Fundamentals of Health in All Policies Approach
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3b. The Foundations
of HiAP
Louise Signal
Health in All Policies
Health in All Policies
Defined
An approach to
public policies across sectors
that
systematically takes into account
the
health implications of decisions
, seeks
synergies, &
avoids harmful health impacts
in
order to
improve population health
&
health
equity.
The Foundations of Health
in All Policies
19
th
Century Public Health
Housing
Water and Sanitation
Mandatory schooling
Nutrition
Workers rights
Economic development
Improved living conditions
Social security
World Health Organization
Constitution
1948
Health is a state of complete physical, mental
and social wellbeing, and not merely the
absence of disease or infirmity.
Governments have a responsibility for the
health of their peoples which can be fulfilled
only by the provision of adequate health and
social
measures
.
Alma Ata Declaration 1978
Health is a fundamental
human right and the
attainment of the highest possible level of
health is a most important world-wide social
goal whose realization requires the action of
many other social and economic sectors in
addition to the health sector. .. and demands
the coordinated efforts of all those sectors
Ottawa Charter for Health
Promotion 1986
Prerequisites for Health
The fundamental conditions and resources for
health are:
peace, shelter, education, food,
income, a stable eco-system, sustainable
resources, social justice, and equity.
Healthy Public Policy
Health promotion…puts health on the agenda of
policy makers in all sectors and at all levels,
directing them to be aware of the health
consequences of their decisions and to accept
their responsibilities for health.
Towards Health in All
Policies
A call for health in all policies - Finnish
presidency of European Union 2006
Highlighting Evidence and
Equity – 2005-2008/9
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Towards Health in All
Policies 2007-2010
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International Momentum
•
Moscow Declaration on Healthy Lifestyles and
Non Communicable Diseases 2011
•
United Nations Summit on the Prevention and
Control of Non-Communicable Diseases 2011
•
Rio Political Declaration on the Social
Determinants of Health 2011
•
The Helsinki Statement on Health in All Policies
Call for Government Action
•
Commit to health and health equity as a political priority
by adopting the principles of HiAP and taking action on the
social determinants of health.
•
Ensure effective structures, processes and resources
that
enable implementation of the HiAP across governments at
all levels
•
Strengthen the capacity of Ministries of Health to engage
other sectors of government
Call for Government Action
•
Build institutional capacity and skills
that enable
the implementation of HiAP
•
Adopt transparent audit and accountability
mechanisms
for health and equity impacts
•
Establish conflict of interest measures
that include
effective safeguards to protect policies from
distortion by commercial and vested interests and
influence.
•
Include communities, social movements and civil
society
in the development, implementation and
monitoring of HiAP
The Challenge
The globalization of unhealthy lifestyles is by no means
just a technical issue for public health.
It is a political
issue. It is a trade issue. And it is an issue for foreign
affairs
… Efforts to prevent NCDs go against the business
interests of powerful economic operators. In my view, this
is one of the biggest challenges facing health promotion…
it is not just Big Tobacco anymore. Public health must also
contend with
Big Food, Big Soda, and Big Alcohol
. All of
these
industries fear regulation
, and protect themselves
by using the
same tactics
.
The Challenge
This is formidable opposition. Market power
readily translates into political power.
Few
governments prioritize health over big
business.
… Let me remind you. Not one single
country has managed to turn around its obesity
epidemic in all age groups. This is not a failure
of individual will-power. This is a failure of
political will to take on big business.…In the
view of WHO, the formulation of health policies
must be protected from distortion by
commercial or vested interests.
The Opposition
Policies designed to enable people to lead
healthy lives face
opposition from many sides
.
Often they are challenged by the interests of
powerful economic forces
that resist regulation.
Business interests and market power
can affect
the ability of governments and health systems to
promote and protect health and respond to
health needs.
Margaret Chan – Director-General WHO
UN Resolution on HiAP
17
Implications
•
HiAP higher up the international agenda
•
Gives us permission, helps build capacity, provides
a body of evidence, strong equity focus, strong
focus on powerful economic interests
opposing
health
•
Strengthed by support from WHO Director-
General Margaret Chan
•
Strengthened by guidance for Country Plans of
Action
•
Means to address the Sustainable Development
Goals.
Means to address the SDGs
19
Health in All Policies (HiAP) is an approach that considers health implications in decision-making to enhance population health and equity. It builds on historical foundations of public health, emphasizing the importance of social determinants and intersectoral collaborations. Key documents like the WHO Constitution, Alma Ata Declaration, and Ottawa Charter underscore health as a fundamental human right and the need for a holistic approach to health promotion.
