How can local governments level the social gradient in health among families with children? The case of Norway

Abstract

The Norwegian National government has recently developed policies to reduce health inequalities; this should be achieved by a Health in all Policies approach (HIAP). Most policies are to be implemented at the local level and municipalities are responsible for the implementation. The aim of this paper is to answer this question: How can municipalities reduce social inequalities and among families with children through a mixed methods approach, using surveys as well as qualitative interviews in the collection of data? The main conclusion is that they are in different places when it comes to implementing public health and health promotion policies. The responsibility for public health and health promotion is to a large degree still left to the health sector, including those in positions as public health coordinators. To achieve HIAP, these positions should have an executive function in order to coordinate and influence local policies using a combination of universal and targeted measures. However, no extra funding has been allocated via the national budgets, and intensified efforts are still funded via projects. Still, we observe a change towards increased awareness of the HIAP approach to reduce social inequalities.