  Citation: Karlsen, T.-I.; Kiland, C.; Kvåle, G.; Torjesen, D.O. ‘Health in All Policies’ and the Urge for Coordination: The Work of Public Health Coordinators and Their Impact and Influence in Local Public Health Policies: A Cross-Sectional Study. Societies 2022, 12, 11. https:// doi.org/10.3390/soc12010011 Academic Editors: Elisabeth Fosse and Marit Kristine Helgesen Received: 29 September 2021 Accepted: 22 December 2021 Published: 13 January 2022 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. Copyright: © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). societies Article ‘Health in All Policies’ and the Urge for Coordination: The Work of Public Health Coordinators and Their Impact and Influence in Local Public Health Policies: A Cross-Sectional Study Tor-Ivar Karlsen 1, * , Charlotte Kiland 2 , Gro Kvåle 2 and Dag Olaf Torjesen 2 1 Department of Psychosocial Health, University of Agder, 4604 Kristiansand, Norway 2 Department of Political Science and Management, University of Agder, 4604 Kristiansand, Norway; Charlotte.kiland@uia.no (C.K.); gro.kvale@uia.no (G.K.); dag.o.torjesen@uia.no (D.O.T.) * Correspondence: tor-ivar.karlsen@uia.no Abstract: Building heavily on the Health in All Policies (HiAP) approach, Norway implemented the Public Health Act in 2012 to reduce social inequalities in health. Local public health coordinators (PHCs) at municipal levels were seen as tools to provide local intersectoral public health work. In this study, we examine factors related to intersectoral agency and if intersectoral work is understood as relevant to securing social justice in local policy outcomes. A national web-based survey in 2019 of all Norwegian PHCs (n = 428) was conducted with a response rate of 60%. Data were analysed through multiple linear regression, hierarchical regression modelling and structural equation modelling. Neither factors relating to community contexts nor individual characteristics were associated with intersectoral agency. Organisational factors, especially position size, being organised at the top level and having a job description, were significantly associated with perceptions of intersectoral agency. PHCs seeing themselves as intersectoral agents also found themselves able to affect annual budgets and policy outcomes. We conclude that municipal PHC positions can be important HiAP tools in local public health policies. However, organisational factors affect how PHCs perceive their influence and role in the municipal organisation and thereby their possibilities to influence local policymaking through intersectoral agency. Keywords: municipalities; public health; public health coordinators; intersectoral collaboration; health in all policies 1. Introduction The Health in All Policies (HiAP) approach [1,2] has become central to the current understanding of population health and health promotion globally. The foundation of the HiAP principle is to examine determinants of health that can be altered to improve health, which implies that these determinants are mainly controlled by sectors other than health [1]. The approach highlights the importance of public policy and practice at all political levels and public and social sectors, ranging from international arenas to national, regional and municipality levels, to improve population health and health equity [3,4]. Of special interest is the municipality level where people live and thrive. However, gaps exist in the understanding of how HiAP works at this level, as shown by a scoping review of research published between 2006 and 2015 [5], especially in the understanding of local strategies to diminish social inequalities in health [6,7]. The social gradient in health inequalities demonstrates that health worsens as one descends the socioeconomic ladder [8–10] and levelling the social gradient is considered an important aim of public health policies, both globally [2] and in Norway [11,12]. However, challenges of increased social inequalities in health, and the conditions for preventing or reducing poor health, are quintessentially complex and ‘wicked’ and do not fit within traditional organisational, jurisdictional, geographical, societal and/or functional Societies 2022, 12, 11. https://doi.org/10.3390/soc12010011 https://www.mdpi.com/journal/societies