Geographical and survey data to inform local public policy

Local and regional knowledge about self-reported health and well-being combined with actual resources in the built environment may give new insight useful for public health policy and actions.

Background
The Norwegian public health act dictates county councils and municipalities to keep an overview of the population health and determinants. This to inform policy making and public health initiatives. In performing this task regional and local data are particularly relevant. More specifically local planning concerned with creating health promoting environments, that for example stimulates physical activity, social engagement and sense of community belonging, may benefit from questionnaire data combined with data on spatial objects. This study aims to give knowledge useful for this purpose, combining data from a regional public health survey, registry data and geographical data.
Methods
In 2021 a public health survey was carried out in Vestfold and Telemark, Norway, including adults 18 year and older. A broad range of validated questions were included. For example, self-rated health, accessibility to facilities, social support, well-being, and lifestyle habits. 34 147 adults participated (38 % response). Statistics Norway retrieved geographical coordinates for the address of the participants. Distance from the participants to health promoting objects was created as new variables. Distance variables then returned to Statistics Norway before merging questionnaire data, registry data and geographical distance variables. Descriptive results are preliminary and focus on the distance variables.
Results
Coordinates were identified for nearly all the participants (99,6 %). 44 distance variables were created, containing information about for example distance to public transport and number of bus stops within a certain radius, similarly for service facilities, libraries, cultural institutions, indoor and outdoor sports facilities, green areas and pathways for walking/biking. The number of a specific facility was counted within an 800- and 3000-meter radius. Following are a few descriptive examples. 78,4 % of the participants live in urban areas. The average distance to the nearest bus stop is 429 m, 81 % have access to a pathway within a radius of 400 m, and the average area of green space within a radius of 800 m is 32,3 %. 21,7% have access to one or two indoor sports facilities within 800 m, and likewise 34,8 % for outdoor sports facilities and 27,5 % for cultural institutions.
Conclusions
The distance variables created show a variation of access among the participants. Next more complex analysis will be performed on the merged data, focusing on reported well-being and lifestyle habits in relation to perceived accessibilities, use and actual accessibility to health promoting facilities. In addition, socioeconomic background factors will be included. This is the first presentation of a rich new local data source for public health policy.