









































October 2019 Volume  4 Issue 1

MADE TO ORDER: USING GUBERNATORIAL EXECUTIVE 
ORDERS TO PROMOTE HEALTH IN ALL POLICIES

Maxim Gakh, JD, MPH

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 HiAP-
promoting 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.  

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A HiAP strategy aims to promote health through 
collaboration across sectors

Health Impact Assessments (HIAs) can help address 
the social determinants of health across sectors that 
make decisions with health consequences (NRC, 
2011). These sectors include the built environment, 
housing, education, agriculture, and energy (NRC, 
2011; Rudolph, Caplan, Ben-Moshe, & Dillon, 2013; 
Wernham & Teutsch, 2015; Towe et al., 2016). HIAs 
have the ability to engage communities in decision-
making, educate policymakers, create partnerships, 
and link data and scientific evidence to real-time 
decisions (NRC, 2011; Dannenberg, 2016; Wernham 
& Teutsch, 2015). In fact, HIAs are one of the few 
existing, systematic tools available to target decisions 
that impact these social determinants (NRC, 2011). 
Addressing the social determinants of health can 
simultaneously impact populations across multiple 
health outcomes (Frieden, 2010). Yet HIA work also 
faces challenges (NRC, 2011; Dannenberg, 2016; 
Rudolph et al., 2013). An important challenge of using 
HIAs to target the social determinants is that most 
HIAs analyze a limited number of issues rather than 
creating consistent and sustainable change in how 
decisions with indirect health impacts are approached 
(NRC, 2011; Wismar et al., 2006).  

Thus, it is important that HIAs are part of a larger 
movement aiming for comprehensive integration of 
health into all sectors’ decisions (IOM, 2011; Kemm, 
2006; Rudolph et al., 2013; Wernham & Teutsch, 
2015). This movement, sometimes called “Health in 
All Policies” (HiAP), is rooted in the “healthy public 
policy” concept (Gottlieb, Fielding, & Braveman, 
2012; IOM, 2011; Rudolph et al., 2013; Sihto, 
Ollila, & Koivusalo, 2006; Gase, Pennotti, & Smith, 
2013; Wernham & Teutsch, 2015). HiAP has gained 
acceptance in the public health field both in the U.S. 
and globally (Rudolph et al., 2013; Ollila, 2011; Sihto 
et al., 2006; Wimar et al., 2006; Wernham & Teutsch, 
2015) along with the recognition that the social 
determinants of health are critical in shaping health 
outcomes (Sihto et al., 2006; Frieden, 2010; Wernham 

& Teutsch, 2015; WHO, 2008; CDC, 2018; IOM, 2011; 
APHA, 2012; HHS, 2019). 

Like HIAs, at its core, HiAP focuses on integrating 
health concerns into non-health sectors (IOM, 2011; 
Rudolph et al., 2013; Sihto et al., 2006; Gase et al., 
2013; Wernham & Teutsch, 2015; Gakh & Rutkow, 
2017). It involves addressing the health implications 
of policy decisions in non-health sectors, because 
“other sectors are often key in terms of health 
determinants” (Ollila, 2011, p.13). But this is easier 
said than done: “The central issue facing HiAP is 
how to enhance the feasibility of placing health 
criteria on the agendas of policy-makers who have 
not previously considered health” (Sihto et al., 2006, 
p.11). Operationally, HiAP-related efforts can take 
many forms (Sihto et al., 2006; Rudolph et al, 2013; 
Ollila, 2011; Wernham & Teutsch, 2015; Gase et al., 
2013). They can focus on specific social determinants 
or health-related issues (Sihto, et al., 2006; Rudolph 
et al., 2013; Ollila, 2011; Wernham & Teutsch, 2015). 
Alternatively, HiAP efforts can directly focus on 
decision-making processes and systems change to 
encourage consideration of health across decisions 
(Sihto et al., 2006; Rudolph et al., 2013; Ollila, 2011; 
Gase et al., 2013; Wernham & Teutsch, 2015).

Cross-sector partnerships are also central to HiAP 
endeavors (Sihto et al., 2006; Rudolph et al., 2013; 
Ollila, 2011; Gase et al., 2013; Wernham & Teutsch, 
2015). In the broadest sense, these partnerships 
involve collaboration among governmental, for-
profit, and non-profit organizations formed around 
health-related goals and comprised of context-
specific activities and enabled by different structures 
(Johnston & Finegood, 2015). HiAP efforts are not 
exclusively government-centric (Rudolph et al., 
2013; Ollila, 2011; Wernham & Teutsch, 2015). 
However, governmental HiAP efforts usually 
involve collaboration by government agencies 
that are organized around sometimes seemingly 
inconsistent missions (Rudolph et al., 2013; Sihto et 
al., 2006). In the HiAP context, Greer & Lillvis define 
“intersectoral governance” as “the set of political, 



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legal, and organizational structures that enables 
the coordination of multiple sectors to address 
causes of ill health, and is therefore the mechanism 
permitting HiAP” (2014, p.13). Implementing this 
type of cross-sector governmental collaboration can 
encounter barriers, such as variable organizational 
cultures; limited understandings across organizations; 
inconsistent definitions of success; and limited 
resources, tools, and expertise (Johnston & Finegood, 
2015; Sihto et al., 2006; Rudolph et al., 2013; Gase et 
al., 2013; Wernham & Teutsch, 2015). 

HiAP implementation can pursue formal strategies, 
informal strategies, or both (Rudolph et al., 2013; 
Gase et al., 2013; Wernham & Teutsch, 2015). Formal 
HiAP endeavors, including implementation that relies 
on law, can catalyze or set out cross-sector HiAP 
work (Rudolph et al., 2013; Gakh, 2015; Wernham 
& Teutsch, 2015). In fact, as Hall & Jacobson found 
in interviews with policy actors, legal mandates 
can sometimes “encourage buy-in for cross-sector 
collaboration” (2018, p.6). Different formal, law-
based mechanisms are available to issue HiAP-related 
mandates – including legislation, regulation, and 
memoranda of understanding – and choosing among 
them can involve balancing structural factors like legal 
authority and political realities (Rudolph et al., 2013; 
Gakh, 2015). 

Gubernatorial executive orders (GEOs) may be 
the right mechanisms for state-level HiAP efforts, 
depending on legal structures and de facto realities 
(Rudolph et al., 2013; Gakh, 2015). GEOs allow 
governors to mandate action from multiple state-
level sectors simultaneously and may present fewer 
procedural obstacles and require less political capital 
to adopt than other legal mechanisms that formalize 
HiAP (Gakh, 2015). A closer look at GEO documents 
and how they can be crafted to encourage HiAP is 
therefore in order. Examining these documents in 
detail is also an important first step to inform studies 
on how GEOs impact HiAP implementation. 

