Health in All Policies approach at Community and Public Health

Health in All Policies (HiAP) is an approach to working on public policies across sectors and with communities. It 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.

The determinants of health are biological, lifestyle and environmental factors that play a major role in the health and wellbeing of the community. Many of these factors are beyond the control or influence of the individual or the health sector. These factors form a complex web that is influenced by many sectors such as local government and transport – as illustrated in the diagram below.

The HiAP team at Community and Public Health is involved in building strong partnerships and working collaboratively with other sectors to consider the positive and negative impacts that policies and decisions have on health and wellbeing for the people of Canterbury, South Canterbury, the West Coast, and the Chatham Islands.

The aim of the Health in All Policies Team is to ensure health, wellbeing, sustainability and equity issues are explicitly addressed in all policy, planning and decision making processes – to improve health outcomes and mitigate health disparities.

• Find out how Community and Public Health applies the Health in All Policies approach.

Work at Community and Public Health aims to reflect the concepts of DEET: Determinants, Equity, Evidence and Treaty. Our work is guided by a social determinants approach that:

• promotes fairness and justice;
• is informed by evidence; and
• is framed by the Treaty of Waitangi.

HiAP is compatible with the holistic nature of Māori perspectives of health and wellbeing, by recognising the importance and interconnections between these factors.

Health in All Policies in Canterbury

Organisations in Canterbury have been working in a HiAP way for many years – beginning with Healthy Christchurch (since 2002), the Canterbury Health Impact Assessment Partnership Project (2009 to 2011) through to the Canterbury Health in All Policies Partnership (CHIAPP).

“The regional council’s work is very much about human health and wellbeing – working to make sure that people throughout Canterbury have a strong and healthy environment and economy, and cultural and social opportunities.  We have found through working together that a joined up approach considering health is more than a planning process and we’re starting to see our staff explicitly factor these determinants of health into their everyday work.” – Bill Bayfield, Chief Executive, Canterbury Regional Council (Environment Canterbury).

• View a timeline summarising HiAP work and relationships in Canterbury.
• Find out more about applying the Health in All Policies approach in Canterbury, including tools in action.

Health in All Policies is an international approach

Canterbury’s HiAP work is modelled on an approach widely promoted by the World Health Organisation (WHO) and used by public health organisations around the globe.  From roots in the WHO declaration of Alma-Ata (1978) and the Ottawa Charter (1986) with their focus on healthy public policy and the social determinants of health, the concept of HiAP has been outlined and refined in a series of statements:

• The Adelaide Statement on Health in All Policies (2010) outlined how all sectors need to work together to improve health outcomes and advance sustainability and equity.
• The Helsinki statement on Health in All Policies (2013) further defined HiAP and called on government to ensure that health considerations are taken into account in policy-making.
• The Adelaide Statement II (2017) provides new direction for Health in All Policies within our current global political climate and the Sustainable Development Goals (SDGs).

Canterbury’s success as a national and international leader in HiAP was confirmed in 2017 when WHO included the Greater Christchurch Urban Development Strategy in their Case Study book “Progressing the Sustainable Development Goals through Health in All Policies”.

• Read more about the inclusion of the Greater Christchurch Urban Development Strategy in the WHO Case Study book.

Legislative context for HIAP in New Zealand

The HiAP approach aligns with several pieces of legislation in New Zealand, including:

• The New Zealand Health and Disability Act 2000 – District Health Boards are required to improve, promote and protect the health of people and communities, and these responsibilities can be effectively carried out using a HIAP approach.
• The Resource Management Act 1991 which promotes the sustainable management of the use, development, and protection of natural and physical resources in a way that enables people and communities to provide for their social, economic, and cultural wellbeing.
• The Human Rights Act which aims to ensure that all people in New Zealand are treated fairly and equally.

Community and Public Health’s HIAP approach recognises and gives effect to the articles of Treaty of Waitangi 1840. Tools associated with HiAP can be used to assess and address the inequitable health outcomes experiences by Māori.

Documents

• Tools to support a Health in All Policies Approach: A guide for moving from theory to practice (Community and Public Health – updated November 2019).
• Integrated Assessment: A Guide (Ward, Quigley, Banwell and Timms 2019).
• Christchurch Alcohol Action Plan 2017-2021 (Christchurch City Council and partner agencies including Canterbury DHB 2017).
• Health in All Policies: Framework for Country Action (World Health Organisation).

• Health in All Policies: Seizing opportunities, implementing policies (European Observatory on Health Systems and Policies 2013).
• Health in All Policies: A Guide for State and Local Government (American Public Health Association and Public Health Institute 2013).
• The Health Equity Assessment Tool: A User’s Guide (Ministry of Health 2008).
• Whanau Ora Health Impact Assessment (Ministry of Health 2007).
• Te Pae Mahutonga Implementation Planning Guide (Ministry of Health 2004).

Links

• Christchurch City Health Profile (Healthy Christchurch).
• Sustainable Development Goals (World Health Organisation).

Get the latest on Health in All Policies in Canterbury

The Canterbury Health in All Policies Newsletter is produced by the Policy Team at Community and Public Health. It features HiAP approach in action in Canterbury as well as useful resources and links.

• View the latest Canterbury Health in All Policies Newsletter.
• Subscribe to the Canterbury Health in All Policies Newsletter.

Information Sheets about Health in all Policies

Community and Public Health staff developed the following information sheets on Health in All Policies – as part of the Canterbury Health in All Policies Partnership (CHIAPP). All information sheets were updated January/ February 2015.

These sheets will be replaced with new resources in 2019.

• Overview of CHIAPP.
• Background Information on Health in All Policies (Sheet 1).
• Background Information on Health Impact Assessment (Sheet 2).
• International Literature (Sheet 3).
• New Zealand examples (Sheet 4).
• Collaborative working guidelines (Sheet 5).
• HiAP Tools and Concepts (Sheet 6).
• Impact of Canterbury earthquake on CHIAPP (Sheet 7 – was Sheet 8).
• Self Evaluation and Monitoring Tool (Sheet 8 – was Sheet 10).