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Presentation Transcript
Health in All Policies 3b. The Foundations of HiAP Louise Signal otago.ac.nz/uowsummerschool
Health in All Health in All Policies Defined Defined Policies An approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies, & avoids harmful health impacts in order to improve population health & health equity.
The The Foundations of Health Foundations of Health in in All Policies All Policies 19th Century Public Health Housing Water and Sanitation Mandatory schooling Nutrition Workers rights Economic development Improved living conditions Social security
World Health Organization World Health Organization Constitution Constitution1948 1948 Health is a state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity. Governments have a responsibility for the health of their peoples which can be fulfilled only by the provision of adequate health and social measures.
Alma Ata Declaration 1978 Alma Ata Declaration 1978 Health is a fundamental human right and the attainment of the highest possible level of health is a most important world-wide social goal whose realization requires the action of many other social and economic sectors in addition to the health sector. .. and demands the coordinated efforts of all those sectors
Ottawa Ottawa Charter for Health Charter for Health Promotion 1986 Promotion 1986 Prerequisites for Health The fundamental conditions and resources for health are: peace, shelter, education, food, income, a stable eco-system, sustainable resources, social justice, and equity.
Healthy Public Policy Healthy Public Policy Health promotion puts health on the agenda of policy makers in all sectors and at all levels, directing them to be aware of the health consequences of their decisions and to accept their responsibilities for health.
Towards Towards Health Policies Policies Health in in All All A call for health in all policies - Finnish presidency of European Union 2006
Highlighting Evidence and Highlighting Evidence and Equity Equity 2005 2005- -2008/9 2008/9 Commission on the Social Determinants of Health, World Health Organization Final Report 2008 - 2009 World Health Assembly The social determinants of health are the conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels, which are themselves influenced by policy choices. The social determinants of health are mostly responsible for health inequities - the unfair and avoidable differences in health status seen within and between countries.
Towards Towards Health Policies Policies 2007 2007- -2010 Health in 2010 in All All South Australia adopts Health in All Policies approach 2007/8 International Meeting on Health in All Policies: Adelaide Statement on Health in All Policies 2010
International Momentum Moscow Declaration on Healthy Lifestyles and Non Communicable Diseases 2011 United Nations Summit on the Prevention and Control of Non-Communicable Diseases 2011 Rio Political Declaration on the Social Determinants of Health 2011 The Helsinki Statement on Health in All Policies
Call for Government Action Commit to health and health equity as a political priority by adopting the principles of HiAP and taking action on the social determinants of health. Ensure effective structures, processes and resources that enable implementation of the HiAP across governments at all levels Strengthen the capacity of Ministries of Health to engage other sectors of government
Call for Government Action Build institutional capacity and skills that enable the implementation of HiAP Adopt transparent audit and accountability mechanisms for health and equity impacts Establish conflict of interest measures that include effective safeguards to protect policies from distortion by commercial and vested interests and influence. Include communities, social movements and civil society in the development, implementation and monitoring of HiAP
The Challenge The globalization of unhealthy lifestyles is by no means just a technical issue for public health. It is a political issue. It is a trade issue. And it is an issue for foreign affairs Efforts to prevent NCDs go against the business interests of powerful economic operators. In my view, this is one of the biggest challenges facing health promotion it is not just Big Tobacco anymore. Public health must also contend with Big Food, Big Soda, and Big Alcohol. All of these industries fear regulation, and protect themselves by using the same tactics.
The Challenge This is formidable opposition. Market power readily translates into political power. Few governments prioritize health over big business. Let me remind you. Not one single country has managed to turn around its obesity epidemic in all age groups. This is not a failure of individual will-power. This is a failure of political will to take on big business. In the view of WHO, the formulation of health policies must be protected from distortion by commercial or vested interests.
The Opposition Policies designed to enable people to lead healthy lives face opposition from many sides. Often they are challenged by the interests of powerful economic forces that resist regulation. Business interests and market power can affect the ability of governments and health systems to promote and protect health and respond to health needs. Margaret Chan Director-General WHO
Implications HiAP higher up the international agenda Gives us permission, helps build capacity, provides a body of evidence, strong equity focus, strong focus on powerful economic interests opposing health Strengthed by support from WHO Director- General Margaret Chan Strengthened by guidance for Country Plans of Action Means to address the Sustainable Development Goals.
