*>EPA
United States
Environmental Protection
Agency
EPA/600/RR-21/020
Health Impact Assessment (HIA)
& EnviroAtlas
Integrating Ecosystem Services
into the Decision Making Process
Office of Research and Development
Center for Public Health & Environmental Assessment

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Preface
This document was created to highlight the many ways that the U.S. EPA Enviro Atlas suite of ecosystem
services tools can be used to aid in the Health Impact Assessment (HIA) process. Ecosystems provide
numerous services and benefits to individuals, communities, businesses, and other entities. Changes in
policies, plans, programs, or projects that alter natural elements of the environment may change the
distribution of these services and benefits. Taking into consideration these natural components of the
environment and their effects on public health during the decision making process can help mitigate
unintended results or stimulate health promoting plans. HIA practitioners can use Enviro Atlas maps and
tools to understand the role of ecosystem services and benefits in public health; to access watershed,
census block group, and other scales of ecosystem services data for specific regions; and to visually
assess these spatial data through a user-friendly interface.
The appropriate citation for this report is:
U.S. Environmental Protection Agency. 2020. Health Impact Assessment & EnviroAtlas: Integrating
Ecosystem Services into the Decision Making Process. Office of Research and Development, Center for
Public Health and Environmental Assessment, Research Triangle Park, NC. EPA/600/RR-21/020,
Acknowledgements
This document was developed by Leah Yngve and Pamela Barclay, research fellows hosted by EPA's
Office of Research and Development (ORD), and Laura Jackson, EPA/ORD. It was reviewed by Florence
Fulk, EPA/ORD, and Arthur Wendel, U.S. Centers for Disease Control and Prevention. Updates were
performed by Daniel Rosenbaum, research fellow, and Erica Wood, contractor, hosted by EPA/ORD, and
Laura Jackson and Jessica Daniel, EPA/ORD. The cover page photo was taken at the Old Fourth Ward
Park in Atlanta, GA by Riley Perszyk.
This publication was supported by EPA Cooperative Agreement Number X3-83555301 with the
Association of Schools and Programs of Public Health (ASPPH), by Interagency Agreement Numbers
DW-89-92298301 and DW4589-92 525001 with the U.S. Dept. of Energy (DOE), and by contract # 68-
HERPI-20-D-0003 with Oak Ridge Associated Universities (ORAU). The findings and conclusions do not
necessarily represent the official views of EPA, DOE, ASPPH, or ORAU.
EnviroAtlas Contact Information
If you have questions or need additional information, email the EnviroAtlas Team at
Enviro Atlas@epa.gov or go to the EnviroAtlas website (https://www.epa.gov/enviroatlas).
i

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Table of Contents
Preface	i
Acknowledgements	i
EnviroAtlas Contact Information	i
Introduction to Health Impact Assessment and Ecosystem Services	1
What is Health Impact Assessment (HIA)?	1
What are Ecosystem Services?	1
Ecosystem Services as Health Determinants	2
Why are ecosystem services relevant for HIA?	3
Integrating EnviroAtlas and Health Impact Assessment	5
What is EnviroAtlas?	5
Incorporating EnviroAtlas Tools & Resources into the HIA Process	6
Overview of the Interactive Map	7
Overview of the Eco-Health Relationship Browser	10
How EnviroAtlas can support HIA	12
How EnviroAtlas can address HIA challenges	14
More Information about EnviroAtlas Resources & Tools	15
Integrated Mapping and Analysis Tools	15
Data Layer Fact Sheets	17
Metadata and Data Download	17
Case Studies and Use Cases	18
Downloadable GIS Tools	19
Additional Resources	20
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Introduction to Health Impact Assessment and Ecosystem Services
The Steps of HIA
SCREENING
What is Health Impact Assessment (HIA)?
Many organizations recommend the use of HIA to explicitly consider
potential public health consequences of a pending decision. As described by
the Health Impact Project, "HIA is a systematic process that uses an array of
data sources and analytic methods and considers input from stakeholders to
determine the potential effects of a proposed policy, plan, program, or
project on the health of a population and the distribution of those effects
within the population. HIA provides recommendations on monitoring and
managing those effects."1
The use of HIA to incorporate health into the decision-making process from
neighborhoods to multi-state regions is on the rise. The length of time to
complete an HIA varies based on the context and decision-making timeline.
HIAs generally consist of six steps: screening, scoping, assessment,
recommendations, reporting, and monitoring and evaluation (Figure 1).
For more information on HIAs, visit:
https://www.cdc.gov/healthvplaces/hia.htni.
What are Ecosystem Services?
Ecosystem goods and services, often shortened to just ecosystem services,
are the benefits that humans receive from nature. These benefits underpin
almost every aspect of human well-being, including our food and water,
security, health, and economy. However, we are so accustomed to this
natural provision of benefits that we are not always conscious of the links
between our surrounding environment and our well-being, and thus may not
always take the "true value" of ecosystems into account in our decision-
making processes. Many of the decisions that we make, from how we
develop the infrastructure in our communities, to the ways that we manage
the land surrounding our communities, affect the provision of ecosystem
services. Thus, considering the true value of ecosystem services in our
policies and decision-making can help us better manage our resources in a
way that may benefit us economically, environmentally, and socially.
For more information on ecosystem services, visit:
https://www.epa.gov/enviroatlas/ecosvstem-services-enviroatlas-Q.
Determine whether an HIA is
needed and likely to be useful.
SCOPING
In consultation with stakeholders,
develop a plan for the HIA, includ-
ing the identification of potential
health risks and benefits.
ASSESSMENT
Describe the baseline health of
affected communities and assess
the potential impacts of the
decision.
RECOMMENDATIONS
Develop practical solutions that
can be implemented within the
political, economic or technical
limitations of the project or policy
being assessed.
REPORTING
Disseminate the findings to deci-
sion makers, affected communities
and other stakeholders.
MONITORING AND
EVALUATION
Monitor the changes in health or
health risk factors and evaluate the
efficacy of the measures that are
implemented and the HIA process
as a whole.
The HIA process encourages public
input at each step.
Figure 1. Steps of Health Impact
Assessment; Health Impact Project2
1	"Improving Health in the United States: The Role of Health Impact Assessment". National Research Council.
https://www.nap.edu/resource/13229/Health-Impact-Assessment-Report-Brief-Final.pdf.
2	"HIA Process". Health Impact Project, https://www.pewtrusts.org/eii/proiects/health-impact-proiect/health-impact-
assessment/liia-process.
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Ecosystem Services as Health Determinants
Health determinants are "factors that contribute to a person's current state of health."3 They range from
biologic factors to the social environment, and can affect health positively or negatively. Natural
ecosystems and even natural features in developed settings can function to improve the quality of the
environment and its ability to support life. Vegetation and soils filter many pollutants and can buffer
communities from extreme events. Additionally, the green space within and around our communities
provides opportunities for physical activity, social interaction, and engagement with the natural world.
Studies have found positive associations between exposure to green space and many aspects of physical
and mental health. Multiple mechanisms contribute to the public health benefits derived from ecosystem
services; these range from carbon sequestration in distant forests and oceans to highly local influences on
personal behaviors and prenatal exposures (Figure 2).

