Health in All Policies
Tools for Advancement of Health Equity and HiAP
HiAP emphasizes the importance of all members of a community being actively included in the processes of planning and proposing new developments, projects and initiatives. Any role within a community can make significant contributions to the Five Key Elements of HiAP. Community organizations and groups, government agencies, businesses, elected officials and residents can work together to promote HiAP.
What Can I Do?
Click the buttons below for a listing of different stakeholder positions within a community and examples of actions to promote HiAP. This is not an exhaustive list of community roles or next steps.
What is your role in the community?
Government Agency Worker/Elected Official
- Engage in HiAP or equity learning opportunities
- Participate in community engagement opportunities
- Establish a HiAP task force
- Propose a Health Impact Assessment
- Use the Health Lens Checklist
- Consider adoption of HiAP or an Equity Ordinance
- Pass a County, City or Township HiAP Resolution
Community Organization or Group
- Engage in HiAP or equity learning opportunities
- Participate in community engagement opportunities
- Convene or join a HiAP task force
- Propose a Health Impact Assessment
- Use the Health Lens Checklist
- Adopt a HiAP framework for practices, programs or services
Business Owner or Manager
- Engage in learning opportunities
- Participate in community engagement opportunities
- Support or propose a Health Impact Assessment
- Use the Health Lens Checklist
- Adopt a HiAP framework for practices, programs or services
- Apply a health equity lens to decision-making processes
Resident
- Engage in HiAP or equity learning opportunities
- Participate in community engagement opportunities
- Use the Health Lens Checklist
- Advocate for HiAP to agencies, community leaders, or elected officials
- Champion HiAP where you live, learn, work and play
Equity Learning Opportunities
Kent County Health Department’s Health Equity team offers learning opportunities surrounding health equity, social determinants of health, and HiAP.
Health Equity and Social Justice Dialogue Workshops
Kent County Health Department partners with Strong Beginnings and Healthy Kent to offer a Health Equity and Social Justice Dialogue Workshop. The two-day workshop addresses multicultural self-awareness, perspectives on oppression and privilege, social determinants of health, root causes of health inequities, the historic role of public health in social change and how these factors affect community health today. Enrollment is open for anyone who is interested. For more information, please visit: https://www.accesskent.com/HealthEquity
Health in All Policies Learning Lab
Accesskent.com/HiAP is your online destination for information, resources and learning opportunities. This robust and relevant website provides ways to both start and scale the HiAP conversation. You may have your questions addressed by public health professionals or request a HiAP presentation by email at: HIAP@kentcountymi.gov
Community Engagement
Grassroots organizations and community initiatives are working to promote equity in Kent County. Building intentional relationships with leaders and members of the community promotes strategic learning and much needed alliances to further equity work and HiAP. Individuals and institutions that desire to improve population health or implement HiAP need to understand the communities they serve and the impact that some policies and practices have on health inequities. This begins with authentic community engagement and listening to the voices of community residents.
Principles for Community Engagement
- Empower residents through meaningful inclusion and partnerships
- Build capacity for high level engagement
- Prioritize community knowledge and concerns
- Target resources to support ongoing engagement
- Facilitate mechanisms that encourage mutual learning and feedback mechanisms
Health in All Policies Task Force
The creation of a multi-agency HiAP task force is a commonly-used method for incorporating HiAP into government and community work. A HiAP task force promotes the Five Elements of HiAP, with a focus on cross-sector collaboration. A task force can keep agencies and other stakeholders accountable and streamline initiatives or programs working to improve community health and outreach. Often there are groups of people and organizations whose experience and mission align with a HiAP approach, but there’s a lack of opportunity and connection for shared goals and objectives to transpire. Some communities have gone as far as creating task forces through legally binding ordinances (see Ordinances and Resolutions for more information). The Resources and Acknowledgements tab contains links to sources with guidelines for creating a HiAP task force under the Health in All Policies General Information heading.
National Association of County & City Health Officials (NACCHO) created the seven strategies specifically for local health departments to use for implementing HiAP.
Ordinances and Resolutions
HiAP work begins before any legislation is passed. However, ordinances and resolutions can help institutionalize HiAP into government and other community work. King County, Washington implemented an ordinance stating that equity and social justice impacts will be considered in all decisions made. A task force and an “Equity Impact Review Tool” were established to assure this happens. Change Lab Solutions also offers a model ordinance for local municipalities to adapt as they see fit.
Resolutions are another way to institutionalize HiAP. Though resolutions do not hold the power of the law behind them, they give accountability to elected officials to follow-up on the HiAP initiatives. Typically, resolutions are a more accessible option. Public Health Institute has extensive experience with HiAP and successfully worked with the State of California to establish a HiAP task force and HiAP resolution. As a local Michigan example, the Ingham County Board of Health passed a resolution asking the Board of Commissioners to consider HiAP. Change Lab Solutions also gives a sample HiAP resolution, similar to their sample ordinance. If you are interested in the sample ordinances and resolutions mentioned, the Resources and Acknowledgements tab will direct you to some examples.
Ordinances Vs. Resolutions
Ordinances are legally binding policies and laws for local level governments and its constituents.
Resolutions are official government policy. Resolutions do not have the power of the law but express the intent of a government to follow a policy.
Change Lab Solutions.
Examples of Community Ordinances with a focus on HiAP or Equity
Health Impact Assessments
Health Impact Assessments (HIA) are the most comprehensive procedure for implementing HiAP. HIA’s provide a systematic strategy for implementing HiAP into the proposal, deliberation and execution of a project or policy. The main goal of a HIA is assuring health inequities are considered in the decision-making process and to promote sustainable development. Other communities have used HIA’s to guide decision-making and planning with projects in transportation, street design, housing and other community development topics.
HIA’s six-step procedure uses qualitative and quantitative evidence to analyze the possible long term effects of social determinants of health, including environmental and physical risks. HIA’s add a new dimension to decision-making in the hope of reducing adverse health effects and promoting beneficial ones. A HIA will preferably be completed before a project or policy is finalized, allowing for informed and data-driven decision-making. If you are interested in learning more about HIA’s, the Resources and Acknowledgements tab will direct you to further information.
6 Steps for a HIA
1. Screening
Identifying plan, project, or policy decisions for which an HIA would be useful.
2. Scoping
Planning the HIA and identifying what health risks and benefits to consider.
3. Assessment
Identifying affected populations and quantifying health impacts of the decision.
4. Recommendations
Suggesting practical actions to promote positive health effects and minimize negative health effects.
5. Reporting
Presenting results to decision makers, affected communities, and other stakeholders.
6. Monitoring
Determining the HIA’s impact on the decision and health status.
Healthy Places: Health Impact Assessments. Centers for Disease Control and Prevention. https://www.cdc.gov/healthyplaces/hia.htm