GEOs are an important public health policy 
mechanism that is well suited for HiAP

GEOs are an essential and sometimes overlooked 
policy mechanism that can advance public health 
(Gakh, Vernick, & Rutkow, 2013; Gakh, Callahan, 
Goodie, & Rutkow, 2019). A GEO may allow a state 
governor to set or operationalize formal changes to 
programs and policies without the need for official 
legislative support (Gakh et al., 2013). State laws 
vary in what a governor can legitimately direct by 
executive order (CSG, 2010; Ferguson & Bowling, 
2008; Gakh et al., 2013). GEOs may be used for 
symbolic gestures, such as flying flags on state 
property (Ferguson & Bowling, 2008). But they may 
also undertake various substantive public health goals 
by targeting public health emergencies, establishing 
or modifying government agencies or programs, 
directing public health agencies, prioritizing health 
issues, and controlling state operations (Gakh et al., 
2013). 

GEOs can promote the cross-sector governmental 
work that constitutes HiAP. The literature contains 
examples of GEOs as law-based, state-level 
mechanisms to promote HiAP (Pepin, Winig, Carr, 
& Jacobson, 2017; Weisman, Helmy, Moua, & Aoki, 
2018; Gakh, 2015; Polsky, Stagg, Gakh, & Bozlack, 
2015; Rudolph et al., 2013; Gase et al., 2013; 
Wernham & Teutsch, 2015). But a closer look at the 
mechanism itself in the context of HiAP is warranted 
because most public health-related GEOs tend to 
include directives salient to HiAP. These directives 
include managing government agencies, establishing 
new government entities, mandating cross-sector 
collaboration, or requiring the investigation and 
development of recommendations to address 
particular health problems (Gakh et al., 2019). This 
review uses frameworks focused on public health 
policy and cross-sector collaboration to demonstrate 
that, like other formal mechanisms, GEOs (1) can 
promote HiAP with or without using a HiAP label; 
(2) help prioritize, formulate, adopt, implement, and 
evaluate HiAP efforts; and (3) address some common 



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barriers to state-level governmental HiAP efforts. 
To illustrate these points, this review relies on GEOs 
identified through key terms searches in relevant 
databases (e.g., Westlaw’s Netscan Executive Orders 
database and the Lexis Advance databases containing 
state statutes and legislation and administrative codes 
and regulations) and from a priori knowledge.

GEOs may promote HiAP with or without an 
articulated commitment to HiAP

HiAP implementation can involve sweeping efforts 
that focus on modifying decisions that impact the 
social determinants of health or on more discrete 
health-related priorities (Rudolph et al., 2013). GEOs 
can support both types of efforts and can do so 
with or without labeling the effort as “HiAP.” This is 
important because it demonstrates that GEOs that 
support HiAP can take many forms.   

At the broad and explicit end of the range of GEO 
types, for example, in 2015, Vermont Governor 
Shumlin issued an order to establish a HiAP Task 
Force (Vt. Exec. Order No-07-15 (Oct. 6, 2015)). This 
order recognizes the role that non-health sectors 
play in health behaviors and outcomes and therefore 
that health necessitates a “shared responsibility 
and an integrated and sustained policy response 
across government” (Vt. Exec. Order No-07-15 
(Oct. 6, 2015, p.1)). The Vermont HiAP Task Force, 
chaired by the state health commissioner and with 
representatives from different state agencies (e.g., 
agriculture, commerce, transportation, public service, 
education, human services, natural resources), is 
responsible for determining how “to more fully 
integrate health considerations into all state programs 
and policies, and promote better health outcomes 
through interagency collaboration and partnership” 
(Vt. Exec. Order No-07-15 (Oct. 6, 2015)). California’s 
HiAP efforts similarly include a 2010 GEO, issued 
by Governor Schwarzenegger, that also directly 
establishes an intergovernmental HiAP Task Force 
rooted in the state’s efforts to manage growth (Cal. 
Exec. Order No. S-04-10 (Feb. 23, 2010)). A recent 

New York GEO requires state government entities to 
integrate the state’s Prevention Agenda priorities and 
World Health Organizations Domains of Livability, 
which focuses on healthy aging, into their plans, 
“guidance, policies, procedures, and procurements” 
to promote “Health Across All Policies” (N.Y. Exec. 
Order No. 190 (Nov. 14, 2018, p.1)).   

However, considering only GEOs that institute broad 
HiAP initiatives and include HiAP labels overlooks 
HiAP-promoting GEOs that contain substantive 
directives that can facilitate cross-sector HiAP work 
but are not cast in “health in all policies” language. At 
its core, HiAP is defined as integrating health concerns 
into other sectors (IOM, 2011; Rudolph et al., 2013; 
Sihto et al., 2006); HiAP implementation strategies are 
therefore not limited to HiAP-oriented government 
organizations (Rudolph et al., 2013; Wernham & 
Teutsch, 2015; Gase et al., 2013). Understanding 
how HiAP-like orders can integrate health into other 
sectors is critical because it reveals a more subtle use 
of GEOs to advance the HiAP approach.

GEOs focused on education and children from several 
states illustrate how GEOs with no mention of HiAP 
can encourage more nuanced HiAP-like practice. 
For example, on its face, a Kansas GEO makes no 
mention of HiAP, the social determinants of health, 
or the connection between education and health 
(Kan. Exec. Order No. 10-05 (Jun. 17, 2010)). However, 
the order creates a statewide advisory group, with a 
state health agency representative, focused on early 
childhood education to examine opportunities for 
collaboration among state government agencies and 
to improve existing data systems (Kan. Exec. Order 
No. 10-05 (Jun. 17, 2010)). A Connecticut order uses 
a similar approach; it requires the state Office of 
Early Childhood to establish an interagency effort 
around early childhood education that includes 
the health department (Conn. Exec. Order No. 35 
(Jun. 24, 2013)). It also requires the state executive 
branch to “collaborate and cooperate with the Office” 
(Conn. Exec. Order No. 35 (Jun. 24, 2013, p.2)). 
Similarly, recognizing that many state government 



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agencies “lead programs that are important to the 
success and well-being” of children, a Tennessee 
GEO establishes a Children’s Cabinet focused on 
“shared policy, planning, coordination, cooperation, 
and collaboration” (Tenn. Exec. Order No. 10 (Jan. 
30, 2012, p.1)). This Cabinet includes state-level 
government entities, including agencies responsible 
for education, human services, and health, and 
requires executive agencies to support the Cabinet’s 
efforts (Tenn. Exec. Order No. 10 (Jan. 30, 2012)). The 
Kansas, Connecticut, and Tennessee orders illustrate 
that, even when GEOs do not contain HiAP language, 
they can include HiAP-like content requiring cross-
sector collaboration around health and integrating 
health into government work in areas that are 
important to the social determinants. 

