Bert Fabrizio, Scaioli Giacomo, Gualano Maria Rosaria, Siliquini Roberta
Department of Public Health, University of Turin , Italy.
J Public Health Res. 2015 Apr 1;4(1):393. doi: 10.4081/jphr.2015.393. eCollection 2015 Feb 20.
New scenarios are emerging in the European and worldwide context: the ageing of society, the climate changes, the increasing of health inequalities and the financial crisis. In this context, the scientific community and the decision-makers agree on the role of health in all policies (HiAP) strategy in improving the population's health. The HiAP takes into account factors not strictly related to health but with important health consequences. To bring public health in all policies a change is needed, but there are some obstacles to overcome: for instance, the lack of evidence regarding the governance tools and frameworks for HiAP, the difficulty of convincing stakeholders and producing a cultural change in the political positioning of decision-makers. Consequently, it is necessary: i) to implement stronger and responsible decision-support approaches, such as health impact assessment and health technology assessment; ii) to encourage and coordinate all relevant sectors in playing their part in reducing health gaps within the European Union; iii) to strengthen cooperation and make better use of existing networks and existing public health and related institutions. The final aim will be to monitor the impact of the health determinants in order to promote the effective implementation of HiAP approach. Significance for public healthThis paper makes public health professionals aware of the pivotal role that they could play in reducing health inequalities and in helping to overcome the crisis of the European health systems. It discusses how, thanks to a systematic approach based on new instruments like health impact assessment and health technology assessment, and thanks also to a stronger cooperation among stakeholders and policy makers, it is possible to monitor the health determinants and consequently to bring health in all policies.
在欧洲乃至全球范围内，新的情况不断涌现：社会老龄化、气候变化、健康不平等加剧以及金融危机。在这种背景下，科学界和决策者一致认同健康融入所有政策（HiAP）战略在改善民众健康方面的作用。健康融入所有政策考虑的是那些并非严格与健康相关，但却会产生重要健康影响的因素。要将公共卫生纳入所有政策，就需要做出改变，但仍有一些障碍有待克服：例如，缺乏关于健康融入所有政策的治理工具和框架的证据，难以说服利益相关者并促使决策者在政治定位上实现文化变革。因此，有必要：i）实施更有力且负责任的决策支持方法，如健康影响评估和健康技术评估；ii）鼓励并协调所有相关部门在欧盟范围内发挥作用，以缩小健康差距；iii）加强合作，更好地利用现有网络以及现有的公共卫生和相关机构。最终目标是监测健康决定因素的影响，以促进健康融入所有政策方法的有效实施。对公共卫生的意义本文让公共卫生专业人员意识到他们在减少健康不平等以及帮助克服欧洲卫生系统危机方面可以发挥的关键作用。本文讨论了如何借助基于健康影响评估和健康技术评估等新工具的系统方法，以及利益相关者和政策制定者之间更有力的合作，来监测健康决定因素，进而将健康纳入所有政策。
