Health in All Policies (HIAP) is an approach to policymaking that introduces health-related aspects into virtually any public policy. HIAP aims to account for health implications in any public decision making process, to seek synergies and to avoid harmful health impacts, in order to improve population health and health equity.
One example from the WHO is deaths linked to air pollution, which represent 1 out of 8 of all deaths globally. Health ministries cannot tackle the problem alone. Rather, cooperation with relevant stakeholders in the sectors of energy supply (especially household energy), transport, urban planning and housing is required to address the issue. Further interactions with stakeholders in waste management; major industrial producers; the healthcare sector; international, national, regional, and local authorities; and NGOs is needed to affect the current mortality numbers in the future. Looking beyond air pollution, it is clear that HIAP is the answer to major modern health challenges: non communicable diseases, health inequity, climate change and the spiraling healthcare costs.
HIAP shall be employed to integrate health-related policy elements into data-related policies. Some have such elements in place at national levels, but no comprehensive framework has been developed so far. Hence, the links between health, economic, demographic, educational and other data must be strengthened. The WHO states that the subsets of indicators on health determinants need constant surveillance.
At national levels, the cooperation of the Health Ministries’ Centers of Digital Competence / Digitisation may monitor the legislation to formulate health-related edits. Ministries of Health can also extend existing health promotion and primary prevention portfolios by interacting with various stakeholders in multi-sectoral and intersectoral formats.
The WHO considers health promotion and primary preventions of particular importance. WHO has developed an overall guidance for countries developing Health in All Policies, termed the Framework for Country Action Across Sectors for Health and Health Equity.
One of the HIAP practical implementations is Health Impact Assessment (HIA). It is a systematic process that enables the application of HIAP in the real world by facilitating the evaluation of health effects on policy. It is a cross-disciplinary activity that employs quantitative and qualitative methods. HIA usually consists of four to six stages, some of which may include screening, scoping, appraisal, reporting and monitoring. This tool may be used along with other assessment methods, such as risk assessment and cost-benefit analysis.
HIAP approach is grounded in the following principles:
Legitimacy grounded in the rights and obligations conferred by national and international law
Accountability of governments towards their people
Transparency of policy-making and access to information.
Participation of wider society in the development and implementation of government policies and programmes.
Sustainability in order that policies aimed at meeting the needs of present generations do not compromise the needs of future generations.
Collaboration across sectors and levels of government in support of policies that promote health, equity, and sustainability.
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