GEOs may prioritize, formulate, adopt, 
implement, and evaluate intergovernmental 
HiAP work

Policymaking is a complex and dynamic process with 
the ability to change health (Brownson, Chriqui, 
& Stamatakis, 2009; Golden & Moreland-Russell, 
2016). Multiple models and frameworks are useful 
to understand policy in the context of health (Oliver, 
2006). Although policy-making is difficult to categorize 
meaningfully, one way to visualize policymaking is as 
a five-step cycle comprised of policy prioritization, 
formulation, adoption, implementation, and 
evaluation – and back to the start (Golden & 
Moreland-Russell, 2016). GEOs can support HiAP 
efforts throughout each step of this policymaking 
cycle. 

GEOs can prioritize integrating health into other 
sectors through cross-sector collaboration. 
Prioritization involves identifying, selecting, or framing 
a health-related issue for policy intervention (Golden 
& Moreland-Russell, 2016). Both HiAP-based and 
HiAP-like GEOs can do this. For example, the Vermont, 
New York, and California GEOs clearly establish 
health as a cross-cutting issue for state government 
agencies, elevating the importance the importance of 

considering health across government decisions and 
the pursuit of HiAP as a goal (Vt. Exec. Order No-07-
15 (Oct. 6, 2015); N.Y. Exec. Order No. 190 (Nov. 14, 
2018); Cal. Exec. Order No. S-04-10 (Feb. 23, 2010)). 
HiAP-like GEOs can also prioritize health issues and 
approaches across sectors. For instance, a Louisiana 
GEO names an existing commission as an interagency 
council to establish, review, update, and implement 
the state’s plan to address homelessness (La. Exec. 
Order No. BJ 2013-5 (Mar. 19, 2013)). Similarly, a 
North Dakota order establishes a statewide, cross-
sector coalition to improve “collaboration and 
coordination on behavioral health services for service 
members, veterans, and their families and survivors” 
(N.D. Exec. Order No. 15-01 (Jan. 8, 2015, p.1)). In 
these examples, GEOs emphasize the importance of 
health issues and frame health-related problems as 
cross-sector problems.

GEOs can also formulate policy to incorporate 
health into other sectors. Policy formulation involves 
developing, articulating, and considering policy 
solutions to health problems (Golden & Moreland-
Russell, 2016). Vermont’s executive order, for 
instance, requires the interagency HiAP Task Force 
to report to the governor “potential opportunities to 
include health criteria in regulatory, programmatic, 
and budgetary decisions” and strategies from other 
jurisdictions to integrate health across government 
decisions (Vt. Exec. Order No-07-15 (Oct. 6, 2015, 
p.2)). Although not explicitly focused on HiAP, 
Nevada’s GEO establishing a cross-sector food security 
council in the health department calls for annual 
reports with recommendations (Nev. Exec. Order 
No. 2014-03 (Feb. 12, 2014)). Both GEOs require 
cooperation around identifying and articulating cross-
sector policy solutions focused on health.

In addition, GEOs can be vehicles to adopt HiAP 
or HiAP-like policy. Adoption involves processes 
that result in choosing a particular policy (Golden 
& Moreland-Russell, 2016). The issuance of the 
Vermont, New York, and California HiAP GEOs 
embodies the adoption of a HiAP approach through 



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formal policymaking channels (Vt. Exec. Order No-
07-15 (Oct. 6, 2015); N.Y. Exec. Order No. 190 (Nov. 
14, 2018); Cal. Exec. Order No. S-04-10 (Feb. 23, 
2010)). Similarly, while not explicitly HiAP-focused, a 
Massachusetts GEO that formally adopts for multiple 
state executive agencies a policy of “procuring 
Environmentally Preferable Products and Services” 
to conserve natural resources, limit generation of 
toxic substances, and reduce negative impacts on 
health and the environment also operates as formal 
adoption of state policy integrating health concerns 
across sectors (Mass. Exec. Order No. 515 (Oct. 27, 
2009, p.2)). 

Executive orders issued by governors can help 
implement polices that embed health into non-health 
sectors through collaboration. The implementation 
phase involves operationalizing adopted policy 
through specific strategies, tasks, and responsibilities 
(Golden & Moreland-Russell, 2016). The California, 
New York, and Vermont HiAP GEOs lay out specific 
implementation strategies to operationalize HiAP. 
The Vermont and California GEOs both create HiAP 
Task Forces (Vt. Exec. Order No-07-15 (Oct. 6, 2015); 
Cal. Exec. Order No. S-04-10 (Feb. 23, 2010)). In 
addition, the California order requires the state health 
department to staff and facilitate the work of the 
HiAP Task Force (Cal. Exec. Order No. S-04-10 (Feb. 23, 
2010)), while the Vermont order requires its HiAP Task 
Force to develop tools to help state agencies consider 
health impacts of policy decisions (Vt. Exec. Order 
No-07-15 (Oct. 6, 2015)). The New York order requires 
each agency to appoint and deputize a coordinator 
responsible for HiAP implementation (N.Y. Exec. Order 
No. 190 (Nov. 14, 2018)). HiAP-like GEOs can also 
help implement policies that embed health across 
sectors. For example, Maryland’s Governor Hogan 
used a GEO to create an executive council committee 
centered on paid sick leave with representatives from 
multiple agencies and duties that include collecting 
data, surveying employees and employers, developing 
policy recommendations, providing regular updates, 
and submitting a final report (Md. Exec. Order No. 
01.01.2017.08 (May 25, 2017)). While varying in HiAP 

scope and, with or without using HiAP labels, the 
Vermont, California, New York, and Maryland GEOs 
illustrate how GEOs can be used to operationalize the 
HiAP approach and HiAP principles. 

Finally, GEOs can also be helpful mechanisms to 
launch evaluation of efforts that bring health into 
other sectors. Evaluation is the last stage of the 
policy cycle and involves examining the impacts of 
an implemented policy on its target and on other 
indicators so necessary adjustments can be made 
(Golden & Moreland-Russell, 2016). The Vermont 
GEO encourages evaluation of HiAP efforts by 
requiring Task Force members to describe how they 
are integrating health concerns into their respective 
decisions (Vt. Exec. Order No-07-15 (Oct. 6, 2015)). 
While not mentioning HiAP, a Michigan GEO that 
forms a state Interagency Council on Homelessness, 
with representatives from many government agencies 
including health, orders the Council to craft a plan to 
end homelessness and then “monitor and oversee 
the implementation” of the plan through measurable 
goals, coordinated data and reporting systems, and 
progress reports (Mich. Exec. Order No. 2015-2, Jan. 
16, 2015, p.1)). GEOs can therefore include evaluation 
components to state-level efforts that bring the 
health lens into other sectors.

