How to Evaluate Health in All Policies at the Local Level: Methodological Insights Within Municipalities From the WHO French Healthy Cities Network

Document Type : Original Article

Authors

1 Department of Social Sciences, Ecole des Hautes Etudes en Santé Publique, Laboratoire Arènes URM CNRS 6051, Université Rennes 1, Rennes, France

2 Ecole des Hautes Etudes en Santé Publique, Leres, Irset UMR- Inserm S 1085, Rennes, France

3 Santé Publique France, Saint-Maurice, Paris, France

4 LADYSS, Université Paris-Nanterre, Nanterre, France

5 Institut de Santé globale, Université de Genève, Genève, Switzerland

6 Department of Health and Environment, Ecole des Hautes Etudes en Santé Publique, Laboratoire Arènes URM CNRS 6051, Université Rennes 1, Rennes, France

Abstract

Background 
This article proposes a method for analysing the degree of maturity of Health in All Policies (HiAP) among World Health Organization-French Healthy Cities Network (WHO-FHCN) as part of the GoveRnance for Equity, EnviroNment and Health in the City (GREENH-City) project. We focused on the creation or enhancement of healthpromoting environments, and more specifically, public green spaces.

Methods 
We conducted a cross-sectional quantitative study guided by the evaluative framework of the HiAP maturity level developed by Storm et al mixed with a qualitative interpretation. A self-administered questionnaire was sent to elected officials and health department officers in the 85 member cities of the WHO-FHCN in 2017. Subsequently 58 cities were included in the analysis, which was based on a multiple correspondence analysis (MCA) and a hierarchical ascending classification (HAC).

Results 
Thirty-two criteria among a total of 100 were identified and were used to organize the cities into 8 groups which was then reduced to three profiles among the cities: a less advanced HiAP profile, an established HiAP profile and an advanced HiAP profile. This process allows us to identify 4 dimensions that make it possible to evaluate the level of maturity of cities in the HiAP process, namely: (1) the consideration of social inequalities in health and/or health issues in the policies/actions of the sector studied, (2) occasional intersectoral collaboration, ie, one-off initiatives between the health department and others sectors, (3) the existence of joint projects, ie, common projects between two or more sectors, (4) the existence of intersectoral bodies, in this case on the theme of urban green spaces including an intersectoral committee and/or working groups.

Conclusion 
Four dimensions which allow to the measurement of the degree of progress in implementing healthall-policies are proposed. With a view to integrating knowledge into public action, this study carried out under real conditions offers a realistic method to evaluate HiAP.

Keywords


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Articles in Press, Corrected Proof
Available Online from 18 June 2022
  • Receive Date: 30 June 2021
  • Revise Date: 03 June 2022
  • Accept Date: 15 June 2022
  • First Publish Date: 18 June 2022