A report to the Ontario Ministry of Health and Long-Term Care
Findings:
- Whole-of-government, “health in all policies” approaches focused on health equity have been implemented in 16 countries or sub-national areas worldwide: Australia, Brazil, Cuba, England, Finland, Iran, Malaysia, New Zealand, Northern Ireland, Norway, Quebec, Scotland, Sri Lanka, Sweden, Thailand and Wales.
- In every case, a formal, whole-of-government “health in all policies” approach was preceded by intersectoral initiatives that were less formal and broad-reaching.
- Government-wide Health Impact Assessment (HIA) or a variant thereof to measure health outcomes/health needs was instituted in almost all jurisdictions.
- “Health in all policies” strategies were usually aimed to improve working/living conditions, or to target individual behavior change. Improving access to health care was also stressed. Fewer than a third of cases involved wealth redistribution to address health inequities.
- By definition, “health in all policies” approaches have a broader focus than vulnerable populations only. Most jurisdictions combined attention to vulnerable populations and universal policy initiatives. The preponderance of policy activity related to vulnerable groups.
- “Health in all policies” involved a high degree of interaction and interdependence across sectors, and limited individual sectors’ autonomy. “Health in all policies” was not supported through simple information-sharing.
- Mechanisms for supporting “health in all policies” included formal, intersectoral committees (e.g. cabinet committees, interdepartmental committees), joint budgets, and evaluation and monitoring tools. In most jurisdictions a mix of horizontal and vertical integration management strategies was used to manage policy implementation.
Download a workbook related to the methods we used to explore the implementation of Health in All Policies: Realist Multiple Explanatory Case Studies. Read “Health in All Policies” case studies from around the world including Brazil, Cuba, Finland and Malaysia.
