Southgate Institute for Health, Society and Equity, Flinders University, Adelaide, SA, Australia.
Int J Health Policy Manag. 2018 Oct 1;7(10):968-970. doi: 10.15171/ijhpm.2018.67.
The article by Susanne Hagen and colleagues on Health Promotion at Local Level in Norway discusses actions by municipal governments to assess and address heath inequities within their respective regions, as required under the Norwegian Public Health Act (PHA). Although the broad intent of the Norwegian government is to encourage action on social determinants of health (SDH), Hagen et al find that many of the initiatives undertaken by municipalities 'tend to cash out as single, targeted initiatives,' and focus on individual behaviours. In this commentary, I use the concept of place-based policy and ideas from policy theory on the institutional behaviours of public policy agencies and services, to discuss reasons behind this narrowing of perspective and policy action. I argue in favour of an alternative approach involving public agencies and services supporting processes of community-led action and social change.
本文由 Susanne Hagen 及其同事撰写,题为《挪威地方一级的健康促进》,探讨了市政府根据《挪威公共卫生法》的要求,评估和应对各自区域内健康不平等问题的行动。尽管挪威政府的广泛意图是鼓励针对健康的社会决定因素(SDH)采取行动,但 Hagen 等人发现,许多市政府采取的举措“往往只是单一的、有针对性的举措”,并侧重于个人行为。在这篇评论中,我使用基于地点的政策概念和政策理论中关于公共政策机构和服务的制度行为的观点,来讨论这种观点和政策行动收窄的背后原因。我主张采取一种替代方法,即公共机构和服务支持社区主导的行动和社会变革的过程。