Social Equity and Equality, Empowerment, Inclusiveness: The Pillars of Public Health Promotion in Modern Societies

A special issue of Societies (ISSN 2075-4698).

Deadline for manuscript submissions: closed (1 February 2023) | Viewed by 15188

Special Issue Editor

Department of Nevrodmedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, 7004 Trondheim, Norway
Interests: salutogenesis; sense of coherence; social capital; social determinants of health; neighborhoods; community; empowerment; social inequity; policies; politics; collaboration; inclusive processes

Special Issue Information

Dear Colleagues,

For the last four decades, Health Promotion has made major contributions to public health research and practice. The Ottawa charter emphasizes the importance of strengthening individuals and community action, creating supportive environments, and building healthy public policy (WHO, 1986). However, alongside Health Promotion research and practice advances we can observe adverse societal developments. Increasing social inequality within and between societies negatively impacts population health. Matters of structural racism, stigma, and exclusion that have been highlighted in the public debate, but are yet to be resolved, continue to impact health and opportunities to participate in society. Increasing tension and polarization between societal groups adversely affect population health and impact the social determinants for health (SDoH) and social relationships.

In this light, it is unsurprising that Health Promotion regularly includes notions of empowerment, social inclusion, and equity. Health Promotion efforts in communities regularly apply strategies and pursue goals that are linked to empowerment and inclusion and counteract social inequality. Research on Health Promotion illustrates that matters of empowerment and inclusion are crucial for individual and collective health outcomes, as well as for sparking healthy societal developments in line with Health Promotion goals. Moreover, they play an important role in combating both the consequences and root causes of societal marginalization and inequality with respect to health and the SDoH.

In this Special Issue, we aim to deepen our knowledge about the role of empowerment, inclusion and social equity in health promotion research and practice. Understanding more about how these affect individual, community and population health and how they can be addressed and promoted through Health Promotion efforts can contribute to built theory and develop effective approaches for practice. Moreover, explicitly linking health promotion to matters of power, inclusion, and equality also implies that these matters might and should be addressed in the context of broader societal developments towards more equity, inclusion, and sustainability—as addressed in the sustainable development goals (UN, 2017), for example.

Accordingly, we would like to invite you to contribute to this Special Issue focusing on “Social Equity, Empowerment, Inclusiveness: The Pillars of Public Health Promotion in Modern Societies”. We welcome papers addressing issues linked to social equity, empowerment, and/or inclusiveness in the context of health promotion. This includes (but is not limited to) papers that describe and evaluate health promotion efforts at the individual, community, or societal level; outline beneficial approaches and strategies; address challenges and potential solutions with these approaches; and/or explore and discuss the theoretical foundations of Health Promotion and how it is linked to matters of Social equity, empowerment and/or inclusiveness, as well as inter-relations between those concepts.

In this Special Issue, Contributions must follow one of the three categories of papers, article, conceptual paper or review, of the journal and address the topic of the Special Issue.

Dr. Ruca Maass
Guest Editor

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Keywords

  • social equality
  • social equity
  • empowerment
  • inclusiveness
  • inclusion
  • health promotion
  • public health
  • health equity

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Published Papers (6 papers)

