"First, Do No Harm": Have the Health Impacts of Government Bills on Tax Legislation Been Assessed in Finland?

Aaltonen, Natassa; Chydenius, Miisa; Kokkinen, Lauri

doi:10.15171/ijhpm.2018.39

Cited by 15 publications

(3 citation statements)

References 5 publications

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“…Using public health arguments, the Ministry of Environment gained support from the Ministry of Social Affairs and Health (which they considered to be more powerful) and made their own objectives and actions easier to engage with for a wide range of policy-makers throughout the government system. The fact that we only found evidence on using public health arguments to advance non-health sectors’ own objectives from Finland might be due partly to the historical legacy and institutionalisation of intersectoral action in the Finnish context [34–36]. This legacy could also help to explain why there was relatively little evidence that buy-in for HiAP required the development of a shared language, since non-health sectors may already understand the rationale for HiAP and their role in the approach.…”

Section: Discussionmentioning

confidence: 99%

How and why do win–win strategies work in engaging policy-makers to implement Health in All Policies? A multiple-case study of six state- and national-level governments

Kokkinen

Freiler²,

Muntañer

et al. 2019

Health Res Policy Sys

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BackgroundMuch of the research about Health in All Policies (HiAP) implementation is descriptive, and there have been calls for more evaluative evidence to explain how and why successes and failures have occurred. In this cross-case study of six state- and national-level governments (California, Ecuador, Finland, Norway, Scotland and Thailand), we tested hypotheses about win–win strategies for engaging policy-makers in HiAP implementation drawing on components identified in our previous systems framework.MethodsWe used two sources of data — key informant interviews and peer-reviewed and grey literature. Using a protocol, we created context–mechanism–outcome pattern configurations to articulate mechanisms that explain how win–win strategies work and fail in different contexts. We then applied our evidence for all cases to the systems framework. We assessed the quality of evidence within and across cases in terms of triangulation of sources and strength of evidence. We also strengthened hypothesis testing using replication logic.ResultsWe found robust evidence for two mechanisms about how and why win–win strategies build partnerships for HiAP implementation — the use of shared language and the value of multiple outcomes. Within our cases, the triangulation was strong, both hypotheses were supported by literal and contrast replications, and there was no support against them. For the third mechanism studied, using the public-health arguments win–win strategy, we only found evidence from Finland. Based on our systems framework, we expected that the most important system components to using win–win strategies are sectoral objectives, and we found empirical support for this prediction.ConclusionsWe conclude that two mechanisms about how and why win–win strategies build partnerships for HiAP implementation — the use of shared language and the value of multiple outcomes — were found as relevant to the six settings. Both of these mechanisms trigger a process of developing synergies and releasing potentialities among different government sectors and these interactions between sectors often work through sectoral objectives. These mechanisms should be considered when designing future HiAP initiatives and their implementation to enhance the emergence of non-health sector policy-makers’ engagement.

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Section: Discussionmentioning

confidence: 99%

How and why do win–win strategies work in engaging policy-makers to implement Health in All Policies? A multiple-case study of six state- and national-level governments

Kokkinen

Freiler²,

Muntañer

et al. 2019

Health Res Policy Sys

Self Cite

View full text Add to dashboard Cite

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“…Although Finland has had challenges in implementing HiAP, and although HiAP is a complex and deeply political process, 14 Finland has sustainably engaged in HiAP implementation efforts 15,16 and is arguably an exemplary country in their engagement and success of HiAP. Despite Finland's leadership in HiAP, and despite the growing and rich literature on HiAP in Finland [17][18][19][20][21] including literature on HiAP implementation at the national level, 15,16,22 there is a dearth of literature focused HiAP implementation at the municipal or local level. Indeed, even on an international scale the literature on HiAP implementation locally is limited, as reported in a recent scoping review.…”

Section: Key Messagesmentioning

confidence: 99%

A Realist Explanatory Case Study Investigating How Common Goals, Leadership, and Committed Staff Facilitate Health in All Policies Implementation in the Municipality of Kuopio, Finland

