I 
109TH CONGRESS 
2D SESSION 
H. R. 5088 
To require Federal agencies to support health impact assessments and take 
other actions to improve health and the environmental quality of commu-
nities, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
APRIL 4, 2006 
Ms. SOLIS introduced the following bill; which was referred to the Committee 
on Energy and Commerce 
A BILL 
To require Federal agencies to support health impact assess-
ments and take other actions to improve health and 
the environmental quality of communities, and for other 
purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Healthy Places Act 
of 2006’’. 
SEC. 2. DEFINITIONS. 
In this Act: 
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(1) ADMINISTRATOR.—The term ‘‘Adminis-
trator’’ means the Administrator of the Environ-
mental Protection Agency. 
(2) BUILT
ENVIRONMENT.—The term ‘‘built 
environment’’ means an environment consisting of 
all buildings, spaces, and products that are created 
or modified by people, including— 
(A) homes, schools, workplaces, parks and 
recreation areas, greenways, business areas, 
and transportation systems; 
(B) electric transmission lines; 
(C) waste disposal sites; and 
(D) land-use planning and policies that im-
pact urban, rural, and suburban communities. 
(3) DIRECTOR.—The term ‘‘Director’’ means 
the Director of the Centers for Disease Control and 
Prevention. 
(4) ENVIRONMENTAL HEALTH.—The term ‘‘en-
vironmental health’’ means the health and well-being 
of a population as affected by— 
(A) the direct pathological effects of chemi-
cals, radiation, and some biological agents; and 
(B) the effects (often indirect) of the broad 
physical, psychological, social, and aesthetic en-
vironment. 
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(5) HEALTH IMPACT ASSESSMENT.—The term 
‘‘health impact assessment’’ means any combination 
of procedures, methods, tools, and means used under 
section 4 to analyze the actual or potential effects of 
a policy, program, or project on the health of a pop-
ulation (including the distribution of those effects 
within the population). 
(6) SECRETARY.—The term ‘‘Secretary’’ means 
the Secretary of Health and Human Services. 
SEC. 3. INTERAGENCY WORKING GROUP ON ENVIRON-
MENTAL HEALTH. 
(a) DEFINITIONS.—In this section: 
(1) INSTITUTE.—The term ‘‘Institute’’ means 
the Institute of Medicine of the National Academies 
of Science. 
(2) IWG.—The term ‘‘IWG’’ means the inter-
agency working group established under subsection 
(b). 
(b) ESTABLISHMENT.—The Secretary, in coordina-
tion with the Administrator, shall establish an interagency 
working group to discuss environmental health concerns, 
particularly concerns disproportionately affecting dis-
advantaged populations. 
(c) MEMBERSHIP.—The IWG shall be composed of 
a representative from each Federal agency (as appointed 
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by the head of the agency) that has jurisdiction over, or 
is affected by, environmental policies and projects, includ-
ing— 
(1) the Council on Environmental Quality; 
(2) the Department of Agriculture; 
(3) the Department of Commerce; 
(4) the Department of Defense; 
(5) the Department of Education; 
(6) the Department of Energy; 
(7) the Department of Health and Human 
Services; 
(8) the Department of Housing and Urban De-
velopment; 
(9) the Department of the Interior; 
(10) the Department of Justice; 
(11) the Department of Labor; 
(12) the Department of State; 
(13) the Department of Transportation; 
(14) the Environmental Protection Agency; and 
(15) such other Federal agencies as the Admin-
istrator and the Secretary jointly determine to be 
appropriate. 
