Creating a burden of evidence to consider the impact of Health in All Policies: A program logic approach

An important part of government efforts to address the social determinants of health is encouraging healthy public policy. To facilitate this, the South Australian (SA) Government has adopted a Health in All Policies (HiAP) approach. The approach was implemented in 2008 and is now being evaluated through research funded by the Australian National Health and Medical Research Council (NHMRC).

Throughout this paper we draw on a case study to show how we are building a ‘burden of evidence’ that supports logically coherent chains of relations between HiAP activities and the intended outcomes. The case study is based on a project that HiAP staff in SA have undertaken with the education sector to increase parental engagement in children’s literacy among lower SES families. We have developed a program logic model to explain how activities undertaken during the project contribute to the short term objective of increasing parental engagement in literacy, and also how these activities link with broader public health evidence that demonstrates connections between literacy and health outcomes. The paper details the activities, processes and actors involved in the project, and highlights how these comprise essential components of implementing HiAP in a way that supports the underlying theory of change.

This paper contributes theory and empirical evidence that can inform political debate about how the impact of government efforts to address the social determinants of health may be evaluated. The work also provides insight into how integrated and coordinated efforts are achieved across government and how the effectiveness of these efforts in progressing shared goals, and achieving sustainable change, can be assessed.