Advocating for Health Promotion Policy in Norway: The Role of County Municipalities

Abstract

Background: The Norwegian National government has developed public health policies that reflect health promotion principles, and these are particularly reflected in the recent Public Health Act (PHA). The counties (CMs) have been given a central role in the implementation of the PHA, and in this paper we explore how the CMs fill this role. Methods: Qualitative as well as quantitative data have been applied; a survey, a document study and personal interviews have been conducted. Results: The findings show that the CMs find it challenging to influence all sectors to change the focus from classical lifestyle issues to a focus on the social determinants of health. The Directorate of Health has the main responsibility for implementing the PHA, but the signals from the Directorate are not always consistent. The Directorate still launches campaigns and interventions to improve diets and stimulate physical activity, without launching them in the context of the PHA. Conclusion: The CMs regard the supporting role toward the municipalities as their highest priority. However, they find it hard to anchor and integrate the principles of the PHA. They explain this partly with the sectorised government organisation.