









































December 2021 Volume  6 Issue 1

1

Gina Powers
Cynthia Stone, DrPH, MSN, RN

TEN YEARS OF SOPHIA

Introduction

In 2021, the Society of Practitioners of Health 
Impact Assessment (SOPHIA) celebrates its 
10-year anniversary.  To commemorate this 
milestone, we surveyed SOPHIA founding 
members and key leaders in July of 2021, asking 
them to reflect on the organization’s formation 
in 2011, to share thoughts on SOPHIA’s 
key challenges and to highlight important 
accomplishments. Survey respondents also 
weighed in on the future of SOPHIA and the 
value of SOPHIA membership.

The first section, titled “History of Health Impact 
Assessment and the Formation of SOPHIA,” is 
based on a combination of survey responses 
and published materials as sources. The 
second section titled “SOPHIA’s first 10 years: 
Accomplishments, Challenges, the Future, 
and the Value of Membership” summarizes 
perspectives shared by survey respondents 
on SOPHIA’s current and future state and the 
value of SOPHIA membership. The final section, 
“Summary and Conclusions,” summarizes key 
messages in the first two sections.

History of Health Impact Assessment and 
the Formation of SOPHIA

History of Health Impact Assessment
The development of HIA was preceded by 
the 1969 National Environmental Policy Act 
(NEPA). NEPA was one of the first laws ever 
written to protect the environment (Summary 
of the National Environmental Policy Act, n.d.), 
establishing a national policy with the following 
purpose:  

To declare a national policy which will 
encourage productive and enjoyable 
harmony between man and his 
environment; to promote efforts which 
will prevent or eliminate damage to the 
environment and biosphere and stimulate 
the health and welfare of man; to enrich 
the understanding of the ecological 
systems and natural resources important 
to the Nation; and to establish a Council 
on Environmental Quality (The National 
Environmental Policy Act of 1969, as 
amended, 1971).



Ten Years of SOPHIA Powers; Stone

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While stimulating the “health and welfare of 
man” was one of NEPA’s stated purposes, 
most environmental impact assessments have 
emphasized environmental impacts without 
directly connecting environmental impacts 
to health impacts (Dannenberg, 2016). Ross, 
Orenstein and Botchwey (2014) point out 
that Environmental Impact Assessments 
(EIAs) “rarely incorporate broad measures of 
health, or focus too narrowly on exposure to 
environmental toxins.” (p. 5). 

This void led to the development of other 
methodologies designed to examine the social 
and health outcomes of proposed policies, 
projects and programs and the distribution 
of those social and health outcomes (Ross, 
Orenstein and Botchwey, 2014). In 1986, the 
World Health Organization (WHO) set the stage 
for the development of HIA with the Ottawa 
Charter for Health Promotion and in 1997, with 
the Jakarta Declaration on Leading Health 
Promotion into the 21st Century (Dannenberg, 
2016). The Jakarta Declaration lists “equity-
focused health impact assessments as an 
integral party of policy development” as a 
priority for health promotion in the 21st century. 
(WHO, 1997). In 1999, the WHO outlined 
HIA definition and values in the Gothenburg 
Consensus Paper. (Ross, Orenstein, & Botchwey, 
2014, p. 6).

Early HIAs were conducted primarily in Europe 
in the 1990s (Dannenberg, 2016). The first HIA 
in the United States was commissioned in 1999 
by the San Francisco Department of Health 
(SFDH) and published in 2001 (Bhatia & Katz, 
2001). 

In 2002, the Centers for Disease Control and 
Prevention (CDC) hosted a workshop in Atlanta 
to discuss research on health and the built 
environment.  HIA was one recommended 
approach that emerged from this meeting as 

a promising approach to assessing how the 
built environment can affect health.  In 2004, 
The Robert Wood Johnson Foundation (RWJF) 
and the CDC hosted a second workshop to 
discuss providing HIA examples and resources, 
building HIA training capacity and expanding the 
field (Dannenberg, 2016). The CDC and RWJF 
remained involved in the next steps that were 
identified during the second conference.  

