensity
Barren Land (Rock/Sand/Clay)
Deciduous Forest
Evergreen Forest
Mixed Forest
Shrub/Scrub
Grassland/Herbaceous
Pasture/Hay
Woody Wetlands
NLCD 2006 Land Use
Q3 Procter Ck Watershed
/~N_x Proctor Ck
^— Boone Blvd Study Site
1/2 mile Study Site Buffer
Figure 30. A Map of the 2006 NLCD Land Use Cover data for Proctor Creek Watershed and the
designated community.
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What is the risk of flooding in the community and in other areas of the watershed?
The HIA Core Project Team analyzed historical precipitation data and modeled the probability of flood
events. The 30-year average (1981-2010) maximum and minimum monthly precipitation data from
PRISIM Climate Group and the annual monthly average precipitation data for Atlanta from
www.weather.com were downloaded, analyzed, and graphed. The average monthly precipitation for both
the City of Atlanta and the Proctor Creek Watershed stayed between three to five and half inches; the
highest occurring in July. Mid-summer (July) and late winter (February-March) are the periods when
flooding is more likely to occur due to the high average storm water volume. Data from three monitoring
stations located in and near the Proctor Creek Watershed showed the typical rainfall events occurring in
the area. Figure 31 shows the hourly precipitation recorded at each of these stations within the last five
years. Individual rain events (i.e., rainfall period separated by four or more hours of no precipitation;
(Hamilton and Rowe 1949) were graphed by event size and duration using the National Climatic Data
Center (NCDC) Mapper tool, developed by the National Oceanic and Atmospheric Administration
(NOAA). Over the past five years, 85% of the rain events were at or below 0.77 inches of stormwater.
Approximately 93% of the rain events were at or below 1.2 inches, which is the state's criterion for
standard water quality sizing of stormwater BMPs (ARC and GA-DNR 2001).
Rainfall Events by Size and Duration
5
4.5
4
3.5
1/t
2 3
• ¥ *
• AA *
A * *A- J^i
*±**^ "A Ai ^
15 20 25
Event Duration (Hours)
I Dobbins (7/7/08-6/26/13) A Hartsfield (7/4/08-7/31/12) » Fulton (7/4/08-6/25/13)
Figure 31. Graph of the recorded rainfall events by size and duration, from the three surrounding
precitipations stations, over the past five years. (Source: NCDC Mapper)
The estimated flood frequency (i.e., probability of a flood event) for the area upstream of the community
was calculated using the previously calculated watershed areas and percent impervious area as inputs
(Gotvald and Knaak 2008). The HIA Core Project Team found, that in any given year, there is a 50%
chance that there will be a flood event with a peak flow of 918 ft3 per second in the area upstream of the
proposed Green Street Project. The peak flow may range from 429 to 1,970 ft3 per second, given the 95%
confidence interval.
NOTE: Because the impervious surface for this area is 67.9%, the results must be interpreted with
caution since the U.S. Geological Survey template used to calculate these flood frequencies has an
unknown accuracy when impervious surface area is above 35% (Gotvald and Knaak 2008).
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The HIA Core Project Team also looked at Federal Emergency Management Agency (FEMA) flood
hazard maps and data. This data is useful for examining large-scale flood events that tend to be
associated with high volume, long duration rainfall events and large runoff and/or melting events. Figure
32 highlights the FEMA Special Flood Hazard Zones (SFFiZ), which are areas subject to flooding by the
Chance Annual Flood (i.e., the chance that the area will flood in any given year; (FEMA 2013).
FEMA Flood Hazard Areas
Bart™ ClWOkee for.
C3 Procter Ck Watershed
/^\^f Proctor Ck
Boone Blvd Study Site
Flood Zone (Risk)
^B Zone AE (High)
0.2% Annual Chance Flood Hazard (Moderate)
Zone X (Minimal)
2 Miles
I
Figure 32. A map of the FEMA Special Flood Hazard Zones in the Proctor Creek Watershed.
Source: (FEMA 2013)
According to this data, there are some areas around the proposed project site that may see localized
flooding, but the probability of that event occurring is one in 500 years (or 0.2% annual chance). The
chance of flooding increases greatly as one moves further downstream in the watershed. For a
community of this size, the data does not provide enough information to predict flash flood events.
How the Green Street Project May Impact Flood Management
Will the Green Street Project affect flooding and related public health issues?
The proposed project spans 117,612 ft2 (or 2.7 acres), in which approximately 14,788 ft2 of impervious
surfaces will be converted to pervious surfaces. In addition, the plan puts into service stormwater BMPs,
including different soil and plant components designed to capture and retain runoff before it goes into the
combined sewer conveyance system. Tetra Tech designed each element of the BMPs to meet the state's
water quality sizing criteria, which requires each element to capture and treat runoff from a 1.2-inch
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rainfall event or the first 1.2 inches of rainfall from larger rain events. The sizing criteria represent one
part of the recommended measures to meet Georgia's minimum performance requirements for new
development or redevelopment sites (ARC and GA-DNR 2001). With this information, the HIA Core
Project Team used modeling tools to predict the changes in stormwater retention in the proposed project
area. Table 29 lists the measurements calculated and the results of the modeling.
Table 29. Expected Impacts of the Proposed Green Street Project
Measurement
Total Project Area"
Impervious Surfaces"
Percent Impervious15
Average Annual Runoffb
Percent of All Runoff Retained15
Days Per Year with Runoffb
Percent of Wet Days Retained15
a Source: Tetra Tech (201 3)
b Source: EPA Stormwater Calculator, release
Existing
Conditions
117,612ft2
63,040 ft2
53. 6% (63 ,040
ft2)
45.6 inches
13.1%
69.5 days per
year
17.2%
1.0.0.9
Predicted
Change
-
48,252 ft2
41.0%
36.4 inches
30.7%
64.6 days
23.2%
Difference
-
| by 14,788 ft2
| by 12.6%
| by 20%
t by 17.6%
I by 5 days per
year
t by 5%
The proposed project is expected to reduce the amount of stormwater entering the conveyance system by
20% and reduce the number of days with runoff by 5 days per year. It is highly likely that these benefits
will translate into reductions CSO events and slow stormwater runoff peak flow. Increasing the amount
of pervious surfaces in this area will help reduce pooling and standing water along the street. Reducing
the potential for pooling and standing water on the street are beneficial to health because it removes
hazards for injury from slips, falls and floating debris. Reducing the amount of stormwater going into the
conveyance system will extend the useful life of the system and may prevent breaks/leaks, which can
damage homes and buildings. Reducing CSO events and standing water will help reduce habitats that
support pests and disease carrying insects. The improvements in flood management will affect a
moderate number of people, including pedestrians, cyclists, drivers and passengers, and property owners
in the immediate vicinity. Improvement in flood management is expected to last a moderate length of
time, if the green infrastructure elements are properly maintained and functioning as designed. Improving
flood management in this area will benefit vulnerable populations by reduced risk of injury and/or illness
in a predominantly low-income area overburdened by flash flooding, mosquitoes, and vacant and/or
derelict properties. The evidence linking green infrastructure to improved stormwater management is
strong. The evidence linking flooding to CSO events and mosquito populations is also strong. However,
the evidence linking between flooding and health is limited, with more circumstantial associations. Table
30 summarizes the predicted health impacts of the proposed project related to flood management and
potential strategies to manage those impacts.
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Table 30. Potential Health Impacts from Changes in Flood Management and Management
Strategies
Criteria
Likelihood
Direction
Magnitude
Permanence
Distribution
Strength of
Evidence
Scale
Highly
Likely
Positive
Moderate
Moderate
Vulnerable
Populations
Benefit
Limited
Potential Impact Management Strategies
None provided.
None provided.
Expand BMPs (green infrastructure) throughout the community to help
to maximize flow reduction going into storm sewers. This will not only
provide capacity relief for the CSO, but may also reduce the number of
overflows, which is a major contributor to fecal coliform in surface
waters. Increasing law enforcement of nuisance laws in regards to
abandoned properties, property maintenance and upkeep, and illegal
dumping. Derelict or damaged homes can provide a dwelling for pests,
which can carry diseases that affect humans and pets. Dumped trash and
pooling water provide breeding habitats for mosquitoes and other
insects. Increase community awareness of environmental factors that can
lead to mosquitoes and of preventative measures against vector-borne
pathogens in the area. Develop a policy, plan, and/or ordinance to
resolve/address the problem of vacant housing.
Ensure that the monitoring/maintenance plan for green infrastructure
elements is followed as directed. Routine maintenance and monitoring
of sites ensures that the cell is performing as intended. Clogging and
blockage from debris can slow or stop water moving through the cell,
which can lead to pooling at the street level.
Improve flood safety hazard warnings in flood-prone areas to raise
awareness of health risks, especially for those who may be more at risk.
None provided.
4.3.3. Climate and Temperature
At the first HIA Advisory Group meeting, stakeholders identified a need in the community to address heat
stress and charged the HIA Core Project Team with evaluating the proposed project's potential for
impacting local climate conditions and relief from heat stress. In order to answer this question, the HIA
Core Project Team had to first determine what conditions in the local community might predispose
residents to higher temperatures and then evaluate how the project's design might mitigate exposure to
extreme heat events. The team used the empirical evidence to establish pathways of impact and
supplemented predicted impacts to health with observed patterns in climate and temperature.
Results of the Literature Review
What elements of the physical environment in an urban community might contribute to higher
temperatures?
Climatolegists have been studying the effects of urban development on climate conditions for several
decades. Changing a permeable surface area (i.e., covered with soil and vegetation) to impermeable
surface area (i.e., covered with pavement, concrete, or metal) can change the ability of that surface to
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absorb, shed, and reflect heat. When a material is exposed to sunlight, the energy from the sun is either
absorbed and stored as heat, absorbed and transferred to the air and other surfaces (i.e., thermal emittance)
or reflected back to space (i.e., as albedo). Infrastructure, such as concrete, pavement, and metal,
typically has lower albedo and higher heat capacity, which means more energy is absorbed in the material
and less energy is reflected back to space (U.S. EPA 2013b). These factors combine to create a warmer
surface temperature.
Warm surfaces can transmit heat to the surrounding air causing an increase in air temperature. Berdahl
and Bretz (1997) conducted a temperature survey of different building roof materials and found that on a
dry, summer day, the roof surfaces were 50-90°F (about 10-32°C) higher than the ambient air
temperature. As surface temperature rises, air temperature also rises, which can affect local climate
conditions (Voogt and Oke 2003). Wind disperses ambient heat lowering surface air temperature (NOAA
2014b). The spacing and dimensions of infrastructure also affect surface temperature by influencing wind
flow.
Vegetation (i.e., trees, bushes, and grasses) plays an important role in regulating surface and air
temperature. Shaded and/or wet surfaces resist temperature changes. Trees, especially deciduous trees
(i.e., trees that grow and shed leaves) provide shading for surfaces, which blocks sun radiation. Seasonal
variations, apart from changes in the intensity of the sun on the surface of the earth, influences changes in
ground cover (i.e., leaf on or leaf off), which influences surface temperature. Plants release water into the
surrounding air via evapotranspiration, which dissipates ambient heat and thereby lowering air
temperature (U.S. EPA 2013b). Elliot and Barnard (1990) found that tree size and texture influenced
wind flow (e.g., magnitude of wind gusts and wind speed) as air moves around the tree.
Expansive development can lead to a more widespread change in microclimate, a phenomenon otherwise
known as the urban heat island (UHI) effect. UHIs occur when urban, developed regions experience
warmer temperatures than their rural, less-developed regions (U.S. EPA 2013b). Large cities (i.e., over 1
million people) that are experiencing UHIs can see an annual average air temperature that is 34-37°F
(about 1-3°C) higher than surrounding rural areas (Oke 1997). The extent of UHI effect or change in
temperatures can be affected by spatial (i.e., dimensions and spacing), temporal (i.e., time of day),
seasonal (e.g., summer, winter, etc.,), and weather conditions (e.g., wind and cloud cover). It is important
to consider the different types of UHIs. A surface UHIs (i.e., canopy UHIs) refers to the relatively high
temperatures in the layer of air from the ground to the top of trees. Whereas, atmospheric UHIs occur
when there are relatively high temperatures above the canopy where the effect area is broader. Surface
UHIs are present at all times of day and night. The most intense heat (i.e., peak heat intensity) occurs
during the day and in the summer (Oke 1997, Voogt and Oke 2003, U.S. EPA 2013b).
How does exposure to higher temperatures affect health and wellness?
UHI exacerbate the effects of heat waves or relatively long periods of extreme heat. Living in areas that
experience UHIs predisposes residents to health impacts of extreme heat events, which include general
discomfort, heat-related illnesses, and complications with pre-existing health conditions (e.g. heart
disease, behavioral disorder, metabolic disorder, etc.) (Luber and McGeehin 2008). Those more
vulnerable to extreme heat are children, older adults, and persons with certain heath conditions that
predispose them to heat-sensitivity (Luber and McGeehin 2008). For example, an extreme heat event is
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likely to affect a person more if he or she takes a medication that alters their ability to stay hydrated
and/or sweat (i.e., reduced ability to relieve body heat). Researchers in Toronto, Canada studied whether
there was a relationship between ambulance calls and oppressively hot days. They found that the average
number of ambulance calls increased by 10% on the "oppressively hot days," specifically in urban,
industrial and recreation areas (Dolney and Sheridan 2006). Based on these findings, heat related illness
are likely to occur more often in highly developed areas and places where people play outdoors.
Although incidences are rare, extreme heat events can cause death.
Existing Conditions Related to Climate and Temperature
The GA DPH OASIS tool does not report heat-related illnesses. Therefore, any potential changes to
health outcomes were inferred based on the empirical evidence and expected changes to the conditions
that affect climate and temperature.
What are the historic temperatures experienced in the community?
Boone Street is located in an urban, highly developed area in the southern region of the United States.
This region experiences relatively higher average annual temperatures than other regions of the US, with
temperatures that usually range from 40-80°F (4 to 26°C) (Figure 33). Although April and October show
slightly lower temperatures, the overall temperature pattern in the Proctor Creek Watershed follows the
same pattern as the measurements taken in Atlanta, GA (PRISM Climate Group 2014).
Average Monthly Temperature
.*:
0)
|
^
Jan
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Atlanta Monthly Avg (Source: weather.com)
• Watershed Averages (Source: PRISM 30-year Average 1981-2010)
Figure 33. PRISM monthly temperature and precipitation averages plotted with Atlanta regional
averages.
Are there areas in the community that may by "hot spots" or have higher surface temperatures?
The HIA Core Project Team used satellite infrared imaging to identify impervious surfaces (e.g.,
buildings, pavement, etc.) in the community. Figure 34 identifies the areas of impervious surfaces in red.
Apart from residential housing, the expansive impervious surfaces were mostly located along Boone
Street and in the industrial/commercial areas to the east. These areas will have higher than average
surface temperatures than areas with pervious surfaces and shading.
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A/cHydio Generated Drainage
Proposed Project Area
" i Neighborhood Planning Units
fp Neighborhoods
C~3 1/2 mile Study Site Buffer
Q3 Procter Ck Watershed
— Streets
| Impervious Surfaces'
•Source: AtUrrtJ «l$Jrfl'pf'vm's Surface polygons
Figure 34. A map of the impervious surfaces in the HIA study area.
How the Green Street Project May Impact Climate and Temperature
Is the Green Street Project, as designed, expected to change the microclimate and influence surface
temperature and its related health impacts?
It is highly likely that the proposed project will reduce surface temperatures once the planted vegetation
has matured and is providing shading. Only one bus stop in the project area provided cover/shade from
the sun (at the eastbound intersection of Boone Street and Vine Street). No other areas along the corridor
provide sufficient shading of impervious surfaces. Thus, it is also highly likely that the added shading
from trees will provide some reprieve from the sun, especially on oppressively hot days. The proposed
project will add 14, 788 ft2 of permeable surface area. Impervious surfaces are known to contribute to
urban heat island (UHI) effect, surface area will improve the ability of the corridor to absorb, shed and
reflect heat. Decreasing impervious surfaces and increasing shading will help reduce surface
temperatures, which will provide relief and some protection against heat-related illnesses. Relief from the
heat and sun will affect a moderate number of people, specifically those using the sidewalks and traveling
in the street. Considering the small size of the project, the impact on UHI effect may not be significant or
measureable beyond the street. The benefits of reduced surface temperatures and shaded reprieve from
the sunlight will continue for many years, but only during leaf-on seasons for deciduous trees. Vulnerable
populations will benefit more from the added shading and lower surface temperatures along the proposed
project site. Persons who are more vulnerable to heat related illness include children, older adults, and
persons with certain health conditions that predispose them to heat-sensitivity. The causal evidence is
strong as to how impervious surfaces and a lack of shading leads to UHIs. Several case studies illustrate
the harmful impacts to human health from exposure to oppressively hot days and/or extreme heat events
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in an area affected by UHI. Table 31 summarizes the predicted health impacts of the proposed project
related to climate and temperature and potential strategies to manage those impacts.
Table 31. Potential Health Impacts from Changes in Climate and Temperature and Management
Strategies
Criteria
Likelihood
Direction
Magnitude
Permanence
Distribution
Strength of
Evidence
Scale
Highly
Likely
Positive
Moderate
Long Lasting
Vulnerable
Populations
Benefit
Strong
Potential Impact Management Strategies
None provided.
None provided.
Select native tree species that have taller, broad canopies that could
increase the shading of surface area, especially impervious surface areas.
Place trees with larger canopies near bus stops or other areas where
people may congregate to provide relief for people waiting on public
transit.
None provided.
None provided.
None provided.
4.3.4. Air Quality
Both natural and human activities influence the quality of the outdoor air. Although stakeholders did not
identify air quality as a priority health concern, the HIA Core Project Team identified air quality as a
health-related impact of the proposed project and looked at different factors that could influence air
quality, specifically related to traffic-sources. Vegetation could influence ambient air pollution at the
street level via several mechanisms. This review focused on air pollutants caused by motor vehicles.
Results of the Literature Review
What influences ambient air quality, especially in urban communities?
Air quality is often described by the presence of harmful pollutants. Sources of air pollutants can be
natural (e.g., plants releasing pollen/seeds) and/or from human activities (e.g., burning fossil fuels) (U.S.
EPA 2012c). Most air pollutants are from human made sources, including mobile sources (e.g., motor
vehicles, trains, etc.) and stationary sources (e.g., factories, refineries, power plants, etc.) (U.S. EPA
2014d). The EPA monitors and regulates six harmful air pollutants (i.e., criteria air pollutants) for the
protection of public health and the environment. Those pollutants are particulate matter, ozone, carbon
monoxide, nitrogen dioxide, sulfur dioxide and lead (U.S. EPA 2014d). Each of these pollutants can
come from road sources (e.g., motor vehicle emissions, pavement, tire particles, motor oil, etc.). It is
important to note that the presence of lead from road sources has become less of an issue since regulatory
action in the 1990s caused lead to be almost completely removed from use in fuel for on-road motor
vehicles (U.S. EPA 2014e). Additional monitoring for other air pollutants and sources does occur at the
national, regional, state and local levels. However, regulated standards have not yet been established for
those pollutants.
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Plants, such as grasses, bushes and trees, can influence the levels of ambient air pollutants in multiple
ways. Trees are the most efficient at filtering the air, followed by shrubs, then grasses (Givoni 1991).
One mechanism, in which plants remove pollutants from the air, is the filtration of the ambient air via gas
exchange through leaf stoma. Another mechanism involves small particles falling on to the surface of
plants. From there, pollutants can be washed to the ground by precipitation or re-suspended into the air.
Plants use carbon from gases in the atmosphere to build mass, a process known as carbon sequestration.
Plants can also offer a physical barrier to the dispersal of pollutants in the ambient air. Pollutants are
dispersed to different areas by wind and vertical mixing of air columns from temperature changes and air
rising/sinking. Trees with dense canopies help to prevent vertical mixing of pollutants (Givoni 1991).
Plants can also contribute pollutants to the ambient air. Some plants release volatile organic compounds
(VOC), which react with other pollutants to form ozone (Taha 1996). Certain plants release higher levels
of VOC than others (Benjamin and Winer 1998).
How does air quality influence health and wellness?
There is enough evidence worldwide that adequately supports the causal relationship between the quality
of the outdoor air and specific health outcomes. In fact, it is possible to measure a person's risk of death
and illness based on pollutant levels. For example, daily death rates in Europe rises by 0.3% overall and
by 0.4% for deaths related to heart disease per 10 ug/m3 increase in ozone exposure (WHO 2006).
European cities with high levels of air pollution had higher mortality rates than cities with less air
pollution (WHO 2006). Persons most sensitive (vulnerable) to the effects of air pollutants are those with
pre-existing respiratory conditions (e.g., persons with asthma and lung disease), the elderly and young
children (U.S. EPA 2012c). Health impacts of road source air pollutants are discussed, below.
Particulate matter refers to tiny particles in the air. They are complex compounds of varying size that can
come from a variety of sources (e.g., burning matter, plants, chemical reactions in the atmosphere, etc.)
(U.S. EPA 2012c). Small particulate matter (i.e., less than 10 microns in diameter; PMio) includes dust
particles, pollen, and molds (GA-EPD 2012). In comparison, the human hair ranges between 50 and 70
microns in diameter. Ultrafine particulate matter (i.e., less than 2.5 microns in diameter; PIVb 5) includes
combustion source particles, organic compounds, and metals (GA-EPD 2012). To date there are
thousands of studies that link exposure to particulate matter to health effects.
Researchers found that prolonged exposure to particulate matter could lead to increased risk of lung
cancer, cardiovascular disease, and respiratory disease. The main mechanism in which particulate matter
interferes with health occurs when small particulate matter enters the lungs and interferes with gas
exchange and causes inflammation (WHO 2006). The U.S. EPA performed an extensive review of the
literature as part of their integrated science assessment for particulate matter (U.S. EPA 2009).
Researchers found a positive ling between short-term (24-hour) exposure to PM2 5 and a number of health
outcomes, including cardiovascular disease, respiratory symptoms and pre-mature deaths.
Epidemiological studies reported consistent positive associations between exposure to PM2 5 and
emergency department visits and hospital admissions for respiratory infections and cardiovascular-related
symptoms. The levels of impact were not fully consistent across studies; however, the EPA considers the
evidence sufficient to monitoring and regulation. Currently, the National Ambient Air Quality Standards
(NAAQS) for PIVbsbased on long-term and short-term exposures, are annual average 15.0 (ig/m3 and 24-
hour 35 (ig/m3, respectively (U.S. EPA 2014d).
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Ozone (Os) is caused by complex chemical reactions in the atmosphere in the presence of ultraviolet
radiation. Ground level ozone (i.e., smog), which is formed by other gases in the air mixing together with
sunlight, causes irritation of mucus membranes in the nose, throat, and airways (GA-EPD 2012). Ozone
also causes breathing problems and exacerbates symptoms of chronic respiratory diseases and reduced
lung function (WHO 2006). Ozone can also affect healthy individuals over a long period. Exposure to
ozone for 6 to 7 hours, even at relatively low concentrations, significantly reduces lung function and
induces respiratory inflammation in normally healthy people (non-asthmatics) (U.S. EPA 2012c, WHO
2006).
Nitrogen dioxide (NO2) is a normal component of ambient air formed from high temperature combustions
and lightning (GA-EPD 2012). As a strong oxidizing agent, NO2 reacts with water molecules in the air to
form corrosive nitric acid and toxic organic nitrates, which contribute to acid rain. NO2 is also a precursor
or contributing compound in the development of ground level ozone. As a brown gas, NO2 can reduce
visibility and even become toxic at levels above 200 ug/m3 (U.S. EPA 2014d). A high level of nitrogen
dioxide in the air causes significant inflammation of the airways, reduces lung function growth, and can
lead to increased trips to the emergency room or hospital for difficulty breathing (U.S. EPA 2014d).
Sulfur dioxide (802) is a colorless reactive gas formed from burning sulfur-containing materials (GA-
EPD 2012). SO2 affects the respiratory system, mainly through inflammation of lung tissue, and causes
eye irritation (U.S. EPA 2012c). This is partly due to the chemical reaction that occurs when sulfur
dioxide combines with water yielding sulfuric acid. For example, people with asthma experience changes
in pulmonary function and respiratory symptoms after periods of exposure to SO2 as short as 10 minutes
(WHO 2006).
Carbon monoxide (CO) is an odorless, tasteless gas produced any time from the burning of fossil fuels
(CDC 2014). When inhaled, CO enters the bloodstream where it prevents oxygen from bonding to
hemoglobin (GA-EPD 2012). This ultimately reduces oxygen delivery to the rest of the body and vital
organs. The loss of oxygenated blood can lead to headaches, dizziness, nausea, and oxygen starved
muscles (e.g., the heart). Long term exposure or high exposures over a short amount of time can even
cause death (U.S. EPA 2012c). Young infants, pregnant women, elderly, and persons with anemia or
emphysema have a higher risk of adverse health effects of CO exposure (GA-EPD 2012). Motor vehicle
emissions contribute approximately 56% of total carbon monoxide emissions in the U.S. (U.S. EPA
2012c).
In regards to development, Schweitzer and Zhou (2010) examined neighborhood emissions and exposures
in 80 metropolitan areas across the United States to determine whether air quality outcomes are better in
compact regions (i.e., urban) or in regions characterized by sprawl (i.e., suburban and rural). They found
that ozone concentrations are significantly lower in compact regions, but human exposures to ozone were
higher. Individuals who spend a lot of time outdoors are going to have higher exposure levels to
pollutants, even if the pollutants are present at relatively low levels. Fine parti culate concentrations did
not correlate significantly with compactness; but exposures to fine particulates were higher in compact
regions. Schweitzer and Zhou (2010) concluded that compact development does not necessarily solve air
quality problems for a particular region. Their suggestion was to include considerations of exposure— not
just emissions— when planning for new development.
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Existing Conditions in the Community
EPA regulates air quality by the authority outlined in the Clean Air Act. However, state and/or local
governments perform most air quality monitoring (i.e., air sampling and data analysis). For example, the
GA—EPD Air Protection Branch performs yearly air sampling through its Ambient Air Monitoring
Program. Results are reported by sampling site and county. Since there were no air-sampling monitors
relatively near the community to acquire air quality data, the HIA Core Project Team used the
information from the latest air surveillance report by the state and relative health statistics from the
OASIS database to characterize existing conditions related to air quality and respiratory health.
What is the existing status of air quality and related health outcomes in the community?
In the state of Georgia, mobile sources accounted for most of the total emissions for CO, NO2, and Os for
the entire 2008 year (i.e., 2.3 million short tons, 292 thousand short tons, and 231 thousand short tons,
respectively (GA-EPD 2012)). In 2011, the metro-Atlanta region did not meet the NAAQS for ozone or
particulate matter. Atlanta had 44 days in the year when ozone average values exceeded the NAAQS for
ozone (GA-EPD 2012). Since 2004, Atlanta was declared a non-attainment area for not meeting
particulate matter NAAQS and is currently implementing apian for reducing particulate matter levels
(GA-EPD 2012). All other criteria pollutants remained well below harmful levels. Lead values were
almost non-existent, with concentrations staying below 0.01 ug/m3 for the entire year (GA-EPD 2012).
Although health status information was limited, the GA—DPH reported ER visits for respiratory diseases
and subsequent diagnoses. ER visits related to respiratory diseases for the years 2006-2010 were among
the lowest to higher percentiles for the Census tracts surrounding the proposed project area (Figure 35).
Chronic lower respiratory disease surrounding the proposed project area appeared to be among the lower
in number, except for the upper English Avenue neighborhood (Figure 36). ER visits for asthma among
residents appear in the lower to higher quintile (Figure 37). This may be due to the impact of air quality
or reflect the difficulty in managing chronic asthma.
Proposed
project site
Figure 35. Choropleth map of the 2006-2010 aggregate number of ER visits for all respiratory
diseases, by Census tract. (Source: GA-DPH 2013; 2000 Census)
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Proposed
project site
Figure 36. Choropleth map of the 2006-2010 aggregate number of ER visits for chronic lower
respiratory disease, by Census tract. (Source: GA—DPH 2013; 2000 Census)
Proposed
project site
r
Figure 37. Choropleth map of the 2006 to 2010 aggregate number of ER visits for all asthma, by
Census tract. (Source: GA-DPH 2013; 2000 Census)
How the Green Street Project May Impact Air Quality
Will the proposed project as designed, affect local air quality and related health outcomes?
It is highly likely that the proposed project will be able to reduce ambient air pollutants by adding green
infrastructure along an urban corridor. The added trees, bushes and grasses provide natural mechanisms
that will filter some air pollutants from the adjacent street. However, the efficiency in removal of air
pollutants depends on the species, number, and placement of the plants along the proposed project site.
Motor vehicles release harmful gases and particles into the air that travel and react to form other harmful
pollutants. Exposure to harmful air pollutants can increase respiratory symptoms, amplify visits to the
emergency room or doctor's office for respiratory discomfort and raise a community's overall risk of
heart and lung disease. Any measures aimed at reducing air pollutants will help protect health and ensure
other efforts to promote healthy living do not have harmful consequences. Due to the proposed project's
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small size, the changes to the ambient air will only affect a moderate number of people, especially
persons traveling along the street. The ability of the plants to capture and/or filter pollutants form the air
will last a long time (for many years), given that vegetation is present and viable. Improving local air
quality will benefit vulnerable populations in a predominantly low-income, urban community. Persons
more sensitive to the presence of air pollutants, such as asthmatics and those with pre-existing respiratory
health conditions, the elderly and youths. There is strong causal evidence on the pathways of impact
between the different air pollutants, especially the six criteria pollutants, and health impact. The potential
for the proposed project to remove or capture some of those road source pollutants is founded in known
natural processes. Table 32 summarizes the predicted health impacts of the proposed project related to air
quality and potential strategies to manage those impacts.
Table 32. Potential Health Impacts from Changes in Air Quality and Management Strategies
Criteria
Likelihood
Direction
Magnitude
Permanence
Distribution
Strength of
Evidence
Scale
Highly
Likely
Positive
Moderate
Long
Lasting
Vulnerable
Populations
Benefit
Strong
Potential Impact Management Strategies
None provided.
None provided.
Select native plant species that have low volatile organic compound
VOC emissions and have higher capacity for filtering pollutants out of
the air. NOTE: for any planting of vegetation in urban areas, it is
recommended that a minimum of three species be selected. Place plants
that are lower to the ground (especially grasses and bushes) in areas
where vehicles are likely to idle, so they can filter air pollutants from
vehicle emissions. Taller trees should be spaced so that vertical mixing
of pollutants is minimized.
None provided.
None provided.
None provided.
4.3.5. Traffic Safety
At the first HIA Advisory Group meeting, stakeholders informed the HIA Core Project Team that there
needed to be a better balance between the design of the built environment and environmental hazards
(refer to Table 10). Injury from motor vehicles was one hazard identified in the discussion. The HIA
Core Project Team looked at the literature evidence and the design of Boone Street to evaluate whether
the proposed project could change traffic safety along the street.
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Results of the Literature Review
What characteristics of the physical environment contribute to traffic safety?
Transportation routes are traditionally designed to move people and goods efficiently, which may or may
not include the safest measures for pedestrians and cyclists. The National Highway Traffic Safety
Administration (NHTSA) conducted a national telephone survey in 2012, which found that poor quality
of street facilities was the leading cause of pedestrian injury. There is growing awareness that transit
corridors need to meet the needs of all modes of transit. Researchers and city planners are finding that
streets can be designed to help minimize adverse impacts to health and safety in addition to meeting
transportation needs (CDC 2011).
Implementing a road diet (i.e., reducing the number of traffic lanes) is one of many strategies used to
increase traffic safety for drivers, pedestrians and cyclists. Thomas (2013) studied incidences where road
diets were implemented in various types of communities and concluded that road diets are one of the
transportation sector's greatest success stories. The Federal Highway Administration (FHWA) released a
report in 2004 that concluded road diets reduce the overall number of motor vehicle crashes, but may
increase the number of angle crashes (Highway Safety Information System 2004). Furthermore, the
literature cautioned against implementing road diets in corridors that have an annual average daily traffic
(AADT) above 20,000 vehicles, due to the likelihood of increased traffic congestion (Highway Safety
Information System 2004). Eliminating excess roadway also helps reduce costs for road maintenance.
Other safety measures can include reduced speed limits, speed bumps, pedestrian crossing infrastructure
(e.g., painted crossing zones, crossing counters, street lighting, etc.), separated bike lanes, safety signage,
and traffic calming practices (e.g., streetscaping, circular intersections, etc.) (Heath, et al. 2006). In a
pedestrian safety study by the New York Department of Transportation (NY DOT), investigators found
that serious pedestrian crashes involving unsafe speeds were twice as deadly as crashes with lower speeds
(NY DOT 2010). There is some debate as to whether shared lanes or separate bike lanes are safer for
cyclists.
Existing Conditions Related to Traffic Safety
What are the existing traffic conditions and traffic safety practices present along the project site?
Boone Street is a four lane, bi-directional roadway that travels east to west. The road functions as a major
collector, connecting neighborhood roads with main arterial roads. The Georgia Department of
Transportation (GA DOT) uses a portable traffic counter (Short Term Station 1215679) to monitor
vehicle miles traveled, AADT volumes, and other data since 1990 (GA Office of Transportation Data
2013, GA-DOT 2013). Traffic volume along Boone Street has been on the decline since the 1990s, when
the roadway served an AADT of 10,410 vehicles (GA-DOT 2013). Currently, the road functions well
below its designed capacity, which was a contributing factor to the proposal for reducing traffic lanes. In
2013, Boone Street saw an AADT volume of only 5,090 vehicles per day (approximately four cars per
minute), which was 7.5% lower than the year before (Figure 38). Traffic volume should be higher on
special event days, due to its proximity to major event facilities, but residents at the scoping meetings
stated that patrons to these events are not traveling through the community.
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/• •
. *.
" T • ' ' •
%5 • »
==>-
Annual
Average
Daily
Traffic
Vehicles
• 1.000
• 5,000
• 10.000
100,000
300,000
WlAADJ-Sourt* GOOF
Figure 38. GIS generated map of traffic data showing AADT in Atlanta. (Source: GA—DOT 2013)
Several safety measures exist along the proposed project site, including a speed limit of 35 miles per hour
(MPH), stoplights and pedestrian crossings at every intersection, and crossing counters at almost all of the
intersections. There were no speed humps/bumps present. The outside travel lanes are also shared
bicycle lanes. The road surface showed signs of low to moderate pavement wear and areas of degraded
pavement and striping. According to the OASIS mapping tool, the Census tracts surrounding Boone
Street were among the lowest 20th percentile for emergency room visits related to motor vehicle crashes
(MVC). MVC was one of the most common causes of death among children, in Fulton County, GA, as
referenced in 4.2.4 Health Status.
NOTE: It is important to consider that hospital data is reported by residence, not location of injury.
How the Green Street Project May Impact Traffic Safety
Is the Green Street Project Designed to Improve Traffic Safety?
The proposed project is very likely to reduce risk of injury from automobiles, because road diets,
streetscaping, and adding bicycle infrastructure are effective ways to improve traffic safety; provided that
the reduced lanes can handle the traffic volume and not increase congestion. Road diets are one of the
most successful strategies used to improve traffic safety. Since the AADT for Boone Street is so low,
changes to traffic volume/congestion are not expected. Installing streetscaping can help slow traffic,
which helps reduce injury severity from MVCs. Adding bicycling infrastructure and traffic safety
measures (i.e., traffic calming landscaping) will improve traffic safety. Improvements in traffic safety
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will protect health and support efforts to promote healthy, active living. Boone Street is one of few major
roads connecting the community to downtown and destinations in the suburbs west of downtown and
serves an average 5,000 automobiles per day. Therefore, the proposed project has the potential to reduce
risk of injury for a high number of people. The impacts from the proposed project are expected to last for
a long time (many years), since pavement and striping have a long useful life. The improvements to
traffic safety will benefit all, but especially vulnerable populations. Populations who are more at risk of
injury from a motor vehicle include children (under 18 years old), elderly, and physically disabled.
Although there are a few strong studies linking road diets to improve traffic safety, there are only a few
studies regarding the outcomes of streetscaping and implementing separated bike lanes. Table 33
summarizes the predicted health impacts of the proposed project related to traffic safety and potential
strategies to manage those impacts.
Table 33. Potential Health Impacts from Changes in Traffic Safety
Impact
Likelihood
Direction
Magnitude
Permanence
Distribution
Strength of
Evidence
Scale
Highly
Likely
Positive
High
Long
Lasting
Vulnerable
Populations
Benefit
Limited
Potential Impact Management Strategies
Add infrastructure that promotes safety for pedestrians and cyclists (e.g.,
street lighting traffic calming approaches, designated and protected bike
lanes, bike traffic signals, cycling greenways, etc.). For more examples,
visit the Green Lane Project website at
http://www.peopleforbikes.org/green-lane-proj ect) .
Ensure that placement or selection of vegetation does not impede or
obstruct visibility of pedestrians or other motor vehicles.
None provided.
None provided.
None provided.
Continue to monitor traffic volume to ensure the road diet does not lead
to more traffic congestion.
4.3.6. Exposure to Greenness
Both the HIA Advisory Group and residents at the first community meeting agreed that the community
needed to be more aesthetically pleasing and that streetscaping projects, such as the Boone Boulevard
Green Street Project, would help to improve the aesthetic appeal along Boone Street. The HIA Core
Project Team took these considerations and looked at how adding natural elements to an urban
environment could influence health.
Results of the Literature Review
How does the amount of greenness in a neighborhood affect residents living in that neighborhood?
The amount of natural environment in a geographic area can be measured by the percentage of
vegetation-covered land (greenness). Researchers are finding increasing evidence that the amount of
nature or greenness in an area is linked to health status, especially among certain groups.
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A study performed in several urban areas of Canada found that individuals who lived in areas that were
more green had lower mortality rates over two decades than those living in less green areas (Villevue, et
al. 2012). Maas et al. (2009) looked at morbidity data from primary care physicians in the Netherlands
for a large population (n= 345,143) and found that those living in an area with a higher percent of
greenness had lower prevalence of certain diseases (e.g., coronary heart disease, depression, anxiety
disorder, upper respiratory tract infection, asthma, migraine/severe headache, etc.) than those living in
less green areas. In their study, they found that increasing greenness by 1 percentage point yielded an
effect of 1-year lowered age on physician-assessed morbidity (Maas, van Dillen, et al. 2009). Five year
survival for senior citizens (after controlling for age, sex, living arrangement, and living expenses)
improved when there was space for taking a stroll near their home and that space had parks and tree lined
streets (Takano, Nakamura and Watanabe 2002). Reported populations particularly sensitive to the
benefits of the natural environment include those with lower income and lower educational attainment,
youth, and the elderly (Lee and Maheswaran 2010).
Views of nature have also been found to affect psychological, emotional, and mental health benefits in
college students, hospital patients, inner city girls, public housing residents, and apartment residents
(Bedimo-Rung, Mowen and Cohen 2005). A ten year study of patients recovering from surgery showed
that patients with a view of trees had statistically significantly shorter hospitalization stays (7.96 days
compared to 8.7 days), needed less pain medication, and had fewer negative comments in nurses' notes
than did patients with window views of a brick wall (Ulrich 1984). Breast cancer patients studied post-
surgery showed an increase in attention capacity when a nature-oriented intervention was used (Cimprich
1991). Another study found that prisoners who had views of rolling farmlands had a 24% lower
frequency of sick call visits and a lesser frequency of reported stress symptoms compared to prisoners
who had views of the prison courtyard (Moore 1981). Nearby nature has been shown to improve
psychological health in children (Taylor, Kuo and Sullivan 2001, Kuo 200Ic, 2011). Wells and Evans
(2003) suggest that the presence of nearby nature buffers the impact of life stress on children and
enhances self-worth. Outdoor activities that involve in a natural environment, such as fishing or soccer,
have been shown to reduce symptoms of attention deficit disorder (ADD) and attention deficit
hyperactivity disorder (ADHD) in children who had been medically diagnosed (Kuo and Taylor 2004).
Greener play areas have also been shown to attenuate ADD symptoms and improve concentration
(Taylor, Kuo and Sullivan 2001).
According to Edward O. Wilson's biophilia hypothesis (Wilson 1984), humans' have an innate attraction
to nature. Researchers believe that the natural environment provides a form of involuntary attention
requiring effortless interest, a sense of escape from one's usual settings, a sense of being part of a greater
system, and compatibility with one's individual needs from that environment (Wilson 1984, Frumkin
2001). Aesthetically pleasing urban landscape with trees and greenness encourages social interaction and
healthy behaviors and attitudes. The natural environment has been shown to have an independent
influence on mental health and health behaviors (Mitchell and Pompham 2008). Natural environments
provide a source of "serenity" or peacefulness and provide a space for reprieve from a stressful
environment. Mental stress (i.e., psychosocial stress) is a known heath determinant for hypertension and
reduced overall mental health and well-being (Pickering 2001). Disparities in mental stress and perceived
overall wellness have been reported in numerous studies, especially among African Americans of lower
income and lower education (Williams, et al. 1997). A stressful environment at an early stage has been
associated with decreased mental and physical health in adulthood (Taylor, et al. 2004).
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A higher percent of greenness has been linked to an increased utilization of public space and higher
perceived safety and security. In a public housing development in Chicago, where residents were
randomly assigned to apartments, researchers found that those living in buildings with more vegetation
felt safer and had higher rates of attentional restoration, less overall aggression and psychological
aggression, less cases of mild violence and severe violence, and used fewer aggressive actions against
their partners and children, than residents living in buildings with less vegetation (Kuo and Sullivan
2001a, 200 Ib). The use of public space and improved attitudes encourages a social atmosphere of
friendliness and being physically active outdoors.
Lachowycz and Jones (2014) wanted to determine if physical activity mediated the relationship between
greenness and mortality. They found that the relationship between greenspace and mortality was
independent of physical activity levels and hypothesized the relationship was due to psychological factors
such as stress reduction and social cohesion (Lachowycz and Jones 2014). Similar results of an
independent effect of green space on mortality (i.e., irrespective of physical activity levels) have also been
found by other researchers (Groenewegan, et al. 2012, Richardson, et al. 2013). Both running and
walking in greener settings has been linked to reduced mental fatigue and increased recovery from mental
fatigue (Bodin and Hartig 2003, Hartig, Mang and Evans 1991).
Having natural views in the workplace is related to lower levels of perceived job stress and higher levels
of job satisfaction, as well as fewer reported illnesses at work (Kaplan and Kaplan 1989). Intensive care
nurses who took breaks in a room with a window and view of trees reported less stress and made 40%
fewer errors than did those nurses who took breaks in a room with no windows (Ovitt 1996). University
students with nature views scored higher on tests than those with non-natural views (Tennessen and
Chimprich 1995).
Existing Conditions Related to Greenness
How green is the community around the proposed Green Street Project?
The HIA Core Project Team used GIS support to investigate the amount of greenness in the community
and any extended areas that lacked natural elements. Satellite imagery with light detection and ranging
(LiDAR; 2011 NAIP 1-meter) technology was used to identify the vegetated land cover and non-
vegetated land-cover and overlaid that data layer with the community boundary area in ArcMap. Figure
39 shows the community with the identified areas of canopy cover, grasses/yards, impervious surfaces
(i.e., concrete, pavement, metal, etc.) and bare soil. The impervious surfaces constituted 53.6% of the
land, leaving 46.4% as permeable surfaces (e.g., bare soil or vegetated land-cover). The 2006 NLCD was
used to calculate the development intensity in the community. Researchers found that the surface area in
the community was mostly developed, ranging from medium intensity to high intensity (43.5%, and
33.8%, respectively). Only 4.3% of the land surface was developed open space (2006 NLCD).
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Landuse*
Canopy Cover |
Grass/Yards Q
Impervious Surfaces |
Bare Soil Q
* J Neighborhood Planning Units
Neighborhoods
1/2 mile Study Site Buffer
Procter Ck Watershed
icurce: Created by the authors using 20
0 0.25
7^_=u
urce: Created by Ih* authors using 20li~rJMM-5nS««." ' K/lTlpc ^H • 1
md imagery and £KfMap Classification Toolbar. :^ 1
••Vb^JKV^U' i I ^ ^-•!••*• < • t-3 t?— '~t i>i-v-Thr-v~%^?r-J~lr—^ ..•*!* f I
Figure 39. A map of the vegetation-covered surfaces and impervious surfaces in the HIA study
area. (Source: ArcMap, 2011 NAIP 1-meter)
Are mental and behavioral disorders a concern in the community?
Stress and mental health was the most commonly reported health outcome associated with exposure to
greenness and the natural environment. The HIA Core Project Team downloaded and analyzed
emergency room visits and hospitalization data for mental and behavioral health disorders at the county
and Census tract levels from the OASIS database. Fulton County has a higher rate of hospitalizations for
mental and behavioral health disorders than the state average (GA-DPH 2013a). At the county level,
mental and behavioral disorders were higher among African Americans, compared to their Caucasian
counterparts, and among men compared to women. Interestingly, the age group with the highest rate of
hospitalizations related to mental and behavioral health were individuals aged 45-59 years; the age group
expected to have higher rates of disease are persons above 60 years. The number of emergency room
visits for mental and behavioral disorders for residents living around the proposed Green Street Project
were among the lowest to highest in Fulton County (Figure 40). These findings do not suggest the
prevalence of mental health, only the number of people who were treated at the emergency room for
mental or behavioral disorders.
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Proposed
project site
Figure 40. Choropleth map of the 2006-2010 aggregate number of emergency room visits for all
mental and behavioral disorders, by Census tract. (Source: GA—DPH, 2013a; 2000 Census)
How the Green Street Project May Impact Exposure to Greenness
Will the added greenness of the Green Street Project along Boone Street be enough to impact health
outcomes related to mental and behavioral health?
The proposed project will add planter boxes and vegetated strips in areas that are currently pavement.
Thus, it is highly likely the proposed project will increase the amount of greenness along the street.
Increasing the amount of greenness in a residential area will increase the exposure to the natural
environment, which has been associated with reduced prevalence of disease and higher perceived overall
health and wellness. Exposure to greenness or a natural environment can enhance recovery from mental
fatigue, increase perceived health, and reduce fear, stress, and anxiety. The amount of greenness in an
area has been linked to improved cognitive function, increased social cohesion and physical activity, and
reduced aggression and violence. Increased greenness in an area has been linked to reduced risk of stroke
and other cardiovascular diseases (by reducing stress and increasing outdoor physical activity), reduced
deaths (especially among older adults), reduced hospital stays and lower usage of pain medication in
patients, increased perceived overall health and well-being from improved neighborhood satisfaction,
reduced stress, and increased social interaction. Those who would benefit from the added exposure to
greenness would include only those persons who use the street or can view the street from their place of
work or residence. The health benefits of the Green Street Project are expected to last the life of the green
infrastructure element, which will be more than several years, as long as routine maintenance is
performed. Studies have shown that those who may benefit more from increased greenness in their
environment include low-income households, persons with low educational attainment, young children,
and older adults. Due to the qualitative nature of the non-physical effects, some of the evidence linking
exposure to the natural environment and stress is limited. However, many studies support the associations
between the amount of greenness (i.e., natural environment) and mental stress, stress-related health
outcomes, and adverse social behavior. Table 34 summarizes the predicted health impacts of the
proposed project related to exposure to greenness and potential strategies to manage those impacts.
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Table 34. Potential Health Impacts from Changes in Exposure to Greenness and Management
Strategies
Impact
Likelihood
Direction
Magnitude
Permanence
Distribution
Strength of
Evidence
Scale
Highly
Likely
Positive
Moderate
Long
Lasting
Vulnerable
Populations
Benefit
Limited
Potential Management Strategies
Ensure a "visible change" takes place that aesthetically improves
Boone St. along the proposed project site.
None provided.
Maximize "greenness" for the entire Green Street Project as much as
possible.
None provided.
None provided.
None provided.
4.3.7. Exposure to Urban Noise
Exposure to urban noise was one of the health determinants identified in the preliminary literature search
and impact pathway development processes. Since the proposed project is sited in a residential
neighborhood along a major urban street, the HIA Core Project Team wanted to know whether the
proposed project could affect the level of noise along the corridor and how public health may be affected.
A critical review of the available peer-reviewed literature was performed to answer the question: How
does living by a major urban corridor affect resident health and well-being? Next, the HIA Core Project
Team reviewed evidence on modeled noise in Fulton County, Georgia and noise-induced health outcomes
available at the county level. All of the information gathered is summarized below.
Results of Literature Review
How does living near a major urban corridor affect resident health and well-being?
The literature suggested that ambient noise in urban residential communities was a growing concern and
more public health professionals were including "soundscape" or the acoustic setting in their
investigations of environmental factors that influence community health. Most of the current literature on
the effects of exposure to traffic-related noise was derived from European countries. According to the
Commission of the European Communities (1996), ambient noise levels above 65 decibels dB(A)13 are
considered unacceptable by health experts due to the adverse impacts to behavior and attitudes, sleep
disturbance, cardiovascular and psycho-physiological systems (e.g., stress-response pathways)
(Commission of the European Communities 1996). Systematic, critical reviews of the available evidence
on noise exposure and public health found sufficient evidence that high levels of ambient noise (i.e.,
above 70 dB(A)) can induce hearing impairment, high blood pressure and changes in the cardiovascular
system; interfere with communication and social behavior; increase annoyance and sleep disturbance; and
13 Decibels are expressed as dB, but measurements of ambient noise levels over a period of time, which take into
account variations in sound levels at different points in the day, are expressed as dB(A) or A-weighted decibels.
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lower performance and productivity (Passchier-Vermeer and Passchier 2000, Berglund and Lindvall
1995).
Noise exposure throughout the day was found to be higher in urban communities than rural communities.
The main contributor to ambient levels of noise in urban communities was road traffic, typically reaching
above 55 decibels (Berglund and Lindvall 1995). Traffic noise can also be controlled by permitting the
types of vehicles and traffic speeds on the street. Heavier vehicles (i.e., vehicles with more than two
axels, such as tractor-trailers), pavement type, traffic speed, and engine types are different factors that can
influence traffic source noise. Traffic-related noise has become an increasingly known environmental
factor that can affect a person's health and well-being.
Berglund and Lindvall (1995) concluded that "to protect the majority of people from being seriously
annoyed," sound pressure from steady, continuous noise in outdoor living areas should not exceed 55
dB(A) during the day and 45 dB(A) at night. Bluhm, Nordling, and Berglind (2004) wanted to estimate
the degree of annoyance and sleep disturbance related to traffic noise exposure in an urban, residential
community. They issued a questionnaire to 1,000 individuals living in a heavy traffic area of Stockholm,
Sweden and estimated individual noise exposure using noise dispersion models and local noise
assessments. Their study found that more residents reported frequent annoyance and sometimes/frequent
sleep disturbance in areas where traffic noise was greater than 50 dB(A) compared to areas where traffic
noise was less than 50 dB(A) (Bluhm, Nordling and Berglind 2004).
In a longitudinal study following the development of hypertension (i.e., high blood pressure) among
Swedish men and women exposed to air traffic noise (greater than 50 dB(A)), researchers found a
significant increase in risk of developing hypertension among non-tobacco using men who were exposed
to air traffic noise compared to those who were not exposed. Differences in noise sensitivity or health
related impacts between genders have not been consistently reported; however, impacts on school-aged
children have been found.