The determinants!'
health and well-l
in our neighbourhoods
,/¦
Water cycling and carbon sequestration are some of the
key processes that operate at global scales, sustaining life
on earth.
Natural ecosystems store and filter our drinking water,
provide pollinators for nutritious crop yields, and offer
spiritual, cultural, and recreational opportunities.
Urban green space, such as parks, greenways, and street
trees, enhances the built environment by buffering noise
and pollution, reducing summer temperatures, and
providing green views.
Urban green space, such as parks, greenways, and street
trees, increases opportunities for outdoor recreation,
environmental education, and active transportation.
Urban green space provides common ground for
community members to meet and interact.
*¦ Access to urban green space and wild ecosystems can
promote active lifestyles and engagement with nature.
Environmental factors such as clean air and water and
buffers from stress affect the prenatal environment,
maternal health, and birth outcomes.
Figure 2. Ecosystem services are part of the Barton and Grant social, economic, and environmental determinants of health model.4
3	"Social Determinants of Health." Centers for Disease Control and Prevention.
https://www.cdc.gov/socialdetenninants/.
4	Barton, H. and Grant, M. A health map for the local human habitat. 2006. The Journal for the Royal Society for the
Promotion of Health, 126 (6). pp. 252-253. ISSN 1466-4240.
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Why are ecosystem services relevant for HIA?
Ecosystem services, or societal benefits from nature, underpin almost ever} aspect of human well-being,
including our food and water, security, health, recreational opportunities, and economy (Figure 3).
Though critically important to human well-being, ecosystem services are often overlooked. They may not
be directly observed and can be difficult to quantify because of their complexity. For example, street trees
can reduce natural hazards such as flooding or extreme heat, as well as filter air and water pollutants.
Benefits may also depend on interactions among several natural features, or between natural features and
built infrastructure.
ECOSYSTEM SERVICES
Provisioning
FOOD
FRESH WATER
WOOD AND FIBER
FUEL
Supporting
NUTRIENT CYCLING
SOIL FORMATION
PRIMARY PRODUCTION
Regulating
CLIMATE REGULATION
FLOOD REGULATION
DISEASE REGULATION
WATER PURIFICATION
Cultural
AESTHETIC
SPIRITUAL
EDUCATIONAL
RECREATIONAL
LIFE ON EARTH - BIODIVERSITY
CONSTITUENTS OF WELL-BEING
Security

PERSONAL SAFETY

SECURE RESOURCE ACCESS

SECURITY FROM DISASTERS

Basic material

for good life
Freedom
ADEQUATE LIVELIHOODS
of choice
SUFFICIENT NUTRITIOUS FOOD
and action
SHELTER
ACCESS TO GOODS
OPPORTUNITY TO BE
ABLE TO ACHIEVE
WHAT AN INDIVIDUAL

Health
STRENGTH
VALUES DOING
AND BEING
FEELING WELL

ACCESS TO CLEAN AIR

AND WATER

Good social relations

SOCIAL COHESION

MUTUAL RESPECT

ABILITY TO HELP OTHERS

ARROW'S COLOR
Potential for mediation by
socioeconomic factors
Low
ARROW'S WIDTH
Intensity of linkages between ecosystem
services and human well-being
¦	Weak
Source: Millennium Ecosystem Assessment
Medium
High
Medium
~ Strong
Figure 3. Model of the relationship between ecosystem services and human well-being.5
5 "Ecosystems and Human Weil-Being: General Synthesis". 2005. Millennium Ecosystem Assessment, pp 15.
World Health Organization. https://www.milleimiumassessment.org/en/Svnthesis.aspx.
3

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Integrating EnviroAtlas and Health Impact Assessment
What is EnviroAtlas?
EnviroAtlas is a free collection of interactive tools and resources that allows users to explore the many
benefits people receive from ecosystem services. EnviroAtlas combines maps, analysis tools, fact sheets,
and downloadable data into an easy-to-use, web-based resource. It also includes an interactive literature
review, the Eco-Health Relationship Browser. A primary objective of EnviroAtlas is to assist stakeholders
in the measurement and communication of the type, quality, and extent of the goods and services that
families and communities receive from nature so that the true value of environmental assets can be
considered in decision-making processes. Users can access, view, and analyze diverse information to
better understand how various decisions can affect an array of ecological, health, and equity outcomes.
The initial version of EnviroAtlas was released in May 2014 and the website has been continually
updated. As of 2020, the EnviroAtlas Interactive Map contains hundreds of data layers, including high
resolution land cover and metrics for thirty U.S. urban areas. This web-based tool is available to anyone
with a computer and an internet connection; no special software is needed. EnviroAtlas is developed
collaboratively by the U.S. Environmental Protection Agency, in partnership w ith the U.S. Geological
Survey, LandScope America, the U.S. Department of Agriculture's Forest Service and Natural Resources
Conservation Service, and other federal and non-profit organizations, universities and communities,
including state, county, and community-level stakeholders.
For more information on EnviroAtlas, please visit: https://www.epa.gov/enviroatlas.
5