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Research

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0 pages, 290 KiB  
Article
The Relative Importance of Family, School, and Leisure Activities for the Mental Wellbeing of Adolescents: The Young-HUNT Study in Norway
by Bodil Elisabeth Valstad Aasan, Monica Lillefjell, Steinar Krokstad, Mari Sylte and Erik Reidar Sund
Societies 2023, 13(4), 93; https://doi.org/10.3390/soc13040093 - 3 Apr 2023
Cited by 3 | Viewed by 2363 | Correction
Abstract
It is well-known that the social environment in which children and adolescents live and grow has an impact on their mental wellbeing, though the relative importance of different social contexts may vary. In the present study, we used data from the Young-HUNT4 survey [...] Read more.
It is well-known that the social environment in which children and adolescents live and grow has an impact on their mental wellbeing, though the relative importance of different social contexts may vary. In the present study, we used data from the Young-HUNT4 survey in Norway (n = 8066, age range 13 to 19 years). Linear regression models were used to investigate the relative importance of family cohesion, school climate, and number of leisure activities on psychological distress, loneliness, and life dissatisfaction among Norwegian adolescents by investigating whether the strength of association varied across social contexts for the three outcomes. Additionally, analyses were stratified by parental education to investigate whether the relative importance of family, school, and leisure activities differed between adolescents from families with low and high parental education. We found that family cohesion showed the strongest association with all three outcomes, followed by the school climate and number of leisure activities. Generally, these associations did not vary significantly between low and high parental education. Understanding the relative importance of social contexts may be essential in developing effective public health policies and interventions in preventing mental ill health and promoting mental wellbeing in children and adolescents. Full article
13 pages, 583 KiB  
Article
‘Nothing Gets Realised Anyway’: Adolescents’ Experience of Co-Creating Health Promotion Measures in Municipalities in Norway
by Mari Sylte, Monica Lillefjell, Bodil Elisabeth Valstad Aasan and Kirsti Sarheim Anthun
Societies 2023, 13(4), 89; https://doi.org/10.3390/soc13040089 - 1 Apr 2023
Viewed by 1721
Abstract
In this study, we aimed to explore how adolescents experience co-creating health promotion measures in four municipalities in Norway. We applied a qualitative design with group interviews (n = 9) among forty-nine adolescents participating in projects related to ‘Program for Public Health [...] Read more.
In this study, we aimed to explore how adolescents experience co-creating health promotion measures in four municipalities in Norway. We applied a qualitative design with group interviews (n = 9) among forty-nine adolescents participating in projects related to ‘Program for Public Health Work in Municipalities’ (2017–2027). Additionally, participatory observation of project activities was performed in two municipalities. We conducted a data-driven thematic analysis to analyse the data. The most prominent finding was that the adolescents often expressed feelings of resignation and dissatisfaction. Furthermore, we identified four underlying reasons behind the resignation and dissatisfaction. These were related to long project duration, the experience of not having an influence on the outcome, promises not being kept and lack of information and continuity in their participation. Essential features for meaningful participation were not present, and the findings suggest that the municipalities had limited success in facilitating participation that adolescents perceived as meaningful. The findings indicate that despite good intentions and policies supporting children’s participation, effort placed on implementing such policies in practice is still needed. This study adds knowledge regarding important factors to consider when involving young people in co-creating measures to avoid unintended effects such as disempowering adolescents. Full article
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15 pages, 599 KiB  
Article
Planning for Health Equity: How Municipal Strategic Documents and Project Plans Reflect Intentions Instructed by the Norwegian Public Health Act
by Monica Lillefjell, Siren Hope, Kirsti Sarheim Anthun, Eirin Hermansen, John Tore Vik, Erik R. Sund, Bodil Elisabeth Valstad Aasan, Mari Sylte and Ruca Maass
Societies 2023, 13(3), 74; https://doi.org/10.3390/soc13030074 - 18 Mar 2023
Cited by 1 | Viewed by 1751
Abstract
The Norwegian Public Health Act (PHA) mandates municipalities to integrate a systematic, knowledge-based, cross-sectoral approach aimed at levelling the social gradient in health. This study aimed to describe and analyse how the intentions of the PHA are addressed in municipal plans and project-planning [...] Read more.
The Norwegian Public Health Act (PHA) mandates municipalities to integrate a systematic, knowledge-based, cross-sectoral approach aimed at levelling the social gradient in health. This study aimed to describe and analyse how the intentions of the PHA are addressed in municipal plans and project-planning documents. A document analysis of municipal plans and project documents extracted from four municipalities in Central Norway was employed and complemented with deductive, qualitative content analysis. Findings indicate awareness of public health work as a whole-of-municipality responsibility. Systematic knowledge-based processes that make use of relevant data in planning and decision-making processes are described across municipality projects and plans. Multisectoral working groups are set up at a project level; however, opportunities for further improvements arise in respect to the anchor of these structures and systematic knowledge-based working procedures in the wider municipal context. Public health process aims (systematic knowledge-based approach, cross-sectoral governance) receive more attention than outcome aims (health equity) in both program documents and municipal plans. Only very rarely does the document hold operationalizations of how to achieve health equity. As such, effort placed on cross-administrative levels and sectors to promote structures for health equity is still needed. Full article
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18 pages, 591 KiB  
Article
Ambiguous Facilitation: An Ethnographic Study of the Contextual Aspects of Participation in Group Activities in a Norwegian Healthy Life Centre
by Tonje Cecilie Indrøy, Lisbeth Kvam and Aud Elisabeth Witsø
Societies 2023, 13(2), 32; https://doi.org/10.3390/soc13020032 - 31 Jan 2023
Viewed by 1743
Abstract
Background: Participation is essential in health promotion initiatives such as the Norwegian Healthy Life Centres (HLCs) which offer lifestyle-related guidance to people with lifestyle-related diseases or at risk for such diseases. While participation has been studied in this setting from the perspectives of [...] Read more.
Background: Participation is essential in health promotion initiatives such as the Norwegian Healthy Life Centres (HLCs) which offer lifestyle-related guidance to people with lifestyle-related diseases or at risk for such diseases. While participation has been studied in this setting from the perspectives of health personnel or service users, no studies have been conducted on the contextual aspects of participation through studying the interactions between the actors involved in group activities within the service. To lead group activities requires competency in facilitation of learning in groups. The aim of this study is to explore participation in group activities in the context of a Norwegian HLC by studying the interaction between the various actors involved in the activities there. Methods: An ethnographic study was designed based on participant observation of physical activity groups and a healthy nutrition group in a Norwegian HLC over a period of three months. Findings: The findings suggest that (1) the multiple roles of the Health Professional (HP), (2) the process of goal setting, and (3) time frames and the physical context are central contextual aspects of participation in this setting, leading to an ambiguous facilitation of group activities. Full article
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12 pages, 261 KiB  
Article
Volunteering: A Tool for Social Inclusion and Promoting the Well-Being of Refugees? A Qualitative Study
by Silje Sveen, Kirsti Sarheim Anthun, Kari Bjerke Batt-Rawden and Laila Tingvold
Societies 2023, 13(1), 12; https://doi.org/10.3390/soc13010012 - 31 Dec 2022
Cited by 2 | Viewed by 2780
Abstract
Background: The Norwegian government’s increased expectations that volunteering can be used as a means of integration and the scarce research regarding refugees’ experiences with volunteering is taken as the background for this study. Our purpose is to adopt a salutogenic perspective to [...] Read more.
Background: The Norwegian government’s increased expectations that volunteering can be used as a means of integration and the scarce research regarding refugees’ experiences with volunteering is taken as the background for this study. Our purpose is to adopt a salutogenic perspective to investigate whether and how formal volunteering contributes to developing a sense of social inclusion and well-being among refugees in Norway. Methods: Qualitative in-depth interviews were conducted with 12 volunteers with refugee backgrounds in a semi-rural district in Norway. Stepwise deductive induction was used for analysis. Results: Three themes were identified as a result of the analysis: (1) feeling safer due to increased knowledge regarding cultures, values, and systems and achieving mutual acceptance; (2) feeling more confident when communicating in Norwegian and contributing to society, and (3) feeling more connected via social relations. Conclusions: Our study indicates that participation in volunteering may contribute to social inclusion and that the participants’ resources and volunteering experiences may have a health-promotive impact under certain conditions. Full article

