Supporting Social Justice through Health in All Policies planning: A Public Health Imperative framed in a Post-disaster context

Initiating a Health in All Policies (HAP) approach to local planning can face a number of challenges. But in Galveston, Texas, a small city of 60,000, we found that a natural disaster—Hurricane Ike, which damaged 70% of the city's structures—created a window of opportunity for supporting a HAP approach that would have been difficult to achieve under normal circumstances. Galveston, which had unusually large social and health inequities prior to the disaster, faced even worse inequities after the hurricane. This presentation explores lessons in relation to accelerating local planning to address social determinants of health and health inequities through a HAP approach in post-disaster contexts, and the generalizability of those lessons. Working with local government, civil society, and others, our Center adapted the Healthy Development Measurement Tool to establish a baseline of health- and recovery-relevant indicators related to environmental stewardship, transportation, social cohesion, essential goods and services, housing, and the economy. This baseline was used to identify recovery planning needs and fed into the city's Comprehensive Plan and Master Redevelopment Plan. The presentation will outline lessons learned on implementing the work (and compare that experience to lessons described in the literature), the critical features that create that “window of opportunity” for accelerating a Health in All Policies approach and how to recognize that window even when a natural disaster has not struck, strategies for framing messages and advancing action to support a social determinants approach within such contexts, and tools found to be effective in our experience.