Richmond VA > Mayor's Healthy Richmond Campaign > Health in All Policies> HiAP

Last Updated: 2016-04-25

Myra's Story: Click on image lower middle section ( sidewalk arrow ) for larger graphic


- Health in All Policies:
A Guide for State and Local Governments

Written by the California Health in All Policies State Task Force, this guide is geared toward local government leaders who want to use inter-sectoral collaboration to promote healthier environments.

- From Start to Finish:
How to Permanently Improve Government through Health in All Policies

The ChangeLab Solutions toolkit is intended as an introduction to HiAP, outlining five key strategies: Engage & Envision, Convene & Collaborate, Make a Plan, Invest in Change, and Track Progress.

HiAP Ordinances

Other U.S. Cities

Richmond, California:

- Richmond, CA:

Approved April 18, 2014, this ordinance establishes Health in All Policies as a strategy for improving health and health equity for the city. Includes: HiAP findings, definitions and a HiAP implementation Strategy.

King County, Washington:

- King County, WA:

Approved October 20, 2010, Ordinance 16948 establishes definitions and directs implementation steps related to the fair and just principle for the countywide strategic plan.

Richmond, Virginia

HiAP City Resolution

- Richmond, VA:

Passed by Richmond City Council on January 12, 2015, Resolution No. 2014-R262-2015-7: To adopt the Health in All Policies approach for the City of Richmond in the form of a “Policy for HiAP Framework”, and includes: Resolution, O&R Request, HiAP definitions, and Richmond CAO HiAP-related planned actions.

- Richmond HiAP:
Resolution Explained

Presentation from the December 2015 Richmond HiAP Workshop, outlining the main points of the Richmond HiAP Resolution.


Richmond HiAP Workshop

From December 8-9, 2015:

- Concepts Supporting HiAP

Presentation by NACCHO provides background on basic goals and strategies underling HiAP as a response to the need to engage all sectors simultaneously in order to improve social determinants of health at the population level.

- Implementing HiAP

Presentation by NACCHO provides information on building cross-sector relationships, and integrating health considerations into policy, funding, and evaluation decision-making.

- Health Equity in Richmond

Presentation by Dr. Danny Avula (Director, Richmond City Health District) provides details of health, income, educational and other disparities in Richmond, and describes some of the policies that led to these outcomes.

- Myra's Story

Presentation by Dr. Mike Royster (Vice President, Institute for Public Health Innovation) outlining how the quality of life of hypothetical 12-year old ‘Myra’ is influenced by various social determinants of health.

- Creighton Court Redevelopment Scenario with Questions for Discussion

- Health Equity Impact Tool

- Social Determinants of Health Infographic

- Summary of Myra’s Story with Questions for Discussion

- Office of Community Wealth Building Fact Sheet

- RVA Road Map
(for Strategic Plan)

What is Health in All Policies (HiAP)?

Health in All Policies (HiAP) is an emerging trend in government at the local, state, and national levels, where-in all agencies come together to leverage their resources and experience to address the complex factors that influence population health, equity, and quality of life, also known as the social determinants of health.

Social determinants of health include access to adequate housing, quality educational attainment opportunities, employment skill-building and job opportunities, healthy and affordable foods, transportation options, and safe neighborhoods. The goal of the interdepartmental collaboration beneath the umbrella of HiAP is to create the maximum-possible positive impact on the well-being, health, and quality of life of all residents.

In Richmond, HiAP is spearheaded by a cross-sectoral HiAP Team, made up of representatives from the Richmond City Health District, the Institute for Public Health Innovation, and the city offices of Strategic Budget and Planning, Community Wealth Building, and Human Services.

This online toolkit provides Richmond City Government employees with resources to understand HiAP goals and implementation, using materials from Richmond and other U.S. localities.

What does HiAP do?

HiAP is guided by a set of central goals

The five central focus areas are:

1. Governance Goals

  a) Adopt local legislation (resolution, ordinance or other policy) to institutionalize

  b) Establish HiAP Interdepartmental Team or Task Force within local government
       responsible for implementing HiAP principles into routine policies, programs,
       and other decision-making procedures.

