Housing affects health, yet health is seldom considered in housing decisions. Health impact assessment (HIA) is a tool that can improve housing-related policies, plans, programs, and projects by bringing together scientific data, health expertise, and stakeholder engagement to identify the potential health effects of proposed decisions. We systematically identified and reviewed HIAs of housing decisions in the United States, yielding 54 HIAs between 2002 and 2016. Two examined federal proposals; the others explored decisions in 20 states. A variety of organizations led the HIAs, including non-profits, public health departments, and academic institutions. The primary decision-makers each HIA sought to inform were housing, planning, and/or elected officials. Eighteen HIAs focused on housing policies, codes, design elements, and utilities in residential structures. The remaining 36 HIAs included housing as one element of broader community development and transportation planning decisions. HIA recommendations changed decisions in some cases, and the assessment process helped strengthen connections between public health and housing decision-makers. To illustrate key characteristics of housing HIAs, we purposefully selected three HIAs and described the decisions they informed in detail: off-campus student housing in Flagstaff, Arizona; a rental housing inspections program in Portland, Oregon; and revitalization plans for a major thoroughfare in a suburb of St. Louis, Missouri. With a few exceptions, federal, state, and local agencies in the U.S. are not required to consider the health impacts of housing decisions, such as where housing is sited, how it is designed and constructed, and policies for ensuring that it is affordable and safe. HIA has emerged as a tool for advocates, health and housing practitioners, and policymakers to fill this gap. However, few studies have examined whether HIAs do in fact change housing decisions, shift the way that decision-makers think, or ultimately shift determinants of health (e.g., housing affordability and quality). This review demonstrates that HIAs can facilitate the consideration of health during housing decision-making. Housing HIAs can also help decision-makers address commonly overlooked effects, such as changes to social cohesion, and improve civic participation by engaging communities in the decisionmaking process.

住房影响健康，但住房决策中很少考虑健康。健康影响评估 (HIA) 是一种工具，可以通过汇集科学数据、健康专业知识和利益相关者参与来确定拟议决策的潜在健康影响，从而改进与住房相关的政策、计划、计划和项目。我们系统地识别和审查了美国住房决策的 HIA，在 2002 年至 2016 年间产生了 54 个 HIA。两项审查了联邦提案；其他人探讨了 20 个州的决定。各种组织领导了 HIA，包括非营利组织、公共卫生部门和学术机构。每个 HIA 试图告知的主要决策者是住房、规划和/或民选官员。十八个 HIA 专注于住房政策、法规、设计元素、和住宅结构中的公用事业。其余 36 个 HIA 将住房作为更广泛的社区发展和交通规划决策的一个要素。HIA 的建议在某些情况下改变了决策，评估过程有助于加强公共卫生和住房决策者之间的联系。为了说明住房 HIA 的关键特征，我们特意选择了三个 HIA 并详细描述了他们做出的决定：亚利桑那州弗拉格斯塔夫的校外学生住房；俄勒冈州波特兰市的出租房屋检查计划；以及密苏里州圣路易斯郊区一条主要通道的振兴计划。除了少数例外，美国的联邦、州和地方机构不需要考虑住房决策对健康的影响，例如住房选址、它是如何设计和建造的，以及确保其价格合理且安全的政策。HIA 已成为倡导者、健康和住房从业者以及政策制定者填补这一空白的工具。然而，很少有研究检验 HIA 是否确实改变了住房决策，改变了决策者的思维方式，或最终改变了健康的决定因素（例如，住房负担能力和质量）。该审查表明，HIAs 可以促进在住房决策过程中对健康的考虑。住房 HIA 还可以帮助决策者解决通常被忽视的影响，例如社会凝聚力的变化，并通过让社区参与决策过程来提高公民参与度。卫生和住房从业人员以及政策制定者来填补这一空白。然而，很少有研究检验 HIA 是否确实改变了住房决策，改变了决策者的思维方式，或最终改变了健康的决定因素（例如，住房负担能力和质量）。该审查表明，HIAs 可以促进在住房决策过程中对健康的考虑。住房 HIA 还可以帮助决策者解决通常被忽视的影响，例如社会凝聚力的变化，并通过让社区参与决策过程来提高公民参与度。卫生和住房从业人员以及政策制定者来填补这一空白。然而，很少有研究检验 HIA 是否确实改变了住房决策，改变了决策者的思维方式，或最终改变了健康的决定因素（例如，住房负担能力和质量）。该审查表明，HIAs 可以促进在住房决策过程中对健康的考虑。住房 HIA 还可以帮助决策者解决通常被忽视的影响，例如社会凝聚力的变化，并通过让社区参与决策过程来提高公民参与度。该审查表明，HIAs 可以促进在住房决策过程中对健康的考虑。住房 HIA 还可以帮助决策者解决通常被忽视的影响，例如社会凝聚力的变化，并通过让社区参与决策过程来提高公民参与度。该审查表明，HIAs 可以促进在住房决策过程中对健康的考虑。住房 HIA 还可以帮助决策者解决通常被忽视的影响，例如社会凝聚力的变化，并通过让社区参与决策过程来提高公民参与度。