“Health in all policies” (HiAP) describes a framework intended to increase public officials’ accountability for health impacts at every level of public policymaking, including the consequences of budget and policy decisions on health systems, environmental sustainability, and social determinants of health — structural and community conditions that play a fundamental role in health outcomes. In order to effectively address these determinants, which include both structural factors, like the inequitable distribution of power and opportunity, and the environments of everyday life — where people are born, live, learn, work, play, worship, and age — HiAP approaches must incorporate an explicit emphasis on health equity. Health equity, as defined by the Robert Wood Johnson Foundation, means that everyone has a just and fair opportunity to be healthy.
A robust governmental commitment to HiAP, then, requires collaboration across sectors to address racial and social inequalities in housing, education, income, wealth, safety, and access to opportunities. Various departments, agencies, and community-based groups may not be accustomed to working with each other and may need to cultivate trust and understanding of the respective constraints under which they operate. Effective policies should include comprehensive guidance for public officials and staff throughout city government, as well as transparent tools for measuring results and accountability. Building on the recognition that the causes of poor health outcomes are multiple, complex, and interrelated, HiAP approaches can identify and remove obstacles to attaining and maintaining good health for historically underserved communities.
For more resources on HiAP, see the Prevention Institute and the Public Health Institute.