(d) DUTIES.—The IWG shall— 
(1) facilitate communication and partnership on 
environmental health-related projects and policies— 
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(A) to generate a better understanding of 
the interactions between policy areas; and 
(B) to raise awareness of the relevance of 
health across policy areas to ensure that the po-
tential positive and negative health con-
sequences of decisions are not overlooked; 
(2) serve as a centralized mechanism to coordi-
nate a national effort— 
(A) to discuss and evaluate evidence and 
knowledge on the relationship between the gen-
eral environment and the health of the popu-
lation of the United States; 
(B) to determine the range of effective, 
feasible, and comprehensive actions to improve 
environmental health; and 
(C) to examine and better address the in-
fluence of social and environmental deter-
minants of health; 
(3) survey Federal agencies to determine which 
policies are effective in encouraging, and how best to 
facilitate outreach without duplicating, efforts relat-
ing to environmental health promotion; 
(4) establish specific goals within and across 
Federal agencies for environmental health pro-
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motion, including determinations of accountability 
for reaching those goals; 
(5) develop a strategy for allocating responsibil-
ities and ensuring participation in environmental 
health promotions, particularly in the case of com-
peting agency priorities; 
(6) coordinate plans to communicate research 
results relating to environmental health to enable re-
porting and outreach activities to produce more use-
ful and timely information; 
(7) establish an interdisciplinary committee to 
continue research efforts to further understand the 
relationship between the built environment and 
health factors (including air quality, physical activity 
levels, housing quality, access to primary health care 
practitioners and health care facilities, injury risk, 
and availability of nutritional, fresh food) that co-
ordinates the expertise of the public health, urban 
planning, and transportation communities; 
(8) develop an appropriate research agenda for 
Federal agencies— 
(A) to support— 
(i) longitudinal studies; 
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(ii) rapid-response capability to evalu-
ate natural conditions and occurrences; 
and 
(iii) extensions of national databases; 
and 
(B) to review evaluation and economic data 
relating to the impact of Federal interventions 
on the prevention of environmental health con-
cerns; 
(9) initiate environmental health impact dem-
onstration projects to develop integrated place-based 
models for addressing community quality-of-life 
issues; 
(10) provide a description of evidence-based 
best practices, model programs, effective guidelines, 
and other strategies for promoting environmental 
health; 
(11) make recommendations to improve Federal 
efforts relating to environmental health promotion 
and to ensure Federal efforts are consistent with 
available standards and evidence and other programs 
in existence as of the date of enactment of this Act; 
(12) monitor Federal progress in meeting spe-
cific environmental health promotion goals; 
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(13) assist in ensuring, to the maximum extent 
practicable, integration of the impact of environ-
mental policies, programs, and activities on the 
areas under Federal jurisdiction; 
(14) assist in the implementation of the rec-
ommendations from the reports of the Institute of 
Medicine entitled ‘‘Does the Built Environment In-
fluence Physical Activity? Examining the Evidence’’ 
and dated January 11, 2005, and ‘‘Rebuilding the 
Unity of Health and the Environment: A New Vision 
of Environmental Health for the 21st Century’’ and 
dated January 22, 2001, including recommendations 
for— 
(A) the expansion of national public health 
and travel surveys to provide more detailed in-
formation about the connection between the 
built environment and health, including expan-
sion of such surveys as— 
(i) the Behavioral Risk Factor Sur-
veillance System, the National Health and 
Nutrition Examination Survey, and the 
National Health Interview Survey con-
ducted by the Centers for Disease Control 
and Prevention; 
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(ii) the American Community survey 
conducted by the Census Bureau; 
(iii) the American Time Use Survey 
conducted by the Bureau of Labor Statis-
tics; 
(iv) the Youth Risk Behavior Survey 
conducted by the Centers for Disease Con-
trol and Prevention; and 
(v) the National Longitudinal Cohort 
Survey of American Children (the National 
Children’s Study) conducted by the Na-
tional Institute of Child Health and 
Human Development; 
(B) collaboration with national initiatives 
to learn from natural experiments such as ob-
servations from changes in the built environ-
ment and the consequent effects on health; 
(C) development of a program of research 
with a defined mission and recommended budg-
et, concentrating on multiyear projects and en-
hanced data collection; 
(D) development of interdisciplinary edu-
cation programs— 
(i) to train professionals in conducting 
recommended research; and 
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(ii) to prepare practitioners with ap-
propriate skills at the intersection of phys-
ical activity, public health, transportation, 
and urban planning; 
(15) not later than 2 years after the date of en-
actment of this Act, submit to Congress a report 
that describes the extent to which recommendations 
from the Institute of Medicine reports described in 
paragraph (14) were executed; and 
(16) assist the Director with the development of 
guidance for the assessment of the potential health 
effects of land use, housing, and transportation pol-
icy and plans. 
