Institut national de
santé publique du Québec
About HiAP

Health in All Policies (HiAP): A Canadian Framing

1. Official Definition

The World Health Organization (WHO) defines Health in All Policies (HiAP) as “an approach to public policies across sectors that systematically takes into account the health implications of decisions, seeks synergies, and avoids harmful health impacts in order to improve population health and health equity” (WHO & Ministry of Social Affairs and Health, Finland, 2014, p.2). 

In plain language, HiAP means integrating health considerations into decision making across all sectors, with the goal of improving health and wellbeing, reducing inequities, and avoiding unintended harm.

2. Core Principles

HiAP is grounded in the understanding that:

  • Health and health equity are shaped not only by health policies and programs but also by social determinants—such as housing, education, employment, the environment, and community safety—most of which lie outside the health sector and are influenced by decisions in other government sectors and by non-government actors.
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  • Improving health and health equity, therefore, requires intersectoral collaboration to align goals, break down silos, and improve policy coherence.
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  • Intersectoral action relies on collaboration across government sectors and, where relevant, the involvement of non-governmental actors.

3. A Context-Driven Approach and an Evolving Process 

HiAP is not a one-size-fits-all approach; its structure and focus shift depending on local priorities, governance systems, and available resources. This adaptability is a strength, allowing each jurisdiction to shape the approach to its specific needs and realities. 

HiAP can also be understood as a developmental process that progresses through different stages of maturity (Storm, 2016). At earlier stages, it may remain less formalized, taking the shape of ad hoc collaborations—such as informal networks, shared planning, or joint projects. At the more advanced end, it becomes institutionalized through governance structures and formal mechanisms for intersectoral collaboration. 

Acknowledging these different stages underscores that HiAP can generate value well before becoming fully institutionalized, and that each step contributes to building more coherent and equitable policy.

4. The Canadian Context

In Canada, HiAP operates within a complex system of government, where responsibilities for health and its determinants are shared across federal, provincial/territorial (F/P/T) and local governments, in addition to the distinct roles of First Nations, Inuit, and Métis (FNIM) governments and governance systems. 

Implementation opportunities differ across levels of government: 

  • Federal level of government – responsibility for regulating hazards to health and safety (e.g., tobacco, food, and drugs, developing national policy frameworks to improve the wellbeing of Canadians, convening partners and interested parties, and funding cross-jurisdictional initiatives.
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  • Provincial/territorial level of government – typically responsible for health care systems and many determinants of health (e.g., education), with opportunities to embed HiAP into sectoral strategies and interministerial mechanisms.
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  • Local and regional level of government – closer to communities, often leading on program delivery, local partnerships, and place-based approaches to address social determinants.
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  • FNIM governments and governance systems – drawing on the governance systems of FNIM peoples for policy and program planning and delivery, and grounding actions in their holistic worldviews, unique determinants of health, distinct rights, concepts of wellbeing, knowledges, governance practices, and self-determination. 

5. CNHiAP’s Role 

Established in 2022, the Canadian Network for Health in All Policies (CNHiAP) is a bilingual network that brings together public health actors from across Canada—including federal, provincial, territorial, regional, and local governments; First Nations, Inuit, and Métis governments and organizations; universities; and not-for-profits—who are working on or interested in HiAP approaches. Through its activities and resources—accessible to members and the wider public health community—the CNHiAP promotes HiAP approaches that reflect Canada’s diverse contexts, governance systems, and ways of knowing, helping to make healthier public policies the norm across the country. 

The CNHiAP adopts the WHO definition of HiAP as a guiding framework and works to: 

  • Understand and document how HiAP is interpreted and implemented in Canadian contexts;
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  • Identify challenges and opportunities for advancing HiAP practice;
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  • Strengthen collaboration across sectors and levels of government; and
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  • Promote approaches that integrate FNIM perspectives and address health equity. 

By connecting practitioners, policy makers, and researchers, the CNHiAP aims to support diverse HiAP practices that are effective, context-sensitive, and equity-driven. 

References

Storm, I. (2016). Towards a HiAP cycle: Health in All Policies as a practice-based improvement process. [Vrije Universiteit Amsterdam]. https://research.vu.nl/ws/portalfiles/portal/42165582/chapter%206.pdf 

World Health Organization & Finland Ministry of Social Affairs and Health. (2014). Health in All Policies: Helsinki statement. Framework for country action. The 8th Global Conference on Health Promotion. https://www.who.int/publications/i/item/9789241506908