Document 3:11 (2014-2015) The Office of the Auditor General's investigation of public health work was submitted to the Storting (Norway’s parliament) on 29 June 2015.
A new Public Health Act was adopted in 2011 as part of the Coordination Reform. The Act stipulates that public health work must be systematic and knowledge-based, and imposes a duty on municipalities to take appropriate measures to improve public health. The Storting has pointed out that it is important to even out health differences arising from social inequalities. The OAG's audit shows that the municipalities are positive to the Public Health Act, and nine out of ten believe it has led to increased investment in local public health.
However, the audit shows that many municipalities have yet to put in place systematic public health work. Only 24 per cent of municipalities have prepared an overview of the health status of residents and factors that have a bearing on their health. Well over half of the municipalities have not discussed public health challenges and set goals and strategies for public health work in their municipal plans. Every fourth municipality has not evaluated its own public health measures. "State authorities should provide closer follow-up and measures to assist municipalities, particularly aimed at those that have not made much progress in their efforts," says Foss.
Almost half of the municipalities believe that social inequalities and disparities in living conditions represent some of the greatest public health challenges. At the same time, the municipalities' public health measures appear to lack focus towards this objective.
"If public health work is to help equalise differences in health, it is important that the Ministry of Health and Care Services contributes to increased knowledge about which policies and measures are effective," says Foss.
Although public health is largely affected by factors outside the health sector, the audit shows that many municipalities have not established systematic collaboration on public health across sectors. "Not only municipalities, but also the central government can do a better job of coordinating efforts for improving public health across sectors and levels of public administration," says Foss.
In his reply to the OAG, the Minister of Health and Care Services said that the recommendations will be followed up. Among other things, the Government will strengthen the knowledge basis, assist with the implementation of the Public Health Act in the municipalities and bolster efforts to embed public health initiatives across sectors.