Strengthening Health in All Policies at city level: results from the French Healthy Cities Network

Abstract Issue The WHO Healthy Cities Network supports cities in implementing healthy public policies through a Health in All Policies (HiAP) approach. In France, the lack of a clear legal framework limits the integration of HiAP into policymaking. Facing growing financial constraints and increasing awareness of the impact of public policies on health, French Healthy Cities seek to strengthen HiAP at the local level. Problem As part of the European JA PreventNCD project, the French Healthy Cities Network (FHCN) launched a working group (WG) to identify barriers and enablers to HiAP implementation in municipalities. Elected officials and technicians from 44 cities of the FHCN joined the WG, discussing and sharing experiences and best practices around four themes: Governance; Coordination; Processes and Tools; Resources. Ten online meetings are organised, from Sept. 2024 to early 2026, with sessions recorded and analysed to identify key factors for local HiAP implementation. Results Four meetings have been held so far, with an average of 50 participants. Preliminary results highlight several obstacles and enablers to HiAP implementation in municipalities. Barriers are lack of recognition of health services, limited visibility of health-related actions in non-health sectors, fragmented and insecure funding, siloed approaches, insufficient human and financial resources. Main enablers include strong political commitment, joint budget planning, shared health determinants approaches, intersectoral governance bodies, health referent networks within municipalities, and clear coordination mechanisms. Lessons Although public health is traditionally a state responsibility, cities are key actors due to their close connection to communities. Sharing tools and practices is essential to strengthen HiAP locally, despite political shifts and budget constraints. The HiAP approach offers a chance to enhance public health action, promoting collaboration, breaking silos, and maximizing co-benefits. Key messages • The Health in All Policies approach is an opportunity for municipalities to address legal and financial challenges and enhance their public health actions at the local level. • Sharing tools, practices, and experiences among cities is essential to finding innovative solutions and promoting residents’ health.