[Health promotion by the public health service--problem areas and perspectives]

Abstract

For more than ten years policy makers and researchers in the field of health policy have been requesting the local health departments in Germany to focus primarily on population-oriented and structural strategies in health promotion. Based on empirical findings of a study carried out in Berlin, this article argues that several structural and organizational factors in practice influence the implementation of these strategies by the local health departments. These factors can constrain or enable the implementation of the strategies. The paper draws the conclusion that several requirements must be fulfilled for the local health departments to define themselves in health politics and policy. More than ever, the definition of their tasks and targets needs to be linked to questions of organizational change and personnel. Moreover, the local health departments should define their role more clearly in relation to the other institutions in the sector of public health and in relation to the citizens.