Elements of Health in All Policies
Triple Aim
The focal point of the Triple Aim of Health Equity is social inclusion within communities. The triple aim of health equity recognizes diversity within our society and works to include diverse perspectives in community engagement and improvement.
Strengthening community engagement through the generation of ideas, decision-making, and the distribution of resources, and accountability for outcomes can strengthen the communities’ ability to create the conditions for health and well-being. Additionally, it creates an environment that promotes shared leadership.
Source: Association of State and Territorial Health Officials (ASTHO)
Image description: The Triple Aim of Health Equity.
A triangle diagram explains three items:
Implement Health in All Policies: Implement a health in all policies approach with health equity as the goal.
Strengthen Community Capacity: Strengthen the capacity of communities to create their own healthy future.
Expand Understanding of Health: Expand our understanding of what creates health.
Five Key Elements of HiAP:
1. Promote health, equity, and sustainability. Health in All Policies promotes health, equity, and sustainability through two avenues:
- incorporating health, equity, and sustainability into specific policies, programs, and processes, and
- embedding health, equity, and sustainability considerations into government decision-making processes so that healthy public policy becomes the normal way of doing business.
2. Support intersectoral collaboration.
Health in All Policies brings together partners from the many sectors that play a major role in shaping the economic, physical, and social environments in which people live, and therefore have an important role to play in promoting health, equity, and sustainability. A Health in All Policies approach focuses on deep and ongoing collaboration.
3. Benefit multiple partners.
Health in All Policies values co-benefits and win-wins. Health in All Polices initiatives endeavor to simultaneously address the policy and programmatic goals of both public health and other agencies by finding and implementing strategies that benefit multiple partners.
4. Engage stakeholders.
Health in All Policies engages many stakeholders, including community members, policy experts, advocates, the private sector, and funders, to ensure that work is responsive to community needs and to identify policy and systems changes necessary to create meaningful and impactful health improvements.
5. Create structural or process change.
Over time, Health in All Policies work leads to institutionalizing a Health in All Policies approach throughout the whole of government. This involves permanent changes in how agencies relate to each other and how government decisions are made, structures for intersectoral collaboration, and mechanisms to ensure a health lens in decision-making processes.
Image description: Understanding the Spectrum within Local Contexts.
00 Ignore Marginalization: Marginalization represents the status quo, given current systems have been historically designed to exclude certain populations. If concerted efforts are not made to break-down existing barriers to participation, then by default, marginalization occurs.
01 Inform Placation: Information is the foundation for taking action towards real solutions to the threats we face. As the saying goes, knowledge is power. If, however, community engagement efforts remain at the level of one-way information sharing, such efforts result in placation.
02 Consult Tokenization: The most common form of ‘community engagement’ among mainstream institutions is consultation. Usually in the form of semi-interactive meetings in which members of the community have the change to offer input into pre-based plans.
03 Involve Voice and Power Shift: Community organizing and power building is needed to bring community engagement out of tokenization and into true involvement of impacted residents in the decisions that impact them.
04 Collaborate Delegated Power: As a culture of systems, change develops through community organizing, advocacy, and relationship-building. Through this the limits of local systems to carry out changes on their own becomes apparent. At this point, the opportunity to collaborate across sectors emerges and makes culture shift possible.
05 Defer to Community Ownership: We are building community ownership to ensure communities have a direct say over what is needed to survive and thrive.