If the ultimate goal of all development is to improve the prerequisites for long-term survival and the well-being of the population in a region, then this entails action for increased social inclusion and a more equitable distribution of the social determinants of health. The intentional consequences of participatory approaches go far beyond the health sector and more into the realm of creating positive sustainable social change. Through the engagement of stakeholders, recognizing the value of each person’s contribution to the process is not only practical but also collaborative and empowering in finding solutions together. WHO’s Health 2020 policy calls for a whole-of-government and whole-of-society approach that involves a range of stakeholders at all levels. This publication documents the experiences of participatory approaches taken by Region Skåne (Sweden) and three case studies: the Autonomous Province of Trento (Italy), the Autonomous Community of Andalusia (Spain) and Wales (United Kingdom).