In the years following the second conference, 
HIA grew as a topic of academic research. A 
database of academic articles was created 
by the Health Impact Project, a collaboration 
between RWJF and the Pew Charitable Trusts 
(Dannenberg, 2016). HIA teaching and training 
was provided by multiple organizations, 
including the CDC, the San Francisco 
Department of Public Health, Human Impact 
Partners, and the University of California 
– Berkeley, and the American Planning 
Association with the National Association of 
County and City Health Officials (Dannenberg, 
2016).  HIA use expanded in scope to become 
a tool for analyzing health impact for policies 
beyond its original use for the built environment.  

The Formation of SOPHIA
Beginning in approximately 2008, a group of HIA 
practitioners in North America started HIA of 
the Americas, an annual meeting to discuss HIA 
practice and to advance the field. The Society 
of Practitioners of Health Impact Assessment 
(SOPHIA) is the product of a working group 
during the 2010 HIA of the Americas meeting, 
and the organization was formed in late 2011 
(About Sophia, n.d.). 

According to survey response from founding 
members and SOPHIA leadership, SOPHIA was 
formed to advance the practice of HIA with the 
following goals in mind:



Ten Years of SOPHIA Powers; Stone

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1. To establish and promote Standards of 
Practice for HIA Practitioners

2. To build capacity by promoting and 
expanding the field of HIA

3. To build a community of practice to share 
experiences and learn

4. To conduct workshops and conferences
5. To promote community engagement and 

equity
6. Advocate by producing position 

statements, papers, and resources for 
addressing   emerging challenges 
and opportunities

Today, SOPHIA is an international association 
that provides leadership and promotes 
excellence in the field of health impact 
assessment (HIA). 

SOPHIA’s first 10 years: Accomplishments, 
Challenges, the Future, and the Value of 
Membership

Methodology
This section summarizes survey feedback 
from SOPHIA leaders and founding members 
regarding SOPHIA accomplishments, 
challenges, the future, and the value of 
membership. A survey was distributed in July 
of 2021 to eleven active SOPHIA members, 
many of whom have served as president, 
vice president, board member or founding 
member for SOPHIA. Eight responses to survey 
questions were returned, seven in writing and 
one verbally (see survey questions in Appendix).  
Of those who responded to the survey, nearly 
all have been conducting Health Impact 
Assessments (HIAs) for 10 or more years. 
Survey respondents’ HIA experience included 
assessments focused on a variety of policies, 
projects and programs, including housing, land 
use, economic security, the built environment, 
transportation, immigration policies, minimum 
wage policies, criminal justice and more.

SOPHIA Accomplishments
According to survey respondents, SOPHIA has 
contributed substantially to the field of HIA 
during the first 10 years. Key accomplishments 
that respondents identified are summarized 
below.   

Practitioner Resources
High-quality resources that have defined 
HIA standards of practice were frequently 
mentioned as a key SOPHIA accomplishment 
during the first ten years. One survey 
respondent specified that guidelines on 
stakeholder engagement and equity stand out 
as key materials that have strengthened and 
advanced the field. The website and document 
library and the Health in all Policies Screening 
tool were also included as important practitioner 
resources that SOPHIA developed and made 
available. 

Education and services
Practitioner Workshops (formerly known as HIA 
of the Americas) and webinars were cited as 
top accomplishments.  Specifically, Practitioner 
Workshops were called out as a consistent and 
wonderful environment for peer learning and 
sharing.  Also, the support provided to new 
practitioners and basic HIA education for those 
looking for more information were listed as 
important contributions to the field.

Other notable accomplishments related to 
education and services include the journal, 
Chronicles of Health Impact Assessment, and 
the peer exchange program. 

Established Professional Network
One major contribution to the field of HIA has 
been the network of practicing HIA professionals 
that comprise SOPHIA. SOPHIA has kept the 
field going by providing a forum for continued 
discussion and collaboration among colleagues.  
  



Ten Years of SOPHIA Powers; Stone

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Sustainability as an organization / Expanding 
the field

Finally, SOPHIA’s continued existence through 
four presidents and leadership transitions 
is notable and points to the organization’s 
sustainability.  SOPHIA is viewed as a driver 
behind the more widespread understanding 
over the past 15-20 years that policy decisions 
have health impacts. SOPHIA has grown to be 
an international organization and facilitates 
connections between members.  