Lercher, et al. (2002) found a significant association between GIS-modeled noise exposure at home and
child reported mental health indicators among those who had pre-existing birth complications (e.g., pre-
term and low birth weight). The pre-existing birth complications were provided by parents of the survey
respondents (Lercher, et al. 2002). Exposure to constant ambient noise or periodic levels of noise above
55 decibels have been associated with changes in behavioral and mental activities, as well as lowered
cognitive performance among school-aged children (Shield and Dockrell 2003, WHO 2009b). Ambient
noise has also been linked to the serenity or peacefulness of a community. A lack of that peacefulness or
ability to find a quiet place for rest and relaxation has been closely tied to noise-related health problems.
Gidlof-Gunnersson and Ohrstrom (2007) revealed in their study that residents in urban neighborhoods
with higher traffic noise (i.e., above 48 dB(A)) reported that noise frequently disturbed their desire to stay
outdoors.
Noise abatement policy has been around in Europe and the United States for decades and can be
evidenced by the presence of noise as a public nuisance in municipal ordinances.14 Sounds from the
14 To see civil code ordinances related to noise control in the City of Atlanta, refer to the Code of Ordinances 1997-
48 Part 1, Chapter 74-Environment, Article 4: Noise Control. Available online at
http://www.nonoise.org/lawlib/cities/atlanta.htm.
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roadways travel through open space and out into the rest of the community. City and transportation
planners are beginning to consider other strategies for controlling the movement of sound in residential
communities. Road-side barriers have been used to block traffic noise from intruding into surrounding
residential areas. The design and placement of the home has been considered in efforts to reduce the
impacts of traffic noise. The prevalence of both annoyance and sleep disturbance was higher in homes
with bedroom windows facing the street, whereas residences with a quieter side of the house (i.e., back
side with lower sound levels) seemed to be a protective factor against noise related problems (Bluhm,
Nordling and Berglind 2004, Gidlof-Gunnarsson and Ohrstrom 2007). Simply moving residences back
from main roads can reduce the road source sound traveling to the residence. According to Bolund and
Hunhammar (1999), doubling the distance can reduce the sound equivalent level by 2 dB(A).
How can the natural environment influence the adverse health impacts of noise generated from an urban
street?
Vegetated barriers, such as rows of trees and bushes, offer a unique solution that is aesthetically pleasing
and blocks sound waves from moving out through a neighborhood, albeit with varying results (Bolund
and Hunhammar 1999). Greening urban areas has been found to influence traffic noise-related health
problems among residents. Researchers have found that greener areas had fewer residents who perceived
traffic noise as a neighborhood problem (Gidlof-Gunnarsson and Ohrstrom 2007). Residents in Sweden
who were lived by noisy streets and had no access to a "quieter side" of a residence benefited more from
greener areas, reporting less symptoms of being very tired, irritated/angry, and feeling stressed (Gidlof-
Gunnarsson and Ohrstrom 2007). Designing residences with more grass or lawn between the residence
and the street, compared to using pavement or concrete, can reduce the reflection of road sounds towards
the residence (SOU 1993).
Existing Conditions Related to Exposure to Urban Noise
What are the current levels of ambient noise generated from Boone Street?
In Europe, planners and public health professionals have used an array of standard methods for measuring
sound levels, and GIS-based modeling programs for evaluating individual level exposures. Fortunately, a
team of academic researchers, led by Jeong Seong from the University of West Georgia, previously
performed noise exposure modeling and analysis of traffic-related data in Fulton County, Georgia that
included our designated community. Their study included collecting traffic data, modeling and
visualizing noise levels (via Sound Plan Version 7.0), and estimating percent population exposed to noise.
Based on the modeling from Seong, et al. (2011), noise patterns along the proposed project area ranged
from 56-67 dB(A) during the day and 51-65 dB(A) at night. The neighborhood area behind Boone Street
(i.e., English Avenue and Vine City) shared lower levels of traffic noise (i.e., under 40 dB(A)) (Seong, et
al. 2011). Thus, the homes and businesses adjacent to the proposed project site bear the most burden
from roadway noise due to their close proximity. There are 29 parcels zoned for residential use and 35
parcels zoned for commercial use along the proposed Green Street Project (City of Atlanta 2013). As a
comparison with the other European studies, Seong et al. (2011) found that 40-59% of the population
around Boone Street were exposed to sound levels above 55 dB(A).
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There are other sources of noise in the community, such as the Georgia Dome and Congress Center, but
the amount and reach of the noise coming these sources is unknown. It can be expected that on event
days when these buildings are in operation, high levels of noise is generated and may be carried out to the
rest of the neighboring communities (i.e., Vine City and English Avenue).
What are the existing conditions of health outcomes that are most related to urban noise exposure?
As identified in the literature review, the prominent health problems associated with noise include
hypertension and stress. Unfortunately, hypertension health data were not available lower than county
level and only available at the Census tract level in a qualitative form, and stress is not a reported
diagnosis in the OASIS. Instead, the HIA Core Project Team examined mortality and morbidity rates of
hypertension and hypertension-related cardiovascular disease in Fulton County, Georgia. The HIA Core
Project Team looked at a comparison of health outcomes at the county and state levels and found that
hypertensive morbidity rates in Fulton County were consistently higher than the state average (GA-DPH
2013a). African Americans had a higher rate of hospitalizations for hypertension and hypertension-
related hospital visits than their Caucasian counterparts (GA-DPH 2013a). Hypertensive heart disease
was higher over the five year period among women compared to men (GA-DPH 2013a), and as expected,
hypertensive hospitalizations were higher among older adults (over 65 years) than younger counterparts
(GA-DPH 2013a). It should be noted that hypertension and related chronic diseases have several factors
that influence the risk of disease, such as physical activity and nutrition.
How the Green Street Project May Impact Exposure to Urban Noise
Will the Green Street Project as designed, be enough to influence how noise from the street travels
through the surrounding community and related health outcomes?
Traffic or street noise is the most common contributor to urban ambient noise levels. Noise generated at
the street can be reflected off buildings and hard surfaces (e.g., pavement and concrete) and projected out
into the nearby residential areas. The vegetative plantings and landscaping associated with the proposed
Green Street Project can provide a buffering effect against noise traveling from the street out into the
community, which may reduce the ambient noise levels around the home. Reducing ambient noise levels
in and around the home space may improve public health by increasing serenity or peacefulness in the
community, reducing sleep disturbance from noises coming from the street, and reduce long-term changes
in physiological functions caused by an increased excited state.
It is plausible that the proposed project will help to reduce ambient noise from the street, considering
vegetative barriers buffer sounds from the road and help to prevent noise intrusion into nearby residential
areas. However, it is unclear whether noise coming from the street is an issue for residents. It is
important to note that noise will be generated from constructing the proposed project. Efforts to reduce
traffic noise in urban communities helps to protect against adverse impacts to behaviors and attitudes,
sleep disturbances, cognitive function, and long term changes to cardiovascular and psycho-physiological
systems. Most of the benefits from the expected noise abatement are anticipated to be felt by those on the
street and properties in close proximity to Boone Street. There are 29 residential properties adjacent the
proposed project site. The reduction in noise coming from the street is expected to last several years,
provided that the planter boxes and planting strips are properly maintained. Persons who are more
sensitive to traffic noise, such as young children and those with pre-existing conditions (e.g.,
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hypertension), will benefit more from the predicted noise abatement, given that noise is closely linked to
stress levels, annoyance, and sleep disturbance. There are many strong epidemiological studies available
that show the relationship between chronic exposure to traffic noise and increased risk of health-related
issues. Table 35 summarizes the predicted health impacts of the proposed project related to exposure to
urban noise and potential strategies to manage those impacts.
Table 35. Potential Health Impacts from Changes in Exposure to Urban Noise and Management
Strategies
Criteria
Likelihood
Direction
Magnitude
Permanence
Distribution
Strength of
Evidence
Scale
Plausible
Positive
Moderate
Long
Lasting
Vulnerable
Populations
Benefit
Strong
Potential Impact Management Strategies
Place low brush/grasses in planter spaces near residences to
block/absorb some of noise from roadway.
Implement best practices during implementation phase to reduce the
amount of noise or time of day noise is generated from construction.
None provided.
None provided.
None provided.
None provided.
4.4. Existing Conditions and Health Impacts Related to the Social Environment
The HIA Core Project Team reviewed the literature further to better understand how using elements of
green infrastructure along a street corridor could influence the social environment and related health
determinants in the community around Boone Street. The social environment is independently linked to
disparities in overall morbidity and mortality. Social determinants of health included in this assessment
were accessibility, crime (actual and perceived), and social capital (cognitive and structural-.
4.4.1. Access to Goods, Services, Greenspace, and Healthcare
The HIA Core Project Team strongly felt that the community needed improvement in accessibility for
residents and visitors to the area. Thus, accessibility was evaluated with the key destinations of interest
being goods, services, greenspace and healthcare.
Results of the Literature Review
How can implementing green infrastructure along a street influence accessibility?
Bertolini, le Clercq and Kapoen (2005) defined accessibility as "the amount and the diversity of places of
activity that can be reached within a given travel time and/or cost." Barriers to accessibility can be three-
fold, including physical barriers that prevent mobility, perceived barriers that reserve a person's
utilization of a space, and financial barriers that economically strain or burden a person.
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In a systematic review of case studies and other reviews of environment and policy strategies to promote
physical activity, researchers found that community-scale and street-scale urban planning and land use
policies and practices were the most effective interventions for increasing active transport (i.e., walking
and bicycling) (Heath, et al. 2006). Travel burden, both perceived and actual, was found to be a key
element in conceptualizing geographic access to goods and services. The time it takes to reach a
destination was found to be more influential than the distance between the place of origin and destination.
Those with physical disabilities can be limited in mobility if transport conditions are poor (e.g., broken or
uneven sidewalks, obstructions in the sidewalk or bicycle lane, etc.) A study in Europe showed how the
majority of urban renewal projects, including improved walk-ability, construction of new public spaces
and more community programs, had positive and important effects on the overall well-being of
participants (Mehdipanah, et al. 2013). It is assumed that by having a more connected network, improved
public transit, and increased safety, access to goods and services (e.g., grocery stores, department stores,
schools, workplaces, etc.) will improve.
Active transport is the use of physical activity (e.g., walking and bicycling) to travel from one destination
to another. Passive transport, on the other hand, refers to the use of motorized vehicles for travel, which
requires little to no physical activity. It is important to note that public transit ridership requires both
active and passive modes of transit. Streets designs that are more compact and include infrastructure for
pedestrians and cyclists (e.g., wide sidewalks and cycle lanes) encourage walking and bicycling by
improving feelings of safety and accessibility, and discourage motorized transport.
How does accessibility affect health?
Greenspace is widely defined as open public space with natural elements that can be used for recreation,
relief, or social interaction (Comber, Brunsdon and Green 2008, J. Maas, R. Verheij, et al. 2006, Lee and
Maheswaran 2010). Greenspace provides an opportunity to experience nature in a sea of buildings and
concrete (Wilson 1984, Frumkin 2001). Access to greenspace has the potential to lead to multiple
positive health outcomes, such as increased well-being, fear and anxiety reduction, increased cognitive
functioning, increased self-discipline, better impulse control, better mental health, increased stress relief,
higher neighborhood satisfaction, increased social cohesion, increased physical activity, lower BMI and
violence reduction (Kuo 2001c, Jong, et al. 2012, Ward, et al. 2012, White, et al. 2013, Bell, Wilson and
Liu 2008, Sugiyama 2008, van den Berg, et al. 2010, Stigsdotter, et al. 2010, J. Maas, R. Verheij, et al.
2009).
However, equity issues have been found with access to parks and greenspace. The National Housing
Federation found that those in less affluent areas only had one-fifth the access to local parks than those in
more affluent areas (Wheeler 2011). In addition to access, the quality of greenspace can also influence
the utilization of that space (Lee and Maheswaran 2010). This is important since access to green space
and health has been found to be stronger in children, the elderly and those with lower incomes, most
likely because they spend more time closer to home and in their neighborhoods (Maas, van Dillen, et al.
2009). This is an important issue to address, considering those who would stand to benefit the most from
high access to greenspace are typically those who also have the least access (Lachowycz and Jones 2014).
Accessibility, regardless of public versus private transportation, was identified as an influential factor in
the behavior to seek and acquire healthcare. After all, patients must have some mode of transit to get
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healthcare, unless the patient receives in-home care. Zullig, et al. (2012) sent a questionnaire with
validated scales to male cancer patients of the Veterans Affairs hospital. Of the few that reported
transportation issues, the two causes were related to experiencing pain and/or not having someone to take
them to their doctors' appointments (Zullig, et al. 2012). Another study showed that as travel time
increases, health outcomes (e.g., blood pressure, cholesterol levels, etc.) and visits to pharmacies and
general practitioners were lower (Hiscock, et al. 2008). Some studies have shown that economically -
disadvantaged and ethnic minority populations were disproportionately affected by travel burdens. A
national sample from the National Household Travel Survey (NHTS) showed that the average trip for
care in the U.S. in 2001 entailed 10.2 road miles and 22.0 minutes of travel, with African Americans
spending more time traveling to care than non-African Americans (Probst, et al. 2007). Children have
reportedly been impacted by transportation-related access to healthcare in numerous studies (Syed,
Gerberand Sharp 2013).
It is assumed that by having a better-connected network, improved public transit, and increased safety;
access to healthcare services such as clinics, doctor's offices, and pharmacies will improve. Access to
healthcare has been related to all health outcomes, considering it determines the ability for individuals to
manage personal health and seek and receive treatment for illness and injury. Accessibility can indicate
several different meanings, including financial access (i.e., employment insurance and disposable
income), physical access (e.g., proximity to a medical home or health services and ease of transport), and
social-related access (e.g., social support for healthy behaviors, policies that support health services for
vulnerable groups, Medicaid and/or Medicare). There are very few scientific studies, however, that have
found a connection between features of the built environment and access to healthcare and/or a medical
home. This is due to the many additional factors that play a role in a person's ability to seek healthcare
(e.g., affordability, employment status, network provider, etc.). Studies have been inconsistent as to how
much transportation and access play a role in seeking and acquiring healthcare, considering the presence
of other equally influential factors (e.g., health insurance, expendable income, etc.) that can modify or
negate the effect of having physical access to a healthcare provider.
Poor design and high traffic can make a community seem less accessible for motor vehicles and
pedestrians. Norman et al. (2006) found that the amount of intersections in a small space was an indicator
of physical activity among girls, aged 6 to 19 years old. Walk-ability is a major predictor for physical
activity levels in a community (Saelens, et al. 2003). Walk-ability incorporates the physical design and
ease in which residents can walk around their neighborhood (i.e. sidewalks, pedestrian crossings, and
traffic safety for pedestrians). Walk-ability is also strongly influenced by social civility and crime.
According to Giles-Corti et al. (2005), "access to attractive, large public open space (POS) is associated
with higher levels of walking. To increase walking, thoughtful design and redesign of POS is required
that creates large, attractive POS with facilities that encourage active use by multiple users (e.g., walkers,
sports participants, picnickers)." Studies that assessed the relationship between the perceived
environment and physical activity practices or effectiveness in providing a more inviting and safer
outdoor environment for activity found several benefits for health and well-being, including increased
sense of community and decreased isolation, reductions in crime and stress, and increased walking and
bicycling. Physical activity is helpful in preventing chronic diseases. Even a small increase in daily
physical activity may prevent weight gain and could limit health complications associated with obesity,
such as high blood pressure, type-2 diabetes, high cholesterol, and asthma (Office of the Surgeon General
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2001). Positive health outcomes associated with increased active transport include reduced risk for
obesity and cardiovascular disease and improved mental health and perceived overall wellness. Physical
activity helps to reduce stress, which is a contributing factor to anxiety and depression.
Existing Conditions Related to Accessibility to Goods and Services, Greenspace and Healthcare
How walkable and bikeable is the area along Boone Street?
Investigators looked at the existing walkability and bike-ability of Boone Street. Joseph E Boone Street
NW was ranked by Walkscore® (www.walkscore.com) as being somewhat walkable, meaning that some
errands could be accomplished on foot, due to its nearby amenities, pedestrian friendliness, population
density, and road metrics. Boone Street was ranked as having good transit for its many nearby public
transportation options. Figure 41 shows the close proximity to downtown Atlanta, GA and some of the
metrics used to calculate walkability along Joseph E. Boone Street (i.e., sidewalk width, public transit,
etc.).
Figure 41. Joseph E. Boone Street, facing east towards downtown Atlanta. (Source: David Egetter
2014)
There was a local study that was performed in Atlanta, GA that looked at transportation-related barriers,
socio-economic barriers, and other factors among a nonrandom group of people in an emergency room.
Rask et al. (1994) performed a cross-sectional survey of disadvantaged and predominantly minority
patients presented for emergency care at an urban public hospital in Atlanta, GA. They found that 61.6%
of those who participated had no medical home and 48.4% had waited at least two days before coming to
the ER for care. Investigators checked the responses against statistical analysis and found that no health
insurance, exposure to violence, and living in a supervised home, independently predicted whether a
respondent said if they had a medical home (Rask, et al. 1994). Of those who waited to seek care,
researchers found that having no insurance, no access to a vehicle, and less than a high school degree
were linked to respondents who had waited more than two days to seek care (Rask, et al. 1994). These
findings provide some insight on potential barriers to access among a population similar to that in the
community.
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How the Green Street Project May Impact Access to Goods, Services, Greenspace, and Healthcare
(Active Transport)
Is the Green Street Project capable of influencing accessibility for residents and visitors along Boone
Street?
It is very likely that the design elements in the Green Street Project will address previous perceived and
actual barriers to accessibility along the proposed project site and thereby support increased mobility and
access to destinations. Based on the literature findings, one could infer that lacking access to a private
vehicle, living in a deprived area, and lower educational attainment could be influential factors as to
perceived or actual barriers in access to goods and services. One can assume that improved infrastructure
and incorporating land use in transportation planning and policies will improve access to all goods and
services, including healthcare. Efforts to improve transportation infrastructure, such as improved walk-
ability and bike-ability, will help to address the physical barriers to accessibility, especially among
persons who are dependent on active transport (i.e., those who do not have access to a vehicle) and
increase the opportunity for choosing active transport methods to reach destinations. Those persons who
frequently use the current transport features along Boone Street will have greater exposure to the changes
and therefore be more likely to be affected by the changes. Persons who are more dependent on public
and self-transport mechanisms (i.e., physically disabled and children) are more likely to feel the benefits
of improvements to accessibility. The natural elements of the Green Street Project and the infrastructure
changes are expected to last for many years, given that adequate maintenance is continued. There are
many studies that show the relationships between access/mobility and health. There is some (limited)
evidence that supports the benefits to public health by incorporating natural elements and land use
policies and practices in transport infrastructure planning. Table 36 summarizes the predicted health
impacts of the proposed project related to access to goods, services, greenspace, and healthcare and
potential strategies to manage those impacts.
Table 36. Potential Health Impacts from Changes in Access to Goods, Services, Greenspace, and
Healthcare and Management Strategies
Criteria
Likelihood
Potential Impact Management Strategies
Highly
Likely
None provided.
Direction
Positive
None provided.
Magnitude Moderate
Work with the Atlanta Department of Planning and Community
Development to consider local zoning ordinances and regulations
regarding land use (i.e., residential vs. commercial, mixed-use, or
private vs. public). Incorporate EPA's Smart Growth Principles in the
Green Street Project design. Consider the Smart Growth America -
Complete Streets in the Southeast Case Studies. Encourage
coordination with Fulton County Department of Health and Wellness
(FC-DHW). Provide clear signage and way-finding designs for
pedestrians and cyclists (e.g. directions to the Beltline, bike zone,
share-the-road, etc.). Consider (in the project design)
connecting/expanding the walking and cycling paths to reach broader
bike/pedestrian routes (e.g., PATH foundation routes, Atlanta Beltline,
etc.). Converse with local active transport groups (e.g., Atlanta Bicycle
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Criteria
Potential Impact Management Strategies
Coalition) to ensure that implementing the project does not impede or
discourage active transportation (i.e., cycling or walking).
Permanence Long
Lasting
None provided.
Distribution Vulnerable None provided.
Populations
Benefit
Strength of Strong
Evidence
None provided.
4.4.2. Crime, Perceived and Actual
One of the topics discussed as a concern among community residents and other stakeholders is the
amount of crime committed in the neighborhood and the perceived safety and/or security that contributes
to the community's identity. Apart from gaining awareness of the current crime statistics in the
community, the HIA Core Project Team wanted to also gain an understanding of how crime rate
translates to the community's perceived identity and health outcomes. Investigators performed a
literature review to identify the mechanisms in which crime affects a person's perceived safety and
security and how that reflects on the community as a whole. Online search engines and key search terms
were used to locate peer-reviewed journal articles and agency reports related to crime.
Results of the Literature Review
How does crime influence health?
The literature available is abundant on the relationship between crime and perceived security. The
primary pathway of impact to health, however, appears to be a more indirect route through human
behaviors and attitudes, with inconsistent conclusions. The HIA Core Project Team found that not
including considerations for the potential impact to crime and fear of crime in a neighborhood can
undermine efforts to increase active living and occupancy in that area (Roman and Chalfm 2008).
Safety refers to the risk of injury or loss by circumstance, accident, or negligence, whereas security refers
to the risk of injury or loss by the motives of another individual. Crime levels and insecurity are social
factors that can influence mental stress (i.e., psychosocial stress), which affects many physical and mental
health outcomes. Higher levels of crime were significantly linked to more people with negative
perceptions of neighborhood disorder (Latkin, German, et al. 2009, Kruger, Reischl and Gee 2007).
Observations of antisocial behaviors and crime (e.g., public drunkenness, burglary, drug dealing, etc.) and
previous victimization were associated with feelings of lower safety/security of the area (Sampson and
Raudenbush 1999, Yen, Michael and Perdue 2009, Latkin, German, et al. 2009, Bazargan 1994).
Increased social disorder has been linked to increased fear of crime, risk of mental health disorders (e.g.
anxiety and depression), and the severity of depression among adults (Ross 2000, Kim 2008). Overtime,
the stress from crime or fear of crime in a community can cause poor physical health (e.g., hypertension,
cardiovascular disease, immune dysfunction) (Latkin and Curry 2003, McEwen 2008, Glaser and Kiecolt-
Glaser2005).
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Some researchers suggest that a perceived unsafe living area, either due to perceived or actual high
occurrences of crime, impedes physical activity outdoors (Yang, et al. 2012). Physical activity is an
important protective factor for good health (Fox 1999). Even when there was a lack of association (i.e.,
no connection) found between perceived neighborhood problems and physical activity, researchers found
strong ties between perceived social disorder in the neighborhood and self-rated health and distress
among residents (Steptoe and Feldman 2001). Neighborhood management, which reduces problems of
social disorder, was found to be important to people walking in the neighborhood.
It is important to note that neighborhoods with high crime rates do not impact everyone equally. If a
resident does not consider high crime rates as a threat, then the crime rate may have no bearing on that
person's physical activity levels or perceived safety/security in that neighborhood. Individual-level
factors, such as age, gender, and differences in socioeconomic status, were found to influence the levels
of perceived fear and/or perceived safety/security (Bracy, et al. 2014, Latkin, German, et al. 2009). For
example, Patnode, et al. (2010) found that girls reporting being impacted more by perceived safety than
boys. Youth and young children, who are often the recipients of violent crimes, are highly susceptible to
the influences of the social environment and stress (Administration on Children, Youth and Families
2012). Many adolescent mental health disorders (e.g., anxiety and depression) that developed from the
perceived environment often carry into adulthood (Aneshensel and Sucoff 1996). Persons who have been
victims of a crime in the past are more likely to be affected by perceived safety/security and actual crime
rates than non-victims.
How can implementing green infrastructure influence crime?
The amount of greenness in an urban community has also been linked to the amount of crime that is
committed in that area (Snelgrove, et al. 2004). Research has indicated that the presence of natural
elements bring a sense of serenity to a space and aesthetic appeal. Greenness of common spaces has been
linked to decreased aggression and violence, lower mental fatigue, higher resiliency to stressful life events
and the ability to adjust. Mental fatigue and aggression are precursors to conflict behavior. Preventing or
reducing these behaviors may improve perceived safety/security and reduce the amount of crime.
Interestingly, a recent study found that daily mean ambient temperatures were related to the daily rates of
crime in a way that during periods of temperature between 80 °F and 90 °F, there was a significant
increase in violent crime (Gamble and Hess 2012). However, as soon as the temperature reached above
90°F, the crime rates went back down (Gamble and Hess 2012). This reflects the inter-relationship
between hot temperature and increased aggravation and unfriendly behaviors among humans.
Implementing green infrastructure and reducing impervious surfaces has been found to reduce the urban
heat island effect and low surface temperatures, and thus may prevent aggressive or unfriendly behaviors
among people.
The management of natural elements can be an important aspect to crime prevention. One approach is to
follow safety measures in the Crime Prevention Through Environmental Design (CPTED), such as
designing landscape along the street with a thirty-inch "window" between vegetation at the car-widow
level to allow visibility from the road and shops along the street (Carter, Carter and Dannenberg 2003).
CPTED is thought to help differentiate between public and private property and enhance the pedestrian
environment (Carter, Carter and Dannenberg 2003). Not maintaining natural elements in an urban
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community, however, can provide opportunities for crime. Tall, overgrown bushes provide cover for
assailants. Low visibility from the road greatly reduces the number of people who can observe
pedestrians and businesses on the sidewalk. Routine landscaping can ensure the green infrastructure
elements and prevent opportunities for crime.
Existing Conditions Related to Crime
Does the area experience a high crime rate?
In order to assess the actual crime levels in the community, the HIA Core Project Team used a few
different venues to obtain information. Raw crime data was downloaded from the Atlanta Police
Department website (http://www.atlantapd.org/crimedatadownloads.aspx) and annual reports. Crime data
was also requested and obtained from the Atlanta Police Department, Tactical Crime Analysis Unit for
the 12 months of August 2012 to August 2013. The Atlanta Police Department organizes neighborhoods
by zone and constituent beats. Both English Avenue (beat 103) and Vine City (beat 102) neighborhoods
are included in zone 1, which also encompasses all of Proctor Creek Watershed. The data was refined to
the half-mile buffer area and quantified into crime rate and type. Crime rate is used to describe the
prevalence of crime in a community and can be compared to other communities and benchmarks. Crime
rates typically are expressed as observations per 1,000 people per year. The Atlanta Police Department
provided crime statistics on felonies (i.e., aggravated assault, auto theft, burglary of a residence and non-
residence, homicide, rape, vehicle and non-vehicle related larceny, and robbery of pedestrian and
residence). From August 2012 to August 2013, there were 557 reported crimes in the community
(Atlanta Police Department 2013). The crime rate was calculated as 40.0 crimes for every 1,000 people
per year.
Equation for calculating the crime rate in the community:
Crimes Reported (n=557)
Total Population (n=13,914)
x 1,000 people per year = 40.0 crimes (felonies) per 1,000 people per year
The breakdown of the different types of crimes committed in the study area is illustrated in Figure 42.
There was no crime-related injury data available below the county level and only homicides were
reported. The homicide death rate for Fulton County Health District was 9.3 deaths per 100,000 people in
2011 (GA-DPH2013a).
Homicide
1%
Rape
Aggrevated
Assault
Larceny/
Auto
Theft
50%
Robbery or
Buglary of
Residence/
Commercial
/ Pedestrian
35%
The HIA Core Project Team coded the reported
crimes into four distinct categories (i.e.,
homicide, rape, aggravated assault, robbery or
burglary of residence/commercial/pedestrian,
larceny/auto theft) and mapped out the locations
within the community (Figure 43). There
seemed to be no distinct spatial pattern observed
in the community where crimes were committed.
Figure 42. (Left) Crimes committed in the study
area from August 2012 to August 2013. (Source:
Atlanta Police Department 2013)
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Although, there were more crimes reported in the surrounding neighborhoods, such as Washington Park,
Hunter Hills, and West Lake, which showed distinct clustering around local businesses and apartment
complexes (Atlanta Police Department 2013).
Crime from August 2012-August 2013:
Vine City & English Ave.
Comedy Club
Proposed Project Site
Esn. HERE D*L»™ Mapmylna* r. OMnStrwIMap oonwtWKKS aMff«G5
uaer coiwnunllv
Figure 43. A map of the Uniform Crime Reporting numbers for felonies committed near the project
site from August 2012 to August 2013. The locations of significantly higher crimes reported are
circled in blue. (Source: Atlanta Police Department 2013)
The crimes committed in the community account for only 1.6% of the total felonies committed in the City
of Atlanta during the same time period and represents 11.2% of the total crimes in zone 1 during 2013 (n
= 4,988) (Atlanta Police Department 2013, Atlanta Police Department 2014a). There were 4,988 felonies
committed in zone 1 in the year 2013, which was a 16% decrease from the year before (5,909 felonies)
(Atlanta Police Department 2014b). It is important to note that although these counts seem high, zone 1
had the lowest overall crimes than any of the other six zones. Crime throughout the entire city has been
declining since 2011. In fact, total felonies in 2013 were 4.4% lower than in 2012 and 8.8% lower than in
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2011 (Atlanta Police Department 2014a). The crime rate in neighborhoods of English Avenue and Vine
City were reduced between 2007 and 2011, by 45% and 44%, respectively (WSBTV-2 2013).
How the Green Street Project May Impact Crime
Does the Green Street Project have the potential to influence crime in the community?
It is plausible that the proposed project will reduce the risk of crime by improving behaviors and attitudes
through improved aesthetics, reducing surface temperatures, and providing an appealing and natural
landscape. Implementing measures to prevent crime and improve perceived security will promote health
by reducing the risk of injury from crime, reduce stress and stress-related illness from a lack of security,
and improve perceived overall wellness. Improvements in actual and perceived crime (security) will
affect a moderate number of people, specifically those who pass along Boone Street and can visibly see
the changes made to the area. If the plants are allowed to overgrow (not properly maintained) or CPTED
measures are not adopted, the benefits of reducing crime can be quickly and easily reversed. Persons who
are more vulnerable to crime (e.g., young women, children, and physically disabled) are more likely to
benefit from a reduction in crime due to lowered vulnerability and increased "eyes on the street." There
is some evidence that supports the benefits to public health by incorporating natural elements and land use
policies and practices to prevent crime. Table 37 summarizes the predicted health impacts of the
proposed project related to crime and potential strategies to manage those impacts.
Table 37. Potential Health Impacts from Changes in Crime (Perceived and Actual) and
Management Strategies
Criteria
Likelihood
Direction
Magnitude
Permanence
Distribution
Strength of
Evidence
Scale
Plausible
Positive
Moderate
Quickly and
Easily
Reversed
Vulnerable
Populations
Benefit
Limited
Potential Impact Management Strategies
Increase street lighting along the proposed project site. Utilize the
CPTED (Crime Prevention through Environmental Design) elements in
the Green Street Project design, (e.g., the lowest branches on trees
should be taller than 5 feet from the ground and the tallest
bushes/grasses should be no taller than 3 feet from the ground to allow
for a "window" for onlookers at eye-level.
None provided.
None provided.
None provided.
None provided.
None provided.
4.4.3. Social Capital (Cognitive and Structural)
The HIA Core Project Team identified aspects of the social environment (identified later as social capital
through the preliminary literature search) that needed improvement in the community, such as improved
social cohesion and relationships among residents and more opportunities for developing social/emotional
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support. Therefore, the HIA Core Project Team assess the potential impact the proposed project's may
have on social capital.
Results of the Literature Review
Social capital refers to "the benefit that individuals and communities derive from having social contacts
and networks throughout their communities and is based on the notion that individuals who interact with
each other will support each other to the benefit of the entire community" (ENTRIX, Inc. 2010). Social
capital has been defined by two categories - structural and cognitive social capital. Structural social
capital, also known as bridging capital, is the existence of community linkages. Cognitive social capital,
also known as bonding capital, concerns the appreciation of trust, mutual help, and reciprocity in the
community (Wind, Fordham and Komproe 2011). There are some contradictions in the literature
regarding the effect of social capital on health outcomes. While the literature expresses the need for
further research in aspects of social capital, the existing contradictions point to the complexity of social
capital and how health outcomes may be dependent upon other variables.
How does streetscaping and revitalization efforts relate to social capital at the neighborhood level?
There is an increase in research that ties economic development, economic inequality, and geopolitics as
having direct effects on social capital as it relates to large-scale cooperation (Robbins 2013). It is likely
beneficial to weigh impact of economic development decisions on a community so as to increase social
capital, which would be important in disenfranchised communities. An increase in social capital can also
be attributed to an increase in vegetation and green spaces through the 'high road' approach, which is a
scalable economic development strategy to build a society characterized by environmental sustainability,
shared prosperity, and democratic governance (ENTRIX, Inc. 2010). High road standards result in
substantial, measurable, and long-term economic, environmental, and social benefits (Gordon, et al.
2011). The potential for improved social capital is not likely evident in smaller scaled projects, but there
may be a greater magnitude of impact on larger scaled projects. Space can be designated for transport,
such as street right-of-ways, sidewalks, and bicycle lanes, as well as private versus public and residential
versus commercial. Each designation further defines the territory that can be occupied and by whom.
What assets are available in the community that provide space to build social capital?
The HIA Core Project Team used GoogleMaps® and ArcGIS to identify and map the locations of assets
in the community that could provide space to build social capital. The HIA Core Project Team identified
a few spaces along Boone Street (mostly churches) and a variety of spaces to build social capital within
the half-mile radius around the proposed Green Street Project site (Figure 44). The community is
abundant in churches and religion-based organizations where people can congregate and develop social
ties and bonds. There are two community centers located along the proposed project site where people
can meet and be physically active. Schools, which provide common space for students and their families
to interact with other families, be physically active, and engage in social activities and learning, are
located both in and immediately outside the half-mile radius. The future site of Mini's Park, which will
be a large open green space for recreation and social activities, is sited immediately adjacent to the
proposed Green Street Project site. In addition, there are places to seek care for elders and child care
within the community.
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Child Care
Church
Community Center
Rrhnnl
Park
1/2 mi Study Site Buffer
Figure 44. Map of community assets where social capital can be influenced. (Source: Google Maps
2014)
How does social capital influence health?
Although there is research that directly links social capital to health outcomes, some research has found
that social capital has less direct contribution on health than other variables. For example, when social
capital is considered with greening the environment, the changes in health outcomes are more a result of
the change in environment (Modie-Moroka 2009). Vegetation is also associated with reduced crime rates,
potentially due to increased social capital or potentially due to a direct effect on behavior (ENTRIX, Inc.
2010). Furthermore, physical activity causes a significant reduction to the direct effects of neighborhood
social capital on health (Mohnen, et al. 2012). Some research shows that social capital acts as a buffer
during economically difficult times regardless of social status of the public, but there is not enough
evidence upon which to make predictions. The effect of social capital on health has been repeatedly
proposed to be mediated through health behaviors, specifically physical activity (Nieminen, et al. 2013).
Nieminen et al. (2013) found "that the direct effect of social capital on health becomes weaker if physical
activity is included in the model."
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How the Green Street Project May Impact Social Capital
Is the Green Street Project expected to influence social capital in the community
Efforts that supports more sustainable transport modes, including walking and bicycling, increase the
opportunity for residents and visitors in the community to interact and develop social ties and bonds and
be more physically active outside. Due to the relatively small size of project site, it is plausible, but not
likely that the proposed project may improve social capital, by removing barriers to occupy the space
along the street. The proposed project is a demonstration project for revitalization, which encourages
further investment into the community. Strengthening social capital is a positive health impact because a
strong presence of social capital can protect individuals and a collective community against hardships and
build capacity to address issues (in some cases). Increasing the opportunity to develop social capital will
affect a moderate number of people, specifically those who frequently pass through the proposed project
site. The social benefits of the proposed project are expected to last a few years (moderate length of
time), but expanded improvements are needed for an impact to be lasting. Vulnerable populations benefit
from improved social capital. Persons who are more sensitive to social conditions and connectivity to
other people and services, such as children and the elderly. There is some evidence that supports the
benefits to public health from incorporating green infrastructure and providing more opportunities for
developing social capital. However, case studies of communities whose culture or social norms do not
support healthy attitudes and behaviors did not see benefits from such changes. Table 38 summarizes the
predicted health impacts of the proposed project related to social capital and potential strategies to
manage those impacts.
Table 38. Potential Health Impacts from Changes in Social Capital (Cognitive and Structural) and
Management Strategies
Criteria
Likelihood
Direction
Magnitude
Permanence
Distribution
Strength of
Evidence
Scale
Plausible
Positive
Moderate
Moderate
Vulnerable
Populations
Benefit
Limited
Potential Impact Management Strategies
Provide meeting space (i.e., open public space) for local community
meetings in close proximity of the green street. Install public benches
at local hangouts or highly populated areas to increase social
interaction.
None provided.
Coordinate with "Atlanta Streets Alive" to host a community festival
after completion of the project. Provide other catalyst to
increase/enhance outreach to the community.
Cultivate and maintain mechanisms in City policy, development, and
economic decisions and activities for building trust with the
community.
None provided.
None provided.
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4.5. Existing Conditions and Health Impacts Related to the Economic Environment
Economic conditions in a community are closely tied together with the physical conditions of the built
and natural environment. For example, constant flooding ages the conveyance system infrastructure
causing damage that is expensive to repair and/or replace. Flooding damage to homes can affect
insurance premiums, reimbursement (or lack of reimbursement), household repairs and/or maintenance,
and property values. The contamination or degradation of water quality from CSOs and SSOs can affect
recreation and tourism dependent on the rivers and their tributaries. These impacts to household and
community level economic conditions can also have health consequences.
4.5.1. Household Economics - Cost of Living and Employment
At the first HIA community meeting, residents stated that there was an overwhelming need for jobs and
economic activity in the area. However, community residents wanted job creation to be focused on more
"green" jobs or job training that supported sustainability projects. In addition to jobs, stakeholders in the
HIA Advisory Group were concerned about the potential impact the proposed project would have on the
affordability or financial ability to stay in the area. Thus, the HIA Core Project Team used empirical
literature to examine the potential economic impacts of the proposed project on household economies in
relation to current cost of living and employment in the community.
Results of the Literature Review
How does streetscaping affect living expenses among nearby properties?
The economic impact of some green infrastructure benefits (e.g., exposure to greenness, shade, noise
abatement, flood management, social capital, etc.) can be seen in changes to property values in proximity
to green infrastructure implementation.
Restoring the natural environment in urban areas has been shown to enhance health and economics.
Clemants and colleagues (2006) showed that green redevelopment has been linked with reduced costs
related to urban sprawl and infrastructure, increased investment and tourism, higher property values,
avoided flood damage, and protected environmental quality.
The implementation of green infrastructure has repeatedly been shown to increase property values in
surrounding areas. Many aspects of green infrastructure can impact property value, including aesthetics,
home cooling costs, and stormwater control and drainage. Ward et al. (2008) found that the introduction
of green infrastructure and low-impact development in Seattle via natural drainage systems (i.e.,
bioswales, reduced pavement, increased vegetation, and replacement of traditional curbs with sloping
edges to encourage water drainage) increased the property values of adjacent property 3.5-5%. Similarly,
a survey of single family residential property sales in Atlanta, Georgia showed a 3.5-4.5% increase in
sale prices for houses with landscaping that included trees (Anderson, L., and H. Cordell 1988)
A study by Dill et al. (2010) evaluated the economic benefits of green street projects in particular.
Controlling for other attributes, the study found that each additional green street treatment within 500 feet
of a single family home was associated with a $968 increase in sales price. The green streets were also
associated with some higher levels of social interaction and residents living near a green street thought it
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was a better place to live than before the green infrastructure installation. In Philadelphia, residents
expressed concerns about vacant land, trash, and the condition of their neighborhood. Through the
creation of an open space management plan, vacant lots were able to be cleaned up and transformed into
community gardens. As a result of the green revitalization plan, the housing market was improved and
green collar jobs were created (Karlinsky 2000). Another study in Philadelphia found curbside tree
planting attributed 2% of the observed price increase in the intrinsic value of the homes in neighborhoods
(Wachter 2008). What is of even greater interest, however, is the price differential observed for the two
tree planting programs examined in the study - one focused in low income neighborhoods that involved
tree plantings along an entire block and the other that responded to individual requests for tree plantings
and had no specific target areas. The former program did not observe any benefit beyond the 2% increase
attributed to the intrinsic value; however, the latter program observed an additional 5-9% increase in
housing prices (7-11% total price differential) for properties within 4,000 feet of tree plantings. This
additional increase was attributed to social capital creation and/or the signaling of positive physical
capital changes, suggesting that the economic impacts of tree plantings (and green infrastructure in
general) may extend beyond the benefits of the aesthetics.
How does green infrastructure impact employment or the opportunity for employment in disadvantaged
communities?
Green streets and green infrastructure can also stimulate job creation and in particular "green collar jobs."
These green collar jobs are defined as well-paid jobs that contribute directly to preserving or enhancing
environmental quality. They range from low-skill, entry-level positions to high-skilled positions, and
tend to be local and promote sustainable economies (Apollo Alliance and Green for All 2008). Green
infrastructure, green policies, smart growth, and sustainability programs are positive drivers for green
collar jobs and will result in the potential growth of jobs in this sector during the next decades
(Pinderhughes 2006). Smart growth elements such as mixed income developments, provision of
affordable housing, and housing development, in combination to access to goods and services, can create
jobs by concentrating development. Landscaping improvements can also increase local employment
opportunities (Forest Research 2010). According to the advocacy group, Alliance for Community Trees
(2014), in some sectors of the economy, such as tree care, there is a job for every trained worker, because
companies struggle to find qualified employees.
Increased property value and housing market revitalization is a positive benefit of implementing green
infrastructure in the community, but can have adverse impacts on individual household economics and
has the potential to lead to gentrification - a pattern of neighborhood change in low-income areas that
have experienced revitalization and reinvestment, in which low-income households are displaced by an
influx of higher income households (Kennedy and Leonard 2001). With increased property values comes
higher property taxes and increased rent, both of which raise the cost of living. While there are some
benefits of green infrastructure that could potentially reduce household costs, such as reductions in
summer cooling costs with the addition of plantings (Alliance for Community Trees 2014) and cost
savings related to effective storm water management, increased cost of living has the potential to influence
the ability of a household to meet basic needs, such as healthy food, clothing, and healthcare; threaten
financial security; and lead to the acceptance of overcrowded and substandard living conditions and even
displacement (Pollack C, Egerter S, Sadegh-Nobari T, Dekker M, Braveman P 2008). The inability of a
household to meet basic needs and overcrowded/substandard living conditions (i.e., poor housing quality)
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can increase the risk for chronic disease, such as heart disease, hypertension, and diabetes; infectious
disease; poor mental health, and even mortality (Human Impact Partners 2010) (Krieger J, Higgins DL.
2002) (Krieger, Takaro and Rabkin 2011) (Jacobs, D.E.; Wilson, J.; Dixon, S.L.; Smith, J.; Evens, E.
2009). Increased financial instability can lead to displacement, which occurs when residents are forced to
move out of an area because the cost of living becomes higher than what they can afford. This movement
can result in the loss of jobs, social support and cohesion, and feelings of belonging; childhood
development issues; and stress and its associated impacts, such as poor mental health and suppressed
immune function (Human Impact Partners 2010) (Keene and Geronimus 2011) (Bhatia and Guzman
2004) (Oilman SE, Kawachi I, Fitzmaurice GM, & Bika SL 2003). Displacement also leads to a shift in
the population that inhabits the community.
How does employment and income impact health?
Employment and health have a bidirectional relationship (Hartman n.d.). Employment status may have
implications for an individual's health status and vice-versa. Employment status is directly connected to
health via income and benefits, such as health insurance. Income and health insurance can increase
access to nutritious foods, adequate housing, and healthcare, reducing the risk for chronic disease,
communicable disease, and poor mental health (Human Impact Partners 2010).
Existing Conditions Related to Cost of Living and Employment
What is the existing employment level and cost of living in the community and how much if a person's
income is going to housing costs?
Economy/Jobs/Poverty was one of the highest priority categories of concern/need identified by
stakeholders. The HIA Core Project Team extracted data by Census tract from the 2006-2010 ACS 5-
Year Estimates Employment Status (S2301), Financial Characteristics (S2503) and Poverty Status in Past
12 Months (SI701) datasets for indicators related to employment, income, and poverty. The data was
compiled in Excel and aggregate estimates were calculated with their associated margin of errors.
As shown in the population profile, approximately 39.1% of the community potentially affected by the
Green Street Project is living in poverty, including over half of the individuals under 18 years of age and
approximately one-third of individuals over 65 years of age (U.S. Census Bureau 2010). Of the occupied
housing units, 46% have an annual household income of less than $25,000, and an additional 28% of
those units have annual household incomes of $25,000-$49,000 (U.S. Census Bureau 2010). The
majority of these lower income households rent, spending on average of $820 (+/- $314) a month for
housing costs (U.S. Census Bureau 2010). Renters in the lowest income bracket spend a significant
percentage of their monthly income (approximately 41%) on housing costs, as do home owners in the
highest income bracket (>$75,000), who spend approximately 42% of their monthly income on housing
costs (U.S. Census Bureau 2010). Households that spend more than 30 percent of their income on
housing are considered cost burdened according to HUD (2013) and may have difficulty affording basic
needs such as food, clothing, transportation, and healthcare.
The annual living wage (i.e., cost of living) for a 2-person household in Atlanta, Georgia (as calculated by
the Living Wage Calculator) is estimated to be $31,511-$39,527, and for a 3-person household, the
annual cost of living is estimated to be $37,728-47,078 (Glasmeier, Amy K. and Massachusetts Institute
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of Technology 2014). These calculations take into account monthly expenses of food, healthcare,
housing, transportation, child care (if applicable), and other necessities.
Of those in the workforce (i.e., civilian labor over 16 years of age), 16.3% are unemployed (U.S. Census
Bureau 2010). Of those unemployed, 70% are living below poverty level.
There are an estimated 12,865 individuals (+/-1,371) age!6 years and over, of which 61% (+/-0.06%) are
in the labor force (U.S. Census Bureau 2010). Of the group in the labor force, 16.3% (+/-0.02%) were
unemployed (U.S. Census Bureau 2010). Unemployment was high for both African Americans and
Caucasians, at 19.2% and 16.3%, respectively (U.S. Census Bureau 2010). There were more employed
women than men, especially women with children under 6 years old (69.6% +/-0.33) (U.S. Census
Bureau 2010). Table 39 highlights the employment status of persons in the community by educational
attainment. Persons with higher levels of professional education were more employed than persons with
less education, and persons with less than a high school degree made up the largest proportion of those
unemployed. These findings illustrate the importance of education in relation to employment.
Table 39. Employment Status by Educational Attainment among Population 25 to 64 Years Old
Educational Attainment
Total Population 25 to 64 Years Old
Less Than High School Graduate
High School Graduate or GED
Some College
At least a Bachelor's Degree
Estimated
Population
Employed
63.0%
29.7%
53.6%
70.5%
82.0%
Margin of
Error1
+/-0.08
+/-0.1
+/-0.12
+/-0.12
+/-0.15
Estimated
Population
Unemployed
12.2%
32.5%
9.5%
10.2%
10.1%
Margin of
Error1
+/-0.02
+/-0.14
+/-0.03
+/-0.03
+/-0.04
Source: 2006-2010 ACS 5-Year Estimates, Employment Status dataset
1 Margin of Error was calculated in MS Excel.
Income, which is closely related to employment status, was found to be somewhat widely distributed
among the residents in the HIA study area. Approximately 14% of the households had an annual income
over $75,000, 12% had an annual income between $50,000 to $75,000, and only 14% had an annual
income between $25,000 and $50,000 (U.S. Census Bureau 2010). It should be noted that almost half of
the population (46%) was living with a yearly income less than $25,000 (U.S. Census Bureau 2010).
The HIA Core Project Team investigated the severity of poverty in the community. The U.S. Census
Bureau uses a set dollar value threshold, which varies by family size and composition, to determine who
among the population is living at or below poverty. For example, if a family's total household income is
less than the threshold dollar value for poverty (i.e., federal poverty threshold level), then that family and
every individual in it are considered to be living in poverty. The poverty threshold values do not vary
geographically, but they are updated annually for changes in cost of living and inflation using the
Consumer Price Index. Poverty status is determined for all people except those institutionalized, people
in military group housing, individuals living in college dormitories, and unrelated individuals under 15
years old (U.S. Census Bureau 2013).
According to the 2006-2010 ACS, Poverty Status in Past 12 Months (S1701) dataset, the largest group
living in poverty is children. Over half of the persons under 18 years of age and approximately one-third
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of persons over 65 years are living in poverty (54.4% +/-0.12 and 31.2% +/-0.18, respectively). More
men are living in poverty than women (40.4% compared to 37.6%). Approximately one-third (36.4%) of
Hispanics in the community study area are living in poverty. One in four Caucasians and 40.8% of
African Americans in the community study area, for whom poverty status is determined, are living in
poverty. It is not surprising that of those unemployed, 70.1% are living below the federal poverty level.
(U.S. Census Bureau 2010)
The HIA Core Project Team looked at housing data from the 2000 and 2010 Census data files to better
understand the changes that have occurred in housing over the past decade and what the existing
conditions were for housing in 2010.
In 2010, there were atotal of 5,706 households in the community, with an average household size of 2
individuals (1.9 persons per household). Almost half (44.3%) of the households in the community were
families; the average family household size was 3 individuals (U.S. Census Bureau 2010). Total occupied
housing units decreased almost 3% from 5,904 in 2000 to 5,751 in 2010. There was very little change,
albeit positive, from 2000 to 2010 in the ratio of owner-occupied to renter-occupied housing units (0.31 to
0.33, respectively); this indicated an increase in home owners in the community. The most remarkable
change observed was the explosive increase in vacant housing over the decade, rising 167.7% in just ten
years. This finding parallels the concern community residents and other stakeholders voiced on the
increasing prevalence of vacant and abandoned houses in the community. Interestingly, the number of
total housing units in the community study area went up almost 30% from 2000 to 2010. This indicates
that a large proportion of the housing units gained in the past decade are standing vacant. Table 40 shows
the housing occupancy indicators used and their values.
Table 40. Differences between 2000 and 2010 Census Housing Occupancy Indicators
Housing Indicator
Total Housing Units
Owner-occupied
Renter-occupied
Owner-occupied to
Renter-occupied Ratio
Total Occupied Units
Total Vacant Units
20001
7,253
1,396
4,508
0.31
5,904
1,349
20101
9,362
1,411
4,340
0.33
5,751
3,611
Net Change
£29.1%
t 1.1%
| 3.7%
tO.02
| 2.8%
1 167.7%
1 Data Source: 2000 and 2010 Census Summary File 1
The HIA Core Project Team collected data on financial housing characteristics in the Census tracts
intersecting the half-mile buffer from the 2006-2010 ACS 5-Year Estimates, Housing by Financial
Characteristics dataset (S2503) and graphically analyzed the data (Figure 45). The findings show that of
the total households in the community, almost half (46.2%) live with a combined household income less
than $25,000. There are striking differences in household incomes between households who live in a
home they own and those households that rent their home space. Over half of the renter-occupied
housing units are occupied by households with an average income less than $25,000, whereas those who
have the highest household income live in the home they own. There appears to be an inverse
relationship between household income and whether a household rents or owns their housing unit, such
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that the lower the income bracket - the higher the prevalence of renter-occupied housing units, and the
higher the income bracket - the lower the prevalence of renter-occupied housing units.
