The adoption of a place-based framework to inform municipal health strategies

Abstract Background Health is a place-based issue. Research shows that inequalities in health are significantly influenced by social, economic, and environmental factors, making local policies related to these domains critical determinants. Yet, place-based health planning remains underutilized by local practitioners, not receiving adequate attention from policy-makers. Departing from the Municipal Health Strategy of Coimbra, this presentation aims to showcase the framework used for guiding municipal health planning, addressing multidimensional factors, geographic analysis, intersectoral collaboration and participatory approaches. Methods The conceptual and methodological framework followed a population health approach with a geographic lens, looking at how the health outcomes and health determinants were geographically distributed across the municipality (data disaggregated at sub-municipal level), as well as the extent to which policies from multiple sectors can address them. The planning cycle followed an iterative seven-stage process based in five key actions: 1 - Assess (Health Profile), 2 - Prioritize (Priorities), 3 - Plan (Objectives and Strategies), 4 - Implement (Action Plan) and 5 - Monitor (Targets and Measures, Monitoring Plan). Participatory processes were conducted involving local stakeholders and citizens to identify needs, establish priorities and actions. Results The framework for action integrates 14 goals and 94 actions across six policy domains: Sustainable Mobility and Public Places, Safe and Adequate Housing, Accessible Healthcare, Social Cohesion and Participation, Education and Health Literacy and Intersectoral and Collaborative Leadership. Conclusions Adopting a place-based framework to health planning, involving a geographical and multidimensional health assessment as well as the participation of local stakeholders and citizens, was considered effective in turning evidence into practice. Key messages • Municipal health strategies should be developed with a place-based perspective, prioritizing health as the focal point across various intersectoral municipal policies. • The integrated framework shed light on the experience of co-creation to inform health-oriented planning, ensuring that actions address specific needs of localities.