HiAP-HiAP-Hooray for BC
The idea that stood out the most to me from this week’s readings was the Health in All Approach to policy. This wasn’t the fist time that I had come across this idea, however, in light of readings which presented theories of policy making, I found myself contemplating how likely the adoption of a HiAP approach is here in BC. This is not to say that I think that a HiAP framework would not be appropriate or beneficial, quite the contrary. Rather, I wonder what the chances are that such an approach could be adopted in BC given our current political and economic climate.
With the ten year track record of the BC liberal party proving that they are most concerned with “bottom-line-in-all-policies” I am doubtful that under the current leadership HiAP would be genuinely supported and/or adopted. As counter productive as it may seem to those of us working in or studying public health, the penny-wise-pound-foolish policies of the previous two provincial administrations doesn’t exactly jibe with the lessons presented in the publications from the 2010 Adelaide Meeting. As the Adelaide convention acknowledges HiAP is a long term forward thinking approach to public policy. Effectively implementing HiAP takes a significant amount of time and sincere dedication from various policy actors. Furthermore, realising the benefits can take years. In a political climate more concerned with immediate results and short term fiscal savings I can’t help but think HiAP uptake (from current leadership) is far from near. I am aware that a HiAP inspired initiative for improving chronic health condition in BC has been implemented (ActNow BC). However, while a complete assessment of this initiative is beyond the scope of this posting, I do question whether a one off program, targeting very narrowly defined health conditions can truly be considered HiAP? With the upcoming election polls heavily favouring Adrian Dix, will have to wait and see what tack he will take in addressing the social and health inequalities that he has campaigned on and whether a comprehensive and collaborative policy approach will factor into his solution of these issues.
Admittedly, the above discussion has been focused on political leadership which, as A Glossary of Theories for Understanding Policy Making made clear, is but one aspect of many when it comes to policymaking. I was surprised then, at the lack of discussion from this paper in regards to the role public opinion and influence has on the policy making process. Having previously studied this process I was curious to know how Canadians feel about HiAP. In November 2012 the Canadian Nursing Association published findings from a nation wide survey on its website indicating that most Canadians believe that public policy should be evaluated for the effect it will have on the health of fellow citizens. While I do find some results more striking than others, I will say that I was somewhat surprised by the extent of public support for HiAP.
I began this posting by reflecting on my reaction to this week’s readings as they apply to BCs current political landscape. While I wasn’t surprised to find HiAP research and support within the realm of public health discourse in Canada (ie CIHR, CAN) or even examples of HiAP style initiative being put into practice, I am still left wondering what it will take before the value of health is truly factored into all aspects of public policy in BC.