GEOs may address some of the problems of 
cross-sector collaboration around health

GEOs can also tackle some common challenges faced 
by cross-sector collaborative efforts to bring health 
into governmental decision-making. Greer & Lillvis 
identify two major barriers to HiAP’s intersectoral 
governance – (1) “coordination” (i.e., how to get 
the non-health sector to focus on health) and (2) 
“durability” (i.e., how to maintain HiAP efforts 
across time) – by synthesizing relevant literature 
from the public health, political science, and public 
administration fields (2014, p.14). They identify 
three categories of possible ways to overcome these 
barriers: (1) “political leadership” (i.e., actualizing 
commitment from leaders), (2) “bureaucratic change” 



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(i.e., modifying existing processes, procedures, and 
modes of interaction) and (3) “indirect strategies” 
(i.e., pursuing longer-term changes to policy-
making) (Greer & Lillvis, 2014, p.14-15). Related 
to these solutions, Kania and Kramer articulate 
five common conditions of “successful collective 
impact”:  (1) shared agendas, (2) consistent metrics, 
(3) collaborative work that reinforces each other, (4) 
constant communication, and (5) an organization 
that can take on coordination (2011, p.23). They 
argue that “collective impact” – or “the commitment 
of a group of important actors from different 
sectors to a common agenda for solving a specific 
social problem” – provides a way to solve complex 
problems like health (Kania & Kramer, 2011). Both 
frameworks provide guidance for HiAP efforts. They 
are also consistent with other discussions in the HiAP 
literature (Rudolph et al., 2013; Gase et al., 2013, 
Wernham & Teutsch, 2015). GEOs are important tools 
that can be part of the solution to overcome barriers 
to HiAP.   

Leadership by policymakers and shared agendas 
can promote HiAP (Kania & Kramer, 2011; Greer & 
Lillvis, 2014). GEOs can foster both. Issuing a HiAP-
promoting GEO formally establishes HiAP as a cross-
sector priority at the highest level of state executive 
leadership. By using GEOs to create HiAP task forces, 
the Vermont, New York, and California governors 
formally signaled to state government agencies from 
different sectors and to others that they recognize the 
value of and are committed to HiAP (Vt. Exec. Order 
No-07-15, (Oct. 6, 2015); N.Y. Exec. Order No. 190 
(Nov. 14, 2018); Cal. Exec. Order No. S-04-10 (Feb. 23, 
2010)). The language of all three orders acknowledges 
that health policy is made across sectors and the 
importance of incorporating health into decision-
making (Vt. Exec. Order No-07-15, (Oct. 6, 2015); 
Cal. Exec. Order No. S-04-10 (Feb. 23, 2010); N.Y. 
Exec. Order No. 190 (Nov. 14, 2018)). All three orders 
establish HiAP as a shared priority for state agencies 
and health as a cross-sector responsibility through 
formal policy mechanisms issued by the state’s chief 
executives (Vt. Exec. Order No-07-15, (Oct. 6, 2015); 

Cal. Exec. Order No. S-04-10 (Feb. 23, 2010); N.Y. 
Exec. Order No. 190 (Nov. 14, 2018)). The Vermont, 
California, and New York GEOs also enshrine at least 
some robustness into their HiAP efforts. California 
requires delivering one report with recommendations 
to state government (Cal. Exec. Order No. S-04-10 
(Feb. 23, 2010)); Vermont requires an annual report 
with recommendations to the governor and periodic 
reporting of progress (Vt. Exec. Order No-07-15, 
(Oct. 6, 2015)). And New York requires establishing 
responsible parties (N.Y. Exec. Order No. 190 (Nov. 
14, 2018)). HiAP efforts would likely be sustained at 
least until completion. Furthermore, as long as these 
GEOs remain in effect, they can serve as a formal 
commitment to HiAP articulated for all state agencies 
by the state’s chief executives.

HiAP-like GEOs, too, can be a vehicle for leadership 
to support coordination and durability and to set 
cross-sector agendas on issues with health impacts. A 
Colorado GEO, for example, adopts a shared agenda 
of supporting “zero emissions vehicles” (Colo. Exec. 
Order No. B-2019-002 (Jan. 17, 2019, p.2)). It creates 
a cross-sector workgroup of state agencies, including 
health, and encourages agencies to coordinate efforts 
while requiring workgroup members to modify their 
rules, programs, and plans to support this health-
promoting goal (Colo. Exec. Order No. B-2019-002 
(Jan. 17, 2019)). By requiring the implementation of 
specific policies and clarifying that the GEO stands 
“until modified or rescinded” (Colo. Exec. Order 
No. B-2019-002 (Jan. 17, 2019, p.1)), this GEO also 
supports the robustness of HiAP-related work.

HiAP can involve modifying bureaucratic processes 
and entities to support coordination and durability, 
establish coordinating organizations, require 
reinforcing work, and encourage continuous 
communication (Kania & Kramer, 2011; Greer & 
Lillvis, 2014). GEOs can support these types of 
changes. The California and Vermont GEOs design 
new state government entities – HiAP task forces – 
as organizations to coordinate HiAP and assign the 
responsibility of leading the HiAP efforts to health 



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departments (Vt. Exec. Order No-07-15 (Oct. 6, 
2015); Cal. Exec. Order No. S-04-10 (Feb. 23, 2010)). 
Both orders also require agencies to collaborate in 
ways that augment each other’s work and encourage 
communication. California’s GEO calls upon all 
agencies that report to the governor to cooperate 
with the HiAP Task Force (Cal. Exec. Order No. 
S-04-10 (Feb. 23, 2010)). Vermont’s order requires 
agencies constantly to interact through the new task 
force as they identify health-promoting strategies; 
integrate health into their “rulemaking, policies, and 
programs;” and regularly report progress (Vt. Exec. 
Order No-07-15, Oct. 6, 2015, p.2). While New York’s 
order requires establishing HiAP-responsible staff 
across agencies who also must liaise with a central 
HiAP committee (N.Y. Exec. Order No. 190 (Nov. 14, 
2018). These changes attempt to modify normal 
bureaucratic structures and processes to enable HiAP.

