Working towards Health Equity: The Coproduction of a Health in All Policies (HiAP) Strategy and Ordinance in Richmond, CA

In April, 2014, the City of Richmond, California, became one of the first and only municipalities in the USA to adopt a Health in All Policies (HiAP) ordinance and strategy. HiAP is increasingly recognized as an important method for ensuring policy making outside the “health sector” addresses the determinants of health and social equity. A central challenge facing HiAP is how to integrate community knowledge and health equity considerations into the agendas of policymakers who have not previously considered health as their responsibility or view the value of such an approach. In Richmond, the HiAP strategy and ordinance has an explicit focus on equity and guides city services from budgeting to built environment improvements, violence prevention, education, access to health care and social environment programs. In this presentation we will describe the evolution of Richmond’s HiAP strategy and its content. Highlighting how this HiAP was the result of the coproduction of science policy. Coproduction includes participatory processes where different public stakeholders, scientific experts, and government sector leaders come together to jointly generate policy goals, health equity metrics and evaluation, and policy drafting and implementation strategies. We conclude with some insights for how public health professionals, university partners and city governments might consider HiAP as an approach to achieve “targeted universalism,” or the idea that general population health goals can be achieved by targeting actions and improvements for specific vulnerable groups and places to achieve health equity.