What we need to know about Health in All Policies (HiAP)?

Health in All Policies

Helsinki Statement on Health in All Policies 2013 stated that ”Health in All Policies is an approach to public policies across sectors that 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.”– Helsinki Statement on Health in All Policies 2013; WHO (WHA67.12) 2014. Contributing to social and economic development: sustainable action across sectors to improve health and health equity.

Important Documents for Health in All Policies (HiAP)

Adelaide Statement on Health in All Policies 2010 & 2017
The Helsinki Statement on Health in All Policies 2013
What we need to know about Health in All Policies (HiAP)?

Health equity is achieved when every person has the opportunity to “attain his or her full health potential” and no one is “disadvantaged from achieving this potential because of social position or other socially determined circumstances.” To improve equity in health (including in Universal Health Coverage) it is necessary to change the underlying distribution of the role of social determinants of health.

Impacts Health in All Policies :Example

One in eight deaths is linked to air pollution exposure – mostly from heart and lung disease, and stroke. To tackle air pollution, a health ministry cannot act alone. Collaboration is needed within many sectors:

• Household energy– works to ensure clean cooking, heating and lighting technologies are available in the home, It educates people about adopting clean fuels (liquid gas, ethanol),avoiding coal and kerosene use in the home, and cooking in areas with good ventilation.
• Energy – works to increase use of low-emissions fuels and renewable combustion-free power sources (like solar, wind or hydropower); adopt co-generation of heat and power; and distributed energy generation (e.g. mini-grids and rooftop solar power generation). Also works to reduce reliance on wood, diesel and coal generators, and protect against deforestation, occupational risks from coal mining and fumes from combustion of dirty fuels.
• Transport – works to prioritize urban transit, walking, cycling networks in cities so there is less reliance on vehicles. It works to shift technologies to cleaner heavy duty vehicles and low-emissions vehicles and fuels, including fuels with reduced sulfur and particle content.
• Urban planning – works to make cities more compact, and thus energy efficient.
• Housing – works to improve the energy efficiency of buildings through healthy and affordable construction standards.
• Waste Management – works reduce waste through separation, recycling and reuse or waste reprocessing; as well as improved methods of biological waste management such as anaerobic waste digestion to produce biogas.
• Industry – uses clean technologies that reduce industrial smokestack emissions and improves management of urban and agricultural waste, including capture of methane gas emitted from waste sites as an alternative to incineration (for use as biogas).
• Health Sector – works to connect all sectors. It tracks data on air-pollution related diseases and health gains from key interventions nationally and supports the energy-sector in needs-based assessments and fuel evaluations for the energy use of disadvantaged groups. The sector also advocates for policies to introduce clean technologies and reduce fuel poverty, and adopts renewable energy sources, especially in remote areas dependent on diesel generators.
• International – WHO sets guidelines, determines which interventions have the greatest impact, builds global databases to monitor global progress on health impact and advocates for clean air..
• Local, Regional and Country Municipalities – works to develop policies to reduce tobacco smoking and thus second hand smoke. They also set emission rate targets, approve planning codes and housing development and grant tax incentives energy efficiency certification schemes.
• NGOs, donors, civil society – works to provide access to improved cooking stores and helps fund initiatives for clean home energy technologies and fuels.

Overall, the health sector is the champion for health, driving dialogues to keep health on the agenda.

Why do governments/ societies need Health in All Policies?

Health in All Policies (HiAP) is based on the recognition that our greatest health challenges—for example, noncommunicable diseases, health inequities and inequalities, climate change, and spiralling health care costs—are highly complex and often linked through the social determinants of health. The social determinants of health are the circumstances in which people are born, grow up, live, work and age, and the wider set of forces and systems affecting these circumstances: e.g. economic and development policies, social norms, social policies, and political systems.

In this context, promoting healthy communities, and in particular health equity across different population groups, requires that we address the social determinants of health, such as public transportation, education access, access to healthy food, economic opportunities, and more. While many public policies work to achieve this, conflicts of interest may arise. Alternatively, unintended impacts of policies are not measured and addressed. This requires innovative solutions, and structures that build channels for dialogue and decision-making that work across traditional government policy siloes.

What roles do ministries of health play in HiAP?

WHO resolution WHA67.12 calls upon ministries of health ”to champion health and the promotion of health equity as a priority and take efficient action on social, economic and environmental determinants of health”. Although each country has its own political structure and forms of administration, the role of the health ministry or similar body at the national level, in relation to health in all policies usually includes work on health determinants that includes:

• Supporting the growth of scientific knowledge on health determinants;
• Identifying and prioritizing emerging health issues resulting from changes in society;
• Monitoring the activities of other sectors that impact on health;
• Creating structures and mechanisms for dialogue across government and with whole of society;
• Facilitating negotiations between sectors and with non-government stakeholders; and
• Overseeing the implementation, monitoring and evaluation of policy with respect to health outcomes, health determinants and equity.

Important Documents for Health in All Policies (HiAP)

• Adelaide Statement on Health in All Policies 2010 & 2017
• The Helsinki Statement on Health in All Policies 2013
• What we need to know about Health in All Policies (HiAP)?
• Health in All Policies: A Guide for State and Local Governments
• FINAL REPORT The 1st Global Meeting of the Global Network for Health in All Policies (GNHiAP) 2017
• Key Learning on Health in All Policies Implementation from Around the World Information Brochure
• PRACTISING A HEALTH IN ALL POLICIES APPROACH— LESSONS FOR UNIVERSAL HEALTH COVERAGE AND HEALTH EQUITY A policy briefing for ministries of health based on experiences from Africa, South-East Asia and the Western Pacific
• HEALTH IN ALL POLICIES TRAINING MANUAL
• Progressing the Sustainable Development Goals through Health in All Policies: Case studies from around the world
• Health in All Policies Toolkit – ASTHO