Too soon to tell if health-in-all-policies approach improves equity, study finds
- A health-in-all-policies (HiAP) approach can boost awareness of health disparities, but there is no consistent evidence that it leads to broad policy reforms or improvements in health equity, a study published in Health Affairs concluded.
- The researchers talked in-depth with U.S. public and private health officials in five states in 2016 and 2017 about their experiences with HiAP initiatives — a process aimed at interweaving health and government policy.
- They found that HiAP reinforces scrutiny of health equity and led to more cross-sector collaboration. However, officials differed on how they perceived health equity, and the focus on equity in HiAP initiatives varied according to the specific issue being addressed.
“We found that HiAP is a useful framework for promoting health equity but that the HiAP-equity connection is issue dependent and conditional on the preferences of other actors in the political environment,” the researchers write.
The study underscores the growing attention that population health and social determinants of health are getting in the national healthcare discussion. Areas with high rates of chronic conditions like hypertension, obesity and diabetes often also have high rates of food and housing insecurity. Transportation issues can also limit access to care.
Policies that target social determinants of health can help to reduce disparities and reduce overall healthcare costs.
In an analysis published Wednesday in Health Affairs, the authors proposed a roadmap for identifying health disparities and deploying evidence-based interventions to narrow the gap. The roadmap, developed by the National Quality Forum, also recommends tying performance measures for health equity to payment incentives and financial support.