Maryland Center for Health Equity Leads Workgroup Advancing Maryland's "Health in All Policies" Approach
From housing policies to minimum wage laws, all policies can affect the health of our communities—especially for the most vulnerable among us.
That’s the basis of the “Health in All Policies” model developed by the World Health Organization. The model evaluates the health implications of every policy, integrates health considerations into policymaking and recognizes that health is influenced by a multitude of factors beyond healthcare and at times, beyond the scope of traditional public health activities.
In Maryland, the General Assembly has tried to establish a statewide Health in All Policies procedure, explained Wesley Queen, a senior staff member at the School of Public Health. But the legislation never received a majority vote due to budget constrictions.
Instead, the University of Maryland School of Public Health’s Center for Health Equity (M-CHE), in partnership with a group of Maryland lawmakers, introduced a bill that engaged M-CHE in advising state lawmakers on healthy public policy. The bill, SB 340, was sponsored by Maryland State Senator Shirley Nathan-Pulliam and Delegate Robbyn Lewis and signed into law by Governor Larry Hogan in 2017.
The law directed M-CHE to convene a workgroup to make recommendations to and inform state and local legislators on laws and policies that promote health equity and have a positive impact on the lives of Maryland’s residents.
The workgroup, operating without a budget, was also tasked with submitting a final report with their findings and recommendations, as well as draft legislation necessary to carry out the recommendations, to the Senate Education, Health, and Environmental Affairs Committee and the House Health and Government Operations Committee by January 31, 2018.
For over a year, M-CHE's Stephen Thomas and Queen, in cooperation with agencies across Maryland, led the workgroup in examining the health of Maryland residents and identifying ways for the State and local government to collaboratively implement policies with a positive impact on the health of state residents. They considered health factors such as educational attainment, economic stability, public safety, environmental factors and access to transportation.
“The workgroup was the first step, the foundation, for a statewide Health in All Policies model,” said Queen. “And because the university had responsibility for developing and managing the workgroup, it provided opportunities for graduate students to get involved and play a role.”
Lanna Duarte, MPH '19 (Health Policy and Management), who was part of the workgroup for her capstone project, contributed to the final report and led the development of a toolkit to provide state actors with information about Health in All Policies. The toolkit built on research into already-established Health in All Policies models in other states, such as California and Tennessee.
“In creating the tool kit, we asked ‘how do we highlight social determinants of health and that all agencies have a part to play?” said second-year health policy and management master’s student Sarah Hurlbert. As the administrative assistant for the workgroup, Hurlbert arranged and recorded the monthly workgroup meetings between the M-CHE and the various groups.
“[With the workgroup], I got something very unique, very different than a typical internship because I got to be on an incredibly interdisciplinary team,” said Hurlbert. “I definitely want to work in policy when I graduate. This showed me that I can go anywhere and have an impact.”
The workgroup presented their final report and recommendations to the General Assembly earlier this fall. Recommendations include creating a Council, developing a toolkit with a reference guide and establishing data-sharing between state agencies, among others.
Lawmakers could have a chance to vote on whether to implement these recommendations as soon as the next session, which runs from January 8 to April 6, 2020. However, it may take another year for the recommendations to reach the floor.
“If I had a choice, I would want them to pass the Council recommendation,” said Queen.
The Council would consist of a wide variety of stakeholders, including workgroup members and their organizations, state agencies, local and community organizations and community members. The Council’s purpose would be to implement the Maryland Health in All Policies Program, which includes advising policymakers on how to consider and address social determinants of health.
“Once the Council is established, it could begin to implement key aspects of the Health in All Policies framework,” said Queen. “The only question is financing.”
Individuals interested in supporting the Health in All Policies framework can contact their representatives and encourage them to pass the workgroup’s recommendations.