健康中国视角下地方政府运动促进健康政策变迁的影响因素及推进路径

uencing Factors and Promotion Paths of Local Government Movement for Exercise Promoting Health Policy Change in the Perspective of Healthy China

新时代,建立具有地方特色的运动促进健康新模式离不开地方政府相应的政策体系支持。以上海市运动促进健康政策为例,采用清晰集定性比较分析法(csQCA),根据多源流理论分析框架,探究运动促进健康焦点问题、国家层面运动促进健康政策出台、党和国家领导人重要讲话、运动促进健康议案提案、本地体育用地规划和体育产业政策出台等5种单因素对地方政府运动促进健康政策变迁的影响,发现存在8条影响因素组态,可分为“政治源流”主导、“问题—政治”驱动、“问题—政策”驱动、“政治—政策”驱动和“问题—政治—政策”综合驱动5种类型,且可归纳为3个关键特征:政治源流是地方政府运动促进健康政策变迁的核心动力;问题源流是地方政府主动制定运动促进健康政策的内生动力;政治源流和政策源流的耦合是部门层面运动促进健康政策变迁的必要动力。基于此,提出优化运动促进健康顶层设计,加强政治源流推动力;提高地方政府关注社会问题的主动性,强化问题源流驱动力;充实政策共同体力量,增强政治源流和政策源流耦合动力的推进路径。

The establishment of a new model of exercise for health with local characteristics can not be achieved without the support of the local government’s corresponding policy system in the new era.Taking Shanghai’s exercise promoting health policy as an example,this study uses the clear set qualitative comparative analysis(csQCA)to explore the influence of five single factors on the change of local government exercise promoting health policy based on a multi-stream theoretical analysis framework,including exercise promoting health focus issues,the introduction of national-level sports promotion health policies,important speeches by top party and national leaders,sports promotion health bills and proposals,and the introduction of local sports land use planning and sports industry policies.Results suggest that there are eight groups of influencing factors,which can be divided into the political type,the problem-politics type,the problem-policy type,the politics-policy type and the problem-politics-policy type.These five types of combined issue-policy drivers can be summarized into three key features:(1)the political sourceflow is the core driving force;(2)the problem source is the endogenous driving force;(3)the coupling of political source and policy source is the necessary driving force for the department level policy changes.To provide useful references for formulating policies,this study proposes the promotion path of optimizing the top-level design of movement for health and strengthening the driving force of the political source stream;improving the initiative of local governments to pay attention to social issues and strengthening the driving force of issue source stream and enriching the power of policy community to enhance the coupling power of political and policy source stream.