Challenges

While SOPHIA has accomplished a great deal 
as an organization, respondents acknowledge 
challenges exist. 

Funding
A lack of funding has presented significant 
challenges.  In the absence of funders, SOPHIA 
relies on membership fees to support a part 
time staff member.  The amount of money 
raised through membership fees limits 
SOPHIA’s services and activities.

Resource challenges
SOPHIA does not have full time dedicated staff; 
rather, officers, workgroups and others serve 
as volunteers.  Limited individual and group 
bandwidth makes participating in workgroups 
or being a workgroup chair challenging.  
Organization leaders must balance their daily 
work responsibilities with their efforts to move 
SOPHIA forward.  The voluntary nature of 
SOPHIA leadership or workgroup participation 
sometimes leads to SOPHIA work being 
deprioritized in favor of work responsibilities. 

Shifting Field and Social Priorities
Interest in the field from funders and 
government agencies appears to be waning.  
When SOPHIA was established ten years ago, 

there was significant energy focused on HIA 
work. There appear to be fewer people fully 
allocated to HIA work and as a result, fewer 
people are active in SOPHIA.   

The Future of SOPHIA – The Next 10 Years

As SOPHIA moves into its second decade, 
it is important to analyze current state and 
consider priorities for the next 10 years.  Survey 
respondents shared their thoughts on the future 
of SOPHIA.  

Health in All Policies
Some respondents raised the question of 
whether SOPHIA should incorporate Health in 
All Policies (HIAP) as a focus in addition to HIA. 
As stated on the SOPHIA website (Health in All 
Policies, n.d., 1st paragraph), “HIA is a powerful 
and effective tool used to achieve the larger goal 
of HiAP.”

Student Training
In 2015, SOPHIA leadership made efforts to 
evaluate which universities offered courses 
on HIA to students. It is important to update 
this information to understand to what extent 
student training is continuing, and to evaluate 
whether gaps exist and how to fill them. 

Information hub 
The CDC and PEW have archived some of the 
HIA information on their websites.  SOPHIA 
should continue to track and share information 
on upcoming HIA-related publications.  SOPHIA 
should also retain information from the PEW and 
CDC sites that has been archived or add this 
information directly to the SOPHIA site. SOHIA 
should advocate for continued presence from 
these organizations.

Funding, Staffing and Membership
There is a need to consider how to sustain 
the association from a funding and staffing 



Ten Years of SOPHIA Powers; Stone

5

perspective, to re-invigorate the membership 
base and working groups and to increase 
membership retention and growth. Having a 
ten-dollar membership fee for new members 
was a great way to celebrate SOPHIA’s 10-year 
anniversary.

Value and Mission
The environment is ever-changing, and it is 
important to ensure HIA is still relevant in 
today’s world. SOPHIA should expand its 
mission to be broader than HIA, but to continue 
emphasizing HIA as a gateway tool for Health in 
All Policies. SOPHIA must examine and define 
the unique value that SOPHIA provides and 
convey this value relative to others working in 
the HIAP and health equity spaces. 

Another approach might be for SOPHIA to 
connect to other emerging practices with 
similar values and focus on being a network for 
a broader mission, not just HIAs. 

Benefits of SOPHIA Membership

Survey respondents were asked what benefits 
they have received from SOPHIA membership.  
Nearly all emphasized that the relationships 
built with other practitioners and the learning 
opportunities stand out as important 
membership benefits.

Network of Practitioners
For most, SOPHIA has provided a forum for 
practitioners to connect and discuss updates 
and challenges.  Being part of a supportive 
community provides a space to discuss sticky 
questions.  Ruth Lindberg writes, “I have 
received many benefits from my involvement 
with SOPHIA, particularly deep and enduring 
relationships with other members who have 
become thought partners in my own HIA and 
Health in All Policies work.  I continually learn 
from other members, and really value the 

peer learning and collaborative aspects of the 
organization.”

