Centering Health Equity in Decisionmaking in the United States

Documenting the state of the HIA and HiAP field

Recognizing that health is influenced by a wide range of social, economic, and environmental factors, the public health community in the United States has been working over the last two decades to incorporate health considerations into cross-sector decisions and policymaking.

Inspired by international initiatives beginning in the 1990s, practitioners in the U.S. began
by applying and refining a rigorous methodology for health impact assessment (HIA), which quantifies the potential health effects of proposed policies, projects, and programs. While exploring the strengths and limitations of HIA, some in the field began to apply another broader framework called Health in All Policies (HiAP), which is “a collaborative approach to improving the health of all people by incorporating health considerations into decision-making across sectors and policy areas.”

In partnership with the Health Impact Project and our advisors State of Equity, Onside Partners and our affiliate Ang Hadwin explored the current state of the HIA and HiAP field through interviews and a literature scan in 2022-2023. We produced the following briefs and theories of change to document and share our findings.

Onside Partners and Ang Hadwin are grateful to field practitioners and funders who generously gave their time and expertise to this project.

This project was supported by the Health Impact Project, a collaboration of the Robert Wood Johnson Foundation and The Pew Charitable Trusts. The views expressed are those of Onside Partners and do not necessarily reflect the views of the Health Impact Project, The Pew Charitable Trusts, or the Robert Wood Johnson Foundation.