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Incorporating EnviroAtlas Tools & Resources into the HIA Process
Click on topics of interest for more information (To return to this figure after clicking use ALT • <-).
SCREENING
ASSESSMENT
RECOMMENDATIONS
REPORTING
MONITOR/EVALUATE
Determine the need and
value of an HLA
Eco-Health Relationship
Browser
Documents potential
health impacts related to
natural resources
Interactive Map
Helps to identify
environmental stressors
and disparities
Case Studies &
Use Cases
Provide examples of
EnviroAtlas applications
Fact Sheets
Contain information on
relevance of each
EnviroAtlas map to
public health and well-
being
Determine who will be
involved, what will be
evaluated, analysis
methods, and a plan
and timeline
Eco-Health Relationship
Browser
Can guide selection of
potential HIA focus areas
Fact Sheets
Highlight the
environmental, social,
and economic importance
of ecosystem services
Case Studies &
Use Cases
Can provide examples of
previous HIA focus areas
Profile existing health
conditions; Evaluation
of impacts and
consideration of sub-
populations
Interactive Map
Ecosystem services
layers can be overlaid
with demographics
Mapping & Analysis
Tools
Overlay local data onto
the online tool or use
drawing/analysis tools
GIS Tools
Download GIS tools to
further assess existing
conditions
Metadata/Data Download
Support detailed
understanding or
additional analyses of
EnviroAtlas metrics/data
Strategies to address
selected health impacts
Eco-Health Relationship
Browser
Highlights the potential
outcomes of different
decision alternatives
Fact Sheets
Contain suggestions on
the application of each
EnviroAtlas map to
public health and well-
being
Case Studies &
Use Cases
Can provide examples of
previous HIA
recommendations
Develop final report;
Communicate findings
Mapping & Analysis
Tools
Maps can be created and
printed directly from
EnviroAtlas
Interactive Map
Decision makers,
communities, and
stakeholders can all
access EnviroAtlas
information online
Track impact of HIA
(process, decisions &
health outcomes)
Figure 4. Recommended EnviroAtlas resources for the HL4 process.
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EnviroAtlas and HIA
Overview of the Interactive Map
The Interactive Map is a primary component of EnviroAtlas. EPA researchers and partners are developing
and incorporating the best available science to map and analyze indicators of ecosystem services. These
research efforts also focus on drivers that may change their production or demand; these include land use
changes, point and non-point source pollution, ecosystem restoration, population growth, and
transportation and energy development potential. Data are provided at various scales, including by 12-
digit hydrologic watershed basin (12-digit HUC) and U.S. Census block group, and at the pixel level from
one-meter to 30-meter resolution. In addition to data on ecosystem services, demographic and other
relevant data are included to help users better understand the context of ecosystem services within
specific populations, environmental conditions, and geographic areas. EnviroAtlas data layers can be
viewed in the Interactive Map viewer, accessed through web services, or downloaded.
Ecosystem Services and Biodiversity data are organized
into seven benefit categories (Figure 5):
•	Clean air
•	Clean and plentiful water
•	Climate stabilization
•	Natural hazard mitigation
•	Recreation, culture, and aesthetics
•	Food, fuel, and materials
•	Biodiversity conservation
In the Interactive Map, data layers are grouped using an
expandable topic menu. Designed to help users discover
data of interest, this menu includes topics such as Land
Cover: Near-Water, Land Cover: Type, Landscape
Pattern, and Near Road Environments (e.g., Figures 6
and 7). Relevant ecosystem services benefit categories
are indicated by colored icons underneath each data
layer name. Some data layers are linked to multiple
benefits and therefore may show icons for multiple
benefit categories.
r
EnviroAtlas Icons
Icons give you information about each data layer.
Associated ecosystem services benefit categories
Clean Air
Q Clean and Plentiful Water
O Climate Stabilization
Natural Hazard Mitigation
Recreation, Culture, and Aesthetics
Food, Fuel, and Materials
Biodiversity Conservation
Spatial extent
O National dataset. Most national data provide wall-to-wall coverage for the
contiguous U.S.
Community dataset High resolution data developed for one of our
EnviroAtlas featured communities.
Data type
© Data summarized by sub-watershed (12 digit HUC)
© Data summarized by Census block group
Non-summarized point, line, or polygon data
Non-summarized gridded data
Figure 5: EnviroAtlas icons indicating benefit categories
and other information for data layers in the Interactive
Map.

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© 3S ft © 6
EnviroAdas Data	(1
Expand ~ Hide Icons ¦
Search All Layers
4 « g • s t « n a
OPercentage of land 8rea in
classified as agriculture
* Q N Percentage of la
fioodplains class
39.40- 100.00
15.47-39.39
2 -15.46
~	Percentage of iand 8rea in estimated fioodplains (T)
classified as forest
4 6	N 12
~	Per centage of iand area in estimated fioodplains Q)
classified es natural
~	Percentage of land 8rea in estimated fioodplains ©
classified as shrubland
+ A 1 • s + « " «
~	Percentage of iand area in estimated fioodplains Q
classified as wetland
* A I • s t * « u
_ Roads Crossing Streams	Q
Q Count ^Density
~	Roads near streams (km/km)	@
4 A I • - ~ * "u
Figure 6. Screen capture of Interactive Map displaying percent of land area within fioodplains that are classified as developed.
EnviroAtlas provides a large suite of very high-resolution maps for 30 U.S. urbanized areas
(''communities"), encompassing more than 1,400 cities and towns. Based on Meter-Scale Urban
Landcover (2010-2016), these maps emphasize potential health issues associated with each benefit
category.
A few examples from approximately 100 community maps are:
•	Proximity to green space (Figure 7) and walking distances to parks
•	Potential of near-road tree cover to buffer air pollution from traffic
•	Capacity of natural vegetation to protect water quality and reduce urban heat-island effect
•	Adverse health events avoided and dollars saved due to air pollutant removal by trees
•	Potential of near-road tree cover and green space to increase shading and mitigate heat along
walkable roads.
EnviroAtlas national data span the contiguous lower 48 states, with a subset of data for Alaska, Hawaii,
Puerto Rico, and the US Virgin Islands. Some examples of fine-scale national datasets include:
•	Downscaled population distribution (dasymetric), which represents the areas where people live
and omits areas such as waterbodies and wetlands.
•	Estimated floodplain data that fills in gaps in the FEMA flood hazard data. Communities in areas
prone to flooding may be at greater risk of exposure to contaminants or other hazards.
8

