Municipal health promotion programs: is childhood obesity a concern at local level in Portugal?

Health promotion programs, targeted at distinct health outcomes such as childhood obesity, at local level are increasingly used worldwide. Therefore, there is a need to better understand the role of local governments (municipalities) as key public health promoters namely in the prevention of obesity in children. We aimed to provide some input regarding this issue in Portugal. First, we identified health-enhancing programs promoted by Portuguese municipalities in which children could participate. Then, we conducted a document analysis to provide clues about how municipalities conceptualized child health by retrieving information on which topics the programs were focused in, or acted upon, and identifying which socio-ecological model levels were addressed (or not) by each program. The 77 identified programs were promoted by 30 of the 308 Portuguese municipalities and only 11 programs addressed childhood obesity. Most programs focused in the individual health determinants and provided limited information which disabled its deeper analysis. Portuguese municipalities seem to disregard their potential as public health promoters. Childhood obesity is a major public health concern at national (and global) level but the same does not emerge locally. Municipalities are the closest government entities to the population, and it is their responsibility to ensure the population's quality of life, by addressing the social determinants and the physical environments. Therefore, municipalities should acknowledge health in their actions and delineate health improvement programs considering current evidence, specifically in the case of childhood obesity prevention that besides being a health problem in itself, is a risk factor for non-communicable diseases.
Health promotion programs at local level are increasingly used worldwide, specifically targeted at tackling childhood obesity. Thus, local governments (municipalities) become key public health promoters and play an important role in the prevention of obesity in children. We identified health-enhancing programs promoted by Portuguese municipalities in which children could participate. The 77 identified programs were promoted by 30 of the 308 Portuguese municipalities and only 11 programs addressed childhood obesity. It appears that a large number of Portuguese municipalities disregard their potential as public health promoters. Despite the clear governmental concern about childhood obesity at national level, the same does not emerge locally. Municipalities' are responsible for ensuring the population's quality of life, namely through multisectoral actions, which is particularly relevant in the prevention of childhood obesity. Therefore, all municipalities should include childhood obesity prevention in their concerns.
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