Housing Unit Type by Income in the Past 12 Months
'5.
c =
= 1
l Total Occupied
Housing Units
I Owner-Occupied
Housing Units
Renter-Occupied
Housing Units
< $25.000
$25.000 to
$49.999
$50.000 to
$74,999
> S75.000
Housing Income in the Past 12 Months (in 2010 inflation-adjusted dollars)
Figure 45. Graphical analysis of occupied housing units by household income. It should be noted
that the margin of error for percentage of occupied housing units by income never went above +/-
0.06%. (Source: 2006-2010 ACS 5-Year Estimates, Housing by Financial Characteristics dataset
(S2503))
The HIA Core Project Team wanted to know how much residents in the community were spending on
monthly housing costs. Again, the team used the 2006-2010 ACS 5-Year Estimates, Housing by
Financial Characteristics dataset to obtain this information. The average amount spent on monthly
housing costs was estimated at an $858 (+/- $335) for all residents, $1,280 (+/- $1,473) for home owners,
and $820 (+/- $314) for renters (U.S. Census Bureau 2010). Households spending more than 30% of their
income on monthly housing costs were further delineated by housing type and total household income in
the past 12 months (Figure 46). Researchers found differences in income spent on housing costs between
renter-occupied and owner-occupied housing.
n.
I
40
30
Percentage of Occupied Housing Units Paying More Than
30% of Income Towards Mouthy Housing Costs
£ 1
•o s
2
'ts
I
'i
_
20
15
10
5
0
I Tot;i] Occupied
Housing Units
I Owner-occupied
Housing Units
Renter-occupied
Housing Units
< S20.CXK)
$20.1 tOO to $35,000-$49,999 $50,000 to
34.999 $74.999
> S75000
Total Household Income in the Past 12 Months
Figure 46. Graphical analysis of the percentage of occupied housing units paying more than 30% of
income for monthly housing costs by housing type. It should be noted that the margin of error for
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percentage of occupied housing units by income never went above +/-0.03%. (Source: 2006-2010
ACS 5-Year Estimates, Housing by Financial Characteristics dataset (S2503)).
Of the estimated 5,706 occupied housing units, approximately 3,372 (59.1%) are paying more than 30%
of their income for monthly housing costs (U.S. Census Bureau 2010). Households in the lowest income
bracket (i.e., less than $20,000 a year) were more likely to pay over 30% of their income towards monthly
housing costs than the higher income brackets. There were a higher proportion of renters, compared to
home owners, in the lowest income bracket that paid more than 30% of their income towards monthly
housing costs. Home-owners in the higher income bracket (i.e., greater than $75,000) were more likely to
pay over 30% of their income towards monthly housing costs than renters. Renters were more likely to
pay more than 30% of their income towards monthly housing costs if they were lower income than higher
income.
As indicated in the literature review results, the implementation of green infrastructure has repeatedly
been shown to increase property values in surrounding areas. The median property value of the 36
residential properties abutting the Green Street Project is $16,000 (City of Atlanta 2013). Figure 47
shows the appraised residential property values in parcels surrounding the Green Street Project.
500 r- Median: S14.990
Feel / Mean. $16,684
LI * of Parcels: 198
Median: $12.500
Mean : S15,374
# of Parcels : 25 1
Median: $11 700
Mean : S 1 5.766
# of Parcels: 365
Median: $ 1 3.800
Mean S 1 6.619
H of Parcels : 480
Median: $14,100
Mean : S31.930
* of Parcels: 650
_. _, ^ _ Median: S16.000
_ ™ ™ Mean- S19 ,936
" # of Parcels: 36
Residential parcels abutting
Boons 81 vet Green Street Project
SSI
*
: "."['
U-*
500 Feet
Residential Property
t
Source City of Atlanta 2013 Tax Digost
f_wi. HtRt, OeLorme. Mapmvindia. ©OrwnSweelMap contributors, and thesis user cwnmunpTv
Figure 47. Appraised value of residential parcel units within one half mile of the Green Street
Project.
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Assessment
How the Green Street Project May Impact Household Economics (Costs of Living and Employment)
Is the total investment in the Green Street Project expected to affect costs of living and/or employment?
Based on the evidence reviewed, the HIA Core Project Team judged how the proposed Green Street
Project could affect household economics and qualitatively characterized how that impact would affect
health. The proposed project design plans to incorporate elements of green infrastructure (i.e., rain
gardens, planter boxes, and permeable pavement) to create a streetscape along Boone Street. Planter
boxes and rain gardens will include a variety of vegetation, including trees, bushes, grasses, and other
plantings. Green infrastructure has been shown to increase property values, which can improve
community economy, but detract from household economy via increased costs of living. There are some
cost savings anticipated from the green infrastructure implementation (e.g., reduced cooling bills due to
shading from vegetation, but increased costs of living via increased rent and taxes can have negative
health impacts, especially for those that are already cost burdened (i.e., spending more than 30% of their
monthly income on housing). Increased costs of living have the potential to lead to displacement of low-
income residents, and should this project signal a revitalization and reinvestment in the neighborhood,
gentrification.
Using green infrastructure, as opposed to grey infrastructure (e.g., concrete and pavement), can stimulate
job creation due to the increase in required seasonal and continuous maintenance. Maintenance can
include pruning, mulching, removing debris, refilling the bioretention media, and watering vegetation,
among other things. Green infrastructure is often referred to as a creator of "green collar jobs," or
sustainable jobs that are dedicated to environmental work. Landscaping improvements, therefore, are
often used as a revitalization strategy in a community to help with local job creation. Due to the size of
the Green Street Project, community-wide employment impacts are not expected; however, local job
creation has the potential to significantly impact those that are unemployed and those living below the
poverty level, assuming local residents are given priority in hiring and funding for maintenance continues.
Those individuals in the community who are at increased risk of experiencing disproportionate (positive
or negative) impacts due to changes in household economics, include:
• Persons living on a fixed income, below the federal poverty level;
• Households that are cost burdened (i.e., spending more than 30% of monthly income on housing);
• Persons who are on long-term unemployment or are physically incapable of labor; and
• Persons who are limited by age, such as children under 16 years and older adults (over 67 years).
Predicted increases in property values and cost of living, cost reductions via green infrastructure features,
and job creation indicate that the proposed project will likely impact household economics. Cost savings
and job creation as a result of the Green Street Project can increase income available to meet basic needs
and promote health; however, increases in property values as a result of the project (and with it cost-of-
living) can impact the ability to meet basic needs, impact health negatively, and can potentially lead to
displacement and gentrification. Impacts to costs of living are expected to be localized and affect some
groups in the vicinity of the Green Street Project; due to the size of the project, job creation is expected to
be minimal and therefore, impact few. Impacts to household economics and the ability to meet basic
needs are reversible, but can substantially affect the well-being and livelihood of individuals. Job
creation and costs savings will benefit those that are low income and unemployed, while increases to cost
Proctor Creek's Boone Boulevard Green Street Project HIA Page 116
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Assessment
of living will negatively impact those on a fixed income, living below poverty level; cost burdened
households; those on long-term unemployment or incapable of work; and the age limited (under 16 or
over 67 years old). Evidence is limited, but a few good studies exist linking green infrastructure to
increased property values and job creation.
Table 41 summarizes the predicted health impacts of the proposed project related to household economics
and potential strategies to manage those impacts.
Table 41. Potential Health Impacts from Changes in Household Economics (Cost of Living and
Employment) and Management Strategies
Criteria
Likelihood
Direction
Magnitude
Permanence
Distribution
Strength of
Evidence
Scale
Plausible
Both
Positive and
Negative
Moderate
(Positive)
and Low
(Negative)
Quickly and
Easily
Reversed
(Both)
Both
Benefits and
Harms for
Vulnerable
Populations
Limited
Potential Impact Management Strategies
Incorporate employment opportunities for local residents during
maintenance and construction, starting with those in Vine City and
English Avenue. Develop and incorporate Green Jobs Training for
local residents and community groups.
None provided.
Provide funding opportunities for local entrepreneurs (e.g., small
business grants, foundation matching, matching grants for job creation,
etc.) aimed at creating jobs.
Develop and implement policies for new development to ensure that a
% will be dedicated for mixed income housing. Develop and
implement policies that limit renting and encourage more home
ownership.
Develop and implement property tax and rent control
ordinances/policies to ensure housing costs do not increase as a result
of revitalization and/or redevelopment (i.e., gentrification).
None provided.
4.5.2. Community Economics (Business Performance)
In scoping, factors related to the local economy were high priority topics of concern/interest among
stakeholders. Community stakeholders, in particular, voiced that the area needed a community-owned
asset that would generate economic activity. They stressed the importance for local businesses to have
enough patronage to stay open and viable. Local businesses should be profiting from the increased traffic
during special events due to their proximity to the stadium and convention center. This advantage is not
occurring. Instead, businesses have suffered over the years, many of which have closed. For purposes of
this HIA, the HIA Core Project Team looked at potential impacts the project may have on local
businesses, including business performance (i.e., demand for goods and services) and overall community
economics.
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Assessment
Results of the Literature Review
How does streetscaping influence business performance?
In Chicago, an EPA-funded effort to help clean-up and re-green a community (including some
brownfields) resulted an improvement in local job opportunities in the area by retaining businesses and
attracting new businesses and industry to the area (Clemants, et al. 2006). A study by Dill et al. (2010)
evaluated the economic benefits of green street projects in particular and found that residents living near a
green street were more likely to be more physically active (walk five times or more a week), interact with
their neighbors more, and thought it was a better place to live than before the green street infrastructure
was in place. Communities designed to promote walking and cycling have been shown to have more
successful businesses than those designed mainly for motorized traffic. The increased foot and bike
traffic brings in more regular patronage and attracts new businesses, entrepreneurs, and customers to the
area. When businesses do well in a community, it improves economic growth by creating new jobs and
increasing access to amenities and services; this, in turn, can improve health in a community (e.g., access
to healthcare and nutritious foods, mental health status, and the prevalence of chronic disease).
Walkable commercial districts are a key component of communities that promote active living.
Destination is a key predictor of walkable communities; if there are businesses and services within
walking distance, people have an excuse to walk to them. There is evidence that green space improves
aesthetics, reduces crime, and therefore promotes walking. A recent report by Hack (2013) examines
whether there are also economic benefits to businesses in walkable communities. The study consisted of
a meta-analysis of 70 studies, with only 15 that addressed economic performance directly. While there is
still not much research on this topic, the evidence seems to suggest that walkable retail is on the upswing,
and likely to grow over the next several decades. Since 45% of daily trips, on average, are made for
shopping and running errands, encouraging walking is an important strategy in reducing obesity and
improving health. Additionally, further emerging research (People For Bikes and Alliance for Biking &
Walking 2014) shows how bike lanes specifically can improve business performance, as people who
arrive by bike to a business spend less money but visit more often (becomes a regular client), resulting in
more money spent overall. The use of bike lanes is also important for reducing energy usage and carbon
emissions; this is why a green street implemented along with a road diet, bike lanes and more sidewalks
can make walkable communities and enhance economic development.
As was mentioned in the household economies discussion, the implementation of green infrastructure can
increase property values in surrounding areas. This can have an effect on both property taxes and/or rent
for businesses, and therefore, affect the business' bottom line. However increases in property value can
also signal improvements in physical capital, which promotes revitalization and ultimately development.
Planting trees and vegetation around businesses can also help reduce costs associated with heating,
cooling, and stormwater management.
Existing Conditions Related to Business Performance
What are the current property values for businesses in the community?
Based on the U.S. Census Bureau's Zip Code Business Patterns (U.S. Census Bureau 2012), there were a
total of 1937 establishments within 1/2 mile of the proposed Green Street Project (i.e., zip codes 30313,
Proctor Creek's Boone Boulevard Green Street Project HIA Page 118
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Assessment
30314, and 30318; see Table 42). Footnotes to the table describe the types of establishments within each
of the four main North American Industry Classification System (NAICS) sectors - retail trade;
professional, scientific, and technical services; accommodations and food services; and other services
(except public administration).
Table 42. Business Establishments within One Half-Mile Radius of the Green Street Project in 2010
Establishments, by NAICS Sector Total Within Half-mile Buffer
Utilities
Construction
Manufacturing
Wholesale trade
Retail trade1
Transportation and warehousing
Information
Finance and insurance
Real estate and rental and leasing
Professional, scientific, and technical services2
Management of companies and enterprises
Administrative and support and waste management and
remediation services
Educational services
Health care and social assistance
Arts, entertainment, and recreation
Accommodation and food services3
Other services (except public administration)4
Industries not classified
Total
5
92
106
165
259
41
94
53
113
296
24
94
31
110
52
205
195
2
1,937
1 Retail trade includes businesses such as supermarkets, gasoline stations with convenience stores, convenience stores, and
beer, wine, and liquor stores.
2 Professional, scientific, and technical services includes businesses such as lawyer offices, graphic design services, custom
computer programming services, and marketing consulting services.
3 Accommodation and food services includes businesses such as full-service restaurants, limited-service restaurants, and food
service contractors.
4 Other services includes businesses such as religious organizations, civil and social organizations, general automotive repair,
and beauty salons.
5 Zip codes included in the half-mile buffer were 30313, 30314, and 30318.
It should be noted, while the number of businesses in the study area in 2010 is known, nothing is known
of the performance of those establishments, nor is the existence and business performance of those same
establishments known today. The data does show, however, that there are businesses and services within
walking distance in the community.
As noted previously, the implementation of green infrastructure has repeatedly been shown to increase
property values in surrounding areas. The median property value of the 31 non-residential properties
abutting the Green Street Project is $51,800 (City of Atlanta 2013). Figure 48 shows the appraised non-
residential property values in parcels surrounding the Green Street Project.
Proctor Creek's Boone Boulevard Green Street Project HIA
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Assessment
500
Feet
Median S54.160
• ''. Moan: S34.5677
4 of Parcels : 91
Median: S 5 0.4 00
Mean: 141,7293
# of Parcels: 124
Median: £60,300
Mean : $847.811
# of Parcels: 163
Median S 1 9 700
Mean: S3.093.795
# of Parcels: 185
Median : £145.300
Mean: 13.952.666
* of Parcels: 1 58
Median: $51 .800
Mean : $146.664
# of Parcels : 31
imrnrp
i ••',?-.•• »•
.-. . ...:.; ....[ .
«-Jl»<
T
Non-Residential Properties
N on -r e sictantia I p a rc&Ss abutting
Boo n e B i v d Green Street Project
500 Feet
.
Tax Digest
Source Ctly of Atlanta 2013 T
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Assessment
Based on the evidence reviewed, the HIA Core Project Team judged how the proposed Green Street
Project could impact business performance and qualitatively characterized how that impact would affect
health. The proposed project design plans to incorporate elements of green infrastructure (i.e., rain
gardens, planter boxes, and permeable pavement) to create a streetscape along Boone Street, convert 5 ft.
of roadway on each side to a designated bike lane, and add 1-2 spaces for street side parking.
The landscaping, aesthetics, and improved biking and walking infrastructure are expected to positively
impact business performance, which in turn can enhance economic growth and development (e.g., by
creating jobs and attracting new business and customers). Lowered utility bills and reduced property
maintenance and repair costs can also improve the overall performance of a business by reducing costs.
Improved business performance can, in turn, improve health in the community.
Predicted improvements in walkability/bike-ability and cost reductions via green infrastructure features
will likely improve access to goods and services in the community and improve business performance.
Walking/biking infrastructure improvements can improve access to existing businesses and potentially
attract new business. This, combined with expected cost reductions (i.e., cooling and property
maintenance/repair costs) could improve business performance, lead to increased access to goods and
services and job creation, and improve health. Impacts to business performance are expected to be
localized and affect some groups in the community. Impacts to business performance are reversible, but
can substantially affect the well-being and livelihood of individuals in the community. Job creation will
benefit those that are low income and unemployed, while improved access to good and services will
positively impact those on a fixed income, living below poverty level; cost burdened households; those on
long-term unemployment or incapable of work; and those of age to work. Evidence is limited, but a few
good studies exist linking walkability/bike-ability to improved business performance. Table 43
summarizes the predicted health impacts of the proposed project related to community economics and
potential strategies to manage those impacts.
Table 43. Potential Health Impacts from Changes in Community Economics (Business
Performance) and Management Strategies
Criteria
Likelihood
Direction
Magnitude
Permanence
Distribution
Strength of
Evidence
Scale
Plausible
Positive
Moderate
Quickly
and Easily
Reversed
Vulnerable
Populations
Benefit
Limited
Potential Impact Management Strategies
Install bike racks in front of businesses along the proposed project site.
None provided
Encourage the implementation of green infrastructure to business
owners and residents along the proposed project site (e.g., provide tax
incentives for implementing storm water BMPs).
Consider zoning ordinances to reduce fast food, cash advance, and
alcohol establishments. Consider tax incentives for development of
healthy establishments (e.g., small business seed grant).
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Recommendations
Chapter 5. Recommendations
HIA recommendations aim to manage identified health impacts either by modifying the pending decision
or by introducing health-supporting measures that minimize potential adverse impacts and maximize
benefits for all.
5.1. Developing the HIA Recommendations
The HIA Core Project Team used a step-wise approach to develop and prioritize the recommendations.
First, each member of the HIA Core Project Team identified measures to help manage predicted changes
to each health determinant assessed so that potential benefits were maximized and potential harms were
avoided and/or minimized. Next, the HIA Core Project Team gathered to discuss the main findings and
initial recommendations identified. As a group, the team verified whether the proposed mitigation actions
were appropriate, based on the assessment findings, and identified additional opportunities for DWM to a)
mitigate or avoid potential harmful consequences of the proposed project, and b) maximize co-benefits
and ensure equitable impact. The HIA Core Project Team presented the list of initial recommendations at
the final stakeholder meeting (see Appendix C Documentation of the Final Stakeholder Engagement
Meeting, June 5, 2014) and solicited feedback from stakeholders. The recommended items were further
refined, based on the input received from stakeholders, and scored using the framework provided in Table
44. The combined score was used to rank the items within their implementation phase.
Table 44. Framework for Prioritizing Recommendations
Criteria
Phase of implementation
Score and Description
4= Implement immediately (before-construction)
3= Implement in the short-term (during construction)
2= Implement in the short-term (after construction)
1= Implement in the long-term
Intended purpose
4= Protect environmental and/or public health
3= Promote healthy living
2= Encourage collaboration/coordination among stakeholders
1= Encourage sustainable development
Correlates with
stakeholder-identified
priority (from Scoping
exercises)
4= Received 20 or more votes (Environment, Community Engagement,
Economy/Job s/Po verty)
3= Received 10 to 19 votes (Housing, Health, Education)
2= Received 5 to 10 votes (Safety and Transportation)
1= Received less than 5 votes (Recreation, Social/Cultural,
Politics/Government, Total Investment)
Potential for co-benefits
l=Yes
0=No
NOTE: Costs and/or feasibility for implementing the recommendations was not including in developing
and/or ranking the recommendations. DWM should consider these criteria should they prevent the
recommendations from being implemented. For those recommendations not carried out, the City should
provide rationale or reasoning to stakeholders that explains the decision for not implementing the
recommendation. This will help to ensure trust and transparency in the decision-making process.
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Recommendations
5.2. Final Recommendations to Decision-Makers
In the following tables, the HIA Core Project Team lists the final recommendations from this HIA that should be adopted and implemented by
DWM and the City of Atlanta. The recommendations are grouped by phase of implementation. Table 45 lists the recommendations that should be
implemented immediately (before construction). Table 46 lists the recommendations that should be implemented during construction of the
proposed project. Table 47 lists the recommendations that should be implemented shortly after construction of the proposed project. Table 48
lists the long-term recommendations that should be adopted implemented in the next several years after project construction. Recommendations
are listed with their intended purpose, benefits to health determinants of interest, evidence supporting the recommendation, and the final combined
score. Furthermore, the HIA Core Project Team highlighted the recommendations identified by stakeholders at the combined stakeholder
engagement meeting that also received support from the community residents. If the list of HIA recommendations cannot be implemented in its
entirety, the team recommends that DWM and the City of Atlanta at a minimum address and/or adopt these items (shaded in gray).
Table 45. Short-term HIA Recommendations That Should Be Implemented Immediately (Before Construction)
Final Recommendations
1- Increase law enforcement of nuisance laws in
regards to abandoned properties, illegal dumping,
and property maintenance.
Intended Purpose Health Benefits Recommendation Supported Score
Protect
environmental
and/or public health
Water Quality
and Flood
Management
2- Improve "flood safety hazard" warnings in flood-
prone areas.
3- Improve "water quality hazard" warnings for
water contact.
Quantitative Analysis
Qualitative Analysis
GIS-supported mapping
and/or spatial analysis
Empirical Literature
Stakeholder Input
13
Protect Flood
environmental Management
and/or public health
• GIS-supported mapping
and/or spatial analysis
12
Protect
environmental
and/or public health
Water Quality
Qualitative Data Analysis
12
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Recommendations
Final Recommendations
4- Strictly follow the recommendations outlined in
section 6.1 (Common Elements of the Green
Infrastructure Technical Specifications) of the
project design regarding selection of soil media,
mulch, and fertilizer use (i.e., use soil media low in
phosphorous and nitrogen content, avoid manure-
or compost-based mulch, and limit the use of
fertilizers).
Intended Purpose Health Benefits Recommendation Supported
By
Protect
environmental
and/or public health
Water Quality
• Qualitative Data Analysis
• Empirical Literature
Score
12
5- Select native tree species that have tall, broad
canopies that could increase the shading of surface
area (especially over impervious surfaces).
Protect
environmental
and/or public health
Climate and • GIS-supported mapping
Temperature and/or spatial analysis
• Empirical Literature
• Stakeholder Input
12
6- Select native plant species that have low volatile
organic compound (VOC) emissions and have
higher capacity for filtering pollutants out of the
air. NOTE: for any planting of vegetation in
urban areas, it is recommended that a minimum
of three species be selected.
7- Remove (address) foul (sewage) smell from
Proctor Creek/North Avenue combined sewer
outflow.
Protect
environmental
and/or public health
Air Quality
Empirical Literature
12
Protect
environmental
and/or public health
Water Quality
Stakeholder Input
12
8- Increase soil media height of planter boxes from 2
feet to at least 2.5 feet (30 in) to improve pollutant
removal efficiency.
Protect
environmental
and/or public health
Water Quality
• Qualitative Data Analysis
• Empirical Literature
12
9- Increase community awareness of environmental
factors that can lead to mosquitoes and
preventative measures against vector-borne
pathogens in the area.
Protect
environmental
and/or public health
Flood
Management
• Qualitative Analysis
• Empirical Literature
• Stakeholder Input
11
10- Maximize "greenness" for the proposed project
site to increase the potential for psychosocial
improvements (e.g., reduced stress, improved
mental health, and reduced aggression).
Promote healthy
living
Exposure to • GIS-supported Mapping and
Greenness and Spatial Analysis
Crime • Qualitative Data Analysis
• Empirical Literature
11
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Recommendations
Final Recommendations
11- Incorporate employment opportunities for local
residents and businesses during construction and
maintenance, starting with those in Vine City and
English Avenue.
Intended Purpose Health Benefits Recommendation Supported
By
Promote healthy
living
Household • Quantitative Data Analysis
Economics • Qualitative Data Analysis
• Stakeholder Input
Score
11
12- Provide funding for local entrepreneurs (e.g.,
small business grants, foundation, matching
grants, etc.) aimed at creating jobs.
Promote healthy
living
Household
Economics
Qualitative Data Analysis
11
13- Add infrastructure that promotes safety for
pedestrians and cyclists (e.g., street lighting,
traffic calming approaches, designated and
protected bike lanes, bike traffic signals, cycling
greenways, etc.).
Protect
environmental
and/or public health
Traffic Safety
• Qualitative Analysis
• Empirical Literature
• Stakeholder Input
10
14- Increase street lighting along the proposed project
site.
Protect
environmental
and/or public health
Crime
• Qualitative Analysis
• Empirical Literature
• Stakeholder Input
10
15- Utilize the CPTED (Crime Prevention through
Environmental Design) elements in the Green
Street Project design. For example, the lowest
branches on trees should be taller than 5 feet from
the ground and the tallest bushes/grasses should
be no taller than 3 feet from the ground to allow
for a "window" for onlookers at eye-level.
Protect
environmental
and/or public health
Crime
• GIS-supported Mapping and
Spatial Analysis
• Qualitative Data Analysis
• Empirical Literature
10
16- Increase police presence on the ground (i.e.,
walking or on bicycles) in the area with a focus on
crime "hot spots."
Protect
environmental
and/or public health
Crime
Stakeholder Input
10
17- Incorporate EPA's Smart Growth Principles in
the Green Street Project design. Refer to the
Smart Growth America - Complete Streets in the
Southeast Case Studies for examples.
Promote healthy
living
Access to
Goods, Services,
Greenspace, and
Healthcare
Empirical Literature
18- Coordinate with local active transport groups
(e.g., Atlanta Bicycle Coalition) to ensure that
implementing the project does not impede or
discourage walking or bicycling.
Encourage
coordination /
collaboration
among stakeholders
Access to
Goods, Services,
Greenspace, and
Healthcare
Qualitative Analysis
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Recommendations
Final Recommendations
Intended Purpose Health Benefits Recommendation Supported
By
Score
19- Consider (in the project design) connecting and/or Encourage
expanding walking and cycling paths to reach sustainable
broader bike/pedestrian routes (e.g., PATH development
foundation, Beltline, etc.).
Access to
Goods, Services,
Greenspace, and
Healthcare
Qualitative Analysis
Empirical Literature
Table 46. Short-term HIA Recommendations That Should Be Implemented During Construction
1-
2-
3-
4-
5-
6-
7-
Final Recommendations
Place trees with larger canopies near bus stops or
other areas where people may congregate.
Place plants that are lower to the ground
(especially grasses and bushes) in areas where
vehicles are likely to idle so they can filter
pollutants from vehicle emissions. Taller trees
should be spaced so that vertical mixing of
pollutants is minimized.
Install public benches at local hangouts, bus stops,
areas often populated to provide infrastructure
that supports social interaction.
Develop and incorporate Green Jobs Training for
local residents and community groups
Install bike racks in front of businesses along the
proposed project site.
Ensure that placement or selection of vegetation
does not impede or obstruct visibility of
pedestrians for drivers.
Place low brush/grasses in planter spaces near
residences to block/absorb some of the noise from
the roadway.
Intended Purpose
Protect
environmental
and/or public health
Protect
environmental
and/or public health
Promote healthy
living
Promote healthy
living
Promote healthy
living
Protect
environmental
and/or public health
Protect
environmental
and/or public health
Health Benefits
Climate and
Temperature
Air Quality
Social Capital
Household
Economics
Community
Economics
Traffic Safety
Exposure to
Urban Noise
Recommendation Supported Score
By
• Empirical Literature 1 1
• Stakeholder Input
• Empirical Literature 1 1
• Qualitative Analysis 10
• Empirical Literature
• Quantitative Analysis 10
• Qualitative Analysis
• Stakeholder Input
• Qualitative Analysis 10
• Stakeholder Input
• Empirical Literature 9
• Empirical Literature 9
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Recommendations
Final Recommendations
8- Implement best practices to reduce the amount of
noise or time of noise being generated from
construction.
Intended Purpose Health Benefits Recommendation Supported
By
Score
Protect
environmental
and/or public health
Exposure to
Urban Noise
Empirical Literature
Stakeholder Input
Table 47. Short-term HIA Recommendations That Should Be Implemented After Construction
1-
2-
3-
4-
Final Recommendations
Ensure that routine maintenance and monitoring
plan for green infrastructure elements are
followed as directed.
Utilize multiple strategies to increase the
magnitude of the Green Street Project's impact,
such as community outreach, policy development,
ordinance enforcement.
Have DWM and/or EPA conduct soil and water
quality testing further upstream in the headwaters
of Proctor Creek (starting in this community) and
invite residents to participate in future studies.
Make clear distinction between private and public
space (i.e., define open public areas).
Intended Purpose
Protect
environmental
and/or public health
Protect
environmental
and/or public health
Protect
environmental
and/or public health
and encourage
coordination /
collaboration
among stakeholders
Promote healthy
living
Health Benefits
Water Quality;
Flood
Management;
Access to Goods
and Services,
Greenspace, and
Healthcare;
Crime; and
Social Capital
Water Quality
Water Quality
Social Capital
Recommendation Supported
By
• Qualitative Analysis
• Empirical Literature
• Stakeholder Input
• Quantitative Analysis
• Qualitative Analysis
• GIS-supported mapping
and/or spatial analysis
• Empirical Literature
• Stakeholder Input
• Qualitative Analysis
• Stakeholder Input
• Qualitative Analysis
• Empirical Literature
• Stakeholder Input
Score
10
10
10
9
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Recommendations
5-
6-
7-
Final Recommendations
Coordinate with "Atlanta Streets Alive" to host a
community festival after completion of the
project.
Ensure a "visible change" takes place aesthetically
improves Boone Street along the proposed project
site.
Provide clear signage and way-finding
infrastructure for pedestrians and cyclists (e.g.,
directions to the Beltline, bike zone, share-the-
road, etc.).
Intended Purpose
Encourage
coordination /
collaboration
among stakeholders
Promote healthy
living
Promote healthy
living
Health Benefits
Social Capital
Exposure to
Greenness
Access to Goods,
Services,
Greenspace, and
Healthcare
Recommendation Supported
By
• Qualitative Analysis
• Stakeholder Input
• Empirical Literature
• Qualitative Analysis
• Stakeholder Input
Score
8
8
7
Table 48. Long-term HIA Recommendations That Should Be Implemented In The Next Several Years
Final Recommendations
1- Expand BMPs (green infrastructure) throughout
the community to help maximize pollutant removal
and flow reduction going into storm sewers.
Intended Purpose Health Benefits Recommendation Supported Score
By
Protect
environmental
and/or public health
and encourage
sustainable
development
All
Quantitative Analysis
Qualitative Analysis
GIS-supported mapping
and/or spatial analysis
Empirical Literature
Stakeholder Input
11
2- Encourage the implementation of green
infrastructure to business owners and residents
along the proposed project site (e.g., provide tax
incentives for implementing stormwater BMPs).
Protect
environmental
and/or public health
Community
Economics
Qualitative Analysis
Stakeholder Input
3- Continue to monitor traffic volume to ensure the
road diet does not cause an overburden of traffic
congestion along the street. If problems arise,
coordinate with transportation department to
problem-solve and implement counter measures
(e.g., measures to divert traffic to nearby corridors,
axel restrictions, re-evaluating bus routes, etc.)
Protect
environmental
and/or public health
Traffic Safety
• Quantitative Analysis
• GIS-supported mapping
and/or spatial analysis
• Empirical Literature
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Recommendations
4-
5-
6-
7-
8-
9-
10-
11-
Final Recommendations
Develop a policy, plan, and/or ordinance to
resolve/address the problem of vacant housing.
Include context for advocacy (e.g., community
factsheets/posters/outreach materials) so that
residents and organizations can use the materials
for addressing the community's needs.
Consider local zoning ordinances to reduce fast
food, cash advance, and alcohol establishments.
Consider local tax incentives for development of
healthy establishments (e.g., small business seed
grant).
Cultivate and maintain mechanisms in City policy,
development, and economic decisions and activities
for building trust with the community.
Develop and implement property tax and rent
control ordinances/policies to ensure housing costs
do not increase as a result of revitalization and/or
redevelopment (i.e., gentrification).
Develop and implement policies for new
development to ensure that a % will be dedicated
for mixed income housing and encourage
community economic growth.
Coordinate/collaborate with the Atlanta
Department of Planning and Community
Development for future activities/efforts in the
communities of Proctor Creek.
Intended Purpose
Promote healthy
living
Promote healthy
living and
encourage
coordination /
collaboration
among stakeholders
Promote healthy
living
Promote healthy
living
Encourage
coordination /
collaboration
among stakeholders
Encourage
sustainable
development
Encourage
sustainable
development
Encourage
coordination /
collaboration
among stakeholders
Health Benefits
Social Capital
Social Capital
Community
Economics
Community
Economics
Social Capital
Household
Economics
Household
Economics
Access to
Goods, Services,
Greenspace, and
Healthcare
Recommendation Supported
By
• Quantitative Analysis
• Qualitative Analysis
• GIS-supported mapping
and/or spatial analysis
• Empirical Literature
• Stakeholder Input
• Stakeholder Input
• Qualitative Analysis
• Qualitative Analysis
• Stakeholder Input
• Qualitative Analysis
• Stakeholder Input
• Quantitative Analysis
• Empirical Literature
• Stakeholder Input
• Qualitative Analysis
• Stakeholder Input
• Qualitative Analysis
• Stakeholder Input
Score
8
8
8
8
7
6
6
6
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Recommendations
Final Recommendations
12- Coordinate/collaborate with Fulton County
Department of Health and Wellness (FC-DHW) for
future activity planning.
Intended Purpose Health Benefits Recommendation Supported
By
Score
Encourage
coordination /
collaboration
among stakeholders
Access to
Goods, Services,
Greenspace, and
Healthcare
Qualitative Analysis
13- Develop and implement policies aimed to lower Encourage
resident turnover, such as encouraging more home sustainable
ownership in the community. development
Social Capital
• Quantitative Analysis
• Empirical Literature
• Stakeholder Input
14- Consider whether local zoning ordinances and Encourage
regulations regarding land use (i.e., residential vs. sustainable
commercial, mixed-use, or private vs. public) are development
appropriate to protect the environment and public
health and support economic and social growth.
Access to
Goods, Services,
Greenspace, and
Healthcare
• Qualitative Analysis
• Stakeholder Input
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Reporting
6. Reporting
The overall goal of the reporting step is to develop the HIA report, inform stakeholders on the progress of
the HIA, and communicate HIA findings and recommendations to decision-makers, the population
affected by the decision, and other stakeholders.
6.1. HIA Reporting Activities
Several reporting activities were performed to support this HIA. The HIA Core Project Team were able
to implement the reporting activities, as planned in Chapter 3: Scoping. The regional HIA Project Lead
(Tami Thomas-Burton) served as the primary point of contact between stakeholders and HIA Core Project
Team members. The HIA Core Project Team raised awareness about this HIA within the Agency and
outside the EPA through many avenues. Before each stakeholder engagement meeting, the regional HIA
Project Lead (Tami Thomas-Burton) was required to brief management in the EPA regional office on the
purpose of the meetings, progress of the HIA, and any materials that would be shared outside the Agency.
In addition, the ORD HIA Project Lead (Florence Fulk) also met with ORD management to report on the
HIA's progress and share information about the HIA with fellow colleagues at the EPA. PowerPoint
presentations were prepared for those meetings. In addition, several presentations were given by
members of the HIA Core Project Team to inform the different communities of practice at the CDC,
Proctor Creek Stewardship Council meetings, at the Regional Brownfields Conference meeting (May 15-
17, 2013), and at several national conferences. Progress reports were also provided in EPA Region 4
Environmental Justice weekly newsletter.
Examples of the communications materials and documentation from the stakeholder engagement
meetings can be found in Appendix C. The HIA Core Project Team began using a standardized format
or "brand," for almost all of the HIA communication materials. The use of branding helped increase
recognition and consistency of HIA materials. Before materials were shared outside the team, several
steps were followed. First, the materials were developed and reviewed by the HIA Core Project Team,
including the Technical Editor. Once comments and edits were addressed, HIA materials were sent to the
HIA Project Leads for final approval. Once cleared, the materials were shared with members of the HIA
Advisory Group and general public. In addition to the flyers, factsheets, handouts, and PowerPoint
presentations, members of the HIA Core Project Team developed this HIA report as the final reporting
outputs of the HIA. The document was reviewed by the Technical Editor, EPA ORD Management, and
three external peer-reviewers. A hardcopy of this report was shared with DWM and other stakeholders by
request and uploaded to EPA's HIA website (currently under construction).
Note: The HIA Core Project Team recognized that the HIA report is an extensive document and may not
be easy to manage and/or use for advocacy due to the level of detail provided in the report. Therefore,
the team provided an executive summary of the full HIA report with separate, one-page factsheets for
each health determinant addressed in the HIA. This document was created as a stand-alone document so
community stakeholders could use it for advocacy and/or raising awareness.
Table 49 lists the key reporting activities performed to support this HIA, the date they were performed,
their intended purpose, and the primary target audience.
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Reporting
Table 49. Summary of Key HIA Reporting Activities
Reporting Outlet
1st public, community
meeting flyer
1st public, community
meeting, Atlanta, GA
Summary of the 1st
public, community
meeting
Invitation Letter to
Participate in the HIA
Advisory Group
Proctor Creek Watershed
and Community Profile
Handout
Health Determinants and
Outcomes Handout
Proctor Creek Green
Street Project Overview
1st HIA Advisory Group
meeting, Atlanta, GA
Date
Released
February 20 13
March 22,
2013
Released April,
2013
Released April
2013
Released April
2013
Released April
2013
Released April
2013 (revised
July 20 13)
April 3 0,2013
Purpose
This one-page flyer was developed to inform the public and resident
stakeholders about the upcoming HIA and invite them to participate in
the process by attending the first stakeholder engagement meeting.
The purpose of this meeting was to inform community residents about
the HIA, its intended purpose, and encourage participation in the HIA.
Meeting activities were focused on gathering input on residents'
interest and/or concerns related to their community, opinions about
health, and thoughts on how the quality of life in the community could
be improved. The input from this meeting was used to guide the HIA
scope.
This three-page handout was developed to provide a summary of the
discussions and activities that occurred during the first stakeholder
engagement meeting.
The HIA Project Leads prepared an invitation to key stakeholders that
provided background information about the HIA and invited
interested parties to participate in a major role.
This two-page handout was developed to help inform the HIA
Advisory Group about the conditions in the community study area,
including a profile of the population affected.
This two-page handout provides an overview of factors that affect
health (i.e., determinants of health) and health disparities.
This document summarizes the overall purpose and intent of this HIA.
The factsheet highlighted the conditions within the Proctor Creek
Watershed, a general community profile, green infrastructure basics,
the Boone Boulevard Green Street Project Conceptual Design, the
overarching theoretical pathway diagram, and the value added by and
application of HIA.
The purpose of this meeting was to broadly introduce HIA, the HIA
process, and intended purpose; as well as gain insight from local
businesses and organizations, local government, and federal agencies
on ways to improve the quality of life in the community and what the
HIA should focus on in the assessment. The input from this meeting
was used to guide the HIA scope.
Primary Audience
Public
Community residents
All stakeholders
All stakeholders
HIA Advisory Group
HIA Advisory Group
All stakeholders
HIA Advisory Group
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Reporting
Reporting Outlet
Summary of the 1st HIA
Advisory Group meeting
Released May This five-page handout provided stakeholders with a summary of the
2013 discussions and activities that resulted from the first HIA Advisory
Group meeting. The meeting activities focused on refining the
interests and/or concerns related to the community and what the HIA
should focus on in the assessment.
Primary Audience
All stakeholders
EPA SHC Partners
Webinar titled,
"Integration at
Communities: Health
Impact Assessments and
integrating multiple
sectors into critical
community decisions,"
webinar
June 5, 2013 An HIA Project Leader presented on the HIA in this webinar to
showcase how HIA is being used to address a community issue and its
future direction in EPA. A brief presentation was given that identified
why the community is an environmental justice community of
concern, the issues facing the community, and how the HIA plans to
address these issues.
Federal Partners in
EPA's Sustainable
and Healthy
Communities
Research Program
2nd HIA Advisory Group
meeting, Atlanta, GA
July 23, 2013 The purpose of this meeting was to inform stakeholders of the HIA's
progress and enlist assistance in identifying potential data, sources,
and tools available to address identified data gaps. The HIA Core
Project Team presented the identified data sources, analysis methods,
and preliminary findings.
HIA Advisory Group
Atlanta Federal Executive August 14,
Board Green
Infrastructure
Community of Practice
Meeting and Poster
Presentations, Atlanta,
GA
2013
Members of the HIA Core Project Team presented on this HIA at the
meeting to highlight the collaborative efforts and work performed as
part of the Boone Boulevard Green Street Project HIA. The
presenters also provided background information about why EPA is
using HIA to evaluate a green infrastructure project in Atlanta, GA.
Federal Agencies and
The City of Atlanta
2nd HIA Annual Meeting,
Washington, DC
September 24, This HIA was presented at the National HIA Annual Meeting to
2013 inform the HIA community of practice about the HIA and showcase
the strategies and tools used to support the HIA activities.
HIA Community of
Practice
2nd HIA community March 22,
meeting, Atlanta, GA 2014
The purpose of this meeting was to update the community on the
HIA's progress, report some of the initial findings, and elicit feedback
on how the HIA was progressing and potential data sources to fill data
gaps. The second half of the meeting was dedicated to community
capacity building.
Community residents
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Reporting
Reporting Outlet
Summary of the 2nd
public, community
meeting
HIA Presentation to the
City of Atlanta, GA
EPA ORD Sustainability
Workshop
Presidential Advisory
Group to the National
Prevention Council
Meeting, Washington, DC
Final HIA Advisory
Group and community
stakeholder meeting
International Society of
Exposure Science 2014
Symposium: Turning
Gray to Green: Exploring
the Public Health Benefits
of Green Infrastructure,
Cincinnati, OH
HIA Presentation to the
City of Atlanta DWM
HIA Report
HIA Executive Summary
of Key Findings and
Recommendations1
Date
Released April
2014
April 15,2014
April 16,2014
April 28, 2014
June 5, 2014
October 20 14
April 16, 2015
April 20 15
April 20 15
Purpose
This four-page handout was developed to provide a summary of the
discussions and activities that occurred during the second community
meeting.
The purpose of this meeting was to share with the Atlanta city
government (including DWM) the information presented at the
community meeting and update DWM on the HIA's progress
One of the HIA Project Leads presented on this HIA at EPA's ORD
Sustainability Workshop to highlight the tools used in the HIA that
address Sustainability in an assessment to support a community -level
decision
The HIA Project Lead was asked to present on the HIA at the
Advisory Group meeting. The presented information would be used
to inform the National Prevention Council's recommendations
regarding HIA and its use to protect and promote health.
The purpose of this meeting was to update stakeholders and the
general public on the HIA's purpose and progress; report the findings
and initial recommendations from the HIA activities to the decision-
makers, community, and general public; and elicit feedback from
those groups on the assessment findings and recommendations.
At this symposium, two members of the HIA Project Team presented
on the work performed and the initial findings from the HIA to fellow
environmental scientists and experts in green infrastructure. The
presentation helped further inform the scientific community about the
HIA and its use to evaluate a green infrastructure project.
Members of the HIA Core Project Team presented the final HIA
findings and recommendations, HIA report, and Executive Summary
to the decision-makers.
The final HIA report documents the details of the HIA process,
including the methods used, persons involved, and outputs of the HIA.
The executive summary of the HIA report highlights the main findings
and recommendations of the HIA. As a supplement to the full report,
this factsheet aids in sharing and distributing the results of the HIA.
Primary Audience
All stakeholders
Decision-makers
(DWM and City of
Atlanta)
EPA and
environmental
science community
of practice
National leaders in
public health
All stakeholders
Environmental
science community
of practice
Decision-makers
(DWM and City of
Atlanta)
All stakeholders
All stakeholders
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Reporting
6.2. Stakeholder Input from Reporting Activities
6.2.1. Stakeholder Participation and Input on Assessment Findings
On June 5, 2014, the HIA Core Project Team presented the HIA findings and initial recommendations to
the stakeholders. Meeting attendees included members of the HIA Core Project Team, HIA Advisory
Group, Community residents, and the decision-makers. The meeting agenda and presentation materials
are provided in Appendix C under Documentation of the Final Stakeholder Engagement Meeting, June 5,
2014). A short PowerPoint presentation was given at the beginning of the meeting, which provided an
overview of the HIA process for new participants, what had been done for this HIA, and a short profile of
the existing population in the community. Next, stakeholders were asked to visit each of the posters
staged around the room, which contained specific information about each of the health determinants
appraised. A member of the HIA Core Project Team stood at each of the posters to answer questions and
facilitate discussions about the predicted impacts of the proposed project on that health determinant. The
poster presentation strategy allowed for a more individualized discussion about the assessment performed
and provided direct access for stakeholders to those who performed the assessment. After the poster
presentation was completed, the HIA Core Project Team solicited feedback and comments from
stakeholders about the assessment and findings presented.
Stakeholders were asked to respond to the following prompt questions:
• What are your thoughts on the findings? Did anything "stand out" to you?
• Was there anything that was presented today that you had not seen/heard before?
• Do you agree with what was observed or what the findings showed?
• Do you have any concerns/issues with what was presented?
The HIA Core Project Team discussed each of the stakeholder responses from the final stakeholder
meeting. There were several recommendations that received strong support from both residents and non-
residents. However, the team noted several differences in priorities between those stakeholders who were
residents in the study area and those who were not residents. Overall, stakeholders strongly supported the
recommendation to expand the size of the proposed project as well as look for other opportunities to
implement green infrastructure throughout the watershed. The recommendations that were able to gain
the most support from residents and other stakeholders included those that asked for more advocacy
support, more policing and enforcement of civil ordinances, and more opportunities for employment and
job training. Table 50 documents the specific comments from stakeholders at the final stakeholder
meeting and responses from the HAI Core Project Team.
Table 50. List of Stakeholder Comments to Assessment Findings
Stakeholder Comments
Stakeholders supported HIA's
consideration to look at impact of trees
(root zone) on water flow/percolation
and maintenance of bioswales.
Responses from HIA Core Project Team
No response needed.
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Stakeholder Comments
BMPs should be defined in the
(findings) posters (i.e., what does BMP
stand for?).
Responses from HIA Core Project Team
The HIA Core Project Team went through the report and
supplemental communication materials (i.e., posters,
factsheets, and handouts) to make sure all acronyms were
explicitly defined to prevent any unnecessary confusion.
Investigators should consider the
impacts of the pilot/demonstration
project on a large scale (i.e., if the
project was expanded). For example,
what would happen if we replicate
green infrastructure projects
throughout the whole watershed?
The Core Project Team supported this suggestion and the
HIA Project Leads began building support among Agency
management and partners to expand the HIA discussion to
the broader geographic scope. The HIA Project Leads
were able to identify a proposed decision and secure
support in developing a second (expanded) HIA in the
Proctor Creek Watershed that would evaluate the process
of siting green infrastructure projects in the (proposed)
Proctor Creek Environmental District.
Investigators could have identified
more opportunities for stormwater
runoff and flood prevention in the
community (e.g., Super Giant
Community Garden parking lot). The
HIA could look at the first teaching
gardens in the U.S. for low-income
neighborhoods.
The purpose of this HIA was to inform the
implementation of the proposed Green Street Project
along Boone Street. The HIA Core Project Team does
want to recognize the opportunity to expand this
discussion to other areas in the watershed and work has
begun to develop a second (expanded) HIA in Proctor
Creek Watershed.
Residents have observed a foul, sewage-
like smell coming from the Proctor
Creek/North Avenue combined sewer
outflow. Residents want the smell
addressed and removed.
A foul, sewage-like smell from the outflow is both a water
quality concern and nuisance for residents. This
information was incorporated into the observations under
Chapter 5: Assessment. This stakeholder-identified
recommendation received support from other
stakeholders, which indicates that this issue should be a
priority for DWM. The recommendation was added to the
final list of recommendations and ranked.
The proposed Super Giant Food (sited
on Moreland Avenue) will have a
community meeting room available to
the public once renovations are done.
Moreland Avenue is outside this HIA study area, but the
information provided will be transferred to the second
(expanded) HIA in the Proctor Creek Watershed.
Several stakeholders pointed out that
the HIA lacked a mapping of the
community's assets. One person at the
stakeholder meeting announced that
the Healing Community Health Center
(at 2600 Martin Luther King by
Hamilton Holmes Dr.) is now a
federally-qualified health center.
Researchers should inventory existing
measures that address crime through
asset mapping.
The HIA Core Project Team recognized this missed
opportunity and revisited the section. The team gathered
data on existing community centers, schools, and other
assets in the community that provides opportunity to build
social capital. The assets were mapped using Arc-GIS
and verified in Google Maps©. The added information
yielded a more informed discussion related to social
capital in the study area. The health center mentioned
(left) was well-outside the HIA study area, but the
information provided will be transferred to the second
(expanded) HIA in the Proctor Creek Watershed.
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Stakeholder Comments
The assessment needed to consider the
difference between subjective
(perceived) safety versus objective
(police recorded measures) safety and
the residual factors of crime (i.e. fear,
lack of policing) in the project area.
Responses from HIA Core Project Team
The HIA Core Project Team went back through the
assessment on crime (perceived and actual) to ensure the
literature review findings were explicit when referring to
perceived versus actual safety and/or security.
Furthermore, the HIA Core Project Team used GIS-
supported modeling to map the crime data, provided by
the Atlanta Police Department. This new information was
added to the discussion in Chapter 4: Assessment under
the health determinant— crime.
Researchers need to be cautious about
relevance of relationships, such as the
connection between green
infrastructure and access to healthcare
- neither one affects the other.
The HIA Core Project Team revisited the discussion
regarding access to goods and services, greenspace, and
healthcare. The nature of the relationship was made more
explicit. For example, the proposed project is expected to
remove barriers to accessibility, such as improving traffic
safety, reducing surface temperatures, providing shaded
relief along the proposed project site, and supporting
healthy behaviors. Although these improvements are not
directly linked to healthcare, accessibility is one of the
many factors that influence healthcare use.
Investigators need to keep in mind size
of project and that it is a demonstration
project, because of the potential for
cumulative impact. There was not
enough discussion on the estimated
impacts of the project. Researchers
needed to recognize that this is a
demonstration project and that values
(both qualitative and quantitative)
would better support community and
agency decision-making.
The HIA Core Project Team recognized and agreed that
the small size of the project limited the project's
magnitude of impact. The team revisited the
characterization of each impact and ensured the
characterization reflected this limitation. However, the
recommendation to expand the use of green infrastructure
and/or replicate the proposed project elsewhere in the
watershed still stands due to the potential for stakeholders
to benefit from the cumulative nature of the impacts, as
suggested in the stakeholder's comment (left).
There was not enough recognition for
solid waste and tires as a problem for
the community and whether they
should be reduced or prevented.
The HIA Core Project Team recognized and agreed that
the illegal dumping activities was a substantial concern in
this community and a contributing factor to the water
quality in the area (albeit an unknown magnitude of
contribution). This issue is discussed in the introduction,
scoping, and assessment chapters of the report. The
recommendation (identified by the HIA Core Project
Team) to "increase law enforcement of nuisance laws in
regards to abandoned properties, illegal dumping, and
property maintenance" was ranked the first item to be
adopted and/or implemented by the City.
More research is needed on impacts of
greenness (percent) and access to goods
and services.
The HIA Core Project Team recognized the limited
evidence available to directly attribute health status to
greenness, although there are many studies that indicate a
relationship exists. Investigating these relationships
further could add great value to the field of environmental
research and public health. Thus, members of the HIA
Core Project Team committed to investigating these
relationships further after the completion of the HIA.
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Stakeholder Comments
The HIA could include more
context/background that could be used
by the community to advocate for more
efforts to address issues.
Prompt question for researchers: What
can we do to build the capacity for self-
determination for communities and
organizations?
Responses from HIA Core Project Team
The HIA Core Project Team recognized that the posters
prepared at the meeting did not provide the necessary
detail to portray the conditions in the community required
to advocate for needs effectively. The posters were
provided to give stakeholders at the meeting a summary of
the key findings from the HIA so that feedback on the
findings and recommendations could be provided. The
full HIA report would be used to fulfill this need by
providing more details about the conditions in the study
area, history of the community, and stakeholder needs.
The team also recognized that the report may be more
extensive in some places than what was needed for
advocacy. Thus, the team resolved to provide an
executive summary of the HIA report, including the main
findings and recommendations, that was appropriate in
length and detail for community groups to advocate for
their needs.
