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Societies
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The Role of Municipalities in Health Promotion
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The Role of Municipalities in Health Promotion

A special issue of Societies (ISSN 2075-4698).

Deadline for manuscript submissions: closed (15 December 2021) | Viewed by 22083

Special Issue Editors

Prof. Dr. Elisabeth Fosse

E-Mail Website
Guest Editor
Department of Health Promotion and Development, Faculty of Psychology, University of Bergen, 5015 Bergen, Norway
Interests: health promotion; health promotion policies; implementation of policies; social inequalities in health; policies to reduce social inequalities in health; local government studies; European welfare regimes
Prof. Dr. Marit Kristine Helgesen

E-Mail Website
Guest Editor
Faculty of Health and Welfare, Østfold University College, 1757 Halden, Norway
Interests: professions and professionalization; knowledge and the digital society; multilevel governance and collaborative processes

Special Issue Information

Dear Colleagues,

Current research on health promotion originated in the WHO Ottawa charter in 1986. Health Promotion represented a renewal of the understanding of the determinants of health, including social, environmental, and political aspects. These determinants gained increased momentum through the work of Whitehead and Dahlgren, particularly their ecological model of social determinants and the global commission on the social determinants of health (Whitehead and Dahlgren 1991, WHO 2008).

In most Western countries, local level plays an important role in developing and implementing public health promotion policies and measures. Municipalities are often responsible for services, with great significance for health and the social determinants of health. Schools, day care, leisure time activities, and care for the elderly are all examples of areas that may be the responsibility of municipalities.

In this Special Issue, we aim to explore how municipalities in different countries deal with developing and implementing health promotion policies and measures. Many approaches to this may be addressed, for example: How are the principles of health promotion reflected in local policies and measures? Does the national level support the municipalities, or do they have to prioritize within tight budgets? Which target groups are receiving services and how is the quality? Are municipal policies to reduce social inequalities universal or is it possible to speak of proportional universalism? 

Is there an awareness of the social determinants of health, and how is this reflected in the policies and measures provided? Are all sectors involved in health promotion or is it mainly the responsibility of the health sector?

These are among many potentially relevant research themes, and in this Special Issue, we welcome these and other perspectives on research addressing the role of municipalities in health promotion.

Prof. Dr. Elisabeth Fosse
Prof. Dr. Marit Kristine Helgesen
Guest Editors

References

  1. Whitehead, M. and Dahlgren, G. (1991): What Can Be Done About Inequalities in Health? Lancet. 1991 Oct 26; 338(8774): 1059-1063.
  2. World Health Organization (2008): Closing the gap in a generation. Health equity through action on the social determinants of health. Final report from Commission on Social Determinants of health, Geneve: WHO.

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Keywords

  • health promotion
  • municipalities
  • health determinants
  • social inequalities
  • intersectoral collaboration
  • governance
  • universalism

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Published Papers (6 papers)

