Rethinking the Theory of Change for Health in All Policies 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"

Aim: National public health policies in Norway are based on a Health in All Policies (HiAP) approach. At the local level, this means that public health, as a cross-sectional responsibility, should be implemented in all municipal sectors by integrating public health policies in municipal planning and management systems. The paper investigates these local processes, focusing on the use of public health terminology and how this terminology is translated from national to local contexts. We ask whether the terms ‘public health’ and ‘public health work’ are suitable when implementing an HiAP approach. Methods: A qualitative case study based on analyses of interviews and planning documents was performed in three Norwegian municipalities. Results: The results present dilemmas associated with using public health terminology when implementing an HiAP approach. On the one hand, the terms are experienced as wide, complex, advanced and unnecessary. On the other hand, the terms are experienced as important for a systematic approach towards understanding public health ideology and cross-sectional responsibility. One municipality used alternative terminology. Conclusions: This paper promotes debate about the appropriateness of using the terms ‘public health’ and ‘public health work’ at the local level. It suggests that adaptation is suitable and necessary, unless it compromises knowledge, responsibility and a systematic approach. This study concludes that the use of terminology is a central factor when implementing the Norwegian Public Health Act at the local 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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Health Impact Assessment (HIA) of a Fluvial Environment Recovery Project in a Medium-Sized Spanish Town

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17051484 ◽

2020 ◽

Vol 17 (5) ◽

pp. 1484

Author(s):

Cristina Casajuana Kögel ◽

Tània Rodríguez Peña ◽

Isabel Sánchez ◽

Montserrat Tobella ◽

José Alonso López ◽

...

Keyword(s):

Public Health ◽

Impact Assessment ◽

Health Impact Assessment ◽

Local Level ◽

Health Agency ◽

Health Impact ◽

City Council ◽

Health Impacts ◽

Health Determinants ◽

Health In All Policies

Introduction: The Interdepartamental Public Health Plan of Catalonia (2014) seeks to enforce Health in All Policies (HiAP) at the regional and local levels. Within this context, the City Council of Sant Andreu de la Barca (SAB), the Metropolitan Area of Barcelona (MAB), and the Public Health Agency of Catalonia started a Health Impact Assessment (HIA) of an urbanistic redesign of the Llobregat fluvial area in SAB, the results of which are presented in this paper. Methodology: In 2018, after a HIA screening, a prospective nonquantitative HIA was conducted. Politicians, professionals, and citizens participated in identifying potential impacts. Impacts were prioritized and linked to health determinants, scientific evidence, and potentially affected social groups. Afterwards, recommendations were formulated in order to improve the health impacts of the project. Finally, indicators were selected to evaluate HIA implementation. Results: The HIA was successfully implemented with the participation of technicians and citizens of SAB. The health impacts identified were mainly related to environmental, public safety, lifestyle, socioeconomic, and political contexts. Ten recommendations were defined to minimize the potential negative health impacts of the project, with six of them directly included and only one dismissed due to incompatibility. Conclusion: A HIA was successfully carried out in the medium-sized town of Catalonia, promoting Health in all Policies at a local level and improving health impacts of an urbanistic project.

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The affordable dream

The Great Health Dilemma ◽

10.1093/oso/9780198853824.003.0003 ◽

2021 ◽

pp. 59-76

Author(s):

Christopher Dye

Keyword(s):

Public Health ◽

Health Promotion ◽

Workplace Health Promotion ◽

Health Sector ◽

Health Coverage ◽

Health In All Policies ◽

Workplace Health ◽

Preventive Methods ◽

Universal Health ◽

Public Demand

Prevention is integral to achieving health equity and Universal Health Coverage. And yet prevention is a healthcare orphan: it is not usually a priority in the health sector or in any other sector of government. This chapter suggests five ways to redress that disadvantage: give prevention and public health budgets that are separate and protected from medical services, based on demonstrated benefits; define the goals of prevention in collaboration with, and considering the objectives and values held by, those who make the decisions; reassess the value for money provided by preventive methods that presently command large budgets, such as ‘healthy condition monitoring’; stimulate latent public demand for prevention by improving access to screening programmes, calibrating health insurance to favour prevention, and through workplace health promotion schemes, among others; and improve the appeal of prevention across the whole of government (beyond the health sector), using evidence to reinforce the long-standing goal of putting ‘Health in All Policies’.