6.2.2. Stakeholder Participation and Input on HIA Recommendations
The core recommendations were presented to the stakeholders by poster presentation at the meeting on
June 5, 2014. Nine posters, discussing 1-2 health determinants each, were posted on the walls around the
meeting room with a member of the HIA Core Project Team at each poster to facilitate discussion and
answer questions. The stakeholders were asked to consider three questions while reviewing each poster:
• Do you agree with the recommendations made?
• Do you think the recommendations are feasible?
• Is there anything we may have missed or did not include in the recommendations presented that
should be included?
Stakeholders were then asked to place their comments and additional recommendations on a sticky note
and post it to the related health determinant. There were two reoccurring themes in the stakeholder-
identified recommendations, which were to a) keep the community engaged in the planning,
implementation, and monitoring phases of the project; and b) to help support community advocacy in
addressing the community's needs. After the meeting, the posters were documented and summarized.
Table 51 lists specific responses from stakeholders regarding the recommendations.
Table 51. List of Stakeholder Comments to the Initial HIA Recommendations
Stakeholder Comments
Stakeholders supported the repaying of the
street and restriping the road to include a
designated bike lane so the road is safer for
cyclists, as well as using permeable pavement
to treat stormwater runoff.
Responses from HIA Core Project Team
No response needed.
Recommendations or proposed changes need
to take into account community-specific
The HIA Core Project Team revisited the
recommendations proposed to ensure they were
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Stakeholder Comments
context, because changing something may not
necessarily make situations better.
Responses from HIA Core Project Team
appropriate for the community. Caveats were
provided, where appropriate, to ensure possible
negative consequences were avoided and/or
mitigated.
Researchers should include Westin Heights
and Bankhead neighborhoods in
recommendations.
The areas identified in this comment were outside
the study area for this HIA, and thus were not
included in the assessment nor recommendations.
However, The HIA Core Project Team resolved to
ensure the second (expanded) HIA in Proctor
Creek included these areas in considerations.
One stakeholder recommended that the HIA
involve or connect with local schools to have
kids involved in the monitoring and
evaluation plan.
The HIA Core Research Team agreed with this
suggestion and resolved to incorporate this
recommendation into the monitoring plan.
The Arthur Blank Foundation and the Emory
Health Initiative could be solicited as potential
resources for assessing/monitoring impacts
after the project has been implemented. It
would be great to use/publish data from the
results of the Green Street Project to establish
the effects it had immediately after
completion, 1 year after completion, 5 years
after completion, etc.
The HIA Core Research Team agreed with this
suggestion and resolved to incorporate this
recommendation into the monitoring plan.
The monitoring (plan) should include
monitoring impacts of street diet on traffic
noise (e.g., loud cars, music boxes, etc.) and
(local) air quality.
The HIA Core Research Team agreed with this
suggestion and resolved to incorporate this
recommendation into the monitoring plan.
Stakeholders were asked to vote on the recommendations they supported using red dot stickers.
Residents in the community were given red dots with an asterisk (*). The HIA Core Project Team asked
each stakeholder to review the recommendations posted for each of the health determinants and cast their
votes (using the stickers given) for the recommendations they deemed as their highest priority. The
purpose of this exercise was simply to identify which recommendations were of high importance to the
stakeholders, especially those who lived in the community. Three stakeholder-identified
recommendations received a high number of votes from stakeholders. Those three items were added to
the final list of HIA recommendations.
Note: The team assumed that each stakeholder who attended the meeting also participated in the voting.
It was not documented whether each person used all of their votes or whether they voted more than once
on a particular recommendation.
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Monitoring and Evaluation
7. Monitoring and Evaluation
After the HIA is completed, several follow-up activities should occur. The design and implementation of
the HIA should be evaluated (i.e., perform a process evaluation). There should be a follow-up on the
result of the decision to determine whether the HIA influenced the decision-making process and/or final
decision (i.e., perform an impact evaluation). To some extent, the effect(s) of the final decision on health
and/or determinants of health should be included in the follow-up activities (i.e., perform monitoring to
inform an outcome evaluation).
7.1. Monitoring, Impact and Outcome Evaluation
Monitoring is an important follow-up activity to the HIA process and is performed after the HIA findings
and recommendations have been reported. If monitoring is not included in the original HIA work plan,
the HIA project team should provide a plan for monitoring the decision and health impact after the HIA is
completed. There are two main aspects of monitoring after the HIA— one of which is to follow up on the
decision and/or decision-making process, the other involves following up on the health impacts predicted
in the HIA. These follow-up activities inform whether the HIA influenced the decision-making process
and/or final decision (i.e., informs the impact evaluation) and whether the effect of the final decision on
health (i.e., informs the outcome evaluation).
7.1.1. Monitoring the Impact(s) of the HIA
The HIA Core Project Team identified several questions that would inform stakeholders whether the HIA
influenced the decision-making process and/or final decision (i.e., inform an impact evaluation):
• Was the proposed Green Street Project implemented as outlined in the conceptual design or were
there changes made? If so, what were the specific changes and why were they made?
• Did DWM adopt and implement each of the recommendations from the HIA? If not, was there
rationale provided for why the recommendations(s) were not adopted?
• Has there been any change to the policies of developing and/or implementing green infrastructure
or other community-based projects by the City of Atlanta?
• Does DWM accredit the HIA with
Each of these questions can be answered in a short survey or by interview of a representative from the
DWM after the project has been implemented. The questions and responses should be documented in a
one-page factsheet or flyer and provided, at minimum, to the list of stakeholders that participated in this
HIA, as well as made publically available. If DWM does not implement the proposed project at all, then
they should provide a factsheet and/or flyer to the public explaining why this was the final decision and
whether information from the HIA was used to make this decision.
7.1.2. Monitoring the Impact(s) of the Decision
Monitoring health impacts is not typically done as a part of the HIA, since the HIA is completed to
inform the decision and monitoring changes in health outcomes and/or health determinants is a time-
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Monitoring and Evaluation
intensive process. It may take years before changes to health are actually observed and reported.
Furthermore, it is difficult to attribute a change in health to any specific decision, simply because a
person's health is affected by various factors that may or may not have been assessed as part of this HIA.
Since the timeframe of this HIA was limited to a year, the HIA Core Project Team provides a plan for
monitoring changes to health and/or determinants of health that result from the decision (i.e., inform an
outcome evaluation).
Note: If one or more of the health determinants and/or health outcomes are found to be too impractical to
monitor, a proximate health determinant should be considered as a substitute. For example, waterborne
illness can be difficult to diagnose and monitor, given that most illness is treated with over-the-counter
medications. A more practical and highly recommended option is monitoring water quality, which is
already performed by the City of Atlanta, State of Georgia, and EPA.
Monitoring activities are often determined by the amount of resources available, but should be performed
in interval periods (e.g., every 6 months, every year, every other year, etc.) after the proposed project it
completed in its entirety. Utilizing members from the community (i.e., citizen-participatory research) in
follow-up activities allows for limited resources to be used more efficiently, improves specificity by
targeting specific areas of concern, accelerates early detection of pollution and remediation actions,
increases community-buy-in for environmental improvement efforts, and increases community outreach
and capacity building. One example includes the routine monitoring performed by the Upper Oconee
Watershed Network, which monitors water quality northeast of Atlanta, near Athens (Little, et al. 2007).
There are many chronic diseases or cause-specific health outcomes monitored at the county and state
levels by the GA—DPH surveillance program. There is an opportunity for partnerships between the City
of Atlanta, Fulton County Department of Health and Wellness, and local/regional 501(c)(3) hospitals15 to
conduct periodic community health needs assessments (CHNA) in the community. CHNAs incorporate
individual characteristics with community characteristics, including strengths and needs, to investigate the
health status of a community and identify intervention opportunities aimed at improving public health.
CHNAs are generally performed at the regional or metropolitan statistical area; however, a neighborhood
or community level assessment could be incorporated into a larger CHNA dataset.
Regardless of methods or tools used in follow-up activities, the HIA Core Project Team stresses the
importance of collaboration between stakeholders to perform monitoring. For this reason, the HIA Core
Project Team prepared list of outcomes that should be monitored after the final decision is made and
identified potential partners for carrying out those activities (Table 52).
Note: The purpose of this exercise is to provide a more focused approach for stakeholder collaboration in
future monitoring efforts. The HIA Core Project Team did not account for feasibility (i. e., cost, personnel
available, timing, etc.) in the proposed monitoring plan because the entities performing the monitoring
were not yet identified. The HIA Core Project Team did identify potential partners for monitoring
outcomes so that stakeholders could initiate conversations regarding follow-up activities.
15 New requirements under the Affordable Care Act (passing in 2010) state that in order for 501(c)(3) hospital
organizations to keep their tax-exempt status, they must perform a CHNA, publically report the findings, and adopt
an implementation strategy to address identified needs at least once every three years.
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Table 52. Proposed Plan for Monitoring Health Impacts Post-decision
Determinant of
Health
Water Quality
Potential Indicators
Fecal coliform and/or E. coli
(cfu/lOOmL) in effluent from
Proctor Creek/North Avenue
combined sewer outflow
Nitrate nitrogen (NO3N; mg/L)
Total kjeldahl nitrogen (TKN;
,g/L), Total Phosphorous (TP;
mg/L), Total Suspended Solids
(TSS; mg/L), Biochemical
Oxygen Demand (BOD; mg/L),
Copper (Cu; ug/L), Lead (Pb;
ug/L), Zinc (Zn; ug/L) and
oil/grease (mg/L) in effluent
from bioretention cells along
Boone Street
Number and location of illegal
dump sites (for waste and/or
tires)
Number and location of code
issues
Potential Data Sources
GA—EPD Water Quality Monitoring Reports
and/or data
City of Atlanta DWM
EPA Region 4 Water Protection Division
and/or RCRA Program
FC—DHW Environmental Health Services
Division Community- Based Clean-up surveys
City of Atlanta Strategic Community
Investment (SCI) Report data and City of
Atlanta 2013 Tax Digest (use GIS mapping)
Potential Partners
• GA-EPD
• DWM
• EPA Region 4 Water Protection
Division and/or RCRA
Program
• FC-DHW
• City of Atlanta Department of
Planning and Community
Development
• Community residents (use
NPUs)
• Academia (e.g., Emory
University, Spelman
University, Georgia Institute of
Technology, Georgia State
University, Kennesaw State
University Department of
Geography and Anthropology)
• West Atlanta Watershed
Alliance
• Chattahoochee Riverkeeper
• Environmental Planning and
Historic Preservation
Association
Flood Management
Topographic Wetness Index
(TWI)
Number and location of vacant
and/or derelict properties
Storm flow (cm/wk) and Peak
Discharge (m3/L) of effluent
from the bioretention cells
along Boone Street
EPA Region 4 Water Protection Division
and/or RCRA Program (use GIS mapping)
City of Atlanta SCI Report data and City of
Atlanta 2013 Tax Digest (use GIS mapping)
City of Atlanta DWM
EPA Region 4 Water Protection
Division and/or RCRA
Program
City of Atlanta Department of
Planning and Community
Development
City of Atlanta DWM
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Determinant of
Health
Potential Indicators
Potential Data Sources
Potential Partners
• Community residents (use
NPUs)
• Academia
Climate and • Land surface temperature
Temperature during summer months
• Infrared imaging of impervious
surface area
• Earth Explorer Landsat data (cloud free
images)
• Landsat Thermal Remote Sensing (TRS) Tools
for ArcGIS Desktop
EPA Region 4 GIS Specialists
Academia
Air Quality
1 meter, 4-band, leaf-on
imagery from National
Agriculture Imagery Program
(NAIP)
Number and classification of
tree species along corridor
ArcMap 10.0 Classification Toolbar
City of Atlanta Tree Planting List
EPA Region 4 GIS Specialist
U.S. DA Farm Service Agency
City of Atlanta Office of
Buildings Arborist Division
Traffic Safety • AADT
• Traffic Crashes along Boone
Street (Zone 1)
Georgia State Traffic and Report Statistics
(STARS) Traffic Counter #5679, Fulton
County, Boone Street at Elm Street, County
Code #121, non-directional
Atlanta Police Department Beat 102 and 103
• GA- DOT
• City of Atlanta Police
Department
• Atlanta Bicycle Coalition
Exposure to
Greenness
1 meter, 4-band, leaf-on
imagery from National
Agriculture Imagery Program
(NAIP)
Resident-reported mental and
behavior health concerns
• ArcMap 10.0 Classification Toolbar
• CHNA survey tool
EPA Region 4 GIS Specialist
U.S. DA Farm Service Agency
City of Atlanta
FC-DHW
Local/regional 501(c)(3)
hospital(s)
Community residents (use
NPUs)
Academia
Exposure to Urban
Noise
Measured and/or modeled (day
and night) ambient average
noise levels from traffic
Resident-reported annoyance
and/or sleep disturbance from
urban noise
• Sound level (decibel) meter
• CHNA survey tool
• Academia
• FC- DHW
• Community residents (use
NPUs)
• Academia
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Determinant of
Health
Access to Goods
and Services
Potential Indicators
• Average Commute
• Walkability (walk score)
• Bike-ability (bike score)
• Transit score
Potential Data Sources
• City of Atlanta SCI Neighborhood Investment
Area Wave
• www.walkscore.com (2013 Walk Score®)
• Walkability survey tool
Potential Partners
• FC- DHW
• Community residents (use
NPUs)
• Academia
• Atlanta Bicycle Coalition
• Atlanta Beltline, Inc.
• Community Improvement
Association
Crime
• Number, location, and type of
crime incidences
• Resident-reported perceived
safety and/or security in home
and in neighborhood
• City of Atlanta Police Department Beat 102
and 103 Yearly Crime Count
• City of Atlanta SCI Neighborhood Investment
Area Wave
• CHNA survey tool
• City of Atlanta Police
Department
• City of Atlanta Department of
Planning and Community
Development
• FC- DHW
• Community residents (use
NPUs)
• Local/regional 501 (c)(3)
hospital(s)
• Academia
• Community Improvement
Association
Social Capital
Number and location of public
benches, bike racks, and
covered-bus stops
Population growth and density
Educational attainment
(population over 25 years)
Number and location of
community assets
Window (windshield) survey tool
CHNA survey tool
City of Atlanta SCI Report data
U.S. Census Bureau
GIS-based asset mapping
FC-DHW
City of Atlanta Department of
Planning and Community
Development
Community residents (use
NPUs)
Local/regional 501(c)(3)
hospital(s)
Invest Atlanta
Georgia Trust for Public Lands
Community Improvement
Association
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Determinant of
Health
Potential Indicators
Potential Data Sources
Potential Partners
• Academia
Household
Economics
Employment rate
Households living below
federal poverty level
Annual household income
Monthly housing costs (renter
and home-owner)
Number of cost -burdened
households (paying more than
30% of annual income on
monthly housing costs)
Mean and median residential
properties values
Location affordability index
• U.S. Census Bureau
• City of Atlanta Tax Digest
• ArcGIS mapping (parcels located every 500
feet from the project site)
• HUD location affordability index
(http://www.locationaffordability.info/lai.aspx)
HUD-Atlanta Regional Office
Atlanta Department of Planning
and Community Development
Community
Economics
Retail Access
Curb Appeal
Real Estate Transaction Value
Mean and median non-
residential properties values
• City of Atlanta SCI Neighborhood Investment
Area Wave
• City of Atlanta Tax Digest
• ArcGIS mapping (parcels located every 500
feet from the project site)
• HUD-Atlanta Regional Office
• Atlanta Department of Planning
and Community Development
• Invest Atlanta
• Georgia Trust for Public Lands
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7.2. Process Evaluation - Evaluating the HIA Design and Implementation
After the HIA was completed, the HIA Core Project Team evaluated the ability of the HIA to meet its
stated goals and the Minimum Elements, and Practice Standards of HIA (North American HIA Practice
Standards Working Group 2010). Evaluating the design and execution of the HIA results in valuable
information that can be used to help refine methods and approaches used in HIA and advance the HIA
community of practice. Early in the HIA process, the HIA Core Project Team developed a plan for
evaluating the HIA, which included an Agency administrative review, and an external peer-review by
three HIA practitioners. In addition, the HIA Core Project Team identified successes, challenges, and
lessons learned.
7.2.1. HIA Goals Achieved
At the completion of this HIA, the HIA Core Project Team reviewed the original goals established in the
Scoping step and evaluated whether those goals were achieved or not achieved. The results of this
evaluation are documented in Table 53.
Table 53. Evaluation of HIA Goal Achievement
HIA Goal
Add a vehicle for equitable
inclusion of all
stakeholders in the
decision-making process.
Achieved?
Yes
Documentation
The HIA Core Project Team strongly agree that this goal
was achieved. EPA was able to solicit participation in
the HIA from a broad perspective of stakeholders groups,
including representatives from the community, decision-
makers, business investors, universities, national and
state government agencies, and non-government
organizations. In addition, the input provided by the
stakeholders was incorporated into the HIA findings and
recommendations and presented to the decision-makers
for consideration.
Assess the effectiveness of
the proposed green
infrastructure project and
raise awareness of the
environmental, economic,
and societal impacts of
implementing green
infrastructure in the
designated community.
Yes
The HIA Core Project Team judged this goal achieved
because the assessment was able to evaluate the
effectiveness of the proposed project to improve
stormwater qualtiy and flood management. Those
impacts are described in the report. Furthermore, the
HIA Core Project Team was able to assess the proposed
project for its potential to effect other environmental,
social, and economic factors that affect health and
reported the main findings to the stakeholders via poster
presentation, PowerPoint presentation, and in the HIA
report and separate Executive Summary.
Provide recommendations
for implementing the
proposed project that
incorporate approaches to
stormwater management,
ecosystem restoration, and
community revitalization.
Yes
The HIA final recommendations presented to decision-
makers integrated aspects to protect environmental and
public health, promote healthy living, encourage
stakeholder collaboration and/or coordination, and
encourage sustainable development. Furthermore, short-
term recommendations focused on strategies DWM could
implement that would maximize potential benefits and
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HIA Goal
Achieved?
Documentation
minimize and/or avoid potential adverse effects from
implementing the proposed project.
Increase transparency,
local accountability,
community empowerment,
and ownership of the
proposed plan through
meaningful stakeholder
engagement.
Yes
Through the HIA process, EPA was able to raise
awareness of the proposed project among the different
stakeholder groups and engaged those stakeholders in
each step of the process, in addition to serving as
members of the HIA Core Project Team. The HIA Core
Project Team engaged documented the activities in the
HIA report and communication materials to ensure
transparency. Furthermore, the HIA Core Project Team
hosted an HIA training workshop (on May 23, 2013) and
capacity building workshop (on March 22, 2014) for
local residents and organizations.
7.2.2. Successes Identified by the HIA Core Project Team
The HIA Core Project Team identified successes experienced in carrying out this HIA. Those successes
are provided below.
• Branding materials helped to increase recognition of materials coming from the HIA and created a
unified format that expedited material production.
• Reviewing previous HIA Reports and practice guidelines helped in the development of this HIA and
in ensuring that the HIA achieved the Minimum Elements and Practice Standards.
• EPA and GHPC held a full-day HIA training workshop at the beginning of the HIA process for
stakeholders. This training helped to provide more background on the HIA process and further
acquaint stakeholders with HIA, since the process is unique and different from other commonly used
impact assessments.
• As a federal Agency, EPA might appear to be removed from the community in which the assessment
occurred. Having the HIA co-led by the EPA regional office, with team members from or familiar
with the community, helped to alleviate this challenge.
• Hosting public meetings in the community and at the federal building near the community helped to
ensure accessibility for community residents and other stakeholders to become engaged in the HIA
process.
• This HIA used a single person as the gatekeeper for sharing information between groups. This
strategy helped streamline the sharing of information and the recognition of materials coming from
the HIA. Furthermore, this strategy provided a clear point of contact for community-based groups
and other stakeholders.
• Stakeholder engagement in this HIA had participation from many community-based organizations, as
well as several community residents. Each HIA Advisory Group meeting had a diverse group of
stakeholders and representatives from both the community and the decision-makers at the table.
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7.2.3. Challenges Identified by the HIA Core Project Team
The HIA Core Project Team identified challenges faced during this HIA. The HIA Core Project Team
utilized several strategies to counteract unanticipated challenges. Those challenges are provided below.
• Overall, the nature of being a federally led HIA posed some unique challenges regarding expectations
about the assessment and its intended purpose. One expectation was that EPA would perform a
scientific evaluation of the proposed project. Although the HIA process uses science-based methods,
it is not a scientific process. In other words, HIA is a pragmatic exercise that involves using the best
available evidence with varying levels of uncertainty and assumptions. The HIA Core Project Team
used multiple strategies to manage expectations, such as providing an HIA training workshop,
holding one-on-one meetings with individuals functioning under a misconception, and explicitly
defining the purpose, scope, and limitations of the HIA for each stakeholder engagement activity.
• As a federally led HIA, the HIA Core Project Team proactively avoid the misconception that
recommendations from the HIA would have a regulatory component. Although EPA led the HIA, the
HIA Core Project Team that included members outside the Agency developed the recommendations.
The HIA Core Project Team made it very explicit that the recommendations coming from the HIA
were given as guidance. Recommendations were developed under the assumption that they could be
adopted or not adopted at the discretion of the decision-makers (i.e., DWM and the City of Atlanta).
The recommendations and proposed monitoring plan are not intended in any way to proceed in a
regulatory manner and were posed only as a suggestion for future action.
• A reoccurring challenge in the HIA was the misconception about what was involved in the process
and how to differentiate HIA from other impact assessments (e.g., environmental impact assessment,
community health needs assessment, community needs assessment, impact assessment, etc.). Several
of the stakeholders and members of the HIA Core Project Team and HIA Advisory Group were
familiar with and had practiced other forms of impact assessment. This often led to preconceived
ideas about what the HIA process should entail. The HIA Core Project Team addressed this issue by
co-hosting an HIA Training Workshop with the HIA Advisor from the Georgia Health Policy Center
at the EPA Region 4 Office, in addition to a brief 3-5 PowerPoint presentation about the HIA process,
including a question and answer session, preceding each stakeholder engagement activity.
• An unforeseen obstacle in the planning of this HIA was the actions of Congress that led to
sequestration and a 16-day shutdown of the federal government. Sequestration is the action of taking
legal possession of assets until a debt or claims have been met. In the case of the U.S. government,
this meant budget cuts across the different branches of government, including programs and agencies
that are managed through yearly appropriations. The sequestration resulted in periodic mandatory
leave of absence for EPA staff and its federal contractors, causing temporary arrest of HIA work. In
addition, the federal government shutdown on October 1, 2013 resulted in a mandatory leave from
work that lasted sixteen days. Furthermore, scheduling conflicts among the HIA Core Project Team
and between the HIA Core Project Team and other stakeholder groups was one of the most common
causes of delay in the HIA timeline. Inevitably, these actions resulted in a shifting of the HIA
timeline from its original expected completion date (end of October 2013) to its current date of
completion (April 2015). Throughout the process, the HIA Core Project Team kept in close contact
with community leaders and decision-makers to ensure the change in timeline would not render the
HIA irrelevant or its information unusable.
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7.2.4. Lessons Learned Identified by the HIA Core Project Team
Based on the success and challenges experienced during this HIA, the HIA Core Project Team offers the
following list of lessons learned for future HIA practice.
• Consider commitment requirements (e.g., time, personnel, funding, etc.) for both stakeholders and
those performing the HIA. One of the EPA contractors that worked on this project from the scoping
step to the completion of the HIA reported 1,455 hours dedicated to this HIA, which equates to
approximately 182 days or six months of full-time work (i.e., 8 hours per day, 40 hours per week). It
should be noted that this HIA was only one of many projects in which the members of the HIA Core
Project Team were involved. As such, scheduling conflicts was one of the most common causes of
delay in the HIA timeline. Thus, future HIA project managers need to account for the amount of time
participants can commit to the HIA when establishing the HIA project team. Furthermore, there
needs to be different levels of participation intensity in the HIA for stakeholders who have limited
and/or varying levels of resources, but want to participate.
• Incorporate reporting and evaluation aspects of HIA early on in the process (i.e., as early as
screening) to ensure documentation of the process is thorough and to avoid too much time lapse
between the completion of the HIA and reporting to stakeholders.
• Develop the HIA timeline to allow extra time for potential unexpected delays, scheduling conflicts, or
other unexpected complications that may arise during implementation of the HIA.
• The HIA team needs to continue vigilant communications with stakeholders and decision-makers
throughout the process to avoid unmet expectations and scheduling conflicts.
• Develop a core team of individuals responsible for performing the HIA that have multiple skills and
expertise so that the various tasks in the HIA process can be accomplished. Table 54 provides
examples of the various roles and skills that are valuable in the HIA process.
Table 54. Valuable Roles and Skills in the HIA Process
Roles
Community
Liaison
Public Health
Researcher
Project
Leader
HIA Technical
Advisor
Researcher(s)
Writer/Editor
Skills Needed
Team member with knowledge of the community, that has access to the community
social and formal networks (e.g., community leader, historian, member of a
community representative organization, long-time resident)
Team member with knowledge of basic public health principles and mediating
factors that influence health (e.g., public health professional, physician, health
educator)
Team member who is well versed and has experience managing teams with multiple
skills/fields of expertise; leading meetings and discussions; organizing action items;
and establishing project goals, frameworks, timelines and communication plans.
Team member or advisor who has extensive knowledge and experience conducting
and evaluating HIAs, including best practices and lessons learned (e.g.,
representative from HIP, GHPC, OPHI, and UCLA-HIA program)
Team member(s) with experience planning and conducting research who can
perform literature reviews, risk assessments, and develop and test research
questions/hypotheses (e.g., epidemiologist, community health researcher, etc.).
Team member with experience writing and editing scientific papers and producing
reports and materials for different agencies.
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Roles Skills Needed
Field Member(s) with experience and knowledge about the specific fields of interest in the
Expert(s) HIA (e.g., housing, transportation, watershed management, ecology, engineering or
architecture, public and community health, etc.). These individuals typically serve
on the HIA project team and/or an advisory committee.
7.2.5. External Peer-Review of HIA
This HIA Report underwent a review by HIA practitioners external to the HIA effort (i.e., external peer-
reviewers) who could provide an experienced perspective outside of those directly involved in the process
and/or the decision. The external peer-reviewers were charged with evaluating the HIA against the HIA
Minimum Elements and Practice Standards (North American HIA Practice Standards Working Group
2010). Blind invitations were sent through a third party to potential reviewers, inviting them to provide a
critical review of this HIA. Three practitioners agreed to provide a critical review and were provided
monetary compensation for their time and effort. The three reviewers included Mandy Green, Kitty
Richards, and Jonathan Heller.
Mandy Green is the Founder and Principal at Green Health Consulting, LLC in Portland, Oregon. Ms.
Green is a public health professional and environmental epidemiologist with 10 years of experience at
state and local government agencies and in non-profit organizations, in addition to being a founding
member of the Northwest HIA Network. Kitty Richards is a Program Manager at Bernalillo County
Environmental Health Department in New Mexico and a member of the New Mexico Environmental Law
Center Board of Directors. Ms. Richards has expertise in educating and informing the public about
environmental health issues and over 15 years of work in public health with an emphasis on impacts of
land use development on community health. Johnathan Heller is the co-Director and co-Founder of
Human Impact Partners, one of the organizations leading HIA practice in the U.S. Mr. Heller has worked
on over a dozen HIAs, conducted many HIA trainings, and has mentored others on how to conduct HIAs.
Mr. Heller currently serves as the Chair of the Provisional Steering Committee for the newly formed
Society of Practitioners of Health Impact Assessment (SOPHIA) and as Chair of the Board of the Center
for Community Change.
The external peer-reviewers provided comments that fell into four major categories: general, editorial,
HIA process, HIA documentation, and stakeholder participation. The HIA Core Project Team responded
to each of the reviewer comments and proposed revisions, as appropriate (refer to Appendix E
for the specific comments from the external peer-reviewers and responses from the authors of the
HIA report). The following sections provide a summary of the comments from the external peer-
reviewers by category.
General Comments
Two reviewers commented on EPA's choice to perform an HIA on a project with such a small geographic
area of impact. The authors revisited the Screening chapter and recognized that the discussion could
benefit from more documentation of how the HIA was screened. The HIA was initially screened to
inform the implementation of the PNA Vision. Later, DWM could not secure funding to implement the
master plan in its entirety and selected the Boone Street demonstration project as a catalyst for building
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support for implementing the rest of the plan. Thus, the HIA was quickly rescreened for the smaller
project. The authors resolved to document (more explicitly) how the HIA was screened and the
considerations made during the screening process. In addition, the HIA Project Leads committed to
expanding the HIA to examine green infrastructure implementation throughout the entire Proctor Creek
Watershed, as requested by stakeholders and other participants in the HIA.
One reviewer commented that it would be beneficial to strengthen (i.e., add more text addressing) the
discussion of equity in the HIA, including use of equity metrics recently released by a Society of
Practitioners of Health Impact Assessment (SOPHIA) working group. The equity metrics were not used
for this HIA because they were issued after the HIA was complete, but will be considered in future HIAs.
Equity was identified as a core value of HIA up front and identification of vulnerable populations and
consideration of impact distribution. The authors acknowledged that the potential for impact inequity
identified in the literature could have been further examined and documented for each health determinant.
This is a shortcoming of the HIA and perhaps the instructions for the literature reviews. The authors will
examine the instructions for the literature reviews and modify them, as necessary, for future HIAs to
ensure that equity issues documented in the literature are adequately captured.
Editorial Comments
These comments received from reviewers addressed wording, mechanical errors, formatting issues, and
requests for verbiage clarification in the text. The authors addressed all of these issues and made
revisions in the report.
HIA Process Comments
Overall, all three reviewers commended the thoroughness, quality, and appropriateness of the HIA
process undertaken (including the evidence on which the HIA was based). There were a few comments
identifying possible areas of improvement in the HIA process.
One of those areas of improvement regard the length of time it took to complete the HIA and the
opportunity for lessons learned in HIA planning. The authors acknowledged this opportunity in the
discussion of HIA timeline and resolved to clarified (in the text) the actual time taken to conduct the HIA,
accounting for the unavoidable delays due to the sequestration, government shutdown, scheduling
conflicts, etc. and the lack of dedicated full-time equivalents for the duration of the HIA.
One reviewer commented on the need to clarify the connections/pathways identified among the health
determinants and provide more detail on the particular pathways from health determinant to health
outcome. The authors addressed this issue by clarifying in the text the primary and secondary pathways
of impact identified and provided an example explanation of the connections between them. The authors
referred readers to the stakeholder handout with the overarching theoretical impact pathway diagram that
shows how the proposed project was linked to each health determinant and their related health outcomes.
One reviewer commented that it seemed African Americans should have been included as a vulnerable
population in the HIA. The authors acknowledged that being a minority race and/or ethnicity can
predispose individuals to health inequities. Although African Americans are often identified as a
minority and hence a vulnerable population in other study areas. However, in this study area African
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Americans are the majority population and the HIA Core Project Team felt it was more appropriate to
identify population characteristics that were directly related to the health determinants of interest (e.g.,
persons living in poverty, young children, elderly, physically disabled, and cost-burdened households).
One reviewer questioned the ratings used for characterizing magnitude of impacts suggesting that the
number of individuals affected should be indicated and suggested using severity, rather than permanence,
as one of the characterization factors. The authors acknowledged that the number of people potentially
affected was not numerically assessed in the HIA, nor was severity of impact. However, the authors
revisited the descriptions of the magnitude and permanence ratings and modified them to reflect more
accurately the way in which the HIA Core Project Team appraised the impacts. The HIA Core Project
Team provided a more accurate account of relative magnitude, since the impacts are expected to be
localized due to the size of the project (i.e., changing "impacts to the entire population" to be "impacts to
populations beyond the street" and "impacts to some groups" to be "impacts to the population using the
street").
Reviewers commented that the profile of existing conditions is appropriate as a baseline against which to
assess impacts, and commented on the thoroughness of assessment given the small study area. One
reviewer commented on the identified lack of existing conditions for social capital. In response, the HIA
Core Project Team performed a desktop asset analysis of the study area and provided a map and text to
the authors. The authors added this new information identifying assets available in the community that
provide space to build social capital in the HIA report. Reviewers identified additional sources of
evidence that could have been used in the assessment (e.g., transit usage, data related to heat related
illness, etc.), but overall commended the evidence selection and gathering, including the use of GIS to
identify patterns in data when the data were not specifically available for the small study area. Some of
the identified data were considered for inclusion, but were unable to be collected (e.g., transit usage) or
did not include a sample size appropriate for analysis (e.g., heat-related illness).
All three reviewers commented that the recommendations provided by the HIA were reasonable and
supported by the evidence, but that the list of recommendations was too long and lacked any sort of
prioritization. The authors acknowledged this shortcoming in the original draft of the HIA report and
resolved to include the information regarding prioritization of the recommendations that the HIA Core
Project Team provided. Furthermore, the authors related the recommendations back to the predicted
impacts in the Assessment chapter under each of the health determinants of interest. One reviewer also
commented on the practice of highlighting the recommendations from stakeholders (vs. those developed
by the HIA Core Project Team) could be seen as a negative, but the HIA Project Team wanted those
recommendations to be highlighted to encourage support of those recommendations by the decision-
makers. The authors added text in the HIA report to clarify the intent of highlighting the stakeholder
recommendations.
One reviewer commented that the HIA report and factsheet were minimal avenues of communication and
there was a lack of detail in the dissemination of communication materials. The authors revisited this
discussion in the Reporting chapter and resolved to provide more detail to the reporting activities and
dissemination plan. The HIA Core Project Team provided more information presentations given to the
public, practitioners, and stakeholders throughout the duration of the HIA and details added about how
the communication materials were distributed.
Proctor Creek's Boone Boulevard Green Street Project HIA Page 152
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The reviewers commended the inclusion of plans for evaluation and monitoring, but the monitoring plan
lacked contingency plans if stakeholders observed negative impacts during monitoring, considerations for
feasibility of implementing the plan, and whether there was indication that stakeholders committed to
implementing the plan. The authors acknowledged these missed opportunities in the HIA report.
HIA Documentation Comments
All three reviewers commended the clearly written, logical, comprehensive, and transparent nature of the
report, but warned that the report was too lengthy and in some areas too detailed and technical.
Suggestions included shortening the report, creating an executive summary, and moving some of the more
detailed discussions to the Appendices. All of of these suggestions were incorporated. The authors
prepared an Executive Summary and made modifications throughout the report to condense text, tables,
and figures and move material to the Appendices where appropriate. Primary sections of consolidation
included the flood management and air quality sections and a large table identifying captured stakeholder
input was moved from under Scoping to the Appendices to help streamline the document.
Stakeholder Participation Comments
Reviewers commended the use of multiple avenues of stakeholder participation and inclusion of methods
and materials documenting that participation in Appendices. One reviewer questioned whether
community and stakeholders were involved in screening and another asked for clarification of what input
was gathered by community organizations and which organizations were represented at each stakeholder
meeting. The authors revised the stakeholder engagement plan by separating it out by HIA step and
which roles were included, added text clarifying how stakeholders participated in the Screening step, and
provided the organization represented next to each participant. However, the authors were unable to
identify which participant provided which input because documentation was not available.
Proctor Creek's Boone Boulevard Green Street Project HIA Page 153
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Appendix A. Tetra Tech's Conceptual Design of Boone Boulevard Green Street Project
Vegetated Median
B Perrrwable One i/tey Cycle liacK
B ImperFneabf* Qno-Wsy CycW Frack
o >
o
o
CO
- O
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^Q
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m
oo
i
o
I
785 Joseph E. Boone Btvd NW, facing west
Section B-B'
Rmsea Vegetated Median
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0
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Permeable On&Way Cycle Tract
Existing Sidewalk
Drainage Aggregate /.Ho B stonej
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Coarse Base (No 2 stone)
4" PVC Underdrain
Proctor Creek's Boone Boulevard Green Street Project HIA
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Appendix B. Original HIA Timeline
. :
Health Impact Assessment (HIA) of Green Infrastructure in the
Proctor Creek Communities of Atlanta, Georgia
U. S. Environmental Protection Agency, Region 4 and Office of Research and Development
Oct. Mil Nor. 2012 Dec. 301! J™. 2013 Feb. 2013 M»rdil«13 April 1013 M»y2013 Jui2D]3 J«Jy 1013 AnE.3013 Sfpt2013 Oa. 2013 N«2013 D«.J013
t
Pnnen Funded by EPA
SCKEEMNG (Cws RisMTdl Team FnraBl - EPA BOS!
t
The deepen to be studied:
"Green Soea Prefect"
SCOF1SG
lKCaBuaunitv
Kfeaqg
(March)
I'AifcBoiy
GiDup- MeettRE
(Aprit)
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Demesraphiz P&polatian Dar
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DATA ANALYSIS
£-Qwmllr
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{Jane}
2™ Ath-isarv
Groiif Meetms
(Mr)
Key Contacts:
Tami Thomas-Burton, B.S,. MPH
U.S. EPA—Region 4
Office of th€ Regional Administrator,
Environments! Justice & Sustainabilrty
1404! £62-3027
Thornas-bLjrtan.tamijffifipa.gov
Florence Fufk
U.S. EPA—ORD
Office Df Research end Development.
Ecological Research Division
(513J 569-7379
Fulk.florence@epa.gov
Re&earch & Literatuie E.evww Teaju
(May, JTUM? Jaly)
HNDD'GS
D«-elop Reseaidi Quertwna,
CcQectPnniary i Sscoidary
RICOilMEXDATlONS & REPORT
HIA Project Enciaa.
EVALUATION & MONITORING
EPA-R4&EPA-ORI>
Pcxit FoUow-up Evaluation
Process Evalnatic-a and Imfza
E^ilLadoQ Conducted
Proctor Creek's Boone Boulevard Green Street Project HIA
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Appendix C. Stakeholder Engagement Meeting Documentation
Documentation of First Community Engagement Meeting, March 22,2013
First Community Engagement Meeting Invite (Flyer)
COMING TO YOUR COMMUNITY!
HEALTH IMPACT ASSESSMENT
U.S. EPA | UNITED STATES ENVIRONMENTAL PROTECTION AGENCY-REGION
Atlanta, Geor
Health Impact Assessment (HIA) for
Green Infrastructure in the Proctor Creek
Community of Atlanta, GA
The U.S. EPA is conducting a Health Impact Assessment (HIA) for Green Infrastructure
in the Proctor Creek Communities of Atlanta, Georgia. This is the first time EPA—
Region 4 will be conducting an HIA. EPA hopes to gain experience that can be used in
similar projects in other areas.
EPA and its partners are evaluating solutions for flooding , public health issues, and other
deterrents to development and community revitalization. This HIA would inform
decisions around Green Infrastructure approaches to Storm Water Management,
Ecosystem Restoration, Economic Development, and Community Revitalization. The
goal of the HIA is for EPA to provide information to the City of Atlanta on Green
Infrastructure projects identified in the PNA (Procfor Creek/North Avenue) Study
conducted by Park Pride and the Communities of Proctor Creek in 2010.
The Proctor Creek consists of 9 miles of impaired waters and drains an area of
approximately 10,198 acres to the Chattahoochee River. This HIA will not focus on the
entire 9 miles of the Proctor Creek. The HIA will focus on the Boone Street—Green Street
Project
EPA will conduct the HIA on a conceptual green infrastructure plan identified in the PNA
Study for a "green street" on Joseph E. Boone Boulevard NW. A green street is a street
designed with a landscape system that can reduce stormwater runoff and improve access
for pedestrians and bicycles. The study area will extend to Northside Drive NW (to the
east) to James P. Brawley NW (to the west) on Joseph E. Boone Blvd NW. The Vine City
community is bounded by Joseph E. Boone Blvd to the south and the English Avenue
community to the North.
HIA Next Steps:
On Friday. March 22. 2013, 5:30 PM—8:00 PM
EPA will begin the information gathering stage of the
HIA with Community Stakeholders.
• We will hold a Community Meeting at the
Neighborhood Union Health Center.
186 Suiiset Ave., Atlanta. GA 30314
where we will present our plans for moving
forward with the HLA.
• We hope to get feedback and input from the
community on this HIA plan. This is your
opportunity to share your thoughts!
- Wiat is au HLA?
A Health Impact Assessment (HLA)
is used to evaluate objectively the
potential positive and negative
health effects of a project or policy
before it is built or implemented,
and recommends changes to
manage those effects.
* Why is an HIA important?
A Health Impact Assessment (HIA)
is a tool to ensure that health and
equity are considered in decision-
making.
Key Contacts:
Taini Thomas-Burton. B.S.. MPH
U.S. EPA-Region 4
Office of the Regional Administrator,
Environmental Justice & Sustainability
(404) 562-8027
Thomas-burton.tami(S;epa.gov
Floreuce Fulk
U.S.EPA-ORD
Office of Research and Development,
Ecological Research Division
(Si3)5t>9-7379
FuDt.florence@epa.gov
Camilla Warren
U.S. EPA—Region 4
RCRA Brownfields Program
(404) 502-8519
Warren.camiDa@epa.gov
David Egetter
U.S. EPA-Region 4
RCRA Brownfields Program
(404) 502-8250
Egetter.david@epa.gov
General Info:
EPA Toil-Free Customer Service
1-800-241-1754
xvEPA
U 1 l.O SUHrt.
gtfAtoMwml
0 Light Snacks and Beverages will be Provided 0
Sidei
Proctor Creek's Boone Boulevard Green Street Project HIA
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proposed Boone Street-Green Street Design
(Diagram: Courtesy of Park Pride, Illustration by Gri/fis King)
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Boone Street—Green Street Location (Google Map)
Side 2
— Partners —
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Health Policy
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Proctor Creek's Boone Boulevard Green Street Project HIA
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Notes from First Community Engagement Meeting
Topic: Question. What does Health mean to you?
Community's Response:
• Ability to heal
• Wellness
• Absence of sickness
Condition of your body & life
Condition allow you to function without disease and discomfort
• Waking up mentally "clear"
• Optimal state of physical, mental, and social well being
• Everything
• Close to what you are created to be
Things that make you feel good
Quality of Life
There's good health & bad health
• State of "upness"
Source: Tami Thomas-Burton, HIA Project co-Lead
Proctor Creek's Boone Boulevard Green Street Project HIA Page 166
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Community Stakeholder-Identified Interests and/or Concerns in the Community (Flipchart)
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Proctor Creek's Boone Boulevard Green Street Project HIA
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Summary of the First Community Engagement Meeting (Handout)
Health Impact Assessment (HIA) of Green Infrastructure in the Proctor
Creek Communities of Atlanta, Georgia
United Slates
Environmental Protection
Agency
U. S. Environmental Protection Agency, Region 4 and Office of Research and Development
Community Engagement Meeting
Green Infrastructure HIA
• The U.S. EPA is conducting a Health Impact Assessment
(HIA) of Green Infrastructure in the Proctor Creek
Communities of Atlanta, Georgia.
• An HIA is a tool used to objectively evaluate potential
positive and negative health impacts of a policy or project
before it is implemented and provide recommendations to
minimize adverse health impacts and maximize beneficial
impacts.
• HIAs ensure that health and equity are considered in the
decision-making process and that impacted communities
are engaged.
Community Engagement Meeting
Summary
• The community engagement meeting took place at the
Neighborhood Union Health Center in Atlanta, Georgia on
March 22, 2013 from 5:30-8:00pm.
• Community leaders and representatives from
neighborhood groups in the study area were invited to
attend. Eighteen (18) individuals attended (Figure 1).
• Three exercises were conducted at the meeting in order to
capture residents' views on health, primary concerns
related to their community, and thoughts on how the
quality of life in the community could be improved.
City of Atlanta Dept of Watershed Management (COA-DWM)
Community Improvement Association
C.T. Vivian Leadership Institute (CTVLI)
Delon Hampton and Associates
Eco-Action Incorporated
English Avenue Neighborhood Association
Historic Westside Gardens, Inc
NPU (L), Chair
English Avenue Neighborhood Association
Southwest Coalition (SWC3)
Vine City Civic Association
Figure 1. Participating community organizations of NPU-L
Large Group Exercise: Defining Health
• Question Prompt: "What does Health mean to you?"
• Thirteen (13) of the 18 attendees responded; 72.2%
participation.
• Responses were coded and tallied according to 5 potential
categories: physical health, mental health, social health,
overall wellness (physical, mental, and social), and non-
descriptive.
Results:
5 of 13 responses related to physical health
4 of 13 responses related to overall health
2 of 13 responses related to mental health
2 of 13 responses were non-descriptive*
*Responses: "close to what you are created to be" and
"there's good health and bad health" were non-descriptive.
Analysis:
While physical well-being remains the most recognizable
determinant of health, overall well-being (including physical,
mental, and social determinants) was also recognized as a
factor of health.
Individual Exercise: Improving 'Quality of Life'
• Each attendee was asked to fill out an information card
identifying what could be done to improve the 'quality of
life' in their community and how to address their
community concerns.
• Sixteen (16) of the 18 attendees responded; 88.9%
participation.
• Each phrase on the information cards was coded and
organized into 1 of 10 pre-determined categories.
• A facilitated group discussion took place to ensure all the
input had been adequately captured and organized into the
proper categories.
• Community members identified an additional category to
capture community engagement needs, making it 11
categories total.
Proctor Creek's Boone Boulevard Green Street Project HIA
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&EPA
United Status
Environmental Protection
Agency
Health Impact Assessment (HIA) of Green Infrastructure in the Proctor
Creek Communities of Atlanta, Georgia
U. S. Environmental Protection Agency, Region 4 and Office of Research and Development
Results:
Community Thoughts on Improving
"Quality of Life"
• Economy/ Jobs/ Poverty
• Environment
Health
• Transportation
Education
Housing
Politics/ Government
Safety
Social/ Cultural
Recreational
Community Engagement
Categories
Graph 1: Total number of times each category was cited on
participants' information cards.
Analysis:
The category most cited (referred to) in this activity
was the environment. This result is not surprising, considering
that community members were asked to identify ways to
improve the quality of life and the environment category
included items such as stormwater management, clean-up of
contaminated properties, beautification, and investment in
green infrastructure. Education was the second most cited
category that community members thought would improve
the overall quality of life. In the discussion, community
members explained their belief that expanding career
training and education on environment and health concerns
would greatly impact the community and create a "unified
vision of environmental justice."
Large Group Exercise: Prioritizing Community Concerns
• Community members were asked to vote on which of the
eleven (11) categories captured their top concerns for
the community (Figure 2).
• Each individual was given 4 independent votes. The
categories with the most votes were considered priority
community concerns.
• Out of 72 total votes possible (18X4= 72), 62 points were
cast; 86.1% participation.
' *Mi"> - I "'• I •••_'" "•
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Figure 2. Illustration of categories of concern with
associated votes (dot stickers).
Results:
Community Priorities
Categories
• Economy/ Jobs/ Poverty
• Environment
a Health
• Transportation
Education
• Housing
Politics/ Government
Safety
Social/ Cultural
Recreational
Community Engagement
Graph 2: Total votes, by community members, for each category
to identify top priorities for the community.
Proctor Creek's Boone Boulevard Green Street Project HIA
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Environmental Protection
Ag&ncy
Health Impact Assessment (H1AJ of Green Infrastructure in the Proctor
Creek Communities of Atlanta, Georgia
U. S. Environmental Protection Agency, Region 4 and Office of Research and Development
Analysis:
Although the environment was the most discussed way
to improve 'quality of life' in the previous activity, community
engagement was voted as the top priority concern. This
category included the need for involvement in governmental
decision-making processes, presence of a community meeting
place, and the need for community outreach. It is interesting
to note that the second-highest priority concern of the
community members is the environment. This category
includes, but is not limited to stormwater management,
clean-up of contaminated properties, improving water
quality, improving city services and code enforcement, and
restoring creek beds and stream, all of which are documented
hazards in the area.
Discussion Summary
It is without question that community engagement and
improving the environment are the highest priority concerns for
this community. Other top priorities for this group are the
economy, education, and housing. These issues are not surprising,
given the history of the area. The Proctor Creek Watershed has
been the focus of environmental justice and community
revitalization efforts for over ten years. One of the goals of the
Proctor Creek Green Infrastructure HIA is to address these issues
and prevent further issues from developing.
The prioritization of concerns for the community is helpful to
the final scoping of the HIA by narrowing the focus of the
assessment on those impacts with the greatest potential
significance. This meeting was instrumental in assessing the
community's needs, improving transparency and engaging
community members in the HIA process.
Key Contacts:
Tami Thomas-Burton, B.S., MPH
U.S. EPA—Region 4
Office of the Regional Administrator,
Environmental Justice & Sustainability
(404) 562-8027
Thomas-burton.tami@epa.gov
Florence Fulk
U.S. EPA-ORD
Office of Research and Development,
Ecological Research Division
(513) 569-7379
Fulk.florence@epa.gov
- Partners -
v>EPA
United States
Environmental Protection
Agency
FULTON COUNTY
Georgia
Health Policy
Center
Proctor Creek's Boone Boulevard Green Street Project HIA
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Documentation of First HIA Advisory Group Meeting, April 30, 2013
First HIA Advisory Group Meeting Invite (Letter)
April 10, 2013
Name
Title
Company
Address
City, State, zip
Dear
You are invited to participate as a member of a new Proctor Creek Health Impact Assessment (HIA)
Advisory Group that is being formed by the EPA and its partners. The initial meeting of this group will be
Tuesday, April 30, 2013, 9:30 a.m. - 12:00 noon in conference room 10T33.
The EPA and its partners are conducting an HIA of a conceptual green infrastructure plan
identified by the City of Atlanta's Department of Watershed Management. An HIA is used to
objectively evaluate the potential positive and negative health effects of a project or policy
before it is built or implemented and recommends changes to manage those effects. This tool is
also used to ensure that health and equity are considered in decision-making.
The green infrastructure plan identified will be for a "green street" on Joseph E. Boone Boulevard, NW.
A "green street" is a street designed with a landscape system that can reduce storm water runoff and
improve access for pedestrians and bicycles. The study area will extend from Northside Drive, NW (to the
east) to James P. Brawley, NW (to the west) on Joseph E. Boone Blvd, NW. This "green street" has
implications for improved health within the entire watershed which is prone to flash flooding and water
quality issues. The HIA will consider the impacts of the "green street" as a storm water control and water
quality management tool.
The "green street" HIA site is within the Proctor Creek Watershed and its location is considered
the headwaters of the watershed. The Watershed is approximately 10,198 acres and drains an
area consisting of 9 miles of the Proctor Creek and its tributaries, leading the Chattahoochee
River. These waters are designated by the Georgia Environmental Protection Division as
impaired waters (bacterial impairment - E.coli). This HIA will not focus on the entire 9 miles of
the Proctor Creek, only the "green street" location.
The EPA and its partners are evaluating solutions for flooding, public health issues, and other deterrents
that impede development and community revitalization in this stadium community. Also, the EPA hopes
to gain experience with this new HIA tool that can be used in similar projects in other areas. This is an
exciting project because it is the EPA's first time nationally conducting a health impact assessment.
The HIA advisory group will include federal, state, city, non-governmental organizations, universities,
and key community organizations. The advisory group will provide high-level strategic oversight of the
Proctor Creek's Boone Boulevard Green Street Project HIA Page 171
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Proctor Creek HIA and will help to facilitate access to information, data, contacts and other resources
necessary to ensure its successful completion. It is anticipated that the HIA Advisory Group will meet
three more times after the first meeting, before the project end date in October 2013.
The Proctor Creek HIA also has a Core Research Team who oversees the daily execution of the HIA.
This team has met regularly since October 2012, to conduct the screening and scoping processes.
Moreover, the Proctor Creek HIA will also have a Research-Subject Matter Subcommittee that will help
to lay the conceptual and logistical groundwork required to generate the evidence-based findings.