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•	Potentially restorable wetlands on agricultural land, which are important for providing clean and
plentiful water, along with other important ecosystem services.
•	Facilities that have the potential to release chemical or microbial contaminants into surroundings.
Interactive Map

within 1/4 square
Percent gr
kilometer
¦tfcible'
within 1/4 square
kilometer
| Insufficient Date
Figure 7. Screen capture of Interactive Map displaying Percent Green Space within % square kilometer in Philadelphia, PA.
A full list of map layers can be found in the EnviroAtlas Data Layer Matrix online at:
https://www.epa.gov/enviroatlas/enviroatlas-dvnamic-data-matrix. Current and pending EnviroAtlas
Communities are shown here: https://www.epa.gov/enviroatlas/enviroatlas-communities.
The Interactive Map and associated data layers may aid in HIA by:
•	Identifying issues of concern for inclusion in an assessment
•	Exploring existing or baseline conditions
•	Enabling overlay of demographic, environmental, and built environment data
•	Exploring metadata for information on data analysis and processing methods
The Compare My Area tool in the Interactive Map allows users to compare local demographics,
contamination, and health risks to surrounding county and state, offering powerful contextual information
for HIAs.
More information on accessing and using the Interactive Map can be found at:
https: //www .epa. gov/enviroatl as/how-use -enviroatl as.
9

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Overview of the Eco-Health Relationship Browser
The Eco-Health Relationship Browser is an interactive tool that visually illustrates published linkages
among ecosystems, ecosystem services and more than 35 health outcomes (Figure 8). A growing body of
evidence suggests that ecosystems can provide protection from natural and man-made hazards and
promote healthy behaviors .*5' 7 Most of the summarized studies highlight statistically significant, plausible
associations that account for multiple key factors, rather than cause-effect relationships. The Browser is
updated periodically to reflect the scientific literature.
Ecosystems
Agro-
Ecosystems
Forests
Urban
Ecosvstems
Wetlands
Drylands
Ecosystem Services
Aesthetics &
Engagement
with Nature
Air Quality
Water Quality
Heat Hazard
Mitigation
Recreation &
Physical
Activity
Water Hazard
Mitigation
Health Outcomes
ADHD
Aggression
Anxiety

Arthritis
Asthma
Birth Outcon
les
Broneh
Cane
Cardiova
Diseas
itis
sr
scular
es
Cognitiv
Con
C(
e Function
fusion
)PD
D
epression
diabetes
Fatigue
Gastrointestinal
Illness
Happiness
Healing
Heat Stroke
High Blood
Pressure

Hospital
Admissions
nfl animation
Kidney
Malfunction
L
Me
ongevity
ntal Health
Mig
Misc<
raine
irriage
Mortal
Obesit
PTSE
ty
y
Respiratory
Symptoms
Self Esteen

Social &
Community
Ties
Stress
Thyroid
Dysfunction
Vision
Vulnerable
Populations
Table 1. Eco-Health Relationship Browser component categories as of December 2020.
The Eco-Health Browser may aid in HIA by:
•	Identifying issues of concern for assessment
•	Illustrating the evidence-based connections between health and ecosystem services
•	Highlighting the potential outcomes of different decision alternatives
•	Providing examples of how relationships between ecosystems, ecosystem services, and health
have been previously assessed
More information on the Eco-Health Relationship Browser can be found at:
https://www.epa.gov/enviroatlas/enviroatlas-eco-health-relationship-browser.
: Jackson, L. E.. Daniel, J., McCorkle, B„ Sears, A., & Bush, K. F. (2013). Linking ecosystem services and human
health: the Eco-Health Relationship Browser. International Journal of Public Health, 58(5), 747-755.
https://doi.org/10.10G7/s00038-013-0482-l.
7 Twohig-Bennett, C., Jones, A. (2018). Fhe health benefits of the great outdoors: A systematic review and meta-
analysis of greenspace exposure and health outcomes. Environ Res., 166. 628-637.
https://doi.Org/10.1016/i.envres.2018.06.030.
10

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Urban
Ecosystems
Anxiety
Aggression
Wetlands
Birth
Outcomes
Forests
Cardiovascular
Diseases
Drylands
Cognitive
Function
Vulnerable
Populations
Aesthetics
Confusion
Vision
Engagement
With Nature
COPD
Stress
SocM.&
Com muni;:
Ties
Depression
Respiratory \ self-Esteem
Symptoms /
Fatigue
Happiness
High Blood
Pressure
Obesity
Healing
PTSD
Longevity
Mortality
Ecosystem
Agro-Ecosystems
Drylands
Forests
Urban Ecosystems
Wetlands
Ecosystem Services
Aesthetics & Engagement With Nature
Air Quality
Heat Hazard Mitigation
Recreation & Physical Activity
Water Hazard Mitigation
Water Quality
Health Outcomes
ADHD
Aggression
Anxiety
Arthritis
Asthma
Birth Outcomes
Navigate by either selecting a topic bubble or clicking the
Linkages	X
Aesthetics & Engagement With Nature — ADHD
Several studies suggest that spending time in green settings versus other environments
has a positive effect on children with ADHD. Children were able to function better overall,
direct their attention, and perform concentration tasks more quickly following outdoor
activities in green settings. Living in greener areas may also be associated with lower risk
of ADHD.
Benefits for those with ADHD
[1] Children ages 5-18 with ADHD who played in a green setting experienced a
significantly larger reduction of symptoms after the activity versus those who played
indoors or in a built outdoor environment (Kuo and Faber Taylor 2004; n=452, USA).
Aesthetics & Engagement With Nature ~
Bibliography	Eco-Health Relationship Browser: Public Health Linkages to Ecosystem Services
|| Aesthetics & Engagement With Nature
Aesthetics & Engagement
With Nature
Many people around the world enjoy
recreating, relaxing, and spending time
outdoors Scientific studies show that
exposure to nature is positively
associated with numerous aspects of
both physiological and psychological
health, as well as with good social
relations. Causal mechanisms for some
of these associations have been
demonstrated in the laboratory: faster
recovery from neurological fatigue
appears to be responsible for the
^observed effects that greenness has on
^.concentration and the alleviation
I of ADHD^wftjoms in children
Exposure to natu?&K£enery, even
through a window or a pfitfctQraph.
slows the heart rate and calms a?ti
Humans" innate affinity for nature may
be responsible for observations that
people are preferentially drawn to
vcommunity green space, where they
e more inclined to interact with
neightjors while relaxing or recreating.
These infractions are directly
beneficial b^njcreasing social capital
(Putnam 2Q0Q)>^ich in turn
contributes positivel^o a variety of
hoalth anri u/gll-hoinn
drop-down menu.
Click on the "i" sign to explore evidence for the selected association.
Figure 8. Example screen capture from the Eco-Health Relationship Browser, highlighting key features of the tool.
11

