Ambiguous Expectations for Intersectoral Action for Health: A Document Analysis of the Danish Case

Ditte Heering Holt, Susanne Boch Waldorff, Tine Tjørnhøj-Thomsen, Morten Hulvej Rod

Research output: Contribution to journalJournal articleResearchpeer-review

Abstract

Ideas about intersectoral action and policy-making for health (ISA) are prominent among public health professionals. They are often presented as effective ways to address root causes of poor health and health inequality, and as such the best way to promote population health. The implementation of such ideas has proven difficult though. In this paper we argue that neo-institutional theory can help us conceptualize implementation challenges by pointing to implicit expectations and contradictions associated with the ISA idea itself. With Denmark as empirical case, we conducted a document analysis of recommendations for municipal ISA. The analysis shows how the recommendations provide a very abstract conceptualization of ISA that does not give much practical guidance for action. We show how ISA is discursively constructed with buzzword qualities as the natural way to organize health promotion, by being presented as a means to produce better quality services, more cost-effective operations and ensure the future of the welfare state, while at the same time hardly changing much at all. By applying the lens of institutional logics we show how ISA, although being vaguely defined, offer ambiguous normative and symbolic repertoires for action. We discuss the implementation challenges associated with this advocacy rhetoric and suggest that the domination of the corporation logic may appear to reduce the political character of ISA and potentially conflict with the ideals of health as a matter of social justice and human rights.
Ideas about intersectoral action and policy-making for health (ISA) are prominent among public health professionals. They are often presented as effective ways to address root causes of poor health and health inequality, and as such the best way to promote population health. The implementation of such ideas has proven difficult though. In this paper we argue that neo-institutional theory can help us conceptualize implementation challenges by pointing to implicit expectations and contradictions associated with the ISA idea itself. With Denmark as empirical case, we conducted a document analysis of recommendations for municipal ISA. The analysis shows how the recommendations provide a very abstract conceptualization of ISA that does not give much practical guidance for action. We show how ISA is discursively constructed with buzzword qualities as the natural way to organize health promotion, by being presented as a means to produce better quality services, more cost-effective operations and ensure the future of the welfare state, while at the same time hardly changing much at all. By applying the lens of institutional logics we show how ISA, although being vaguely defined, offer ambiguous normative and symbolic repertoires for action. We discuss the implementation challenges associated with this advocacy rhetoric and suggest that the domination of the corporation logic may appear to reduce the political character of ISA and potentially conflict with the ideals of health as a matter of social justice and human rights.
LanguageEnglish
Journal Critical Public Health
Volume28
Issue number1
Pages35-47
Number of pages13
ISSN0958-1596
DOIs
StatePublished - 2018

Bibliographical note

Published online: 09 Feb 2017

Keywords

  • Intersectoral action for health
  • Municipal health promotion
  • Governance

Cite this

Heering Holt, Ditte ; Waldorff, Susanne Boch ; Tjørnhøj-Thomsen, Tine ; Rod, Morten Hulvej. / Ambiguous Expectations for Intersectoral Action for Health : A Document Analysis of the Danish Case. In: Critical Public Health. 2018 ; Vol. 28, No. 1. pp. 35-47
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Ambiguous Expectations for Intersectoral Action for Health : A Document Analysis of the Danish Case. / Heering Holt, Ditte; Waldorff, Susanne Boch; Tjørnhøj-Thomsen, Tine; Rod, Morten Hulvej.

In: Critical Public Health, Vol. 28, No. 1, 2018, p. 35-47.

Research output: Contribution to journalJournal articleResearchpeer-review

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