There are six basic steps in the process of an HIA, 1) screening; 2) scoping; 3) assessing risk & benefit; 4)
developing recommendations; 5) reporting and 6) monitoring and evaluation and the Proctor Creek HIA
is in the Scoping phase of the process.
For more information about the use of Health Impact Assessments nationally and
internationally:
• Health Impact Project website http://www.healthimpactproiect.org/, and the Policy Link
website: Promoting Equity through HIA
http://www.policylink.org/PromotingEquityThroughHIAPractice
• CDC - Centers for Disease Control Health Impact Assessment
http://www.cdc.gov/healthyplaces/hia.htm
• WHO - World Health Organization: Promoting health across all sectors of activities
http ://www. who, int/hi a/en/
We greatly value your involvement and hope you will consider participating as a member of the Advisory
Group. You would be a key partner in the Proctor Creek HIA and local capacity building efforts. You will
receive this invitation by email and by postal mail. Instructions, directions, a one-pager on HIA and a list
of invited Advisory Group members are enclosed.
Please let me know of your availability by April 15. 2013. If you have questions, or cannot participate but
would like to recommend someone else from your staff, you may contact me at thomas-
burton.tami@epa.gov or 404-562-8027.
We look forward to working with you to make this Green Infrastructure project a catalyst for healthy,
sustainable living.
Sincerely,
xxxxxxxx
Tami Thomas-Burton
Office of Environmental Justice
Enclosures
cc: Camilla Warren, Maryjo Bragan, Florence
Fulk, EPA, Office of Research and Development
Proctor Creek's Boone Boulevard Green Street Project HIA
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1. Nikel Bailey
2. Todd Boatman
3. Dr. Daniel M. Deocampo
4. Michael Dobbins
5. George Dusenbury
6. Debra Edelson
7. Michael Elliott
8. Curtis Flake
9. Stacy Funderburk
10. Darryl Haddock
11. Lee Harrop
12. Dudley Hartel
(CUIF)
13. TamayaHuff
Coordinator
14. Na'Taki Osborne-Jelks
15. Dr. Cassandra Y.Johnson
16. Yvonne Jones
17. Jewelle Kennedy
18. Dr. Eloisa Klementich
Development
19. EricKuehler
20. Dr. Stephanie Madson
21. Kevin Moody
22. Dr. Yomi Noibi
23. Dr. Mark Patterson
24. Demarcus Peters
25. Neela Ram
26. Walt Ray
27. Monica Robinson
28. Dr. Catherine Ross
29. Joe Rozza
30. James E.Shelby
31. Jonette Simmons
32. Julie Todd
33. TonyTorrence
34. Jason Ulseth
35. Dr. Latoria Whitehead
36. Ellen Wickersham
37. Dr. Andrea Winquist
Invited HIA Advisory Group Members
(Alphabetical)
HUD-Atlanta Regional Office
U.S. Army Corps of Engineers (USAGE - Mobile District)
Georgia State University
Georgia Tech - College of Architecture
City of Atlanta - Department of Parks, Recreation & Cultural Affairs
Trust for Public Lands - Georgia
Georgia Tech - Center for Quality Growth & Regional Development
U.S. Army Corps of Engineers (USACE - Mobile District)
The Conservation Fund - Georgia
WAWA - West Atlanta Watershed Alliance
Atlanta Beltline Inc.
USDA - Forest Service (Southern Research)
Georgia Department of Transportation
WAWA - West Atlanta Watershed Alliance / Georgia State University
USDA - Forest Service (Southern Research)
Neighborhood Planning Unit - L (Vine City & English Ave)
City of Atlanta - Office of Planning
Invest Atlanta
Neighborhood Stabilization Program
Chief of Staff
Associate Professor
Professor of the Practice of Planning
Commissioner
Senior Program Director
Associate Director
Chief of Planning & Environmental Division
Real Estate Associate
Environmental Education Director
Program Management Officer
Center Manager - Urban & Interface Forestry
State Bicycle and Pedestrian Safety
WAWA, Chair/PhD Student
Station Research Social Scientist
NPU-L, Chair
Urban Planner
Managing Director of Business
USDA - Forest Service (Urban Forestry South)
FEMA- Region IV (Environmental Planning & Historic Preservation)
FHWA - Office of Technical Services
Environmental Community Action Inc.
Kennesaw State University (Department of Geography & Anthropology)
English Avenue Neighborhood Association
ARC-Atlanta Regional Commission
Park Pride
Fulton County- Department of Health Services
Georgia Tech - Center for Quality Growth and Regional Development
The Coca-Cola Company
City of Atlanta - Department of Planning & Community DevelopmentComm/ss/oner
HUD - Atlanta Regional Office Neighborhood Stabilization Program
City of Atlanta - Department of Watershed Management Environmental Compliance Manager
Community Improvement Association, Inc. Director
Chattahoochee Riverkeeper Technical Programs Director
CDC - Office of Minority Health & Health Equity Environmental Justice Officer
Invest Atlanta (Parks and Greenspace Acquisition) Senior Manager
Emory University- Rollins School of Public Health Epidemiologist
Technical Transfer Specialist
Deputy Regional Environmental Officer
Ecologist
Executive Director
Professor, Environmental Studies Coordinator
Director
Senior Environmental Planner
Director of Park Visioning
Environmental Planner
Director
Sustainability Manager
Proctor Creek's Boone Boulevard Green Street Project HIA
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HIA Advisory Group-Identified Interests and/or Concerns in the Community (Flipchart)
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Summary of the First HIA Advisory Group Meeting
4>EPA
United StatBS
Environmental Protection
Aqency
Health Impact Assessment (HIA) of Green Infrastructure in the Proctor
Creek Communities of Atlanta, Georgia
U. S. Environmental Protection Agency, Region 4 and Office of Research and Development
HIA Advisory Committee Meeting
Green Infrastructure HIA
The U.S. EPA is conducting a Health Impact Assessment
(HIA) of Green Infrastructure in the Proctor Creek
Communities of Atlanta, Georgia.
An HIA is a tool used to objectively evaluate potential
positive and negative health impacts of a policy or project
before it is implemented and provide recommendations to
minimize adverse health impacts and maximize beneficial
impacts.
HIAs ensure that health and equity are considered in the
decision-making process and that impacted communities
are engaged.
HIA Advisory Committee
The HIA Advisory Committee is a multi-organization group
of internal and external stakeholders who have an
invested interest in the community around the potential
Boone Boulevard Green Street Project.
The HIA Advisory Committee will provide high-level
strategic oversight of the Proctor Creek HIA and will help
to facilitate access to information, data, contacts, and
other resources necessary to ensure its successful
completion.
Members of the committee represent federal, state,
county, and city government; universities; non-
governmental organizations; and key community
organizations.
Welcome and remarks
from EPA R4 Chief of
Staff, Javoyne Hicks
White, on behalf of R4's
Regional Administrator.
Advisory Committee Meeting
Summary
• The Advisory Committee meeting took place on Tuesday,
April 30, 2013 from 9:30 a.m. - 12:00 noon at the Sam
Nunn Federal Center in Atlanta, Georgia.
Twenty-four (24) of the 37 invited committee members
attended, in addition to 17 EPA staff members.
Background information on the Proctor Creek watershed
and community profile, Boone Boulevard Green Street
Project, and the HIA process was presented at the
meeting. Handouts summarizing this background
information were provided prior to and/or during the
meeting.
Three exercises were conducted at the meeting in order
to capture Advisory Committee's thoughts on how quality
of life in the Proctor Creek community could be improved,
their primary concerns for the community, and how
priority concerns identified by community members
during the community engagement meeting differed from
those identified by the Committee.
Background Information
Proctor Creek Watershed
The Proctor Creek Watershed (HUC 12:031300020101) is
located in the municipal jurisdiction of Atlanta, GA and
drains over 10,100 acres of primarily urban residential and
commercial lands to the Chattahoochee River (Figure 1).
Proctor Creek Watershed
Figure 1. Proctor Creek Watershed in Atlanta, Georgia.
Community Profile
• The HIA will examine impacts to the community within a
%-mile radius around the proposed Boone Boulevard
Green Street Project - a study area approximately 1.25 sq.
miles in size.
Proctor Creek's Boone Boulevard Green Street Project HIA
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United Stums
Environtnerttg! Pfotecllon
Agency
Health Impact Assessment (HIA] of Green Infrastructure in the Proctor
Creek Communities of Atlanta, Georgia
U. S. Environmental Protection Agency, Region 4 and Office of Research and Development
Census Block Groups
2010
*~^^ Proctor Creek
Boone Blvd Study Site
C~^) 1r? mrte Study Srte BrJlter
r'~] 8G» Intersectmg )r2 Mile Buffer
Q Ceo*us_2010_bg .Intersect
Figure 2. Census block groups within and/or intersecting
the %-mile buffer around the Green Street Project.
HIA Study Population (Figure 2)
• The total population of the study area in 2010 was 12,023,
down 21.85% from 2000 (US Census 2010, 2000).
• This community is a predominantly African American
community (82.62% according to the 2010 US Census),
with ties to historical African American leaders.
• According to the 2011 American Community Survey
estimates from the previous 12 months, the estimated
median household income is $29,788.
The EPA Office of Environmental Justice is dedicated to
ensuring that minority and low-income communities are not
led or left out of decision-making processes.
Environmental Hazards
• Due to the prevalence of impervious surfaces at the
headwaters (Figure 3) and a strained combined sewer
system, flooding is a major concern for the community
and watershed downstream.
Percent Impervious ~^~<
• Much of Proctor Creek and its tributaries are rated by
FEMA as high flood hazards (Figure 4).
FEMA Flood Hazard:
Figure 4. FEMA flood hazard ratings in the Proctor Creek
Watershed.
Pervasive flooding in the Proctor Creek community has
created environmental, public health, economic, and
redevelopment issues.
Proctor Creek is on the 303(d) list of impaired waters due
to poor water quality and high counts of fecal coliform.
There are numerous Brownfields sites located in the
Proctor Creek Watershed.
Green Street Project Overview
The City of Atlanta's Department of Watershed
Management selected a green infrastructure project to
implement in the Proctor Creek Watershed in order to
address some of the community's concerns of flooding.
The overall vision for the Boone Boulevard Green Street
Project involves implementing green infrastructure
practices along Joseph E. Boone Boulevard between
Northside Drive NW (to the east) and James P. Brawley
NW (to the west) in collaboration with planned road diet
improvements.
The proposed green street design includes a combination
of planter boxes, permeable pavements, bioretention
areas, and planting strips.
Figure 3. Percent impervious surfaces in the Proctor Creek
Watershed.
Proctor Creek Community Needs
> Flood reduction and stormwater
management to provide capacity relief for
the combined sewer system;
> Cleaner surface and ground water;
> Improved streets and sidewalks; and
Proctor Creek's Boone Boulevard Green Street Project HIA
Page | 176
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v>EPA
United Stales
Environmental Protection
Agency
Health Impact Assessment (HIA) of Green Infrastructure in the Proctor
Creek Communities of Atlanta, Georgia
U. S. Environmental Protection Agency, Region 4 and Office of Research and Development
HIA Process
• A brief overview of what an HIA is and the general process
for conducting HIAs was presented.
• The specific goals for the Green Infrastructure HIA being
conducted by EPA Region 4 Office of Environmental
Justice and EPA Office of Research and Development were
identified. Goals include:
- To provide technical assistance in assessing the impacts
of implementing the proposed Boone Boulevard Green
Street Project.
- To ensure equity and transparency in the decision-
making process.
- To provide the City of Atlanta, GA recommendations for
implementation of the project prior to the project start
date.
- To inform community members of potential health
impacts and to ensure that local health concerns are
addressed.
- To provide the EPA and other agencies "Best Practices"
for implementing an HIA.
Large Group Exercise: Improving 'Quality of Life'
• The Advisory Committee was asked to participate in a
similar exercise to one conducted with community
members at a community engagement meeting in March.
• Attendees were asked to identify what could be done to
improve the 'quality of life' in the Proctor Creek
community and address the concerns facing that
community.
• Responses were recorded for each of the 11 categories
from the community engagement meeting (Figure 5).
• The Advisory Committee identified an additional category
entitled : Total Investment in Community making a total of
12 categories (Table 1).
Results:
Category
Community
Engagement
Economy/Jobs/
Poverty
Education
Environment
Health
Housing
Politics /
Government
Recreational
Safety
Social / Cultural
Transportation
Total Investment
in Community
Concerns and Ways to Improve Quality of Life
Community needs a "greater voice"
Need for internal institutions for community
engagement (meeting space)
Economic opportunities
Opportunities for 'green spaces' that are
maintainable
Capacity building (training for jobs)
Education for 'healthier' living and eating
Education on environmental risks
More green space
Deficiencies in the 5 mechanisms of healthy
communities (transportation,
telecommunications, power, wastewater, water
supply)
Balanced 'built environment' with environmental
hazards
Broader view on green infrastructure
implementation
Opportunities to reduce 'heat stress' (trees)
Access to healthy foods
Need for a medical home
Risk factors to health in community (lead-
poisoning, asthma, etc.)
Disease transmission (vector control)
Removal of dilapidated housing
Affordable housing
More suitable housing
Need for a step-wise approach that looks at short-
term, medium-term, and long-term impacts
Recreational opportunities
Built environment that supports safe / civil
activities and deters crime
Improved relationships between established
community institutions and educational
institutions
Social impacts
Opportunities for social / emotional support
Different "branding" of community
Community cohesion
Access to basic needs (proximity to laundry,
healthy foods, etc.)
Access to employment
Ability to live in community after investment is
implemented
Table 1. Advisory Committee thoughts on improving 'Quality
of Life'.
Figure 5. Recording of Advisory Committee concerns.
Proctor Creek's Boone Boulevard Green Street Project HIA
Page | 177
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v>EPA
Environment*) Pn
Aqencv
Health Impact Assessment (HIA) of Green Infrastructure in the Proctor
Creek Communities of Atlanta, Georgia
U. S. Environmental Protection Agency, Region 4 and Office of Research and Development
Analysis:
The categories most cited (referred to) in this activity
were: Environment and Social/Cultural. These results are not
surprising, considering that the Advisory Committee was
asked to identify ways to improve the quality of life in the
community, included items such as wastewater and water
supply, increased green space, and broader green
infrastructure implementation. The social/cultural category
included items such as increased social cohesion and
opportunities for increased social inclusion.
Large Group Exercise: Prioritizing Committee Concerns
• The Advisory Committee was asked to participate in the
same exercise used to prioritize concerns identified by
community members at the community engagement
meeting in March.
• The Advisory Committee was asked to vote on which of
the 12 categories captured their top concerns for the
community.
• Each individual was given 4 independent votes. The
categories with the most votes were considered priorities
for the Advisory Committee (Graph 1).
• Members of the committee, who were also participants in
the community engagement exercise, were asked not to
discuss the results of the community prioritization
exercise until after the voting.
Results:
Advisory Committee Priorities
• Economy/Jobs/Poverty
Categories
• Environment
• Health
Transportation
• Education
Housing
• Politics/ Government
Safety
Social/Cultural
Recreational
Community Engagement
Total Investment in
Community
Analysis:
The Advisory Committee voted economy, jobs, and
poverty as the top category of concern (10 votes). Specific
concerns identified in this category included the need for
economic opportunities and the ability to grow and maintain
an economy in the community. The environment and
transportation were tied for votes as the second-highest
priority concerns to the Advisory Committee. Although the
Total Investment category received no votes, the committee
deemed this an important issue to keep in mind based on
past experiences on similar projects.
Large Group Exercise: Comparing Community and
Advisory Committee Concerns
• A summary was presented of the community engagement
meeting that was held in March to capture community
concerns and provide information to the community on
the HIA and Boone Boulevard Green Street Project.
• At that meeting, the 18 representatives in attendance
from invited community groups and organizations were
asked to identify and prioritize ways to improve the
quality of life in the community and address community
concerns (just as the Advisory Committee did in this
meeting).
• The results of both the community's identification and
prioritization exercises (Graph 2) were presented.
Results:
Community Priorities
• Economy/Jobs/ Poverty
• Environment
• Health
— • Transportation
• Education
• Housing
• Politics/ Government
_ I Safety
Social/Cultural
Recreational
Community Engagement
Categories
Graph 1. Total votes, by Advisory Committee members, for
each category to identify top priorities for the community.
Graph 2. Total votes, by community members, for each
category to identify top priorities for the community.
Proctor Creek's Boone Boulevard Green Street Project HIA
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oEPA
ii Sum
Environmental Protection
Auency
Health Impact Assessment (HIA) of Green Infrastructure in the Proctor
Creek Communities of Atlanta, Georgia
U. S. Environmental Protection Agency, Region 4 and Office of Research and Development
Moving Forward and Next Steps
Analysis:
The facilitated discussion comparing the concerns and
priorities of the community and Advisory Committee (Figure
6) recognized that both groups identified similar concerns
for the community overall, and in some cases even
prioritized concerns similarly (Graphs 1 and 2). For instance,
both groups identified the environment as the second-
highest priority for the Proctor Creek community. This
category included the need to increase 'green space' and
beautification and improve community services (e.g.,
transportation, power, telecommunications, wastewater
management, and water quality). The need to have a better
balance between the built environment and environmental
risk and a broader view on implementing green
infrastructure was also expressed.
The top priorities identified for the community differed
between the groups, however. The top priority identified by
community members was community engagement (13
votes), which included items such as a secure community-
owned meeting space, more involvement of the community
in decision-making processes, and information and outreach
to the community. The Advisory Committee, in comparison,
rated this as one of the lowest priorities for the community.
The Advisory Committee identified the economy, jobs,
and poverty as the top priority for the community, pointing
to the need for economic opportunities and revitalization.
Community members also acknowledged this as an
important need, voting it as one of the top three areas of
concern.
Transportation, which was not identified as a top
priority for the community, was voted as one of the top
three areas of concern by the Advisory Committee. The
accessibility to basic needs (healthy foods, laundry, work,
etc.) was a common theme throughout the discussion.
The added value of the HIA process is the ability to
engage both the community and the stakeholders and
ensure transparency and equity in the decision-making
process. The prioritization exercises conducted by both
groups were a key element in the scoping process for the
HIA. The priority concerns and discussion points of the
community and Advisory Committee will both be
incorporated into the final scoping to help determine areas
of focus for the HIA.
The next steps in the HIA process will be to finalize the
scoping phase, develop research questions, and initiate the
assessment phase.
Upcoming Events
• The next Advisory Committee meeting will be held on July
23, 2013 form 9:30 a.m. -12:00 p.m.
• The next Community Engagement meeting is planned for
June 2013 (date: TBD).
• There will be a full day of HIA Training, made available by
the CDC, on Thursday, May 23, 2013 from 9:00 a.m. -4:00
p.m. Please contact Karen Smith at 404-562-9703 for
registration.
Key Contacts:
Tami Thomas-Burton, B.S., MPH
U.S. EPA-Region 4
Office of the Regional Administrator,
Environmental Justice & Sustainability
(404) 562-8027
Thomas-burton.tami@epa.gov
Florence Fulk
U.S. EPA—ORD
Office of Research and Development,
Ecological Research Division
(513) 569-7379
Fulk.florence@epa.gov
Partners -
x>EPA
United States
Environmental Protection
Agency
Georgia
_ _ o -^—,
Figure 6. Discussion comparing concerns and priorities identified by the
community and Advisory Committee.
FULTON CDUNTY
Health Policy
Center
Proctor Creek's Boone Boulevard Green Street Project HIA
Page | 179
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Documentation of HIA Training Workshop, May 23, 2013
EPA and GHPC Health Impact Assessment Training Workshop
May 23, 2013
Exercise: Each group will design a causal pathway diagram, based on the scenario/decision given, and recommendations for avoiding/mitigating
potentially adverse impacts and maximizing beneficial impacts
Scenario 1
Decision: Whether or not to implement permeable pavement
Direct Impacts
I impervious surface
area
Changes to Environment
t drainage
J, standing water
t water quality
t soil quality (via water filtration)
t groundwater recharge
I runoff
J, sewer overflow
Changes to Exposure/Behavior
I mosquitoes
J, exposure to raw sewage
I exposure to E. coli and other
pathogens
Health Outcomes
I risk of contracting West
Nile/mosquito-borne diseases
I negative health impacts of
exposure to raw sewage
Recommendations :
None
Scenario 2
Decision: Whether or not to add more cycling infrastructure (e.g., bike lanes)
Direct Impacts
Designated bike lanes
Changes to Environment
I air pollution emitted from motor-
vehicles
t bike-ability
Changes to Exposure/Behavior
Less exposure to air pollutants
t active transport/ physical activity
(bicycling)
Health Outcomes
t respiratory health (J, risk of
developing asthma, lung cancer,
respiratory disease, and
emergency room visits for
respiratory symptoms)
t cardiovascular health
I diabetes
Proctor Creek's Boone Boulevard Green Street Project HIA
Page 180
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I passive transport (driving)
t access to food, health, recreation,
education, etc.
t social cohesion
Communications
Interacting
I blood pressure and heart disease
I weight and obesity
t mental health
Jin stress levels
I violence
Avoided traffic collision injuries
Recommendations :
Install cement buffer/strong physical barrier between impermeable bike lane and traffic on Boone Street for safety
Install bike lane (for pleasure and transportation) to specified location (1 - Maddox Park, 1.5 - Beltline)
Scenario 3
Decision: Whether or not to add planter boxes and/or bioretention cells
Direct Impacts
t greenery
J, pavement (ISA)
t shading
t humidity
J, Ambient temperature
Changes to Environment
t beautification (depending on where and
plant selection)
t | rodent and pests (mosquitoes)- could
be offset by increased biodiversity
(predators), need more literary evidence
J, Heat island
t air quality (J, air pollution/VOCs based
on tree selection)
t maintenance requirements- (depending
on plant selection and invasive species)
already overgrown vegetation present
t risk of storm damage
t Carbon sink
I runoff
t property values
Changes to Exposure/Behavior
I safety- more hiding places
t urban gardens (need more literary
evidence)
1 exposure to nitrites, sulfites, lead,
and particulate matter
Health outcomes
t allergies (choose the right
plants)
t mental health (J, stress and t
sense of wellbeing)
t sense of community (social
cohesion)
t physical health
t cardiovascular health
Recommendations :
Develop policy or guideline for types of greenery used so that respiratory triggers would not increase for the project area
Proctor Creek's Boone Boulevard Green Street Project HIA
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Plant maximum # of trees in strategic locations that are native and lower likelihood of common allergens (e.g. avoid oaks and Bradford pears).
Additional considerations: location/placement of plants, species selection, allergens, existing vegetation, maintenance requirements, job
creation, business/stakeholder resident opinions
Exercise: Based on the causal pathways developed, characterize predicted changes to the health determinants/outcomes identified.
Health
Determinants/Outcome s
Air pollution
Respiratory health
(asthma, bronchitis,
chronic respiratory
disease, etc.)
Physical Activity
(cycling)
Impact Characterization Table
Direction Magnitude Impact Significance/ Distribution
Likelihood
improve
health
improve
health
improve
health
Low-
medium
Medium-
high
Medium-
high
Medium Possible
Medium-
high
Likely
Medium- Likely
high
Entire surrounding
neighborhood
Vulnerable
population (>5, >64)
Entire surrounding
neighborhood
Proctor Creek's Boone Boulevard Green Street Project HIA
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Documentation of the Second HIA Advisory Group Meeting, July 23,2013
Second HIA Advisory Group Meeting Invite (Email)
Date: June 4, 2013
Greetings Proctor Creek Health Impact Assessment (HIA) Advisory Group,
In preparation for our upcoming meeting on Tuesday, 07/23/13, 9:30 am - 12 noon, please see the
attached Agenda and pre-reading materials. Also, please reply to this invitation so that we can prepare a
"Visitor's List" for our security desk. Our July meeting will be held in Room 9E on the 9th Floor.
Address:
EPA Region 4
Sam Nunn Federal Center
61 Forsyth Street SW
Atlanta, GA 30303
Attachment # 1: Agenda - July Meeting
Attachment #2: Summary of Previous Advisory Group Meeting - April 30th
Attachment #3: Theoretical Impact Pathway Diagram
Attachment #4: Example Approach for Assessing Health Risk Factors in HIA Study Population
Attachment #5: Group Exercise: Research - Data sources & tools (Note: Please Read & bring your
expertise & resource info to the meeting!)
Attachment #6: Directions to Sam Nunn Building
Proctor Creek's Boone Boulevard Green Street Project HIA Page 183
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Meeting Agenda from the Second HIA Advisory Group Meeting
Umled Siaies
Environmental Protection
Aa«ncv
Health Impact Assessment (HIA) for Proctor Creek's
Boone Boulevard Green Street in Atlanta, Georgia
U. S. Environmental Protection Agency, Region 4 and Office of Research and Development
HIA Advisory Group Meeting
Tuesday, July 23, 2013, 9:30 AM - 12:00 noon
Sam Nunn Federal Center - 61 Forsyth Street SW, Atlanta, GA 30303 * Room ft 9E (9th Floor)
biectives:
• Review final Scoping Pathway Diagram
• Discuss Assessment Methods & Topics Assignments for Research
• Identify Data gaps and Resources
• Discuss sources of uncertainty and limitations of evidence
9:30 AM-9:45 AM
Welcome / Introductions
Overview
Tami Thomas-Burton
EPA Region 4 —Office of Environmental Justice &
Sustainability (OEJS), Project Lead
Tami Thomas-Burton
Update on Boone Blvd Green Street Project
Julie Todd
City of Atlanta Department of Watershed Management
Environmental Compliance Manager
9:45 AM-10:30 AM Recap: Scoping Process & Previous Meeting
(Pre-Reading Material, Quick Overview)
Assessment & Literature Review Process
Tami Thomas-Burton
Michelle Marcus-Rushing
Georgia State University Health Policy Center
HIA Practitioner — Research Associate II
10:45 AM-11:45 AM
Theoretical Impact Pathway Diagram
(Pre-Reading Material, Quick Overview)
Example Approach
Group Exercise: 6Topics —Identify Resources
& Data gaps (Pre-Reading Materials)
Researcher Report Outs / Group Discussion
Lauren Adkins
CSS - Dynamac
Public Health Specialist
Assessment Approach
(Pre-Reading Material)
Lauren Adkins
10:30 AM - 10:45 AM
• IS MINUTE BREAK II
Lauren Adkins
Lauren, Tami
HIA Researcher's by Topic
11:45 AM -12:00 Noon
New News: Climate Change Effects on
Vulnerable Populations of the Proctor Creek
Watershed and Green Infrastructure Solutions
Next Steps
David Egetter
EPA - Brownfields
Ecologht /Brownfields Project Manager
Tami Thomas-Burton
Proctor Creek's Boone Boulevard Green Street Project HIA
Page 184
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Boone Boulevard Green Street Project HIA Theoretical Causal Pathway Diagram (Handout)
Unilocl Sum,!.
Entfiiornnprtinl Pmii-.tM.fi
Afloncy
Proctor Creek's
Boone Boulevard Green Street Project
Health Impact Assessment [HIA)
U. S. Environmental Protection Agency, Region 4 and Office of Research and Development
Theoretical Impact Pathway Diagram
Decisions
Boulevard
Green Street
Project
{Green
Infrastnictu
Pathways of Impact
r
•re)
Upstream Impacts
Downstream Impacts
Health Determinants
1
--
A Personal Safety
(Crime/Civility!
i Perceived Safety
A Traffic Safety
A Employment
AWalkability/
Bikeability
A Access to Public
A Open/Green
Space
A Beautification/
Aesthetics
A Land Cover
{Vegetation,
Permeable Surf ace]
__
:
A Traffic Conditions
*
A Community
Economics
~T
L
A Housing
(Property Value,
Damage)
A Flooding/
Water Quality
Volume
A Biodiversity
AShading
•=*)
A Physical
Activity
(SI
A Access to
Healthcare
A Socio-
economic Status
ASocial Capital
(Cohesion,
Culture)
A Water
Quality
A Vector
Control
A Climate &
Temperature
(Urban Heat
Island Effect)
A Air Quality
A Noise
Pollution
A Traffic
Accidents
Proctor Creek's Boone Boulevard Green Street Project HIA
Page 185
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oEPA
l Stain*
Erwlronnwrtlnl Protection
Anoncv
Proctor Creek's
Boone Boulevard Green Street Project
Health Impact Assessment [HIA]
U. S. Environmental Protection Agency, Region 4 and Office of Research and Development
Decision
Pathways of Impact
Boulevard
Green Street
Project
(green
infrastructt
Xurel
Health Determinants
Health Outcomes
A Hypertension &
Related Chronic
Disease
A Climate&
Temperature
{Urban Heat
Island Effect!
fl Respiratory Disease
(Including Asthma]
Proctor Creek's Boone Boulevard Green Street Project HIA
Page 186
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Example Approach for Assessment (Handout)
oEPA
United Stales
Environmental Protection
Aqencv
Proctor Creek's Boone Boulevard Green Street Project
Health Impact Assessment (HIA)
U. S. Environmental Protection Agency, Region 4 and Office of Research and Development
Example Approach for Assessing Health Risk Factors in the HIA Study Population
Purpose
The purpose of this example is to lead the discussion on potential methodologies for data collection,
assessment/ analysis, and monitoring of health factors (determinants) in the Boone Boulevard Green Street Project
HIA.
Example: Green Space as a Health Determinant for Stress
Stress is a known health determinant for hypertension and reduced overall mental health and well-being
(Pickering 2001). The relationship between mental stress and environmental factors is a more current research
topic. The natural environment and access to green space has been shown to have an independent influence on
health and health behaviors (Mitchell and Popham 2008). A stressful environment at an early stage has been
associated with decreased mental and physical health in adulthood (Taylor et al. 2004). Disparities in increased
stress and lowered perceived overall wellness have been reported in numerous studies, especially among African
Americans of lower income and lower education (Williams et al. 1997). Because there is a large portion of the
vulnerable population in this community, it is important for this HIA to assess the potential impacts this project will
have on stress and related health outcomes.
Approach
The proposed approach for this HIA is to 1) identify health outcomes and their risk factors in the community; 2)
assess how the proposed green infrastructure project will address/not address risk factors; 3) use evidence-
supported relationships between risk factors and health outcomes to infer or predict how health outcomes of the
community may change if the decision is implemented. Recommendations can then be distilled from the predicted
change and proposed best practices to mitigate negative health factors (risks) in order to optimize positive impact.
Method
Decision:
Health
Determinant/Outcome:
Geographic Scope:
Temporal Scope:
Boone Boulevard Green Street Project (BBGSP)
Green Space/Stress-related Health Outcomes
% mile radius around proposed BBGSP
Post-implementation of BBGSP*
Baseline Research
Question
What is the current
risk distribution for
health outcomes
related to stress in
this community?
Impact Research
Question
How will the
proposed project
impact stress in this
community and
potential
disparities?
Key Indicators
Hypertension Rates;
Hypertensive
Cardiovascular
Disease Rates;
Mental and
Behavioral Disorder
Hospitalization
Rates
Data Sources
Georgia
Department of
Public Health;
Online Analytical
Statistical
Information
System (OASIS);
Literature Review
Analysis
Method
GIS
Mapping;
Predictive
Data
Graphing
Monitoring
Method
Periodic monitoring
of indicators using
OASIS Mapping
Tool;
Periodic
community surveys
via social
institutions
Literature Evidence
There is an increasing amount of evidence of the relationships between the natural environment (particularly
green space) and health. "One population study found that increasing green space by 1 percentage point yielded
an effect of 1-year lowered age on physician-assessed morbidity" (Maas et al. 2009). Due to the qualitative nature
Proctor Creek's Boone Boulevard Green Street Project HIA
Page 187
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OtlTr\ Proctor Creek's Boone Boulevard Green Street Project
Uniiad Status
En,:™,™ *«.,, Health Impact Assessment (HIA)
U. S. Environmental Protection Agency, Region 4 and Office of Research and Development
of the non-physical effects, some of the evidence on stress is limited by self-reporting. That being said, mediators
have been found that support the associations between green space and stress-related health outcomes.
Commonly reported populations particularly sensitive to the benefits of green space include lower income, lower
educational attainment, youth and the elderly (Lee, 2010). From the literature, we can hypothesize that after
green infrastructure is implemented along Boone Boulevard we may see overall improvements in perceived
physical and mental health, as well as a reduction in stress-related chronic diseases and all-cause
mortality/morbidity. This hypothesis is also contingent on other additional changes that might occur in the
community. Changes that would confound results may include: a significant shift in population demographics or
household economics.
Figure 1. Results from
Literature F
Stress as a
between G
and Health
Impacts
I
% green
space
(vegetation)
Legend:
<5 Strong Studies
5<10 Strong Studies
>10 Strong Studies
Known Mechanisms
2view:
lediator
sen Space
0
o
W
<
11 I
ft
>
't* Social Bonding, Ties1
1> Social Interaction1
't* utilization of public
space1
1> Safety (perceived)1-3
J, Mental Fatigue2
J
t Ability to Adjust1
•f Social Cohesion
>| t Physical Activity |-
Health Outcomes
J, All Cause Mortality/
Morbidity3-4
'f Perceived Overall
Health SWellbeing3
1> Odds of Better
Mental Health2
•4, Risk of Hypertensive
CVD3
T
4- Hypertension
.1
>
4- Acute & Chronic
Stress
Key Articles:
1Kuo, FE, WC Sullivan, RL Coley, L Brunson. 1988. Fertile Ground for Community: Inner-City Neighborhood Common Spaces. American Journal of
Community Psychology.
2Sugiyama, T, E Leslie, B Giles-Corti, N Owen. 2008. Associations of neighborhood greenness with physical and mental health: do walking, social
coherence and local social interaction explain the relationships? Journal of Epidemiology for Community Health.
3Maas, J, et al. 2009. Morbidity is related to a green living environment. Journal of Epidemiology for Community Health.
"Mitchell R, Popham F. 2008. Effect of exposure to natural environment on health inequities: an observational population study. The Lancet.
We can assume based on previous case studies and measured changes in perceived and physical health
indicators that the percent of green space in the neighborhood can act as a risk factor to health. Strong
associations have been found between the percent of green space and certain health outcomes, such as all-cause
mortality/morbidity, perceived overall health and wellness, odds of better mental health, and stress-related
chronic disease. Although strong correlations have been found, there is no evidence that green space directly
affects health. The natural environment can influence individual health behavior and the social environment,
which directly alter internal stress levels. The health impacts of high stress levels have been extensively studied
and generally accepted. Consequently, stress acts as a mediator between the amount of green space and health.
Baseline Analysis for Stress-Related Health Outcomes
Baseline conditions of stress-related health outcomes were gathered for the study population. Due to the
sensitivity of individual health information, only publically-available aggregate data was used. There is an
overburden of poor health in the study area. Figures 2 and 3 show death rates for Fulton County, Georgia
compared to state averages. For both mental and behavioral disorder death rates and hypertension death rates,
Fulton County is well above the state average. Figures 4-6 show the percent of emergency room visits by cause for
the study population area. The census tracts that make up the study population stay within the top percentage for
each health outcome.
Proctor Creek's Boone Boulevard Green Street Project HIA
Page 188
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Figure 2. Dashboard for Hypertension Death Rates among African Americans in
Fulton County, GA (1,158 per person-year) compared to the state average. The
dial shows the Age-Adjusted Death Rate for Fulton County is 76.3. In
comparison, the Georgia Age-Adjusted Death Rate is only 57.6. Additional
values on the gauge represent percentiles from the lowest county rate to the
highest county rate. (GADPH 2013)
Figure 3. Dashboard for Death Rates from all other mental and behavioral
disorders among African Americans in Fulton County, GA (660 per person-year)
compared to the state average. The dial shows the Age-Adjusted Death Rate
for Fulton County is 57.0. In comparison, the Georgia Age-Adjusted Death Rate
is only 44.6. Additional values on the gauge represent percentiles from the
lowest county rate to the highest county rate. (GADPH 2013)
Figure 4-A (left). Percent of emergency room visits for high
blood pressure (Hypertension) by census tract in Fulton
County (2006-2010). Map created Jul 17, 2013. Data
classification method is quartiles. The numbers indicate the
seven census tracts (2010) included in our study area.
Figure 4-B (below). Hypertension morbidity rates for Fulton
County, 2006-2010 (GADPH 2013).
Percentage
Hype
Ho
M S 200
*S
a °
£? 3 ISO
re t_
-= u
S 3
5 v 100
•o S
s <*•
re -a
$s
~o -a
& < 0
rtension Morbidity Rates at Acute Care
.pitals, Disparities at the County Level
^^— • Series!
^^^^Series2
i^^— Series:?,
12345
Figure 5-A (left). Percent of emergency room visits for all
cardiovascular disease by census tract in Fulton County
(2006-2010). Map created Jul 17, 2013. Data classification
method is quartiles. The numbers indicate the seven census
tracts (2010) included in our study area.
Figure 5-B (below). Hypertensive heart disease rates for
Fulton County, 2006-2010 (GADPH 2013).
Percentage
Do.5-16
Dl7-19
2.0-21
22-2.4
25-35
HYP
Rat
is- 80
l§
8 §~ 60
U> rH
1 I 40
Si
S S 20
11
11 0
1*
ertensive Heart Disease Morbidity
es, Disparities at the County Level
^^— Seriesl
"^ --^ Series2
12345
Proctor Creek's Boone Boulevard Green Street Project HIA
Page 189
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Figure 6-A (left). Percent of emergency room visits for all
mental and behavioral disorders by census tract in Fulton
County (2006-2010). Map created Jul 17, 2013. Data
classification method is quartiles. The numbers indicate the
seven census tracts (2010) included in our study area.
Figure 6-B (below). Mental and behavioral disorder
morbidity rates, Fulton County, 2006-2010 (GADPH 2013).
Percentage
DtO-20
D2.1-25
LJ26-28
• 29-37
• 3.8-11 1
Impact Analysis
1000
v
£.
S
| | 500
Mental & Behavioral Disorder Morbidity
Rates at Acute Care Hospitals, Disparities at
the County Level
• Seriesl
»Series2
SeriesB
By following our theoretical pathway logic model, we can hypothesize where change will be seen and how
those changes will impact health. Below is a table illustrating the hypothesized impact the Boone Boulevard
Green Street Project will have on residents in the community.
Health
Outcome
Overall Stress
Hypertension
Mortality/
Mortality
Rates
Hypertensive
CVD
Morbidity/Mo
rtallty Rates
Direction
Positive
Positive
Positive
Magnitude
Low
Likelihood
Likely
Distribution
Restorative Equity
• A 10% increase • Stress-related • Low-income;
in greenness= indicators are • Lower
Permanence/
Severity
Medium
Quality of
Evidence
Sufficient
• Long-term effects • Seen
associated with consistently
0.5% of extremely high educational length of season across
population with
better perceived
health [Mitchell
and Popham
2008)
High
• Large percent of
for this area attainment;
• Youth and
Likely
• Green space
residents with exposure
hypertension-
related ER visits
(GADPH 2013)
High
• Large percent of
significantly
associated with
mortality rates
(Maasetal.
2009)
Likely
• Low % of green
elderly impacted
more
Disproportionate
Benefit
• African
Americans;
• Elderly impacted
more
Disproportionate
Benefit
Medium
• Hypertension
numerous case
studies with
few "no effect"
studies
Limited
• Consistent but
requires limited
extensive qualitative
management,
benefits can be
easily reversed
High
• CVD rates have
evidence
Limited
• Consistent but
residents with space yielded a • African Americans been declining limited
CVD-related ER 42.2% increased have the highest for past five
visits (GADPH risk for CVD rate of years and
2013)
(Mitchell hospitalization for direction not
Popham, 2008) CVD in Fulton Co, likely to change
. CVD rates have GA (GADPH 2013) (GADPH 2013)
been decreasing
in every group
over the past 5
years (GADPH
2013)
qualitative
evidence
Proctor Creek's Boone Boulevard Green Street Project HIA
Page 190
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Mental and
Behavioral
Disorder
Morbidity/
Mortality
Rates
Key
Positive
Positive:
changes
may
improve
health
Negative:
changes
may
detract
from
health
Uncertain:
Unknown
how
health will
be
impacted
No Effect:
No effect
on health
Medium
• Those with
neighborhoods
perceived as
highly green had
1.6 times Odds
Possible
• Mental health
rates have been
stagnant over
Disproportionate
Benefit
Low
• Impact would
Limited
• Consistent but
• Lower -income; be easily | limited
• Lower educational
the past 5 years attainment
in Fulton Co, GA impacted more
reversible from qualitative
confounding evidence
genetic factors
Ratio of better (GADPH 2013) | |
mental health
than less green
neighborhoods
(Sugiyama et al.
2008)
High:
Causes impacts to
many people
Medium:
Causes impacts to
Very
Likelv/Certain:
Adequate evidence
for a causal and
general effect
wider number of Likely:
people Logically plausible
Low: effect with
Causes impacts to substantial and
Equal Impact:
High:
The decision will Causes impacts
result in equal that are chronic,
impacts throughout irreversible or
the population fatal
Sufficient
Evidence:
Many strong
studies (>10
studies) with
Disproportionate Medium: consistent results
Harms: Causes impacts and conclusions of
The decision will that necessitate causal association
result in
no or very few consistent disproportionate
people supporting adverse effects to
(relative to evidence and populations defined
population size)
substantial by demographics,
treatment or Limited Evidence:
medical
management and
Few studies (2-3)
with strong
are reversible associations, but
Low: limited on causal
uncertainties culture or Causes impacts
Possible:
Logically plausible
effect with limited
inferences due to
geography that can be quickly potential
Disproportionate and easily confounders/
Benefits: managed or do not other factors
or uncertain The decision will 1 require treatment Lacking/Insufficie
supportive result in
evidence disproportionate
Unlikely/Implausib
l£l
Logically
implausible effect;
substantial
evidence against
mechanism of
effect
Insufficient
Evidence/Not
beneficial effects to
populations defined
by demographics,
culture, or
geography
Restorative Equity:
The decision will
reverse or undo
existing or
historical
Evaluated: inequitable health-
relevant conditions
or disparities
Insufficient
Evidence/Not
nt Evidence:
Studies are weak
or vary in results
Unknown/Not
Studied:
-
Conclusion
We can conclude from the evidence that our study population has a high risk of stress-related disease.
Fortunately, the Boone Boulevard Green Street Project will help address the overburden of disease by increasing
green space. This will in turn help to mitigate some causes of stress in the community. In relation to the health
indicators, we recognize there are many factors other than green space that influence health. Simply adding more
green space will not directly cause change in health outcomes, but the opportunity for change will be more
equitable among sub-populations. Further study would involve surveying community residents to measure
perceived stress levels and any changes after implementation. Educational outreach can be used to help teach
residents to identify causes of stress and ways to cope. Recommendations should be drafted to help further
reduce sources of stress in this community to maximize the benefits to health.
References
Proctor Creek's Boone Boulevard Green Street Project HIA
Page 191
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Georgia Department of Public Health (GADPH). 2013. Online Analytical Statistical Informational System (OASIS).
Atlanta, Georgia: US Accessed? July 2013. .
Kuo SE, Sullivan WC, Coley RL, Branson L. 1998. Fertile ground for community: inner-city neighbourhood
common spaces. American Journal of Community Psychology. 26 (6): 823-851.
Lee AM, et al. 2010. The health benefits of urban green spaces: a review of the evidence. Journal of Public Health.
33 (2): 212-222.
Mass, et al. 2009. Morbidity is related to a green living environment. Journal of Epedimiology and Community
Health. 63: 967-973.
Mitchell R, PophamF. 2008. Effect of exposure to natural environment on health inequities: an observational
population study. The Lancet. 372 (9650): 1665-1660.
Pickering TG. 2001. Mental Stress as a causal factor in the development of hypertension and cardiovascular disease.
Current Hypertension Reports. 3: 249-254.
Sugiyama T, Leslie E., Giles-Corti B, Owen N. 2008. Associations of neighbourhood greenness with physical and
mental health: do walking, social coherence, and local social interaction explain the relationships? Journal of
Epidemiology Community Health. 62 (e9): 1-6.
Taylor, et al. 2004. Early Environment, Emotions, Responses to stress, and Health. Journal of Personality. 76 (6):
1365-1394.
Williams DR, Yu Y, Jackson JS. 1997. Racial Differences in Physical and Mental Health. Journal of Health
Psychology. 2 (3): 335-351.
Proctor Creek's Boone Boulevard Green Street Project HIA Page 192
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HIA Advisory Group Exercise (Handout)
Proctor Creek's Boone Boulevard Green Street Project
Health Impact Assessment (HIA)
U. S. Environmental Protection Agency, Region 4 and Office of Research and Development
Group Exercise
Purpose:
The purpose of this group exercise is to help the research team to identify potential tools and sources, including published evidence, local data, and
peer-reviewed literature, for the topics below. Asa member of the Advisory Group, you may gather information prior to the meeting by filling out this table
wherever possible and discuss sources during the group exercise.
Topics
Environment
Public Space and Recreation
Transportation
Mobility, Access to Services
Social Capital
Baseline Condition
Water Pollution
Flooding and Storm Water Management
Soil and Filtration
Air Pollutants (PM, CO, C02, etc.)
Temperature and Humidity (Urban Heat Island Effect)
Ecology and Biodiversity
Disease Vectors and Transmission
Surface Permeability
Grey to Green Space (Land Cover)
Physical Activity (Opportunity and Actual Activity)
Parks and Recreational Space
Traffic Conditions and Road Diet
Traffic Calming Practices
Traffic Accidents
Traffic-related Air Pollution
Traffic-related Noise Pollution
Walkability and Bikeability
Public Access Points (Bus stops, electric cars, etc.)
Social Bonding and Ties (Support)
Social Cohesion and Social Contract
Culture and "Branding"
Social Institutions (churches, schools, community groups, etc.)
Data Sources
Tool(s)
Proctor Creek's Boone Boulevard Green Street Project HIA
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Politics/Government
Vulnerable Populations
Economics
(Household and Community)
Safety
Public Meeting Space
Educational Outreach
Capacity Building (Jobs)
Stakeholder Involvement In Planning (NPU-L)
Resource Allocation
Educational Attainment
Income
Occupation
Housing Status
Race and Ethnicity
Age
Industry in the Community
Poverty and Unemployment
Property Values
Affordable Housing and Housing Costs
Vacant and Occupied housing
Housing Quality (Damage)
Crime and Civility
Perceived Safety
Traffic Safety
Deterring Incivilities
Proctor Creek's Boone Boulevard Green Street Project HIA
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HIA Advisory Group Input on Potential Data Sources, Methods, and Contacts for the Assessment Step (Posters):
Poster Category and Subtopics
(Health Determinant Groupings)
Environment
Topics included, but not limited to:
• Water pollution
• Flooding and Stormwater
• Soil and filtration
• Air pollution
• Evapotranspiration and humidity
• Ecology and biodiversity
• Surface permeability
• Disease vectors and transmission
• Gray to green space (including
Brownfields)
Stakeholder Input and Considerations for the Assessment Step
Leaf-on (tree canopy coverage area) http://datagateway.nrcs.usda.gov/
Leaf-off, LiDar (Tree Canapy & tree height) - Class 1 - Used to better evaluate the urban
tree (green infrastructure) component of the watershed)
Other Multiband, high resolution imagery - I have access to the military clearinghouse for
remotely sensed data (satellite & airplane) and check it frequently for any up-to-date
imagery that we may be interested in and that could possibly support this HIS
assessment and additional work in Proctor Creek Watershed https://warp.nga.mil/
Green Health - G.I. (tree canopy) & Human health. Peer-reviewed, 1400 citations.
www.greenhealth.washington.edu
http://depts.washington.edu/hhwb/ This is Kathy Wolfs work (kwolfgju.washington.edu
Hydro (itree) and ECO (itree)
Open Tree Map (tree mapping & how it affects Environmental Services) This is open
source http://www.azavea.com/products/opentreemap/
Community Viz (Planning & Design Scenario's, effects) No longer free, but possibly an
HIA scenario builder tool http://placeways.com/communityviz/
EPA STORET
Atlanta DWM (monitoring data)
USGS
Green Streets (http://www.epa.gov/owow keep/podcasts/greenstreetsusa.html)
West Nile Study - Auburn University, should have mosquito habitat results (basically old
tires & water) by 1st quarter 2014
Water Environment Research Fund (WERF)- Green Infrastructure Valuation, several
recent EPA funded research projects... An Evaluation of the Functions and
Effectiveness of Urban Riparian Zones (WERF 99WSM4)- (Executive summary
attached) Tools for Evaluating Green Infrastructure (attached) and... Stormwater to
Street Trees - Engineering Urban Forest for Stormwater Management (EPA 841-B-13-
001) - Not "ground-breaking" but the basics; (this was not a WERF project)They
(EPA) also are funding a current project (with WERF) on Green Infrastructure Asset
Management that is scheduled for completion http://www.werf.org/
CDC's Environmental Public Health Tracking System. Georgia is not in portal yet. But,
other states are there.
Economics
Beltline - Affordable Housing (Assessment of AH options)
Proctor Creek's Boone Boulevard Green Street Project HIA
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Poster Category and Subtopics
(Health Determinant Groupings)
Topics included, but not limited to:
• Industry in the community
• Poverty and unemployment
• Property values
• Housing quality (damage)
• Affordable housing and housing cost
• Vacant and occupied housing
Stakeholder Input and Considerations for the Assessment Step
Fulton County - Tax Parcel Data Housing Values
BLS - Bureau of Labor Statistics (Job Classifications)
ACS - Census Income information
Economic Development - Industry Information Merchants Association
Atlanta Code Enforcement - Vacant & Occupied Housing Information
Real Estate Association - Housing cost
Insurance Companies - Housing Damage information
Atlanta Regional Commission (ARC) - Reports
Community Improvement District Associations (Rodney Mullins)
Chamber of Commerce
Transportation
Topics included, but not limited to:
• Traffic Conditions and road diet
• Traffic calming practices
• Traffic accidents
• Traffic-related air pollution
North South Public Transportation on J.E. Lowery between Marietta Street & Ashby
Marta Station
Bike riders (sidewalk). Multiuse lanes for bikers & walkers... versus Street bike riders
(inclusive of all riders)
Should trees & shrubs be planted in the street? right of ways obscuring views of traffic
(veg. cover?)
COA-City of Atlanta /APD-Atlanta Police Department: Accident Survey
Mobility, Access to Services
Topics included, but not limited to:
• Public access points (bus stops, electric
cars, etc.)
• Walkability
• Bike-ability
ARC GIS Data (bus routes/stops, sidewalks, bike paths (Cassandra)
WalkScore - http://www.walkscore.com/
Atlanta Bicycle Coalition, bike counts, http://www.atlantabike.org/BicycleTrafficCounts
MARTA
Beltline user counts (Lee H.)-
PATH traunetwork
American Community Survey
National Academy TRB (Transportation Research Board) Circa 2008 (Kevin M.)
Politics/Government
Topics included, but not limited to:
• Stakeholder involvement in planning
(i.e., NPU-L)
• Resource allocation
i-Parcs (look-up: Dr. Kathleen Wolf, University of Washington. Database of Parks and
Greenspace studies) http: //www.nature within. info/new .html
Atlanta Regional Commission (ARC)
ABI/PATH trail (connectivity options to Greenspace) - (Lee H.)
Safe Routes to School
American Association of Retired People
PAR Courses (DPH)
URBAN-LAND-INSTITUTE (Walt R.)
Project for Public Spaces (Walt R.)
Proctor Creek's Boone Boulevard Green Street Project HIA
Page 196
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Poster Category and Subtopics
(Health Determinant Groupings)
Stakeholder Input and Considerations for the Assessment Step
City Parks Alliance (Walt R.)