A HiAP-like GEO from Washington focused on carbon 
pollution (Wash. Exec. Order 14-04 (Apr. 29, 2014)) 
also changes bureaucracy, establishes coordinating 
entities, requires reinforcing work, and encourages 
continuous communication. Among its mandates 
are requirements to non-health agencies like the 
departments of transportation, commerce, ecology, 
and administration, to take on specific tasks related 
to clean energy (Wash. Exec. Order 14-04 (Apr. 
29, 2014)). It contains requirements for mutually-
supportive work, such as including reviewing 
statutory limits on greenhouse gas emissions, 
reducing state government contributions to 
emissions, and stimulating renewable energy (Wash. 
Exec. Order 14-04 (Apr. 29, 2014, p.8)). These tasks 
contribute to a more comprehensive state policy. This 
Washington order also shifts existing government 
structures. It creates an “Energy, Transportation, 
and Climate subcabinet […] to organize, coordinate, 
and implement state agency work” related to 
carbon pollution, comprised of senior leaders from 
various state departments (Wash. Exec. Order 
14-04 (Apr. 29, 2014)). Furthermore, this GEO 
encourages communication through collaboration 
on recommendations and by including federal, tribal, 

regional, and local partners in implementation (Wash. 
Exec. Order 14-04 (Apr. 29, 2014)). 

Finally, stressing transparency and inclusiveness as 
well as creating and using shared data and metrics can 
support sustaining HiAP indirectly (Kania & Kramer, 
2011; Greer & Lillvis, 2014). Here too GEOs may be 
a helpful mechanism. For example, the California 
GEO requires its HiAP Task Force to “convene regular 
public workshops to present its work plan” and also 
to “solicit input from stakeholders” to inform its HiAP 
report (Cal. Exec. Order No. S-04-10 (Feb. 23, 2010, 
p.2)). The California and Vermont GEOs may also 
indirectly encourage transparency and inclusiveness 
through HiAP reports and recommendations that 
are made publicly available. Similarly, a Pennsylvania 
HiAP-like GEO, which focuses on cross-sector 
management, policy, and problem-solving, attempts 
to “engage internal and external stakeholders” 
to improve state government operations through 
“continuous process improvement methods” and by 
tracking key data indicators and publishing online the 
goals and progress of the governor’s administration 
(Pa. Exec. Order 2018-01 (Feb. 1, 2018, p.1)). By 
improving data systems, integrating stakeholders 
into government decision-making, and promoting 
transparency, these GEOs may indirectly contribute to 
HiAP efforts.  

Order with Caution

GEOs serve as a legal mechanism with the potential to 
support state-level HiAP efforts. They can do this by 
focusing directly on HiAP or by championing HiAP-like 
principles. They can help prioritize, formulate, adopt, 
implement, and evaluate HiAP efforts. They can also 
target some of the common obstacles that HiAP cross-
sector efforts face.  

However, GEOs may not always be the most 
appropriate vehicle to establish formal HiAP 
endeavors, and cautious optimism is in order. The 
GEOs presented here demonstrate the potential of 
GEOs to promote HiAP. But GEOs are just mechanisms 



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

9

– means to ends. Like all mechanisms, GEOs as 
mechanisms are outcome-neutral. The extent to 
which they promote or hinder HiAP is a function of 
what they actually say and how they are actually 
implemented. 

Even though, on their face some GEOs look like 
they could support HiAP, they miss opportunities; 
they do not contain language to integrate health 
into other sectors even when they recognize the 
role other sectors play in health. Florida’s order on 
transportation in one of the state’s economic hubs 
serves as an example. While this GEO articulates the 
importance of health and the connections between 
health, transportation, community development, 
economic activity, and the environment, and also 
includes cross-sector collaboration and community 
engagement directives, the order alludes to health 
without saying that some of the cross-sector partners 
must bring a health perspective to the collaboration 
(Fla. Exec. Order No. 13-319 (Nov. 1, 2013)). 
Therefore, the precise language of the GEO plays a 
vital part in the GEO’s ability to promote cross-sector 
collaboration with health in mind.  

GEOs also have structural limitations that are 
consequential in the HiAP context. For example, as 
previously discussed, there is state-by-state variation 
about what governors can do with GEOs (CSG, 2010; 
Ferguson & Bowling, 2008; Gakh et al., 2013). In 
some states there is no express legal authority to 
issue GEOs in areas especially relevant to HiAP – 
such as reorganizing the executive branch, creating 
governmental entities, or targeting administration – 
though there nevertheless may be implied authority 
to do so (CSG, 2010). Similarly, in some states, certain 
GEOs may need to undergo legislative review or 
the same procedural processes as administrative 
regulations (CSG, 2010; Ferguson & Bowling, 2008). 
Such requirements may lessen the appeal of GEOs for 
HiAP by negating some of the speed and simplicity 
that makes GEOs appealing in the first place. Like 
other policy mechanisms, GEO requirements can 
change over time, lapsing in many ways; they can 

sunset by their own provisions, expire by operation 
of law, or be over-ridden through political processes 
– by the same or a subsequent governor or through 
legislative action (Gakh et al., 2013). Recognizing 
these limitations is important in deciding whether to 
pursue a HiAP-promoting GEO.
While state governments are critical for HiAP 
implementation in the United States, federal and 
local governments should not be overlooked. There 
are many important HiAP efforts at the local level, 
some that also use executive orders. For example, 
the sustainability effort in Washington D.C. includes a 
mayoral order creating a cross-sector HiAP task force 
to plan for and recommend HiAP operationalization 
(D.C. Exec. Order No. 2013-209 (Nov. 5, 2013)). 
Local-level orders should be examined in further 
detail. Beyond executive orders, municipal, county, 
and regional government entities are important 
HiAP partners (Rudolph et al., 2013; Wernham & 
Teutsch, 2015), especially because many of the social 
determinants of health (e.g. education, housing, 
transportation) are particularly affected by local policy 
(Dean, Williams, & Fenton, 2013). 

Relatedly, in evaluating the potential use of a GEO 
for HiAP, interactions between federal, state, and 
local government entities should be considered. As 
Washington State’s Partnership Council on Juvenile 
Justice GEO demonstrates, sometimes HiAP-like GEOs 
may be in direct reaction to federal policy. This order 
makes clear that the Council it establishes is a direct 
response to federal legislation that “requires each 
state to establish a state juvenile justice advisory 
group to receive [federal] funds” (Wash. Exec. Order 
No. 10-03 (Sept. 13, 2010, p.1)). While orders like 
these can simultaneously respond to federal policy 
and promote HiAP, the extent to which they evidence 
a genuine commitment to state-level, HiAP-promoting 
policy merits asking. It may be difficult to distinguish 
policy from politics; the intent of a GEO that looks 
like it promotes HiAP may actually be to achieve an 
alternative goal. This is important because the intent 
of a HiAP-promoting GEO may affect the robustness of 
the resulting HiAP effort. 



