Ambiguous expectations for intersectoral action for health: a document analysis of the Danish case

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    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 neoinstitutional
    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.
    Original languageEnglish
    JournalCritical Public Health
    Volume28
    Issue number1
    Pages (from-to)35-47
    ISSN0958-1596
    DOIs
    Publication statusPublished - 2018

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