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Research

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8 pages, 451 KiB  
Article
Evaluating ‘Health in All Policies’ in Norwegian Municipalities
by Ellen Strøm Synnevåg
Societies 2022, 12(3), 92; https://doi.org/10.3390/soc12030092 - 10 Jun 2022
Viewed by 2173
Abstract
The Health in All Policies (HiAP) approach has emerged as a central strategy for promoting health at local, regional, and state levels in different countries. Representing a complex and complicated strategy, evaluations of HIAP at the local level are scarce, and scholars call [...] Read more.
The Health in All Policies (HiAP) approach has emerged as a central strategy for promoting health at local, regional, and state levels in different countries. Representing a complex and complicated strategy, evaluations of HIAP at the local level are scarce, and scholars call for more knowledge and critical discussions regarding how to evaluate at this level. In this conceptual paper, I discuss how summative and formative evaluation approaches might supplement each other when evaluating HiAP at the local level. First, I discuss the possibilities of using summative and formative evaluation of HiAP. Further, I discuss how formative-dialogue research might represent possibilities for evaluation by combining the two approaches. Finally, I ask if there has been a shift in the Norwegian evaluation discourse, from the promotion of summative evaluation alone to a combination of both summative and formative methods. Full article
(This article belongs to the Special Issue The Role of Municipalities in Health Promotion)
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14 pages, 266 KiB  
Article
Policies to Reduce Child Poverty in Norway: Can Municipalities Ensure Positive Functionings for Children through Housing Policies?
by Marit Kristine Helgesen and Petter Arvesen
Societies 2022, 12(1), 25; https://doi.org/10.3390/soc12010025 - 12 Feb 2022
Cited by 4 | Viewed by 3551
Abstract
Child poverty is an increasing challenge for Norwegian society and its municipalities. Policies to reduce it include housing as one particularly important health determinant. The capability approach allows us to focus on determinants for health. Methods were triangulated and literature and document studies, [...] Read more.
Child poverty is an increasing challenge for Norwegian society and its municipalities. Policies to reduce it include housing as one particularly important health determinant. The capability approach allows us to focus on determinants for health. Methods were triangulated and literature and document studies, interviews and participating observations were part of the data-gathering process. Thematic analyses were used to analyse data. Children and adults view housing as important. Housing determines families’ possibilities of consuming other goods and choosing what functionings they will convert their resources into. Municipalities can change the course of development by engaging with the Norwegian Government Housing Bank and implementing instruments such as social housing, housing allowances and starter loans giving families the possibility to become homeowners. Housing determines intra- as well as inter-generational life chances. Housing is a corrosive functioning if children live in families that have low-quality housing or high housing costs. Housing is a positive functioning for children if families own their housing. Housing is defined as a market good and a welfare asset. Policies enable some families to buy their own housing, whereas the number of poor children still increases. Full article
(This article belongs to the Special Issue The Role of Municipalities in Health Promotion)
13 pages, 761 KiB  
Article
Lessons Learned from an Intersectoral Collaboration between the Public Sector, NGOs, and Sports Clubs to Meet the Needs of Vulnerable Youths
by Disa Tell, Olin Oldeide, Torill Larsen and Ellen Haug
Societies 2022, 12(1), 13; https://doi.org/10.3390/soc12010013 - 20 Jan 2022
Cited by 3 | Viewed by 4529
Abstract
The Norwegian Government emphasizes intersectoral collaboration to achieve health goals such as reducing social health differences. However, research shows that achieving fruitful collaboration between different organizations and the public sector is challenging. The sports sector is one potential partner for such collaboration. Although [...] Read more.
The Norwegian Government emphasizes intersectoral collaboration to achieve health goals such as reducing social health differences. However, research shows that achieving fruitful collaboration between different organizations and the public sector is challenging. The sports sector is one potential partner for such collaboration. Although the Government calls for intersectoral collaboration that includes the sports sector, there are few concrete guidelines for how this may be implemented in practice. Guided by The Bergen Model of Collaborative Functioning, the purpose of this study was to explore factors that promote or inhibit collaboration in an intersectoral project involving the sports sector, NGOs, and public sector. The current project aimed to work towards creating health promoting activities aimed at vulnerable youths. Methods: A qualitative case study of the Sports Project with interviews of eleven collaborative partners. Results: Factors promoting collaboration amongst the different partners were having a common mission, an appreciation of the partners’ complementary skills and knowledge, and a consistent user perspective. Conclusions: By orienting the collaboration towards the users’ needs, the partners have succeeded in creating tailored health-promoting activities for vulnerable youths. However, a challenge remains in transforming the collaborative project into a sustainable structure. Full article
(This article belongs to the Special Issue The Role of Municipalities in Health Promotion)
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17 pages, 834 KiB  
Article
‘Health in All Policies’ and the Urge for Coordination: The Work of Public Health Coordinators and Their Impact and Influence in Local Public Health Policies: A Cross-Sectional Study
by Tor-Ivar Karlsen, Charlotte Kiland, Gro Kvåle and Dag Olaf Torjesen
Societies 2022, 12(1), 11; https://doi.org/10.3390/soc12010011 - 13 Jan 2022
Cited by 3 | Viewed by 3741
Abstract
Building heavily on the Health in All Policies (HiAP) approach, Norway implemented the Public Health Act in 2012 to reduce social inequalities in health. Local public health coordinators (PHCs) at municipal levels were seen as tools to provide local intersectoral public health work. [...] Read more.
Building heavily on the Health in All Policies (HiAP) approach, Norway implemented the Public Health Act in 2012 to reduce social inequalities in health. Local public health coordinators (PHCs) at municipal levels were seen as tools to provide local intersectoral public health work. In this study, we examine factors related to intersectoral agency and if intersectoral work is understood as relevant to securing social justice in local policy outcomes. A national web-based survey in 2019 of all Norwegian PHCs (n = 428) was conducted with a response rate of 60%. Data were analysed through multiple linear regression, hierarchical regression modelling and structural equation modelling. Neither factors relating to community contexts nor individual characteristics were associated with intersectoral agency. Organisational factors, especially position size, being organised at the top level and having a job description, were significantly associated with perceptions of intersectoral agency. PHCs seeing themselves as intersectoral agents also found themselves able to affect annual budgets and policy outcomes. We conclude that municipal PHC positions can be important HiAP tools in local public health policies. However, organisational factors affect how PHCs perceive their influence and role in the municipal organisation and thereby their possibilities to influence local policymaking through intersectoral agency. Full article
(This article belongs to the Special Issue The Role of Municipalities in Health Promotion)
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16 pages, 272 KiB  
Article
Involvement and Multi-Sectoral Collaboration: Applying Principles of Health Promotion during the Implementation of Local Policies and Measures—A Case Study
by Monica Lillefjell and Ruca Elisa Katrin Maass
Societies 2022, 12(1), 5; https://doi.org/10.3390/soc12010005 - 25 Dec 2021
Cited by 3 | Viewed by 3982
Abstract
Five principles for health promotion (HP) stand out in various forms, providing guidance for HP measures and policy implementation: (1) a broad and positive health concept, (2) participation and involvement of key stakeholders, (3) build action and action competence by involving and empowering [...] Read more.
Five principles for health promotion (HP) stand out in various forms, providing guidance for HP measures and policy implementation: (1) a broad and positive health concept, (2) participation and involvement of key stakeholders, (3) build action and action competence by involving and empowering target groups, (4) a setting perspective, and (5) equity in health. The purpose of this study is to describe, and critically discuss, how the five HP principles can be applied to structure collaboration processes for implementing HP measures in local communities. A case study methodology was applied when investigating how the HP principles guided actions and focus-of-attention throughout the process of implementing a local community HP measure. Of special importance was the broad involvement of stakeholders and the anchoring of overarching, as well as specific, HP goals in the municipal strategic documents to ensure political commitment, ownership, and adequate resources. Direction on how to apply or achieve the HP principles should be further explored, described, and brought into systematic day-to-day work for a better society-development. Full article
(This article belongs to the Special Issue The Role of Municipalities in Health Promotion)

