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Health in All Policies: Embedding Health and Equity

Learn about the Health in All Policies approach that considers the health implications of decisions, promotes synergies, and avoids harmful impacts to improve population health and equity.

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Health in All Policies: Embedding Health and Equity

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  1. <?xml version="1.0"?><AllQuestions /> <?xml version="1.0"?><AllResponses /> <?xml version="1.0"?><Settings><answerBulletFormat>Numeric</answerBulletFormat><answerNowAutoInsert>No</answerNowAutoInsert><answerNowStyle>Explosion</answerNowStyle><answerNowText>Answer Now</answerNowText><chartColors>Use PowerPoint Color Scheme</chartColors><chartType>Horizontal</chartType><correctAnswerIndicator>Checkmark</correctAnswerIndicator><countdownAutoInsert>No</countdownAutoInsert><countdownSeconds>10</countdownSeconds><countdownSound>TicToc.wav</countdownSound><countdownStyle>Box</countdownStyle><gridAutoInsert>No</gridAutoInsert><gridFillStyle>Answered</gridFillStyle><gridFillColor>255,255,0</gridFillColor><gridOpacity>50%</gridOpacity><gridTextStyle>Keypad #</gridTextStyle><inputSource>Response Devices</inputSource><multipleResponseDivisor># of Responses</multipleResponseDivisor><participantsLeaderBoard>5</participantsLeaderBoard><percentageDecimalPlaces>0</percentageDecimalPlaces><responseCounterAutoInsert>No</responseCounterAutoInsert><responseCounterStyle>Oval</responseCounterStyle><responseCounterDisplayValue># of Votes Received</responseCounterDisplayValue><insertObjectUsingColor>Red</insertObjectUsingColor><showResults>Yes</showResults><teamColors>Use PowerPoint Color Scheme</teamColors><teamIdentificationType>None</teamIdentificationType><teamScoringType>Voting pads only</teamScoringType><teamScoringDecimalPlaces>1</teamScoringDecimalPlaces><teamIdentificationItem></teamIdentificationItem><teamsLeaderBoard>5</teamsLeaderBoard><teamName1></teamName1><teamName2></teamName2><teamName3></teamName3><teamName4></teamName4><teamName5></teamName5><teamName6></teamName6><teamName7></teamName7><teamName8></teamName8><teamName9></teamName9><teamName10></teamName10><showControlBar>All Slides</showControlBar><defaultCorrectPointValue>0</defaultCorrectPointValue><defaultIncorrectPointValue>0</defaultIncorrectPointValue><chartColor1>187,224,227</chartColor1><chartColor2>51,51,153</chartColor2><chartColor3>0,153,153</chartColor3><chartColor4>153,204,0</chartColor4><chartColor5>128,128,128</chartColor5><chartColor6>0,0,0</chartColor6><chartColor7>0,102,204</chartColor7><chartColor8>204,204,255</chartColor8><chartColor9>255,0,0</chartColor9><chartColor10>255,255,0</chartColor10><teamColor1>187,224,227</teamColor1><teamColor2>51,51,153</teamColor2><teamColor3>0,153,153</teamColor3><teamColor4>153,204,0</teamColor4><teamColor5>128,128,128</teamColor5><teamColor6>0,0,0</teamColor6><teamColor7>0,102,204</teamColor7><teamColor8>204,204,255</teamColor8><teamColor9>255,0,0</teamColor9><teamColor10>255,255,0</teamColor10><displayAnswerImagesDuringVote>Yes</displayAnswerImagesDuringVote><displayAnswerImagesWithResponses>Yes</displayAnswerImagesWithResponses><displayAnswerTextDuringVote>Yes</displayAnswerTextDuringVote><displayAnswerTextWithResponses>Yes</displayAnswerTextWithResponses><questionSlideID></questionSlideID><controlBarState>Expanded</controlBarState><isGridColorKnownColor>True</isGridColorKnownColor><gridColorName>Yellow</gridColorName></Settings> <?xml version="1.0"?><AllAnswers /> Health in All Policies (HiAP):Embedding Health and Equity into Local Communities October 23, 2018 Mimi Hall, Director Santa Cruz County Health Services Agency

  2. We will always end up somewhere “Cheshire Puss, …would you tell me, please, which way I ought to go from here?” “That depends a good deal on where you want to get to,”said the Cat. “I don’t much care where ----”said Alice. “Then it doesn’t matter much which way you go,”said the Cat. “---So long as I get somewhere,”Alice added as an explanation. “Oh, you’re sure to do that,”said the Cat. Lewis Carroll, Alice’s Adventures in Wonderland