Trust for Public Lands (Park Score) (Walt R.)
National Recreation Parks Alliance (Walt R.)
Active Net (Sports & Activity)
Public Space and Recreation
Topics included, but not limited to:
• Physical Activity (opportunity and
actual activity)
• Parks
• Recreational space
Co-development
Churches
AUC
N-hood events (books & backpacks)
Community development corporations (religious & non-religious development)
Girls & Boys Club
Teach for America College Students
Schools (Parent Teacher Associations)
AmeriCorp
Volunteers of America
Resources to engage the community (meeting times & locations to attend, $$ to travel)
Stipends to Community for their time.
Safety
Topics included, but not limited to:
• Crime/civility
• Traffic safety
• Perceived safety
• Deterring incivilities
Atlanta Police Department
City of Atlanta Bike and/or Pedestrian Accident Summaries
City of Atlanta Public Works - Traffic Management (signed inventory / maintenance)
Crime Prevention through environmental design (CPTED)
Department of Energy studies for accelerator in Texas
Chicago: Pilsen and Southside studies
Community cohesion models
Social Capital
Topics included, but not limited to:
• Social bonding and ties (support)
• Social cohesion and social contact
• Culture and branding
• Social institutions (churches, schools,
community centers)
• Education outreach
• Public meeting spaces
• Capacity building (jobs)
Concerning Black Clergy
AUC (Education & Outreach)
State Behavioral Health
Neighborhood Planning Unit
Neighborhood Associations
Garry Harris's Center for Sustainable Communities
Fraternities & Sororities
Fulton County Human Services Department
Churches located in the neighborhood
Urban Gardens - Rashid
Food Commons - Kwabenna Nkormo
Proctor Creek's Boone Boulevard Green Street Project HIA
Page 197
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Poster Category and Subtopics
(Health Determinant Groupings)
Stakeholder Input and Considerations for the Assessment Step
Food Bank
New Horizons Senior Center
Historical Preservation Department of Labor (Local Jobs)
Vulnerable Populations:
Topics included, but not limited to:
• Educational attainment
• Income
• Age
• Race and ethnicity
• Housing status
• Occupation
(Chris) number of jobs and/or individuals with connections in relation to change in
physical activity
(Chris) Single parent families with opportunity for physical activity
(Cassandra) Census data and/or American Community Survey
(Cassandra) Social Vulnerability Index (SoVI), University of South Carolina indicators
[Susan Cutter ]
(Lucy Wang) Property values (economic balance between income & poverty)
(Lucy Wang) Piedmont study
(Lucy Wang) Property value - renovation, restoration
(Lucy Wang) Youth and lack of educational, involvement of parents (i.e., social support)
Monitoring Health-Related Quality of Life (HRQoL)Index
Georgia Tech - Quality of life website for City of Atlanta, (professor: Botchwey)
U.S. Department of Housing and Urban Design block grant programs (CDBG)
Neighborhood stimulus program (e.g., HERA - ARRA)
Foreclosed Homes - refurbish and resale for affordable housing
Note: There was no scribe a the second HIA Advisory Group meeting and thus no a summary of the meeting was prepared.
Proctor Creek's Boone Boulevard Green Street Project HIA
Page 198
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Documentation of the Second Community Engagement Meeting, March 22,2014
Second Community Engagement Meeting Invite (Flyer)
ANNOUNCEMENT: Upcoming Community Meeting!
Proctor Creek's Boone
Boulevard Green Street
Project - Health Impact
Assessment
During the past year, the U.S. Environmental Protection Agency (EPA)
has been conducting a health impact assessment (HIA) on a proposed
green infrastructure project in the headwaters of Proctor Creek. The
proposed "Boone Boulevard Green Infrastructure Conceptual Design"
is under consideration of the City of Atlanta's Department of
Watershed Management to be implemented along with the road diet
planned for Joseph E. Boone. The proposed green street project was
designed as a demonstration project for implementing Green
Infrastructure to address local storm water runoff, water quality, and
other environmental health issues.
The purpose of this HIA is to evaluate the proposed project for
potential impacts on environmental and public health and inform
future decisions around green infrastructure approaches to storm
water management, ecosystem restoration, economic development,
and community revitalization. A presentation will be given on initial
findings of the HIA regarding key impacts related to the community.
Come learn about the HIA process and how your input can improve
your community!
Headwaters of the Proctor Creek
Watershed: Commitments and
Capacity Building
The City of Atlanta and the EPA are preparing
for future activities in the communities of Proctor Creek. The
director of EPA's Office of Water Protection will be presenting on
their organization's commitments in the area and how residents can
get involved. A roundtable discussion on how to build capacity for
community projects through grant funding and building partnerships
will be facilitated by local community leaders and researchers.
Come and learn how you can empower your organization to make
change!
~ Light food & beverages will be provided ~
NG INFORf\
WHEN:
Saturday, March 22, 2014
from900AMtol:OOPM
Doors Open: 8:30 AM
WHERE:
Central United Methodist Church
501 Central Street SW,
Atlanta. GA 30314
SPEAKERS:
Tami Thomas-Burton
EPA Region 4 -Office of
Environmental Justice and
Sustainability, HIA Project Co-Lead
Jim Giattma
EPA Region 4 -Office of Water
Protection, Director
David Egetter
E PA Region 4 - Resource
Conservation and Recovery Act
Program (Brownfields)
Monica Robinson
Fulton County - Department
of Health & Wellness
Dr. Yomi Noibi
Eco-Action Inc.
Na'Taki Jelks Osborne
WAWA & Georgia State University
MEETING CONTACT:
Tami Thomas-Burton
Office (404) 562-8027
email
Thomas-burton.tami@epa.gov
GENERAL INFORMATION
EPA Toll-Free Customer
Service* 1-800-241-1754
SEPA
United Slates
Environmental Protection
Aflencv
' ^SSH
Proctor Creek's Boone Boulevard Green Street Project HIA
Page 199
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Notes from Second Community Engagement Meeting
Key "Take-aways" we heard from HIA Community Meeting Discussions
1. After the HIA report is completed, we still need funding for Community-led projects
2. Teach us how to leverage Fed, State, and local funding
3. A need for grants training & proposal writing
4. Conflict Resolution needed for long-term resolutions efforts & capacity building
5. Partnerships with local schools for sustainability
6. Recognition of Community Organizations for their contributions
7. Lack of knowledge concerning local issues, initiatives, and projects happening in the community
8. Create training & train-the-trainer models for
a. community research,
b. green Infrastructure,
c. green jobs,
d. and water sampling stewards.
9. Empower, train, and employ people in the community on sustainability matters
10. There is a perception outside of the community that the headwater community organizations are
not organized. Help us create new ways to build capacity in the community and change
perception.
Source: Tami Thomas-Burton, HIA Project co-Lead
Proctor Creek's Boone Boulevard Green Street Project HIA Page 200
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Summary of the Second Community Engagement Meeting (Handout)
Flip Chart Notes & Powerpoint Highlights from HIA Community Meeting
Proctor Creek's Boone Blvd Green Street Project
Saturday, 03/22/2014 (9:00 am - l:00pm)
HIA- Health Impact Assessment Meeting Objective, Review & Update
• (Tami's Highlights)
o Meeting Objective: Engage Community Members in the HIA process, Give update on the HIA's
progress - Present initial findings of the HIA, Discuss EPA's Commitment to Proctor Creek, Obtain
feedback from Community Members on HIA and path forward for continued Community Capacity
Building, Discuss Community-Lead Projects on the horizon.
o HIA Defined: A Health Impact Assessment is a science tool used to evaluate both the positive &
negative health effects of a project or policy before it is implemented.
o Understanding Health Assessment Terminology: All Health Assessments are not the same. A Health
Impact Assessment is different from the following. For more detailed information see:
http://www.cdc.gov/healthyplaces/types_health_assessments.htm
• PHA- Public Health Assessment: The evaluation of data on the release of hazardous
substances into the environment in order to assess any past, current, or future impact on
public health, ....from this assessment... thus health advisories are developed.
• HRA-Health Risk Assessment: An assessment to determine the risk of adverse health
effects that would be caused by exposure to specific chemicals or other hazards.
• EIA - Environmental Impact Assessment: provides a systematic, reproducible, evaluation of
the potential physical, biological, cultural, and socioeconomic effects of a proposed action
and its practical alternatives.
o What is Health: Health is a state of complete physical, mental and social well-being and not merely
the absence of disease or infirmity.
o Social Determinants of Health: are the economic and social conditions that can influence the risk for
a disease, or vulnerability to disease or injury.
o What the Boone Blvd Green Street HIA is about: Evaluate potential positive and negative health
impacts of the green street design and inform stakeholders. The green street design in concert with a
planned road diet will help manage the flooding, to help in cleaning the surface water and ground
water, to improve the streets and sidewalks, and to help in economic revitalization.
• (Monica R. & David's Highlights)
o Recap of previous community & advisory group meetings: Community Group and the Advisory
Committee identified issues of interest and areas of concern in the community.
o Topics Evaluated in HIA
• Water Quality
• Air Quality (Outdoor)
• Flooding
• Climate and Temperature
• Ecology and Biodiversity
• Pollutant and Pathogen Transmission
• Noise Pollution
• Transportation and Traffic Safety
• Vector Control (Mosquitoes)
• Job Creation/Unemployment
• Housing and Development
• Access and Mobility
• Social Interaction and Cohesion
• Community Economic Revitalization
Proctor Creek's Boone Boulevard Green Street Project HIA Page 201
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Flip Chart Notes & Powerpoint Highlights from HI A Community Meeting
Proctor Creek's Boone Blvd Green Street Project
Saturday, 03/22/2014 [9:00 am - l:00pm)
• Physical Activity
• Healthy Eating / Nutrition
• Mental and Behavioral Health
• Morbidity and Mortality
o Examples of how Stormwater can impact health: Exposure to Injury from Flooding, Exposure to
Vector-borne Diseases, Exposure to Waterborne Disease, Exposure to stress from loss / damage of
property and self.
o Next Steps of HIA:
• Document findings from assessment step of HIA
• Need to incorporate local business owners in HIA process
• Input received from community will be incorporated into findings of HIA
• Nitrogen/Phosphorus prevention vs. treatment -> needs to be addressed/revisited
in findings.
• Project (Boone Blvd) Impacts vs. Community-wide Impacts vs. Watershed-wide
Impacts
• Develop initial recommendations based on findings of HIA
• Currently planning department at City requires more parking spaces if you expand
the capacity of your building (Rev. Bright's example). No mechanism for green
infrastructure recommendations here. Atlanta Dept. of Watershed and Planning
should discuss this disconnect.
• Initial recommendations will be presented to community and other stakeholders for input /
feedback.
• Finalize recommendations and present report to the City of Atlanta and public.
• Timeline: Develop HIA Report and Present HIA Report (June/July 2014)
Community Discussion
• (Dr. Yomi) Hasthere been consideration of the community-wide impact not just the% mile radius of Boone
Blvd.
• (Tony Torrence) How much will the proposed Green Street capture in Water? Has that been calculated?
• (Rev. Bright) Has the City of Atlanta considered the impacts of more impermeable surfaces and increased
traffic as the new stadium goes in?
• (Deborah Scott, Yvonne Jones, Rep. Able Mable Thomas) There are many moving parts and too many entities
(agencies) working in silo's. We need to find a way to breakdown the wall of transparency and get this
information and messages to city council.
• (Rev. Bright) Who is looking at the Nitrogen and Phosphorus loads in the headwaters of the Creek? What
preventive considerations are taking place? (Tami's clarification notes: Nitrogen & Phosphorus "Nutrients"
can be produced by animal and human wastes [pet waste, septic tanks, waste water treatment plants]...too
much can cause problems in water bodies)
• (Rep. Able Mable Thomas) Sustainability comes from involving community youth/schools/education.
Youth/kids then subsequently make the change through educating their parents, family, relatives, friends, etc.
Highlights from Jim Giattina Discussion
• One of EPA's priority and commitment is "Making a Visible Difference in Communities."
• Proctor Creek became one of 18 Urban Waters Partnership communities in the country; many community
members participated in the December 2013 meeting with the Federal Partners.
• We must constantly learn from the community to create a livable community
• How can we work together? How can we do more with fewer resources?
• Let us focus on issues with structure, hard work, and ongoing discussions.
• How do we engage while keeping the community front & center?
• Charge/Actions/Questions to think about:
o How do we share leadership?
o How do we create an accountability structure?
o How do we communicate our plans with each other better?
o What resources are available in the community?
Proctor Creek's Boone Boulevard Green Street Project HIA Page 202
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Flip Chart Notes & Powerpoint Highlights from HIA Community Meeting
Proctor Creek's Boone Blvtl Green Street Project
Saturday, 03/22/2014 (9:00 am - l;00pm)
"Capacity Building" facilitated by Dr. Yomi
• Community Capacity Building (CCB)
o Generate inclusive process that processes that strengthen trust and build commitment and good
relationships
o Strategic Questions
• Whose capacity are we trying to build?
• Capacity to do what and why?
• When do we need to build these capacities?
• Who should deliver the capacity building?
• How will we know if we have succeeded?
o Assumptions: All communities are perceived as having inherent strengths, skills, and abilities (or
assets within them).
Community discussion from Capacity Building exercise
• Ways to build capacity in the community
o Issue: Trust, Dependability, Accountability
• Potential Intervention: Conflict Resolution
• Potential Intervention: Create a Shared Process
• Potential Intervention: Create Transparency among groups
o Westside Communities should embark on a major green initiatives
o Build a community park at Lowery Boulevard
o Green Infrastructure starts with code enforcement
o We need to partner with schools for sustainability purposes (each one teach one through
children)
o Resources are needed because we have community organizations in place
• Potential Intervention: Grants Training
o For the different Group and Community Organizations, they are asking, "What's in it for me?"
How do we create the longevity of these organizations in the community?
o On an ongoing basis, we need to find a way to recognize the contributions made by these
community organization
• Potential Intervention: Awards Recognition
o Take preventive measures
o There is a perception outside of this community that the headwater communities do not have
capacity.
o We need an Urban Waters Partnership "Prevention" outlook for Proctor Creek
• EPA should provide data
• Train-the-trainer models should be developed concerning EPA data
o People resources to do some of the work in the community (knowledge of local issues)
o Need to communicate and involve residential & business more
o Teach communities how to Leverage Resources
o Restructuring to support community (specifically on non-point pollution)
o Shared leadership requires shared power within the community
o Local, State, and Federal collaboration and how to leverage all funding
o Always seek out community to help
o Sustainability always and continues to be a problem:
• Empower, Employ, and Train people in the community concerning sustainability
• Poverty and lack of ownership is a problem
Proctor Creek's Boone Boulevard Green Street Project HIA Page 203
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Flip Chart Notes & Powerpoint Highlights from H1A Community Meeting
Proctor Creek's Boone Blvd Green Street Project
Saturday, 03/22/2014 (9:00 am - l:00pm)
Community-Led Projects & Initiatives in Action
• (Na'Taki Osborne Jelks)
o WA WA - West A tlanta Watershed Alliance
o The West Atlanta Watershed Alliance (WAWA) is a community-based non-profit organization whose
mission is to improve the quality of life within the West Atlanta Watershed by protecting, preserving
and restoring our community's natural resources. WAWA represents African American
neighborhoods in Northwest and Southwest Atlanta that are most inundated with environmental
stressors, but are least represented at environmental decision-making tables.
o Identify Hot Spots for Priority Areas
o 10 Proctor Creek Researchers (to collect Data & Identify gaps)
o Photo Voice (Inventory history & local knowledge)
o Create our own community maps
o Kick-off: May/June 2014
• (Tony Torrence)
o Community Improvement Association & Proctor Creek Stewardship Council (PCSC)
o PCSC Mission Statement -" Proctor Creek's people participating to preserve and protect the
prosperity of the watershed utilizing local knowledge/skills to improve public health for the people of
Proctor Creek."
o Educate / Train how to test the water (Creating Water Stewards within the Community)
o Stream Clean-up's (Ongoing)
o Sustainability Efforts
• (Deborah Scott & Jackie Treadville-Samuel)
o Georgia Stand-up / Trade-up / Build-up
o Georgia Stand-Up empowers residents to ensure economic development meets the needs of their
neighborhoods and uses community benefits agreements and policies to assist communities.
o Recognizing the contributions of the community
o Training community with skill sets in construction, apprenticeship programs, and deconstruction
o Community Service
o Georgia "Build-up" is a new arm of Georgia Stand-Up and addresses "real-time" events.
Source: Tami Thomas-Burton, HIA Project co-Lead
Proctor Creek's Boone Boulevard Green Street Project HIA Page 204
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Documentation of the Final Stakeholder Engagement Meeting, June 5,2014
Final HIA Stakeholder Engagement Meeting Invite (Email)
Hello Proctor Creek Advisory Group & Community Leaders,
We will be holding our Final Proctor Creek combined Advisory Group & Community Stakeholder
Meeting on:
Date: Thursday, June 5, 2014
Time: 12:30 pm - 3:30 pm
Location: Sam Nunn Federal Center
61 Forsyth Street SW
Atlanta, GA 30303
Room: 9th Floor, Room 9D/9E
Check-in: Please allow extra time to go through Security & obtain a "Visitors Pass." After
obtaining your pass, go to the elevator (9-14).
Parking: Parking surrounding the Sam Nunn Building can be expensive. We encourage you to use
Marta. We are located Kati corner from the "Five-Points" MARTA stop.
If Driving, Paid Parking located at:
145 Lower Alabama Street Parking Lot (apprOX. $10)
76 Forsyth Street Parking Garage (apprOX. $7)
55 Spring Street Lower Parking Lot (apprOX. $5 - $7)
Looking forward to your attendance at this very interactive meeting. Your participation, feedback, and
input is valued!
Proctor Creek's Boone Boulevard Green Street Project HIA Page 205
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Meeting Agenda from the Final Stakeholder Engagement Meeting
SEPA
United States
Environmental Protection
Aqancy
Health Impact Assessment (HIA) for Proctor Creek's
Boone Boulevard Green Street in Atlanta, Georgia
U. S. Environmental Protection Agency, Region 4 and Office of Research and Development
HIA Combined Advisory Group and Community Stakeholder Meeting
Thursday, June 5, 2014, 12:30PM - 3:30PM
Sam Nunn Federal Center - 61 Forsyth Street SW, Atlanta, GA 30303 Room # 9D/9E (9th Floor)
Meeting Objectives:
• Brief overview of HIA progress
• Discuss Initial Research Findings
• Engage for feedback and recommendations
• Prioritize recommendations
12:30 PM- 12:45 PM
Welcome / Introductions / Logistics
Tami Thomas-Burton
EPA Region 4 - Office of Environmental Justice &
Sustainability, HIA Co-Lead
12:45 PM- 1:15 PM
Recap HIA and HIA Progress:
HIA Progress & Timeline
Boone Blvd. Green Street Project:
"Background and Path Forward"
Florence Fulk
EPA Office of Research and Development
NERL - Molecular Ecology Research, Branch Chief
HIA Co-Lead
Todd Hill
City of Atlanta — Department of Watershed Management
Watershed Director
1:15 PM-1:25 PM
1:25 PM - 2:25 PM Key Findings of the HIA
Group Exercise: 9 - Poster Presentations of
Predicted Impacts (HIA Researchers by Topic)
Group Discussion on Findings
Lauren Ad kins
EPA Contractor: CSS — Dynamac
Public Health Specialist
2:35 AM -3:05PM Developing Recommendations
Group Exercise: 9-Initial Recommendation
Posters (Post-it Edits Exercise)
Group Exercise: Prioritization / Voting
3:05 PM -3:30PM
New & Upcoming HIA Project :
HIA Project #2 - Expanded Scope
Wrap-up and Recognitions
Lauren Ad kins
Florence Fulk
David Egetter
EPA - Brownfie/ds, Ecologist
HIA Core Team & Researcher
Tami Thomas-Burton
Proctor Creek's Boone Boulevard Green Street Project HIA
Page 206
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Assessment Findings Presented to Stakeholders (Posters)
ENVIRONMENT
WATER QUALITY &
FLOOD MANAGEMENT
DMWMs of Project
The protect win me elements of
pee* infrastructure (nun nrdeiu.
pMer bents, mi permeable pve-
moKi K> create a aeeucapt along
fcaiBJ I ; .. ',. :•!..• '. :-h> . .
The desigl includes
• Converting 5 ft wide of roadway
o« etch ode at the street from a
shared tra»el lane into a deafntod
Stomwattr runoff nnd storm sewer overflow s arc two of the moat
iiaainmnan nf imfaii iln iinimaim At stonnwater moves
over a swfaoe. it p^ks in? substances previously deposited on that
surface (e.g. debris, heavy metal*, sod. bacteria, etc i Crccn intn
struct«re it commonly m*d to redno; or slow ranofl nnd capture and/
or remove i
lncreisjB| the perneabitiry of the tnodd and ptanunj
• WatrrQwlity
'A ,ik " . .l.L 1". I . 'I.U.I.
tn/cd by the physical
properties, chemical prop
crticv and orgauUH liv-
ing m ihc » afer bfev
tion aooYorcontact *uh
team soil nxdui and vqeWion ingwet *e ih«y to opUR and
absorb potlouuMs novng n wafec. PDUBUM rwoovai has been foHd
lo improve over tin as the uructnre afet and ne soil i
Typical %> mpton» of
w'akitorK Ulaev
n..L',il. -1 ^v j'.!r. :i i
tion. cfaan|c« in the
ttstro mtsliiul tract
• Convenint \1 It wide of roadway
01 one side (eaoboond fide) of m?
street IMO pLmlef bcmes
•Convening lift wide of roadway
::'- II .:L t.'t :'! J:I. T f- ' I. .1
"I .1 : - ,11 I ' V : I .
• • : '. •[. • i r 'i , • : il I • i . :
rvntMhal occur in toils and surface wafer. Although
.n. . •MUI 'i .,i i, i pirn ttya hw •
even
The proposed projecf s design win;
• Add 14.788 ft: more of pervions surfaces:
• CaptuE and rertain all of the rain from Qlt of storms • M average
year and up to I 2 inches of larger storm (57% increa* • total nun-
'WlMk-Klv M*J •»•••!! I
| *,[('. .1 • I. : .
ml of brcomuig ill but
tarn -i : j< .>- .:.: ta
*m
re-
.,l.vl t II --.I I • I,
. i.ti. ir i :*•- I' f-1. '•. :
perceived safety.
rnn?M levels.
anoYor poor Mrninon
•n: HIV. do
death.
• Flood Manage me ni
Storm» Jtr itself can be
harmful in high votnnes
et i
Thtw who are imastd
-.. -.'i lajai] f -i
fkndwg. overflows of
• Adding 12 ymco for street days i y?\ reduction i:
• Capnue and/or remove apto 9°% of sobstaaces carried in stormwa
ler ranoff. s«ch as suspended solids, niiuxnu heavy metals, oilt aad
> [Jderty. and
buildaigs. Hash flooding
increases ne risk of uv
inry by cn>acin| bazank
for slips. falK and impact
with floating debris.
• Reduce up to 7KrOulin
Flood Muu*tmrnt
IHrnun.
f
Ukxlihood
»»*
ss
Mitmlu.k
*
cc
IVmunrncT
*
94
l*i .mli -..'tin n
+
+
Smucih of
tvtdcflcc
M
**
Cammnb
bnjaast
• -Tbedunp m*c *••• <•«•••• wiO pout hMkh •*! «vlli»M>
*• vvkKnfak popttteiDiM flvy tnefitnoe or equity tn the opfionunity Corbeatehy Inrinf wiflhe 'i^i'" 1
Proctor Creek's Boone Boulevard Green Street Project HIA
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ENVIRONMENT
•••••••••al
Den* i!
CLIMATE, TEMPERATURE &
AIR QUALITY
rinding* -. "mnMn
Hfrallfa OnlromK
boa; s. and (Kira; mi: pmsineir i to
crczx i slxct-capc -ik-''-nj. josejii lr_
Ikxine Strcd NorthwKi The dcsipi
Sac TnhinHiiiijJaKriElierstc UEtoGlhii IE Iwal
mas ax few IERES hifbcr xai
H^lJLiiir: imjxr> >:wiB jurtKri iara die IX irae ftaslinif basci
aad cttKr uecn Earner a nin am mcnjllf it
jnecaaa* intiliri) u>J it
i gtffaiEi icjt concEtfM
cxi impure t
naar nd TcinpirauB! Impact*
* BuEBE «arc emneouiES can lead m:
dJl'Smllii dhaBuoi. Caul mi lun-
[n[i»rm*niuE5 can cl'lt
ence besf ises aid mimics ua inntib-
au ic Hcicued aim anamaUUhcilui
inpicu. au± u dcncuiafi, pli" -ii'i.'ji
-il ±jnpU:a mtpon-lnBEaUic Of a
* Pie? nani Wmms; and
unpacts. incluLoit nllma;n dioLik carfeai
ID the p jntj kxn./ ma a OTTI-
Air quilitu 'a i em neii Ic itia.lr UK ftaacc of
a Ite u njlBSEU an EC njUnlh txaa-
[KHfcn from ptonis;«-B;ia»£na» Imnin
cranbuEkn OEI fern mofervbicEvi
CtHfaadiDn aid nKitftchrirbs c*&tiijmc u linasfl.
19 as lie lirwa KTOCO, of itr paaUim in te US.
and
rhtra
ways to -«feiii panu
iii; w Ihc
-2 spaces fai died fide
in lac
Hjau aburt jazs
aid an them (•:< anienLs aid hem.
onsr KB; p» unr
ei trd rain gaidei»
HEludic [fL/Tunm tvpcs of iv^c
. hurhc^ grasses, cici and soil
pinacbSL e*l and uitinrJ
lltMi^ i MIHHl COtTRlHUI Ijf BK miNCItl
u bccancj Uxi: il Jpcls ihcrc Ml ta'm'
Cabaa nnKniit EUBXS UE ibilin for bkad CHI bad ui
pmhiajs. Maa^n Btfarai •>HIHIZB. oil
nstaiEi laaf) faadloi InhaVd panunlae
miucr laaavli BEHb bj imrfcrln) wiUi jss
iissa: tcjdli ikav. uli tml SiSn-ins
ilk 11 ti>?h JL*^[5 'llffl 'flflZIDC 'ml? Ll^Va.L BKj
CBUE cfc fioiiaa J-.Tmiim TjjKniic i
tntufldE •addon en OHEXE apnam: no
I jf.cni- VI
bae oUOim hciBh onKtf >3E. sudi is
jsumi. •IAIVCL
int OEdcil aadlhnL
The roja sauiL>c jtmna. la
:iuii
incicat lir pcDulinu c>cr UHE
dtit p«in. Iroubi! bmiuUci.
ilrn,
Ohkr adulc ieldcdi u
•I
dcclnr i rflkc fn tspiiaurj discomftrt
in ,1 . asmiu mi hug
jsk-rt (EEl jnl line; difli
ind [pcnD zwji£^f*
MaanlBrie iTranancaKX
K\ pan re lu A rabif ni
r
The change in ihc ihcaJih dcEimuianlviJl JITO.TVM hcahh jndw:UiE»
- low
- - i--wlncTHt pgnuljucro ma hcncfit male oic^iiily in the c^poitiinift tar rcslifn
Proctor Creek's Boone Boulevard Green Street Project HIA
Page 208
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ENVIRONMENT
boous. sxj pcmx^t ju^>!
CTCZE a stjccucapc alc4^ Joseph 1!.
Doone Sued Nnrth"i:a. lie dea^s
•-,. jilo
* Con»i!rtiJif ? II vide of ro«l»ay an
c ach side of Ihc sued fram a duiid
liavet IDE mio i designjKd talk: lane
* Ccnvertcnj vacaa pzatrnd Bio
HOB tmien cc lls inm finln»k
jpill" IVH. jnd 9unnK3lcr olch
« C'an*ierlini 12 ft wile of n»J»ay an
one side (eadbcund side t of the arcei
ijii! planCT boies;
* CcBvcriuij i2 k wide of maditay
liltTiat ut Use ntantaT tot' ben a
center mm bane Jl rquimi jaenec-
tinny, and
* Addinf 1-2 spices for dn:ct fide
rur* ?nv
PlaEKT ban s and rain gaidens wU]
incluie differed lypcs uf vepiacicn
i lre«. buslK!, gnsEs. eic) and scnl
' i Imuich. ami. reck, c: L.
.jTihK- uf lifc and hciLih in arcsmnoniLT Iro^rttvuig die
jri^in, . safeLv jnd fiaieie; to a vanaty cf IraKTKnulJ
ha& Lhc pc4£niiii tn save livci
l^sign c ran pcocnb; thai canciun^ 'Jie enk'urorocnL in a wj
rJiM pnxnccea coffir SI&HV include snsci kjndng, pcde&rix
erossmj infiacimdcnc. trxIFic cnlnxnj appniadia i sudi •
sna;d hunspo, ind balfic ecules.i. tfrcci ijni*^nnp
cbxd speed: hmi Is ind traffic lanes dead dfeitl Ro
.ire one if tie mosi fijccessfui sim^gies used lo i
fie ufeb. 1 "IE benefit lo uiznv however. >an dirmniih -U
•nfhcT i-afHi- VDlurecs oscc uc number of baffit lanes musi
be able in acDdmrnodai! Ihe eiafTk \-olume
Sircct designs chac uc nwre cimiriacl ami inctodc izifiTMiBctux
for pcdesUura and ryclrsti (wide iridewalki and bin cJe lanes I
oionuri(p oiore adns taasfoAMicm (walking and cycltnji
jnd descourBp ranoriiE d IraEqmi. Coonenurra plays si
imparii^ rot in Ihe decincin orsEELilL in nhc
istuccicn and pre^'oniion of
moiar^^bclc-rciatd iniancK * Mnlct^hicb: ruUfcd iLfr^craidiv
±.ililx
f'i?pi|.i
'. -The change in Ihc hejlLh CEUarninam win prcEnoc heallh md
"•-high, "-iBcderafc *- lc»
-i- - »TilncTahle populatiMa aim bcnefe mun; wcquiiy k uv opportunity I'sir heiltin iK'inj will he cstccd
Proctor Creek's Boone Boulevard Green Street Project HIA
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ENV1RONMEN
of Project Deagi
Findmr. Swmnarr
VECTOR CONTROL AND
HOUSING QUALITY
Health Outcome. Vulnerable Population
(D*ten»UBts) hfcr
TV JISIMI:! MtQ uc denartiufpaM
4 U- L»
.t. ,u,fc.a«^n«.q^U»*-u».^J«- . ...^^Vcna...*.. [""""• •=•"»«•«— ••»•" **
t-3K . Ijantn u r fadkliacal Rlfcr.^ . JLU Uw ai Ul! CEaMea j-jj. - afcfl *
»Vrc pa*.»u.j anioab jini»nk a TIK*) i
ll) to awl . ..«fai h
• aneaKape akxif JaaaA E a aaafue wdu SUKC (bc» lapiuc ilftyaa*! a aVMA-flinua| IMIBT tar
TW4a«ji RirfmUcaaaauiiueaaDicxaJt tfuou|ll hUu} u> adinclh nxaii cxpuuae to
il nuu> ».wiLff f » tccaa
Viw
InA.-f .
• ru.1— —A -LJ——
• TkrtUart.aKl
BMPl ml pin> . bi«c |.M in ilrli naaa»t Art *n Jimu, K ihru
I lf| infc.gi.laaallua.. a^»«.Mi-~.c./«c™.«»cla».,Ti'.ii. ici WrtVilcVm.mJHa.to- Toavn aalunnlkuool aMci- • ftuplt mn >aena
nfcMot.., Joe t.lte»«vl.,, •"i—K^-l—o ««U1 VkainMoo ««J n«Vai> -Ui aKd wlb opOMC b pun liak-
( l,,» UMlloL p.nnmi «Jaa *•" *l •>» «,««mca.jl aM». "«<>»»-«• '"J-fc
Fojpk fcktn(in lno-aua>elnaiil|navck«*uaalk>acalaueue>nAoT ' ' ;.
cxpcaan? Ill attMfUfcjc* LXMapansfl %iui *mueo 11 K^t-w .BIC JICBX w BajftB 9 EVKBHR a> Pant laaanu
«*«•• «Eoaa:Ba«Mt«afiUoaa^«d»irtir»rhraniona«ii».««:«eafliMaj»i GarfiDuu (Jt—ii. Oato,. • Lowanj
is vc K|0kal tv Me KU*c aMwaKaje IM lacMMaax* ••f DC ntf^Cf auto M Ui«*a ittanvc ^^^a^
uliaaiaaaaM h ^4fif^»* ittc^f v danpa* aJBa Mea aad rtfcli r"*T^-lia^l^i £«|KM«ie lit pixc auamy .tvilibim*
•e •QIC a>a«il»« • an»B iaia.il onaaBa»aic» Th« uaaaaauO ka» •aaunuf »»• •"•««• o«vuuaaia*l ~*ma V«^nl «
•dhaite
!ft«idc1ifiua3«. ate^JaawlnaMjaKiaaaujlaHl t II uf taaf tint Cnnomiaha. Il.ai|aa1l ]
cauaa lo»l tMu i IIIIIIT 1« i t in i | 1 • i 1111 inailiiip hal *im|*ii IfTI |
i-i'hewl di»-
..utvi ml |v
irfperau Inoaj ia the bnaot fan*.
ruoOBrlxalc poo*.aWpoa ViaaieiaEMUi»ct uaK.ka«| Krai
.
iriilgl«ll»iii i naill [mil llu I in *i ail Tae
• viiim i-:
I-A».
'iaiKl Uno ftml ta0 ^•nV-TBi »;ll n|
l«n. »"*o- "mill ac) «ad «jl atoa-j|.i he!«>.«»
Zxpo:vn to Vector-bone
Pt«h*»««: f\"«lor Coarrol;
Eipo-.mrr » Po« H»nua;
Pr-iKtMl H«kk favjract
DumbnnoD
of
Endue*
Co
' =7h« ciittji a ti» nuUh 3«t«ciiajar vil prcmccc iwlth and vallaou
•*'=iiak ««=a»d«als, «=Iow
om nsr.' b«os5t son 3s a?"—n' in tie cpfcrmnrr.' fcr haaidr.' ktiEE «-Jl b« n-.:s
Proctor Creek's Boone Boulevard Green Street Project HIA
Page 210
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ENVIRONMENT
EXPOSURE TO GREENNESS
AND URBAN NOISE
)*>d*a»
a otMtvcap* along )c Mfh £
Tat
-.am tke a»ry b. mon urn
bni*Jtc ™dB»drakcf ttrak* toduuwmatuoftetaom
NiwcanboviMUBdMMKbv mi
rfa p%a«r ITBM.
'* a**v»hu] at«ds and narars
X«tMRh ha* then tkataB aMhtbcaBy pluung ait an
C.MChud.Oftfa.
iihmdtnv^lan.
; ii_=j-*d>.i*.i3i
;r«i. and «sx»r.- law a
CMaaa^: ^ in ana «a>
_.t,_ ,^_ 1 . , •...•.
pbrucal acvvur.
oidac adnln;. r»-
dac*d hotpcal iri^-. aad !l*oa. pubbc houuu. b: ;p:a;; ^m- «c-.n«;
_!.: :zi» :: ^L-':» .
rxpc SB» to coiatBM anaram Bom
ci pwx-ic iiEh >.-»n af acu«
(abm«!!dK2biai)kK«
Nctw ha> b*ccoM am auzwuaclv
a
kai alvo
.Yt^.-.i^ji :
itan;oe
i-tjiraa to *•§••»•
roadmfBc 7b.bom*t and
jon&Ai &OBD t&t TOAOMTIVI BWW
OBamipac* aad omaos tb.mtof mt.
Head ud. bamer. nn» OMO aud to Uodt
otr prk and vcnni
Psr.joi «uk ft»
bua-.-.anl asd ar
dm am i.»f. AonDaa Deficit
• Pwvsni irnn p3»dupouat} AMT-
(. i. MT infac-
•amtaST'1
••itBi
•cv nd a* rewt of n*i aad bukK.
•^.v .. -i.-^i-i.-x. r.i;: j: .ti '!: :i . :'^: •-•^- i
I oat taratgfe a acigkbocbood.
I* 1
dmi^r
Djiorojc. anxuty. dafniuoa. Me.)
(nokk. -jnd. roi. «e.)
Healtk
Dctmamaur
Irpo.ur to
Eipo-.arf 10
I'rfca Nau«
• =Th. chjnn in t^* SMfts dtfcccinut Till prcoaot. aiMitk lint n*>Tln. 1 1
••• = kiai. ** = Eod«r»» * = low
- = • -ihuaifcl. popnadaoM may bao«Si nsot» cr Wjaatf m taw apporrmur.- f ct btaiay ii-.^aj aul b* nuond
Proctor Creek's Boone Boulevard Green Street Project HIA
Page 211
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SOCIETY
ACCESS TO GOODS, SERVICES,
GREENSPACE & HEALTHCARE
The project win UNCO*menu of
green iMraKtracUBe irain gardens.
ptantrboies. and pemEable pave
men»to create a streetKape atong
Jowpb t- Boon? Street Northwest
The design includes:
• converting 5 ft wide of roadway
on each side at the street from a
shard travel lane into a designated
bike lane:
• Converting vacant grassland into
biaretotkm cells train gardens i.
•-, - -pi !'>.:'. - .ir,t -|..in«j:..r
caich hasutx.
• Converting 12 ft wide of road
»av on one nds icattbound side *
of the street iMo planter boxes;
• Convening i:rt wide of mad-
way < alternate to the planter box i
*ab a center tarn UUK at requdcd
atencciioos: and
• Adding 1-2 spices lor street side
p«kag.
Planer bates and ntn gardens win
include ifcrlcrera types of vegeta-
tion luces, bushes. graszs,e«o
and »*l media \ mutch, sand, rock.
rtndmes ^uHiram
AOCBM can be dr tnark-J tn num » JN i >UL h .
s. Financial access and sooil acceu.
Physical access is the ibibAr for a penon to travel 10 a dcsu
nation *her goods and <«rvices «e piDvideiL The built environment lu.\
UK poCDUU ID improve physic.* acce« by removing hani
en to tiansporotitBi and Ifaereby improving rKibibry. Snurt
pai«th cuninnoiicreen space.
may iatxase pny sical acbv ity
outdoors, improve healthy
eatuif lubiis. and improved
healhy behaviors md atti
thai can be as^ociaiod w idi
i access lo goods,
. jnd
heaUhcnc may include:
Reduced risk for obe-
sity and cardiovascular
dissascv from tin
proved Dinriiim and
Acre ased physical
Votaenn
terms of l
:are oicSudc:
• it-r»ii»> » i* pro
existing ccmdiboK.
such as chronic dtr
>:.i .. -
ftnwni ol low i
unemployment or low
Lower moruiiTi
i dealt; i aad chronic
One cm assume dial UTprwed lofraaructure and transpor
tatiun wm lead to better access to all goods and services.
There are very few scientific studies, nowevcr. thai found a
connection ber* eeti fcaturs of the built emironnvM and
access In hcilrhcare and a medjcal borne Ttis ts due to the
many additional factors itut play a rot in i person's arulitv
to voek bealthcarc The ability to ifTord healthcare vr> ..es
can be determined by employ rnent sutus. income, and
benefits, such as hcattli insurance aid network provider
II is a*suntxi that having a belter connected social nerwurk
will impnwe the social support and programs available trut
promote health and weilnes*. One study showed that the
lack ol social soppon could act as a barrier to seeking
healthcare and health promoting yrv ices
• Access to HeaHhMfe
A persons access to healthcare
an control« bit crv ioc s L an
heobUinedaodhcw**U
bealh issues can be UIOMI-
laded or ncvenled. There is
nil cnoogh evidence to con-
clude that the project may in-
fluence access to Healthcare, as
there are many independent
facton that can determine an
individual's accossibibry.
The Htionc ttoulfvard
Ijreen Street Project migkl
haite mintmal impacts as
tke praira it mall.
Honvleu: and
Racial and ethnic mi
QtirKies.
Goods
md Services
llf jjcli
r« in lit»MK^are
( i itnnif nt\
Lqtnd.
;- fhi; ctuaqc in the heatlh
-------
SOCIETY
CRIME
(PERCEIVED AND ACTUAL)
prqjsnwiU use eta
srean LnTraaraeuuE (nan gzr-
uens. pvjnL-rbaiM, mdpernu-
shfc pfinami lo create KITUJI
scipe alntw Joaepb IL Daane
Sane i Nartrmffii.
* Converting 5 ft vide of road-
way en cadfa side ;;f '.he ram
bin a iduiEd tnve I lane into a
ik signaled bike lane;
sato biocscnlinn cet* train fin-
ifcnsi prase- 5inli-»a\s. End
• Addoif 3.1^uo»fnr sued
• ''.X.' ~ iTk 'n-
?l J3fj.'t hjw » aid Tain ij jr.ir:
" i ! include ail'ij r.:m >•>;: df
vcgcEalinn I Irae t nude ^
[raeHK do isd ITIJ ch. und, r.i.k. etc).
of crntt hi 3.001-
-_-in. •%; ji; Mf-'i iijjhi-.f •• i" iilin .•!' p; .k v.nj-.. .-, ih;
vKfcwall- md Uc pmcncf isfsecurih c^njipancni Tne amount
c f gro.1 nncrv ic an unaai cniaauzih' has iKD hecn .inked t3
lie anwum of cnnc iha is uirninaiL'd in lhal am.
K^iiamh hu uii&oisd [h> the pnc^r.o; nf rjliiriJ .: tr^.:rL-:
brji^, i jc roc of serenirt lo a if ate ad jcislhecic appeal
Greenness of coTicnnn spaces has been linked en -ilccniaiEd
j£Crca-i;!n »^H vj;iL* rui UTVCT mcnlai FacigiE! . higher Ejil-
icncy ID dc-isEsI lit cvenli jnd UK abilily io adjust, and in-
creBied social nrEiacbon ancVor anomarricalitm. These
chsn£Ci cm impmvi! cora^Lnilv resiliency, socii cchehm,
and pc KEIIXM! siliu led setcrtv
• Convrtizg 12 fs mide uf mad-
way on tmc .'ride i£ unbound sde)
is'lte sircanrtD pUntr boles;
* Converting )2 ft wife of ra&j-
way (alternate i • .in planier
bo:t> BAD a Dene' urai lane ji
SL-MIL' or* aid social cahefian
LTime, hfemaJ faii^oc- and a£^ssion jrc piair>:f7 lo cnnrliu
bchaiTor IhE vcmrij or cdinnj i.rc« bcJia»-inr5 ^n rcdux
the amount oT cnm: in a ccrcenoiirv
Sane la; an hen have Faund m ssociitiim hecwaia higher
pcnzned aknlsaachiy and bctat mure cfencallv actrne
wiflring for race abon md tnnsponjuaa
Crime fLncn'ililyi en; be riunc-
terv.ed a: social ic,g,. imakint
jnauherpcrwxii "f phvlies!
(inirolving pnipntyi Whenthec
E. physical inpin' ID j peivn. Ju
crime i; consiitaral vialcTL I^ss
>iolen or aorrvioi: m ^nrrc • in-
clude Ihoic tn»hich Lie danug.«
oo^r w pfjpcrrv ar pie x of
mmd. bul do iocs lejd u ]4ryxicai
•arm at i pe raon.
cnroc
imprcwa bezlin tjr.
* K^dtraitj SUES'! fram bar and
jnoe of vioicno:; J^**
* Injcneasing cczdouf phynol acirr.
ir. 1 leisure icrxre I L
Accordc^ CD lie Cky of AlimU1 s fclice fkparlraail 1 3)1 2—
10] JI cnrrc <<«". both Via: Cfh i Fajlish Are (Boal I D2 £
l03i.tndKJE hijb lews Is of fcssvii^em crime |^ergU
vacd EMiit, Bid rofctery-/ and Iff trvclj nr" mure vnlen,
irrim: lirape and hcoKcidel.
* Chnmic nETial /aii-^ue;
* Lowered hczllh. nialed ^uilitv of
life and1
• Increaxd aiortabb' liiltei
>ho ire n»ru a: nsk of*
htin£ viairai of mms include:
* Rarsms Lh-in j b rnjhly
* Y:xnh;-.4ru
I ,.rji.
I kith outciinzs
bigher crime raE3 induik:
* Increased rei of heal ih crnnpitca-
tiers is'.-ciaied »Tlh dincni:
stress imi tick of physicil jBivdy
Docsny. anrl high blood pres-
sure. and zjnlic
r. j^e and jj>noccnnan3LC
slauu Kis run round lo play a
fdrc laspfe >xx=i|; fcmafcs arc
mure Hke ry ID be ess active otd.-
dnon due EC* iootHed pKceivnl
zcurily lie - moe bin lhan
males-
rnosc who tix-t had Jiuioica
eircriciKEi«ruh crime of heiB|
victiramd ix iLta men like 1> ID
hove bower perceived safety,"
scurily.
EMERGENCY
roua CALL
FIRE
MEBICAL
911
SSSHc
Italnh Del#rmiiiiint
Crime
Direction
i
LiLdQiaod
*=
M*li™lfc
**
Fcrnmnce
**
h .1 rf is i
-
SrrtMjlh nf
EhidtDcz
**
Cai-mer*.
' - The change in ihc hcjJLh dctmninsnl will promot health jnd we linens
"' - hitfh, " - raodiEiA * - le*
+ - vulnerable populations- nay bone ft mare ar^quity vi Ihc oppanuniLy for hcjUby iK'inj i»ii! be estacd
Proctor Creek's Boone Boulevard Green Street Project HIA
Page 213
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SOCIETY
SOCIAL CAPTIAL
(COGNITIVE & STRUCTURAL)
I'indinp. <«ramarj
Tic [B-OKCi will UK dcnrnls •:•!
goal Enfnoiucatc (rain ganfcns.
ptanla boacs, and pcnneafak:
pavement : tocn:.uc i ssroe BinfE
ak-'Rg Joseph- !:. Room Slice)
The dcajn includes
• QmverUai ? fl. wiii of road-
wjy caa each ikfc nf ihe am:
from a shucd cnrel lane inls a
: lane;
• f coneniaj vacant nrcnitinif
bgn bicccicflbiui ceih (rain fir
dens L JTISJ spiltwayx. aod suirm-
• Croveruaj 32 ft vide of mad-
way on one .role Cc astound sdde;i
of ihc ^rcet inln pUmerbcues
* Dmvcrung 12 k wide of road-
way (alLeraMc to the plaucrbux I
DZD a CEIET Ion bin; at z quired
SnciaL capilal rcbrc tn VEIKXS jffz^u nriclacionsbips at a
cnminujiih ^vj ^ diivkjed into L»o fojiuics The tins E
known at Bc^Tiilivc capoai wtrirfi is (he apjiEculion DfCnzEt,
naauil hctp. EdidpnKiiy m the corancnity The iccond is
Icnavn a» sUuctunl capilai, whkii is, chf c lisieflce of commit
naty linkager. wilhin i cnmnainr*
rhe uiKiunl CT quality of :oj7iiliv:-uii.-J • iu
accrAt ID «m:e< and support £TCup$-> he^ilhcjic.. jrA a : rrn
notar's jhiuEy to addr^s bscuc^ sucft is- Lhrcac.1: lorafdy or
secnray Itg, vandilisrc.j and t!in.-iiiccinGiui injusticss-
The social caniuJ &! a conannnity hu been linked to lite
amount of vegetation and greenness ind eccmnic develop-
menl. economic inequality and jc^nlil)^- rln;drn larg^
Kale ccc^r rilian Qonge!. cu soruJ zaniul is nm liciy ta he
e viol! nt ci saiaueT ncaled fiEtocU, but can be HKE cvidciu for
tarpr seated jm^ctn.
Bnprovou DKntal heacn and EK-
havioral dsotders
I lo»cwet thee ts not crengin evidem:
to jusufv a -causal asucutian njt»ct!Ti
r iKJtcnmes Hi«« en other cunirib-
Direttino
•:'-T:-k>jrrjd j po^itS'e
impact is an
' -The chjngc in the health, ilct nnnun will jroooe bcallh and wcUness
"'— high, "- mofenuc. * - to"
-- vulnerable pafaunnB nsn1 benefit nwie orcquih m die QfinnaBa^' lor healthy Jiving will be
Proctor Creek's Boone Boulevard Green Street Project HIA
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ECONOMY
EMPLOYMENT, COST OF LIVING,
& BUSINESS PERFORMANCE
Lk n*?nt» J Pmjtct
IkalLh Onicones
lie proKa»i.l uz oicncnu of jrcen
iTifrasncvjc iiain jjxiieii^ pUnfcr
bcixs, and pernxjeile pavemeiz i ta
crease a. stxeiscanc okjqf fcacffc E.
Eloone Slreel NorlhwciO.
» (!cniveriinj ? fl wide o!" roadway on
cch side of ihc street frejcn & shired
Lravel LHE mto a designed hike
Lane;
LEBIJ green inbaimioun: i pUnluif .in[K and rain jpntaisX as oppcacd io
£E\ mnaiuctiiic rraiKKU and panvnvntt csi ^uirvaMa ic*i cicjiion dsc
ED the incEKacii M!a^oiui jrjl tMnu22XK5 mainc iu2icc i ^unud Mzoiii
mace cm incJtxt p9unm{, mulching, ramtninf debrk rafiliinj ine bine-
icncNin mc^di^ BIXEI| oiheT diings. Grac n intrafUuctun: is 5!l'^;Ti x-fiirnod Lo
i5 a ocjdior cf "f ECTI ccUjr jcfcs " or sudjauble jobs Hut jre it Jicacil lo
envircGizfnIZLj » orL L juiscapbig onpFOV! RE nik LhcEcfcn, is iiicxi ta?d
J5 a rj* iuii/anor solicp in i ccraimuiEry In he lp» iLh lorjl job cnalKn.
bLocfcnuon a Its i rain £udcmk frees
spillways. and. -lormwiler calch D*
* Qsjverlinj (2 ft wit of roadway
en OIE side icajlbauvj -:kfc •:;" the
azei into p-lailer DUES;
* (jOTTvcrtEn| '] 2 ft
i alternate in the planter bom !• am a
:jr J.T mm one ji Ecjcireti rti^c :-
mns, and
• Adding 1- 1 spioa far sUcct sde
Ti Lo improve gjv xshedcs nf a dxet, wiiidi is
linled ID ihe prj^ierty values oraiuceEtparccfc Un^wed property value"
>>;iLve h-'ncfii ^t: ir^!'k!rr<:nmr (pxuai in!T^5tnjLiiini. The median
fcr issdcittuj parjllv jdixrcni -.:• iox nh I (l-yr.n Si. is
$16,00(1 rhc Tnem i;f njn-lMii nl'jj property rjlms ts $?] 80(1
/mm oeaty LESS czn Educe Lhe amnuM of e ncTgi- cost' amccutcd
cacOnj a buudm^ »+uch tar. to»cr uli Irtj- rosli. I .cweE-d uu lily tills LSI
improve Lhe overall peTfornune; of a busnes- by cdudng ecus.
