As Vermonters, we take great pride in our quality of life, strong communities, natural places and commitment to healthy living. We share a common goal: to ensure that our state continues to be one of the healthiest and best places in the U.S. for all of us to live, work and play. Complex problems cannot be solved by one agency or discipline alone. We must work together across agencies for collective impact.
what is health in all policies?
Health in All Policies (HiAP) is a collaborative approach to improving the health of all people by incorporating health considerations into decision making of cross-sectors and policy areas. A Health in All Policies approach identifies the ways in which decisions in multiple sectors affect health and how better health can support the goals of multiple sectors. The goal is to ensure that decision-makers are informed about the health consequences of various policy options during the decision making process.
Why Health in all policies?
Cross-sector action is needed to create health equity. Health outcomes are determined less by our access to health care services and the quality of those services – and more by the combination of health behaviors and the social and economic circumstances into which we are born and live. These social and economic circumstances are the roots of inequality.
THE HIAP Task Force
The Health in All Policies Task Force is a cabinet-level body established by Executive Order No. 7-15 to identify programs, policies and strategies to improve the health of Vermonters, especially vulnerable populations, and to coordinate across agencies around issues of healthy communities.
The Task Force developed a Health and Equity Framework for creating economically and socially vibrant communities that build upon the shared values of equity, access and affordability. The framework identified potential areas of impact and domains for measuring successes.
The HiAP Task Force provides an annual report to the governor on –
- Potential opportunities to include health criteria in regulatory, programmatic and budgetary decisions
- Promising practices in other jurisdictions to identify opportunities for innovation and coordination across sectors that include consideration of potential positive and negative health impacts of decisions
- Evidence-based actions and policies to improve the wellness of state employees across state government, including healthy food procurement policies
The Task Force will seek to enhance health while advancing our other goals, such as protecting natural resources and agricultural lands, increasing the availability of affordable housing, improving air and water quality, improving infrastructure systems, promoting public health and active lifestyles, planning sustainable communities, increasing educational attainment and meeting the state’s climate change goals.
Complementing the Health in All Policies approach, Vermont is involved in a project to analyze what we spend on health as a state—not simply individual health care related expenditures. Clinical care is only a small contributor to our overall health and wellness. Other factors—such as social, environmental, and individual behaviors—influence both our health and our ability to make healthy choices. We need to better understand current health-related investments across sectors and rebalance health spending.
- What are we spending now?
- What is our spending getting us?
- What happens when we change the way we spend?
Recommendations will be provided to non-health state agencies to integrate health-related metrics into their existing performance dashboards. These model dashboards will foster shared accountability for health across sectors.
Health in All Policies Efforts Underway
Vermont already has many examples of a Health in All Policies approach. The challenge and opportunity now is to maximize the impact through system-wide changes supported by a cabinet level Task Force empowered to utilize the authority and tools of government.
Best Practices for Population Health and Cross Sector Accountability
The state has the “power of the purse” to promote the purchase, and offering, of healthy local foods. Vermont has developed standards to be used whenever food is offered at cafes and cafeterias on state property or at state-funded meetings, conferences, and events that are paid for with state or federal dollars (in accordance with the Department of Finance and Management Policy 4.0 Department Provided Food and Refreshments).
The Healthy Food Standards for State Government provides a basic description of standards developed to comply with 29 V.S.A. § 160c.
Implementing Vermont's Healthy Food Standards offers suggestions regarding the various options for implementation and some tips from the field.
The Healthy Eating Guidelines for Worksites offers suggestions for food options at workplace gatherings that can promote healthier food choices by following the recommendations put forth by the Dietary Guidelines for Americans.
Eating healthy food, especially a variety of fruits and vegetables, is essential to promote and maintain good health. Local, regional, and state polices can help people access healthy, local food and protect our food system.
- Farm to School helps Vermont schools engage students in their local food system by incorporating local food and farm education into their cafeterias, classrooms and communities.
- Farm to Plate is Vermont’s food system plan being implemented statewide to increase economic development and jobs in the farm and food sector and improve access to healthy local food for all Vermonters.
- Regional Food System Plan for Vermont’s Northeast Kingdom: This plan represents an attempt to develop a vibrant agricultural economy and food system in the region through a regional planning process that builds on the strengths of regional and statewide planning, as well as local and decentralized planning. The goal of this plan is “to drive the development of new and more diverse agricultural activity and to develop a comprehensive strategy to stimulate this innovative food system sector for Caledonia, Essex, and Orleans Counties”.
- Best Practices in Agriculture : The Best Practices are a set of evidence-based guidelines and activities that connect initiatives of each state sector to population health.
Education and health go hand in hand. People with more education have better health outcomes. What this tells us from a policy perspective is that schools of all levels have the ability to improve population health directly.
Vermont School Wellness Policy Guidelines: The Vermont School Wellness Policy Guidelines and Implementation resource was developed using the Local School Wellness Policy Final Rule and USDA’s Smart Snacks Nutrition Standards for all Foods Sold in Schools, as required by the Healthy, Hunger-Free Kids Act of 2010. Each local education agency participating in the National School Lunch Program or the School Breakfast Program is required to develop and implement a local wellness policy. The wellness policy is guides the agency to create supportive school nutrition and physical activity environments. The Policy Guidelines were developed through collaboration between the Agency of Education, Department of Health and Agency of Agriculture.