Guglielmin

Shankardass

Bayoumi³

et al. 2022

Int J Health Policy Manag

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Background: Health in All Policies (HiAP) encompasses collaboration across government and the consideration of health in various governmental sector’s policies and decisions. Despite increasing advocacy, interest, and uptake in HiAP globally, empirical and evaluative studies are underrepresented in this growing literature, particularly literature on HiAP implementation at the local level. Finland has been a pioneer in and champion for HiAP. Methods: A realist explanatory case study design was used to test hypotheses about how HiAP is implemented in Kuopio, Finland. Semi-structured interviews with ten government employees from various sectors were conducted. Data from interviews and literature were analyzed with the aims of uncovering explanatory mechanisms in the form of Context-Strategy-Mechanism-Outcome configurations related to implementation strategies. Evidence was evaluated for quality based on triangulation of sources and strength of evidence. We hypothesized that having or creating a common goal between sectors and having committed staff and local leadership would facilitate implementation. Results: Strong evidence supports our hypothesis that having or creating a common goal can aid in positive implementation outcomes at the local level. Common goals can be created by the strategies of having a city mandate, engaging in cross-sectoral discussions, and/or by working together. Policy and political elite leadership led to HiAP implementation success because leaders supported HiAP work, thus providing justification for using time to work intersectorally. How and why the wellbeing committee facilitated implementation included by providing opportunities for discussion and learning, which led to understanding of how non-health decisions impact community wellbeing, and by acting as a conduit for the communication of wellbeing goals to government employees. Conclusion: At the municipal level, having or creating a common goal, leadership from policy and political elites, and the presence of committed staff can facilitate HiAP implementation. Inclusion of not only strategies for HiAP, but also the explanatory mechanisms, aids in elucidating how and why HiAP is successfully implemented in a local setting.

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“…A literature review on HiAP implementation in Finnish municipalities was also conducted. Peerreviewed studies describing HiAP implementation in Kuopio were included in the analysis as data sources alongside key informant interviews [16][17][18].…”

Section: Data Sources and Collectionmentioning

confidence: 99%

Tools for local health in all policies implementation: evidence from an explanatory case study of Kuopio, Finland

Guglielmin

Shankardass

Bayoumi

et al. 2022

Scand J Public Health

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Aims: This paper describes the use of three governance tools for health in all policies utilised to facilitate implementation in the municipality of Kuopio, Finland: impact assessments, a city mandate (the Kuopio strategy), and shared budgets. Methods: An explanatory case study was used. Data sources included semistructured interviews with 10 government employees and scholarly literature. Realist scientific methods were used to reveal mechanisms underlying the use of tools in health in all policies. Results: Strong evidence was found supporting initial and new theory/hypotheses regarding the use of each tool in achieving positive implementation outcomes. Impact assessments facilitated health in all policies by enhancing understanding of health implications. The Kuopio strategy aided in implementation by giving credence to health in all policies work via formal authority. Shared budgets promoted intersectoral discussions and understanding, and a sense of ownership, in addition to allowing time to be spent on health in all policies work and not financial deliberation. Conclusions: Findings confirm the efficacious use of three governance tools in implementing health in all policies in Kuopio. Knowledge and evidence-based guidelines on local health in all policies implementation are needed as this policy approach continues to be recognised and adopted as a means to promote population health and health equity.

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"First, Do No Harm": Have the Health Impacts of Government Bills on Tax Legislation Been Assessed in Finland?

Cited by 15 publications

References 5 publications

How and why do win–win strategies work in engaging policy-makers to implement Health in All Policies? A multiple-case study of six state- and national-level governments

How and why do win–win strategies work in engaging policy-makers to implement Health in All Policies? A multiple-case study of six state- and national-level governments

A Realist Explanatory Case Study Investigating How Common Goals, Leadership, and Committed Staff Facilitate Health in All Policies Implementation in the Municipality of Kuopio, Finland

Tools for local health in all policies implementation: evidence from an explanatory case study of Kuopio, Finland

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