Health in All Policies (HiAP) is a way of working with policy makers in other sectors that aims to build the social, economic and physical conditions that support good health and prevent health inequalities. Healthy Lives, Fairer Futures, the call to action from the Committee of the Faculty of Public Health in Scotland, calls for a strong commitment to this approach to ensure that all public policies help everyone in Scotland to realise their Right to Health. As partnerships in several areas of Scotland are using HiAP, several colleagues attended a workshop in early December to share our experiences. The workshop was organised by the Scottish Health and Inequalities Impact Assessment Network, which is part of the Scottish Public Health Network.
WHO describes Health in All Policies as ‘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’. In public health we often work with partners to address defined public health priorities. HiAP differs from this because the starting point is a proposed policy and the aim is to identify all the likely effects on health, rather than focusing on one priority issue. This can help identify how to achieve the best overall health outcome from the policy. It often involves a formal approach like Health Impact Assessment, integrating health into other assessments or using other tools. The approach fits well with Scotland’s National Performance Framework, which places Wellbeing as a central purpose of government and recognises the contribution of the other national outcomes to that purpose.
Participants at the workshop shared their experiences of HiAP so far and discussed what is needed to develop and support this work. The group recognised that HiAP should be based on good working relationships and an openness to build understanding of constraints and opportunities in all policy areas. Every local authority area in Scotland has a Community Planning Partnership that brings together public, private and third sectors to agree how to meet the needs of their communities. These are an excellent platform for HiAP and other forms of partnership working and some Community Planning Partnerships have now developed formal governance structures to support HiAP in their areas. We also discussed the place of HiAP within the developing Whole System Approach being taken to the Scottish Public Health Priorities, and noted the need for alignment of national and local approaches and policies.
The workshop identified enthusiasm and commitment to this way of working across partnerships in Scotland. Participants agreed to continue to share experiences and develop our understanding of how use HiAP to achieve better outcomes. The Faculty can also support this, by continuing to advocate for Health in All Policies, at both local and national levels, and encourage Faculty members to adopt this approach. We are optimistic that by working collectively we can create public policies that allow people to thrive, improve health and reduce social and health inequalities.
Written by Dr Margaret Douglas, University of Edinburgh
Further information
Faculty of Public Health in Scotland (2017) Healthy Lives Fairer Futures: a call to action https://www.fph.org.uk/about-fph/board-and-committees/a-call-to-action/
WHO (2013) Helsinki Statement on Health in All Policies https://www.who.int/healthpromotion/conferences/8gchp/8gchp_helsinki_statement.pdf
Scottish Government (undated) National Performance Framework https://nationalperformance.gov.scot/
Scottish Government and Confederation of Scottish Local Authorities (2019) Public Health Reform. Scotland’s Public Health Priorities – Local Partnerships and Whole System Approach https://publichealthreform.scot/media/1570/whole-system-approach-for-the-public-health-priorities.pdf
Scottish Health and Inequalities Impact Assessment Network resources on HiAP and HIA: https://www.scotphn.net/networks/scottish-health-and-inequalities-impact-assessment-network-shiian/shiian-resources-information/reports/
Better Health For All 
Leave a Reply