State and local government officials are responsible for the health and well-being of their people as health is a fundamental human right. They have a critical leadership and stewardship role in the organized effort by society to promote health and well-being. Given this responsibility and the complexity of many contemporary health challenges, governments have a crucial role to play in identifying the barriers to and determinants of good health in their communities, and to jointly work – to invest in programs and policies that create healthier environments for living and working. They need to support communities to identify important health determinants, championing public goods and social justice in health and well-being.




Addressing the social determinants of health through intersectoral action refers to the coordinated efforts of two or more sectors within government to improve health outcomes. This can include working across different levels of government such as district, provincial and national jurisdictions. Intesectoral action through Health in All Policies approach has been implemented differently in different contexts reflecting local social and political cultures as well as government structures. It is important to share experiences and lessons learned to understand how the approach can be most effective at each level. The term intergovernment is sometimes used to refer to these horizontal and vertical linkages between levels of government within a country. The most common structures and mechanisms for intersectoral action include: cabinet committees and secretariats; parliamentary committees; interdepartmental committees and units; mega-ministries and merges; joint budgeting; and intersectoral policy-making procedures.

The conditions that most favour effective intersectoral collaboration that will address social inequities in health include:

  • building and sustaining a strong case for health equity which connects to broader sectoral, governmental and societal goals (which requires capacities and intelligence, including evidence and analysis, in order to stimulate debates in parliament, in cabinet committees and in the media);
  • government support and encouragement of intersectoral action i.e. support for a common understanding of problems and of possible solutions to address social inequities and health improvement.;
  • sectors having shared interests or both benefit from cooperation;
  • addressed issues have high political importance and require urgent action; proposed policy has public support; existence of strong, effective leaders in the bureaucracy (policy champions/entrepreneurs);
  • intersectoral action is well-planned with clear objectives, roles and responsibilities;
  • laws exist or are planned to support the proposed policy; available sufficient resources; and monitoring and sustaining outcomes defined.


Possible obstacles to successful intersectoral collaboration within government are:

  • distracted or unstable leadership;
  • lack of institutional support;
  • fragmented government functions;
  • sub-national geographical and government jurisdiction divisions;
  • limited or misused resources (staff, funding, etc.);
  • poorly planned or unclear objectives and responsibilities;
  • impediments of hostile stakeholders;
  • shifting political priorities; weak enforcement;
  • unrealistic time frames;
  • and restricted policy space.