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How EnviroAtlas can support HIA
Many of the decisions that we make, from how we develop the infrastructure in our communities, to the
ways that we manage surrounding land and resources, affect public health through their impacts on the
provision of ecosystem services. Since the 2005 Millennium Ecosystem Assessment (MEA, Figure 3),
local to national governments, non-profit organizations, and those in academia have been striving to
incorporate the benefits of nature and urban green space into policies and decision-making. Numerous
plans, policies, and projects evaluated by HIAs will affect health via their impacts on the provision of
ecosystem services. Accounting for these impacts will result in a more complete picture of potential
health effects. The causal pathway diagram in Figure 9 illustrates how a plan, policy, or project may
affect ecosystem services and health.
Policy/Plan
Immediate
Outcomes
Intermediate
Outcomes
Long-term
Outcomes
/¦ \
Public housing
redevelopment:
improvements in
site infrastructure
landscaping
(including trees)
street
improvements
-> housing
conditions
Related data available ill
EnviroAtlas
Eco-Healtli Relationship
Browser literature
| water quality
¦ ^1 mental health/healing
/cognitive function
Figure 9. Ecosystem services-public health pathway diagram for a hypothetical public housing redevelopment HIA.
A baseline assessment of many of the above indicators is feasible using resources in the EnviroAtlas
Interactive Map at the block-group scale for featured communities. For the example outlined in red above,
current levels of shade can be assessed for census block groups by entering the Interactive Map, selecting
the community of interest, and following this sequence: Land Cover: Type, Percent Tree Cover (Figure
10). Under the Weather and Climate heading, decreases in average ambient daytime and nighttime
temperatures due to tree shade and evapotranspiration are represented by the Average Reduction in
Ambient Temperature layers (Figure 10). Finally, the relationship of neighborhood greenery to extreme
heat and related health outcomes can be explored in the Eco-FIealth Relationship Browser (Figure 11).
12

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EnviroAtlas and HIA
SplprSed Community-
Durham, NC
Engagement with Outdoors
Health and Economic Outcomes
Land Cover: Near-Water
Land Cover: Type
Envir©Atlas Interactive Map


Layers
Q Sr
- 0 C Average reduction in nighttime ambient
temperature (Celsius)
...
^ 1.25 -1.58

