Lee Chiachi Bonnie, Huang Nuan-Ching, Kung Shiann-Far, Hu Susan C
Department of Health Services Administration, China Medical University, Taichung 404, Taiwan.
Department of Urban Planning, College of Planning and Design, National Cheng Kung University, Tainan 701, Taiwan.
Health Promot Int. 2021 Mar 12;36(1):78-88. doi: 10.1093/heapro/daaa037.
Health in All Policies (HiAP) is an effective approach to promote population health through addressing comprehensive social determinants of health. In 1997, the World Health Organization designed a 20-step protocol for developing a Healthy Cities (HC) project to build healthy public policies. Taiwan adopted the concept of HC in 2002 and established the first demonstration project in Tainan City in 2003. This study explores the impact of the HC initiative on the development of HiAP, as well as how a window of opportunities for HiAP was opened through the HC movement, using Tainan City as an example. Tainan was selected as the case for this study because of its relative maturity in the development of an HC initiative. A theory-driven thematic analysis was conducted in the study with archived documents between 2003 and 2010. We first adopted a Multiple Streams Approach to examine how the city government opened a window for HiAP through the HC initiative and then drew on the Maturity Model to evaluate the stage of HiAP in the Tainan HC project. After analyzing all related documents, we concluded that HiAP in the Tainan HC project had reached Stage V Institutionalization after 7 years. Key contexts, factors, challenges and strategies were identified. This study suggests that the HC initiative can indeed contribute to the development of HiAP and that the window was opened for HiAP through a concurrence of the three streams of problem, policy and politics along with the HC movement process.
健康融入所有政策（HiAP）是一种通过解决健康的综合社会决定因素来促进人群健康的有效方法。1997年，世界卫生组织设计了一个20步的方案，用于开展健康城市（HC）项目以制定健康的公共政策。台湾于2002年采用了健康城市的概念，并于2003年在台南市建立了首个示范项目。本研究以台南市为例，探讨健康城市倡议对健康融入所有政策发展的影响，以及如何通过健康城市运动为健康融入所有政策打开机遇之窗。选择台南市作为本研究的案例是因为其在健康城市倡议发展方面相对成熟。本研究对2003年至2010年期间的存档文件进行了理论驱动的主题分析。我们首先采用多源流方法来研究市政府如何通过健康城市倡议为健康融入所有政策打开一扇窗，然后利用成熟度模型来评估台南健康城市项目中健康融入所有政策的阶段。在分析了所有相关文件后，我们得出结论，台南健康城市项目中的健康融入所有政策在7年后已达到第五阶段制度化。确定了关键背景、因素、挑战和策略。本研究表明，健康城市倡议确实有助于健康融入所有政策的发展，并且通过问题、政策和政治这三股源流与健康城市运动过程的同时出现，为健康融入所有政策打开了这扇窗。
