State of evidence on municipal strategies for health promotion and prevention: a literature and database research (Scoping Review)

Abstract

Background There are gaps in the research regarding the implementation and evidence of overall strategies for municipal health promotion addressing communities. The aim of this scoping review is to gain initial findings concerning theoretical models, approaches and evidence on strategies of municipal health promotion, which include self-care, mutual aid and healthy environments. The findings can enrich the development of health promotion services. Methods A systematic scoping literature analysis was conducted in the databases PubMed, Web of Science, SAGE-Journals, Wiley-Online, ScienceDirect, LIVIVO and WiSo database as well as in a German project database. Evaluation studies and research reports on strategies in municipal health promotion were included and analysed qualitatively. Results According to our predefined inclusion and exclusion criteria, 15 hits were included. Capacity building, planning and the establishment of structures for health promotion were identified as theory-based models and approaches. None of the publications included showed clear evidence of the effects of municipal health promotion measures in terms of classically medically defined evidence. Conclusions The use of evidence-based theoretical models and approaches is no guarantee for the success of strategies for municipal health promotion. Challenges with regard to evidence are the execution of study designs corresponding to higher evidence classes and the isolation of effects of health promotion measures in complex environments. Trial registration This scoping review was not registered beforehand.

Designing a Health Strategy at Local Level: A Conceptual Framework for Local Governments

“…This is the underlying rationale for the concept of “Health in all Policies”, which emphasizes the need to promote health in the context of where citizens live or work by involving all policy areas and intersectoral networks. Additionally, the concept of “Health for all” highlights the importance of the equitable distribution of resources for health and ensuring that essential health services are accessible to everyone [ 12 , 33 , 34 , 35 , 36 ].…”

“…With a key role in linking the central government to society and working closer with communities, municipalities are at the forefront of capitalizing on opportunities to promote citizens’ health and well-being. The local government takes on particular relevance when considering that each location has its own cultural arrangement, which can influence the political, social, and health culture of its stakeholders, thus becoming extremely important in the design of health policies [ 12 ]. In addition, the COVID-19 pandemic revealed the importance of municipalities in dealing with such atypical phenomena but with a high impact on citizens’ health and socioeconomics [ 7 ].…”

“…Local governments usually have primary responsibilities for planning and delivering services that are crucial to addressing the social determinants of health, including education, transport, housing, and urban planning. They are also often in a strong position to assemble a wide variety of local stakeholders to stimulate action in a way that a single sector by itself cannot [ 12 ]. This has led several authors to argue that decentralization enables responsiveness to local needs and values, supports health policymaking that aligns with and empowers various stakeholders, enhances community engagement, and strengthens social capital [ 39 , 40 ].…”

“…Moreover, although the main strategic national document on health in Portugal—National Health Plan 2021–2030—emphasizes the importance of strengthening the role of municipalities in aligning territorial policies and strategies with the health sector, no specific guidelines are provided on this matter. As such, little is known about how local initiatives should be conceptualized, implemented, and evaluated [ 12 ] and, in particular, how a health strategy should be developed at the local level, considering health determinants and taking stock of their proximity to communities.…”

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

“…On the other hand, the inclusion of diverse, often specific settings makes it easier to reach marginalised target groups [6,7]. In a scoping review, Quilling et al [8] present the state of evidence on municipal health promotion, including examples of successful health promotion programs at the municipal level. One of the key findings is that evidence-based theoretical models and approaches 2 of 15 provide guidance but do not guarantee the success of municipal health promotion.…”