^ 1.12-1.24

^ 0.98- 1.11

f>1 0.80 - 0.97

f^1 0.20 - 0.79

P^l No Date for Community

lh.Mnr„Ta Expand ~ Hide Icons ¦
_ Average reduction in ambient temperature (Celsius)
Q Daytime Q Nighttime
* e I • i * * « »
wjujiuy
*» i ••~* y*
~	Percent green space
*	e 1•
~	Percent impervijjifs area [census block group]
•	( # ¦ «
~Peramt impervious area within 1 square kilometer
*!»»*• ' *	
Q Percent tree cover
>ti»f
~ Percent wetlands
• ft >t • * ~ • ' "
~Tree cover per capita (m2/person)
Landscape Pattern
Near-Road Environments
Pollutant Reduction: Air
Pollutant Reduction: Water
Water Supply, Runoff, and Flow
Water Use
Weather and Climate	
I Search All Layers
Q
©
©
Figure 10. Table of Contents and map displaying Percent tree cover and Average reduction in nighttime ambient
temperature for Durham, NC.
Bibliography	Eco-Health Relationship Browser: Public Health Linkages to Ecosystem Services	Heat Hazard Mitigation	v
Heat Hazard Mitigation
The Urban Heat Island (UHI) effect is a
heating phenomenon that occurs in urban
centers and their surrounding suburban
areas. With the UHI effect, metropolitan
areas do not cool down at night due to the
release of heat from dark surfaces that
absorb heat throughout the day. In UHls,
temperatures can be 6 to 8 degrees
higher in urban centers than in nearby
woodlands. This fact is especially
important during heat wave events, where
those who reside in urban areas are often
most effected due to exposure to higher
maximum temperatures and less nighttime
reprieve from heat. In urban systems,
green spaces such as parks, urban forests
and green roofs, can reduce urban
temperatures and mitigate the effects of
heat wave events through
evapotranspiration and shading. The
cooling effects of these green spaces may
be especially important during heat
waves, where temperatures directly
outside the homes in which people are
confined (elderly, infirm) have an effect on
mortality.
Figure 11. Health links to extreme heat as shown in the Eco-Health Relationship Browser, highlighting the Mortality Outcomes
summary.
Urban
Ecosystems
Drylands
Vulnerable
Populations
Heat Hazard
Mitigation
Cognitive
Function
Vision
Respiratory
Symptoms
COPD
Heat Stroke
Kidney
Malfunction
Hospital
Admissions
Linkages
Heat Hazard Mitigation | Mortality
Mortality increases during heat waves, especially among the elderly,
who are particularly vulnerable to heat events. At these times,
greener areas experience lower mortality rates.
Green space, land cover and mortality
[1] Dunng warm months (2000-2011). there were 234.042 deaths in
New York City Those living in greener areas were less likely to die
dunng and immediately after heat waves (OR = 0.96: 95% CI: 0.94.
0.99) in census tracts where grass, shrubs and trees were above the
median value (OR = 0.97: 95% CI: 0.94,1.00). 73% of deaths
occurred in people greater than 65 years of age. Compared with
other warm season days of the study period, deaths were more
common among black people than those of other races and
ethnicities (OR = 1.08: 95% CI: 1.03,1.12), more likely to occur at
MO'tdlity
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How EnviroAtlas can address HIA challenges
In the U.S., HIA is an emerging and growing field. Two reviews evaluating the use of HIA have
identified challenges and areas for improvement/ 9 EnviroAtlas can assist with addressing these
challenges through its resources and tools (Table 2).
IDENTIFIED CHALLENGE
ENVIROATLAS RESOURCES/TOOLS
Establishment of baseline
conditions8
•	Hundreds of data layers based on best available science.
•	Two scales: Watershed (contiguous U.S.) and Census Block Group
(selected communities).
Characterization of impacts8
•	The Eco-Health Relationship Browser provides a broad selection of
recent evidence that highlights statistically significant, plausible
associations between ecosystem services and health outcomes. These
can be used to guide assessment of the direction and magnitude of
potential health impacts from proposed changes to green
infrastructure.
•	The Interactive Map allows for incorporation and visualization of
site-specific HIA data tlirough the option to upload existing local
data.
•	All EnviroAtlas data are free and available through web services and
for download so can be integrated into site-specific HIA analyses via
desktop mapping software or ArcGIS Online.
Broader utilization of existing tools
& resources8
•	Tools and data are publicly available for use online and as
downloadable files.
•	Specialized software and/or applications are not necessary to use
EnviroAtlas.
•	Links to other available resources and tools are provided.
Data gaps & access8'9
•	Contains hundreds of data layers based on best available science.
•	User has ability to incorporate/upload additional data.
•	National and community scale data are available.
Incorporating equity & the
inclusion of vulnerable populations9
•	EnviroAtlas provides data on demographics and built spaces that can
be overlaid with the data on ecosystem sendees and biodiversity to
understand the distribution of ecosystem services and benefits
relative to community needs.
•	The Interactive Map allows for spatial exploration and visualization
of data.
•	User has ability to incorporate/upload additional data.
•	Tools and data are publicly available and downloadable.
Table 2. Identified HIA Challenges addressed by EnviroAtlas tools and resources.
8	Rhodus, J., Fulk. F., Autrey, B., O'Shea, S., Roth, A. 2013. A review of health impact assessments in the U.S.:
Current state-of-science, best practices, and areas for improvement. U.S. EPA: Cincinnati, OH. EPA/600/R-13/354.
9	Bourcier, E., Charbonneau. D„ Cahill. C., & Dannenberg, A. 2014. Do health impact assessments make a
difference? A national evaluation of HIAs in the United States. Seattle: Center for Community Health and
Evaluation.
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More Information about EnviroAtlas Resources & Tools
Integrated Mapping and Analysis Tools
A variety of tools are available within the Interactive Map to assist users in exploring and evaluating
EnviroAtlas data. These include:
•	Compare My Area: Generate a report for census tracts or watersheds to compare environmental
