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

How does population health work help shape municipal planning when integrated to promote sustainable local communities? The last decade has represented an increasing attention to the importance of social sustainability as part of promoting sustainable development. In the same period, social sustainability has become a dominant framework for what population health work is about, especially when it comes to health promotion work. It seems that concepts about, and commitment to, social sustainability function as crucial links between population health work and community development. The issues are both about social equality at population level, with health equity as a main theme, and about social conditions that make local communities viable. 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 good setting for doing research on this connection on a local level. To study this topic 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. Population 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 in working procedures and content in local practices. 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. When two such multitude fields are integrated the results will be multiple as well. In this project the process of integration will be researched from an assumption that concepts of social sustainability are working as ways of conneting local population health work and municipality planning. The project is drawing on theoretical resources from social science (new-institutionalism), pragmatic and collaborative planning theory, combined with understandings of the integration process from public health science. 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). Both laws are expressing ambisions about health equity. The idea of bringing population health work and municipality planning together have different origins. Seen from the view of promoting health it is a part of the 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 an institutional framework for work processes and products that can be analysed. The methodological approach is qualitatively oriented, using empirical material from a few municipalities; document analysis and interviews. The assumed result from the project is a contribution to knowledge about how population health work and municipal planning are integrated through a focus on concepts of social sustainability. This can serve as a basis for further exploration of how the integration between population health work and municipal planning is practised, and for discussions about further development of the relevant tools that are in use.

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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.