Review

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29 pages, 1935 KiB  
Review
Transgender Health between Barriers: A Scoping Review and Integrated Strategies
by Davide Costa
Societies 2023, 13(5), 125; https://doi.org/10.3390/soc13050125 - 14 May 2023
Cited by 6 | Viewed by 3781
Abstract
Transgender people have garnered attention in recent years. They have different health problems; the fact, however, that they belong to a minority means that this is characterized by complex mechanisms of stigmatization. This paper aims to analyze the current literature on the barriers [...] Read more.
Transgender people have garnered attention in recent years. They have different health problems; the fact, however, that they belong to a minority means that this is characterized by complex mechanisms of stigmatization. This paper aims to analyze the current literature on the barriers to health services encountered by transgender people. This scoping review is based on the following research questions: (1) What are the main barriers to health care encountered by transgender people? (2) Is it possible to organize these barriers according to a macro-, meso- and microanalysis approach? (3) What are the main characteristics of the barriers to health care encountered by transgender people? (4) Are there significant relations between the different types of barriers? The review was undertaken following the PRISMA extension for scoping reviews. In total, 32 studies were included from which three types of barriers with different subcategories were identified: health system barriers, social barriers, and individual barriers. In conclusion, due to the complexity of gender issues and barriers to health care, a multidisciplinary approach is necessary. In this regard, some integrated strategies to reduce barriers to health care for transgender people are proposed. Full article
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