A COMMUNITY GROUNDED HIA : THE BENEFITS OF CONDUCTING A HIA DURING THE AIRDS BRADBURY ESTATE REDEVELOPMENT

Background: This paper identifies and discusses the benefits of taking a ‘community grounded’ approach to Health Impact Assessment (HIA) in the context of a place based urban renewal setting and reflect on whether this is a useful approach for people and organisations wishing to undertake HIA’s in similar settings. The HIA was on the redevelopment of the suburban town centre and focussed on the creation of a new multipurpose centre, improvements to a manmade pond and the relocation of sporting fields found in the area. The HIA team aimed to explore what the planned redevelopment of the local town centre area would mean for the local community and its potential health impacts upon residents. Methods: The HIA followed the standard HIA steps. The HIA team took a community grounded approach where particular focus was engaging community members in the HIA process. This included community members being involved in the HIA working group, reference group and providing evidence for the HIA. Results: The HIA report contained a series of recommendations for the redevelopment of the Airds Bradbury estate, found in the outskirts of South-Western Sydney, the estate prior to redevelopment being a predominantly public housing estate and via redevelopment will include a mixture of privately and publicly-owned housing. These recommendations were presented to the Community Reference Group and were adopted by various stakeholders. Conclusion: The community grounded approach influenced both how the HIA was carried out, the decisions that were made within the HIA and ultimately the findings and recommendations. The HIA of this latest stage of the Airds-Bradbury estate redevelopment was a useful project to encourage further collaboration, dialogue and planning between redevelopment agencies, Local Government, and residents of the Airds Bradbury social housing estate.


Introduction
Health Impact Assessment (HIA) can be applied to many different types of proposals and is adaptable to the context in which it is undertaken.This paper identifies and discusses the benefits of taking a 'community grounded' approach to HIA in the context of a place-based urban renewal setting, and reflects on whether this is a useful approach for people and organisations wishing to undertake HIA's in similar settings.
This HIA was conducted to inform plans to redevelop the town centre of the Airds-Bradbury social housing estate * and, through the engagement of residents, to ensure that these plans reflected the needs of the community.This was achieved through the examination of greenspace and infrastructure within the town centre, and how these might be improved or reconfigured to improve the wellbeing and neighbourhood livelihood of residents.
To attain this, the project engaged community members of the estate, academics, and service providers in a 'learning-by-doing' process.This process was useful in initiating all participants to this process in a manner that was practical and accessible to all members of the HIA project team.The effect of undertaking this process was this community grounded approach to HIA.Community grounded in this context means that the HIA is based on the: values, behaviours, norms, and worldviews of the populations they are intended to serve, and therefore are most closely connected to the lived experiences and core cultural constructs of the targeted populations and communities (Okamoto, Kulis, Marsiglia, Holleran Steiker, & Dustman, 2014, p. 104).

The Proposal
The Airds Bradbury suburban area is approximately 50km south-west of Sydney CBD.Airds Bradbury is one of the most socioeconomically disadvantaged of New South Wales (Australian Bureau of Statistics, 2011) consisting of 1,540 dwellings which the majority are publically owned and managed (94%).
The suburb has a large Aboriginal and Torres Strait Islander community making up 15% of the total Airds population.
The Airds Bradbury Renewal project is a large public housing estate renewal plan with the objective to redevelop the area as a mixed tenure neighbourhood of 30% social housing and 70% private housing.This involves redeveloping some areas of the estate and constructing new private and social housing and also making new road connections and new community facilities.This includes demolition of some existing housing and re-location of residents.
Previously established redevelopment plans of the Airds Bradbury Renewal Project were used for this HIA, as they included crucial community infrastructure that residents of Airds Bradbury had previously identified as key to a successful renewal and redevelopment of the area.The HIA focused on stage 3 of the Project concept plan which covers the redevelopment of the suburban town centre which contains the retail centre, local tavern and a multipurpose facility.This stage also includes development of new playing fields, a multipurpose community centre, redevelopment of an existing Pond located off the town centre, a new road connection, a Reserve and new housing lots.
The HIA team aimed to explore what the planned redevelopment of the local town centre area would mean for the local community and its potential health impacts upon residents.The HIA focused on three local sites that the redevelopment plans had identified as crucial to the well-being of local Airds Bradbury residents, and the municipal upkeep of the area, once the redevelopment was completed.These sites were the creation of a new multipurpose centre, improve-3 ments to a manmade pond and the relocation of sporting fields found in the area.

