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The state of Health in All policies (HiAP) in the European Union: potential and pitfalls
  1. Meri Koivusalo
  1. Correspondence to Dr Meri Koivusalo, Senior Researcher, National Institute for Health and Welfare, Social and Health Policy, Po Box 30, FI-00271 Helsinki, Finland; meri.koivusalo{at}


Health in All Policies (HiAP) was formally legitimated as a European Union (EU) approach in 2006. It resulted from more long-term efforts to enhance action on considering health and health policy implications of other policies, as well as recognition that European-level policies affect health systems and scope for health-related regulation at national level. However, implementation of HiAP has remained a challenge. European-level efforts to use health impact assessment to benefit public health and health systems have not become strengthened by the new procedures. And, as a result of the Lisbon Treaty, European-level policy-making is expected to become more important in shaping national policies. HiAP has at European level remained mostly as rhetorics, but legitimates health arguments and provides policy space for health articulation within EU policy-making. HiAP is a broader approach than health impact assessment and at European level requires consideration of mechanisms that recognise the nature of European policy-making, as well as extending from administrative tools to increased transparency, accountability and scope for health and health policy-related arguments within political decision-making in the EU.

  • European Union
  • health impact assessment
  • health policy
  • impact assessment
  • public health
  • public health Europe, public health policy

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  • Linked articles 102129, 102459, 110437.

  • Competing interests None.

  • Provenance and peer review Commissioned; externally peer reviewed.

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