Cismrnc-31 jii-erM unpack ofaicraaifidTirDfperrv values at hiqhe!rpn]pMtv
UKS and incre£«u reti. »hinn nix ihc cos at'JMaj. Gcnlnfiotian k a
j^rm u>yj (.•;. describe! the ^zuatiim » hcTi E siiienb- nxxve c-'j: of jn aExs due
to Lhe coa uf IK'inj becoming higher than » !ul they can afford: The
nvjv-cnunl K jd< Lo i fhifl in Lhe population Uul inhjhiu Ihc ^ommunkt.
|jmlM::r-ine irqT:mes ir.itu:ck icdKEs dime and mipratu Ihe jbiusy to
•a-alk iEiJ hiic in an ZEJ. CDnmiunrcs de^igTEd cu prcraiuc wal^jng and
cvdiog have Men ihn» n ID have man suco: ssr'ul buciness« chan diae
otnrTKd rrjiiuy for raccarincd Lnfft Ilie mcra^ed foot «d b3ce cuf f:c
bnap in mere E fular Tulujr^pe and anractf. TH« buscneraEL e mrapre
neun. and ai-anincni lo the an i
LS direcuy
^csmecEd in hejlih via incosne
a^d Lrjrcfils. such as hejLL3i in-
suruicc LrKCfnc aid health
inH^ance can corunil fuiancui
icons En nuiriiK'U'. fotris, ade-
quate v^-^in;1 and heXihcan:.
* QM of IJving
Ctm nf Irt-inj can ileso bavc a
finmcml cnnlnil on aeons to
he iLthiare. The fiavji spcti on
h«B» and tn'ing COOK "fa*
eipendaht inccnne auqr inttu
em: the mraiic s iv^ubte for
nuUiLimu foods and heallhcaa:
cms impacts, frnm
vd eTnploy
Vul»n»Hc'
rhiss: who MIC a inocucd
risk fci d pc nencini; a.-;.
can mciudb i
access to heibhcin: and
nutiudous fixjds.
loaf term inrxios trora
increased eirrplt-t-meTii, &*
flit cads of thTnj, and
mzpn^'ud hu^Es. perfom-
XKE can uicludt inffrvc-
me nb- n nvjTz^l heallii and!
chronic OKIES,
A patonliiJ n^f s.h>*e outcome
Com uicrniJFa' coaj. of kiv.
mj. can be jcntriflcjJdan, or
Ihc inability for icndera; Lo
afford I Bring in the commu
tmtmiuffjftm
jobs, changes lu costs of
living include:
» fcrsora who are on
tosij-Lcmi une mplov
recnl or are physiczih
tiEapabii: of labor
* Persons who are rim-
•s«tby4iic,J»di*»
Dhilden ender I b
ycjn and nlir idufts
TnimcT viefc, and
When businesses.dowel}EI a
i-rrnmunin'. A i
norac groifJi bv;
job:! ami Lnireasic^ jccc-a ID
Encntiei sd sen-ices wirich csn
in f_rr iznprovc Lne hea£h in a
living ca i
~«ed income due is
he IIT* Lbc federal pov-
env levei
need 10 be mindful nfpocn-
till jenlrificalinn as prcfpecly
vilues incz ise. » hen a rede-
vfMtmnx ffl ti plmud, so tha
neasacs can be taken. Bo
Plasef haus Bid rain gankic- »HI
i-icrjlc it ffcra Ji types af >«^Mioa
(Iffle. huihe& gn.tic.-k clc i and Knl
raedia Inmkh. sznl rock, c ti
C«stcJl-i>cft
mail,'
If nunl (or CnoA ail Ser .
• IK itlBsina»ltrfnBiHizl
f ihd fuid-
HA^r wlibli
iAl Fiw
pi u;im.I l
•-HE dump insE heiUhd'tmuiailwillpnMiKC hedlh n*!1«-1lrnea | -SE dui^c in-JE tuiJtfiitnTiTaii *ill.i'L-x-tlr:rn liafc
•*• - hitJi " - mafcrafe • - to*
- _ nitrite pqiuiUms nut bcnafil on oreqfecr in HE zpfcfanf' for hr.Ulhv ii> &>j will rr rea-nsi • - • -olrtrirt p:ctuu:fii E* eipemicc IE netali*e lib
pacu HKO? Lbai itfcrs
Proctor Creek's Boone Boulevard Green Street Project HIA
Page 215
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Notes from the Final Stakeholder Engagement Meeting
Date: JuneS, 2014
After the welcome and introductions, Florence Fulk from the U.S. EPA Office of Research and
Development gave a brief presentation of the HIA process and a review of the Boone Boulevard Green
Street Project HIA. This presentation served as a refresher course for audience members rejoining the
stakeholder engagement process and provided a brief background about the HIA to new audience
members. Ms. Fulk answered questions from the audience about HIA and/or the process was used for
this project, before turning the presentation over to Todd Hill from the City of Atlanta Department of
Watershed Management (DWM).
Todd Hill serves as the newly appointed Watershed Director for the DWM. Mr. Hill presented on a brief
history of DWM's efforts in Proctor Creek, including the study that led to the design of the proposed
Boone Boulevard Green Street Project. Mr. Hill provided an overview of the green infrastructure
elements included in the project's design and the DWM's next steps in planning for implementation.
After a short break in the agenda, Lauren Adkins from CSS-Dynamac provided a brief overview of the
designated impact study area, including a profile of the population that would be affected by the proposed
project. This part of the presentation aimed to familiarize the audience with the community in which the
proposed project was sited for implementation. After the community profile, the audience was referred to
the posters placed around the room that shared information about the key findings of the assessment for
each of the health determinants appraised. Each poster was accompanied by a member of the HIA Core
Project Team who answered questions from the audience about the findings and the methods used to
come to the conclusions presented on the poster.
Immediately after the poster presentations, the audience was asked for feedback on what they reviewed in
the posters. Key points from the discussions were documented on post-it notes and placed on a flipchart.
Stakeholder Input on Key Findings:
• (From Ms. D. Thomas) It is important to understand how people live in a community and what
efforts and/or activities will make the most difference. For example, you can change something
in a community (e.g., revitalize) but not necessarily make it better.
• (Also from Ms. D. Thomas) What can we (as leaders in the community) do to build the capacity
for self-determination for communities and/or organizations?
• (Mr. Elliot) It is important to keep in mind that the proposed project is a demonstration project.
The small size of the project limits its ability to make an impact as a single entity. However,
demonstration projects that are successful can lead to further investment and/or more projects in
the community. If this project was expanded and/or replicated throughout the headwaters, the
impact could be much greater due to a cumulative effect.
• (Ms. Yvonne Jones) I do not agree with the findings related to changes in access to healthcare. If
something is not relevant (i.e., if two things are not related), then you should not try to make it
(them) relevant. For example, there is no evidence linking green infrastructure to access to
Proctor Creek's Boone Boulevard Green Street Project HIA Page 216
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healthcare. There are many other (more influential) factors, other than green infrastructure, that
determine a person's access to healthcare. The HIA Core Project Team assumes that by
improving accessibility, access to healthcare will also be improved. If a link cannot be found,
then the team should not portray a link. Dr. Cassandra Johnson and Michael Elliot also agreed
that the HIA Core Project Team should go through the predicted health impacts one more time
and weigh each based on relevance to the proposed project (i.e., is the health determinant and/or
related health outcomes truly relatable to the implementation of the proposed project).
• (Dr. Yomi Noibi) The Arthur Blank Foundation has more information about the relationship
between temperature and crime.
• (L. Martin) The findings (or lack thereof), regarding percent greenness and access to goods and
services, illustrates the need for more research in this field of study. I would be more interested
to see if there are more sources regarding this relationship.
• (Unknown) There was not enough discussion on what the estimated impacts are of the proposed
project. Recognizing that this is a demonstration project, values (both qualitative and
quantitative) would better support community and agency decision-making.
• (Dr. Aidman) The HIA Core Project Team could look at and add more resources and/or findings
from agencies and organizations in other developed countries, such as transportation ministries,
Safety Watch, and the Department of Transportation. There are some transportation ministries
that record and monitor how people get healthcare, groceries, laundry, etc. Neighborhood crime
watches may also be a good source for information.
• (Dr. Fatemieh S.) One thing the HIA Core Project Team completely missed was the opportunity
to mapp assets in the community. This information gleamed from this exercise would better
inform the social capital piece of the assessment. For example, asset mapping could tell
investigators where and how many spaces are already in the community to develop social capital.
Dr. Aidman suggested that Emory Health Initiative has done some asset mapping studies and
could provide help if needed.
• (Multiple) The HIA Core Project Team should consider developing and/or including in the report
some context (e.g., background information and/or factsheets) the community could use to
advocate for identified needs and/or inform fellow residents.
• (Unknown) It would be great to use and/or publish data from the result of the Boone Boulevard
Green Street Project (not the HIA) to establish the effect it has in the future [i.e., monitor impacts
after the project has been implemented]. For example, someone could perform an impact
assessment at a 5-year interval after completion on healthcare, crime, etc., [particularly on] social
determinants.
After another scheduled break, Ms. Adkins gave a brief overview about the recommendations step in the
HIA process and informed the audience that the HIA Core Project Team had developed initial
recommendations based on the findings from the assessment. The audience was (again) directed to
posters placed around the room with the initial recommendations for each health determinant. Each
poster was accompanied by a member of the HIA Core Project Team who answered questions from the
audience and discussed the rationale behind the recommendations presented on the poster. The audience
Proctor Creek's Boone Boulevard Green Street Project HIA Page 217
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was requested to document their feedback to the recommendations posed by the team and post them on
the related poster.
After the group finished discussing the feedback on the recommendations, the audience was asked how
they would like the HIA to be reported (i.e., how should the HIA report be distributed, located, and/or
formatted).
Stakeholder Input on Reporting:
• A member of the audience recommended that the HIA Core Project Team look into
connecting with the Georgia Department of Natural Resources to ask if the HIA report could
be uploaded to their website.
• The HIA Core Project Team should put the HIA report in places where there are handouts
and/or webpages on green infrastructure and the Proctor Creek Watershed. For example, the
HIA report (or a link to the report) could be placed on the Borwnfields Association website.
• A hard copy of the HIA report should be placed in the local public library.
• The HIA report should also be presented to community-based organizations, such as the
Proctor Creek Watershed Stewardship Council, and sent to the Office of the Mayor and
Atlanta City Council. Senator Mitchell could also be sent a copy of the report.
• Several members in the audience wondered how the HIA report would be outlined and if
there would be an element in the HIA report that the community could use to advocate for
interests and/or needs (e.g., factsheets, community advocacy flyers, etc.).
• The HIA Core Project Team should also consider developing a visually simple material, such
as a community flyer, that describes how the information gleamed from the HIA is relevant
and/or could be used by residents in the community (i.e., a factsheet that answers, "what is it
to me").
After all of the comments were documented, Florence Fulk and David Egetter gave a brief description of
a new and upcoming HIA in the area. The new HIA would expand on the discussions that came from this
HIA and evaluate the potential health impacts of implementing green infrastructure across the watershed,
focusing on climate and temperature. Stakeholders were charged with keeping an eye out for more
upcoming information and materials about the new HIA.
At the conclusion of the meeting, Tami Thomas-Burton from EPA Region 4's Environmental Justice
Program acknowledged the participants in the HIA and thanked the audience for coming and contributing
to the success of the HIA.
Source: Lauren Adkins, HIA Core Project Team Member
Note: There was no scribe at the final stakeholder engagement meeting and thus no summary was
prepared.
Proctor Creek's Boone Boulevard Green Street Project HIA Page 218
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Initial HIA Recommendations with Stakeholder Input (Posters)
MANAGE M IN
RECOMENDATIONS
M| tut umnuMty i
nrantfiul hciltfi. ncr
ADDITIONAL RECOMENDATIONS
Water Quality Impf ovamenu
mMt <* urbwi ri«* Mdkniucn on Human ma «n*
nt KM mlotceinent *«»« IUc|«l dympmi. ino «
latvn O* 5MJS trtriiuf haul the . immunity
1*1 few th. C W. tkfl m»v 4k. ii iMiui* th* ntmbM o* ov*r%littt, wtuch it
a mj(or contnbulor to fool iDfcfarm m lurfacr wvlcn
a 1&fart (MM
• incrwnc ie«l irwdw fittftit of olMter oa«« frwn 2 feet to «t n
to improve pollutant rtmoM* Hhaency
• Stnctfy (dhciv lo ttv recommendttam outlned m «cttDn 6, t Common i»f
k '•*•!- ' I = Ht'd W l|n«vn by th« PM^ tO
iMwmbwonibto for pdtt)O0»nfre>wth{i >. pr«*«nooncontrol) lh»
iuw% vrk-.tinB w-» rrwdi* w th u* ptMHOttarout tnd nltrofV) (.ontent «TH|
fenfem
* »^flmfn«««of iJwDu*Mrt*t»Awcow^tu^«wpfcf^*f»d»jWf pii*tu
:i-jiog rufTTwt upur»jim n its* h*adteaieri of f*foctv CrMtt lurtanj n thn
Abo. irvtlc nnMtenttto parlkipptt in *Jtiire itu^n > u '
Up«nd BMPi (greerv rtr«ttruclu«l tArouihout thvccvmnwHty to help to rnn
«il» Row 'rductlon fD«n| mto itwm >nwn. Thii wil not aniy provMr c«p«otv
contributor TO fecM collfomi m uxtac* wiwn
• tfiurf* ttnwttcaiw/wwn tntf jorunur* moMto
and morttWmR of «
x«ptanafol
'^ enu.re•- trj* tie
J
>
IRONMI
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CLIMATE, TEMPERATURE AND
AIR QUALITY
RLCOMENDAflONS
U.."i-M':: '•;•
• Select native tree species that have taller, broad
•mcanoples that could increase the shad*ig of sur-
"laie area (especially impervious surface areas).
Place trees with Urptr canopies near bus STOOS or
other areas wfwf people may congregate
ADDITIONAL MCOMENDATH3NS
1
1
Air Quality
• Select native plan-spec** that have low VOC emis
Sions and have higher capacity for filtering po*u
tanls oul ol thr air NOTE for any planting of veg-
etation in urban areas, it is recommended (hat a
rnlninxifn of three ipettes be (elected
• Select tie placement of plant ipecies
-------
TRAFFIC SAFETY
ACTIVE TRANSPORT
^^^^^•^^^^^^^•^^•••^^^^^^^^^•^^^^^^•^^•1
3 f CO Ml NOAT QN>
Tf afllt S*f«tv
* *+ »*—,f*. .-.^fc»,..«»«t^ai
:<•]
'••
Proctor Creek's Boone Boulevard Green Street Project HIA
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VECTOR CONTRO
HOUSING QUALITY
V
Increasing law enforcem«nt of nuisance kaw In re-
gards to illegal dumping Any areas wtiere water
can pool or there n untonttollrt dcceis to
Increaw community awweneu ol environment*!
factors that can l»ad to mosquitoes and preventa-
Ove measurrt against vector borne pathogen* in
live area
-^ >fou*in« Quality
^fc _«_^ncrra',mg Law enforcnnent ol nursarxe law<
fc _• girds to abandoned properties, property mainte-
ance and upkeep Derelict or damaged homes
an provxte A dwelling for pests, wtitc^ can carry
dixcau-i that affect humans and pets.
KKOMtNDATKJNS
Vector Control A
• Ensure routine maintenance and monitoring is be-
ing implemented at director Clogging and Mock-
at* from debrH doet not can slow or stop water
moving through ttie cc'i. wh»quito breeding.
i!1
II
•
I
•
NVIRONMENT
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EXPOSURE TO GREENNESS &
URBAN NOISE
RECOMENDATIONS
ADDITIONAL RECOMENDATIONS
Exposure to Gteennc»
txposurc to
» Assuring a "Visible Change" estheticalh/ happens
on the green street (More Green and less con
crete)
Urban Noise
• Select low brush/grasses in planter spaces near
residences to block/absorb some of noise from
^ roadway.
• Implement best practices during implementation
phase to reduce the amount of noise or time of
being generated from construction.
NVIRONMENT
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ACCESS TO GOODS / SERVICES / GREENSPACE
ACCESS TO HEALTHCARE
RECQMENDATIONS
Access to Goods / ServiCM /
|« t ncou rage new Buiineu generation
• Consider Local zoning ordinances and regular^
(residential versus commercial mixed-use)
• Work with the City a'. Atlanta's Depaflrngnt of Ptan-
oing and Community Development
• Incorporate [PA's Smart Growth Principles Iwtth All
the "tolls & Whistles")
• Consider Smart Growt h America - Complete Streets
in the Southeast Case Studies
ADCXnOHAl KJCOMtNPATKMiS
K» ADVOCACY
Accmra
fCMTNt MOM
Access to Hcarthcare
• f nrouragr coordination with fulton County Dept. of
Public Health and Wetlrwsv
• M^ny unknown confounding factors. Consider HHS's
HHSA - Heath Resource and Servers Adminrur«Hon
for bdveline condition of Hxal health centers
____ t
SOCIETY
Proctor Creek's Boone Boulevard Green Street Project HIA
Page 224
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CRIME
(PERCIEVED & ACTUAL)
« Consider differences between subjective
(perceived Safety) versus objective
(police recorded measures) data.
« Consider residual factors of crime (i.e.
f fear, lack of policing) in the project area.
Lighting on Streets
. Trees should be taller •- 5 feet
* Maximize "Greenness" for the entire
green street project.
« Bushes should be no taller than 3'
A Utilize the CPTED (Crime Prevention
through Environmental Design) model.
AMMTIONAL R£COMENDATIONS
\
SOCIETY
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SOCIAL CAPITAL
(CONONITIVE & STRUCTURAL)
.. & Bc««M| / ItruOunt* NPU 4 Community Or^jmrjlinni. AdwincK* wort tcfcttiet
RKOMtNDATlQNS
• Provide meeting space for local
community meetings in close proximity
of green street.
RtCOMtNPATIQNS
• Install Public Benches
(to increase positive socialization)
(Coordinate with "Atlanta Streets Alive'
to host a community festival after^ f
completion of Green Street installation
-.•• •- ••»•.
. Provide other catalyst to increase /
^1 enhance outreach to the community.
» Cultivate and maintain mechanisms in
policy, development, and economic
decisions and activities for building
tniftll
SOCIETY
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MPLOYMENT / COST OF LIVING
BUSINESS PERFORMANCE
B ^V t«w**mB^K«tu>nn ^T<^ mUMtt
MI>'
i kul<
*mtan
. .-.,
ADDITIONAL RKOMtNOAT'ONS
HOI
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HIA Recommendations Identified by Stakeholders
The following table lists the recommendations identified by stakeholders at the final stakeholder engagement meeting. Those recommendations
that received support from fellow stakeholders are shaded.
Health Determinant
Water Quality
Water Quality
Water Quality
Flood Management
Flood Management
Flood Management
Flood Management
Flood Management
Flood Management
Flood Management
Flood Management
Flood Management
Flood Management
Flood Management
Climate and Temperature
Climate and Temperature
Recommendation(s)1' 2' 3
Include context for advocacy (e.g., develop informative material for advocating for
water quality improvements.
Use (follow) the Florida State Model for Water Quality (Improvement Plan as a
benchmark for improving water quality in the Proctor Creek Watershed)
Re-grade the road pavement (to ensure storm water runoff flows where it should) and
consider (implementing more) permeable pavement.
Restore and preserve floodplains to help with flood issues. Consider leaving vacant
land in low-land areas as undeveloped or use as a community asset (e.g., pocket park,
urban farming, and/or more green infrastructure).
Rain gardens should be incorporated into the design (plan), not the Atlanta (preferred)
boxes.
See if Atlanta DWM will repair pot holes and slip spots where water floods.
Cut back overgrowth on sidewalks, cut overgrown properties where houses are
abandoned.
Build capacity of neighborhood and self-determination of neighborhood
redevelopment.
Develop/Incorporate a plan to resolve issues with vacant housing in the Green Street
Project design.
Ensure proper design and implementation of green infrastructure elements (BMPs).
Consider community involvement in monitoring and illegal dumping.
Follow example of Rachel's Walk - disposal of tires filled with mosquitoes.
Educate residents about landscaping for pest control.
Implement IPM methods for pest control (e.g., distance of landscaping from buildings,
proper surface water control, and proper maintenance).
Place some trees along the long stretches of the road to provide shade, see Courtland
Street near GSU as an example.
Consider policy of encouraging planting of trees on private property-side of sidewalk to
promote shading (ensure critical root zone is adequate for sustainable tree growth).
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Health Determinant
Climate and Temperature
Air Quality
Air Quality
Traffic Safety
Traffic Safety
Exposure to Greenness
Exposure to Urban Noise
Access to Good and Services, Greenspace, and
Healthcare
Access to Good and Services, Greenspace, and
Healthcare
Access to Good and Services, Greenspace, and
Healthcare
Crime (Perceived and Actual)
Crime (Perceived and Actual)
Crime (Perceived and Actual)
Crime (Perceived and Actual)
Crime (Perceived and Actual)
Crime (Perceived and Actual)
Crime (Perceived and Actual)
Social Capital (Cognitive and Structural)
Social Capital (Cognitive and Structural)
Recommendation(s)1' 2' 3
Implement solar panel shade overhangs in public places where the community interacts
(e.g., bus stops).
(Have City) monitor for air quality (in the community).
Remove (address) fecal smell from North Avenue CSO- there is a very foul, sewage
smell.
Install speed bumps (traffic calming practices) to prevent drivers from (speeding) down
the street (i.e., fast drivers affect perceived safety of cycling down street).
Repave street for bike lanes to avoid safety risk factor (e.g., remove pot holes and
bumps in road).
Restrict the use of any signs used for advertisement.
Monitor impact of street diet on traffic noise generation and sources of street noise
(e.g., loud cars, music boxes, etc.).
Consider access to healthy foods, such as urban farming (in the project design).
Include context for advocacy (e.g., develop informative material for advocating for
better access to goods, services, and Greenspace).
(Coordinate/Engage) Transportation Ministry (Department) to get people to goods and
services, such as groceries, Laundromat, jobs, WIC, etc.
Increase police presence on the ground (i.e. bicycles) in the area with a focus on "hot
spots."
(Engage) school district to play a role in efforts to decrease crime.
Keep the design simple to discourage vandalism. In the past, fancy lights on Boon St.
have been stripped of wiring and became targets of vandalism.
Create a "Village Defense" system or neighborhood watch program, including an
anonymous reporting hotline.
Place bushes greater than 12 inches from buildings and (select) "deterrent" types, such
as holly or bramble.
Ensure green space is well maintained (i.e., unmaintained green spaces may encourage
adverse behaviors and stress).
(Allow) good purpose graffiti (i.e., graffiti with positive messaging).
Include context for advocacy (e.g., develop informative material for advocating for
improving social capital).
Incorporate art and local artist talent to promote (local) social control and bonding and
bridging among the community.
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Health Determinant
Social Capital (Cognitive and Structural)
Social Capital (Cognitive and Structural)
Social Capital (Cognitive and Structural)
Household Economics (Employment and Costs
of Living)
Household Economics (Employment and Costs
of Living)
Household Economics (Employment and Costs
of Living)
Household Economics (Employment and Costs
of Living)
Household Economics (Employment and Costs
of Living)
Community Economics (Business Performance)
Recommendation(s)1' 2' 3
Put in great playgrounds for kids.
Help organize community groups to enhance/maintain bioswales as a community
garden (i.e., "adopt" the Boon St.; e.g., local boy scout or girl scout troop)
Work with the community to create capacity to be more responsible of the environment
in which they live.
Include context for advocacy (i.e., develop informative material for advocating for local
jobs).
(Include) training for jobs to help people be more independent.
Use land banking to preserve affordable housing.
Incorporate urban farming opportunities in the design (i.e., addresses access to
affordable, nutritious foods).
(Incorporate) Green training (e.g., rain garden training, nursery garden training, water
works training).
Advertise to developers to encourage Brownfields opportunities.
1 Parenthesis "()" were used to provide context or further explanation for the recommendation per the discussion with the stakeholder.
2 Recommendations that are shaded received support from other stakeholders.
3 Recommendations are organized by each of the health determinants evaluated in this HIA.
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Appendix D. HIA Work Plan
Tasks and Timeframe for Completion of the HIA post-Scoping
The approach for assessing health impacts of the BBGSP was adapted from the Health Impact
Assessment; A Guide for Practice (Bhatia, 2011). The original language from Bhatia (2011) was
modified to fit the needs of this HIA. Tasks were also identified and added for developing
recommendations and reporting to final results of the HIA. This work plan includes tasks to be completed
and their timeframe for completion.
Tasks
Description
Assessment
Timeframe for
Completion
Task 1. Access and
collect data on
existing conditions
in the community1
Collect and analyze data on the current resident
population, including demographic, economic, social,
and health outcome indicators. Synthesize existing
data on identified health determinants and outcomes of
interest.
Update/refine the research questions and pathway
diagrams as needed.
June2013to
December 2013
Task 2. Evaluate
and weigh evidence
of causal
relationships
Access and synthesize peer-reviewed literature and
agency reports for information explaining the
relationships (or lack thereof) between the decision,
current conditions, determinants of health, and health
outcomes.
Evaluate, based on certainty, whether the evidence
demonstrates a cause and effect relationship between
factors and assess whether the information gained
(based on context and range) can be applied to this
project.
Update/refine the research questions and pathway
diagrams as needed.
August 2013 to
March 2014
Task 3. Share
information
gathered and with
stakeholders2
• Present information found and data gaps to advisory
group and discuss initial findings of existing
conditions and elicit stakeholder input to fill in data
gaps.
• Present preliminary findings to community and elicit
feedback.
July 2013 to End
of March 2014
Task 4. Forecast
health effects,
quantitatively
where feasible
Evaluate whether there is enough data/information
available to estimate impacts to health and/or health
determinants quantitatively (if possible) and/or
qualitatively.
Identify and use suitable prediction models (exposure-
response, regression equations, etc.), where
appropriate, to predict estimated health effects
April 2014
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Task 4. •
Characterize
expected health
effects
Task 5 . Evaluate •
the level of
confidence or
certainty in health
impact
characterization •
Characterize the direction of impact, likelihood,
magnitude, permanence, distribution, and strength of
evidence for the impacts estimated, based on the
data/information collected and/or modeled. See table
below.
Compile the evidence that supports the
characterization of impacts and evaluate the level of
confidence or certainty. Prepare communication
materials that represent the information synthesized
and impacts judged.
Present assessment findings to stakeholders and public
to elicit input on the predicted/estimated impacts and
re-evaluate the confidence and certainty of change
based on their input.
Beginning of May
2014
May 20 14 to 1st
week of June 2014
Recommendations
Task 1. Identify •
initial
recommendations
for mitigating •
negative effects and
maximizing
benefits to health.
Task 2. Evaluate •
the level of
appropriateness of
recommendations
using stakeholder
input.
Task 3 . Finalize •
recommendations
for project design
Identify areas in the project design that have predicted
negative health effects or are limited in potential
positive effect.
Assign recommendations to the project design that
will maximize potential net positive effects and
remove/mitigate negative health effects.
Host the final public meeting to discuss initial
recommendations and elicit input and viewpoints of
their practicality.
Incorporate stakeholder and public input into
recommendations .
May 20 14
1st week of June
2014
June 20 14 to
August 20 14
Reporting
Task 1. Develop •
Final Report
Task 2. Finalize •
HIA Report and
Publish
Task 3 . Present •
Final Report to
Stakeholders
Document the HIA process, including materials used,
rational for decision-making, and other minimum
elements.
Initiate external peer-review and internal Agency
administrative review of the HIA process and
incorporate final comments.
Once the HIA report has cleared the review process,
publish the report on EPA website and distribute e-
copy and hard -copy to stakeholders, as preferred.
March 20 13 to
August 20 14
September 2014
October 20 14
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Literature Review Guidelines
Proctor Creek's Boone Boulevard Green Street Project
' Health Impact Assi-ssim-nl (1I1A)
U. S. Environmental Protection Agency, Region 4 and Office of Research and Development
Literature Review Guidelines
Purpose of Literature Review
The goals of this phase are to 1) review the available information (from peer-reviewed articles to grey papers) on green
infrastructure (green streets, specifically); 2) identify ways to measure impacts from the implementation of Boone
Boulevard Green Street Project; and 3) identify data sources and data gaps for measuring impacts. The Master Data
Sheet will serve as a reference document and one of our vehicles for internal communication during the literature
review process. Literature review topics can be seen by health determinant in the Topic Sign-up Sheet (page 2) of the
Master Data Sheet.
Instructions for Literature Review
1. This review is aimed at finding comprehensive information relevant to our particular research questions.
a. Overall, the formulated "Research Questions" per topic will need to be answered as a result of the
Literature Review.
b. Where questions could not be answered by reviewing the literature, primary data will need to be
collected.
c. For each article, a Literature Review Worksheet should be completed.
2. Literature reviews traditionally introduce a topic, summarize the main issues and provide some illustrative
examples. The review should be structured to include:
a. The Baseline Research Question(s)
b. The Impact Research Questions (s)
c. Details of Literature search conducted (publication dates, databases searched, search terms)
d. Findings with short summaries of each study
e. References for all articles and reports
f. Conclusions (Since framing the research questions & reviewing the literature are all an iterative process,
it will be necessary to describe how you reached your conclusion. The conclusion should be based on the
research presented.)
3. The research questions' answer should be related to the overarching decision of implementing green
infrastructure (specifically, green streets & road diet).
a. Each topic may require a number of sub-questions or in other terms "impact questions" to be answered.
These questions will typically focus on potential/anticipated changes (A) due to the installation of Green
Infrastructure (specifically, green streets & road diet).
i. To frame your baseline research question, you will first ask, "What are the current conditions as
related to my topic?" (e.g. Topic - Climate & Temperature: What are the current temperature
and humidity conditions in the study area? )
ii. To frame your impact research question, you will rephrase the initial question and ask. "How
will green infrastructure impact baseline conditions?" (e.g. How will green infrastructure impact
temperature and humidity in the study area?)
b. Keep in mind that as your literature review progresses, the initial framing of the question may need to
be revised or refined as new information is obtained.
4. For every health determinant, vulnerable population information will need to be considered. Information on
the population's demographics and statistics has already been gathered (refer to the Community Profile on page
1 of the Master Data Sheet).
5. To be considered a reliable source of research evidence, the researcher should record how the primary studies
were sought and selected and how they were analyzed to produce their conclusions.
a. Readers need to be able to judge whether all of the relevant literature was likely to have been found,
and how the quality of studies was assessed.
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Proctor Creek's Boone Boulevard Green Street Project
•••'••""••••' HtMlth Impact Assessment (IIIA)
U. S. Environmental Protection Agency. Region 4 and Office of Research and Development
b. Reliable information can come from peer-reviewed |ournal articles and "grey literature" (government
documents that went through a rigorous review process).
c. Check key databases, websites and information provided by the Advisory Group during the group
exercise should also be considered.
6. Information collected during the literature review process will be summarized and inserted into the Master Data
Sheet no later than Tuesday, August 27*
a. The Master Data Sheet shared location will be determined.
b. Once the "Literature Review Results" page is completed, we will convene on Thursday, August 29* to
discuss the results and next steps in the assessment process.
A visual representation of the literature review workflow is shown below:
DEFINE RESEARCH
QUtSTION J
SEARCH TERMS I
CO. ECLIPSf.
«COT>
RESOURCES
IWIIKIAN/ RFAD »
• FXCLU3ION - CUTICAUV I
CRITERIA REVIEW
MJ.V
5EJ
SYNTHESIZE
RESULTS
START WHITING
Figure provided by Aoife Lawton at the Health & Social
Care Professionals Inaugural Research Conference,
February 22, 2013
Resources for Literature Reviews
Here are just a few of the sources available about HIAs and green infrastructure. Valuable information-gathering tools
may include (but are not limited to):
• tPA Website for Green Infrastructure- http://wjtet.epa. eov/infrjstructure/ereeninlrj-jfut.lufe/lndex.cfm
• Centers for Disease control and Prevention, Healthy Places-http://www. cdc.gov/hejlthyplaces/hia htm
• World Health Organization- http://www.who.int/hia/en/
• Google Scholar- http://scholar.EOogle.com/
• UCIS HIA-CUC- http //www.hup.uide.orR/
• EBSCO Academic Search Complete
• LexisNexis
• JSTOR
• Web of Science
• Social Science Research Network
• PAIS International
• ScienceDirect
• PubMed- http://www nibi nlm.nih.aov/oubmed/
• Psychlnfo- hltu
ProQuest- http://www.proquesl.com/en-US/
Proctor Creek's Boone Boulevard Green Street Project HIA Page 234
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Ewt+winwnnl
. . .
Proctor Creek's Boone Boulevard Green Street Project
Health Impact Assessment (MIA)
U. S. Environmental Protection Agency, Region 4 and Office of Research and Development
Final Theoretical Impact Pathway Diagram
Decisions
Project
ICretn
Pathways of Impact
Upstream Impacts
Downstream Impacts
\ Stfcty
r»
A Personal Safety
4 Percemed Safety
A Traffic Sa*et»
AAccesstoPuMc
Transit
1 Open/Grtfn
Spaa
ABuutifiatiorV
Aesthetics
Aland Cover
(VfSf.'oficn
A Cbmmuratv
EcDoomto
4
AHousinf
{Property Value,
Damage}
Heahh Determinants
Proctor Creek's Boone Boulevard Green Street Project HIA
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Literature Review Worksheet
,EPA
Proctor Creek's Boone Boulevard Green Street Project
Health Impact Assessment [UFA]
U. S. Environmental Protection Agency, Region 4 and Office of Research and Development
Literature Review Worksheet for Tracking Research
REVIEWER'S NAME TOPIC:
SUB-TOPIC:
BASIC RESEARCH QUESTION:
IMPACT QUESTION:
CITATION:
SUMMARY OF ARTICLE:
TYPE:
URL's / DATABASE / LOCATION:
ASSESSMENT APPROACH USED BY
AUTHOR (Descriptive; Inferential;
Predictive approaches; or combination)
D Peer- Reviewed D Federal Agency D Grey Literature
Reports
3 REMINDERS!
1 1 Have population
group/demographic factors (including
vulnerable populations) been
considered? Refer to Community Profile
on Master Data sheet.
SEARCH TERMS USED:
Results:
( Key indicators/measurements used by
the author)
RESEARCH CONCLUSIONS:
1 — 1 Has conflicting evidence been LH Have the caveats/limitations of this
identified and weighed? article been captured? Consider
whether the literature being reviewed
has addressed issues of cause and
effect.
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Appendix E. Process Evaluation Results from External Peer-Reviewers
While all comments were invited, the HIA Core Project Team asked reviewers to specifically address certain aspects of the HIA (i.e., charge
questions). The following tables list each response of the reviewer to the charge questions and the response from the authors to the reviewer's
comment.
Table 1. Comments from and Responses to Peer-Reviewer 1 (Mandy Green)
Charge Questions to External
Peer- Reviewers
1. Context of HIA.
la. Was the HIA undertaken to
inform a proposed decision (e.g.,
policy, program, plan, or project)
and conducted in advance of that
decision being made?
Ib. Were the need for and value
and feasibility of performing the
HIA assessed and clearly
documented?
Ic. Do the authors acknowledge
sponsors and/ or funding sources
for the HIA?
Id. Is the screening process
clearly documented in the report?
2. Scope of HIA.
2a. Are the goals and/ or
objectives of the HIA clearly
defined?
2b. Is the scope of the HIA
clearly defined (i.e., decision to
be studied and its alternatives;
potential impacts of the decision
on health, social, environmental,
Peer-Reviewer 1 (Mandy Green)
[Blank]
The Proctor Creek HIA was clearly appropriate in that it was undertaken
to inform a proposed decision, and it was carried out in a timely manner
(despite unforeseen delays) and completed in advance of the decision.
The HIA report documents the potential value of this HIA for promoting
positive health effects and mitigating negative health impacts of the
proposed Green Street, as well as for piloting HIA methodology within
EPA and serving as a model for future use of the method for the agency.
The authors clearly explain the funding sources, stakeholders, and
sponsors of the HIA in the report.
The screening process is described in detail in the report, but could be
improved by adding information about health impacts, potential impact of
HIA findings, and stakeholder interest and capacity that the Project Team
considered when deciding to implement this HIA. Specific questions in
each of these topic areas are available in the Human Impact Partners
Screening Worksheet and were presumably considered by the Project
Team. The table (Table 2) listing decision points and this HIA's expected
influence is an excellent summary and descriptive tool that future EPA
HIA reports should include.
[Blank]
The authors of the report clearly explain the goals and scope of the HIA,
and go into detail about the scoping process.
The report makes clear how priorities differed between groups and how
the Team arrived at a final scope for the HIA. Some of the pathways
shown in Figure 18 were unclear and it would be helpful to provide
explanations of how the authors arrived at these, or to show specific
pathways in more detail (even though some of this is done later in the
Response from Authors
[Blank]
No response needed.
No response needed.
No response needed.
The HIA report authors went back to those involved in the
screening process and extrapolated more information about the
considerations included in the screening of the HIA. The
additional information was organized and reformatted into the
report and double-checked for clarity.
[Blank]
No response needed.
The authors further explained that the pathways were derived
from the stakeholder discussions and preliminary literature
searches. In assessment, these pathways were verified (i.e.,
plausible or not plausible) and further refined, as the author
concedes. The line linking extreme heat events to vector-borne
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Charge Questions to External
Peer- Reviewers
economic, and other health
determinants and their pathways;
populations and vulnerable
groups likely to be affected by
the decision; demographic,
geographic, and temporal scope
of analysis; health impacts and
research questions selected for
examination in the HIA and
why)?
2c. Is the scoping process clearly
documented in the report?
Peer-Reviewer 1 (Mandy Green)
report). For example, it would seem that a change in extreme heat events
could be directly linked to vector-borne illness, but the line is dashed
indicating an indirect effect. The change in climate and temperature is also
linked in this pathway diagram to changes in Access to goods and services
and Social capital — these links are not immediately obvious and would
benefit from explanation in the text. Table 5 is very general, and more
specific pathways for each health determinant would be useful to the
reader (or referring to specific pathways if provided later in the text or in
an appendix). In Table 8, the final scoping worksheet, questions about the
design and implementation of the green street (for example, Ts the Green
Street Project designed to improve traffic safety?) could also be guided by
the relevant parts of health promoting design and implementation metrics
such as the Design for Health checklists (http://designforhealth.net/wp-
content/uploads/2012/12/BCBS jrransChapterChecklist_092607.pdf).
It is possible that the project's conceptual design already includes such
metrics but those are not specifically listed in the report.
Response from Authors
illness is not one of our pathways, but a mapping error. This line
was eliminated in the updated version. The authors elaborated on
the relationships presented in the pathway diagram by following
the links between the proposed project, traffic safety, accessibility,
crime, and social capital. The authors eliminated table 5 and
referred the reader to the handout with the overarching impact
pathway diagram. The authors reviewed the checklist
recommended, which was developed to support the screening
step. The checklist provides one metric for each screening
question to help decide whether the HIA should be performed,
but does not help identify other metrics or how the data can be
obtained. The indicators used in this HIA are provided in the
scoping worksheet.
2d. Are the participants in the
HIA and their roles clearly
identified?
The Project Team should be commended for designing a scoping process
that includes community and advisory group input in a meaningful way.
No response needed.
3. Stakeholder Engagement.
[Blank]
[Blank]
3a. Are stakeholder groups,
including decision-makers and
vulnerable population groups,
clearly identified?
The stakeholder groups and approach to stakeholder participation are
quite clearly described in the HIA report.
No response needed.
3b. Is a stakeholder engagement
and participation approach,
including plans for stakeholder
communications, clearly
described in the report?
The approach is ambitious, with multiple avenues for community
participation at time points throughout the HIA process. The methods
and materials used for stakeholder communications are included in the
appendices.
No response needed.
3c. If so, was input from
stakeholders solicited and
utilized as planned in the HIA
process?
It appears that stakeholder input was gathered and incorporated into the
HIA as originally planned, and that the HIA scope, assessment and
findings and recommendations were directly influenced by this input.
While members of the Project Team, Advisory Group, and Key
Informants are listed by name in the acknowledgements sections, it is less
clear who is connected to which community organization and who is
giving individual input. It would be helpful to list organizational
membership alongside each name. It is also not described in enough detail
in the report exactly what input was gathered from key informants and
how this was used in the HIA. The appendices could also make clear
which community organizations were represented at each stakeholder
meeting and also explain how confident the project leads are about how
representational these organizations may be of the community as a whole.
Overall the stakeholder engagement process appears well-planned and
The authors added the organizations represented to the names at
the begging of the report, under "HIA Participants." The notes
from the stakeholder engagement meetings (with the input from
stakeholders) was added to Appendix C and in a table under the
heading "interests and/or concerns identified by stakeholders."
The input provided by stakeholders was added to the assessment
chapter under each of the related health determinants. The
meeting notes from the HIA Project Leads were added to the
appendices.
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Charge Questions to External
Peer- Reviewers
Peer-Reviewer 1 (Mandy Green)
Response from Authors
executed, and hopefully will continue through the monitoring and
evaluation phases of this HIA.
3e. Where stakeholders given the
opportunity to review and
comment on the findings of the
HIA?
4. Evidence and Analysis.
4a. Are the methods for evidence
gathering and analysis clearly
described and justified?
4b. Was evidence selection and
gathering reasonable and
complete (i.e., was the best
available evidence obtained)?
4c. Are the existing conditions
(e.g., demographics, socio-
economic conditions, health
determinants and health
outcomes, presence of vulnerable
groups, etc.) clearly described?
Is the profile of existing
conditions appropriate as a
baseline against which to assess
the impacts of the proposed
decision?
4d. Are the potential health
impacts of the proposed decision
identified?
4e. If so, is the characterization
of impacts reasonable and
complete (e.g., direction,
magnitude, likelihood,
Refer to comment in 3d.
[Blank]
The scope of the assessment is quite ambitious, with many health
determinants and impacts analyzed. Clearly the small study area made
examination of health outcome data impossible in some cases, however
the Project Team was able to include some health outcome information
and other analyses, in particular the GIS analysis, demonstrated the
potential health effects of specific project elements. The methods for data
gathering and analysis were clearly described and justified, and it appears
that the Team made the best possible effort to identify and include
relevant evidence from the published literature and expert opinion.
Refer to comment in 4a.
The existing conditions are described in detail, and form an appropriate
basis for evaluating potential impacts of the proposed decision.
The potential impacts of the proposed decision are identified, however it
is not clear if the HIA may be used to advocate for specific design or
implementation recommendations beyond simply implementing the green
street or not.
The characterization of impacts appears reasonable though necessarily
incomplete given limitations of the data available for health outcomes and
other specifics such as air monitoring data for the small study area.
Refer to response in 3d.
[Blank]
No response needed.
Refer to response in 4a.
No response needed.
There recommendations regarding specific design elements of the
project (i.e., incorporating CPTED elements and increasing soil
media to at least 2.5 feet or 30 inches). The authors made the
intent of the HIA more explicit in the report- the purpose of the
HIA was to inform DWM's decisions on implementing the
proposed project as they move forward in the planning process.
Text was added to link the recommendations to the assessment
findings in the assessment chapter.
The authors acknowledged that the lack of available data for
health status and to some extent health determinants was a
challenge for this HIA. The time and development requirements
for engaging in the EPA IRB process was a barrier to collecting
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Charge Questions to External
Peer- Reviewers
distribution, and permanence of
impacts addressed; affected
populations clearly identified;
etc.)?
4f. Are the methodologies, data
sources, assumptions,
limitations, and uncertainties of
the assessment clearly identified?
4g. Are the conclusions of the
analysis based on a transparent
and context-specific synthesis of
evidence (i.e., are the conclusions
reasonable and supported by the
evidence)?
5. Recommendations.
5a. Are recommendations,
mitigations, and/ or alternatives
identified that would protect
and/ or promote health?
5b. Are these recommendations
reasonable and supported by the
evidence?
5c. If prioritization of
recommendations took place,
was the method of priority-
setting documented, reasonable,
and appropriate?
5d. Is an implementation plan
identified for the developed
recommendations (e.g.,
responsible party for
implementation, timeline, link to
indicators that can be monitored,
etc.)?
6. Documentation.
6a. Is the layout and format of the
report clear and logical, with
Peer-Reviewer 1 (Mandy Green)
The authors have clearly described their methodology, data sources,
limitations, and assumptions.
The conclusions appear reasonable and well supported by the evidence
presented. Overall, the assessment is thorough and very well done. The
use and synthesis of multiple forms of evidence and analysis are excellent.
[Blank]
The recommendations and mitigations listed in the report are clear and
appear supported by the assessment findings. The list is quite extensive,
with some recommendations more feasible and relevant to the decision in
question than others (for example, 'develop a policy/ plan/ordinance to
address the problem of vacant housing' appears out of scope for the green
street project).
Refer to comment in 5a.
The report describes prioritization of the recommendations with
community stakeholder input, and this seems reasonable and appropriate.
There is some implementation information presented, such as the
responsible party, but a timeline for each recommendation is not present
and indicators that can be monitored are listed in the monitoring plan but
not linked to the specific recommendations. This is a concern given the
number of recommendations, that is, it would be easy for some of them
to be lost in the shuffle and not followed up on after the HIA project is
completed unless there are interested community members with the
capacity to pursue them in the long term.
[Blank]
The HIA report is clear and logically organized, though quite extensive
and possibly difficult for a community member to navigate. The report is
Response from Authors
new information through surveys and other primary data
collection needs. Thus the scale of this HIA was limited to
collecting data already available. A countermeasure identified in
the lessons learned was the importance of partnerships with local
universities/ research professionals that could obtain this data for
the HIA.
No response needed.
No response needed.
[Blank]
No response needed.
Refer to response in 5a.
No response needed.
The authors separated the recommendations by phase of
implementation (i.e., short-term, including before construction,
during construction; after construction, and long-term). The
authors also included the ranking criteria in the report and the
score given to each recommendations.
[Blank]
The authors revisited the text, figures, and tables and simplified
those elements to the best extent possible. The authors
acknowledged that the report is extensive, in part due to the
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information clearly organized in
sections that are easy to follow?
Peer-Reviewer 1 (Mandy Green)
well written with many illustrative examples and graphics used. The maps
in particular are very helpful and well designed.
Response from Authors
reporting standards as a federal agency, and resolved to develop
and include an Executive Summary, which would serve as a
supplement to the HIA report (i.e., a more condensed, simplified
version of the HIA report).
6b. Is the writing style such that
the report is easily read and
understood (e.g., clearly written,
complex or unfamiliar terms
described, examples and
graphics used to illustrate text,
etc.)?
Refer to comment in 6a.
Refer to response in 6a.
6c. Is documentation of the
overall HIA process transparent
(i.e., are the processes,
methodologies, sources of data,
assumptions, strengths and
limitations of evidence,
uncertainties, findings, etc. of the
HIA clearly documented)?
The HIA process has been transparently described in detail such that
readers can understand how each step was implemented and so that the
assumptions and findings are clear.
No response needed.
6d. Does the report identify any
other methods to be used for
documenting and disseminating
the HIA and its findings (e.g.,
briefings, presentations,
factsheets, flyers, newspaper or
journal articles, etc.)?
Chapter 6: Reporting could be strengthened by adding details about
report and factsheet dissemination plans. How will the materials be
actively disseminated to decision makers, community groups and
members? How will the HIA be shared with other public health
professionals and promoted as a pilot of this methodology to potentially
be replicated within EPA? Will the Project Team or community partners
use traditional or social media to disseminate findings and
recommendations?
The authors went back and further described the development
and dissemination of the communications materials.
7. Monitoring and Evaluation.
[Blank]
[Blank]
7a. Was an evaluation of the HIA
process conducted (e.g., who was
involved, strengths and
weaknesses of the HIA,
successes and challenges, how
effective the HIA was in meeting
stated objectives, engagement
and communication with
stakeholders, lessons learned,
etc.)?
It appears that the Project Team has carried out an internal process
evaluation, as information regarding successes and challenges and lessons
learned is presented in the report. An external review of the HIA report is
planned.
No response needed.
7b. Was a plan proposed for
monitoring implementation of
the decision and the effect the
HIA had on the decision-making
process (i.e., impact evaluation)?
There are plans for impact and outcome evaluation described in the
report, including responsible parties and monitoring indicators, however it
is unclear if the Project Team and Atlanta DWM will be able to commit to
implementation of these plans, or if there is community capacity to carry
out monitoring and evaluation.
The commitment to the monitoring plan is unknown at this time.
The HIA process has been transparently described in detail such
that readers can understand how each step was implemented and
so that the assumptions and findings are clear. It is unclear for the
HIA Core Project Team whether this plan could be carried out by
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Response from Authors
stakeholders in the community. This was a short-sight of the
HIA.
7c. Was a plan proposed for
monitoring the impact of the
decision?
8. Overall HIA Process.
8a. Are the methods and
procedures used in the HIA
appropriate?
8b. What aspects of the HIA
process appeared to be
implemented effectively or
successfully and what aspects of
the HIA process could have been
strengthened or improved?
8c. To what extent were the goals
and/ or objectives of the HIA
achieved?
9. General Comments.
9a. General Comment
9b. General Comment
9c. General Comment
Refer to comment in 7b.
[Blank]
The Proctor Creek BBGSP HIA was well designed and carried out
according to the HIA Minimum Elements. This HIA is an excellent first
project for EPA in the use of this methodology. Some of the HIA
Practice Standards were met, and this is appropriate as the Standards are
aspirational and not intended to be completely achieved by any one
project.
The stakeholder engagement and assessment were successfully
implemented and seem very effective. The recommendations could be
more carefully prioritized and developed, and the dissemination plan
could be more clearly described in this report. This HIA could be
strengthened by incorporating more language, measures and analysis
related to equity. The first explicit mention of equity does not occur until
page 131 of the report. The project team could use the recently released
Equity Metrics
(http://www.liiasociety.org/ documents/EquityMetrics_FINAL.pdf)
developed by the Equity Workgroup of the Society of Practitioners of
Health Impact Assessment to evaluate and improve the HIA's coverage
of these issues. EPA has a strong history of work related to environmental
justice, so placing greater emphasis on equity in future HIA reports is
recommended and aligns with EPA's values and strategic emphasis.
Overall, it appears that the goals of this HIA have been met.
[Blank]
Did the advisory group or community members comment on or agree
with the vulnerable populations defined for the study site?
Is there the potential in the future for the Green Street Project to connect
to other green, bike and pedestrian-friendly infrastructure in the area,
thereby magnifying the positive effects of this relatively small
improvement?
In the Climate and Temperature section, it would have been helpful to see
transit usage data because shading of bus stops is listed as a key benefit.
This section could be more compelling if ER admissions or ED visit data
for heat-related illness could have been obtained. However, the
temperature data and infrastructure maps make the case that the Green
Refer to response in 7b.
[Blank]
No response needed.
The issues regarding the recommendations and dissemination plan
have been addressed (as mentioned above). The authors went
back to the introduction and scoping chapters to incorporate
more language regarding environmental justice and communities
of concern. The equity measures in the analysis were more
explicitly called-out, so that their consideration was more
apparent.
No response needed.
[Blank]
The list of vulnerable populations were derived from the
stakeholder discussions in the scoping meetings and literature
review. The final list was not verified with the stakeholder group.
Yes. One of the recommendations from the HIA Core Project
Team was to extend the proposed project and connect it with
existing and planned greenways and/ or bike paths. The DWM is
committed to expanding the proposed project to the planned
Atlanta Beltiine connection point.
The ER admissions data was not available at the time the
assessment was performed. However, this data was acquired after
the assessment and will be used in the expanded PCW HIA,
which was a request from stakeholders at the final stakeholder
meeting.
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Peer-Reviewer 1 (Mandy Green)
Street Project would positively impact the health determinants and
outcomes described.
Response from Authors
9d. General Comment
In the Air Quality section, it would have been helpful to see the traffic
volume data for the street(s) in the study area discussed as it relates to air
quality (since the traffic volumes map is included in the Safety section) to
better understand the burden of mobile-source air pollution for the site.
