Effects of three local authorities’ measures to promote health
A comparison of results in the local authority districts of Assens, Greve and Hjørring

As of 2007, a number of tasks related to preventive health care and health promotion were imposed on Danish local authorities. The overall purpose of the present study was to investi-gate the effect on people’s lifestyles of various ways of arranging and organising health pro-motion programmes in local authority districts.

The primary focus of the study was on local authorities’ measures aimed at two groups: children and adolescents (12–16-year-olds), and seniors (60–75-year-olds).

Particular attention was also given to measures concerned with diet, smoking, alcohol and exercise.

With regard to organisational aspects, the study examined the general organisation of measures to prevent illness and promote good health, financial and human resources, struc-tures and collaborative relations, and also implementation strategy for illness prevention and health promotion measures in various authority services.

The data used in the analyses was taken from identical questionnaires carried out in 2007 and 2009 among a random sample of 12–16-year-olds and a random sample of 60–75-year-olds in the three municipalities of Assens, Greve and Hjørring.

Information about the municipalities’ health promotion programmes was also gathered in 2007 and 2008 by means of interviews with key persons. The information relates to mat-ters including organisation, resources, strategy for implementation of measures to prevent illness and promote good health, and specific types of measures.

Conclusions

The study was not able to establish that differences in the health promotion programmes of the local authorities were reflected in markedly different patterns of change in 12–16-year-olds’ or in 60–75-year-olds’ physical activity or dietary, smoking or alcohol consumption habits. Only a few changes were found in 12–16-year-olds’ and 60–75-year-olds’ health-related behaviour in the three municipalities, and it was only in a few matters that a munici-pality differed from the others in the study.

The municipalities’ health promotion activities were dominated by two types of measures – efforts to provide knowledge about healthy lifestyles and motivate people to adopt healthy habits by means of advice and education, and (with one exception) interventions involving physical activity for defined target groups of people with special needs.

The majority of the advice-giving interventions in the three districts consisted of one or a small number of consultation sessions. However, the “Healthy City” shops in the municipality of Hjørring and the Health Café in the municipality of Greve, for example, also gave out written material. These initiatives have not been sufficient to cause many people to change their lifestyle or health-related habits. In most cases, short dialogues or courses of consultations cannot stand alone.

Interventions for defined groups may have had an effect within the groups concerned, but no impact can be seen in terms of changes in lifestyle or health-related habits of the 12–16 or 60–75-year age group as a whole.

The study confirms that proximity and structural opportunities for a healthy lifestyle are important in relation to people’s health-related habits. We found a link between the opportu-nities for being physically active and the activity level of the population.

It has proved to be a time-consuming process for the local authorities to develop the or-ganisational structures and the preconditions for implementing preventive health care and health promotion within different services, departments and institutions. This is one of the reasons that this study, which covers the period 2007–2009, was unable to demonstrate dif-ferences in programmes that were linked to different organisational structures or precondi-tions.

The study indicates a number of ongoing challenges for local authorities. The particular challenge for the authorities in relation to the 60–75-year-olds seems to be the proportion who are overweight, and that a large proportion are not very physically active. As regards the 12–16-year-olds, it is a challenge that a relatively large proportion would like to get more ex-ercise, but apparently find it hard to get started. It is a continuing challenge to reduce the number of smokers and alcohol consumption among 12–16-year-olds.

The study also indicates that improvements in health-related behaviour cannot be achieved merely by various advice-giving initiatives which reach a circle which may be more or less wide. Measures are also needed that create the conditions and opportunities for habits and lifestyle, that is to say, conditions that limit unhealthy habits and promote healthy ones. This requires organisational structures in the local authority that can promote collaboration between the health care sector, the various authority services and private players, to develop measures that will reach wider groups.

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