Health in All Policies

Health in All Policies (HiAP) was a term first used in Europe during the Finnish presidency of the European Union (EU), in 2006, with the aim of collaborating across sectors to achieve common goals. It is a strategy to include health considerations in policy making across different sectors that influence health, such as transportation, agriculture, land use, housing, public safety, and education. It reaffirms public health's essential role in addressing policy and structural factors affecting health, as articulated by the Ten Essential Public Health Services, and it has been promoted as an opportunity for the public health sector to engage a broader array of partners.

The 1978 World Health Organization (WHO) declaration of Alma-Ata was the first formal acknowledgment of the importance of intersectoral action for health. The spirit of Alma-Ata was carried forward in the Ottawa Charter for Health Promotion (adopted in Ottawa in 1986), which discussed "healthy public policies" as a key area for health promotion.

HiAP is built on the rationale that health is determined by multiple factors outside the direct control of the health care sector, such as education, income, and the conditions in which people live, work, and play. Decisions made in other sectors can positively or negatively affect the determinants of health. HiAP is an approach to policy making in which decision-makers in other sectors routinely consider health outcomes, including benefits, harms, and health related-costs.

HiAP has also been described as an essential component of primary health care. HiAP has been most commonly implemented by federal, state and local governments, but it can also be applied to both private and non-profit policy-making.

HiAP builds off the concepts embedded in "healthy public policies" and "intersectoral action for health," promoted over the past four decades. The spirit of Alma-Ata was carried forward in the Ottawa Charter for Health Promotion (adopted in Ottawa in 1986), which discussed "healthy public policies" as a key area for health promotion. Increased attention to the role of non-health sectors in promoting health continued to grow with discussions held at the Second International Conference on Health Promotion in Adelaide, Australia in 1988. In 2007, HiAP was recommended by Adelaide Thinker in Residence Ilona Kickbusch as a new approach to health and governance in South Australia.

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