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Joining forces to build up knowledge in health promotion: lessons from a French coalition initiative

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.218 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

M Porcherie ◽

A Laurent ◽

C Ferron ◽

P Berry ◽

B Soudier ◽

...

Keyword(s):

Public Health ◽

Health Promotion ◽

Action Plan ◽

Local Level ◽

Experiential Knowledge ◽

National Committee ◽

French Society ◽

Health Authorities ◽

Public Health Authorities ◽

Tool Building

Abstract Issue French public health authorities increasingly rationalize access to public funding, favoring evidence-based programs. Health Promotion (HP) interventions are especially urged to prove their efficiency in this context. To tackle this issue, HP practitioners hold experiential knowledge (EK) that proves useful to assess both the complexity and efficiency of HP interventions. United by this conviction in a multidisciplinary coalition, HP experts from various backgrounds came together five years ago to promote Experiential Knowledge in HP (EKHP) in France. A national committee to promote EKHP 670 HP practitioners were surveyed in 2016. Results reported vast amounts of under-documented and often untapped field expertise in HP and numerous obstacles regarding access to scientific literature or systematic reviews. Consequently, the coalition launched a National Committee for EKHP, meeting 5 times a year since 2016. Members of 6 national HP organizations, of 4 regional HP institutes, national and local public health administrators, researchers, consultants and field workers participate. Steered by the French Society for Public Health and the National Federation for Health Education and Promotion, the committee devised a threefold action plan: 1/ advocate EKHP in all relevant institutional spaces, 2/ develop tools for EKHP, 3/ mobilize for EKHP at the local level. Results The committee designed a method for capitalizing, collecting and circulating EK and published in 2020 a guidebook and a toolkit. French Public Health authorities agreed to share EK nationwide on their online portal. Dissemination within the French HP community has started, through the committee members' networks, and will be amplified with a training program launched in 2021 at the National School of Public Health. Lessons Attention must be brought to HP practitioners’ experiential knowledge, both to recognize HP practitioners' expertise and to help improve the understanding of how HP interventions work. Key messages Experiential knowledge in HP remains undervalued and untapped in France. Dedicated practitioners, policymakers and researchers formed a multidisciplinary committee to promote and disseminate EKHP. A multilevel strategy combining advocacy and tool building can be effective at promoting experiential knowledge. A multidisciplinary coalition provided the necessary context-specific levers in France.

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2.O. Workshop: Climate change and the impact on public and occupational health

European Journal of Public Health ◽

10.1093/eurpub/ckz185.155 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

Keyword(s):

Public Health ◽

Climate Change ◽

Health Promotion ◽

Heat Waves ◽

Local Level ◽

Climate Impacts ◽

Private Life ◽

Integrative Approach ◽

The Impact ◽

Health Advisories

Abstract Objectives Climate change has an impact on people’s physical, mental, and community health. This impact can arise directly and indirectly. Some natural disasters are exacerbated by climate change, like floods, heat waves, storms, wildfires, and landslides. Some effects occur more gradually for example from changing temperatures. Heat waves can weaken the infrastructure (transport, construction) and make food systems less secure (infections, less access). But heat waves can also directly cause severe health effects. Heat waves are examples of direct and indirect climate impacts on society’s physical and mental health. Climate change creates visible impacts in many countries. The number of heat waves increased across the globe the last few decades. This change has an impact on communities’ health both in private life settings as in occupational settings. There is an overlap of impact which influences the effects seen in both settings. The awareness of this overlap is not clear for most stakeholders. Health advisories before, during and after heat waves do not consider this issues in their health promotion activities. This workshop aims at describing different ways how public health could benefit of a more integrative approach of health promotion by linking messages directed at the general public and the occupational work force. Therefore, examples on national as well as regional and local level are presented discussed with specific emphasis on requirements and processes for success on one hand and obstacles on the other. The examples reflect different European regions and country heat waves plans as well as results from the EU-funded projects HEATSHIELD and SCORCH. Key messages Heat will be an increasing issue in public health. Health advisories need to be improved during periods of heat.

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