Pathways

These pathways pages summarize research on common pathways through which policies and projects may affect human health, for example air pollution, education, nutrition and physical activity.  HIAs need to consider two sets of linkages for each relevant pathway: first, how the proposed policy or project affects upstream determinants of health and second, how changes in these determinants affect health outcomes.

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  • Air pollution is not just a problem affecting the outside environment.  Levels of air pollutants in homes, indoor workplaces, and schools may exceed levels found outdoors and people spend approximately 90% of their time in these environments. The sources and causes of indoor air pollution are varied and may include: sub-standard housing that may increase exposure to mold, allergens and... read more
  • Air pollutants such as carbon monoxide, ozone, particulate matter, and sulfur dioxide contribute greatly to poor air quality and have been found to cause significant health impacts, including lung cancer, cardiovascular disease, asthma and other respiratory problems linked to poor quality of life and premature mortality. Unsurprisingly, air pollution and its attendant health risks are not evenly... read more
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  • As with individuals, research shows that low income communities and populations also have higher rates of morbidity and mortality.  However, unlike individuals, absolute levels of income may not be the primary factor associated with the health and wellness of residents; in fact some findings indicate that income inequality within communities may have a more significant association with... read more
  • The nature and size of socioeconomic inequities makes them one of the most significant factors contributing to health disparities.  It has been well documented that members from low income environments tend to suffer from higher rates of morbidity and mortality than those from higher income environments.  Interestingly enough, the same association between socioeconomic position and... read more
  • Education has been shown to be associated with decreased risk of all-cause and coronary artery disease mortality (Hardarson and Gardarsdottir, 2001), and improved physical functioning and self-rated health (Ross and Mirowsky, 1999). Part of this effect is due on the profound effect of education on personal income. Each additional year of educational attainment is associated with an increase in... read more
  • The Institute of Medicine notes that progress in addressing several key health concerns is inhibited due to poor access to health care. The primary barrier to lack of access to health care is cost and/or lack of insurance. Patient access to high-quality primary care makes certain that critical health needs are met in a timely manner and preventative procedures are rendered including annual... read more
  • Though often overlooked as an important determinant of health, housing quality has important impacts on health of adults and children alike.  Housing quality has been shown to be associated with a wide range of health effects.  These include:Infectious disease:  Poor housing quality may include a contaminated water supply, poor waste disposal, and insect and rodent infestation, all... read more
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  • Transportation and land use are intricately related.  Land use typically refers to the relative proximity of different land uses, typically recreational, commercial and residential, within a specified area.  The patterns of placement can affect a person’s proximity to destinations for recreational activity and travel patterns to commercial and employment centers, which affect... read more
  • An emerging body of research is demonstrating the many ways that our mental health is affected by our physical and social environments, including noise levels, time spent commuting by automobile, opportunities for social interaction, civil engagement and recreation, and the extent of greenspace where we live, work and go to school.  The Centers for Disease Control has more information on... read more
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  • Policies that affect noise levels ultimately influence noise pollution. A major source of urban noise is attributed to mass transit as well as other transportation modes. Noise from motor vehicles includes engine acceleration, tire/road contract, horns, and alarms. Therefore, strategies to decrease noise are being considered to improve the quality of life among urban dwellers.The associated... read more
  • Diet, or what one consumes, affects health through a variety of biochemical processes that occur in the body once a food item is consumed. Since diet is in fact a multi-component mixture of a variety of nutrients that interact with each other, the pathways to health are complicated. Nonetheless, numerous studies have shown a strong association between dietary consumption patterns and health... read more
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  • There has been a good deal of attention given to the importance of physical activity in achieving good health in the media. This is largely due to the recent rise in overweight and obesity in population and the vast body of evidence on the benefits of physical activity in weight management and other health effects. Physical activity confers numerous benefits to health through a number of... read more
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  • Social capital, representing the level of social connectedness in a community, has been consistently shown to be associated with improved mental and physical health.  It has been shown to deter unhealthy activities such as crime, drug use, and alcoholism.  While the pathways through which social capital affects health are not fully understood, providing social support, encouraging... read more
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  • The predominant mode of travel in the US is the automobile. Injuries and fatalities from automobile accidents is a major cause for concern in the U.S. Traffic safety measures seek to decrease the risk of death and injury by improving vehicle and road safety.  Automobile travel is by nearly every measure far riskier than either bus or train transit.  Increased use of public transit has... read more
  • The availability of clean water is vital for drinking, recreation and our food supply.  Clean water has important economic benefits. The availability of clean water has improved the health and economic productivity of Americans and is a currently a major focus of economic development efforts internationally.