Laying the foundations for Health in All Policies in local government: A case study from Lane County, Oregon

Lane County Public Health is challenged by declining revenues while also facing increasingly complex and inextricably linked health problems. Research establishes that social, physical, and economic environments and conditions have dramatic implications for how long and how well people live; however, these conditions are rarely called out in local decision making processes. In the fall of 2013, based upon recommendations of local health department staff, the Lane County, Oregon Board of County Commissioners/Board of Health (BCC/BOH) directed the County Administrator to incorporate a health analysis into proposals brought before the Board for consideration. Lane County Public Health (LCPH) was charged with development and implementation of the new administrative procedures. To this end, LCPH drafted the policy language, developed tools and training for county staff, and worked to build support for implementation. A “Health Implications Checklist,” was designed by LCPH to assist all staff, regardless of public health training, to identify, evaluate, and briefly communicate the potential health and equity impact of a proposed policy, program, or action. Staff trainings on the checklist provided a venue for LCPH staff to address concerns regarding the implementation of the policy and, through this discussion, cultivate stronger relationships and buy-in. LCPH is actively evaluating the policy implementation and presenters will describe resources required for implementation; quality and sufficiency of tools and technical support; and impact of the new policy, including extent of adoption, quality of related health impact analyses, and extent to which the analyses guide proposals and Board decisions.