Understanding the Promotion of Health Equity at the Local Level Requires Far More than Quantitative Analyses of YesNo Survey Data Comment on "Health Promotion at Local Level in Norway: The Use of Public Health Coordinators and Health Overviews to Promote Fair Distribution Among Social Groups"

Abstract A legal framework set in Serbia provide good basis for creating healthy living environment and health promotion at local level. The present system of local government in Serbia, with its 174 units is regulated by the Law on Local Self Government. In accordance to this Law each municipality has got a certain level of decision-making. Creating healthy living environment is one of the key objectives of municipal policy and its agenda. However, the extent of their inclusion and implementation is very heterogeneous between municipalities. Unequal municipalities’ capacities (financial, technical, human resources) for coordination and development of healthy living environment on the municipality level are crucial challenge. In order to support the activities at the local level, the Network of 24 regional institutes of public health, led by the Institute of Public Health of Serbia, develops public health guidance, participate in drafting local strategies, programs and activities. Additional support is provided by the Local Health Councils, increasing a political sensibility for prioritizing issues to achieve healthy living environment. The coherent framework of mandates, local strategies and action plans for improving the public health have been established through widespread cooperation between the institutes of public health, health councils, and other stakeholders (e.g. nongovernmental organizations and governmental bodies such as the ministries responsible for education, environmental protection, youth and sport). In spite of that, their implementation is restricted by low awareness of importance of health equity and health promotion. In that sense, training and education on health promotion and health equity issues are crucial to raise the awareness, increase health literacy and enable satisfactory and quality implementation of defined strategies, programs and activities at the municipality level.

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The contemporary self in tobacco control: exploring the introduction of the smoking ban in Ireland

Reframing Health and Health Policy in Ireland ◽

10.7228/manchester/9780719095870.003.0005 ◽

2017 ◽

Author(s):

Eluska Fernández

Keyword(s):

Public Health ◽

Health Promotion ◽

Tobacco Control ◽

Common Sense ◽

Social Groups ◽

Smoking Ban ◽

Political Speeches

This chapter is set in the context of the introduction of an outright ban on smoking in the workplace in 2004, an initiative that is widely regarded by Irish politicians, public health and anti-smoking advocates as a story of success, despite ‘common sense’ commentaries at the time suggested that the ban would be too radical a proposal.Drawing on commentaries from broadsheet newspapers and political speeches from the time, this chapter analyses the introduction of the smoking ban in Ireland as a successful exercise in ‘the conduct of conduct’ (Foucault, 1982) by exploring the types of conduct that were embraced and promoted in the context of the debates over the ban. Informed by the centrality of notions of rational, responsible and civilized selfhood in contemporary public health and health promotion discourses, the chapter reveals how notions of what came to be promoted as rational, responsible and civilized behaviours, and their flipside, irrational, irresponsible and uncivilized ones, were central to the exercise of power. It also reflects on how the regulation of smoking became interlinked with social and moral processes, and how some of these played a symbolic role in promoting boundaries between different social groups.

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Current capacities and challenges for equity-oriented municipal health promotion in Europe

European Journal of Public Health ◽

10.1093/eurpub/ckz185.730 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

C Plantz ◽

E Quilling

Keyword(s):

Health Promotion ◽

Health Equity ◽

Local Level ◽

Promising Practices ◽

Existing Structures ◽

Health Authorities ◽

Public Health Authorities ◽

Self Assessments ◽

Regional Public Health ◽

Municipal Health

Abstract As a basis for implementing actions in the frame of Work package 6 - healthy living environments in the Joint Action Health Equity Europe, each of the 13 participating countries conducted a country assessment. Methods The country assessments were self-assessments conducted in the first quarter of 2019. Partners received templates that had been agreed upon beforehand. Most of them conducted the country assessments by themselves or with the help of colleagues from their institutions as a desk-based review, and validated results with external experts and stakeholders. The first part of the country assessment referred to how municipal health promotion capacities are currently developed in the countries. Through the second part of the country assessment, each of the 13 countries selected up to 4 promising practices. Results In most of the 13 countries, municipalities have a clear mandate to promote health. However, there is a big heterogeneity in resources, structures and capacities of municipal health promotion within and between countries. One key challenge is the self-government of municipalities and health promotion as a voluntary task. One of the main problems is a deficit in intersectoral working. It appears that poor municipalities are even more disadvantaged in terms of capacities for municipal health promotion. 33 promising practices were identified, covering programmes, strategies, tools and interventions mostly from the local level, with a big variety of topics and approaches for health equity. Conclusions There is a big fragmentation and heterogeneity in municipal health promotion between and within European countries. National and regional public health authorities are in the position to contribute a lot to support municipalities. This can include promoting quality development, providing data, integrating health equity in existing structures, plans and approaches or collaborating with the broad range of existing stakeholders and networks.