indicators and relevant demographic information to the surrounding county and state. These
reports are interactive and shareable and include numerous air toxics of concern. An example
report for a census tract in Durham, NC, can be found here:
https: //enviroatlas. epa. gov/enviroatlas/interactivemap/widgets/CompareMvArea/T ractReport .htm
l?tract=3 7063002200.
•	Select Tool: Select and highlight multiple block groups, watersheds, or other geographic areas
and export the accompanying data for other applications (Figure 12).
To use this tool, add data layers of interest to the Active Layer
List. Check the box for one or more layers before selecting an
area. If a layer is grayed-out, zoom in until the layer text is black,
indicating the data can be selected.
Clear
Layer
|n/| Percentage of households below the qu...
Figure 12. Using the Select Tool to select data summarized at the block group level.
•	Watershed Navigation: Click on any location in the conterminous US to identify its watershed
(Hydrologic Unit Code [HUC]), and upstream or downstream watersheds, including headwaters.
•	Change Analysis Tool (ECAT): Users can select a climate variable (maximum temperature,
minimum temperature, potential evapotranspiration, or precipitation) and compare it between two
time periods. Watch a demonstration of ECAT:
https://www.voutube.com/watch?v=oiFtoLlNoSM&feature=voutu.be.
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•	Raindrop Tool: Generates a raindrop flow path (linear feature) from a chosen location and
returns the distance to the nearest water feature as depicted in the National Hydrography Dataset
Plus V2 (NHDPlus V2). This tool does not account for buildings or engineered stormwater
infrastructure. Turning on the National Hydrography Dataset (NHD) flowlines found in
Hydrologic Boundaries adds landscape context to these paths.
•	Elevation Data: Find the elevation at a selected point on the map or generate an elevation profile
based on a user-drawn line.
Mapping Tools: Standard Geographic Information System (GIS) tools include Draw and
Measure, Add Shape file, and Print. These tools help to integrate user data and analyses with
EnviroAtlas data layers.
Watch demonstrations to learn how to use EnviroAtlas tools:
httDs:ffepa:maps.arc2is.com/ar)t)s/MavJournal/index.html?avDid=c9016dba6b304eec974c 1 dd461 le9775.
Mapping and Analysis Tools may assist with HIA by enabling users to:
•	Create and export images and graphics to aid in communicating findings
•	Explore and interact with available data
•	Upload or web-serve user developed and local data for further exploration and analysis
More infonnation on Mapping and Analysis Tools in EnviroAtlas can be found at:
https://enviroatlas.epa.gov/enviroatlas/InteractiveMapEntrance/InteractiveMap/AboutEnviroAtlas.pdf.
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Data Layer Fact Sheets
Each data layer in EnviroAtlas has an accompanying fact
sheet (Figure 13). These fact sheets include:
•	Why the information/topic is important
•	How the data were developed
•	Limitations of the data
•	How the information/topic could be used for
assessment
The fact sheet content is linked to the EnviroAtlas glossary as
well as to the technical documentation for the data layer's
creation (metadata).
The Fact Sheets may aid in HIA by:
•	Providing brief methodology for the data layer
•	Highlighting the environmental, social, and economic
importance of the relevant ecosystem services
•	Offering examples of how data layers may be used
and incorporated into overlays and other analyses
More information on the Fact Sheets can be found at:
https://www.epa.gov/enviroatlas/enviroatlas-fact-sheets.
^ EnviroAtlas
Estimated Walking Distance to a Park Entrance
Hire EnviroAtlas community map estimates Che total
Why is proximity to parks important?
Parks increase ihc liv ability of urban areas and oilen
lams, from large forested porks to recrealMmt fields.
People ollcn recreate m psdi. which provide oppmftmrhei
la socialize wtth other*, participate in physical activity, ami
engage with nature In urban areas, parks provide much-
People prefer to spend !r
health by increasing physical tilncvi- reducing
benefits. People who frequent porks and other gi
close to then homes con have increased social tu
are more likely to participate in neighborly actrvil
to parkland niifam waikiut distance of a child':
been shown to reduce the risk of obesity
e this information?
in be used to sdedify neishbcrtocds Lha! have ready access
i arai tbey The sarnnuno by cctblb block iroup can be used
layers wuhin EnvnoAdai. these maps ,
Figure 13. Example fact sheet for a community map.
30
Metadata and Data Download
EnviroAtlas metadata describe the analytical processes involved in creating each map layer. Metadata and
• • •
data are accessed by clicking the ellipse next to the layer in the active layer list, then selecting
"Metadata" (Figure 14). This action leads to a summary metadata page with a link at the bottom to the
complete metadata, including a description of the layer and the process steps used to create it. All
Interactive Map data are available for download in geodatabase format from the EnviroAtlas website:
https://www.epa.gov/enviroatlas/forms/enviroatlas-data-download.
which also provides metadata links. The EnviroAtlas Dynamic Data
Matrix is another useful way to search for data layers and access fact
sheets and metadata; it is accessible at:
https://www.epa.gov/enviroatlas/enviroatlas-dvnaniic-data-matrix.
The Metadata and data may aid in HIA by:
•	Providing detailed methodology of data layer creation
•	Supplying a framework for modified or additional analyses
•	Describing data sources
•	Allowing HIA practitioners to conduct their own analyses
using EnviroAtlas data.
EnviroAtlas data and metadata are also available from the EPA
Environmental Dataset Gateway at:
https ://edg .epa.gov/metadata/catalog/main/home .page.
Layer List
x
| Layers
C Percent of 'esuiental popUa-jo- t - -n ¦ -L"*J
views of trees
^ 1.80-99.43
^ 0.61-1.79
^ 0.21 -0.60
[fa 0.01 - 0.20
1*^ 0.00
[^1 Block Group Beyond
[^ No People living in B
Transparency
Draw Layer On Tap
Change Appearance
Remove Layer
Map Description
1 Data Fact She«t
'' Access Web So-vice

