Why Does Health in all Policies (HiAP) Matter?

Submitted by: Jody Hoener

President and CEO

The Healthy Bourbon County Action Team, inc.

Health in all policies matters because health happens outside the doctor’s office. Communities reflect their populations—the people and systems that comprise them. Weaving health throughout all policy decisions is critical to community and economic development. We speak the same language as economic developers in terms of measuring key indicators to establish where we are and set goals for the vision of where we’d like to be. Building wealth, increasing average and median household wages, access to food, unemployment, housing, education: a healthy workforce is a prerequisite for economic success in any industry and in all cities.

The social determinants of health clearly identify the conditions that effect health outcomes. Healthy People 2020 list the five key domains as (1.) Economic Stability (2.) Education (3.) Health and Health Care (4.) Neighborhood and Built Environment and (5.) Social and Community Context. Through the Blue Cross Blue Shield Pathways to Healthy Kansas Grant, the Healthy Bourbon County Action Team (HBCAT) is addressing each of these determinants through “pathways,” with the addition of a 6th food pathway.

Social and economic factors impact health. Factors such as quality of education and safe neighborhoods are paramount. Our work at the community level is to improve environments where we live, create accessible support systems, encourage community engagement, and to make the healthy choice the default choice.

Equity means that everyone has a fair and just opportunity to access what they need to thrive. This requires removing obstacles to good health such as poverty, discrimination, and their consequences, including: powerlessness and lack of access to well-paying jobs, quality education and housing, safe environments, and health care (Braveman et al., 2017).

Policies continue to create differences in home ownership, small business development, and other wealth building strategies. Structural inequities create disparities in people’s ability to participate and have a voice in policy and political decision making.

The HBCAT has always defined our target population as Bourbon County, including the six incorporated cities it encompasses. This was defined in 2016 with the completion of the first community health needs assessment. The HBCAT recognizes we are only as strong as our weakest link. Impacts of decisions made by City of Fort Scott officials are often felt throughout the county and policy decisions made through the county are often felt in each of the cities. Regardless of where your home is located, we are all connected and intertwined. Every corner of the county is working toward the same goals in terms of access to safe walkable neighborhoods, healthcare, jobs, income, education, or safe affordable housing.

Policy makers are often juggling competing priorities. Including a Health in all Policy (HiAP) approach will allow policy makers to recognize the health impacts of decisions early on. The strategy is to use the Kansas Health Institute’s Health Impact Checklist (HI-C) tool. The tool asks a series of questions with check boxes and written responses to connect potential changes in social, economic, and environmental conditions with potential health impacts.

Policy decisions can shape what our community looks like and have implications on the health and quality of life for all residents. Research has shown that it is not lack of personal responsibility, low motivation or culture of poverty but deeply entrenched societal factors that cause disparities. The HBCAT looks forward to working with city government on the HiAP checklist to inform decision-making for proposals that appear to be unrelated to health such as housing, transportation, and land use.

Background of the Healthy Bourbon County Action Team:

The Healthy Bourbon County Action Team, inc. is registered through the State of Kansas as a non-profit organization. The action team strives to increase access to healthy food and physical activity, promote commercial tobacco cessation, enhance quality of life and encourage economic growth. The problems of health inequity and social injustice are complex in nature and inextricably linked to key economic indicators. The Healthy Bourbon County Action Team aims to improve health outcomes, promote economic inclusion, and address inequities through direct action in the local community and by nurturing relationships with other helping organizations throughout Kansas.

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