Health in All Policies

Health in All Policies (HiAP) is a data driven approach to solving health related issues through partnership and collaboration across sectors. This framework 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 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.

The HiAP framework can help people like state and local legislators, and school board members to identify the ways that policy decisions in sectors such as transportation, education, and housing may affect population health outcomes.

Implementation Strategies

  1. Developing and structuring cross-sector relationships
  2. Incorporating health into decision-making processes
  3. Enhancing workforce capacity
  4. Coordinating funding and investments
  5. Integrating research, evaluation, and data systems
  6. Synchronizing communications and messaging and
  7. Implementing accountability structures

Case Studies

Three states have enacted legislation that requires an assessment of potential health impacts for certain decisions or projects.

Massachusetts

Officials established a process for assessing the impact of transportation projects on “public health and vulnerable populations.”

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.

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

Incorporated a HiAP 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.

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