‘Health in All Policies’ and the Urge for Coordination: The Work of Public Health Coordinators and Their Impact and Influence in Local Public Health Policies: A Cross-Sectional Study

Building heavily on the Health in All Policies (HiAP) approach, Norway implemented the Public Health Act in 2012 to reduce social inequalities in health. Local public health coordinators (PHCs) at municipal levels were seen as tools to provide local intersectoral public health work. In this study, we examine factors related to intersectoral agency and if intersectoral work is understood as relevant to securing social justice in local policy outcomes. A national web-based survey in 2019 of all Norwegian PHCs (n = 428) was conducted with a response rate of 60%. Data were analysed through multiple linear regression, hierarchical regression modelling and structural equation modelling. Neither factors relating to community contexts nor individual characteristics were associated with intersectoral agency. Organisational factors, especially position size, being organised at the top level and having a job description, were significantly associated with perceptions of intersectoral agency. PHCs seeing themselves as intersectoral agents also found themselves able to affect annual budgets and policy outcomes. We conclude that municipal PHC positions can be important HiAP tools in local public health policies. However, organisational factors affect how PHCs perceive their influence and role in the municipal organisation and thereby their possibilities to influence local policymaking through intersectoral agency.

“Health in All Policies” Approach and Health Impact Assessment in Russia and the world

This study presents analysis of the international and Russian experience of implementation of “health in all policies” approach into legislation, as well as of health impact assessment. Certain steps towards the implementation of this approach have already been made in Russia, however, in general, there is still a lot to be done. It was revealed that the current system regulatory impact assessment (RIA) in Russia has a narrow focus and is focused on protecting the interests of business, which does not correspond to the well-established world practice, which presupposes complex RIA, including the impact of regulation on public health. Recommendations for strengthening the principle of “health by all policies” in Russian legislation and the introduction of the practice of assessing the regulatory impact on public health in Russia are presented.

Applying Salutogenesis in Towns and Cities

This chapter casts light on how cities can facilitate good health through urban planning, design and organisation, and collaboration between multiple sectors. The way we organise cities is one aspect of the social determinants of health and can manifest or balance several aspects of social injustice. This chapter focuses on matters of planning and maintaining infrastructure, including transportation systems, green spaces and walkability, as well as matters of environmental justice across cities. Moreover, it is discussed how a Health in All Policies (HiAP) approach can be implemented at the city level, and in which ways the World Health Organization’s (WHO’s) Healthy City Network contributes to this work. The authors take a closer look at the evaluations of HiAP, as well as the Healthy Cities approach, and to what degree they facilitate long-lasting cross-sector collaboration. Last, it is discussed whether and how a salutogenic orientation can link places and environmental resources to health outcomes, and explore the implications of this approach for salutogenic practice and research.

Updating the Minimum Elements and Practice Standards for HIA to Reflect Evolution in the Field of Practice

The Minimum Elements and Practice Standards for Health Impact Assessment (MEPS) outline the minimum elements that need to be addressed for a study to be considered a health impact assessment (HIA), as well as best practices for how an HIA should be conducted. The document was originally created by a group of leading HIA practitioners in 2009. Since then, it has been updated twice to reflect the evolution of HIA as a practice and the expanded use of HIA as a tool to implement health in all policies. This commentary describes current efforts to revise the MEPS—the first update in six years.

Gesundheit und soziale Lage in Hamburger Quartieren – Ein Ansatz zur Abbildung von Soziallagen mit gesundheitsbezogenen Routinedaten