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

10

Notably, whether HiAP-promoting GEOs actually 
result in HiAP implementation is an important 
question. Just because a health sector representative 
is involved in cross-sector collaboration around 
health does not mean the health perspective will 
prevail or even receive adequate attention. Limited 
authority, resources, commitment, bureaucratic 
changes, or know-how that accompany a GEO that 
appears HiAP-promoting may result in unsuccessful 

State
Citation with Date 

Issued 
Online Availability Order Topic

Additional 
information on 
implementation 

(where available)

California
Ca. Exec. Order No. 
S-04-10 (Feb. 23, 
2010)

https://wayback.archive-it.
org/5763/20101008184544/http://
gov.ca.gov/executive-order/14537/

Health in All 
Policies

https://www.cdph.
ca.gov/Programs/OHE/
Pages/HIAP.aspx

Colorado
Colo. Exec. Order No. 
B-2019-002 (Jan. 17, 
2019)

https://www.colorado.gov/
governor/sites/default/files/
inline-files/b_2019-002_support-
ing_a_transition_to_zero_emis-
sions_vehicles.pdf

Zero Emissions 
Vehicles

https://www.colorado.
gov/pacific/cdphe/
zero-emission-vehi-
cle-mandate-proposal

Connecticut
Conn. Exec. Order 
No. 35 (Jun. 24, 
2013)

https://portal.ct.gov/-/media/
Office-of-the-Governor/Execu-
tive-Orders/Others/Governor-Dan-
nel-P-Malloy--Executive-Or-
der-No-35.pdf

Office of Early 
Childhood

https://www.ct.gov/
oec/site/default.asp

Washington, 
D.C.

D.C. Exec. Order No. 
2013-209 (Nov. 5, 
2013)

https://www.dcregs.dc.gov/
Common/NoticeDetail.aspx?noti-
ceId=N0045216

Sustainable DC
https://www.sustain-
abledc.org/

Florida
Fla. Exec. Order No. 
13-319 (Nov. 1, 2013)

https://www.flgov.com/wp-con-
tent/uploads/orders/2013/13-319-
plan.pdf

East Central 
Florida Corridor 
Task Force

https://spacecoasttpo.
com/plan/east-cen-
tral-florida-corri-
dor-task-force/

Kansas
Kan. Exec. Order No. 
10-05 (Jun. 17, 2010)

https://kslib.info/DocumentCenter/
View/578/EO-10-05?bidId=

Early Childhood 
Advisory Council

---

Louisiana
La. Exec. Order No. 
BJ 2013-5 (Mar. 19, 
2013)

https://www.doa.la.gov/Pages/osr/
other/2013BJexo.aspx

Interagency 
Council on 
Homelessness

---

Massachusetts
Mass. Exec. Order 
No. 515 (Oct. 27, 
2009)

https://www.mass.gov/execu-
tive-orders/no-515-establish-
ing-an-environmental-purchas-
ing-policy

Environmental 
Purchasing Policy

https://www.mass.
gov/environmental-
ly-preferable-prod-
ucts-epp-procure-
ment-programs

HiAP efforts or even further undermine public health. 
Even more crucial but difficult to evaluate is whether 
HiAP-promoting GEOs actually improve the social 
determinants of health. Of course, these evaluation 
questions are equally important to ask of all public 
health efforts, including efforts that use other legal 
mechanisms to formalize policy. Despite these 
cautions, GEOs should not be overlooked by HiAP 
practitioners and advocates as vehicles to promote 
cross-sector HiAP efforts in state government.

https://wayback.archive-it.org/5763/20101008184544/http://gov.ca.gov/executive-order/14537/
https://wayback.archive-it.org/5763/20101008184544/http://gov.ca.gov/executive-order/14537/
https://wayback.archive-it.org/5763/20101008184544/http://gov.ca.gov/executive-order/14537/
https://www.cdph.ca.gov/Programs/OHE/Pages/HIAP.aspx
https://www.cdph.ca.gov/Programs/OHE/Pages/HIAP.aspx
https://www.cdph.ca.gov/Programs/OHE/Pages/HIAP.aspx
https://www.colorado.gov/governor/sites/default/files/inline-files/b_2019-002_supporting_a_transition_to_zero_emissions_vehicles.pdf
https://www.colorado.gov/governor/sites/default/files/inline-files/b_2019-002_supporting_a_transition_to_zero_emissions_vehicles.pdf
https://www.colorado.gov/governor/sites/default/files/inline-files/b_2019-002_supporting_a_transition_to_zero_emissions_vehicles.pdf
https://www.colorado.gov/governor/sites/default/files/inline-files/b_2019-002_supporting_a_transition_to_zero_emissions_vehicles.pdf
https://www.colorado.gov/governor/sites/default/files/inline-files/b_2019-002_supporting_a_transition_to_zero_emissions_vehicles.pdf
https://www.colorado.gov/pacific/cdphe/zero-emission-vehicle-mandate-proposal
https://www.colorado.gov/pacific/cdphe/zero-emission-vehicle-mandate-proposal
https://www.colorado.gov/pacific/cdphe/zero-emission-vehicle-mandate-proposal
https://www.colorado.gov/pacific/cdphe/zero-emission-vehicle-mandate-proposal
https://portal.ct.gov/-/media/Office-of-the-Governor/Executive-Orders/Others/Governor-Dannel-P-Malloy--Executive-Order-No-35.pdf
https://portal.ct.gov/-/media/Office-of-the-Governor/Executive-Orders/Others/Governor-Dannel-P-Malloy--Executive-Order-No-35.pdf
https://portal.ct.gov/-/media/Office-of-the-Governor/Executive-Orders/Others/Governor-Dannel-P-Malloy--Executive-Order-No-35.pdf
https://portal.ct.gov/-/media/Office-of-the-Governor/Executive-Orders/Others/Governor-Dannel-P-Malloy--Executive-Order-No-35.pdf
https://portal.ct.gov/-/media/Office-of-the-Governor/Executive-Orders/Others/Governor-Dannel-P-Malloy--Executive-Order-No-35.pdf
https://www.ct.gov/oec/site/default.asp
https://www.ct.gov/oec/site/default.asp
https://www.dcregs.dc.gov/Common/NoticeDetail.aspx?noticeId=N0045216
https://www.dcregs.dc.gov/Common/NoticeDetail.aspx?noticeId=N0045216
https://www.dcregs.dc.gov/Common/NoticeDetail.aspx?noticeId=N0045216
https://www.sustainabledc.org/
https://www.sustainabledc.org/
https://www.flgov.com/wp-content/uploads/orders/2013/13-319-plan.pdf
https://www.flgov.com/wp-content/uploads/orders/2013/13-319-plan.pdf
https://www.flgov.com/wp-content/uploads/orders/2013/13-319-plan.pdf
https://spacecoasttpo.com/plan/east-central-florida-corridor-task-force/
https://spacecoasttpo.com/plan/east-central-florida-corridor-task-force/
https://spacecoasttpo.com/plan/east-central-florida-corridor-task-force/
https://spacecoasttpo.com/plan/east-central-florida-corridor-task-force/
https://kslib.info/DocumentCenter/View/578/EO-10-05?bidId=
https://kslib.info/DocumentCenter/View/578/EO-10-05?bidId=
https://www.doa.la.gov/Pages/osr/other/2013BJexo.aspx
https://www.doa.la.gov/Pages/osr/other/2013BJexo.aspx
https://www.mass.gov/executive-orders/no-515-establishing-an-environmental-purchasing-policy
https://www.mass.gov/executive-orders/no-515-establishing-an-environmental-purchasing-policy
https://www.mass.gov/executive-orders/no-515-establishing-an-environmental-purchasing-policy
https://www.mass.gov/executive-orders/no-515-establishing-an-environmental-purchasing-policy
https://www.mass.gov/environmentally-preferable-products-epp-procurement-programs
https://www.mass.gov/environmentally-preferable-products-epp-procurement-programs
https://www.mass.gov/environmentally-preferable-products-epp-procurement-programs
https://www.mass.gov/environmentally-preferable-products-epp-procurement-programs
https://www.mass.gov/environmentally-preferable-products-epp-procurement-programs


