RHP&EO is the electronic journal of the International Union for Health Promotion and Education

Creating Supportive Environments For Health: The Process Of Establishing A Comprehensive Health Promotion Programme At The Local Level. A Case Study From Stockholm County

Bo Burstrom(1), Bo JA Haglund(1), Ragnar Andersson(1) and Lena Kanstrom(2)

(1) Dept of Public Health Sciences, Division of Social Medicine, Karolinska Institute S-172 83 Sundbyberg Sweden. (2) Western Stockholm Medical Services District.

Few health promotion programmes have been designed on the basis of creating supportive environments for health. The paper describes the process of establishing an arena-based comprehensive health promotion programme on the level of a health services district in urban Stockholm.

The health services district of western Stockholm (population 200,000), in spite of a 10% budget cut, in 1993 decided to set aside SEK 10 million annually for a

comprehensive public health programme, which has been planned based on the concept of creating supportive environments for health. Initially the programme will focus on health promotion in schools, safety promotion and prevention of psycho-socially related ill health. Six health planners are responsible for initiating and coordinating inter-sectoral collaboration in these fields in five arenas - schools, work sites, residential areas, the physical environment and the health care services. For each of the target areas potential collaborators are identified, and networks formed. An overall strategy will be developed, objectives and targets for activities are agreed on by the actors. The overall aim is to increase equality in health. Activities in the three target areas will be designed so as to be mutually supportive: school health promotion will include safety promotion and prevention of pscyho-socially related ill health; successful actions to reduce psycho-socially related ill health can also be expected to reduce intentional injury.

Problems encountered, in the process of establishing the programme are discussed. These include contradiction between the long term perspective of health promotion and the political need to demonstrate cost-saving results in the short term; the contradiction between the desire to cover many priority areas and the need to concentrate efforts; the need to develop appropriate methods to evaluate the effect and efficacy of working according to the concept of creating supportive environments for health; and difficulties in finding appropriate levels for collaboration with municipal authorities in a large city.

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