Equity in health and well-being a political choice! Do something! Do more! Do better! Dina von Heimburg, public health coordinator Innherred joint municipality and vice-chairman Healthy cities Norway
3 keys for political commitment Strengthen system capacity! Strengthen human capacity! Be patient, brush up on your soft skills, and keep pushing forward!
WHO Healty Cities» Euro Healthy Cities network» National network in Norway» «Laboratory»: Develop and share «best practice» of public health work at the local and regional level.
Verdal and Levanger municipalities Levanger: ca. 20.000 inhabitants Verdal: ca. 15.000 inhabitants Cooperations through Innherred samkommune (joint municipality) since 2004
WHO Health 2020 Health 2020 recognizes that successful governments can achieve real improvements in health if they work across government to fulfil two linked strategic objectives: improving health for all and reducing health inequalities improving leadership and participatory governance for health. 07.04.2017 5
Verdal and Levanger try our best to fulfill the systematic public health circle as requested by national legislation Evaluation Overview of public health and health determinants Implementation of measures Strategic societal planning: overall goals and strategies policy and action plans
Dialogue and enthusiasm! All politicians are public health politicians! 7
2008: Not even on the spectrum? 2012: Partnership with UCL/Marmot team 2010: members of WHO Norwegian HC 2012-2014 Making the case, telling the story, intensive planning 2017 Moving further down the action spectrum (but still a long way to go!) Action Spectrum on inequalities in health (Whitehead 1998) 8
Central principles «back home»: The municipal couincil decides the direction for societal development The Mayor is our captain The Chief Executives facilitates development through leadership, holistic governance, co-creation and co-design. Our work is «glued» to the backbone of the municipal organization.
Political commitment! Public health and equity in health and well-being a political choice! (Trondheim declaration, 2014) However, we politicians need an INFORMED debate in order to make health promoting decitions Well well, then, I guess you need my help!!!!
Holistic governance system Ensuring accountability across sectors and mobilize local community Whole of government Whole of society
«window of opportunity» Problems Policies Politics Based on Kingdon, 2011; Leppo et al. 2013
GUIDELINES VALUES KNOWLEDGE Municipal plan public health strategy Process 2014 Planning strategy 2013-2016 Holistic solutions Municipal plans Health Childhood Culture Buisiness City Centre Revision of public health strategy Developement of services and local community Defining perspectives Existing municipal plans
15
(Trondheims-deklarasjonen, 2014)
Men in Levanger: Life expectancy by education level http://khs.fhi.no/webview/ 17
Percieved loneliness among youth 106 65 30 18
What is Health? "Good health is what a person has when he has the ability and the capacity to cope with and adapt to life's inevitable difficulties and dayto-day requirements." (Peter F. Hjort). 19
Sustainable development H ealth and well-being is created where people are born, play, learn, work, enjoy leisure, shop and live 24 /7 365 Basert på Dahlgren og Whitehead, 1991 og Bloch et al., 2014
21 Focus on ASSETS
45
From disease prevention to community mobilization!
GUIDELINES VALUES KNOWLEDGE Municipal plan public health strategy Process 2014 Planning strategy 2013-2016 Holistic solutions Municipal plans Health Childhood Culture Buisiness City Centre Revision of public health strategy Developement of services and local community Defining perspectives Existing municipal plans
Municipality of Levanger Municipality of Verdal Municipal Masterplan 2015-2030 Vision: Quality of life and growth sustainable societies - a good start and coping throughout the lifespan - generous and robust life environments
GOALS We are working to achieve the following objectives: Our municipalities are good communities to live in for a whole lifetime, and everyone feel as a valued part of the community All children must be given the best possible start in life All the inhabitants feel secure, they have control of their everyday life and they have added several active years of life with good health and well-being Our municipalities are a force for development in a sustainable and robust part of Central Norway
Masterplan = 1 page!
