Policy in all sectors affects health, through multiple pathways and determinants. Health in all policies (HiAP) is an approach that seeks to identify and influence the health and equity impacts of policy decisions, to enhance health benefits and avoid harm. This usually involves the use of health impact assessment or health lens analysis. There is growing international experience in these approaches, and some countries have cross-sectoral governance structures that prioritize the assessment of the policies that are most likely to affect health. The fundamental elements of HiAP are inter-sectoral collaboration, policy influence, and holistic consideration of the range of health determinants affected by a policy area or proposal. HiAP requires public health professionals to invest time to build partnerships and engage meaningfully with the sectors affecting the social determinants of health and health equity. With commitment, political will and tools such as the health impact assessment, it provides a powerful approach to integrated policymaking that promotes health, well-being, and equity. The COVID-19 pandemic has raised the profile of public health and highlighted the links between health and other policy areas. This paper describes the rationale for, and principles underpinning, HiAP mechanisms, including HIA, experiences, challenges and opportunities for the future.

Living in compact neighbourhoods that are walkable, well connected, with accessible green space can benefit physical and mental health. However, the pandemic raises concern up to what extent features of compact neighbourhood design affect transmission of viral respiratory infections. We conducted a systematic review to identify, appraise and synthesise evidence reporting associations between transmission of respiratory viruses, including Covid-19, and dwelling or population density or other features of neighbourhood design. Twenty-one studies met our inclusion criteria. These studies used different measures of neighbourhood design, contributing to inconsistent findings. Whereas no convincing conclusion can be drawn here, the outcome of this review indicates that robust, global evidence is warranted to inform future policies and legislation concerned with compact neighbourhood design and transmission of respiratory and viral infection.

Introduction To inform policymaking, it is important to understand the population health impacts of recent increased inflation, and of measures implemented to mitigate these. Methods We used scenario modelling to estimate (a) how recent increased inflation would affect household incomes in Scotland, (b) how mitigation measures would modify these effects and (c) how mortality outcomes and inequalities in these would change as a result. Against a long-term average inflation scenario (baseline), we compared unmitigated recent inflation and inflation mitigated by UK Government support policies. We estimated differential price inflation by income quintile, based on the proportion of household spending on different goods and services. Using differential inflation rates, we estimated change in spending power (real income) for 2704 Scottish households in the 2015/16 Family Resources Survey, both with and without mitigating UK Government policies, and scaled these to the Scottish population. We estimated mortality effects using a cross-sectional relationship between household income and mortality, by deprivation quintile. Results Unmitigated price inflation was 14.9% for the highest income quintile and 22.9% for the lowest. UK Government policies partially mitigated impacts of the rising cost of living on real incomes, although households in the most deprived areas of Scotland would still be £1400 per year worse off than at baseline. As a result, even with mitigating measures in place, premature mortality was estimated to increase by up to 6.4%, and life expectancy to decrease by up to 0.9%. Effects would be greater in more deprived areas, and health inequalities would increase as a result. Conclusions Large and inequitable impacts on mortality in Scotland are predicted if real-terms income reductions are sustained. Progressive Cost of Living Support payments are not sufficient to offset the mortality impacts of the greater real income reductions in deprived areas.