The authors went back to the air quality section and added
references from the AADT volume data to further solidify this
connection (between air quality and automobiles as pollutant
sources).
9e. General Comment
On page 112 in the discussion of potential adverse respiratory effects of
biking or walking: while it is of course necessary to point out these
adverse effects, several recent studies comparing the overall health impact
of active forms of transportation have concluded that the positive impact
of regular physical activity outweighs the potential negative air pollution
impacts for bikers and walkers. (For example: Woodcock J, et al. Public
health benefits of strategies to reduce greenhouse-gas emissions: urban
land transport. 2009. Lancet. 374(9705). The Project Team should
consider inclusion of these studies.
The studies provided were retrieved and reviewed. An additional
statement to capture this information was added to this section.
10. Additional revisions and/or
comments in the report
(excluding mechanical edits)
No revisions and/or comments provided.
No response needed.
Table 2. Comments from and Responses to Peer-Reviewer 2 (Kitty Richards)
Charge Questions to External
Peer- Reviewers
1. Context of HIA.
Peer-Reviewer 2 (Kitty Richards)
Response from Authors
[Blank]
[Blank]
la. Was the HIA undertaken to
inform a proposed decision (e.g.,
policy, program, plan, or project)
and conducted in advance of that
decision being made?
Yes, the HIA was done to inform a decision on whether to implement the
proposed green infrastructure project.
No response needed.
Ib. Were the need for and value
and feasibility of performing the
HIA assessed and clearly
documented?
The need for the HIA, value added from the HIA, and feasibility of
performing the HIA was assessed and documented. However, while
reading the document I wondered how much time and resources were
spent conducting the HIA, and weighing that with the possible benefits
given the geographically small study area selected, I found myself
questioning the resource commitment. It seems that an HIA may not
have been necessary to come up with the report's conclusions, particularly
if the City of Atlanta, the decision-makers, were already on board with the
decision to move forward with the proposed infrastructure project. A
cost/benefit assessment as to whether to conduct the HIA may have been
helpful beforehand.
In the report, text was added to reflect the changes in screening.
Specifically, the HIA was originally screened to evaluate the PNA
Vision (as a whole), but the City was restricted to implementing
only one of the projects at that time. Therefore, the HIA was
quickly rescreened for the smaller Boone Boulevard Green Street
Project demonstration site C. DWM and EPA agreed the HIA
would still be worth performing on the smaller project site.
However, the HIA project leads committed to expanding the HIA
to evaluate green infrastructure in the rest of the watershed and
began searching for a proposed decision to evaluate.
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Ic. Do the authors acknowledge
sponsors and/ or funding sources
for the HIA?
Id. Is the screening process
clearly documented in the report?
2. Scope of HIA.
2a. Were the goals and/ or
objectives of the HIA clearly
defined?
2b. Is the scope of the HIA
clearly defined (i.e., decision to
be studied and its alternatives;
potential impacts of the decision
on health, social, environmental,
economic, and other health
determinants and their pathways;
populations and vulnerable
groups likely to be affected by
the decision; demographic,
geographic, and temporal scope
of analysis; health impacts and
research questions selected for
examination in the HIA and
why)?
2b. Is the scoping process clearly
documented in the report?
2c. Are the participants in the
HIA and their roles clearly
identified?
3. Stakeholder Engagement.
3a. Are stakeholder groups,
including decision-makers and
vulnerable population groups,
clearly identified?
3b. Is a stakeholder engagement
and participation approach,
including plans for stakeholder
Peer-Reviewer 2 (Kitty Richards)
The authors acknowledged sponsors and funding sources.
The screening process was clear, though it could have been more concise.
[Blank]
Yes, although I believe the discussion could have been more concise.
No comment.
No comment.
No comment.
[Blank]
Yes, although it would have been helpful to have a table showing the
meetings by stakeholder group, meeting purpose, and date. The
discussion regarding the various meetings with the various HIA groups
and dates was difficult to follow.
No comment.
Response from Authors
No response needed.
The authors revisited the screening chapter. Several revisions
were made to streamline the screening chapter. However, some
of the discussions in the introduction chapter were brought into
screening (based on responses from other peer- reviewers). The
final page count for the screening chapter remained at six pages.
[Blank]
The authors revised the scoping chapter. Several revisions were
made and the chapter was reduced to 31 pages (from 40 pages).
The bulk of this chapter comes from the 12-page (large table) of
the final HIA scoping worksheet.
No response needed.
No response needed.
No response needed.
[Blank]
The authors added new tables under the section heading
"stakeholder communication and engagement," that listed the
stakeholder groups involved, activities, and purpose of each
activity for each step in the HIA process. The individuals who
participated in each stakeholder group are identified in the "HIA
Participants" section.
No response needed.
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communications, clearly
described in the report?
Peer-Reviewer 2 (Kitty Richards)
Response from Authors
3c. If so, was input from
stakeholders solicited and
utilized as planned in the HIA
process?
No comment.
No response needed.
3d. Did the HIA utilize
community knowledge and
experiences as evidence and in
No comment.
No response needed.
whati
«iysr
3e. Where stakeholders given the
opportunity to review and
comment on the findings of the
HIA?
No comment.
No response needed.
4. Evidence and Analysis.
[Blank]
[Blank]
4a. Are the methods for evidence
gathering and analysis clearly
described and justified?
Yes, there was evidently a lot of work that went into this.
No response needed.
4b. Was evidence selection and
gathering reasonable and
complete (i.e., was the best
available evidence obtained)?
No comment.
No response needed.
4c. Are the existing conditions
(e.g., demographics, socio-
economic conditions, health
determinants and health
outcomes, presence of vulnerable
groups, etc.) clearly described?
Is the profile of existing
conditions appropriate as a
baseline against which to assess
the impacts of the proposed
decision?
No comment.
No response needed.
4d. Are the potential health
impacts of the proposed decision
identified?
No comment.
No response needed.
4e. If so, is the characterization
of impacts reasonable and
complete (e.g., direction,
magnitude, likelihood,
distribution, and permanence of
impacts addressed; affected
No comment.
No response needed.
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Response from Authors
populations clearly identified;
etc.)?
4f. Are the methodologies, data
sources, assumptions,
limitations, and uncertainties of
the assessment clearly identified?
4g. Are the conclusions of the
analysis based on a transparent
and context-specific synthesis of
evidence (i.e., are the conclusions
reasonable and supported by the
evidence)?
5. Recommendations.
5a. Are recommendations,
mitigations, and/ or alternatives
identified that would protect
and/ or promote health?
5b. Are these recommendations
reasonable and supported by the
evidence?
5c. If prioritization of
recommendations took place,
was the method of priority-
setting documented, reasonable,
and appropriate?
5d. Is an implementation plan
identified for the developed
recommendations (e.g.,
responsible party for
implementation, timeline, link to
indicators that can be monitored,
etc.)?
6. Documentation.
6a. Is the layout and format of the
report clear and logical, with
information clearly organized in
sections that are easy to follow?
Again, I think some of the important points may have been lost due to
the amount of detail that was presented. Additionally, I believe some of
the language was overly technical. For example, I found the section on
flooding and slope unnecessarily far too technical and could have been
much more simplified; I think people automatically grasp the concept of
water flowing to the lowest point, without going into the why and how of
it.
No comment.
[Blank]
Yes, though if I were the government entity responsible for implementing
the recommendations, the number of recommendations would be
overwhelming and costly.
Refer to comment in 5a.
A clear prioritization scheme might have worked here with no more than
three recommendations per pre-construction, during construction and
post cost construction phases presented.
No comment provided.
[Blank]
Throughout the report, it was difficult to get at the important nuggets
because there was so much detail presented. The flow of the report was
good in terms of progression; however, I don't think many people would
be willing to wade through all of it. It was very detailed and used a lot of
technical jargon. The report could have been much more concise with an
executive summary provided at the beginning. The authors should avoid
The authors went back and revised several sections, specifically
the flood management section, and removed some items that were
not necessary or too technical for conveying the key message.
Furthermore, the sentence on flooding and slope was eliminated.
The Assessment chapter was reduced to 75 pages (from 96 pages)
in length.
No response needed.
[Blank]
The authors acknowledged in the report that cost and feasibility
was not considered in the recommendations. This was a short-fall
of the Recommendations step. However, the authors did try to
provide information on phasing the recommendations and
ranking so that not all had to be implemented at one time.
Refer to response in 5a.
The authors revised the explanation of how the recommendations
were prioritized. Unfortunately, the HIA Core Team did not
select the top three recommendations for each implementation
phase.
No response needed,
[Blank]
The authors acknowledged this point in the report and resolved to
eliminate superfluous content and remove technical jargon. The
report in its entirety has been reduced in length. The authors
acknowledge that the report was not written for one audience, but
several groups of audience (e.g., community members, the City of
Atlanta, HIA practitioners, and EPA Agency Administrators, etc.).
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6b. Is the writing style such that
the report is easily read and
understood (e.g., clearly written,
complex or unfamiliar terms
described, examples and
graphics used to illustrate text,
etc.)?
6c. Is documentation of the
overall HIA process transparent
(i.e., are the processes,
methodologies, sources of data,
assumptions, strengths and
limitations of evidence,
uncertainties, findings, etc. of the
HIA clearly documented)?
6d. Does the report identify any
other methods to be used for
documenting and disseminating
the HIA and its findings (e.g.,
briefings, presentations,
factsheets, flyers, newspaper or
journal articles, etc.)?
7. Monitoring and Evaluation.
7a. Was an evaluation of the HIA
process conducted (e.g., who was
involved, strengths and
weaknesses of the HIA,
successes and challenges, how
effective the HIA was in meeting
stated objectives, engagement
and communication with
stakeholders, lessons learned,
etc.)?
7b. Was a plan proposed for
monitoring implementation of
Peer-Reviewer 2 (Kitty Richards)
the jargon in the Fact Sheet and pass it through some of the community
members who participated to make sure it is clear prior to distribution to
the public. Additionally, it was never clear to me who this report was
intended for — I get it was for the decision-makers, but it seems to be
written for other technical audiences. It might have been good to put
some of the details in the appendices rather than in the main body of the
report. If someone were interested in the fine details, they could then
access the appendices.
Refer to comment in 6a.
Refer to comment in 6a.
Refer to comment in 6a.
[Blank]
Yes, in fact I found the lessons learned and challenges experienced to be
the most interesting and straight forward part of the HIA and very
instructive for me as a practitioner. I also liked Table 37 showing the
skills needed for by role for conducting an HIA.
I think the piece that talks about what the community can do, and whom
they can partner with (agencies) after the HIA Core Team exits, could be
Response from Authors
This was a particular challenge for an HIA led by the EPA,
because the content had to go through the Agency review process
and thus present enough information to support the conclusions
made. Thus, the authors resolved to provide a less detailed
version of the HIA report for the less technical audience. This
document would serve as a stand-alone Executive Summary.
Refer to response in 6a.
Refer to response in 6a.
Refer to response in 6a.
[Blank]
No response needed.
Section 7.2.2. Outcome Monitoring- the challenges faced in this
HIA, in regards to the limited health status data available, will be
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the decision and the effect the
HIA had on the decision-making
process (i.e., impact evaluation)?
7c. Was a plan proposed for
monitoring the impact of the
decision?
8. Overall HIA Process.
8a. Are the methods and
procedures used in the HIA
appropriate?
8b. What aspects of the HIA
process appeared to be
implemented effectively or
successfully and what aspects of
the HIA process could have been
strengthened or improved?
8c. To what extent were the goals
and/ or objectives of the HIA
achieved?
9. General Comments.
9a. General Comment
Peer-Reviewer 2 (Kitty Richards)
overwhelming for community-based organizations operating on a shoe-
string budget with volunteer staff.
Refer to comment in 7b.
[Blank]
I commend EPA for attempting to work in local community settings and
experimenting with HIA as a tool to bring forth community knowledge
and scientific evidence. It would be interesting to see how the HIA might
have turned out if it were done for a proposed project was more
controversial and a little less safe. The pending decision seemed to be a
win- win situation with many of the resources already secured, the
decision-makers on board, and the community in favor of the proposed
project.
No comment.
Since, as stated in the report, part of this work was done to strengthen
EPA's relationships with local communities, the most important project
evaluation questions would be, "was the HIA Core Team, consisting of
EPA staff, successful in building and maintaining key relationships with
the community over a 1, 3, 5-year timeframe", "were the organizations
and community members involved in the HIA successful in bringing
about positive policies that promote health using HIA as a tool", and
"post this HIA, how many other HIAs have the
organizations/community members successfully undertaken".
[Blank]
Painstaking work here and I'm sure the community appreciates the
assistance. The challenge is to stay engaged with the community and
continue relationship development post HIA. Sometimes a disservice to
communities can result when agencies come into a community to help,
conduct their work, publish their results, and leave. I'm hopeful that
while conducting the HIA, there was a sincere attempt to train
community members/organizations on conducting future HIAs and a
transfer of knowledge from the community to the HIA Core Team and
vice versa.
Response from Authors
difficult to overcome for any one entity. Thus, several potential
leads to implement the monitoring plan, in addition to potential
partners (for funding and/ or extra personnel) were identified by
the HIA Core Project Team.
Refer to response in 7b.
[Blank]
Some of the stakeholders who participated in this HIA agreed that
the project was a considerably small size for the EPA to be
involved. When this HIA was re-screened after DWM notified
EPA that only one project could be evaluated at that time, EPA
asked stakeholders whether the HIA should proceed. It was
agreed that the lessons learned from implementing the HIA
process was worth the expenditures. Furthermore, the EPA
agreed to expand the HIA to discuss implementing green
infrastructure in the larger Proctor Creek Watershed and its
potential health impacts.
No response needed.
The HIA Core Project Team members can provide further insight
as to how the working relationships have changed or not changed.
The best way to collect this information would be through a
survey-response process. However, the EPA requires IRB
approval before such a process could take place.
[Blank]
The participants in this HIA were leveraged from the existing
Proctor Creek Urban Federal Partnership. These entities are
continuing efforts in the Proctor Creek Watershed and the EPA
Region 4 office meets monthly to discuss the community's issues
and needs, and coordinate efforts in the area.
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9b. General Comment
Peer-Reviewer 2 (Kitty Richards)
Figure 18 was confusing. Table 7 could have been in the appendix or
simplified. I wasn't sure if there was significance to the size of the boxes
under the various categories and found that to be equally confusing.
Response from Authors
The authors revisited Figure 18, which illustrates the pathways
appraised in this HIA. The introductory paragraph for the
pathways was revised to better explain the pathways identified.
Table 7 was moved to the appendices.
10. Additional revisions and/or
comments in the report
(excluding mechanical edits)
[Blank]
[Blank]
lOa. Additional revision and/or
comment
Page iv. [Clarify funding vehicle.] "The HIA was supported through a
collaborative grant from EPA's SHC Research Program (or was it RESES
as stated on page ii.?).
The funding vehicle was through RESES research grant, which is
managed through the ORD. The authors revised the text in the
report to reflect this clarification.
lOb. Additional revision and/or
comment
Page 4. [Suggest] another word to replace "depose."
Page 10. [Suggest] consistently using "Simpson Rd." or "Boone St."
Otherwise, [switching between them] tends to be confusing.
This sentence was eliminated from revision of the entire
paragraph.
lOc. Additional revision and/or
comment
The authors added further clarification, in the background and
history of Boone Street, that "Boone Street was previously named
Simpson Road."
lOd. Additional revision and/or
comment
Page 15. "Each of the BMPs was designed to meet the state's water quality
sizing criteria, which requires the element to capture and treat runoff from
a 1.2 inch rainfall event or the first 1.2 inches of rainfall from larger rain
events." (what element are you referencing? This section is a little
confusing since BMPs seem to convey something other than best
management practices.
The element(s) refers to the elements of green infrastructure that
are also considered stormwater best managment practices (BMPs).
The authors revised this section of the report and created a new
section describing the design of the proposed project. The
overview of green infrastructure elements being used in the design
was left here; while the detailed information about the project's
design (discussion on the BMPs) was moved under the new
section and clarified further.
lOe. Additional revision and/or
comment
Page 16. "The second scenario is almost unlikely as scenario 1" (almost
unlikely- not sure what this means.) "The third scenario is impractical in
nature, considering a large portion of the project is sited in the unused
space left over from the road diet. (Option 3 states there will be no road
diet so I'm not following this). "The expanding support for the project
adds more expectation for the project to be implemented and those
managing the project will be held accountable for its completion." (? Not
sure why the last part of the sentence is here.)
The authors revised this section to make more clear. "Almost"
was removed. Option 3 discusses the impracticality of trying to
add green infrastructure elements in a street without creating
additional space. The last sentence was meant to reflect the
growing support for the project among the residents. If this
support wanes or becomes controversial, then this project may
face delay and/or indefinite postponement.
lOf. Additional revision and/or
comment
Page 21. "Feedback was incorporated, and in early October 2014, the final
recommendations of the HIA were sent to the City and stakeholders.
(Early October has not yet happened).
Because the report had to be reviewed by the Agency before the
final HIA steps were taken, this section was written as if the
report were released post October 2014. However, the timeline
has changed since the external peer-review. This section has been
updated with a new timeline reflecting those changes.
lOg. Additional revision and/or
comment
Page 63. "Identifying key search terms helped to expedite the search of
the literature." (info. On search terms used, cutoff dates of sources (e.g.,
post 2000) would be useful here.
The authors added this information to the text. "Identifying key
search terms (e.g., green infrastructure, efficiency, human health,
extreme heat event, etc.) and setting excursion parameters (e.g.,
sources published after 1995, in English, etc.) helped to expedite
the search of the literature. The authors also added a copy of the
literature review guidelines created for the HIA Core Project
Team in the appendices-to which the readers were referred.
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lOh. Additional revision and/ or
comment
lOi. Additional revision and/ or
comment
lOj. Additional revision and/ or
comment
10k. Additional revision and/ or
comment
10(1). Additional revision and/ or
comment
Peer-Reviewer 2 (Kitty Richards)
Page 79. Table 17. (no description of this table anywhere)
Page 86. "The combined sewer outlet is located outside the designated
community, so a CSO event is not expected to impact the population in
the community study area." (It might have been good to include the
community impacted by the CSO as well since this was a major concern.)
Page 90. First paragraph- (difficult paragraph to read- goes back and
forth)
Page 131. "Simply put, accessibility is the integration of considerations for
transport and land use facets of the environment that influence or
determine what can be reached in a given space and how it can be
reached." (anything but simply put-lots of jargon)
Page 162. "This prioritization strategy to designate whether the individual
was a resident or nonresident was chosen so that the HIA Core Project
Team could identify which recommendations were the preference of
those would be most affected by its implementation." (confusing
sentence)
Response from Authors
The authors added a few statements to introduce Table 17.
The authors did not think the project's size was large enough to
warrant including the population downstream of the combined
sewer outflow. The project will improve water quality going into
the combined sewer system, but that volume of water is negligible
compared to the total volume of stormwater discharged at that
outflow.
The authors revisited this paragraph and revised it for better
clarity.
The authors revised this statement to improve simplicity and
removed the technical jargon.
The authors revised this sentence to improve clarity and
simplicity.
Table 3. Comments from and Responses to Peer-Reviewer 3 (Jonathan Heller)
Charge Questions to External
Peer- Reviewers
1. Context of HIA.
la. Was the HIA undertaken to
inform a proposed decision (e.g.,
policy, program, plan, or project)
and conducted in advance of that
decision being made?
Ib. Were the need for and value
and feasibility of performing the
HIA assessed and clearly
documented?
Ic. Do the authors acknowledge
sponsors and/ or funding sources
for the HIA?
Id. Is the screening process
clearly documented in the report?
Peer- Reviewer 3 (Jonathan Heller) Response from Authors
[Blank] [Blank]
The HIA was undertaken to inform a proposed decision. No response needed.
The need for and value and feasibility of performing the HIA was No response needed.
assessed and clearly documented.
The authors acknowledge sponsors and/or funding sources for the HIA. No response needed.
After reading this section, I believe you all did a thorough job on No response needed.
screening and documented screening well. The screening process was
clearly documented in the report.
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2. Scope of HIA.
2a. Are the goals and/ or
objectives of the HIA clearly
defined?
2b. Is the scope of the HIA
clearly defined (i.e., decision to
be studied and its alternatives;
potential impacts of the decision
on health, social, environmental,
economic, and other health
determinants and their pathways;
populations and vulnerable
groups likely to be affected by
the decision; demographic,
geographic, and temporal scope
of analysis; health impacts and
research questions selected for
examination in the HIA and
why)?
2c. Is the scoping process clearly
documented in the report?
2d. Are the participants in the
HIA and their roles clearly
identified?
3. Stakeholder Engagement.
3a. Are stakeholder groups,
including decision-makers and
vulnerable population groups,
clearly identified?
3b. Is a stakeholder engagement
and participation approach,
including plans for stakeholder
communications, clearly
described in the report?
3c. If so, was input from
stakeholders solicited and
utilized as planned in the HIA
process?
Peer- Reviewer 3 (Jonathan Heller)
[Blank]
The goals of the HIA are clear. Who set these goals? Were these EPA
goals or did a broader set of stakeholders set these? The equity and
democracy principles would suggest that the community should be
involved in setting the project goals.
The scoping process is clearly described. On page 67 [African Americans
represent 82.3% of the population. This makes me think that African
Americans should be a vulnerable population.
After reading this section, I believe you all did a thorough job on scoping
and documented scoping well. The scope is clear.
Participants in the HIA are clearly described.
[Blank]
Stakeholder groups, including decision-makers and vulnerable population
groups, are clearly identified.
The stakeholder engagement and participation approach, including plans
for stakeholder communications, is clearly described in the report.
Input from stakeholders was solicited and utilized in scoping and in the
recommendations phases. It was not used in screening (see more about
that below), based on what I read. And I did not see it used in assessment
either.
Response from Authors
[Blank]
The goals of the HIA were set by the HIA Core Project Team at
the onset of the Scoping step and based on the considerations
with DWM and other stakeholders in the Screening step. The
authors revisited this section of the report and added text that
answered the questions posed by the reviewer.
While African Americans are typically identified as a minority and
hence a vulnerable population, African Americans represent the
majority population in this community and have for a long time.
It is acknowledged that race does present some health
vulnerabilities )e.g., higher rates of particular health outcomes
among African Americans), but the HIA Core Project Team felt it
was more appropriate to identify population characteristics that
could potentially contribute to disparities more directly related to
the health determinants appraised, given that actual health
outcomes within the study area could not be evaluated, but rather
had to be approximated based on health outcome data at a larger
scale (i.e., county level). In the second (expanded) Proctor Creek
Watershed HIA, populations with certain vulnerabilities to the
health outcomes expected will be considered for inclusion as a
vulnerable population.
No response needed.
No response needed.
[Blank]
No response needed.
No response needed.
The authors were able to gather more information from the
discussions in the Screening step. The HIA Project Leads stated
that both DWM, fellow EPA staff and other stakeholders were
consulted in the screening discussions. The authors added the
new information into the report under the screening chapter. The
authors revisited the text in the assessment chapter and add
clarifications where stakeholder input was used (to the best extent
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Response from Authors
possible). Also, a section was created regarding stakeholder
feedback on the assessment and recommendations and the
responses to this feedback was added.
3d. Did the HIA utilize
community knowledge and
experiences as evidence and in
what ways?
3e. Where stakeholders given the
opportunity to review and
comment on the findings of the
HIA?
4. Evidence and Analysis.
4a. Are the methods for evidence
gathering and analysis clearly
described and justified?
4b. Was evidence selection and
gathering reasonable and
complete (i.e., was the best
available evidence obtained)?
4c. Are the existing conditions
(e.g., demographics, socio-
economic conditions, health
determinants and health
outcomes, presence of vulnerable
groups, etc.) clearly described?
Is the profile of existing
conditions appropriate as a
baseline against which to assess
the impacts of the proposed
decision?
4d. Are the potential health
impacts of the proposed decision
identified?
4e. If so, is the characterization
of impacts reasonable and
The HIA utilized community knowledge and experiences as evidence in
deciding what to study during scoping, but not in the assessment phase.
Lived experience was not used as existing conditions data or in predicting
impacts.
Stakeholders were given the opportunity to review and comment on the
findings of the HIA, but it seemed like that was done in a very limited
way. There was no evidence that stakeholders had much to say about the
findings, which makes me think that the way they were asked did not truly
elicit feedback. And the little feedback that was received on posters — not
sure if that changed the HIA findings at all.
[Blank]
The methods for evidence gathering and analysis were clearly described
and justified.
Evidence selection and gathering was reasonable and complete.
Existing conditions were clearly described except for one health
determinant. The profile of existing conditions is appropriate as a
baseline against which to assess the impacts of the proposed decision.
The potential health impacts of the proposed decision were identified.
As you'll see below, I often don't agree with the ratings for magnitude. I
would use different definitions of magnitude and, instead of permanence,
The authors concede that the stakeholder experiences and/ or
viewpoints were used for some health determinants, but not all,
because input was not available for all of the health determinants
included in the assessment. This HIA was limited in ability to
collect information directly from the residents, due to 1KB
compliance requirements, and thus could not fill all of the
identified data gaps. The authors further explained the process of
receiving feedback at the stakeholder engagement meetings and
documented the feedback and the HIA Core Project Team's
responses in the report.
Refer to response in 3d.
[Blank]
No response needed.
No response needed.
The authors went back to the HIA Core Project Team, who
resolved to collected further data for the one health determinant
(social capital) and expanded on the discussions regarding the
predicted impacts based on the new information collected and
analyzed.
No response needed.
The HIA Core Project Team was unable to survey the number of
people who used the street to better inform the magnitude of
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complete (e.g., direction,
magnitude, likelihood,
distribution, and permanence of
impacts addressed; affected
populations clearly identified;
etc.)?
Peer-Reviewer 3 (Jonathan Heller)
use severity. For example, I don't think it is reasonable to say that this
project would have a 2 star magnitude (out of 3) impact on crime. While
that may be true with the definitions you have, it will be perceived as
inaccurate. For magnitude, I think you need to analyze how many people
are likely to have their health affected as a result of the change. For
crime, while "some groups" may truly be impacted, will putting in the
green street project really have a big impact on the level of crime? How
many crimes is it likely to eliminate? And how many people would
therefore really be impacted. Similarly for traffic safety. While lots of
people may walk by there, how many pedestrian collisions are there in that
area and how many will be avoided due to the road diet. I would also
suggest using severity rather than permanence. Severity takes into
account how big a health impact there will be. Will someone die or will
someone get a cold? If you do stick with permanence, I'd change the
definition to about the permanence of the health outcome not the
permanence of the determinant. Will a disease be permanent and
irreversible (e.g., death) or will it be short term (e.g., a cold)?
Response from Authors
some health impacts. In addition, the HIA Core Project Team
could not obtain health data at the resolution of the HIA study
area (beyond a qualitative characterization provided by OASIS).
Thus, the number of people potentially affected was not assessed
for each health impact, nor was severity of impact. Instead,
proximity health determinants were evaluated and the health
impacts were characterized in a qualitative manner. The authors
concede that this was a deficiency in this HIA. The authors did
revisit the descriptions of the magnitude and permanence ratings
and modified them to more accurately reflect the way in which
impacts were assessed and provided a more accurate account of
relative magnitude.
4f. Are the methodologies, data
sources, assumptions,
limitations, and uncertainties of
the assessment clearly identified?
The methodologies, data sources, assumptions, limitations, and
uncertainties of the assessment were clearly identified. The discussion on
flooding and impervious surfaces] is highly technical and, after reading it,
I'm not sure if this is an area that is prone to flooding or not.
See response to K Richards.
4g. Are the conclusions of the
analysis based on a transparent
and context-specific synthesis of
evidence (i.e., are the conclusions
reasonable and supported by the
evidence)?
The conclusions of the analysis were based on a transparent and context-
specific synthesis of evidence.
No response needed.
5. Recommendations.
[Blank]
[Blank]
5a. Are recommendations,
mitigations, and/or alternatives
identified that would protect
and/or promote health?
Recommendations, mitigations, and/or alternatives are identified that
would protect and/or promote health.
No response needed.
5b. Are these recommendations
reasonable and supported by the
evidence?
Recommendations were reasonable and supported by the evidence,
though there is a long list of recommendations and it is not clear which of
them is most important.
The HIA Core Project Team believed highlighting the
recommendations identified and/or supported by residents and
other stakeholders was appropriate because if the list of HIA
recommendations could not be implemented in its entirety, the
team believed DWM and the City of Atlanta should at a minimum
address and/or adopt these items (highlighted in green). Text was
added to reflect this discussion. The authors provided more text
and documentation regarding the recommendation prioritization
process, including the framework used and composite scores of
each recommendation. Furthermore, the authors simplified the
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Peer-Reviewer 3 (Jonathan Heller)
Response from Authors
table by separating out the recommendations by implementation
phase.
5c. If prioritization of
recommendations took place,
was the method of priority-
setting documented, reasonable,
and appropriate?
The method of priority-setting was documented, reasonable, and
appropriate. But some recommendations supported by stakeholders were
called out separately and that may influence the reader's opinion about
these. Great that you all got good input into the recommendations. The
list of recommendations is long and I did not get a clear sense of what are
the most important things decisions makers (for the project) should do. In
general, the recommendations made sense but there were too many and it
was not clear which were most important from a health perspective.
Refer to response in 5b.
5d. Is an implementation plan
identified for the developed
recommendations (e.g.,
responsible party for
implementation, timeline, link to
indicators that can be monitored,
etc.)?
A relatively vague implementation plan was identified for the developed
recommendations (e.g., responsible party for implementation, timeline,
link to indicators that can be monitored, etc.).
The authors were able to gather more specific information from
the HIA Core Project Team for some of the recommendations,
but not all. The HIA core project team acknowledged in the
report that cost and feasibility was not included in the
prioritization of the recommendations.
6. Documentation.
[Blank]
[Blank]
6a. Is the layout and format of the
report clear and logical, with
information clearly organized in
sections that are easy to follow?
The layout and format of the report is clear and logical, with information
clearly organized in sections that are easy to follow. However, the report
is over 250 pages in 11 point font. I doubt almost anyone will read the
report. Hopefully the fact sheet will be concise. The length of the report
hampers its effectiveness. Interested parties will not spend the time to
read it and there is no executive summary (yet?). The report could be
streamlined and much of the information could be cut out to make it
more effective at reaching some of its goals.
The authors re-reviewed the HIA report and eliminated
unnecessary information, where appropriate, and streamlined the
text to the best extent possible (without losing valuable
information). One thing to consider, is that this assessment
evaluated twelve health determinants (originally fifteen, but three
were combined into one overarching determinant). The scope of
this HIA is considerably more comprehensive than most HIAs in
the breadth of impacts assessment. Thus, the report is expectantly
longer to accommodate the full scope. Regardless, the authors
were able to reduce the report to 156 pages of content, 7 pages of
references, and 75+ pages of appendices.
6b. Is the writing style such that
the report is easily read and
understood (e.g., clearly written,
complex or unfamiliar terms
described, examples and
graphics used to illustrate text,
etc.)?
The writing style is such that the report is easily read and understood.
No response needed.
6c. Is documentation of the
overall HIA process transparent
(i.e., are the processes,
methodologies, sources of data,
assumptions, strengths and
limitations of evidence,
Documentation of the overall HIA process is transparent.
No response needed.
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Peer- Reviewer 3 (Jonathan Heller)
Response from Authors
uncertainties, findings, etc. of the
HIA clearly documented)?
6d. Does the report identify any
other methods to be used for
documenting and disseminating
the HIA and its findings (e.g.,
briefings, presentations,
factsheets, flyers, newspaper or
journal articles, etc.)?
7. Monitoring and Evaluation.
7a. Was an evaluation of the HIA
process conducted (e.g., who was
involved, strengths and
weaknesses of the HIA,
successes and challenges, how
effective the HIA was in meeting
stated objectives, engagement
and communication with
stakeholders, lessons learned,
etc.)?
7b. Was a plan proposed for
monitoring implementation of
the decision and the effect the
HIA had on the decision-making
process (i.e., impact evaluation)?
7c. Was a plan proposed for
monitoring the impact of the
decision?
8. Overall HIA Process.
8a. Are the methods and
procedures used in the HIA
appropriate?
8b. What aspects of the HIA
process appeared to be
implemented effectively or
successfully and what aspects of
the HIA process could have been
strengthened or improved?
The report identifies other methods to be used for documenting and
disseminating the HIA and its findings (e.g., briefings, presentations,
factsheets, flyers, newspaper or journal articles, etc.). This feels like the
minimal amount that is needed for communications. You could consider
adding other ways to communicate the findings, including speaking at
public events, giving testimony about the HIA, and trying to get media
coverage. The stated communications activities are not likely to result in
many people seeing the HIA.
[Blank]
An evaluation of the HIA process was conducted. However, the
evaluation should cover whether the goals were met.
A plan was proposed for monitoring implementation of the decision and
the effect the HIA had on the decision-making process.
A plan was proposed for monitoring the impact of the decision
implementation on health determinants and health outcomes (i.e.,
outcome evaluation). If negative health impacts are found during
monitoring, no plan for action is proposed.
[Blank]
The methods and procedures used in the HIA were appropriate. I did not
agree with the predication tables — see comments on that below.
The overall report is well done and the process clearly described. The
Scoping process seemed very complete. Stakeholders could have been
engaged more in the whole process, including deciding the topic of the
HIA and giving more substantive feedback about the findings.
The HIA Core Project Team was able to provide more
information about the materials developed for the HIA and the
different venues where team members presented on the HIA
findings and/ or process. This information was added to the
report under the reporting section.
[Blank]
During the report review process, the HIA was evaluated for its
ability to meet the goals identified in scoping. This new
information was incorporated into the report.
No response needed.
The authors recognized that contingencies for finding negative
health outcomes was not included in the management plan.
Although this practice was not commonly found in previous HIA
reports, this deficiency in developing contingency plans within the
monitoring plan was identified as a missed opportunity to provide
best practices in HIA.
[Blank]
See response above (regarding impact characterization methods).
See responses above (regarding screening and assessment
processes).
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8c. To what extent were the goals
and/or objectives of the HIA
achieved?
Peer-Reviewer 3 (Jonathan Heller)
I don't know if the goals were achieved. That is a question that should
have been answered in the self-evaluation that was done. I don't know
that the HIA process was a route to get more equitable engagement in the
decision making process — I did not see evidence of that in the report, but
you all may have experiences that were not documented in the report
regarding this. There is no discussion of whether the goals for the HIA, as
described in Scoping, were achieved in the evaluation section.
Response from Authors
See response above (regarding evaluation of HIA goals).
9. General Comments.
As I say below (just once), the report is very, very long (and in 11 pt). It
could be streamlined significantly by reducing repetition and moving less
important content to appendices. As is, it will not be super useful for
stakeholders because no one will read it. I know there will be fact sheets,
but an exec summary would be nice too. And, really, would be great if
future reports were shorter.
See responses above (regarding documentation of the HIA).
10. Additional revisions and/or
comments in the report
(excluding mechanical edits)
[Blank]
[Blank]
lOa. Additional revisions and/or
comments
Page 4. "In order to avoid these negative outcomes, HIA practitioners
must use fact-based evidence and proven methods from a variety of
sources to develop an objective opinion regarding the pending decision.
An objective opinion is without preconceived notions, prejudices, or
personal feelings." (I'd suggest dropping this. It propagates the idea that
some people are objective and others are not and that someone is able to
approach something without preconceived notions. The science does not
support this idea — we all have preconceived notions that influence our
ideas. The questions become a) does the HIA practitioner admit to having
those biases and preconceived notions and b) how does the practitioner
take those into account when conducting the HIA. Just leave out the idea
of objectivity.)
The authors revised this section extensively. These two statements
were eliminated.
lOb. Additional revisions and/or
comments
Page 18. Section 2.3 The Decision to Conduct the HIA. (It sounds like
others were not involved in screening this HIA. It would have been nice if
the EJ community described above would have had input into whether
this was a worthwhile project on which to conduct an HIA. They may
have had other ideas about what proposals would be most likely to impact
their lives. An opportunity to model democracy and equity was missed.
The population is mainly African American and has high levels of poverty
and unemployment. If the government is going to try to do something to
help them out, shouldn't they be asked what might have a big impact?
And would they choose a green infrastructure project along a l/z mile of
road as THE thing the EPA should weigh in on to improve their lives?
Maybe so, but it would be good to ask them.). However, I'm left still
wondering whether an HIA was necessary for this project — was it the
best use of resources? Was there any disagreement about the project or
controversy? Did the community have concerns about the proposed
The authors revised this section extensively. The screening
process was further detailed regarding the initial screening for the
implementing the PNA Vision (in its entirety) and then later re-
screened for the smaller project. The HIA Project Leads
discussed with DWM and other key stakeholders (EPA staff and
other Federal Urban Partnership members) the value expected to
come from this HIA. The authors explicitly described the
considerations included in these discussions.
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Peer-Reviewer 3 (Jonathan Heller)
project? If not, could a proposal that had more potential tradeoffs or
more controversy been selected as the topic of an HIA and would that
have been a better use of limited resources? I understand that this may
have been a good demonstration project for the EPA, but I would hope
that resources are focused on the most important equity issues in the
future.
Response from Authors
lOc. Additional revisions and/or
comments
Page 20. "Add a vehicle for equitable inclusion of all stakeholders in the
decision-making process. (Were some stakeholders feeling like they were
not being heard? If so, that should be documented in Screening as a
reason to do the HIA.)
This information came from the considerations discussed in
Screening. The authors were able to provide more information
answering the question posed by the reviewer in the Screening
chapter.
lOd. Additional revisions and/or
comments
Page 20. "Increase transparency, local accountability, community
empowerment and ownership of the proposed plan through meaningful
stakeholder engagement." (Similar to my comment above: were some
stakeholders feeling like the decision-making process was not transparent
and that the community was not involved? If so, that should be
documented in Screening.)
See response above.
lOe. Additional revisions and/or
comments
Page 16. "The second scenario is almost unlikely as scenario 1" (Unclear) See response to K Richards.
lOf. Additional revisions and/or
comments
Page 21. (You may address this below in the evaluation section, but this is
a very long timeline. Most decisions take place on shorter timescales and
the fact that it took 2 years for a federal agency to conduct this HIA on a
relatively small and non-controversial project has implications for the
success of future HIAs conducted by a federal agency.)
The authors provided more information regarding the challenges
faced during the HIA that led to the sliding timeline. More
specifically, the discussion of the HIA timeline was clarified in the
text to reflect the actual time taken to conduct the HIA,
accounting for the unavoidable delays due to sequestration,
government shutdown, schedule conflicts, etc. and the lack of
dedicated full-time equivalents during the duration of the HIA.
These challenges provided informative "lessons learned" for
future HIA practice.
lOg. Additional revisions and/or
comments
Page 30. (This section does not mention race/ethnicity at all. You get to
this in the existing conditions section below, but race is a huge issue in the
area and African Americans face health inequities, even when controlling
for income. The definition of vulnerable populations should include
African Americans.)
See response above regarding vulnerable populations.
lOh. Additional revisions and/or
comments
Page. 36. "It is important for the HIA process that all opinions be
considered equally and addressed in some manner. (I'd say "equitably"
not "equally". The opinions of vulnerable populations that will be
impacted by the proposal may be weighted more than the opinions of the
rich who might be able to move away if they want.)
The authors agreed with the rationale provided and accepted the
word change to "equitably."
lOi. Additional revisions and/or
comments
Page 68. (It would also be helpful to see a map of the % African
American by census tract.)
The HIA Core Project Team disagreed with the reviewer,
regarding the added value of mapping the percentage of African
Americans. The population is almost exclusively African
American and mapping the diversity index by Census tract already
provided information regarding the areas that are more or less
diverse.
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lOj. Additional revisions and/or
comments
Peer-Reviewer 3 (Jonathan Heller)
Page 71. (It would be interesting to see what % of the population is
paying more than 30% and/or 50% of their income on housing. You
have this data, but are not reporting it. This statistic provides a lot of
information, especially since one of your vulnerable populations is low-
income.)
Response from Authors
The authors went back to HIA Core Project Team to obtain this
information. The data was collected, analyzed and incorporated
into the Household Economics section, which had more
information pertaining to this discussion.
10k. Additional revisions and/or
comments
Page 72. "African Americans experienced the highest percentage of
unemployment rates among the groups in the population, which may
merely be a reflection of the proportion of African Americans in the
community. " (Huh? The rates by race/ethnicity do not depend on the
proportion of that race/ethnicity in the population.)
This sentence structure was a copy/paste error (two sentences
were spliced into one). The sentence was revised to it's original
intent- "Of the group in the labor force, 16.3% (+/-0.02%) were
unemployed (U.S. Census Bureau 2010). Unemployment was high
for both African Americans and Caucasians, at 19.2% and 16.3%,
respectively (U.S. Census Bureau 2010)." The highest percentage
of unemployment rates among the groups in the population were
those without a high school, education (32.5%)."
10(1). Additional revisions and/or
comments
Page 82. (From the diagram below, it looks like the level was about 5X
higher at site 6. That seems like a lot and may be worth pointing out.)
The report does not provide the exact level of E. coli cfu, so the
authors could not infer as to how much higher the levels were
than the EPA recommended critical level. The authors revisited
the discussion and removed the images to avoid confusion,
because they showed data from sample sites that were all outside
the HIA study area. The information gleamed from the figures
was converted to text in the report.
10m. Additional revisions and/or
comments
Page 88. "Water like air and pressure, flows down gradients.."(This HIA is
very, very long. Because it is so long, very few people are going to read it
all. There are many places where it could be streamlined. Here is just one
example — probably not necessary to point out that water flows downhill.)
The authors revisited this section and removed superfluous
information and redundancies.
lOn. Additional revisions and/or
comments
Page 88. "Housing renewal in deprived (low-income) areas has resulted in
reduced levels of psychological distress." (Housing renewal sounds too
close to "urban renewal" which did NOT reduce psychological distress in
low income communities — it increased it by causing displacement. I'd
not use the term "housing renewal".)
The authors revised this statement to more specifically outline
intended message- "Efforts to improve and/or restore vacant or
derelict homes can result in reduced levels of distress among
residents and visitors to the area."
lOo. Additional revisions and/or
comments
Page 94-95. (Figures 39 and 40 should be combined).
The authors disagreed with this suggestion. The HIA Core
Project Team wanted to show the differences between residential
and non-residential properties because they have (in some cases)
opposite directions of impact in regards to revitalization (i.e.,
businesses may benefit from revitalization, residences may see
adverse impacts from gentrification). In addition, the figure
pertaining to the non-residential properties and its related text was
moved under its proper heading- Community economics.
lOp. Additional revisions and/or
comments
Page 101. (In my opinion, this table is overstating the impact that this
project will have on flooding and health outcomes.)
The authors re-evaluated the description of impact criteria and
revised them to more clearly qualify the impacts predicted.
However, as defined, the magnitude is moderate because the
people who use the street (walkers, bicyclers, drivers, passengers)
will be impacted by the reduced pooling/standing water and
reduced risks for slips, falls, mosquito proliferation, and CSO
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Peer- Reviewer 3 (Jonathan Heller)
Response from Authors
events. The authors agree and acknowledge that the proposed
project's size limits the magnitude of the impact. Thus, the authors
recommend expanding the project's size and/ or replicating green
infrastructure projects in the rest of the watershed to increase the
magnitude of impact.
lOq. Additional revisions and/ or
comments
lOr. Additional revisions and/ or
comments
10s. Additional revisions and/ or
comments
lOt. Additional revisions and/ or
comments
lOu. Additional revisions and/ or
comments
lOv. Additional revisions and/ or
comments
lOw. Additional revisions and/ or
comments
lOx. Additional revisions and/or
comments
lOy. Additional revisions and/ or
comments
Page 107. (Same as for the table above. This seems like an overestimate
of the benefits of the project. Maybe this means that it would be a good
idea to consider a different scale for magnitude and also include "severity"
as another dimension of impact to analyze.)
Page (Same comment as above for the temperature summary table. This
is not believable. The local impacts of a project like this are so small
compared to the regional AQ situation.)
Page 116. (Could include a discussion of pedestrian and bike injuries and
how they relate to traffic volume and speed.)
Page 118 and 126. (Again, I read this to say that this project will save
many lives and severe injuries, which I do not believe. Yes, many people
will walk near this project, but very few would have gotten into a collision
with a vehicle. To me, this would be a low magnitude but high severity
impact.)
Page 128. (I assume that there are no stationary sources of noise in the
project area? May be worth pointing that out.)
Page 130. (I think about permanence differently than it is being use here.
I think about it as how permanent the health impacts are (e.g., being hit
and killed in a car crash is permanent; acquiring a cold has low
permanence.) But I prefer the measure of severity to permanence.)
Page 130. (It would be helpful to provide a sense of whether these are
high noise levels or not. What do they compare to?)
Page 131. "This is partly due to the qualitative nature of the data (as much
of the data collected is self- reported and susceptible to bias). (I'd suggest
dropping this. Well collected qualitative data is not any more susceptible
to bias than quant data.)
Page 131. (Part of the instructions to reviewers asked us to comment on
whether existing conditions were collected. This is the first instance
where they were not. There are some important questions not answered
as a result, like: Is there a grocery store that would be made more
accessible using active transport? Are there medical facilities that would be
more accessible? Is accessibility an issue for people living here? How
many people in the area do not own cars?)
See previous responses on this issue.
The authors revisited this discussion and discussions among the
HIA Core Project Team and determined that the magnitude
should be (as defined above) only moderate (**). The permanence
should be high (***).
The authors were unable to go back and search the literature for
more references to this pathway.
See previous responses on this issue.
The authors added language referring to event days (when the
stadium and congress center are in use), but it is unknown how
much these sources provide noise and whether those levels
disturb nearby residents (or to what extent).
See previous responses on this issue.
The authors provided more information from the literature about
the ranges of urban noise that impact health.
This statement was removed.
The authors recognized this short-sight and went back to the data
and used GIS to map the existing assets in the community that
could provide space for developing and/or building social capital.
This new information was incorporated into the report.
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lOz. Additional revisions and/ or
comments
lOaa. Additional revisions and/ or
comments
lObb. Additional revisions and/ or
comments
lOcc. Additional revisions and/ or
comments
lOdd. Additional revisions and/ or
comments
lOee. Additional revisions and/ or
comments
lOff. Additional revisions and/ or
comments
lOgg. Additional revisions and/ or
comments
lOhh. Additional revisions and/ or
comments
lOii. Additional revisions and/ or
comments
Peer- Reviewer 3 (Jonathan Heller)
Page 135. (You say above that you don't know how many people have
limited access to goods and services, so how can you make a prediction
here?)
Page. 141. "The amount of greenness in an urban community has also
been linked to the amount of crime that is committed in that area." (This
should be part of the lit review above.)
Page 160. (Was anything done with the feedback below? Did the HIA
report change in any way?)
Page 160. "Several stakeholders pointed out that the HIA lacked a
mapping of the community's assets. (This reflects another concern I have.
While community input appears to have been taken into consideration
during scoping, community experience was not included in assessment.
Do people think the area is walkable currently? Do people walk or bike?
Why or why not? How do people use the local rivers, if they do? Is crime
in the immediate area of the project a concern? Where do people shop?
Etc. Community voice felt like it was missing from the analysis.)
Page 160. (I find it interesting that no one commented on any of the
predictions and whether they agreed with them or not. Was that a
question that was asked? We often think of these kinds of meetings as a
way to "ground truth" the findings, but not sure that happened in this
case.)
Page 168. "Incorporate employment opportunities for local residents and
businesses during construction and maintenance , starting with those in
Vine City and English Avenue." (This could be more specific. What
percent of jobs should be set aside for local hiring?)
Page 168. "Remove fecal smell. . . Increase police presence. . ." (Putting
these last and calling them out specifically as being from residents makes
them seem separate and maybe not backed by the EPA.)
Page 171. "Work with the AD PCD" (To do what?)
Page 172. "Continue to monitor traffic volume to ensure the road diet
does not cause overburden of traffic congestion." (What if traffic volume
increases? What then?)
Page 172. "Consider local zoning ordinances and regulations regarding
land use. (This is not specific.)
Response from Authors
The authors recognized this limitation in the ability to determine
the number of people impacted. Thus, the authors qualitatively
defined moderate number of people as those who use the street.
Whereas a high number of people would include the population in
the whole study area.
The authors moved this discussion under Review of the
Literature.
The authors went back to this input and provided responses (how
the input was used/incorporated into the report) in a table format.
See previous responses on this issue. Also, the authors were
unable to obtain this information (they could not conduct surveys
of the residents, nor were there previous survey data available) at
that time.
The HIA Core Project Team did solicit feedback on the predicted
impacts. The authors added verbiage to document what was asked
of the stakeholders at the final stakeholder meeting (where the
findings and recommendations were provided).
The authors were unable to provide any more specificity to the
number of jobs that should be set aside for residents.
The authors moved these recommendations higher in list to more
accurately reflect the priorities assigned in the scoping process (see
figure 16).
The authors added more specific language to this
recommendation.
The HIA Core Project Team provided added verbiage to this
recommendation- "If problems arise, coordinate with
transportation department to problem-solve and implement
counter measures (e.g., measures to divert traffic to nearby
corridors, axel restrictions, re-evaluating bus routes, etc.)."
The HIA Core Project Team provided added verbiage to this
recommendation- "Consider whether local zoning ordinances and
regulations regarding land use are appropriate to protect the
environment and public health and support economic and social
growth."
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lOjj. Additional revisions and/ or
comments
lOkk. Additional revisions and/ or
comments
10(1)(1). Additional revisions
and/ or comments
10mm. Additional revisions
and/ or comments
lOnn. Additional revisions and/ or
comments
lOoo. Additional revisions and/ or
comments
10pp. Additional revisions and/ or
comments
Peer- Reviewer 3 (Jonathan Heller)
Page 173. "Develop and implement policies that limit renting and
encourage more home ownership. (Wouldn't this make it harder for
people who need to rent? This could be a bad idea.)
Page 173. "Develop and implement policies for new development to
ensure a % will be dedicated for mixed income housing." (What %? And
shouldn't it be for low income housing? That is what is typically not built.)
Page 173. "Consider zoning ordinances to reduce fast food, cash advance,
and alcohol establishments." (This feels pretty distant from the project
that is the focus of this HIA.)
Page 173. There was no recommendation about ensuring upkeep of the
project. Many of the findings rely on long term upkeep of the green
space. Should $ be dedicated to upkeep? What else could be done?
Page 175. "In addition to this review, external peer- reviewers were
solicited to provide an objective, critical review of the HIA." (While I am
providing a critical review, I don't claim to be objective. I am biased by
my belief that we should be trying to achieve equity with HIA practice, for
example. I'd suggest striking the word objective.)
Page 176. "Having the HIA co-led by the EPA regional office, with team
members from or familiar with the community, helped to alleviate this
misconception. (I wonder whether community members would agree with
this.)
Page 178. "Was the HIA completed in time to inform the decision?" (Do
you know the answer to this already?)
Response from Authors
The HIA Core Project Team provided added verbiage to this
recommendation- "Develop and implement policies aimed to
lower resident turnover, such as encouraging more home
ownership in the community."
The HIA Core Project Team could not provide more specific
information to resolve this comment.
The authors agree that this recommendation is very distant to this
proposed project. However, it was a recommendation from the
stakeholders on the HIA Core Project Team.
The authors acknowledge that several of the findings were
assuming upkeep of the proposed project site was maintained.
There are recommendations related to Water Quality and Flood
Management that have this language in them.
The term objective was removed.
No response needed.
The authors revised this chapter and added new information
pertaining to the internal and external reviews. The questions
posed were answered to the best extent possible.
End.
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