Methods
Undertaking a HIA followed a step-by-step process as detailed below (see Table 1) As previously highlighted, this was to be conducted as part of a learning-by-doing HIA training conducted by CHETRE.During day one of the training a screening tools was used by the project team to develop the rationale for the HIA.

Scoping
The HIA team hosted a scoping workshop, which included members of the Airds Bradbury Community Reference Group (CRG), local school administrators and local high school students.Various impacts of the planned redevelopment of the town centre were considered and it was agreed that the HIA would focus on the three main sites within the town centre (i.e. the multipurpose centre, upgrades to the pond and relocation of sporting fields).Initial health impact pathways were developed and validated by a member of the local Aboriginal community.

Identification
Members of the HIA team conducted a literature review focusing on the health impacts of each of the focus areas.Additionally, previous research that had been conducted in the Airds Bradbury community were identified and examined for relevance to the HIA.

Assessment
An assessment meeting was held with local stakeholders, made up of community members, service providers, police, council members, members of the local high school (including administrators and students), NSW Land and Housing Corporation staff and the developers of the redevelopment site (Urban Growth).The HIA presented the findings of the literature review and previous research, stakeholders validated these findings and developed draft recommendations.The findings were also shared with and validated by a member of the local Aboriginal Community.

Decision making and Recommendations
The HIA team developed an initial set of recommendations based on the assessment workshop and input from the local Aboriginal men's group.These were then shared with and prioritised by local stakeholders and a member of the local Aboriginal community, who corroborated these with members of the local Aboriginal men's group.
As the HIA was undertaken it also was a standing agenda item at monthly CRG monthly meetings meeting between May 2016 through to November 2016 with draft recommendations developed at the CRG and reported back to the CRG for comment.
The HIA project team developed a series of report drafts informed through various forms of research -census data, the interviewing of local community groups, and consultations with members of the CRG.This was incorporated into the final recommendations of the eventual HIA report, the report formally submitted to the CRG, the developers Urban Growth, NSW Land and Housing Corporation's Development Director and Campbelltown City Council in December 2016.

Monitoring and Evaluation
As of writing it is anticipated that an evaluation plan will be developed by the HIA project team.
The implementations of the HIA recommendations, as articulated within the final report, are being monitored by the CRG.The HIA is a standing agenda item for ongoing CRG meetings.
It is anticipated that this HIA could act as a case study in which a 'grounded HIA' approach worked well with the local community, and the case study can outline how this was achieved and what contributed to its success.

Results
The potential impacts of the planned redevelopment of the town centre were identified through a creation of a pathway diagram.This considered the potential impacts that the redevelopment would have on Airds Bradbury residents.
The impacts were identified using existing evidence and data collected in a workshop with CRG members.This involved accessing data collected during prior consultations, a rapid literature review, data collected by the Airds Community Renewal team, City of Campbelltown Council and Department of Sports and Recreation, and anecdotal evidence from the Airds Bradbury Community Reference Group (CRG) members.Data included previously collected information from a telephone survey and various community consultations.Given the context specific background of the HIA team, members had direct experience with the community and had a sound understanding of the current needs of the community.
Prior HIA projects, both internationally and locally based, were also researched by the project team to validate the approach taken.It is noted, however, the limited critical nature of this research, in that this research was undertaken ultimately to identify similar kinds of urban redevelopment.The success of these redevelopment projects remained largely unexplored.
While the research demonstrates what is involved in changing the urban landscape -the introduction of green spaces, outdoor recreation facilities, and fixed areas for exercise -what is lacking in the commentary of the redevelopment projects is how effective these changes were toward improving living standards in the neighbourhood.
While the changes obviously improved the landscapes from an aesthetic standpoint, missing were substantial measurements or metrics demonstrating an improvement of the overall health within the neighbourhoods that these changes took place.What the research did provide value toward, however, was providing solid examples on how landscape design can be directed in the process toward improving the quality of life within urban landscapes.This informed the process that the HIA took in assessing what residents considered to be effective urban landscape design..
The HIA report contained a series of recommendations for the redevelopment of the Airds Bradbury estate.These recommendations were presented to the CRG and were adopted by various CRG stakeholders.While these recommendations are not binding and do not have authority over the key estate redeveloper Urban Growth, all members of the CRG consider the report as capturing the views and wants offered by residents in relation to the redevelopment.As a consequence, the HIA report is seen as a substantial document by the CRG.
As a member of the CRG, Urban Growth considers the community feedback the report offers to be of relevance, as the report forms part of the local consultation requirements required to be legally met when undertaking redevelopment on the Airds Bradbury estate.Before the HIA report was completed, Urban Growth requested any early findings of the HIA report to inform their planning, suggesting that Urban Growth considered the HIA as a major source for local feedback regarding the redevelopment.
As of writing the CRG will have a future role in reviewing the Stage 3 concept plan of the Airds Bradbury redevelopment, through a tabling of the draft