2. Training & Capacity Building Goals

  a) Education administration, city council, community residents, and other partners
       regarding HiAP and its value in promoting equity and improved quality of life,
       and other local priorities such as sustained poverty reduction.

  b) Workshops for local agencies, departments, and offices on operationalizing
       cross-governmental HiAP.

3. Community Engagement Goals

  a) Engage community partners, advocates, and residents
       to collectively,

    1) Identify priorities,

    2) Provide input on policies, programs, and procedures,

    3) Track progress in improving quality of life/health equity
         in the population.

4. Policy & Decision-Making Goals

  a) Integrate a HiAP lens across local government to incorporate health and
       equity considerations into all decision-making processes.

  b) Integrate HiAP lens into existing local priorities (city strategic plan, community
       and economic development, poverty reduction strategies, and educational

  c) Utilizie tools to support strategic thinking around HiAP, such as the
Health Equity Impact Tool .

5. Outcome Goals

Evaluate HiAP to document Improvements in population health and equity:

  a) Process measures: increased communication and collaboration across sectors;
       reduced duplication.

  b) Impact measures: collaborative implementation of policies that promote health
       and equity.

  c) Outcome measures: improved health and well-being of all residents, especially
       in high-risk groups.

Does HiAP Work?

HiAP Successes in other localities

The principles of HiAP have seen great successes in some of the most progressive US health communities. We are enthusiastic about the possibility for Richmond, Virginia to join these health pioneers.

Richmond, California

- City of Richmond, CA: Ordinances supporting HiAP

See how HiAP implementation transformed the City of Richmond, California (CA) through engaging city and resident stakeholders.

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- Richmond's (CA) Roadmap to Health

San Francisco, California

- Case Study: San Francisco’s Use of Neighborhood Indicators to Encourage Healthy Urban Development

In 2007 San Francisco developed a comprehensive system of neighborhood indicators including measures of attributes such as crime, noise, proximity to parks and transit services, social capital and student performance.

Why does HiAP Matter?

Education Matters

The Robert Wood Johnson Foundation (RWJF) and Virginia Commonwealth University (VCU) Center on Society and Health explore why Eduation matters to health.

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- Education: It Matters More to Health than Ever Before

Neighborhood Matters

The documentary series Unnatural Causes (Episode 5) explores why your street address is a good predictor of your health.

Video content is powered by YouTube.

- Living in Disadvantaged Neighborhoods is Bad for Your Health

Community Engagement Matters

The Community Tool Box website (Chapter 7) provides practical guidance about how to engage with your community to create positive change and improve health and well-being.

- Encouraging Involvement in Community Work

Guides to Implementing HiAP

Implement HiAP into Local Government Processes

- Health in All Policies: A Guide for State and Local Governments

Written by the public health facilitators of the California Health in All Policies Task Force, this guide is geared toward state and local government leaders who want to use inter-sectoral collaboration to promote healthy environments.

Part I of this guide is a discussion of the concept of Health in All Policies, including its key elements, history, and links to other public health and equity initiatives.

Part II covers the ‘nuts and bolts’ of this work and discusses an array of considerations including structure, relationship building, leadership, and messaging.

Part III of the guide is a case study of the California Health in All Policies Task Force.

Utilizing the Health Equity Impact Tools

Health Equity Impact Tools

- Richmond Health Equity Impact Tool
  Proposed Draft

- King County Equity Impact Review Tool
  Revised October 2010

The Equity Impact Review (EIR) tool is both a process and a tool to identify, evaluate, and communicate the potential impact – both positive and negative – that a policy or program may have on health equity.

The three stages are as follows:

Stage I:     What is the impact of the proposal on                                     determinants of equity?

- The aim of the first stage is to determine whether the proposal will have an impact on equity or not.

Stage II:     Assessment: Who is affected?

- This stage identifies who is likely to be affected by the proposal.

Stage III:     Impact review: Opportunities for action.

- The third stage involves identifying the impacts of the proposal from an equity perspective. The goal is to develop a list of likely impacts and actions to ensure that negative impacts are mitigated and positive impacts are enhanced.

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