Direct links between strategies, measures and (joint) budgeting
INDIKATORER OG RESULTATVURDERING Målindikatorene som er vist under, legges til grunn for resultatvurderingen i årsrapporten. Resultatvurderingen skjer i lys av samfunnsmålene og skal gi pekepinn på om utviklingen går i retning av disse. Der det er mulig skal resultatvurderingen skje ut fra en fordeling på geografi, alder, kjønn og sosial status. Det legges til grunn en ambisjon om at situasjonen skal forbedres for alle og at ulikhet skal reduseres. Levealder (Folkehelseinstituttet) Selvrapportert helse og livskvalitet (HUNT4 og UngData) Leveår med god helse (HUNT4) Andel med fortrolig venn/nettverk som kan hjelpe ved problemer (HUNT4 og UngData) Gjennomføring videregående skole (Fylkesdata) Langtids arbeidsledighet (Nav) Uførhet (Nav) Husholdninger med vedvarende fattigdom/langtids sosialhjelpsmottakere (SSB/Nav) Kulturdeltakelse/deltakelse frivillighet (HUNT4 og UngData) Fysisk aktivitet (Sykkeltelling og selvrapportert fysisk aktivitet HUNT4/UngData) Infrastruktur til gående og syklende (Antall nye meter) Trafikk (Passasjertall kollektivtrafikk, biltrafikkmåling) Borgerindeks (Borgerundersøkelsen) Demokratiindeks (Borgerundersøkelsen) Kommunebarometeret (Kommunal rapport) inequity. Kildesortering (Innherred Renovasjon) Næringsindeks (Næringslivets Hovedorganisasjon) Bedriftsetableringer (Innovasjon Norge) Netto og brutto driftsresultat i % av driftsinntekter (Kommuneregnskapet) Disposisjonsfond i % av driftsinntekter (Kommuneregnskapet) The performance review is supposed to indicate whether the development is moving toward societal goals The ambition is to improve the situation for everybody, and to reduce
Evidence-based? 30
With a little help from our friends... 31
National legislation & compliant municipalities???
Soft skills the «new skills on the block» 33
Soft skills change agents Creative bureacracy facilitate innovation Strategic staff unit bridge spanners who tears down walls between sectors Accumulated group (crowd-sourcing) of change agents strengthen the equity message together. Start with those who are positive and wants to commit.
Soft skills change agents Adjust language and «chapters of the main story» to fit into relevant contexts. Create win-win situations. Tacit leadership Make sure to have some quick wins and successes, and let others take credit
«Narratives on housing» Story-telling and narratives to accumulate knowledge, empwer citizents, and set the political agenda. Based on Clandinin og Connelly (2000) «Three-dimensional narrative space».
38
Supersetting = Coordinated and equal efforts which enhances the effect of each other Principles Actors Participation Bus BUA Citizents Volunteers Integration Marketplace Empowerment Context Knowledge Park and green space Neigbourh ood School Kindergarten Workplace Health instituti on Politicians Media Public sector Private secto Academia Librery Bloch, Bruun Jensen & al. 2014
Supersettings are created by supermen - and superwomen Follow up on political decisions - creating the new welfare municipality Chief of administration Ola Stene, Levanger Chief of administration Jostein Grimstad Verdal Promote public health and wellbeing & Reduce inequity!! Bloch et al. International Journal of Behavioral Nutrition and Physical Activity 2014, 11:118 http://www.ijbnpa.org/content/11/1/118
Holistic planning: 1+1+1 = 5, 6, 7. 42
«Mayors talk» on political leadership for sustainable development, health and well-being for all. Dialogue seminar between politicians, administrative leaders and union representatives, march 2017
3 keys for political commitment Strengthen system capacity! Strengthen human capacity! Be patient, brush up on your soft skills, and keep pushing forwards!
Levanger kommune enhet Kommunalteknikk Levanger ungdomsskole Schools as a place to meet, learn, play, love, and enjoy leisure 24/7-365 48
Siden BUA Levanger åpnet i april 2015 har tilbudet fått nær 800 registrerte kunder, og per januar 2017 er det registrert hele 5519 unike utlån. 49
Levanger kommune enhet Kommunalteknikk Stadionparken 27.08.15 51
Levanger kommune, Røde kors og Levangers unge sanitetsforening inviterte til beachparty 10.07.2016 53
«Dugnad» to make an inclusive place to meet and eat Kafe Verden in Levanger works to include immigrants and other citizents in a supportive community. As volunteers, many people strengthen their social networks, work experience and they get access to references and relationships they can bring with them to enhance their success in working life and society
Levanger Arena Arbeid http://www.levanger.kommune.no/pagefiles/1738/verkt%c3%b8ybok_levanger.pdf http://www.levanger.kommune.no/pagefiles/1738/prosjektplan%20farve%202016.pdf
Contact: dihe@innherredsamkommune.no +47 93043714 Thank you!
Systematisk utvikling av system- og humankapasitet Og underveis har vi hatt det gøy sammen med mange kunnskapsrike og kreative mennesker!