(e) MEETINGS.— 
(1) IN GENERAL.—The IWG shall meet at least 
3 times each year. 
(2) ANNUAL
CONFERENCE.—The Secretary, 
acting through the Director and in collaboration 
with the Administrator, shall sponsor an annual con-
ference on environmental health and health dispari-
ties to enhance coordination, build partnerships, and 
share best practices in environmental health data 
collection, analysis, and reporting. 
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(f) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated such sums as are nec-
essary to carry out this section. 
SEC. 4. HEALTH IMPACT ASSESSMENTS. 
(a) DEFINITION OF ELIGIBLE ENTITY.—In this sec-
tion, the term ‘‘eligible entity’’ means any unit of State 
or local government the jurisdiction of which includes indi-
viduals or populations the health of which are or will be 
affected by an activity or a proposed activity. 
(b) 
ESTABLISHMENT.—The 
Secretary, 
acting 
through the Director and in collaboration with the Admin-
istrator, shall— 
(1) establish a program at the National Center 
of Environmental Health at the Centers for Disease 
Control and Prevention focused on advancing the 
field of health impact assessment, including— 
(A) collecting and disseminating best prac-
tices; 
(B) administering capacity building grants, 
in accordance with subsection (d); 
(C) providing technical assistance; 
(D) providing training; 
(E) conducting evaluations; and 
(F) awarding competitive extramural re-
search grants; 
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(2) in accordance with subsection (f), develop 
guidance to conduct health impact assessments; and 
(3) establish a grant program to allow eligible 
entities to conduct health impact assessments. 
(c) GUIDANCE.—The Director, in collaboration with 
the IWG, shall— 
(1) develop guidance for the assessment of the 
potential health effects of land use, housing, and 
transportation policy and plans, including— 
(A) background on international efforts to 
bridge urban planning and public health institu-
tions and disciplines, including a review of 
health impact assessment best practices inter-
nationally; 
(B) evidence-based causal pathways that 
link urban planning, transportation, and hous-
ing policy and objectives to human health objec-
tives; 
(C) data resources and quantitative and 
qualitative forecasting methods to evaluate both 
the status of health determinants and health ef-
fects; and 
(D) best practices for inclusive public in-
volvement in planning decision-making; 
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(2) not later than 1 year after the date of en-
actment of this Act, promulgate the guidance; and 
(3) present the guidance to the public at the 
annual conference described in section 3(e)(2). 
(d) 
GRANT
PROGRAM.—The 
Secretary, 
acting 
through the Director and in collaboration with the Admin-
istrator, shall establish a program under which the Sec-
retary shall provide funding and technical assistance to 
eligible entities to prepare health impact assessments— 
(1) to ensure that appropriate health factors 
are taken into consideration as early as practicable 
during any planning, review, or decision-making 
process; and 
(2) to evaluate the effect on the health of indi-
viduals and populations, and on social and economic 
development, of decisions made outside of the health 
sector that result in modifications of a physical or 
social environment. 
(e) APPLICATIONS.— 
(1) IN GENERAL.—To receive a grant under 
this section, an eligible entity shall submit to the 
Secretary an application in accordance with this sub-
section, in such time, in such manner, and con-
taining such additional information as the Secretary 
may require. 
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(2) INCLUSION.— 
(A) IN GENERAL.—An application under 
this subsection shall include an assessment by 
the eligible entity of the probability that an ap-
plicable activity or proposed activity will have at 
least 1 significant, adverse health effect on an 
individual or population in the jurisdiction of 
the eligible entity, based on the criteria de-
scribed in subparagraph (B). 
