Municipal Health Promotion as Part of Urban Health: A Policy Framework for Action

Abstract

The link between health, socio-economic status and the living environment is increasingly moving into the focus of public health research and policy. The aim of the European Union’s Project “Joint Action Health Equity Europe (JAHEE)” is to enable countries to identify and implement needs-based measures to promote health equity. In one of JAHEE’s work packages, focusing on healthy living environments as a strategy to tackle health inequities, a Policy Framework for Action (PFA) has been developed. This article gives an insight into the core contents of the PFA, which are valid beyond the project boundaries for all actors that work at the intersection of community health promotion. The PFA was developed as a consensus document in a participatory process between the members of the work package and an interdisciplinary German team of public health experts. Results from project meetings of the partner countries as well as research findings and recommendations from field experts were incorporated. Reducing health inequalities in public health is a cross-sectional issue that needs to be addressed across all policy areas. The municipality setting is of particular importance in this context, as it offers many starting points and can coordinate between all relevant actors with an overarching strategy.

Needs to Create Healthy Living Environments—A Two-Stage Delphi Survey in Europe to Identify Facilitating Factors and Barriers in Municipal Health Promotion

“…The controversial opinions and the discussion about the evidence-based characteristics of interventions show that the participants experience a great challenge in practice. As often described in professional discourse [18,[37][38][39], from their point of view there seems to be a great need to improve the evidence base for creating health-promoting environments. The counter-thesis that actions can also be based on purely practical experience, on the other hand, was also weakened.…”

“…However, even "best" or "promising practice", which is often, though not entirely uncritically, regarded as the best available evidence in municipal health promotion [40], was cautiously described here as a possible basis for action under the aspects of contextualisation and transferability. With regard to the evaluation of projects in municipality structures and neighbourhoods, the complexity and also the rapidly changing framework conditions were explicitly pointed out here as well [18,[37][38][39]. Although evaluation is seen as relevant to practice, it is also perceived as very challenging.…”