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

11

Maryland
Md. Exec. Order No. 
01.01.2017.08 (May 
25, 2017)

https://content.govdelivery.com/
attachments/MDGOV/2017/05/25/
file_attachments/822423/Executi-
veOrder%2B01.01.2017.08.pdf

Committee on 
Paid Sick Leave 
Policy

https://www.dllr.state.
md.us/paidleave/paid-
leavereport.pdf

Michigan
Mich. Exec. Order 
No. 2015-2 (Jan. 16, 
2015)

https://www.michigan.gov/
documents/snyder/EO_2015-
2_479496_7.pdf

Interagency 
Council on 
Homelessness

https://www.
michigan.gov/whit-

North Dakota
N.D. Exec. Order No. 
15-01 (Jan. 8, 2015)

http://www.nd.gov/veterans/
files/resource/2015.1.8%20Execu-
tive%20Order%202015-01.pdf

Cares Coalition
https://www.ndcares.
nd.gov/

Nevada
Nev. Exec. Order No. 
2014-03 (Feb. 12, 
2014)

http://gov.nv.gov/uploadedfiles/
govnvgov/Content/News_and_Me-
dia/Executive_Orders/2014_Imag-
es/EO_2014-03_GovernorsCoun-
cil_FoodSafety.pdf

Governor’s 
Council on Food 
Security

http://dpbh.nv.gov/
Programs/OFS/GCFS_
Meetings/OFS_-_Gov-
ernor_s_Food_Securi-
ty_Council/

New York
N.Y. Exec. Order No. 
190 (Nov. 14, 2018)

https://www.governor.ny.gov/
news/no-190-incorporat-
ing-health-across-all-poli-
cies-state-agency-activities

Health Across All 
Policies

https://health.ny.gov/
prevention/preven-
tion_agenda/health_
across_all_policies/

Pennsylvania
Pa. Exec. Order 2018-
01 (Feb. 1, 2018)

https://www.oa.pa.gov/Policies/
eo/Documents/2018-01.pdf

Governor’s 
Office of 
Performance 
Through 
Excellence

https://www.gover-
nor.pa.gov/about/
office-performance-ex-
cellence/#about

Tennessee
Tenn. Exec. Order No. 
10 (Jan. 30, 2012)

https://publications.tnsosfiles.
com/pub/execorders/exec-or-
ders-haslam10.pdf

Governor’s 
Children’s 
Cabinet

---

Vermont
Vt. Exec. Order No-
07-15 (Oct. 6, 2015)

https://legislature.vermont.
gov/statutes/section/03APPEN-
DIX/003/00069

Health in All 
Policies

https://www.health-
vermont.gov/about-
us/our-vision-mission/
building-culture-health

Washington
Wash. Exec. Order 
No. 10-03 (Sept. 13, 
2010)

https://www.governor.wa.gov/
sites/default/files/exe_order/
eo_10-03.pdf

Partnership 
Council on 
Juvenile Justice

https://www.dshs.
wa.gov/ra/office-ju-
venile-justice/wash-
ington-state-part-
nership-council-juve-
nile-justice

Washington
Wash. Exec. Order 
14-04 (Apr. 29, 2014)

https://www.governor.wa.gov/
sites/default/files/exe_order/
eo_14-04.pdf

Carbon Pollution 
Reduction and 
Clean Energy 
Action

https://www.governor.
wa.gov/boards-com-
missions/workgroups-
and-task-forces/
carbon-emissions-re-
duction-taskforce-cert

