The role of health promotion in community development on the local level

How is public health work being shaped when it is integrated in strategic planning for developing local communities? The mandatory tasks for Norwegian municipalities to make overview documents on health conditions and health determinants, and to applicate this knowledge production into the making of the municipalities planning strategy, offers a possibility to study this question. To study this implies to explore two central elements in WHOs charter on health promotion from Ottawa 1986: that health promotion must be based on knowledge, and that health promotion should be integrated in all fields of politics. Public health is a broad field, understood and practiced in different ways according to understandings of how to work and what kind of issues that are worked upon. Strategic planning differs also a lot in shapes and content in local practices. When two such multitude fields are integrated the results will be multiple as well. The integration processes are framed by and affected by many factors: the conditions in the local community, access to knowledge and resources in the municipality organization. The project is aiming at studying closely a few examples of the integration processes in the Norwegian system, focusing on to issues: - how the integration process is developing policy concerning the relation between public health work, society planning and society development. - the role that is made up for public health work in this policy development process. These two elements will be discussed within a broader perspective from theories on public health and planning. The central dimensions in the analysis is use of knowledge, mobilizing of actors and consolidation of ideational power. That implies to use theories from social science about the role of knowledge, organizational practices, policy development and power together with perspectives from public health science. Literature on health promotion as part of public health indicates that there is rather limited work on public health work applying theories from social science on policy development. This impression seems to correspond with literature review on research about the interface between public health work and strategic planning. The background for the project is an ambition from the state about strengthening health promotion and public health in all politics. This ambition is, as mentioned, expressed in the new mandatory tasks given within planning (The Planning and Building Act), and the making of an overview document (The Public Health Act). The idea of bringing these two tasks together have different origins. Seen from the view of promoting population health, it might be viewed as an implementation of several central ideas from WHOs Ottawa charter from 1986. One is about strengthening the knowledge-based work on population health, built on the theory of health determinants. The second is derived from the idea about the power in mobilizing local society in health promotion. A third idea is about implementing the health promotion perspective in all politics, in this case through Strategic planning. Viewed from society planning perspective this joint venture might be welcomed as a way of strengthening the social dimension in the challenge of planning for a sustainable development. The mandatory tasks provide institutional framing for working processes and products that might be analyzed. The methodological approach is qualitative oriented, using empirical material from a few municipalities; document analysis and interviews. It is assumed that results from the project will contribute, by examples, to knowledge about how strategic oriented policy development in the public health field is carried out in practice. This knowledge may be used in further exploration on how strategic policy development within the field of public health is carried out in practice on the local level. It may also contribute to a discussion about what role public health work can and should play in strategic policy development on the local level.

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Det systematiske folkehelsearbeidet i Norge utvikler seg som følge av krav til kommunene og fylkeskommunene i folkehelseloven. Et forhold er koblingen av oversiktsarbeid etter folkehelseloven opp mot lokal samfunnsutvikling i form av planlegging etter plan- og bygningsloven. Et annet forhold er det statlige initiativet "Program for folkehelsearbeid i kommunene" som har til hensikt, i tråd med loven, å gjøre psykisk helse til en integrert del av folkehelsearbeidet, og knytter det til lokal samfunnsutvikling. Helsefremmende arbeid, som en del av folkehelsearbeidet, og lokal samfunnsutvikling gjennom planlegging etter plan- og bygningsloven, kan betraktes som to ulike diskurser som bringes sammen som beskrevet ovenfor. Med diskurs menes her en spesifikk struktur av ideer, begreper og kategorier, formet i forholdet mellom kunnskap og makt, og uttrykt gjennom ideologier, strategier, språk og praksis. Prosjektet tar mål av seg til gjennom diskursanalyse å undersøke hvilken plass det helsefremmende arbeidet har i lokal samfunnsutvikling, både utfra hvordan "helsefremmende arbeid" forstår og tar opp i seg "lokal samfunnsutvikling" og hvordan "lokal samfunnsutvikling tar opp i seg "helsefremmende arbeid". Dette kan gi kunnskap som grunnlag for å forsterke koblingen. Diskursanalysen skal bygge på litteraturstudier, dokumentanalyse og lokal praksis. Lokal praksis tenkes undersøkt dsom dokumentanalyser og som et fåtall casestudier som undersøkes gjennom observasjoner og informantintervjuer. Kriterier for valg av case er kommuner som både har et aktivt oversiktsarbeid, aktiv kommuneplanlegging og deltar i program for folkehelsearbeid i kommunene. Som folkehelsesjef og tidligere samfunnsplanlegger vil kandidaten kunne gi erfaringsbasert kunnskap til spørsmålsstillingene, samtidig som rollen som observatør og forsker krever metodisk klarhet. Prosjektet forventes å være relevant for fylkeskommuners og kommuners rolle som samfunnsutviklere generelt og innen folkehelse spesielt.