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New BPC Report: Improving America's Health Requires a “Health in All Policies" Approach

Washington, D.C. — Improving population health in the United States requires a shared responsibility by all federal governmental agencies to apply a Health in All Policies (HiAP) approach to decision-making. That’s the message of a new report released today by the Bipartisan Policy Center which provides recommendations on ways to incorporate health considerations, such as mitigating the impact of social determinants of health, across all levels of federal policymaking to improve health outcomes.

“While the United States spends more on health care than any other developed nation, Americans have worse health outcomes in many areas,” said Anand ParekhM.D., BPC chief medical advisor. “Federal policies have a profound influence on the way people live their lives.”

Today the majority of what makes us healthy and unhealthy results from our environment, education, socioeconomic status, and behavior. Beyond clinical services, where we live, work, and play are important factors that influence our health. However, most of these factors are not directly influenced by federal health agencies such as the U.S. Department of Health and Human Services (HHS). While HHS has large responsibilities in advancing the nation’s health, other federal agencies play a significant role.

“Many of the drivers and determinants of poor health in the United States are preventable,” said Parekh. “However, social determinants of health cannot 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 toward the common goal of improving population health.”

BPC’s report examines how three executive branch departments, including the U.S. Department of Education (ED), U.S. Department of Treasury (Treasury), and U.S. Department of Labor (DOL), currently implement a HiAP strategy and provides ways to build on these efforts to improve health outcomes.

The report encourages all executive branch departments to adopt a HiAP approach to policymaking when feasible. It also recommends that the current administration could build on the prior administration’s National Prevention Strategy, which was developed by 17 federal departments to prioritize health and quality of life for all Americans. Alternatively, the current administration could support a similar health in all policies approach in the following ways:

  1. The Office of Management and Budget could ask that departments integrate HiAP approach into their quadrennial strategic plans as well as their annual budget submissions.
  2. The Office of Information and Regulatory Affairs within the Office of Management and Budget could require departmental regulatory proposals to include health impact assessments.
  3. The White House Domestic Policy Council could convene leaders from select departments to establish a HiAP council. HHS could provide technical assistance to the council regarding the determinants of health and evidence-based policies that support them.

“Taking these steps could spark a more robust and comprehensive strategy across the executive branch,” added Bill Hoagland, BPC senior vice president. “Working together, policymakers across all sectors of the federal government have the potential and the opportunity to improve the health outcomes of the nation.”

​Read the report