Health Impact Assessments

Health Impact Assessment (HIA) is a tool that uses a flexible, data-driven approach to identify the potential health consequences of new policies, programs, or decisions. Information gathered through research and stakeholder engagement help create practical strategies to enhance health benefits while minimizing adverse effects of a decision.

The Center for Health Equity is building our capacity to work alongside community and other stakeholders to conduct HIAs. 

For more information on Health Impact Assessments and their potential use in Louisville, contact us at 502-574-6616.


New! Released February 2, 2022 

Health Impact Assessment (HIA) to review impacts of potential changes to Kentucky's Affordable Housing Tax Credit

The Health Impact Assessment of Kentucky's Affordable Housing Tax Credit reviews HB 86, a proposed policy intended to increase the number of affordable housing units available to individuals at up to 60% of the area median income (AMI). With a current shortfall of 75,000 units for low-income families seeking housing, the estimated 6,560 additional units from the $12.5 million in tax credits allocated each year for five years ($62.5 million) could make a considerable impact.

Quality affordable housing creates a range of health impacts. Affordable housing expands family budgets to afford more nutritious food, medical care, and utilities leading to better heart health and reductions in chronic disease. It can help families move from unhealthy environments with mold and lead paint to one that is clean and free of contaminants. Clean, safe, stable housing alleviates depression and anxiety, and can also create stability for a person in recovery with substance use disorder (SUD). Ultimately, affordable housing can strengthen the development of a neighborhood, adding jobs during construction, increasing spending in nearby businesses, and building the local economy.


►Download the full report


Update: What's New with the Health Impact Assessment (HIA) to review impacts of potential changes to Kentucky’s Child Care Assistance Program (CCAP)?

In 2021 the Center for Health Equity released a Health Impact Assessment (HIA) for Kentucky’s Child Care Assistance Program (CCAP) that assessed the health outcomes of CCAP funding related to early childhood education (ECE) and employment benefits for both caregivers and parents. Increasing access to all forms of ECE programs through CCAP impacts health by providing educational and developmental enrichment for children, increasing the ability for parents to seek new employment and educational opportunities, and supporting a child care workforce that has been has been increasingly experiencing a shortage due to poor job quality. While the recommendation of increasing CCAP eligibility from 160% to 200% of the federal poverty level (FPL) was enacted in the 2021 legislative session with limited funds from the American Rescue Plan Act, this expansion did not cover public pre-kindergarten programs. This brief update to our original CCAP HIA discusses the health impacts of creating consistent eligibility among all early childhood education programs as proposed by House Bill 120 in the 2022 legislative session.


►Download the one pager


Health Impact Assessment (HIA) to review impacts of potential changes to Kentucky’s Child Care Assistance Program (CCAP)

Early childhood education and care (ECEC) serves as a foundation to the wellbeing of children and families across Kentucky. From children’s earliest years, the education and support they receive during critical windows of development influence lifetime health outcomes. ECEC affects cognitive development, emotional and behavioral health, impulse control, and the skill of working with others. The child care industry is critical not only for children, but also for the parents and providers who benefit from employment-related health outcomes. Parents who can access child care can work to support the nutritional, housing, and health needs of their families. In turn, child care providers can support themselves and their own families with the same needs. 

Legislation to expand support for Kentucky’s Child Care Assistance Program (CCAP) is proposed for Kentucky’s 2021 legislative session.  HB 106 would raise eligibility for CCAP and public preschool from 160% to 200% of the federal poverty level (FPL). It would also require that the cabinet not implement an individual or a family co-payment requirement as a condition for an individual or a family to participate in the Child Care Assistance Program. The Health Impact Assessment of Kentucky’s Child Care Assistance Program informs this policy, drawing connections to health outcomes associated with investments in early childhood education and care.  

►Download the full report


Health Impact Assessment of Expungement Policy in Kentucky

Basic foundations to health such as employment, housing, and access to food, can be blocked by a minor record acquired decades prior for an acquitted or dismissed case. Poverty, homelessness or insecure housing resulting from unemployment can exacerbate chronic disease, increase risk for mental health concerns, and create barriers to recovery from substance use disorders. Expunged records help people move from economic instability and the associated poor health outcomes to economic independence, providing for themselves and their families while helping to build the local economy.

Though thousands of Kentuckians are eligible for expungement, barriers remain including costs, access to legal assistance, and knowledge of how to navigate the system. The Louisville Metro Department of Public Health and Wellness employed a Health Impact Assessment to review the influence that changes to KRS Chapter 431, Kentucky’s existing expungement policy, would have on health. Utilizing a cross-section of stakeholders to help inform the process, the assessment led to the development of recommendations designed to improve the health outcomes of Kentuckians with expungable records.

►Download the full report

►Download a one-page summary


Pregnant Workers Health Impact Assessment

The Kentucky Pregnant Workers Rights’ Act (KYPWRA) (SB18) works to clarify that Kentucky law protects women who need reasonable accommodations in the workplace due to their pregnancy. SB18 ensures all pregnant workers have equal access to safe and healthy working conditions. The Pregnant Workers Health Impact Assessment works to inform decision making around the policy as a measure to improve the health outcomes of Kentucky’s pregnant workers and their developing babies.

​►Download the full report

Download a one-page summary



Parental Incarceration, Children’s Health, and an Opportunity to Shift the Future

Can Family Responsibility Statements Improve Children’s Health in Metro Louisville?: A Health Impact Assessment  

In 2018, the Special Project Coalition, in partnership with the Center for Health Equity, released an HIA assessing the health impact of incarceration on children. Additionally, the assessment looks at the impact of utilizing a Family Responsibility Statement within the court system. 

Download the full report

Download the report highlights




Repealing the Louisville Metro Abandoned Urban Property Tax

The Abandoned Urban Property Tax (AUP) was established in July 1990 as a property tax at three times the normal rate to be levied against abandoned properties in the Urban Services District of Louisville, KY. Similar taxes, colloquially called blight taxes, have also been enacted in various states and localities. In November 2017, the Vacant & Public Property Administration requested a Health Impact Assessment be conducted by the Center for Health Equity within Louisville Metro Department of Public Health and Wellness on the decision to repeal the AUP.



Reducing Homicide using Drone Technology

Louisville Metro Government (LMG) has employed a range of initiatives to address the rising homicide rate, including the development of the Office for Safe and Healthy Neighborhoods in 2013 and directed funding to the Louisville Metro Police Department (LMPD) initiatives specific to reducing homicide and gun violence. Most recently, LMG focused on homicide in their 2017 proposal to the Bloomberg Philanthropies’ 2018 Mayor’s Challenge which is designed to fund “bold inventive ideas that confront cities toughest problems”. LMG proposed video-equipped unmanned aerial vehicles, or drones, to complement existing LMPD gunshot detection technology. In doing so, LMG posited the drones would ultimately improve the health and safety in the most impacted neighborhoods, particularly through reducing homicide and decreasing gun violence. In March 2018, Office of Civic Innovation and Technology, the lead LMG agency for the proposal, and the Real Time Crime Data Center approached the Department of Public Health and Wellness’ Center for Health Equity to conduct a Health Impact Assessment on the proposed project.



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