https://content.govdelivery.com/attachments/MDGOV/2017/05/25/file_attachments/822423/ExecutiveOrder%2B01.01.2017.08.pdf
https://content.govdelivery.com/attachments/MDGOV/2017/05/25/file_attachments/822423/ExecutiveOrder%2B01.01.2017.08.pdf
https://content.govdelivery.com/attachments/MDGOV/2017/05/25/file_attachments/822423/ExecutiveOrder%2B01.01.2017.08.pdf
https://content.govdelivery.com/attachments/MDGOV/2017/05/25/file_attachments/822423/ExecutiveOrder%2B01.01.2017.08.pdf
https://www.dllr.state.md.us/paidleave/paidleavereport.pdf
https://www.dllr.state.md.us/paidleave/paidleavereport.pdf
https://www.dllr.state.md.us/paidleave/paidleavereport.pdf
https://www.michigan.gov/documents/snyder/EO_2015-2_479496_7.pdf
https://www.michigan.gov/documents/snyder/EO_2015-2_479496_7.pdf
https://www.michigan.gov/documents/snyder/EO_2015-2_479496_7.pdf
https://www.michigan.gov/whitmer/0,9309,7-387-90501_90626-346529--,00.html
https://www.michigan.gov/whitmer/0,9309,7-387-90501_90626-346529--,00.html
http://www.nd.gov/veterans/files/resource/2015.1.8%20Executive%20Order%202015-01.pdf
http://www.nd.gov/veterans/files/resource/2015.1.8%20Executive%20Order%202015-01.pdf
http://www.nd.gov/veterans/files/resource/2015.1.8%20Executive%20Order%202015-01.pdf
https://www.ndcares.nd.gov/
https://www.ndcares.nd.gov/
http://gov.nv.gov/uploadedfiles/govnvgov/Content/News_and_Media/Executive_Orders/2014_Images/EO_2014-03_GovernorsCouncil_FoodSafety.pdf
http://gov.nv.gov/uploadedfiles/govnvgov/Content/News_and_Media/Executive_Orders/2014_Images/EO_2014-03_GovernorsCouncil_FoodSafety.pdf
http://gov.nv.gov/uploadedfiles/govnvgov/Content/News_and_Media/Executive_Orders/2014_Images/EO_2014-03_GovernorsCouncil_FoodSafety.pdf
http://gov.nv.gov/uploadedfiles/govnvgov/Content/News_and_Media/Executive_Orders/2014_Images/EO_2014-03_GovernorsCouncil_FoodSafety.pdf
http://gov.nv.gov/uploadedfiles/govnvgov/Content/News_and_Media/Executive_Orders/2014_Images/EO_2014-03_GovernorsCouncil_FoodSafety.pdf
http://dpbh.nv.gov/Programs/OFS/GCFS_Meetings/OFS_-_Governor_s_Food_Security_Council/
http://dpbh.nv.gov/Programs/OFS/GCFS_Meetings/OFS_-_Governor_s_Food_Security_Council/
http://dpbh.nv.gov/Programs/OFS/GCFS_Meetings/OFS_-_Governor_s_Food_Security_Council/
http://dpbh.nv.gov/Programs/OFS/GCFS_Meetings/OFS_-_Governor_s_Food_Security_Council/
http://dpbh.nv.gov/Programs/OFS/GCFS_Meetings/OFS_-_Governor_s_Food_Security_Council/
https://www.governor.ny.gov/news/no-190-incorporating-health-across-all-policies-state-agency-activities
https://www.governor.ny.gov/news/no-190-incorporating-health-across-all-policies-state-agency-activities
https://www.governor.ny.gov/news/no-190-incorporating-health-across-all-policies-state-agency-activities
https://www.governor.ny.gov/news/no-190-incorporating-health-across-all-policies-state-agency-activities
https://health.ny.gov/prevention/prevention_agenda/health_across_all_policies/
https://health.ny.gov/prevention/prevention_agenda/health_across_all_policies/
https://health.ny.gov/prevention/prevention_agenda/health_across_all_policies/
https://health.ny.gov/prevention/prevention_agenda/health_across_all_policies/
https://www.oa.pa.gov/Policies/eo/Documents/2018-01.pdf
https://www.oa.pa.gov/Policies/eo/Documents/2018-01.pdf
https://www.governor.pa.gov/about/office-performance-excellence/#about
https://www.governor.pa.gov/about/office-performance-excellence/#about
https://www.governor.pa.gov/about/office-performance-excellence/#about
https://www.governor.pa.gov/about/office-performance-excellence/#about
https://publications.tnsosfiles.com/pub/execorders/exec-orders-haslam10.pdf
https://publications.tnsosfiles.com/pub/execorders/exec-orders-haslam10.pdf
https://publications.tnsosfiles.com/pub/execorders/exec-orders-haslam10.pdf
https://legislature.vermont.gov/statutes/section/03APPENDIX/003/00069
https://legislature.vermont.gov/statutes/section/03APPENDIX/003/00069
https://legislature.vermont.gov/statutes/section/03APPENDIX/003/00069
https://www.healthvermont.gov/about-us/our-vision-mission/building-culture-health
https://www.healthvermont.gov/about-us/our-vision-mission/building-culture-health
https://www.healthvermont.gov/about-us/our-vision-mission/building-culture-health
https://www.healthvermont.gov/about-us/our-vision-mission/building-culture-health
https://www.governor.wa.gov/sites/default/files/exe_order/eo_10-03.pdf
https://www.governor.wa.gov/sites/default/files/exe_order/eo_10-03.pdf
https://www.governor.wa.gov/sites/default/files/exe_order/eo_10-03.pdf
https://www.dshs.wa.gov/ra/office-juvenile-justice/washington-state-partnership-council-juvenile-justice
https://www.dshs.wa.gov/ra/office-juvenile-justice/washington-state-partnership-council-juvenile-justice
https://www.dshs.wa.gov/ra/office-juvenile-justice/washington-state-partnership-council-juvenile-justice
https://www.dshs.wa.gov/ra/office-juvenile-justice/washington-state-partnership-council-juvenile-justice
https://www.dshs.wa.gov/ra/office-juvenile-justice/washington-state-partnership-council-juvenile-justice
https://www.dshs.wa.gov/ra/office-juvenile-justice/washington-state-partnership-council-juvenile-justice
https://www.governor.wa.gov/sites/default/files/exe_order/eo_14-04.pdf
https://www.governor.wa.gov/sites/default/files/exe_order/eo_14-04.pdf
https://www.governor.wa.gov/sites/default/files/exe_order/eo_14-04.pdf
https://www.governor.wa.gov/boards-commissions/workgroups-and-task-forces/carbon-emissions-reduction-taskforce-cert
https://www.governor.wa.gov/boards-commissions/workgroups-and-task-forces/carbon-emissions-reduction-taskforce-cert
https://www.governor.wa.gov/boards-commissions/workgroups-and-task-forces/carbon-emissions-reduction-taskforce-cert
https://www.governor.wa.gov/boards-commissions/workgroups-and-task-forces/carbon-emissions-reduction-taskforce-cert
https://www.governor.wa.gov/boards-commissions/workgroups-and-task-forces/carbon-emissions-reduction-taskforce-cert
https://www.governor.wa.gov/boards-commissions/workgroups-and-task-forces/carbon-emissions-reduction-taskforce-cert


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12

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CORRESPONDING AUTHOR
Maxim Gakh, JD, MPH
School of  Public Health, University of  Nevada, Las Vegas
Box 453063, 4505 S. Maryland Parkway
Las Vegas, NV 89154-3063
maxim.gakh@unlv.edu

CHIA Staff:

Editor-in-Chief  
Cynthia Stone, DrPH, RN, Professor, Richard M. Fairbanks School of  Public Health, Indiana University-Purdue 
University Indianapolis

Journal Manager 
Angela Evertsen, BA, Richard M. Fairbanks School of  Public Health, Indiana University-Purdue University 
Indianapolis

Chronicles of  Health Impact Assessment Vol. 4 Issue 1 (2019) DOI: 10.18060/23268
© 2019 Author(s): Gakh, M.
       This work is licensed under a Creative Commons Attribution 4.0 International License

ACKNOWLEDGEMENTS
The author would like to thank his university for supporting this work and also to thank and acknowledge contributions of  
researchers and practitioners in the area of  Health in All Policies. The publication fees for this article were supported by the 
UNLV University Libraries Open Article Fund


