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Health Promotion International Advance Access published online on July 18, 2006
Health Promotion International, doi:10.1093/heapro/dal023
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© The Author (2006). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Article

What makes for sustainable Healthy Cities initiatives?--a review of the evidence from Noarlunga after 18 years

FRAN BAUM 1 *, GWYNETH JOLLEY 2, RICHARD HICKS 3, KATE SAINT 3, and STEVE PARKER 3

1 Department of Public Health, Flinders University, Adelaide, Australia
2 SA Community Health Research Unit, Flinders University, Adelaide, Australia
3 Noarlunga Health Services, Adelaide, Australia

* To whom correspondence should be addressed.
FRAN BAUM, E-mail: fran.baum{at}flinders.edu.au


  Abstract

SUMMARY 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.

Keywords: healthy cities; health promotion programs; sustainability; evaluation.
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