Professional Resources and Best Practices
Creating, using, and disseminating HIA guidance 
documents and other resources have been 
a major benefit of SOPHIA membership.  
The resources that SOPHIA creates and 
disseminates plays a key role in advancing HIA 
practice and supporting HIA development. 

Leadership Development
SOPHIA membership can provide opportunities 
to develop and refine leadership skills by 
participating in workgroups or by serving as an 
officer in the organization.

Advice for Those Considering SOPHIA 
Membership

Respondents were unanimous in their advice 
for those considering SOPHIA membership: 
join. They also provided advice on maximizing 
the value received by joining workgroups and 
getting involved. 

SOPHIA provides an excellent opportunity 
to get to know wonderful and interesting 
people who are passionate about health 
and equity.  All survey respondents highly 
recommended SOPHIA membership as an 
excellent opportunity to advance personal 
and professional goals by networking with 
passionate professionals in the areas of HIA and 
HIAP.  Joining a workgroup, participating in the 
Practitioner Workshop and webinar offerings, 
and using available resources and services can 
help members maximize value.

Summary and Conclusions

The history of HIA in the U.S. has roots in 
the 1969 National Environmental Policy Act. 
However, assessing the impact of proposed 



Ten Years of SOPHIA Powers; Stone

6

policies, projects and programs on population 
health needed sharper focus. The WHO played 
a leading role in promoting and defining 
health impact assessments as essential policy 
development tools between 1986 and 1999. 
During the 1990s, HIA practice grew primarily 
in Europe. The first HIA in the United States 
was commissioned in 1999 and the practice 
grew in the U.S. in the early 2000s, supported 
by involvement from the CDC, RWJF and Pew 
Charitable Trusts. 

SOPHIA was founded in 2011, the product of a 
group of HIA practitioners in North America who 
attended the 2010 HIA of the Americas meeting. 
SOPHIA leaders and founding members who 
responded to our July 2021 survey indicate 
the organization was formed to establish and 
promote standards of practice, promote the 
field and build professional capacity, establish a 
community of practice to share experiences and 
learn, educate practitioners through workshops 
and conferences, promote HIA ideals such as 
community engagement and equity and to 
advocate by producing position statements, 
papers and resources to address emerging 
challenges and opportunities.

After 10 years of existence, is SOPHIA fulfilling 
its goals? What value does SOPHIA add to the 
field? What challenges exist for SOPHIA and 
the field of HIA? And how does the organization 
address emerging challenges and opportunities 
in the coming years?

In July and August of 2021, SOPHIA’s 
leaders and founding members weighed 
in on the organization’s accomplishments, 
challenges, future direction and the value of 
membership by way of survey response. The 
good news? SOPHIA has contributed to the 
field by developing high-quality practitioner 
resources. Respondents pointed to the website, 
document library and the Health in all Policies 

Screening tool as key accomplishments, with 
one respondent calling the guidelines on 
stakeholder engagement and equity a “stand 
out.” SOPHIA has contributed to education and 
service to practitioners through practitioner 
workshops, webinars, the Chronicles of Health 
Impact Assessment, and the peer exchange 
program. Finally, the professional network 
that SOPHIA comprises makes professional 
expertise, experience and mentorship available 
to practitioners at all experience levels. 

SOPHIA’s significant accomplishments and 
contributions to the field point to a clear 
focus on the organization’s original goals. Yet, 
challenges exist. A lack of funding limits the 
scope of services that SOPHIA can provide. 
SOPHIA is volunteer-led, requiring already 
busy professionals to balance their work 
responsibilities with their efforts to move 
SOPHIA to the next level. Perhaps most 
significantly, interest from government agencies 
and HIA funding appear to be declining. 

When SOPHIA was initially formed, the field of 
HIA had significant momentum. One survey 
respondent said, “There was a lot of energy 
around HIA when SOPHIA came to be, but since 
then fewer and fewer people are fully resourced 
to do HIA work, and thus, their ability to be 
active in SOPHIA is harder to justify. I see this as 
a huge missed opportunity since HIA is still an 
effective tool with robust applications - it’s just 
not the ‘shiny thing’ anymore.

