Health Promotion International Advance Access originally published online on July 18, 2006
Health Promotion International 2006 21(4):259-265; doi:10.1093/heapro/dal023
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What makes for sustainable Healthy Cities initiatives?—a review of the evidence from Noarlunga, Australia after 18 years
Department of Public Health, Flinders University Adelaide, Australia 1 SA Community Health Research Unit, Flinders University Adelaide, Australia 2 Noarlunga Health Services Adelaide, Australia
Address for correspondence: Fran Baum Department of Public Health Flinders University Adelaide Australia E-mail: fran.baum{at}flinders.edu.au
This paper examines the factors that have enabled the Healthy Cities Noarlunga (HCN) initiative to be sustainable over 18 years (1987–2005). Sustainability related to the ability of the initiative to continue to operate continuously in a manner that indicated its existence was accorded value by the community and local service providers. The analysis is based on a narrative review of 29 documents related to HCN, including a number of evaluations. Nine factors emerged as important to ensuring sustainability: strong social health vision; inspirational leadership; a model that can adapt to local conditions; ability to juggle competing demands; strongly supported community involvement that represents genuine engagement; recognition by a broad range of players that Healthy Cities is a relatively neutral space in which to achieve goals; effective and sustainable links with a local university; an outward focus open to international links and outside perspectives; and, most crucial, the initiative makes the transition from a project to an approach and a way of working. These sustainability factors are likely to be relevant to a range of complex, community-based initiatives.
Key words: healthy cities; health promotion programs; sustainability; evaluation
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