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Triple Aim: Implementing a 'health in all policies' approach with health equity as the goal

By taking a broader view of what creates health, we can better understand how policies related to transportation, housing, education, public safety or environmental protection can affect health outcomes. The state health agencies can begin to address these factors by taking a “health in all policies” (HiAP) approach that encourages working across sectors to implement policies that broadly affect health in a variety of ways. For example, health departments could partner with transportation department to implement health impact assessments (HIA) that ensures new transportation projects are evaluated based on their health implications (such as walkability and safety), in addition to more traditional transportation metrics.

Examples of actions that could advance this objective:

  • Collaborate with at least one non-health sector partner to implement a HiAP approach to a specific policy initiative
  • Require bills or funding announcements to include a requirement analyzing impact on health equity

ASTHO Resources

Health in All Policies

Health in All Policies (HiAP) requires public health practitioners to collaborate with other sectors and levels of government/organizations to define and achieve mutually beneficial goals by integrating health considerations into policy making and programming to improve the health of all communities and people. See ASTHO’s Health in All Policies page, which includes:

Environmental Health in All Policies

ASTHO has developed a series of topic-specific, evidence-based policy guides to promote HiAP in areas related to Environmental Health. See these and state success stories in implementing these policies on ASTHO’s Environmental Health in All Policies page, which includes:

Infectious Disease Prevention for Hard-to-Reach and At-Risk Populations

ASTHO's Infectious Disease At-Risk Populations Project
Some individuals are at increased risk of suffering severe consequences during an influenza pandemic and may need special assistance to maintain basic medical care, as well as access to food and shelter. These fact sheets and guides describe state/territorial health agency strategies and partnerships to reach at-risk populations.

Mitigating Influenza in Vulnerable Populations
Materials to help state health agencies improve influenza outcomes among vulnerable populations such as pregnant women and racial-ethnic minorities, including tribes.

Public Health and Faith Community Partnerships: Model Practices to Increase Influenza Prevention Among Hard-to-Reach Populations
Designed for both public health and religious leaders, this guide aims to strengthen partnership-building capacity and enhance public health's ability to reduce the spread of influenza.

Additional Resources

Guides and General Resources

Health in All Polices - CDC
Resources from CDC on implementing a health in all policies approach at all levels of public health.

WHO Health in All Policies Training Manual
This manual is a training resource to increase understanding of the importance of Health in All Policies among health and other professionals

Evaluation of Health in All Policies: concept, theory and application
An international evaluation of the Health in All Policies framework, highlighting issues within it and how it can be approved upon.

Health in All Policies FAQ
Developed by NACCHO.

Health in All Policies - NACCHO
NACCHO’s HiaP resources page.

Health in All Policies: A Guide for State and Local Government
An in-depth guide to how state officials can go about implementing these policies; developed by the Public Health Institute.

Whole School, Whole Community, Whole Child
Resources from CDC on collaboration between the education and health sectors to improve child health and development

Case Studies

Health in All Policies for Big Cities
An example of how to implement Health in All Policies in big cities in order to improve health overall and in specific communities.

Local Health Department Strategies for Implementing Health in All Policies
Examples of HiaP strategies for local health departments; developed by NACCHO.

Richmond, California Health in All Policies Report
A local health department’s work in health in all policies.

Making the Business Case: Community Health Investments Yield Results
Video highlighting the positive impacts of CDC's community health efforts across the country.

Promoting Health Equity – The Community Guide
Systematic reviews of interventions to reduce health inequities through education programs and policies, culturally competent healthcare, and housing programs and policies.

California HiAP Task Force Executive Summary
Health in All Policies Task Force Report to the Strategic Growth Council Executive Summary, Sacramento (CA): Health in All Policies Task Force, December 2010.

Health in All Policies: Seizing Opportunities, Implementing Policies
An international report on HiaP from the Finnish Ministry of Social Affairs and Health.

Framework for country action across sectors for health and health equity
A 2014 WHO discussion paper on health action across sectors.

 

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