As SOPHIA leadership considers future 
priorities, the organization’s mission, strategy, 
goals and funding plan must be assessed and 
aligned with a changing environment. Some 
survey respondents suggest broadening 
SOPHIAs mission beyond HIA to encompass 
Health in All Policies and health equity. Another 
recommends connecting with other emerging 
practices with similar values and building 



Ten Years of SOPHIA Powers; Stone

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a network with a broader mission. Some 
respondents suggest that SOPHIA should 
continue to remain abreast of HIA course 
offerings at universities and to be an important 
informational resource.

Above all, survey responders value SOPHIA’s 
supportive practitioner network, best practices, 
professional resources, the Practitioner 
Workshop, webinars and leadership 
opportunities as key membership benefits. 
Their advice to those considering SOPHIA 
membership?  Join!



Ten Years of SOPHIA Powers; Stone

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References
About SOPHIA. (n.d.). Society of Practitioners of Health Impact Assessment.  Retrieved September 5, 2021 

from https://hiasociety.org/About-SOPHIA

Bhatia, R., & Katz, M. (2001). Estimation of health benefits from a local living wage ordinance. American 
journal of public health, 91(9), 1398–1402. https://doi.org/10.2105/ajph.91.9.1398

Dannenberg AL.  A brief history of health impact assessment in the United States. 
Chronicles of Health Impact Assessment.  1(1), 2016. https://journals.iupui.edu/index.php/chia/article/

view/21348 
 
Health Impact Assessment (HIA) tools and methods. (n.d.). World Health Organization. Retrieved November 

10, 2021, from https://www.who.int/tools/health-impact-assessments

Health Impact Assessments. (n.d.). United States Environmental Protection Agency.  Retrieved September 5, 
2021 from https://www.epa.gov/healthresearch/health-impact-assessments

Health in All Policies. (n.d.) Society for Practitioners of Health Impact Assessment. Retrieved September 10, 
2021 from https://hiasociety.org/Health-in-All-Policies2

Ross, C., Orenstein, M., & Botchwey, N. (2014). Health Impact Assessment in the United States. Springer. 

Summary of the National Environmental Policy Act. (n.d.). United States Environmental Protection Agency.  
Retrieved September 5, 2021 from https://www.epa.gov/laws-regulations/summary-national-
environmental-policy-act

 The National Environmental Policy Act of 1969, as amended. (1970, January 1). Retrieved September 5, 2021 
from https://www.energy.gov/nepa/downloads/national-environmental-policy-act-1969

World Health Organization. (1997, July 21). The Jakarta Declaration: on leading health promotion into the 21st 
century. World Health Organization. https://www.who.int/publications/i/item/WHO-HPR-HEP-4ICHP-
BR-97.4

https://hiasociety.org/About-SOPHIA
https://doi.org/10.2105/ajph.91.9.1398
https://journals.iupui.edu/index.php/chia/article/view/21348 
https://journals.iupui.edu/index.php/chia/article/view/21348 
https://www.who.int/tools/health-impact-assessments
https://www.epa.gov/healthresearch/health-impact-assessments
https://hiasociety.org/Health-in-All-Policies2
https://www.epa.gov/laws-regulations/summary-national-environmental-policy-act 
https://www.epa.gov/laws-regulations/summary-national-environmental-policy-act 
https://www.energy.gov/nepa/downloads/national-environmental-policy-act-1969
https://www.who.int/publications/i/item/WHO-HPR-HEP-4ICHP-BR-97.4 
https://www.who.int/publications/i/item/WHO-HPR-HEP-4ICHP-BR-97.4 
https://www.energy.gov/nepa/downloads/national-environmental-policy-act-1969 
https://www.who.int/publications/i/item/9789241506908. 


Ten Years of SOPHIA Powers; Stone

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Appendix

INDIANA UNIVERSITY STUDY INFORMATION SHEET FOR RESEARCH

Ten Years of SOPHIA

You are being asked to participate in a research study. Scientists do research to answer 
important questions that might help change or improve the way we do things in the future.  This 
document will give you information about the study to help you decide whether you want to 
participate. Please read this form, and ask any questions you have, before agreeing to be in the 
study.

