Lessons for Health in All Policies Implementation from Well-Being Policy Approaches: A Qualitative Analysis of Intersectoral Collaboration During the Development of Canada’s Quality of Life Framework

In the context of widening health and social inequalities and increasingly complex public policy issues, the well-being policy paradigm offers an opportunity for public health to collaborate with non-health sectors to address social and structural determinants of health. The Quality of Life Framework for Canada (“the Framework”) is the Canadian federal government’s foray into well-being policy and can be considered a Health in All Policies (HIAP) initiative. This case study examines the Framework’s development alongside the HIAP model, identifying barriers and facilitators for effective multisectoral action. This work was developed as an applied policy case study. Semi-structured interviews were conducted with 18 representatives across 11 federal departments. A qualitative matrix approach and thematic analysis were used to identify success factors, barriers, and opportunities for improvement. The World Health Organization’s (WHO) Four Pillars Model for HIAP was used to guide analysis using the HIAP pillars (governance and accountability; leadership at all levels; ways of working; and resources, financing, and capabilities). Multisectoral action was critical to the success of the Framework’s development. Key facilitators included the establishment of interdepartmental governance, a formalized and transparent mandate, and committed leadership. Findings indicated strong alignment with and adoption of HIAP approaches. The findings from this case study illustrate how well-being policy initiatives can be leveraged to advance collaboration for public health equity and determinants of health. Lessons learned are relevant to the work of public health practitioners as well as those working in non-health sectors, including policy-makers and decision-makers, particularly in a government context.