Elisabeth Jansson NHPRC2013


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Municipalities’ setting approaches in local health promotion – A Swedish case study

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Elisabeth Jansson NHPRC2013

  1. 1. Municipalities’ setting approaches in local health promotion – A Swedish case study Vestfold, June 19th , 2013 Elisabeth Jansson, PhD student Co-authors: Elisabeth Fosse, Per Tillgren
  2. 2. Study background The results of this study are secondary findings from the doctoral studies I conduct at Mälardalen University in Västerås, Sweden *Jansson, Tillgren (2010) **Jansson, Fosse, Tillgren (2011)
  3. 3. Objectives E Fagersta Strängnäs Sala Oxelösund 4 municipalities’ setting approaches in their local health promotion
  4. 4. Methods A multiple case study Content analysis Key person interviews – politicians, executives & officials Documents – annual reports, policies & plans etc. Data collected in 2006 & 2012 E
  5. 5. Analysing procedure in 2006 & 2012 1 Single Case D Sala Single Case C Fagersta Single Case B Oxelösund Single Case A Strängnäs Cross-case analysis A, B, C, D5 432
  6. 6. Results Public health policies Target groups Settings ●Alcohol, tobacco & Children & youths School drug prevention 4/4 Adults Health care Municipality employed Workplace ●Rehabilitation 3/4 Municipality employed Workplace Primary health care centre ●Equality 4/4 Municipality employed Workplace ●Public health 1/4Whole society School Workplace Library Primary health care centre New venues
  7. 7. Results Strategies ●Schools & workplaces are mainly used as location for ad hoc health promotion interventions & programs ●Family centres are the settings where intersectoral collaboration, multiple strategies & a holistic view of health were common (3/4) Advantages ●Entrance & access channel for vulnerable groups ●Enables easier communication between municipal organization & population
  8. 8. Results “The municipality’s power source, that's really the three F's [forces], associations & churches & businesses. From organizing a health week per year to more of this everyday, in general. Then these venues, as I can see as an extremely important public health issue, whether they play bridge or read the hymn book, or whatever they do.” (C-Politician)
  9. 9. Results ”The library has been this kind of activity location. Where we held a health day e.g. with the theme heart. We have done it together with the pharmacy & primary health care centre. [… ] We have turned us into the public & the program consisted of activities & you can try out & you can get information.” (A-Executive)
  10. 10. Results The municipalities doesn’t explicitly express health promotion or settings as an objective or strategy Politicians saw intersectoral collaboration as a strategy to improve the municipality public health in different settings Executives & officials expressed both opportunities & obstacles in intersectoral collaboration in setting based local interventions The municipality organizational structure in horizontal or vertical management affected setting approaches more than political governance profile
  11. 11. Conclusions The setting approach is consistent with the municipalities’ views & possibilities to handle complex public health issues Locally prioritized health issues based on local needs & prerequisites are preferably performed in traditional settings The development & sustainability is seen as possible & achievable by intersectoral collaborations with engaged & committed actors in established settings Challenges in the municipalities’ setting approaches are related to factors like sectorial pipe-line organizations & e.g. confidentiality regulations in collaborations between the municipality & health care sector
  12. 12. Finally, a quot on the road… “I believe very strongly in this structural stuff when it comes to children & youths. I mean you look, yes I can keep long lectures, but ... then, what saves many children, it's the school, the school is one of the biggest health factors.” (A-Official)
  13. 13. Thank you! Elisabeth Jansson Mälardalen University School of Health, Care and Social Welfare Västerås, Sweden elisabeth.jansson@mdh.se Västerås Stockholm
  14. 14. References Jansson, Fosse & Tillgren (2011) National public health policy in a local context: implementation in two Swedish municipalities. Health Policy 103(2-3):219-27 Jansson & Tillgren (2010) Health promotion at local level: a case study of content, organization and development in four Swedish municipalities. BMC Public Health 3;10:455