Abstract
Social determinants of health management is proximal to health promotion of people. The organizational structure of local authorities is conducive for addressing social determinants of health management in communities. This study aims to explore local public policies that managed the social determinants of health and the role of public administration at three different tiers of municipalities. Qualitative study by using direct observations, in depth interviews, and document reviews were conducted in Chiang Rai (Metropolitan) Municipality, Ang Thong (City) Municipality, and Tha Yang (Subdistrict) Municipality. The study revealed that despite different contexts among the three municipalities, a common goal for the well-being of people was set. Those three municipalities provided sustainable public services on health, education, environment and society for their respective communities. For example, they increased the number of healthcare facilities in order to promote accessibility, build health literacy through people engagement, establish student-centered curriculum for children in pre-school to high school along with life-long learning, support and create environment conducive to physical activity (i.e. footpaths, parks and green public spaces). Local authority administration ensured implementation of policies and programs to improve health equity through project planning, building partnerships, budget management, capacity building, and monitoring health outcomes. The study concludes that local authorities should be the main agency for local health promotion. Therefore all related stakeholders should collaborate and synergize their health-promoting effort with local public administrations and regard this approach as key mechanism to address social determinants of health and promote health equity.
