Agencies Should Explore HiAP

The Bipartisan Policy Center’s (BPC) new report “Health in All Policies: Exploring the Role of Three Federal Departments in Influencing Health”, recommends ways for Federal agencies to use the “Health in All Policies” (HiAP) approach to mitigate the impact of social determinants of health across all levels of federal policymaking to improve health outcomes.

“Many of the drivers and determinants of poor health in the U.S are preventable” said, Anand Parekh, M.D., BPC Chief Medical Advisor. “However, social determinants of health can’t be addressed by any one federal agency or within the four walls of a doctor’s office or hospital. It will take forging multi-sector partnerships to work towards the common goal of improving population health.”

The report examines how three Executive Branch Departments, the Department of Education, Department of Treasury, along with the Department of Labor are currently implementing a HiAP strategy.

The Department of Education is in the process of increasing school health services. According to the report, schools have emerged as important places to address childhood asthma, obesity, mental health problems, and other health issues.

Today, more than half of public schools do not have a full time school nurse or counselor and less than five percent of the nation’s students have access to services through a school-based health center. Schools serving low income students have far fewer health services than schools serving middle and upper income students.

According to the report, the Department of Education needs to help schools and school health providers integrate with a healthcare system that increasingly prioritizes prevention, population health, care coordination, and chronic disease management.

The report points out that the Department of Treasury has the capability to develop innovative financing models which would relate directly to improving population health but the Department must first assess community health needs.

The Department of Treasury can affect health through tax policy by providing tax credits to private investors to support affordable housing, provide community benefit requirements for non-profit hospitals to maintain tax exempt status, and include building spending under community benefit spending.

The report also suggests that the Employment and Training Administration (ETA) within the Department of Labor, should actively support workforce opportunities in response to the opioid crisis by addressing the misuse of opioids within communities.

ETA has launched demonstration grants to address the economic impact associated with the opioid crisis and continues to encourage people to enter healthcare fields such as physical therapists plus other professionals to help people affected by the crisis.

In addition, the report encourages all Executive Branch Departments to adopt a HiAP approach to policymaking when feasible. It is recommended that the current administration build on the prior administration’s “National Prevention Strategy”, developed by 17 federal department to prioritize health and the quality of life for all Americans.

The Office of Management and Budget (OMB) could seek to have departments integrate the HiAP approach into their strategic plans and annual budget submissions. They could require departmental regulatory proposals to include health impact assessments. Lastly, the White House Domestic Policy Council could convene leaders from select departments to establish a HiAP Council.

Go to to view the report.

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