Made to Order: Using Gubernatorial Executive Orders to Promote Health in All Policies

Abstract

The Health in All Policies (HiAP) approach presents different and often complementary avenues to address the social determinants of health. But at its core, HiAP relies on collaborations to make health a governmental priority across sectors. In the United States, HiAP efforts can involve multiple levels of government and strategies that may vary in formality. In some states, state-level HiAP efforts may be advanced by gubernatorial executive orders (GEOs). GEOs are often used to promote health. GEOs may be powerful in the HiAP context because of their potential to manage the different sectors that comprise state government and thereby address the social determinants of health. By synthesizing the relevant literature and providing illustrative examples of HiAPpromoting GEOs, this review explores how, why, and whether to use GEOs for HiAP. It demonstrates that GEOs may advance HiAP with or without using a HiAP label, along different steps in the policymaking cycle, and by addressing common HiAP challenges. Champions of HiAP should therefore examine the possible utility of GEOs to promote state-level HiAP efforts.