Collaboration drives equity: the power of cross-cutting policy
18 September 2026
What does innovative, thoughtful and impactful policy- and decision-making look like in the face of overstretched health system budgets?
Health doesn’t begin and end in hospitals, clinics or doctors’ surgeries. It is shaped every day by where we live, learn, work and travel, and by the opportunities available to us. Policies on housing, transport, education, employment, the environment and taxation all influence our health.
That’s why improving health and reducing inequalities cannot be the sole responsibility of the health sector; it requires coordinated action across policy areas and sectors. This is the idea behind a cross-cutting approach: bringing people, expertise and organisations together to tackle interconnected challenges, inform policy and deliver services that meet peoples’ needs.
As health systems come under increasing pressure, this kind of collaboration is no longer optional. It is essential if we are to make better decisions, use resources more effectively and address the root causes of ill health.
Why integrated policy matters
Public institutions often work in silos, making it harder to tackle complex social challenges that cut across sectors – and the consequences of this are both human and financial. Health inequalities lead to poorer outcomes, reduced participation in society and increased pressure on health systems. The European Parliament has estimated that losses linked to health inequities cost around 1.4% of gross domestic product in the European Union.
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Public institutions often work in silos, making it harder to tackle complex social challenges that cut across sectors.
Against this backdrop, there is growing recognition that fairer, healthier societies depend on different sectors working together. Cross-cutting policy helps policymakers align priorities, maximise impact and deliver shared benefits for people, communities and economies.
Despite increasing awareness of its importance, collaboration remains challenging because organisations are often accountable to their own priorities, goals and governance structures, rather than shared outcomes. Differences in organisational cultures, competing objectives, fragmented funding arrangements and a lack of shared data systems can all make collaboration difficult. Building trust, aligning incentives and developing common goals across organisations takes time and resources, which are often in short supply when systems are under pressure.
Health in All Policies: a framework for collaboration
One of the most established cross-cutting strategies is the World Health Organization (WHO) initiative Health in All Policies (HiAP). It recognises that health is shaped not only by healthcare services but also by decisions across government, and aims to ensure that all sectors consider their impact on health and health equity.
HiAP encourages policymakers to look beyond the priorities of a single department and consider how decisions affect different population groups. Transport policy, for example, can influence air quality, access to employment and physical activity. Housing policy can affect safety, financial security and exposure to environmental risks. And education and employment policies can shape opportunities throughout the life course.
By making these wider impacts visible, HiAP supports decision-making, helping sectors identify shared goals, manage trade-offs, avoid unintended harms and work together to improve health and equity.
However, collaboration does not happen automatically. It requires strong leadership, clear governance, shared accountability, and adequate resources and expertise. Tools such as Health Impact Assessments can help ensure health is considered when decisions are made, but their use is inconsistent; and these tools would benefit from clearer guidance, sustainable funding and stronger integration into routine policymaking.
At its core, cross-cutting policy is about ensuring public services work for the people they serve.
Cross-cutting policy in practice
The value of cross-cutting policy can be seen in many areas, with outcomes often shaped by decisions made beyond the health sector.
- Oncology: Cancer outcomes are influenced by education, research, social care and technology policies. Examples include California’s Cancer Prevention Act, which promotes HPV vaccination awareness through schools, and the National Cancer Policy Forum, which brings together stakeholders to address issues spanning prevention, treatment and health inequalities.
- Digital health: Effective digital transformation relies on coordination across healthcare, technology, regulation, finance and workforce planning. Estonia’s e-health system illustrates the need to align data infrastructure, privacy, digital identity and healthcare delivery, while the WHO’s Global Strategy on Digital Health highlights the importance of governance, interoperability, equity and workforce capacity.
- Cardiovascular health: Improving cardiovascular outcomes requires action across food, transport, education and urban planning. Chile’s food labelling legislation increased consumer awareness of the danger of certain additives; studies have shown that products on sale in supermarkets now generally contain less salt, sugar and fats. And the CARDIO4Cities initiative unites partners from different sectors to address cardiovascular risk factors, demonstrating how quickly translating evidence into action can improve urban population health. In São Paulo, Dakar and Ulaanbaatar, the initiative improved population-level hypertension control up to sixfold within two years contributing to reductions of up to 12% in strokes and 13% in heart attacks.
These examples demonstrate that cross-cutting policy requires practical mechanisms for collaboration, including shared objectives, joint accountability, integrated funding and common data systems. They also highlight that health is a political choice. To build government support, health leaders must understand the priorities of other sectors and show how improving health contributes to wider social, economic and environmental goals.
Health equity must be the priority
At its core, cross-cutting policy is about ensuring public services work for the people they serve. The WHO Geneva Charter for Well-being recognises that health is shaped by a wide range of social, economic and environmental factors, and calls for whole-of-government and whole-of-society action to create the conditions that enable people and communities to thrive.
Achieving this will depend on collaboration. Embedding equity into policymaking means considering not only whether a policy improves overall outcomes, but also who benefits, who may be left behind, and how avoidable differences between groups can be reduced.
Cross-cutting policy is not a silver bullet, but it offers a practical way to address complex health challenges and make better use of limited resources. By working towards shared goals, sectors can tackle the root causes of poor health, reduce inequalities and create healthier, fairer societies.