Upgrades and relocation of the playing fields
Potential for positive impact on the community as evidence from the literature and the community demonstrates that improvements in the built environment and access to recreational opportunities have the potential to lead to improved physical activity, social cohesion and mental wellbeing.

Upgrades to pond and surrounding area
Evidence from the literature and community suggest that this had the potential to positively impact the community.Improvements to the built environment have the potential to lead to ownership and improve positive community integration, decrease stigma and improve mental wellbeing.

Creation of new multipurpose centre
Evidence from th eliterature and community found that this activity has the potential to impact the community both positively and negatively.Positive impacts included an increase in availability of local childcare services and employment.Negative impacts included the shifting of the current effective model of practice would lead to a decrease in established community ownership and connection.A reduction in community space would lead to a decrease in utilisation, causing a reduction in community activity, involvement, physical activity and connectedness.plan by Urban Growth to the CRG, and the CRG then seeking to assess this plan against the recommendations contained within the HIA.The HIA remains as a standing agenda item at CRG meetings.Redevelopment under Stage 3 is expected to commence in the latter half of 2017 after local council consents to Urban Growth's future Development Application.This suggests the HIA will continue to exist as an ongoing referencing tool for Stage 3 of the Airds Bradbury redevelopment.That is, the CRG making sure the outcomes of the HIA are included and fulfilled where necessary during the formation of the draft plan by Urban Growth, and then later via the Development Application by Urban Growth to Local Government.