  3. What is Health in All Policies? Health in All Policies is 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.

  4. HiAP Objectives • Integrate health, equity and well-being considerations into all systems • Coordinate governmental decisions and community efforts to achieve shared goals across health, human, social and economic matters • Utilize proven practices and strategies for optimal impact and effectiveness • Promote the establishment of health-promoting conditions (social determinants) of health

  5. HiAP 5 Key Elements • Promotehealth, equity, & sustainability • Support intersectoralcollaboration • Benefit multiplepartners • Engage externalstakeholders • Create structural or processchange

  6. Promote Health, Equity, & Sustainability Decision- Making Processes Healthy Public Policy Policies/ Programs

  7. Santa Cruz County Strategic Plan

  8. Traditional Policy Topics • Land use • Urban infill, mixed uses, neighborhoods • Transportation • Safety, transit oriented development, traffic reduction, • Environmental quality • Pollution, water quality, brownfield cleanup • Physical activity • Parks and recreation, bicycle and pedestrian facilities, co-location of public schools and community centers

  9. Emerging Policy Topics • Equity • Vulnerable population, distribution of opportunity and investment • Public health and prevention • Health as a guiding community principle, relationship to community design, articulating the public health approach • Access to health care • Prevention and access to care across behavioral and physical health, consumer education, collaborative systems • Environment • Climate change, green building and environment

  10. Food Policies – Emerging Topics • Agricultural preservation • Local food • Urban agriculture • Healthy food retail and institutional access • Emergency food and food assistance • Farmers markets, community and school gardens, food trucks • Micro-enterprise home kitchen operations

  11. Healthy Food Access Policy Opportunities • Expanding local food markets • Assess real transit options • Utilize public school educational gardens • Increase established community gardens • Eliminate food deserts • Board access to fresh foods • Community education about healthy food choices

  12. What factors determine our health? $3.3Trillion Prevention, 4% Behaviors & Environment 70% Medical Services 96% Genetics20% MedicalCare 10% Factors InfluencingHealth National Health Expenditures Adapted from CMS 2016 National Health Expenditures Highlights.

  13. Social Determinants of Health • A relationship exists between health status and biology, individual behavior, health services, social factors, and policies. • An ecological approach to disease prevention and health promotion focuses on both individual-level and population-level determinants of health and interventions. • Determinants of health reach beyond the boundaries of traditional health care and public health. • Sectors such as education, housing, transportation, agriculture, and environment can be important allies in improving population health.

  14. A systematic approach is key in addressing major societal concerns • Health is more than healthcare or the absence of injury or disease • The environment in which we live profoundly shapes our health and well-being • Injury and disease are not inevitable; they have root causes that can be addressed

  15. The choices we make are the choices we have – health inequalities are not all natural • Access to fresh, affordable produce • Locations and density of liquor and convenience stores • Public transportation • Clean, safe accessible parks, places to walk, job, bike and play • Community gardens to promote mental and physical health and sustainability • Well financed schools with gyms and after school programs

  16. Healthy Public PolicyTools • Health Lens Considerations • Timing (partners and process) • How will the information be used? • Is there a good reason to the analysis? • Is evidence available? • Are there broader health considerations that are not being considered? • Formal, Structured, Rigorous?

  17. How can decisions impact our health?

  18. How can decisions impact our health?

  19. The how-to of HiAP • Objectives: • Safer environment with fewer risk factors • Improved health equity • Increased health and well-being • Multiple non-health sectors: the sectors that shape social and physical determinants of health • Decision making processes: development, implementation, and evaluation

  20. Tactics for Implementing HiAP • Convene a cross-sector collaborative or task force • Consider health in the policy making process • Establish accountability structures

  21. Local examples of HiAP • Medi-Cal Express Enrollment via School Nutrition Program • Youth access and uptake of tobacco • Universal screening, brief intervention and referral to treatment • Opiate prevention coalitions • Restorative Justice

  22. How can HiAP help our community?

  23. Thank you • Mimi Hall • Phone number: 831-454-7519 • Email address: mimi.hall@countyofsantacruz.us Resources: Guide for State and Local Governments: https://www.apha.org/~/media/files/pdf/factsheets/health_inall_policies_guide_169pages.ashx

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