Health Promotion as a Preventive Strategy: The Experience of the Milan Health Protection Agency

Abstract Preventive programs and health promotion strategies aim to identify and strengthen factors that reduce the onset and worsening of chronic diseases, combat addictions, and maintain good health. Rooted in the salutogenic approach, these strategies focus on promoting well-being and resilience. The new regional healthcare reform (L.r. 22/2021), along with national and regional health promotion documents (PNP 2020-2025; PRP 2021-2025), highlights intersectorality as a key strategy for implementing effective prevention actions. This principle is also reflected in local planning documents, particularly the Integrated Local Health Promotion Plan (PIL). Each year, the Health Ptotection Agency of Milan develops the PIL, which summarizes the vision, preventive programs, and health promotion activities carried out in the area, fostering collaboration between the health, social health, and social sectors. The plan is co-constructed through a joint process involving ATS departments, local ASSTs, external stakeholders (businesses, school offices, etc.), and other health promotion actors. To achieve sustainable results, it is essential to implement a system-wide strategy that engages all territorial stakeholders, local communities, and individuals. This engagement is integrated into both the planning and implementation stages. The plan is divided into five local health promotion programs focused on workplaces, schools, local communities, the first 1000 days of life, and socio-health integration. Within the PIL framework, health promotion is a global social and political process, aiming to strengthen individuals’ skills and participation while modifying social, environmental, and economic conditions that affect public health. This approach empowers individuals to exercise greater control over health determinants, leading to improved health outcomes. Key messages • The PIL is a co-constructed document with all active actors across the territory, addressing the population's health needs from an equity and sustainability perspective. • The integration of health promotion strategies in diverse settings fosters collaborative efforts that improve community well-being, contributing to achieving essential levels of care.