Discussion
HIAs of social housing regeneration projects are relatively common (Harris, Haigh, Thornell, Molloy, & Sainsbury, 2014;Kearney, 2004;McCormick, 2007).Regenration project have significant health impacts on the communities living in in these areas.However, communities often have limited involvement in HIA processes.For example Kearney (Kearney, 2004) in an evaluation of community participation in a regenerartion HIA found that "The results suggest that there may be a large gap between professional rhetoric and the reality of community participation, and that barriers to community participation in HIA may be substantial and institutionalised" Community participation is often considered as a central practice for effective HIAs (den Broeder, Uiters, ten Have, Wagemakers, & Schuit, 2017; Mahoney, Potter, & Marsh, 2007).The presence of local residential involvement and contribution in HIAs has been shown to have a positive impact on the success of projects from development through to implementation (Chadderton, Elliott, Hacking, Shepherd, & Williams, 2012;Chilaka, 2015;den Broeder et al., 2017;Elliott & Williams, 2008;Haigh et al., 2015;Wright, Parry, & Mathers, 2005).However, community participation is often hard to establish, and also for it to be best managed within the timeframes and expectations of policy making, which can make a truly collaborative HIA process a challenge to attain (Chadderton et al., 2012;Parry & Wright, 2003).
This HIA provides a case study of taking a community grounded approach in the context of an urban redevelopment project taking place in a locationally disadvantaged community.In the early planning stages of the HIA a decision was made to ground the HIA in the experiences and knowledge of the local community.The HIA was conducted in collaboration with a variety of local stakeholders, particularly those associated with the Airds Bradbury Community Reference Group (CRG).The CRG consists of the NSW Land And Housing Corporation (LAHC), Campbelltown City Council, Urban Growth, Family And Community Services (FACS) Housing Services, local schools, residents, and local churches.In addition, a representative from Tharawal Aboriginal community provided input into the HIA scoping and assessment steps.The HIA team consisted of representatives of NSW Land and Housing Corporation, (responsible for the management of the NSW Government's social housing portfolio), residents from the Airds and Bradbury suburbs, the Centre for Health Equity, Training Research and Evaluation (an academic research unit that is also a unit of the Local Health District) in collaboration with South West Sydney Local Health District Population Health Unit.
Although engaging community members in HIAs is standard good practice, evaluations of HIAs have found variation in levels of community engagement and community perspectives are often missing or limited to providing evidence in the identification stage (Haigh et al., 2015;Schuchter, Bhatia, Corburn, & Seto, 2014).This similar to the consideration of equity in HIA, where equity is a core value and expected to be considered all HIAs however in reality is often missed or superficially considered (Povall, Haigh, Abrahams, & Scott-Samuel, 2013).Similar to the Equity Focussed HIA approach developed in Australia (Simpson, Mahoney, Harris, Aldrich, & Stewart-Williams, 2005) we felt that it would be useful to adopt an HIA approach that was explicitly grounded in the community.In the community grounded approach, community members had ownership and power in the HIA process.In practical terms the HIA team explicitly considered at each step of the HIA how community perspectives were incorporated into the HIA.This had two main implications for how decisions were made during the HIA: • The views of community members were prioritised when deciding on the areas of focus; and • The views and experience of community members was given a high priority in the assessment stage of the HIA.
This grounded approach also influenced the process of the HIA: • Community members were part of the HIA working group and therefore had power to influence the HIA processes and decision making throughout the HIA.• Throughout the process opportunities were sought to engage community members.
Table 4 demonstrates how the community grounded approach influenced each step of the HIA process.
Despite having community members in the HIA working group, engaging the community actively in the HIA was still challenging.A key issue in the screening and scoping stage of the HIA was how the broader Airds Bradbury community would be engaged in the HIA.At the time that the HIA project group was

Screening
A key driver for deciding to carry out the HIA was the interest from community members in both an HIA being carried out and also being directly involved in the HIA

Scoping
The views of community members were prioritised when deciding on the areas of focus.
Community members were part of the HIA working group and therefore had power to influence the HIA processes and decision making throughout the HIA.

Identification
As well as data from the community being included in the identification stage community members were also involved in deciding what data should be collected and were involved in collecting data from other community members (e.g.local school)

Assessment
Community members were involved in carrying out the assessment step.The views and experience of community members was given a high priority when identifying and describing priority impacts.

Recommendations and decision making
Community members as part of the working group identified an initial set of recommendations that were then validated and elaborated on by a wider community reference group.

