Healthy life centres and similar preventive health services in municipalities 2013-2019

Municipalities are free to organize their health promotion and disease prevention work in the way they find appropriate. Hence, this work can be organized in several different ways in different municipalities. Healthy Life Center (HLC) is an interdisciplinary primary health care service that provides effective, knowledge-based measures for people who need support in health behavior change and in coping with health problems and chronic disease. There is no statutory obligation for a municipality to establish an HLC. The Norwegian Directorate of Health recommends that all municipalities establish such centers to manage the provision of their preventive health services.

Statistics Norway’s surveys of Healthy Life Centers in 2013, 2016 and 2019 enable a closer examination of this preventive health service in the municipalities. Which municipalities that have established HLCs, how they are organized, the personnel resources, activities and services, and cooperation with other actors are elements that are examined in the surveys. An analysis has also been conducted into the differences between municipalities, broken down by county, population size and degree of centrality. The three measurements at three points in time make it possible to look at development over time. For the year 2019, a survey was also conducted into which similar preventive health services are provided by municipalities that do not have HLCs. In addition, a survey of a sample of these municipalities was done, collecting information on how their preventive health services were organized.

Highlights from the results in this report are:

• 60 percent of the municipalities had a Healthy Life Central in 2019, covering 80 percent of the population
• Establishment of HLCs had come further in some counties than in others. HLCs were most common in large municipalities in central areas and least common in small, less central municipalities.
• 306 man-years were employed at HLCs in 2019, a 23 percent increase from 2016. Physiotherapists constitute the largest occupational group.
• Approximately 30 000 persons participated in one or more of the HLC courses in 2019. An increase of 9 percent from 2016. Half of the participants were given a referral to the HLC and most commonly by their general practitioner.
• It was most common to provide “Healthy Life Prescription”, physical activity and good food for better health courses at the HLCs. There were differences between counties in the scope of the services and courses given. Commonly the services are more extensive in large municipalities in central areas.
• 70 percent of municipalities without HLCs offer one or more preventive health services similar to those given at the HLCs in 2019. It was most common to provide courses within physical activity and healthy diets.
• Comparing municipalities with and without HLCs, shows that the share of municipalities providing such services/courses is larger among the munici­palities with HLCs. The extent of the services and courses among the munici­palities without HLCs is greater in large municipalities in central areas.

The additional survey of municipalities without HLCs provides useful information on how these municipalities organize, coordinate and provide their services. 40 percent of the municipalities report that they have well-functioning alternatives to the HLC. In small municipalities 40 percent report that HLCs are not suitable due to a sparse population.