Health in All Policies (HiAP) is a data driven approach to solving health related issues through partnership and collaboration across sectors.
Health in All Policies or HiAP is a collaborative approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts, in order to improve population health and health equity. The HiAP framework employs tools such as Health Impact Assessments (HIA) and Health Lens Analysis to identify the ways that policy decisions in sectors such as transportation, education, housing, and regional planning may affect population health outcomes.
The goal of the HiAP approach is to provide decision makers, such as state and local legislators and school board members, with data on the potential positive and negative impacts of their decisions on health outcomes, health equity, and healthcare costs so they can make better policies and decisions to minimize risks and maximize health benefits.
- Developing and structuring cross-sector relationships
- Incorporating health into decision-making processes
- Enhancing workforce capacity
- Coordinating funding and investments
- Integrating research, evaluation, and data systems
- Synchronizing communications and messaging and
- Implementing accountability structures
Health in All Policies (HiAP) Approach to Lead Poisoning Prevention Webinar
Hosted by NEHA and NCHH, Komal Sheth of the Houston Health Department’s discusses the city’s work on reducing childhood lead poisoning and asthma trigger abatement through the use of a Health in All Policies approach.
2019 Health in All Policies Mini-Grants
NEHA, in collaboration with the National Center for Healthy Homes (NCHH), the National Association of County and City Health Officials (NACCHO), and the Association of State and Territorial Health Officials (ASTHO), is supporting three local governmental health agencies to implement a Health in All Policies strategy as part of their lead prevention implementation program and activities. This effort is supported through cooperative agreements with Centers for Disease Control and Prevention's National Center for Environmental Health. Three organizations were selected to receive a package consisting of a $20,000 mini-grant and up to six months of technical assistance. The purpose of these grants is to advance local efforts to reduce lead exposure and its effects and build capacity to use a Health in All Policies approach for future efforts.
The health of communities is affected by policies and practices not only in the public health and health care arenas, but across diverse sectors such as housing, land-use and planning, transportation, public safety, education, economic and community development, and environmental protection. These policies and practices shape our environment and the conditions in which we live, work, learn and play, impacting our health and well-being directly as well as indirectly by influencing our health-related behaviors.
Examples from States
Three states have enacted legislation that requires an assessment of potential health impacts for certain decisions or projects. Massachusetts, for example, has established a process for assessing the impact of transportation projects on “public health and vulnerable populations.” In Washington, a 2006 law authorized state legislators and the governor to request that the state board of health review legislative or budgetary proposals to consider how they would affect social determinants of health and health disparities.
Taking a different approach, California Gov. Arnold Schwarzenegger issued an executive order in 2010 establishing a Health in All Policies Task Force made up of representatives from 19 state agencies. The California Department of Public Health facilitates this task force which issued cross-sector recommendations for improving health through active transportation, healthy housing, green space, violence prevention and healthy food access.
Michigan has incorporated a Health in All Policies approach in its Health and Wellness 4X4 Plan, which brings together the departments of Health, Agriculture and Rural Development, Transportation, Human Services, Natural Resources, and Economic Development to promote healthy behaviors, and through the Community Health Innovation Regions that are being implemented as part of Michigan’s State Innovation Model (SIM) plan.
Health in All Policies Articles and Statements
HiAP and Implementation
- The implementation of Health in All Policies initiatives: a systems framework for government action
- Health Impact Assessment in New South Wales & Health in All Policies in South Australia: differences, similarities and connections
HiAP and Evaluation
Health in All Policies Tools, Resources, and Manuals
- Health in All Policies in General Plans, Change Lab Solutions
- SOPHIA HIAP Approaches Guide: Finding the Mix of Strategies that Fits Your Needs, Society of Practitioners of Health Impact Assessment
- Health in All Policies Report: Experiences from Local Health Departments, National Association of County and City Health Officials
- How to Permanently Improve Government through Health in All Policies, Change Lab Solutions
- HiAP Fact Sheet, National Center for Healthy Housing
- Health in All Policies Resource Center, Centers for Disease Control and Prevention
- The “Health and Equity in All Policies” approach to decision making, Health Policy Institute of Ohio fact sheet, 2015
- Health in All Policies: A Guide for State and Local Governments, American Public Health Association
- The business case for healthy development and Health Impact Assessments, Health Resources in Action, 2015
Health in All Policies Community Integrators and Backbone Organizations
- Community integrators and backbone organizations, Health Policy Institute of Ohio fact sheet, 2015
- Collective impact, the Greater Cincinnati Foundation
- Understanding the value of backbone organizations in collective impact, FSG Collective Impact Forum, 2014
- Integrator role and functions in population health improvement initiatives, Nemours, 2012
Health in All Policies at State and Local Level
- Resolution: Health Equity in all Policies Approach to Decision Making, Genesee County Board of Health
- HiAP Toolkit, Kent County Health Department
- Health in All Policies and Practice, Madera County Department of Public Health
Health in All Policies Health Equity
- Building Public Health Capacity to Advance Equity from the National Collaborative for Health Equity explores governmental public health’s role in advancing health equity with racial equity as a major priority and community engagement as a central strategy.
- The Health Equity Leadership & Exchange Network (HELEN) bolsters leadership and the exchange of ideas and information among health equity champions relative to the advancement of equity in health laws, policies, and programs.
- Promoting Health and Cost Control in States: How States Can Improve Community Health & Well-being Through Policy Change from the Trust for America's Health (TFAH) strengthens officials' capabilities by highlighting evidence-based and informed policies that can improve health and well-being in their states.