(B) CRITERIA.—The criteria referred to in 
subparagraph (A) include, with respect to the 
applicable activity or proposed activity— 
(i) any substantial adverse effect on— 
(I) existing air quality, ground or 
surface water quality or quantity, or 
traffic or noise levels; 
(II) a significant habitat area; 
(III) physical activity; 
(IV) injury; 
(V) mental health; 
(VI) social capital; 
(VII) accessibility; 
(VIII) the character or quality of 
an important historical, archeological, 
architectural, or aesthetic resource 
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(including neighborhood character) of 
the community of the eligible entity; 
or 
(IX) any other natural resource; 
(ii) any increase in— 
(I) solid waste production; or 
(II) problems relating to erosion, 
flooding, leaching, or drainage; 
(iii) any requirement that a large 
quantity of vegetation or fauna be removed 
or destroyed; 
(iv) any conflict with the plans or 
goals of the community of the eligible enti-
ty; 
(v) any major change in the quantity 
or type of energy used by the community 
of the eligible entity; 
(vi) any hazard presented to human 
health; 
(vii) any substantial change in the 
use, or intensity of use, of land in the ju-
risdiction of the eligible entity, including 
agricultural, open space, and recreational 
uses; 
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(viii) the probability that the activity 
or proposed activity will result in an in-
crease in tourism in the jurisdiction of the 
eligible entity; 
(ix) any substantial, adverse aggre-
gate impact on environmental health re-
sulting from— 
(I) changes caused by the activity 
or proposed activity to 2 or more ele-
ments of the environment; or 
(II) 2 or more related actions 
carried out under the activity or pro-
posed activity; and 
(x) any other significant change of 
concern, as determined by the eligible enti-
ty. 
(C) FACTORS
FOR
CONSIDERATION.—In 
making an assessment under subparagraph (A), 
an eligible entity may take into consideration 
any reasonable, direct, indirect, or cumulative 
effect relating to the applicable activity or pro-
posed activity, including the effect of any action 
that is— 
(i) included in the long-range plan re-
lating to the activity or proposed activity; 
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(ii) likely to be carried out in coordi-
nation with the activity or proposed activ-
ity; 
(iii) dependent on the occurrence of 
the activity or proposed activity; or 
(iv) likely to have a disproportionate 
impact on disadvantaged populations. 
(f) USE OF FUNDS.— 
(1) IN GENERAL.—An eligible entity shall use 
assistance received under this section to prepare and 
submit to the Secretary a health impact assessment 
in accordance with this subsection. 
(2) PURPOSES.—The purposes of a health im-
pact assessment are— 
(A) to facilitate the involvement of State 
and local health officials in community planning 
and land use decisions to identify any potential 
health concern relating to an activity or pro-
posed activity; 
(B) to provide for an investigation of any 
health-related issue addressed in an environ-
mental impact statement or policy appraisal re-
lating to an activity or a proposed activity; 
(C) to describe and compare alternatives 
(including no-action alternatives) to an activity 
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or a proposed activity to provide clarification 
with respect to the costs and benefits of the ac-
tivity or proposed activity; and 
(D) to contribute to the findings of an en-
vironmental impact statement with respect to 
the terms and conditions of implementing an 
activity or a proposed activity, as necessary. 
(3) REQUIREMENTS.—A health impact assess-
ment prepared under this subsection shall— 
(A) describe the relevance of the applicable 
activity or proposed activity (including the pol-
icy of the activity) with respect to health issues; 
(B) assess each health impact of the appli-
cable activity or proposed activity; 
(C) provide recommendations of the eligi-
ble entity with respect to— 
(i) the mitigation of any adverse im-
pact on health of the applicable activity or 
proposed activity; or 
(ii) the encouragement of any positive 
impact of the applicable activity or pro-
posed activity; 
(D) provide for monitoring of the impacts 
on health of the applicable activity or proposed 
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