Joining up settings for health: a valuable investment for strategic partnerships?

Abstract

The concept and practice of healthy settings has developed over the past 17 years, to become a key element of public health strategy. However, there remains limited consensus about either theory or practice, and there has been little critical debate concerning the value of the approach in delivering public health. Furthermore, many settings initiatives have developed in isolation from others, with little concern to formulate an integrated vision or to ensure that their contribution is effectively harnessed. Drawing on the work of the North West Healthy Settings Development Unit, this paper provides an overview of the history, theory and practice of healthy settings, outlines the English policy context, makes a number of observations pertinent to future development, and concludes with a discussion of opportunities and challenges. It is suggested that healthy settings have the potential to provide a tangible ‘joined-up’ delivery route for local strategic partnerships, thereby maximizing their contribution to public health. However, in order to realize this potential, it is argued that local strategic partnerships need to think ‘outside of the box’, that healthy settings initiatives need to work towards a ‘whole systems’ model of practice and see themselves as springboards for wider corporate citizenship, and that bridges need to be built between work in various settings. Only then will the settings approach fully embrace its holistic and radical roots, ensuring an integrated and effective contribution to environmental, economic and social well-being, not only at a local level, but regionally, nationally and globally.