Evaluation and monitoring
It is expected that community representatives will be involved in the ongoing monitoring of the recommendations.
Table 4: Implications of community grounded approach for each step of the HIA formed, the estate redevelopment that the HIA would cover (Stage 3) was only in draft phase by redevelopment agencies, and had yet to be approved by Local Government and still to be tendered by the key developer Urban Growth.Further, as this estate redevelopment stage was only in a draft phase, this also effectively rendered the HIA itself a hypothetical exercise at the time of the HIA's undertaking.
However, there was substantial good faith within the CRG that redevelopment of the town centre area would eventually be made part of the overall redevelopment program for the Airds Bradbury estate.The CRG (which included community representatives) decided to limit consultation so as not to raise suggestions and confusion within the broader community that redevelopment of these key town centre areas had officially commenced.
The HIA process played a part in a collaborative exercise in identifying and addressing the needs of residents, Government agencies, community organisations, and Urban Growth as the key agency responsible for estate redevelopment.Through intensive dialogue with residents, the presence of a steering committee consisting of a variety of stakeholders attached to the Airds-Bradbury estate, and a redevelopment agency with commitment to participating within community groups such as the Airds Bradbury CRG, the HIA has proved to be a useful reference tool for each of these stakeholders.UG involvement in the HIA was a way to further demonstrate their commitment to community and potentially enhancing trust with all stakeholders to the estate.
As a document informing the decision making of the CRG during this current stage of redevelopment on the Airds-Bradbury estate, the HIA itself demonstrated the existence of locational disadvantage within the context of urban renewal.This was demonstrated through the HIA highlighting the importance of neighbourhood life to public housing residents, especially those residents that continue to live on the estate, or will return to the estate after stages of redevelopment are completed.
Also of consideration was the influx of private residents to the estate through the social mix of privately and publicly-owned housing stock established within the redevelopment.This created a challenge for the HIA project team, in which the team needed to identify how overall health of public housing residents would be managed within this social mix component.This required the HIA project team to identify to what extent the redevelopment stage would identify local need, and from this propose a series of recommendations addressing the specific needs of public housing residents in the face of the pending redevelopment.
In the interest of ongoing community vitality within the Airds-Bradbury estate before and after redevelopment, planning for this redevelopment site would particularly need to consider the maintenance, and even improvement, of the community infrastructure found within this location.This was demonstrated in the HIA report through recommending the construction of outdoor exercising apparatus, creation of footpaths and walking tracks, the creation of a multipurpose centre allowing local infrastructure and facilities.Therefore an ongoing addressing of needs of both old and new residents, and the restoration of playing fields to reinvigorate organised sport within the suburb.Maintaining community vitality through redesigning the local landscape is within the scope of Urban Growth to manage.There were a range of contextual factors that influenced the success of taking a community grounded approach.The CRG ensured the autonomy of the HIA project team and due to the sensitivity of the HIA project to the local community, the CRG maintained confidentiality of the project group during the formation and drafting of the HIA report.This provided a space for open discussions with key community stakeholders that would have been otherwise difficult given the sensitivity of the project.This did however place the CRG in a position where it needed to be sensitive with how it would mention the activity of the HIA project group to residents, as the redevelopment of the part of the Airds Bradbury estate that the HIA would cover was yet to be made official by Urban Growth.
In this HIA, taking a community grounded approach was facilitated by the existence of collaborative bodies already attached to a redevelopment project.In the instance of the Airds-Bradbury estate, this was reflected through the existence of the CRG, a steering committee existing within the estate for several years and had a firm presence on the estate prior to estate redevelopment commencing.
Further to this was the implementation of the HIA being based upon draft plans of the redevelopment stage, rather than final plans, thus limiting the scope of the project team.This restricted the amount of engagement that the project team could have with the local community.As they were draft plans, the project team also needed to take into consideration that the plans may be subject to change, and so the team had concerns about the HIA raising false expectations for residents, and causing possible concern for activities that may or may not go ahead.
This was especially important when the team was required to make comment on the stage of the Airds-Bradbury redevelopment that the HIA was implemented toward, this stage being a substantial one as it incorporates the central area of Airds-Bradbury, where there will continue to be an ongoing traffic of cars and people before and after redevelopment is completed.This is also a redevelopment stage where much of the central community infrastructure in Airds-Bradbury is located, which includes a substantial man-made water feature, a multipurpose centre currently owned by the NSW FACS, and commercial establishments such as a hotel pub and local shopping centre.It is an important stage of estate redevelopment in terms of maintaining community harmony and identity, and so information relating to the draft plans needed to be handled sensitively by the project team when communicating to estate residents.
While urban redevelopment of social housing estates in NSW are no longer a new advent, the challenge toward addressing how redevelopment impacts current and future estate residents, and the incoming cohort of private residents, remains.As a community project, the creation of a HIA is especially beneficial towards identifying areas of locational disadvantage within urban renewal projects, and to document the views and needs of a community already having substantial engagement with the agencies responsible for urban renewal.The methodology applied by the HIA when creating this final report may have value for future HIAs within estates undergoing urban redevelopment.This HIA has undertaken a 'community grounded HIA', a report relying upon extensive consultation and documentation of residents, especially long-term residents, and respecting the pre-existing CRG as a central body for all stakeholders connected to the Airds Bradbury estate.The formation of a HIA project group was essentially a collaborative effort between Government agencies and residents, with the group also able to maintain regular contact with the CRG.Members of the project group also demonstrated a commitment to documenting the views of residents while remaining linked to the CRG.
The value that the HIA placed upon the stakeholders attached to the Airds Bradbury estate, and respect towards the collaborative local community bodies also in existence at the time of the HIA, primarily served to inform this 'community grounded' approach.Rather than prescribe or attempt to introduce alternative models toward improving community vitality in lieu of estate redevelopment, the HIA instead resolved to identify and respect previously established stakeholders of the Airds-Bradbury estate.Further, the HIA actively recognised the strengths and commitment that these stakeholders offered to the collaborative effort.
This 'grounded HIA' model can be applied within other contexts, and other social housing redevelopment programs in NSW, Australia and internationally.It serves as a methodology ensuring a documentation of not only how pending redevelopment can affect long term residents of an estate, but also suggesting recommendations for redevelopment that is informed through identifying the views, opinions and efforts of residents and other relevant stakeholders attached to the redevelopment.

