Health in All Policies: A cross-sectional study of the public health coordinators' role in Norwegian municipalities

Abstract

Aims: The public health coordinator (PHC) is a municipal-government position in Norway whose role is to organise and oversee municipal policies and functions to support national public health goals. This cross-sectional study investigates conditions associated with use of PHCs by Norwegian municipalities in the period immediately before the new Public Health Act came into effect in 2012, decentralising responsibility for citizen health to the municipal level. This study provides descriptive baseline data regarding Norwegian municipalities' use of PHCs in this time - a marker for municipal engagement with inter-sectorial collaboration - before this policy was nationally mandated, and explores whether municipal characteristics such as structure, socio-economic status and extent of Health in All Policies (HiAP) implementation were associated factors.

Methods: All Norway's municipalities (N=428) were included. We combined Norwegian register data with survey data. Descriptive analyses and bi- and multivariate logistic regression analyses were performed.

Results: A total of 76% of Norwegian municipalities employed a PHC in the period just before 2012. Of the PHCs employed, 22% were employed full time and 28% were located within the staff of the chief executive office. Our study indicates that partnership for health promotion with county councils (OR=7.78), development of a health overview (OR=3.53), collaboration with non-government sectors (OR=2.85) and low socio-economic status (OR=0.46) are significantly associated with Norwegian municipalities having a PHC.

Conclusions: This study suggests that the municipality's implementation of HiAP, as well as lower socio-economic indicators, is associated with the use of PHCs in Norway, but not factors related to municipal structure.

Keywords: Norway; Public health; governance for health; health in all policies; health promotion; implementation; inter-sectorial collaboration; inter-sectorial coordination; public health coordinator.