Zusammenfassung Ziel der Studie Ziel ist die Erprobung eines innovativen Ansatzes zur kleinräumigen und soziallagensensitiven Verortung und Analyse von gesundheitsbezogenen Routinedaten. Dazu werden GKV-Abrechnungsdaten und Einsatzdaten des Rettungsdienstes um einen kleinräumigen quartiersbezogenen Indikator für die soziale Lage des Wohn- und/oder Einsatzortes als Proxy für die persönliche soziale Lage ergänzt. Methodik Genutzt werden anonymisierte Abrechnungsdaten von drei gesetzlichen Krankenkassen und Einsatzdaten des Rettungsdienstes der Hamburger Feuerwehr, jeweils aus dem Jahr 2017. Die soziale Lage des Wohnortes der Versicherten bzw. transportierten Personen (bei den Rettungsdienstdaten zusätzlich des Einsatzortes) wurde mithilfe sogenannter Statusindexklassen (hoch – mittel – niedrig – sehr niedrig) des Hamburger Sozialmonitorings abgebildet. Die Zuordnung über die Anschriften der betroffenen Personen erfolgte mithilfe eines im Projekt entwickelten Zuordnungsverfahrens durch die jeweiligen Dateneigner. Ergebnisse Exemplarisch zeigen Ergebnisse deskriptiver Auswertungen zu Unfallgeschehen und akutstationärer Versorgung von Kindern und Jugendlichen, dass sich bekannte Soziallagenabhängigkeiten aus Primärstudien auch in den genutzten Sekundärdaten abbilden lassen. Dies spricht für die Eignung des Sozialindikators z. B. im Rahmen einer erweiterten Sozial- und Gesundheitsberichterstattung. Schlussfolgerung Der verwendete quartiersbezogene Indikator scheint vielversprechend und sollte in weiterführenden Analysen einer Validierung unterzogen werden. Darauf aufbauend können Ansätze zu dessen Verwendung im Rahmen der Versorgungsforschung und Gesundheitsberichterstattung entwickelt werden ebenso wie im Sinne einer umfassenden Health-in-all-Policies-Strategie für eine gesundheitsförderliche und bedarfsgerechte Gestaltung von politischen Entscheidungen und Programmen.

Applying Health in All Policies at the University of Wisconsin-Madison

The University of Wisconsin-Madison’s (UW-Madison) response to the COVID-19 pandemic demonstrates how prioritizing health in campus policies is necessary to achieve better health, educational, and workforce outcomes. COVID-19 cases increased on campus as students attended in-person classes at the beginning of the 2020-21 academic year, though dampened as the university ramped up protective measures. Harm may have been prevented had proactive and analytical approaches to policy making, which are foundational to a Health in All Policies (HiAP) approach, been implemented sooner. Specifically, comprehensive and rapid Health Impact Assessments could enhance university leadership’s ability to mitigate the negative effects of existing and future policies. Here, we recognize the COVID-19 pandemic as a justifiable catalyst for implementing a HiAP approach in UW-Madison policymaking. We recommend that the university establish a HiAP subcommittee within the Division of Diversity, Equity & Educational Achievement. This action standardizes the use of tools essential to HiAP across campus while limiting the demand on existing university committees and other administrative offices.

Health in all Policies – Prävention in allen Lebensbereichen denken!

Innungskrankenkassen positionieren sich zur Bundestagswahl 2021/Verpflichtung zur Einhaltung von Gesundheitszielen für alle Politikbereiche über ein Gesundheitsschutzgesetz/Klärung von Zuständigkeitsbereichen und Finanzierungsverantwortung

‘Health in All Policies’—A Key Driver for Health and Well-Being in a Post-COVID-19 Pandemic World

Policy in all sectors affects health, through multiple pathways and determinants. Health in all policies (HiAP) is an approach that seeks to identify and influence the health and equity impacts of policy decisions, to enhance health benefits and avoid harm. This usually involves the use of health impact assessment or health lens analysis. There is growing international experience in these approaches, and some countries have cross-sectoral governance structures that prioritize the assessment of the policies that are most likely to affect health. The fundamental elements of HiAP are inter-sectoral collaboration, policy influence, and holistic consideration of the range of health determinants affected by a policy area or proposal. HiAP requires public health professionals to invest time to build partnerships and engage meaningfully with the sectors affecting the social determinants of health and health equity. With commitment, political will and tools such as the health impact assessment, it provides a powerful approach to integrated policymaking that promotes health, well-being, and equity. The COVID-19 pandemic has raised the profile of public health and highlighted the links between health and other policy areas. This paper describes the rationale for, and principles underpinning, HiAP mechanisms, including HIA, experiences, challenges and opportunities for the future.