Conclusion
The redevelopment of Airds Bradbury will impact current and future residents of these suburbs.Moreover, with specific reference to the areas of focus of this HIA, research has shown that a focused introduction of upgrades to existing greenspace has the potential to positively impact local communities.These types of facilities have the potential to considerably influence community members' participation in sporting and recreational activities and in turn overall physical activity levels (Council, 2010;Health, 2009;Sport, 2016).
In this sense, while the HIA has formed recommendations on this current redevelopment stage of the Airds-Bradbury estate, there will still be reliance upon the CRG to adhere to these recommendations, and ultimately Urban Growth to respect these recommendations as ones that have been previously sourced from estate residents.To this end it is unknown how effective these recommendations are until redevelopment on the estate is actually completed.
The HIA of this latest stage of the Airds-Bradbury estate redevelopment was a useful project to encourage further collaboration, dialogue and planning between redevelopment agencies, Local Government, and residents of the Airds Bradbury social housing estate.However, there remains uncertainty over whether the lessons of this project can be automatically applied to similar redevelopment programs on other estates in Australia.While the HIA was a useful tool in this instance toward consolidating previously-existing collaboration between residents and redevelopment agencies during estate urban renewal, the local context within other redevelopment programs would need to be identified and then integrated toward the overall 'grounded approach'.This collaboration extended to the writing of this paper which was a joint effort by all members of the HIA working group.

Table 1 HIA
Steps 1. ScreeningResidents of the Airds Bradbury social housing estate, and staff working locally for the New South Wales (NSW) Land and Housing Corporation, met with trainers from Centre for Primary Healthcare and Equity (CHETRE) to discuss the possibility of conducting a HIA on the Airds Bradbury (AB) renewal project.This was as a result of calls for expressions of interest for the HIA training.These parties formed the project team for carrying out the HIA.

Table 2 :
Summary of key findings Physical design to include information about local flora and fauna and local aboriginal history and significance and have facilities including shade, lighting, drinking water and rest stations.• Design to encourage participation e.g.walkability, age and ability appropriate.Ensure all three design components (playing fields, pond and multipurpose centre) are easily accessible and integrated.• In longer term, consider alternative modes of operation which reflect needs of the changing community, use of IAP2 Spectrum of Public Participation recommended.• Where possible, naming of existing or newly established infrastructure should be made in consultation with local community including the local Aboriginal community.Cultural participation • Ensure appropriate ongoing engagement with local Aboriginal community to recognise the significance of local Aboriginal community.• Consider introduction of a cultural learning/sharing space within town centre • Consider regular organisation of cultural events that reflect local community • Consider the use of public art that reflects local cultural diversity

Table 3 :
Summary of key findings

Table 2
displays a summary of the key findings and table 3 gives a brief summary of the key recommendations arising from the HIA.