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“Health in All Policies”: Taking Stock of Emerging Practices to Incorporate Health in Decision Making in the United States

Gase, Lauren N. MPH; Pennotti, Radha MPH; Smith, Kenneth D. PhD

Journal of Public Health Management & Practice: November/December 2013 - Volume 19 - Issue 6 - p 529–540
doi: 10.1097/PHH.0b013e3182980c6e
Original Articles

Objective: Policies affecting the determinants of health lie largely outside the control of the health care and public health sectors. Ensuring health considerations in the formation and implementation of policies, programs, projects, and plans from all sectors, though lofty, is the overall aim of Health in All Policies. The purpose of this article was to identify categories of strategies that illustrate how Health in All Policies had been implemented in the United States.

Design: We used a 3-phased process: (1) review of the published and gray literature; (2) analysis of case examples to identify a draft framework, which included tactics and strategies for implementing Health in All Policies; and (3) vetting the draft framework through individual and group consultation.

Results: We identify 7 interrelated strategies for incorporating health considerations into decisions and systems: (1) developing and structuring cross-sector relationships; (2) incorporating health into decision-making processes; (3) enhancing workforce capacity; (4) coordinating funding and investments; (5) integrating research, evaluation and data systems; (6) synchronizing communications and messaging; and (7) implementing accountability structures. For each strategy, we provide illustrative examples from the United States to help public health leaders identify effective tactics for Health in All Policies implementation.

Conclusions: Through our review, we offer a starting point for categorizing and describing the emerging practices used to work across sectors and address the determinants of health. By delineating the different types of strategies and tactics to achieve Health in All Policies, we provide public health practitioners with a “menu” of options for incorporating Health in All Policies into their work.

The purpose of this article is to identify categories of strategies (a framework) that illustrate how Health in All Policies can be implemented in the United States.

Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, Los Angeles, California (Ms Gase); Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry, Atlanta, Georgia (Ms Pennotti); and Chronic Disease and Environmental Health, National Association of County and City Health Officials, Washington, District of Columbia (Dr Smith).

Correspondence: Lauren N. Gase, MPH, Health and Policy Assessment, Division of Chronic Disease and Injury Prevention, Los Angeles County Department of Public Health, 3530 Wilshire Blvd, 8th Floor, Los Angeles, CA 90010 (lgase@ph.lacounty.gov).

The findings and conclusions in this article are those of the authors and do not necessarily represent the views or the official position(s) of the Los Angeles County Department of Public Health or the Centers for Disease Control and Prevention.

The authors thank Rajiv Bhatia, Corinne Graffunder, Dawn Alley, Anne Haddix, Ken Rose, Tony Kuo, and Cathleen Walsh for their contributions to this article.

The authors report no conflicts of interest and have no financial disclosures.

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.