title: Manifestations of integrated public health policy in Dutch municipalities.
abstract: Integrated public health policy (IPHP) aims at integrating health considerations into policies of other sectors. Since the limited empirical evidence available may hamper its further development, we systematically analysed empirical manifestations of IPHP, by placing policy strategies along a continuum of less-to-more policy integration, going from intersectoral action (IA) to healthy public policy (HPP) to health in all policies (HiAP). Our case study included 34 municipal projects of the Dutch Gezonde Slagkracht Programme (2009-15), which supports the development and implementation of IPHP on overweight, alcohol and drug abuse, and smoking. Our content analysis of project application forms and interviews with all project leaders used a framework approach involving the policy strategies and the following policy variables: initiator, actors, policy goals, determinants and policy instruments. Most projects showed a combination of policy strategies. However, manifestations of IPHP in overweight projects predominantly involved IA. More policy integration was apparent in alcohol/drugs projects (HPP) and in all-theme projects (HiAP). More policy integration was related to broad goal definitions, which allowed for the involvement of actors representing several policy sectors. This enabled the implementation of a mix of policy instruments. Determinants of health were not explicitly used as a starting point of the policy process. If a policy problem justifies policy integration beyond IA, it might be helpful to start from the determinants of health (epidemiological reality), systematically transform them into policy (policy reality) and set broad policy goals, since this gives actors from other sectors the opportunity to participate.
authors.affiliation: Department of Public Health, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands d.t.peters@amc.nl dorothee.peters@gmail.com.
authors.forename: Dorothee
authors.initials: D
authors.lastname: Peters
authors.affiliation: Department of Public Health, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
authors.forename: Janneke
authors.initials: J
authors.lastname: Harting
authors.affiliation: Faculty of Social Sciences, University of Tilburg, PO Box 90153, 5000 LE Tilburg, The Netherlands National Institute for Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands.
authors.forename: Hans
authors.initials: H
authors.lastname: van Oers
authors.affiliation: National Institute for Public Health and the Environment, PO Box 1, 3720 BA Bilthoven, The Netherlands Department of Health Sciences and EMGO institute for Health and Care Research, VU University Amsterdam, De Boelelaan 1105, 1081 HV Amsterdam, The Netherlands.
authors.forename: Jantine
authors.initials: J
authors.lastname: Schuit
authors.affiliation: Department of Health Promotion, CAPHRI School of Public Health and Primary Care, University of Maastricht, PO Box 616, 6200 MD Maastricht, The Netherlands.
authors.forename: Nanne
authors.initials: N
authors.lastname: de Vries
authors.affiliation: Department of Public Health, Academic Medical Center, University of Amsterdam, PO Box 22660, 1100 DD Amsterdam, The Netherlands.
authors.forename: Karien
authors.initials: K
authors.lastname: Stronks
mesh_terms: D000437:Alcoholism / Q000517:prevention & control; D002947:Cities; D006291:Health Policy; D006293:Health Promotion / Q000379:methods / Q000458:organization & administration; D006801:Humans; D009426:Netherlands; D050177:Overweight / Q000517:prevention & control; D011634:Public Health / Q000379:methods; D000074606:Smoking Prevention; D019966:Substance-Related Disorders / Q000517:prevention & control
keywords: determinants of health; government programs; healthy public policy; multisectoral policy response