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Abstract：
Background: \'Health in All Policies\' (HiAP) describes the pursuit of health equity. It has five main elements: treat health as a human right; identify evidence of the \'social determinants\' of health inequalities, recognise that most powers to affect health are not held by health departments, promote intersectoral policymaking and collaboration inside and outside of government, and generate political will. Studies describe its potential but bemoan a major implementation gap. Some HiAP scholars learn from policymaking research how to understand this gap, but the use of policy theories is patchy. In that context, our guiding research question is: How does HiAP research use policy theory to understand policymaking? It allows us to zoom-out to survey the field and zoom-in to identify: the assumed and actual causes of policy change, and transferable lessons to HiAP scholars and advocates. Methods: Our qualitative systematic review (two phases, 2018 and 2020) identified 4972 HiAP articles. Of these, 113 journal articles (research and commentary) provide a non-trivial reference to policymaking (at least one reference to a policymaking concept). We use the 113 articles to produce a general HiAP narrative and explore how the relatively theory-informed articles enhance it. Results: Most articles focus on policy analysis (identifying policy problems and solutions) rather than policy theory (explaining policymaking dynamics). They report a disappointing gap between HiAP expectations and policy outcomes. Theory-informed articles contribute to a HiAP playbook to close that gap or a programme theory to design and evaluate HiAP in new ways. Conclusions: Few HiAP articles use policy theories for their intended purpose. Policy theories provide lessons to aid critical reflection on power, political dilemmas, and policymaking context. HiAP scholars seek more instrumental lessons, potentially at the cost of effective advocacy and research.
摘要：
背景：“所有政策中的健康”(HiAP)描述了对健康公平的追求。它有五个主要要素：将健康视为一项人权；确定健康不平等的“社会决定因素”的证据，认识到影响健康的大多数权力不是由卫生部门持有的，促进政府内外的部门间决策和合作，产生政治意愿。研究描述了它的潜力，但哀叹一个重大的实施差距。一些HiAP学者从决策研究中学习如何理解这种差距，但是政策理论的使用是零散的。在这种情况下，我们的指导性研究问题是：HiAP研究如何使用政策理论来理解政策制定？它允许我们缩小以调查该领域并放大以确定：政策变化的假定和实际原因，以及可转移的教训给HiAP学者和倡导者。方法：我们的定性系统评价(两个阶段，2018年和2020年)确定了4972篇HiAP文章。其中,113篇期刊文章（研究和评论）提供了对决策的不平凡的参考（至少一个参考了决策概念）。我们使用这113篇文章来制作一般的HiAP叙述，并探索相对理论的文章如何增强它。结果：大多数文章侧重于政策分析（确定政策问题和解决方案），而不是政策理论（解释政策制定动态）。他们报告说，HiAP预期与政策结果之间存在令人失望的差距。基于理论的文章有助于一本HiAP剧本来缩小差距，或者是一个以全新方式设计和评估HiAP的程序理论。结论：很少有HiAP文章将政策理论用于预期目的。政策理论提供了教训，以帮助批判性地反思权力，政治困境,和决策背景。HiAP学者寻求更多的工具性课程，可能以有效的宣传和研究为代价。
