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supporting documentation, including letters of sup-
port, from potential conductors of Health Impact 
Assessments for the listed proposed activities. Each 
application should also include an assessment by the 
eligible entity of the health of the population of its 
jurisdiction and describe potential adverse or positive 
effects on health that the proposed activities may 
create. 
‘‘(3) PREFERENCE.—Preference in awarding 
funds under this section may be given to eligible en-
tities that demonstrate the potential to significantly 
improve population health or lower health care costs 
as a result of potential Health Impact Assessment 
work. 
‘‘(f) USE OF FUNDS.— 
‘‘(1) IN GENERAL.—An eligible entity shall use 
amounts provided under a grant under this section 
to conduct Health Impact Assessment capacity 
building or to conduct or fund subgrantees to con-
duct a Health Impact Assessment for a proposed ac-
tivity in accordance with this subsection. 
‘‘(2) PURPOSES.—The purposes of a Health 
Impact Assessment under this subsection are— 
‘‘(A) to facilitate the involvement of tribal, 
State, and local public health officials in com-
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munity planning, transportation, housing, and 
land use decisions and other decisions affecting 
the built environment to identify any potential 
health concern or health benefit relating to an 
activity or proposed activity; 
‘‘(B) to provide for an investigation of any 
health-related issue of concern raised in a plan-
ning process, an environmental impact assess-
ment process, or policy appraisal relating to a 
proposed activity; 
‘‘(C) to describe and compare alternatives 
(including no-action alternatives) to a proposed 
activity to provide clarification with respect to 
the potential health outcomes associated with 
the proposed activity and, where appropriate, to 
the related benefit-cost or cost-effectiveness of 
the proposed activity and alternatives; 
‘‘(D) to contribute, when applicable, to the 
findings of a planning process, policy appraisal, 
or an environmental impact statement with re-
spect to the terms and conditions of imple-
menting a proposed activity or related mitiga-
tion recommendations, as necessary; 
‘‘(E) to ensure that the disproportionate 
distribution of negative impacts among vulner-
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able populations is minimized as much as pos-
sible; 
‘‘(F) to engage affected community mem-
bers and ensure adequate opportunity for public 
comment on all stages of the Health Impact As-
sessment; and 
‘‘(G) where appropriate, to consult with 
local and county health departments and appro-
priate organizations, including planning, trans-
portation, and housing organizations and pro-
viding them with information and tools regard-
ing how to conduct and integrate Health Im-
pact Assessment into their work. 
‘‘(3) ELIGIBLE ACTIVITIES.— 
‘‘(A) IN GENERAL.—Eligible entities fund-
ed under this subsection shall conduct an eval-
uation of any proposed activity to determine 
whether it will have a significant adverse or 
positive effect on the health of the affected pop-
ulation in the jurisdiction of the eligible entity, 
based on the criteria described in subparagraph 
(B). 
‘‘(B) CRITERIA.—The criteria described in 
this subparagraph include, as applicable to the 
proposed activity, the following: 
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‘‘(i) Any substantial adverse effect or 
significant health benefit on health out-
comes or factors known to influence health, 
including the following: 
‘‘(I) Physical activity. 
‘‘(II) Injury. 
‘‘(III) Mental health. 
‘‘(IV) Accessibility to health-pro-
moting goods and services. 
‘‘(V) Respiratory health. 
‘‘(VI) Chronic disease. 
‘‘(VII) Nutrition. 
‘‘(VIII) Land use changes that 
promote 
local, 
sustainable 
food 
sources. 
‘‘(IX) Infectious disease. 
‘‘(X) Health disparities. 
‘‘(XI) 
Existing 
air 
quality, 
ground or surface water quality or 
quantity, or noise levels; and 
‘‘(ii) Other factors that may be con-
sidered, including— 
‘‘(I) the potential for a proposed 
activity to result in systems failure 
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that leads to a public health emer-
gency; 
‘‘(II) the probability that the pro-
posed activity will result in a signifi-
cant increase in tourism, economic de-
velopment, or employment in the ju-
risdiction of the eligible entity; 
‘‘(III) any other significant po-
tential hazard or enhancement to 
human health, as determined by the 
eligible entity; or 
‘‘(IV) whether the evaluation of a 
proposed activity would duplicate an-
other analysis or study being under-
taken in conjunction with the pro-
posed activity. 
‘‘(C) FACTORS FOR CONSIDERATION.—In 
evaluating a proposed activity under subpara-
graph (A), an eligible entity may take into con-
sideration any reasonable, direct, indirect, or 
cumulative effect that can be clearly related to 
potential health effects and that is related to 
the proposed activity, including the effect of 
any action that is— 
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‘‘(i) included in the long-range plan 
relating to the proposed activity; 
‘‘(ii) likely to be carried out in coordi-
nation with the proposed activity; 
‘‘(iii) dependent on the occurrence of 
the proposed activity; or 
‘‘(iv) likely to have a disproportionate 
impact on high-risk or vulnerable popu-
lations. 
‘‘(4) REQUIREMENTS.—A Health Impact As-
sessment prepared with funds awarded under this 
subsection shall incorporate the following, after con-
ducting the screening phase (identifying projects or 
policies for which a Health Impact Assessment 
would be valuable and feasible) through the applica-
tion process: 
‘‘(A) SCOPING.—Identifying which health 
effects to consider and the research methods to 
be utilized. 
‘‘(B) ASSESSING RISKS AND BENEFITS.— 
Assessing the baseline health status and factors 
known to influence the health status in the af-
fected community, which may include aggre-
gating and synthesizing existing health assess-
ment evidence and data from the community. 
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