Department for Promotion of Welfare and Health, Ministry of Social Affairs and Health, Finland.
Scand J Public Health. 2011 Mar;39(6 Suppl):11-8. doi: 10.1177/1403494810379895. Epub 2010 Sep 2.
The fact that health is largely constructed outside the remits of the health sector has been known for a long time. However, implementing intersectoral health policies is difficult. The aim of this article is to study possibilities for strengthening the implementation of Health in All Policies (HiAP) approach.
The article analyses earlier efforts in intersectoral health policy-making and adapts Kingdon's theory on policy change for exploring opportunities and challenges for strengthening HiAP approach.
Opportunities for HiAP can be identified by analysing possibilities for amending health determinants on the one hand, and by analysing policy trends, proposals, and actors, especially in fields other than health, on the other. Four basic strategies for HiAP are identified, namely: health strategy, win-win strategy, cooperation strategy, and damage limitation strategy. Their strengths in various situations are explored. Using an adaptation of Kingdon's framework, possibilities for creating opportunities for HiAP by raising health issues on the agenda, developing appropriate tools and by creating conducive momentums are discussed.
It is concluded that systematic efforts of experts in public health, health policy, and international health are important in identifying and prioritising the needs for HiAP, in analysing health implications of policies and policy proposals and making these understood by the policy-makers, as well as in suggesting feasible solutions. Improving health literacy of the public, the policy-makers, and the media is key for improved understanding on health implications of policies. Participatory and transparent approaches to policy-making are prerequisites for strengthening HiAP.
健康在很大程度上是由卫生部门以外的因素构建的，这一事实早已为人所知。然而，实施跨部门卫生政策具有一定难度。本文旨在研究加强“全员健康方法”（Health in All Policies，HiAP）实施的可能性。
本文分析了跨部门卫生政策制定方面的早期努力，并采用金登的政策变化理论来探索加强 HiAP 方法的机遇和挑战。
通过分析一方面修改健康决定因素的可能性，以及分析政策趋势、提案和行为者（特别是卫生以外领域）的可能性，可以确定 HiAP 的机会。确定了四种基本的 HiAP 策略，即：卫生策略、双赢策略、合作策略和损失控制策略。探讨了它们在各种情况下的优势。通过采用金登框架的改编版，讨论了通过将卫生问题提上议程、开发适当工具和创造有利的动力来创造加强 HiAP 的机会的可能性。
专家在公共卫生、卫生政策和国际卫生方面的系统努力对于确定和优先考虑全员健康方法的需求、分析政策和政策提案对健康的影响并使决策者理解这些影响，以及提出可行的解决方案至关重要。提高公众、决策者和媒体的健康素养是提高对政策健康影响理解的关键。参与式和透明的政策制定方法是加强全员健康方法的前提条件。
