Health in All Policies

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Background
​Health in All Policies (HiAP) is gaining traction as an ecological policy approach to addressing public health’s most complex, multi-factor challenges, especially chronic disease and persistent inequities that harm health. Underlying this approach is the realization that a broad array of social and environmental determinants contributes to complex conditions. Local, state, and federal public health agencies are reorienting their services and programs to meet these challenges (see the Community Health Strategist model), but these efforts need a supportive policy environments to be effective. Since social and environmental determinants “live” in sectors other than public health – including education, transportation, finance, businesses, and justice – public health policy development needs to occur in all sectors. HiAP aspires to promote the consideration of the public’s health – including health equity – in every type of policy decision in every type of organization, so that any public or private entity with governance structures always takes health into account. ​​

New to HiAP? Start With These Foundational Resources:

> ASTHO & the California Endowment: Health in All Policies: A Guide for State and Local Government

​>  CDC: Health in All Policies Resource Center

​>  NACCHO: Health in All Policies in Local Health Departments

​>  National Academies: Health in All Policies: Improving Health Through Intersectoral Collaboration

​>  WHO: Health in All Policies Training Manual

Exploring HiAP in Colorado
With support from The Colorado Health Foundation, CALPHO explored what Health in All Policies (HiAP) looks like at a local level in Colorado. Throughout 2017 and early 2018 we compiled a library of resources, conducted interviews, analyzed survey data, and produced case studies that will further our understanding of HiAP’s community-level potential. Specifically, these activities revealed how HiAP is already practiced in Colorado’s counties, and enabled CALPHO to highlight successes that will inform the expansion of HiAP practice. 

Case Studies:

• The Power Building Long-Game: Lake County Build-a-Generation
• Local Public Health Partnerships with Non-Profit Hospitals: A Force for Health in All Policies
• Upstream Determinant as Rallying Cry: Mesa's Connectedness Initiative

Other Resources

• Economic Opportunity and Public Health
• 2017 HiAP Presentation at Public Health in the Rockies (with key informant interview results)

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CALPHO's Recommendations to Colorado LPHAs:

1. "Health in All Policies" may not be the right term for your needs. Cultivating partners in other sectors (a central element of HiAP) often requires public health to understand and adopt those sectors' priorities, and not "lead with health." Explicitly invoking HiAP when approaching new partners might make it harder to convince them that public health cares about their goals. 
2. Use the Community Health Assessment and Improvement process. These processes are often the primary community and partner engagement platform for LPHAs, and these activities are necessary for launching and sustaining a HiAP policy development approach. 
3. ​Make a map of relationships and power in your community. This understanding is critical to fostering cross-sector policy development. Community input and leadership during the mapping process will make the map more meaningful, and can be a powerful collective educational experience for those involved.