Grant: Travel Awards - Institute Community Support

Governments are increasingly using Health in All Policies (HiAP) approaches to improve health equity. However, the challenge of coordinating traditionally "siloed" policy sectors remains. As a result, governments have used a number of strategies to encourage sectors to work together towards improving health equity. Specific policy design may motivate non-health sector participation in HiAP activities. However, there is a gap in the literature examining the role of policy design in addressing complex policy issues, such as health inequities. We are interested in understanding the role legal HiAP mandates, such as those found in Quebec and Thailand, play in motivating sectors to participate in HiAP. In our multiple case study project, we examined HiAP cases from nine jurisdictions: Sweden, South Australia, Quebec, Ecuador, Norway, Scotland, California, Finland and Thailand. We interviewed stakeholders involved in the implementation of HiAP, including civil servants, politicians and academics. Analysis focused on explaining the mechanisms behind why and how sectors decide to participate in HiAP, with a focus on the contextual factors that make each case unique. We found that, although having legislation requiring sectoral participation in HiAP may be effective at having sectors work together, there are multiple strategies governments can employ to encourage participation. In addition, legislating intersectoral action does not necessarily result in strong sectoral participation, or a particularly motivated workforce, which may ultimately weaken the implementation of HiAP. This research helps to understand how and why policy design influences policy implementation, particularly for complex policy issues. While each case's context influences how HiAP work.