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Tatiana Lin, M.A.; Wyatt Beckman, MPH, CHES; Vicki Collie-Akers, PhD, MPH

GUEST LECTURES: INCREASING STUDENT KNOWLEDGE OF 
HEALTH IN ALL POLICIES BY USING THE

HEALTH IMPACT CHECKLIST



Guest Lectures: Increasing Student Knowledge of Health in All Policies Lin; Beckman; Collie-Akers

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Setting for Guest Lectures
The University of Kansas Medical Center 
(KUMC) Department of Population Health is 
home to the University of Kansas MPH program, 
which is the first and longest-standing MPH 
program in Kansas. The program has two 
concentrations: public health practice and 
epidemiology. In addition, the University of 
Kansas Edwards Campus (KU-E) has a newly 
launched, fully online generalist Master of 
Public Health program. The MPH curriculum 
consists of a series of core classes required for 
all concentrations and a set of concentration-

specific classes. A core 
class required for all 
students, regardless of 
concentration, is PRVM 
804: Community Health 
Assessment, Intervention, 
and Advocacy. Average 
class enrollment is 20 
students. The course 
is divided into three 
sections: understanding 
and assessing factors 
which drive health in 
communities, using 
theory- or evidence-based 

approaches for intervention, and advocating for 
community health improvement. 

Curriculum for Guest Lectures
The guest lecture curriculum was built upon 
KHI’s decades-long experience in HiAP efforts 
and was tailored to a virtual setting due to 
COVID-19 risk mitigation policies (including a 
campus shut-down in spring 2020 and a policy 
restricting guest access to campus in fall 2021). 
Since 2010, KHI has completed six health 
impact assessments, developed a workbook, 
delivered trainings, created the HI-C tool and 
provided technical assistance to communities 
across Kansas and nationally. 

Introduction
Evidence-based information, objective analysis 
and civil dialogue can position policy leaders 
to become effective champions for healthy 
communities. Given that young people have 
a significant role to play in transforming 
communities, the Kansas Health Institute 
(KHI) has a goal of collaborating with academic 
institutions to build student capacity in 
recognizing, assessing and communicating the 
health and equity impacts of policies.    

To accomplish this goal, KHI began collaborating 
with the Department 
of Population Health 
at the University of 
Kansas School of 
Medicine (KUMC) in 
2020 to provide one 
guest lecture a year 
to Master of Public 
Health (MPH) students 
enrolled in the PRVM 
804 Community 
Health Assessment, 
Intervention, and 
Advocacy class. As 
of October 2022, KHI 
has delivered two guest lectures. The guest 
lectures introduced students to Health in All 
Policies (HiAP) concepts and ways to examine 
potential positive and negative health and equity 
implications of policies by using the Health 
Impact Checklist tool, which is also referred 
to as HI-C. A seven-question Qualtrics survey 
was developed and administered following 
each lecture to assess student perception of 
the lecture and its effectiveness. Additionally, 
following the 2021 presentation, students were 
asked about ways they could implement HiAP 
approaches in their MPH studies, with results 
immediately shared for all to review using Poll 
Everywhere.  

HiAP is a collaborative approach 
that integrates and articulates 

health and equity considerations 
into policy making and 

programming across sectors, and at 
all levels, to improve the health of all 

communities and individuals. 

-Association of State and Territorial 
Health Officials (ASTHO)

https://www.khi.org/articles/2020-hi-c-health-impact-checklist/
https://www.khi.org/articles/2020-hi-c-health-impact-checklist/


Guest Lectures: Increasing Student Knowledge of Health in All Policies Lin; Beckman; Collie-Akers

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The lectures aimed to achieve the following 
outcomes:

1. Advance student understanding of the 
HiAP framework.

2. Increase student ability to identify strate-
gies to implement HiAP.

3. Increase student understanding of poten-
tial health impacts of policies by partici-
pating in a structured activity to complete 
sections of the HI-C. 

To achieve these outcomes, the class time 
in each guest lecture was divided into two 
sections: an introduction to HiAP and a 
small-group activity. Each section included a 
discussion and a question-and-answer session. 

Introduction to HiAP Introduction to HiAP 
The introduction set the foundation for the 
small-group activity and covered potential 

reasons for adopting an HiAP approach, as 
well as the definition and principles of HiAP 
practice. The HiAP principles described were 
those identified in the Association of State 
and Territorial Health Officials (ASTHO) report 
Health in All Policies: Framework for State Health 
Leadership. 

