The Creation of territories of public health in France
Launched in France on January 31, 2001 by the Ministry of Health, the National Health and Nutrition Program (PNNS) aims to encourage the development of active lifestyles, combined with healthy eating. Because the program makes the region, or territory, the preferred level of operation, the decentralized services of the Ministry of Health are given responsibility for establishing and maintaining relationships with representatives of other ministries and local governments, in order to ensure the effective implementation of the program and its adaptation to local contexts. With the choice of this partnering approach comes the need for an examination of the interterritorial and intersectoral issues that arise when public health activities take place. Our survey of three French health regions shows that governance of the program by “territory” is complicated by the existence of dissension between local governments and sectors of intervention, whether they answer to the State or to municipalities.