Healthy life centres in Norwegian municipalities 2013-2016
Healthy Life Centers (HLCs) offer an interdisciplinary primary health care service that provides effective, knowledge-based assistance to change living habits and cope with diseases and health problems. There is no statutory obligation for a municipality to establish an HLC, but the Norwegian Directorate of Health recommends that all municipalities establish such centers to manage the preventive health services they provide. The target group is people of all ages who are at increased risk of or who have developed, disease and need help to change living habits and mastering disease. This applies for people with long-term health problems and those that having trouble fitting in elsewhere, such as the traditional fitness centers. In addition, it is a goal that HLC’s should contribute to counteracting social differences in living habits and health in the population.
Statistics Norway’s surveys of HLCs in 2013 and 2016 enable a closer examination of this preventive health service in the municipalities when it comes to who have established the centers, how they are organized, personnel resources, activities and cooperation with other actors. An analysis has also been made of the differences between municipalities, broken down by counties, population size and degree of centrality. The fact that there are two measurement points (2013 and 2016), also makes it possible to look at the development during time.
Results show that still more municipalities establish HLCs and that the number of personnel resources and participants increases. At the same time there are regional differences both when it comes to who have established the HLC, personnel resources and participants. By 2017, 266 municipalities, or 60 per cent of the total, established HLCs. In the period 2011-2017, there has been a doubling of municipalities that has established the service. At the same time, the trend flattens out in the last three years of the period. Establishment of HLCs has come further in some counties than others and it is particularly in big municipalities in central areas that the part of the municipalities with HLCs is highest in 2016. When it comes to different types of courses offered at the HLCs, the results show that there are some county differences, and that the scope of courses is most extensive in larger and more central municipalities. There were 248 man-years employed at HLCs in 2016, which is an increase of about 30 per cent from 2013. Physiotherapists constitute the clearly largest occupational group with more than half of the man-years. There were 27,000 persons who participated in one or more of the courses offered at the HLCs in 2016, which is an increase of 11,000 people, or 70 percent from 2013.
In the interviews with selected municipalities without a HLC, it appears that there are essentially secondary preventive health services that are given to the residents. This means that people who already receive services through the municipal healthcare get these services. Although some municipalities offer low-threshold offerings like courses given at HLCs, most of the municipalities do not have similar offers in local government. However, it is often the case that some supplementary low-threshold offers given in private or voluntary sector be preventive and health promoting work. Several municipalities with tight economy find that there are challenges to get politicians to understand the value of preventive health care and that this is usually downgraded in favor of other health care services. Several municipalities advise the health authorities to make the national guide for HLCs more adapted to all types of municipalities. Several find that this supervisor is particularly targeted at large municipalities in central areas. Further, there is a wish that subsidies for preventive health care will be earmarked in the future.