The introduction also described several 
strategies for implementing HiAP principles, 
including HiAP resolutions and ordinances, HiAP 
meetings, cross-sector partnerships around 
specific projects, ways to incorporate health 
and equity considerations into requests for 
proposals and  strategic plans, and conducting 
content analyses of key documents that 
establish a vision for the community from 
an HiAP perspective. For each example, the 
speaker demonstrated which HiAP principles 
were met (Figure 1). 

Figure 1. Example of HiAP Strategy and Alignment with HiAP Principles, from 
Lecture Slide Deck



Guest Lectures: Increasing Student Knowledge of Health in All Policies Lin; Beckman; Collie-Akers

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Following the introduction to HiAP section, 
students participated in a discussion centered 
on these questions: 

• Reasons for using HiAP: What other 
approaches can be used to describe why 
health should be part of the decision-
making process? What questions or push 
back do you anticipate? 

• HiAP strategies: Of the examples 
discussed during the session, which seem 
feasible for your county or community to 
implement? 

Health Impact Checklist Small-Group Activity
The HI-C was developed by KHI and designed 
to inform decisions at many levels (e.g., 
organization, city, county and state). The HI-C 
builds on existing tools, such as Health Notes 
from the Health Impact Project, the Health Lens 
Checklist from Kent County, Michigan, and the 
Health in All Policies: Health Lens Analysis Tool 
from Tacoma-Pierce County Health Department 
in Washington state. The small-group activity 
section of the curriculum guided students 
in identifying potential social, economic 
and environmental impacts of policies, how 
those policies could impact health, and which 
populations may be particularly impacted. 
Students accomplished this by collaboratively 
completing and discussing key sections of 
the HI-C. For these classroom exercises, two 
example policies were pre-identified by the KHI 
instructors. Students in one lecture reviewed 
a county-level nuisance abatement policy 
while students in the other lecture reviewed a 
municipal policy preventing suspension of utility 
service disconnections in response to COVID-19. 
For both policies, KHI had previously completed 
examples of HI-C which supported facilitating 
the classroom activities. 

Students in the guest lecture were collectively 
asked to complete questions 1 and 2 from the 

HI-C tool by naming the policy, decision or 
proposal being evaluated and describing its 
main goals or key points. Students were then 
randomly placed in two virtual breakout groups 
facilitated by KHI to discuss and collectively 
complete question 3 and 5 from the HI-C. For 
question 3, the students used the table shown 
in Figure 2 on page 5 to identify potential 
social, economic and environmental conditions 
that could be impacted if the proposal were 
implemented. For question 5, students used 
their knowledge and experience to describe the 
potential impacts of the proposal on each of the 
conditions they identified. For example, if they 
identified “housing quality” as a condition which 
may be impacted by the nuisance abatement 
policy, students would then think through how 
changes to housing quality stemming from the 
policy may impact health. After 10 minutes, the 
breakout sessions ended and groups reported 
to the class on their discussion. 

Students then returned to their breakout groups 
to complete question 6 of the HI-C which 
asked them to identify the specific populations 
which might be impacted by the policy for each 
identified social, economic or environmental 
condition (Figure 3 on page 5). The breakout 
groups completed this activity and then 
reported back to the class after 10 minutes. 
The session concluded with an overview of the 
remaining components of the HI-C, examples 
of other HiAP resources, and time for questions 
and discussion.



Guest Lectures: Increasing Student Knowledge of Health in All Policies Lin; Beckman; Collie-Akers

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Social, Economic, and Environmental Conditions 1,2

Economic Stability Neighborhood & Physical 
Environment Education

 � Employment  � Housing Quality  � Early Childhood Education 
and Development

 � Income  � Transportation  � High School Graduation

 � Housing Instability/
Homelessness

 � Environmental 
Conditions(e.g., water, air, 
and soil quality)

 � Higher Education

 � Food Insecurity  � Access to Healthy Food  � Language

 � Poverty  � Safety  � Literacy

 � Other:  � Other:  � Other:

 � Other:  � Other:  � Other:

Community and Social 
Context Health and Health Care

Note: The number of social, 
economic, or environmental 
conditions examined 
could depend on available 
resources, stakeholder 
interest and timeline. After 
examining three, additional 
conditions may be examined 
further.

