Incorporating Health in All Policies: Tips for Grantmakers
October 17, 2022
This tip sheet offers a menu of strategies and considerations for organizations interested in incorporating a Health in All Policies (HiAP) and equity-centered approach to the development and implementation of requests for proposals (RFPs) and notice of funding opportunities (NOFOs).
Considerations for Incorporating HiAP and Equity-Centered Approaches
Application Development
✔ Ensure the application process is fair and transparent, especially regarding selection criteria and administrative requirements.
✔ Acknowledge applicants’ capacity to write and submit grant applications. Identify gaps that may hinder non-traditional partners from applying (i.e., workforce capacity, training needs for evaluation). Consider a separate funding opportunity for these non-traditional partners.
✔ Define co-benefits for applicants and the value for their constituents. Consider framing in terms of creating efficiencies to make the business case for promoting HiAP efforts (i.e., collaboratively going further, faster, better, and cheaper). This approach can help bridge a top-down approach for managing costs with a bottom-up approach for improving equitable health outcomes.
Program Design
✔ Prioritize investments in historically marginalized or under-resourced communities.
✔ Balance expectations with flexibility for grantees. Set priorities and provide structure to support grantees, while allowing grantees to define metrics and their vision for success. Encourage going beyond the traditional approach of counting widgets, and move toward assessing longer term outcomes (e.g., relationship building).
✔ Build in opportunities to provide technical assistance for HiAP to grantees based on their ability to work across sectors. Offer parallel training, mentoring, and technical assistance for grantees alongside funding packages. Be specific about the type of support funders can provide.
Implementation Strategies for Incorporating HiAP and Equity
Measurement and Evaluation
✔ Apply a weighted scoring system that prioritizes investment in under-resourced areas while considering economic efficiency.
✔ Ensure there are measurable metrics for social determinants of health—not just aspirational goals. These metrics should be chosen based on alignment with grantees’ work. Consider identifying cross-sector partnership-building as a reported-on metric.
Communication
✔ Improve awareness of public health partners’ role in cross-sector work, such as climate and health, by communicating co-benefits of HiAP strategies.
✔ Use an equitable language guide to incorporate inclusive language into grant opportunities.
✔ Allow grantees to define equity in the context of their work. Use language that is accessible and appropriate for the audience. Step outside of silos to avoid jargon and terms that do not resonate.
Alternative Terminology for HiAP and Equity
Although there is a substantial body of literature around HIAP, the term may not resonate with individuals and communities outside of public health practitioners. For this reason, organizations may choose alternative messaging to communicate the underlying HiAP principles while using more inclusive language with certain audiences.
For example, people may often associate the word “health” with the healthcare industry, which may hold negative connotations due to media coverage of healthcare legislation and response to the COVID-19 pandemic. The word "policies" may also trigger government-centric sentiments or perceptions of political agendas, lobbying, and other government processes, which can lead to pause—most commonly in rural communities. In place of “policies,” organizations may consider using the term “decisions” to communicate a similar concept while avoiding confusion.
Alternative framing for “HiAP” or “equity” may include other terms, such as:
- Community resilience
- Quality of life
- Cross-sector engagement and strategies to get there
- Wellness
- Livability
- Thriving community
- Joined-up decision-making
- All-of-government approach
- Sustainability
- Relationship-building
- Mutual learning
Acknowledgements
ASTHO thanks staff from our partner organizations for their input in this document, including the American Public Health Association, Association of Maternal & Child Health Programs, ChangeLab Solutions, George Washington University, Georgia Health Policy Center, Green & Healthy Homes Initiative, Health Resources and Services Administration, Kansas Health Institute, National Association of County and City Health Officials, National Center for Healthy Housing, National Environmental Health Association, Pew Research Center, and University of Wisconsin.
This brief was prepared with support from CDC. The content of this document is solely the responsibility of the author and do not represent the official view of CDC.