Health Should Be at the Center of Every Policy Decision
By Monica Martinez
So many of the decisions we make in life impact our health—where we live, how we work, what we consume. Whether we think about it consciously or not, our well-being—and that of our family, friends, and neighbors—shapes the choices we make every day.
The same should be true in government. Every policy we enact at the County level—whether it’s about healthcare, infrastructure, land use, housing, or emergency preparedness—has real consequences for the health of our community. Yet too often, health is not an explicit part of our decision-making process. We analyze fiscal and environmental impacts before approving policies, but we don’t always stop to ask: Will this decision improve health outcomes? Who will benefit from this decision? Who will be left behind?
That needs to change.
On February 25, the Santa Cruz County Board of Supervisors took an important step in the right direction, voting unanimously to direct County staff to return with recommendations for embedding a Health in All Policies (HiAP) framework into our policymaking and strategic planning. I brought this initiative forward because, after a decade in health and human services—and as a mother of two—I know firsthand that our County would benefit from putting health at the center of our work.
The urgency of this approach could not be clearer. The federal government has already moved to slash critical programs like Medicaid and food assistance while ramping up immigration enforcement—policies that disproportionately harm low-income families, communities of color, and other vulnerable residents. Roughly half of our County’s budget comes from state and federal sources that fund essential services, and we don’t yet know the full financial toll of these cuts. But we do know the stakes are high.
Our Board has already taken steps to protect those most impacted, including dedicating $200,000 from our contingency budget to support immigrant and LGBTQ+ community members with legal aid and essential services. But Health in All Policies is about more than reacting to crises—it’s about proactively shaping policies that remove barriers to health and opportunity. As our Public Health Director, Emily Chung, put it so well: “Health in public policymaking becomes a normal way of doing business.”
We’ve already seen the power of this approach here in Santa Cruz County—whether through successful efforts to reduce tobacco waste, create safer routes to schools, or expand access to behavioral health services. But we can do more. We should apply this framework when we consider policies on transportation, energy use, climate resilience, and economic development—sectors where disparities in access and opportunity are often the greatest. And as the County works on its next Strategic Plan, I believe health must be a core value that guides our collaboration with the community.
This isn’t about adding bureaucracy or unnecessary costs. It’s about making sure we prioritize public health in the conversations that shape our future. It’s about ensuring that everyone—regardless of income, background, or zip code—has the opportunity to live a healthy life. If we make health a central consideration in our decision-making, we can create a stronger, more just and more resilient Santa Cruz County—one where everyone has the opportunity to thrive.
Monica Martinez
Monica Martinez is a lifelong public servant, nonprofit leader, and committed advocate for health equity. In 2024, Monica was elected as the Santa Cruz County Supervisor for District 5, becoming the first woman elected to represent the district. Learn more about Monica, find constituent times and locations, and write to her at santacruzcountyca.gov/government/boardofsupervisors/district5.aspx