1 Metadata
Open Attribute Table


Figure 14. Accessing metadata for each
dataset from within the Interactive Map.
17

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government, environmental
and public health professionals.
researchers, educators, non-
governmental organizations,
and anyone else with an
interest in ecosystem services
and their role in sustainable
EnviroAtlas is designed for
staff from all levels of
Case Studies and Use
Cases
Figure 15. Excerpt from Story Map examining near-road environments in communities.
and healthy communities.
Users can visually interpret ecosystem sendees in the context of the population to evaluate where they
may most usefully be conserved and enhanced (Figure 15). Access the Figure 15 Use Case at:
https://epa.maps.arcgis.com/apps/MapSeries/index.html?appid=771581d9b2bf481c9bft)6cl9d599f812.
EnviroAtlas provides a screening mechanism for assessing the implications of future planning and policy
decisions, and provides information to consider the importance, capacity, resilience, and fragility of
natural systems.
EnviroAtlas data and tools have been incorporated into a number of programs and projects:
•	Tree Planting: As a part of the project Trees Across Durham. EnviroAtlas community data for
Durham, NC, were used to aid in prioritizing planting locations that maximize the trees"
environmental, social, and economic benefits.
•	Conservation of Natural Lands: The Southeast Atlantic Landscape Conservation Cooperative
has used the EnviroAtlas watershed-scale data layers to help develop a stakeholder-driven
conservation blueprint for the region.
•	Community Education: Several fine-scale EnviroAtlas community maps are included as a part
of the Durham Neighborhood Compass. This website was developed to aid community members
in identifying where their public service efforts may have the greatest impact.
•	Classroom Lesson Plans: A teaching case study uses EnviroAtlas tools and maps to challenge
students to support and defend their opinions on the proposed placement of a greenway trail to
benefit diverse community members.
Case Studies and Use Cases may aid in HIA by:
•	Flighlighting the potential outcomes of different decision alternatives
•	Providing examples of the types of decisions and projects that have integrated ecosystems,
ecosystem services, and health
•	Offering examples of communication and documentation tools and mechanisms
More about EnviroAtlas Case Studies and Use Cases can be found at:
https://www.epa.gov/enviroatlas/enviroatlas-use-cases.
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Downloadable GIS Tools
EnviroAtlas includes information on the geospatial tools that helped with calculating some of the data
layers that are available in the Interactive Map. Access to these downloadable geospatial tools and scripts
is provided on the EnviroAtlas website. They can be used to conduct analyses at different spatial scales or
using local data. Please note: these tools may require certain versions of commercial GIS software. The
downloadable tools are shown in Table 3.
ENVIROATLAS TOOL
HIA APPLICATION
Dasymetric Toolbox:
Dasvmetric mapping is a geospatial technique that uses additional
information to more accurately distribute data that has been assigned
to specific boundaries. For example: census block groups often
encompass uninhabitable areas, such as open water or protected natural
space, and fine-scaled landcover data can be incorporated to constmct
a more realistic model of population distribution. EnviroAtlas
researchers use dasymetric mapping to calculate the distribution of:
•	ecosystem services
•	walking distances
•	viewsheds
•	resource use
•	exposure potential
H1A practitioners may find the
dasymetric mapping tool useful to
improve accuracy in the estimation of
affected populations of place-based
programs, plans, projects, or policies.
For example, an HIA of a park
redevelopment plan could use
dasymetric mapping to more accurately
calculate the percentage of people
within 0.5 mile of the park entrances.
Analytical Tools Interface for Landscape Assessments (ATtlLA):
Calculates many commonly used landscape metrics including:
•	landscape characteristics (i.e. number and size of forest patches)
•	riparian characteristics (i.e. percent cropland within 30 m of
streams)
•	human stressors (i.e. population changes)
•	physical characteristics (i.e. elevation and slope)
It accepts data from a broad range of sources and is equally suitable
across all landscapes, from deserts to rain forests to urban areas.
HIA practitioners can use this tool to
understand the proximity and density
of specific land characteristics such as:
•	percentage of forest within {n}
map units of a sample point
•	percentage of cropland within {n}
map units of a sample point
•	road density
Automated Geospatial Watershed Assessment (AGWA):
Helps identify and prioritize potential problem areas at the watershed
and subwatershed levels. AGWA can be used in many situations,
including:
•	pre- and post-fire assessments
•	implementation of stream buffer zones
•	installation of retention and detention structures
•	land management evaluation
•	landscape assessments at a watershed- or basin-scale
HIA practitioners may find this tool
useful in large-scale land-use change
assessments at the watershed and sub-
watershed level.
Ecosystem Rarity Toolbox:
Allows users to calculate four measures of ecosystem rarity, a measure
based on an ecosystem's rare or unique species, for their specific
geographies of interest:
•	Ecosystem Relative Rarity (U.S. EPA Preferred)
•	Ecofonn Relative Rarity
•	Macrogroup Relative Rarity
•	Macroform Relative Rarity
This tool could be used to assess
ecosystem impacts of large-scale
projects.
Table 3. Downloadable GIS tools descriptions and potential uses in HL4.
More information on EnviroAtlas GIS and Analysis Tools can be found at:
https://www.epa.gov/enviroatlas/geospatial-toolboxes
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Additional Resources
•	Health Impact Project - A collaboration of the Robert Wood Johnson Foundation and The Pew
Charitable Trusts focused on promoting the use of MIA by policymakers across the nation. Hie
Project offers resources on conducting HIA and funding opportunities, and tracks HIAs from
across the nation. The Health Impact Project maintains the Cross-Sector Toolkit, which is an
interactive webtool useful for exploring recent and historic HIAs from around the United States.
•	Human Impact Partners (HIP) - A not-for-profit organization focused on improving health and
health equality through the incorporation of health-based analyses in decision-making. A number
of case stories and completed HIA projects and guides on completing HIAs are detailed on their
website.
•	Minimum Elements and Practice Standards for Health Impact Assessment - A product of the
North American HIA Practice Standards Working Group, this document details the elements
necessary for a HIA and how best to conduct an assessment.
•	Centers for Disease Control and Prevention: Designing and Building Healthy Places - HIA
is a key focus area for healthy community design topics. This site provides resources for
completing HIA and provides "Stories from the Field"': https://www.cdc.gov/healthyplaces/.
•	Society of Practitioners of Health Impact Assessment (SOPHIA) - Tins association of
individuals and organizations supports the community of researchers and practitioners that
perform HIAs. The organization facilitates networking of practitioners, highlights existing and
ongoing HIA work in newsletters and other published materials, and disseminates HIA research.
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The following tools arid models may also be used to understand and assess environmental conditions^
environmental exposures, and their potential impacts.
TOOL/MODEL
DESCRIPTION
SOURCE
AirData
Provides access to the EPA's Air Quality System (AQS)
Data Mart which is updated each week night with air
quality data collected at outdoor monitors across the U.S.
One can get criteria pollutant and air quality index (AQI)
data in multiple forms, including reports, graphs, maps,
and other visualization forms.
Environmental Protection Agency;
https://www. epa. gov/outdoor-air-
qualitv-data
Benefit Mapping
and Analysis
Program (BenMAP)
A GIS-based computer program used to estimate the
health impacts and associated economic value
experienced with changes in air quality.
Environmental Protection Agency;
https ://www. epa. gov/benmap
Co-Benefits Risk
Assessment
(COBRA) Health
Impacts Screening
and Mapping Tool
A free tool that estimates the health and economic
benefits of air quality policies; Allows users to estimate
and map the air quality, human health, and related
economic benefits (excluding energy cost savings) of
clean energy policies or programs; and approximate the
outcomes of clean energy policies that change emissions
of particulate matter (PM2.5), sulfur dioxide ( S02 ).
nitrogen oxides (NOX), ammonia (NH3), and volatile
organic compounds (VOCs) at the county, state,
Regional, or national level.
Environmental Protection Agency;
https ://www. epa. gov/ statelocalenerg
v/co-benefits-risk-assessment-cobra-
health-impacts-screening-and-
mapping-tool
Comparative
Quantification of
Health Risks
Quantifies risk factor exposure and effects for 26 major
health risks and identifies population exposure
distributions, evidence for causality, and estimates of
disease-specific hazards associated with each level of
exposure.
World Health Organization;
https://www.who. int/healthinfo/globa
1 burden disease/cra/en/
EJSCREEN
A web-based application that provides a means for
combining demographic and environmental indicators in
order to assess potential environmental injustices. Users
can also access pre-derived EJ indices that combine these
data. Socioeconomic status and minority population are
combined with other indicators in the EJ indices. Other
community and environmental data can also be added to
the mapping tool.
Environmental Protection Agency ;
https ://www. epa. gov/ei screen
MyEnviron ment
Integrates data from EPA and other sources, including
air, water, energy, and health data, to provide a quick
picture of local environmental conditions.
Environmental Protection Agency;
https ://www3. epa. gov/mvem/envmap
/find.html
ParkScore
Provides measures of how well the 40 largest U.S. cities
meet their need for parks. Using advanced GIS,
ParkScore identifies neighborhoods and demographics
that are underserved by parks, and the number of people
able to reach a park within a ten-minute walk. It also
provides in-depth data to guide local park improvement
efforts.
Trust for Public Land
Table 4. Additional tools and models useful to the practice ofHM (adapted from Rhodus et al. 2013s).
21

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