The Norwegian public health Act as a method for implementing public health strategies

Abstract Implementing national public health policies across sectors at the national, regional, and municipal levels is challenging. In the 1990s and 2000s, action plans were common in Norway, but follow-up was often limited, with small financial frameworks and little significance for political priorities. In 2010, it was decided to establish a Public Health Act, effective from January 1, 2012. The Act emphasizes society's responsibility for health-promoting and preventive measures and contributes to long-term planning, systematic approaches, predictability, and coherence in public health work. It also addresses challenges such as unclear responsibilities, prioritization of prevention and short-term versus long-term effects. The Public Health Act has been in force for over 13 years, and evaluations show that it has strengthened public health work and contributed to reducing health inequities. However, experiences from the pandemic have revealed areas for improvement. Therefore, the government announced a revision of the Public Health Act in the Public Health Report (2023), and in March 2025, Prop. 82 L (2024-2025) was presented with proposed changes, that include: • Clarification of the responsibilities of municipalities, county municipalities, and state level. • Increased emphasis on mental health, including measures to promote good mental health and prevent mental health issues. • Clarification of preparedness provisions based on pandemic experiences. • Increased requirements for the evaluation of public health work. • Elaboration of the county municipality's role as a regional development actor. • Requirement to consider the best interests of the child and public health challenges for the Sami population. • The state is subject to the same requirements as municipalities and county municipalities to protect, promote, and equalize health in the population. The changes to the Public Health Act are expected to be adopted by the Norwegian Parliament in June 2025. Key messages • The Norwegian Public Health Act has contributed to more systematic and knowledge-based public health work in municipalities, county municipalities, and state level. • The experiences have formed the basis for a comprehensive revision, which has strengthened the Public Health Act.