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10 pages, 1726 KiB  
Concept Paper
Can the Theory of Salutogenesis Offer a Framework to Enhance Policy Coherence during Policy Development and Implementation in Municipalities?
by Ruca Maass and Monica Lillefjell
Societies 2022, 12(1), 24; https://doi.org/10.3390/soc12010024 - 10 Feb 2022
Viewed by 2664
Abstract
Health promotion efforts in municipalities demands extensive collaboration, between sectors (multi-sector) as well as between levels (multi-level). To develop, adopt and implement policies that contribute to reduce health inequity demands for policy coherence: consistent approaches across sectors and levels. In this conceptual paper, [...] Read more.
Health promotion efforts in municipalities demands extensive collaboration, between sectors (multi-sector) as well as between levels (multi-level). To develop, adopt and implement policies that contribute to reduce health inequity demands for policy coherence: consistent approaches across sectors and levels. In this conceptual paper, we discuss how the theory of Salutogenesis, and its inherent concept of coherence, can contribute to structure such collaboration processes in coherent ways, and contribute to experiences of policy coherence for both collaborators (practitioners and stakeholders) and inhabitants. We discuss how challenges with fragmented knowledge as well as lack of resources and motivation might be met through an explicit application of Salutogenesis core concepts. First, we argue that framing HP-efforts in terms of positive goals that can be achieved can contribute to motivation for change. Next, we discuss how the concepts of comprehensibility, manageability and meaningfulness can be applied to describe challenges, and plan for coherent policies and processes vertically (between levels) and horizontally (between sectors). Last, we discuss limitations and challenges with this approach, including the need to further develop the theoretical foundation of Salutogenesis, and how it can be applied at a setting- and/or policy-level. Full article
(This article belongs to the Special Issue The Role of Municipalities in Health Promotion)
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