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The Bruche Valley (composed of 26 municipalities and 22,000 inhabitants) is a medium-altitude, rural territory situated in Alsace, France. For more than 40 years, this territory has developed a intercommunal cooperation and local development approach. The district planning authority is a recognised coordinator of public health actions in the region. All of these actions are defined by a special contract called “Contrat local de santé” (CLS), signed by the State, the district planning authority and numerous collaborators including health care insurance funds and local health facility group managers. The contractual period came to an end in 2015. This cross-sectoral approach involves not only health professionals (specialists) but also all partners, such as councillors, Department for Education, voluntary and general public sectors. Health is not seen as an end per se but as fully participating in a local development policy.