 � Civic Participation  � Health Coverage

 � Discrimination  � Provider Availability

 � Toxic Stress  � Access to Health Care

 � Social Isolation  � Access to Behavioral Health 
Services

 � Incarceration  � Quality of Care

 � Other:  � Other:

 � Other:  � Other:

Figure 2. Table of Social, Economic and Environmental Conditions, from HI-C

Figure 3. Table for Identifying Health Impacts for Specific Populations, from HI-C

Social, Economic, 
or Environmental 

Condition

Impacted 
Population Impact on Health Overall Impact on 

Health

 � Positive
 � Negative
 � Mixed
 � None
 � Unclear



Guest Lectures: Increasing Student Knowledge of Health in All Policies Lin; Beckman; Collie-Akers

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Lessons Learned
To assess student perception of the lecture 
and its effectiveness, students were asked to 
complete a short online survey. The survey 
questions focused on assessing changes in 
student understanding of HiAP, Health Impact 
Assessments, connections between policies and 
health, and potential impacts that policies could 
have on populations. Students also rated the 
lecture in terms of its quality and effectiveness. 
Across both lectures, 15 students completed 
the survey. Overall, the survey results showed 
that students found the sessions increased their 
understanding of HiAP and that the HI-C group 

activity contributed to their understanding 
of how policies may impact health through 
modifying social determinants of health. In 
addition, several students suggested focusing 
more time on a small-group activity, peer-
sharing from each group and working through 
policy scenarios, while spending less time on 
lecture material. 

While solidifying the overall concepts of 
HiAP, the group activity provided a valuable 
opportunity for the students to make 
connections between policy changes and 
health impacts. Importantly, the group activity 
facilitated interaction between students and 

allowed them to see potential impacts and 
implications they had not considered. Taken 
together, the introduction to HiAP and the 
course activity supported further utilization 
of, and engagement with, HiAP approaches in 
other areas of their academic study and future 
professional work.  

Discussion
Fostering student understanding and 
competence related to Health in All Policies is 
an important element of MPH education. MPH 
programs are designed to prepare students 
to skillfully fulfill the mission of promoting 
and protecting the health of the public. The 
growing focus on Public Health 3.0 and HiAP 
necessitates inclusion of related content to 
ensure students are well-prepared to engage 
in cutting-edge public health practice and 
research. 

At KUMC, integrating content related to 
HiAP practices and approaches enables this 
preparation and supports development of 
skills and competencies directly related to 
the foundational competencies of the MPH 
program. For a public health institute such 
as KHI, partnering with KUMC through these 
lectures to support public health training and 
engagement with HiAP helps advance the vision 
of healthier Kansans through effective policy. 
KHI continues to support utilization of the 
HI-C tool through technical assistance. These 
lectures offer opportunities to refine KHI’s 
teaching and resources for HiAP and the HI-C.

It was nice to be challenged to think 
differently and to work through the 

process with an example. 
-Student 



Guest Lectures: Increasing Student Knowledge of Health in All Policies Lin; Beckman; Collie-Akers

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References
Association of State and Territorial Health Officials. (2020). Health in All Policies. http://www.astho.org/

Programs/HiAP.

Association of State and Territorial Health Officials. (n.d.). Health in All Policies: Framework for State Health 
Leadership. http://www.astho.org/health-in-all-policies-framework.pdf

Kansas Health Institute. (2020). HI-C: Health Impact Checklist; HI-C: Suspension of Disconnections of 
Utility Services due to COVID-19 (Hutchinson, Reno County); HI-C: Dangerous and Unfit Structures 
Ordinance – Chapman, KS; and HI-C: Environmental Nuisance Abatement – Linn County. https://www.
khi.org/articles/2020-hi-c-health-impact-checklist/

CORRESPONDING AUTHOR
Tatiana Lin
Kansas Health Institute
212 SW Eigth Ave., Suite 300
Topeka, KS 66603
tlin@khi.org

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. 7 Issue 1 (2022) DOI: 10.18060/26481
© 2022 Author(s): Lin, T.; Beckman, W.; Collie-Akers, V.
       This work is licensed under a Creative Commons Attribution 4.0 International License

http://www.astho.org/Programs/HiAP
http://www.astho.org/Programs/HiAP
http://www.astho.org/health-in-all-policies-framework.pdf
https://www.khi.org/articles/2020-hi-c-health-impact-checklist/
https://www.khi.org/articles/2020-hi-c-health-impact-checklist/

