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California Governor Newsom’s State Budget Lifts up Health in All Policies

August 15, 2019

In an historic decision, the 2019-2020 California state budget established three Health in All Policies (HiAP) positions at the cabinet-level California Strategic Growth Council (SGC) in order to promote healthy communities, racial equity, and environmental sustainability across state government and within SGC’s own programs.

This decision builds on nearly a decade of public/private partnership between the State and the Public Health Institute (PHI) to facilitate the California HiAP Task Force and institutionalize Health in All Policies as an approach in state government. While government agencies have contributed significant staff time to this effort over the last ten years, this is the first commitment of resources for Health in All Policies in the State Budget.

PHI’s HiAP Director Julia Caplan noted, “This decision signals the success of the Health in All Policies approach, and is a commitment from Governor Gavin Newsom’s administration and the legislature to advance cross-sector collaborative action on the social determinants of health and equity.” The purpose of Health in All Policies is to transform government, so equity and health are part of the fabric of decision-making across all policy areas and functions. Caplan said, “Our goal is not only to embed health and equity into government programs and practices, but to institutionalize the Health in All Policies approach so that it is a normal part of government operations.”

Established through a Governor’s Executive Order in 2010, California’s HiAP Task Force is the first state-level Health in All Policies initiative in the country. The Task Force integrates health, equity, and environmental sustainability as key priorities across agencies as diverse as housing, transportation, social services, food and agriculture, and corrections and rehabilitation, among others. Key achievements have included:

  • launching the California Office of Farm to Fork,

  • embedding health and equity criteria into transportation and land use guidelines, and

  • launching California’s Government Alliance on Race and Equity (GARE) Capitol Cohort, which engages 19 State departments and agencies in developing and implementing racial equity action plans.

The public/private partnership to support California’s HiAP Task Force has relied upon funding from philanthropic organizations such as The California Endowment, as well as staff provided by the California Department of Public Health (CDPH). SGC has conducted oversight of the HiAP Task Force without any of its own dedicated staff for this work, until now.

According to SGC Executive Director Louise Bedsworth, the new staff will not only support multi-sector collaboration for health and equity across state government, but will also apply this approach to SGC’s own grant-making programs (over half a billion dollars in fiscal year 2018-19), and will support the implementation of SGC’s recently adopted Racial Equity Action Plan.

Caplan stated, “We are incredibly proud of SGC for this step toward institutionalization of the Health in All Policies approach – and our work is far from done. These new state-funded positions are critical anchors for ensuring the long-term stability of the HiAP Task Force, and they will face significant demands as they engage in this relatively new field of practice which requires continual stakeholder engagement, priority alignment, and diplomacy. We look forward to continuing our partnership to support California’s long-term success.”

In the short-term, PHI will focus on transferring institutional knowledge and providing on-the-job learning for new state HiAP staff, filling programmatic staffing gaps in areas that are core to HiAP work, and supporting collaboration between CDPH and SGC to systematize measurement and reporting processes. PHI will also continue to partner with state government to run the GARE Capitol Cohort and expand this program to deepen state capacity and long-term commitments to address institutional and structural racism.