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Critical Narrative Intervention for Health Equity Research and Practice: Editorial Commentary Introducing the Health Promotion Practice Critical Narrative Intervention Special Collection

Health Promotion Practice ◽

10.1177/15248399211046185 ◽

2021 ◽

pp. 152483992110461

Author(s):

Alice Fiddian-Green ◽

Aline Gubrium

Keyword(s):

Public Health ◽

Health Promotion ◽

Health Equity ◽

People Living With Hiv ◽

Narrative Intervention ◽

Equity Research ◽

Special Collection ◽

Health Equity Research ◽

Critical Public Health ◽

Health Promotion Practice

This special collection of Health Promotion Practice introduces critical narrative intervention (CNI) as a key theoretical framing for an asset-based, narrative, and participatory approach to promoting health and addressing social inequality. Innovative digital and visual methodologies highlighted in this special collection—comics and graphic novels, cellphilms and other participatory film, story booths, digital storytelling, and photovoice—are changing the way critical public health researchers and practitioners forge new knowledge, creating new possibilities for interdisciplinary and activist-based inquiry. Public health research and engagement efforts that critically contend with historically repressive structures and intervene through narrative and participatory processes to enact change with and for disenfranchised communities are long overdue. This special collection showcases six CNI projects that promote equity and justice in the context of LGBTQ, nonbinary, and other gender-diverse young people; people who inject drugs living with hepatitis C virus; young women who trade sex; undocumented and formerly undocumented immigrants; and people living with HIV/AIDS. It is our intent that this collection of exemplars can serve as a guidepost for practitioners and researchers interested in expanding the scope of critical public health praxis. Individually and collectively, the special collection illustrates how CNI can create space for the increased representation of historically silenced populations, redress stigma, and provoke important questions to guide a new era of health equity research.

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Open science initiatives: challenges for public health promotion

Health Promotion International ◽

10.1093/heapro/day002 ◽

2018 ◽

Vol 34 (3) ◽

pp. 624-633

Author(s):

Cheryl Holzmeyer

Keyword(s):

Public Health ◽

Health Promotion ◽

Social Determinants Of Health ◽

Health Equity ◽

Social Determinants ◽

Health Research ◽

Open Science ◽

Determinants Of Health ◽

Innovation Ecosystems ◽

Public Health Promotion

SummaryWhile academic open access, open data and open science initiatives have proliferated in recent years, facilitating new research resources for health promotion, open initiatives are not one-size-fits-all. Health research particularly illustrates how open initiatives may serve various interests and ends. Open initiatives not only foster new pathways of research access; they also discipline research in new ways, especially when associated with new regimes of research use and peer review, while participating in innovation ecosystems that often perpetuate existing systemic biases toward commercial biomedicine. Currently, many open initiatives are more oriented toward biomedical research paradigms than paradigms associated with public health promotion, such as social determinants of health research. Moreover, open initiatives too often dovetail with, rather than challenge, neoliberal policy paradigms. Such initiatives are unlikely to transform existing health research landscapes and redress health inequities. In this context, attunement to social determinants of health research and community-based local knowledge is vital to orient open initiatives toward public health promotion and health equity. Such an approach calls for discourses, norms and innovation ecosystems that contest neoliberal policy frameworks and foster upstream interventions to promote health, beyond biomedical paradigms. This analysis highlights challenges and possibilities for leveraging open initiatives on behalf of a wider range of health research stakeholders, while emphasizing public health promotion, health equity and social justice as benchmarks of transformation.

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Workshop: Creating healthy living environments in municipalities – European concepts, needs and actions

European Journal of Public Health ◽

10.1093/eurpub/ckz185.728 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

Keyword(s):

Public Health ◽

Health Promotion ◽

Health Equity ◽

Joint Action ◽

Current Knowledge ◽

European Countries ◽

Healthy Living ◽

Work Package ◽

Living Environments ◽

Municipal Level

Abstract Health equity is influenced by the local social and physical environment we are living in. Municipalities all over Europe have a key role in shaping and addressing these living conditions. This is why one of the Work packages in the current EU Joint Action Health Equity Europe (JAHEE) deals with the living environment, and what municipalities can contribute to shape them in a health promoting and equity-oriented way. Current action in this field is fragmented, varies highly between and within European countries and strongly depends on political leadership. The Work package aims at providing a systematic and structured support for participating countries in taking action to create healthy living environments. In Work package 6 - Healthy living environments, 17 national and regional public health authorities from 13 countries collaborate to exchange knowledge, practices and implement actions that promote healthy living environments. This workshop aims at bringing together current knowledge and experience of why and how to create healthy living environments on the municipal level. Furthermore, it is supposed to inform what countries currently do and need to do in this field of action from the perspective of national public health institutes and ministries of health. And thirdly, an innovative local example of how to put the theory into practice will be presented. The “Should be”: The first presentation will describe the common conceptual basis for the project partners - the Policy Framework for Action. As was agreed upon among the project partners, the specific focus is a broad community approach towards health promotion that is steered from the municipal level. The “To be”: The second presentation will focus on common European challenges and potentials based on the country assessments that were conducted in the frame of the project, and how municipalities can be supported from the European, national and regional levels. Third and fourth presentations will present more in-depth country reports from Greece and Serbia describing the current capacities and potential for municipal health promotion. The “Good Practice”: The fifth presentation from the Netherlands will present an innovative approach from the City of Utrecht that is implemented in the frame of the Joint Action Health Equity Europe. The findings will be discussed using an interactive online-tool, and finally next steps, future actions and recommendations will be outlined. The workshop will give the possibility for stakeholders that are not currently involved in the Joint Action to inform themselves of the activities on the European level. The broadening of the audience is also crucial for enhancing awareness of health equity and healthy living environments as well as increasing the acceptance of the conceptual framework at national levels. Through exchange of knowledge and experience, potential new partners could be reached and involved in the project. Key messages The workshop brings together current knowledge of why and how European municipalities can create healthy living environments. The workshop presents what European countries currently do and need to do in this field of action.

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