Considering the Health Implications
Over the past decade, legislative bodies around the world are increasingly recognizing the value of policies that take a cross-sector approach to health improvement. This Health in All Policies (HiAP) approach takes into account a holistic understanding of health and the social and cultural determinants of public health by considering health implications of policies beyond the traditional health sectors. Important aspects of these policies include the following:

• A central authority with the mandate to coordinate implementation
• A focus that includes multiple sectors
• Encouragement of collaboration
• Adaptability and flexibility
• The dedication of resources to implement the policy
• A system of accountability

In 2011, the City of Eagan, Minnesota, passed a resolution that exemplifies a HiAP policy and provides language for others to use in their own policies. Eagan’s resolution incorporates goals and policies promoting healthy eating and active living both applying generally across city agencies and targeted to specific city agencies.

Promoting Public Health
After providing the health context, Eagan’s resolution (PDF) expresses the council’s intent to promote public health through city policy and practice as well as through public-private cooperation. The resolution then sets out seven specific sections implementing the council’s intent:

• Continuation of existing practices
• Modification of the city’s comprehensive plan
• Goals for all city departments and employees to consider
• Goals specific to parks and recreation
• Goals specific to improving access to healthy foods
• Goals specific to employee wellness
• Investing the Advisory Parks and Recreation Commission with annual reports to the city council on the policy’s progress

Eagan’s resolution applies across sectors by establishing goals for the city as a whole and for specific departments to work towards. Because the comprehensive plan sets out the roadmap to which all city policies and projects are targeted, the inclusion of healthy eating and active living goals applies to any relevant city action. Additionally, because the resolution sets out goals specific for parks and recreation and generally for any applicable employee or department, the resolution invests employees with consideration of these goals regardless of sector. These joint goals and encouragement of intergovernmental efforts, like joint-use recreation policies, and non-governmental efforts, like recreation programs and farmers’ markets, all encourage cooperation across sectors.

Accountability
Eagan’s city council utilized their Advisory Parks and Recreation Commission to provide a mechanism of accountability to their policy. While the policy’s goals and mandates apply across city agencies, the advisory commission holds these agencies accountability by updating the city council on their progress. Because the advisory commission already presumably works closely with the parks and recreation department, with whom the resolution invests the most specific goals, the commission also serves a coordinating role by keeping the council informed of additional steps the council or city agencies could take to further implement the resolution. By establishing healthy eating and active living goals and policies in a cross-sector approach, Eagan’s resolution provides an example of language useful in HiAP policies.

Further Information
Please refer to the Public Health Law Center website for further information. The Public Health Law Center and Blue Cross Blue Shield of Minnesota is working on a larger resources relating to HiAP, and hope to have that resources by year’s end.