Abstract
Our study sought to examine the implementation of Health 2015 [a public health programme prepared following the principles of Health in All Policies (HiAP)] between 2001 and 2015 in the context of welfare state restructuring. We used data from the realist multiple explanatory case study by HARMONICS, which focused on political factors (processes) that lead to the (un)successful implementation of programmes following the principles of HiAP. We analyzed data - key informant interviews, grey and scholarly literature - from our Finnish case to examine how Health 2015 implementation has been affected by the changing role of the state. We find that the dismantling of formal funding allocation decreased the capacity of national authorities to exert control over municipalities' health promotion work, diluting the financial arrangements regarding municipal obligations. As a result, most municipalities failed to contribute to Health 2015, resulting in losses for health promotion activities. Our results also point to joining the EU. Whereas the procedures for preparing Finland's unanimous positions on EU matters were useful in harmonizing ideologies on various policy issues between different ministries, joining the EU also increased commercial interests and the strength of the lobby system, leading to the prioritization of economic objectives over public health objectives. Finally, our informants also highlighted the changing relationship between the state and the market, manifested in market deregulation and increasing influence of pro-growth arguments during the implementation of Health 2015.
| Original language | English |
|---|---|
| Pages (from-to) | 258-268 |
| Number of pages | 11 |
| Journal | Health promotion international |
| Volume | 34 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 2019 Apr 1 |
Bibliographical note
Funding Information:The neoliberal doctrine implied that the global suppression of individual freedom and international competition was what ailed capitalist systems, and that state reform was required to stimulate these outcomes (Harvey, 2005; Patomäki, 2007). Neoliberalism gained academic credence as the Nobel Prize in economics was awarded to Hayek in 1974 and to Friedman in 1976 and was soon heavily supported by powerful international agencies such as the International Monetary Foundation (IMF), the World Trade Organization (WTO), and the Organisation for Economic Cooperation and Development (OECD) (Harvey, 2005; Patomäki, 2007). Critics have, however, argued that since the beginning, the true purpose of the neoliberal doctrine was to reconfigure state institutions to free capital accumulation on a global scale (Navarro, 2014).
Funding Information:
This work was supported by the Finnish Cultural Foundation [00170036 to L.K.]
Publisher Copyright:
© The Author 2017. Published by Oxford University Press. All rights reserved.
Keywords
- Health in All Policies
- healthy public policy
- implementation
- inter-sectoral action
- realist methods
ASJC Scopus subject areas
- Health(social science)
- Public Health, Environmental and Occupational Health