All research is voluntary.  You can choose not to take part in this study. If you decide to 
participate, you can change your mind later and leave the study at any time. You will not be 
penalized or lose any benefits if you decide not to participate or choose to leave the study later.

This research is intended for individual 18 years of age or older.  If you are under age 18, do 
not complete the survey.

This research is for residents of the United States.  If you are not a U.S. resident, do not 
complete the survey.

The purpose of this study is to gather information on the founding of the Society of Practitioners 
of Heath Impact Assessment (SOPHIA) and leadership over ten years. 

We are asking you if you want to be in this study because you are a past or current leader of SOHIA.  
The study is being conducted by Cynthia Stone and Gina Williams of IU Richard M. Fairbanks 
School of Public Health.

If you agree to be in the study, you will do the following things. Complete the survey or be 
interviewed. 

Before agreeing to participate, please consider the risks and potential benefits of taking 
part in this study. You may become uncomfortable with the questions. You can decline 
to answer or stop at any time. The interviews will inform SOPHIA members about the 
founding.

We don’t think you will have any personal benefits from taking part in this study, but we hope to 
learn things that will help SOPHIA in the future.

You will not be paid for participating in this study. There is no cost to participate in the 
study. 



Ten Years of SOPHIA Powers; Stone

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We will protect your information and make every effort to keep your personal information 
confidential, but we cannot guarantee absolute confidentiality. No information which could identify 
you will be shared in publications about this study. The recording will be stored on encrypted 
devices and destroyed after the analyses is complete. 

Your personal information may be shared outside the research study if required by law. We also 
may need to share your research records with other groups for quality assurance or data analysis. 
These groups include the Indiana University Institutional Review Board or its designees, and state 
or federal agencies who may need to access the research records (as allowed by law). 

If you have questions about the study or encounter a problem with the research, contact the 
researcher, Cynthia Stone at 317 278-0761 or cylstone@iu.edu.
For questions about your rights as a research participant, to discuss problems, complaints, or 
concerns about a research study, or to obtain information or to offer input, please contact the IU 
Human Research Protection Program office at 800-696-2949 or at irb@iu.edu.

Questionnaire:

Name______________________________________

Current position: _____________________________________

How long have you been conducting Health Impact Assessments? 

Check one

0-2 years

3-5 years

6-9 years

10 or more years



Ten Years of SOPHIA Powers; Stone

11

Your role in SOPHIA and years involved please complete all that apply

Role Starting year of role Ending year of role

President

Vice President

Board Member

General Member

Founding Member

How did you get involved with HIA work?

What topics or questions have you explored with your HIAs?

How did you get involved with SOPHIA? 

What do you know about the founding of SOPHIA and its initial goals, and how were you involved?

What were challenges you faced during your role in SOPHIA?

What benefits have you received from your activity with SOPHIA?

What advice would you have for those considering membership in SOPHIA?

What do you think are the most notable SOPHIA accomplishments in the first 10 years?

What do you think are the most important goals for SOPHIA during the next 10 years?  What next 
steps do you think are important?



Ten Years of SOPHIA Powers; Stone

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Anything else you would like to share?

Is there anyone else you think we should interview?

Thank you for your time.

CORRESPONDING AUTHOR
Cynthia Stone, DrPH, MSN, RN
Indiana University Purdue University Indianapolis
1050 Wishard Blvd. RG 6146
317-278-0761
cylstone@iu.edu

CHIA Staff:

Editor-in-Chief 
Cynthia Stone, DrPH, RN, Professor, Richard M. Fairbanks School of Public Health, Indiana 
University-Purdue University Indianapolis

Journal Manager 
Angela Evertsen, BS, Richard M. Fairbanks School of Public Health, Indiana University-Purdue 
University Indianapolis 

Chronicles of Health Impact Assessment Vol. 6 Issue 1 (2021) DOI: 10.18060/25658
© 2021 Author(s): Powers, G.; Stone, CL.
       This work is licensed under a Creative Commons Attribution 4.0 International License