We need energy to keep us healthy; energy is used for cooking, heat, transport, medical care, and more. However, not all energy is safe and affordable; fossil fuels can harm our health from their production to their use. Energy efficiency programs like weatherizing homes and using renewable energy improve the health of people and the environment.
Best Practices in Energy : The Best Practices in Energy are a set of evidence-based guidelines and activities that connect initiatives of each state sector to population health. These cross-sectoral activities demonstrate an intentional adoption of a health-in-all-policies framework. The Best Practices are a product of the Public Service Department, developed with technical assistance from the Health Department and the Vermont Health in All Policies Task Force. The Best Practices align with the Total Health Expenditure Analysis as a governmental tool to measure and create a culture of health.
Safe and adequate housing is essential to people’s health and wellbeing. Health and housing policies are designed to ensure people of all ages are not exposed to toxins in their living spaces, or to provide access to essential services from housing sites.
- Support and Services at Home (SASH) coordinates the resources of social service agencies, community health providers and nonprofit housing organizations to support Vermonters who choose to live independently at home.
- Indoor Air Quality Studies have shown that air pollution in our homes can be more of a health concern than air pollution outside. Indoor pollutant levels may be many times higher than outdoor levels. Learn more about how to address indoor air quality at this site.
- Lead Abatement The Asbestos and Lead Regulatory Program works to protect Vermonters from exposure to asbestos and lead when maintaining, renovating, or demolishing buildings and when cleaning up after a fire, flooding, or storm damage. The program strives to prevent exposure of the public to asbestos and lead in workplaces, buildings, and housing associated with asbestos or lead abatement activity.
- Best Practices in Housing : The Best Practices are a set of evidence-based guidelines and activities that connect initiatives of each state sector to population health.
Community planning is essential to creating places that: support active living (walking, biking, recreation); expand access to healthy and affordable foods; have tobacco and substance free spaces; and protect people’s safety, air and water quality – all of which are essential for good health. “Healthy community design” changes the physical environment, community infrastructure and local policies to create such an environment. Healthy community design means planning and designing communities to make it easier for people to live healthy lives.
- Vermont Healthy Community Design Resource, Active Living & Healthy Eating provides an overview of the town planning process and examples of how to crate communities that support active lifestyles and access to healthy food.
- Health Impact Assessment (HIA) is a process that helps evaluate the potential health effects of a plan, project or policy before it is built or implemented. Learn more about Vermont’s HIA work at this site.
- East Central Vermont Plan: This is a regional plan to support planning efforts that integrate housing, land use, economic and workforce development, transportation, and infrastructure investments in a manner that empowers jurisdictions to consider the interdependent challenges of: (1) economic competitiveness and revitalization; (2) social equity, inclusion, and access to opportunity; (3) energy use and climate change; and (4) public health and environmental impact.
- ECOS Sustainability Project: The ECOS Project, “A Sustainable Future for Chittenden County,” represents a once-in-a-generation opportunity to engage citizens, organizations and municipalities in a conversation about the future of our communities and the region as a whole. The plan is an update to the Chittenden County Regional Plan, Metropolitan Transportation Plan, and Comprehensive Economic Development Strategy.
- Best Practices in Land-use and Community Development: The Best Practices are a set of evidence-based guidelines and activities that connect initiatives of each state sector to population health.
Respect. Protect. Enjoy. The Vermont Agency of Natural Resources promotes the sustainable use of Vermont's natural resources, protects and improves the health of Vermont's peoples and ecosystems, and promotes sustainable outdoor recreation. Vermonters are proud of our state's beautiful natural resources. Parks, forests, wildlife, lakes, rivers; we have many opportunities for fun, physical activity, and improving mental health. The economic benefits of natural resources are also important to public health.
- Best Practices in Natural Resources : The Best Practices are a set of evidence-based guidelines and activities that connect initiatives of each state sector to population health.
A connected network of adequate, safe, and accessible transportation options is essential for people of all ages and abilities to access goods and services, including education, jobs, food, health and dental care, recreation and social opportunities. Local, regional, and state polices that ensure all modes of transportation are included in all transportation and development projects will support good health.
- Complete Streets ensures streets safely accommodate all transportation system users, regardless of age, ability, or their preferred mode of transportation, including walking, biking, driving, or the use of transit. Learn more about Vermont’s Complete Streets efforts at this site.
- Vermont Bicycle and Pedestrian Program: Learn about Vermont’s Bicycle and Pedestrian Program, whose goal is to provide safe and convenient facilities for those Vermonters who desire alternative transportation opportunities.
- Best Practice in Transportation: The Best Practices are a set of evidence-based guidelines and activities that connect initiatives of each state sector to population health. These cross-sectoral activities demonstrate an intentional adoption of a health-in-all-policies framework. The Best Practices are a product of the Agency of Transportation, developed with technical assistance from the Health Department and the Vermont Health in All Policies Task Force. The Best Practices align with the Total Health Expenditure Analysis as a governmental tool to measure and create a culture of health.