Sustainable development has been defined by 17 UN goals, with the third goal (SDG3) focusing on a universal healthcare system that ensures healthy lives and wellbeing. To implement these ambitions, the goal needs to fit a regional setting before it can achieve and support healthy lives and wellbeing amongst the population. This article analyses how four Swedish regions incorporate SDG target 3.4 on non-communicable diseases and mental health into their respective healthcare organisations. The comparative analysis applies the lens of normative institutional theory to policy documents and interviews. All the regions recognise SDG3.4 by acknowledging the need for health promotion. The results show a general absence of similarities in organisational practices and policy outcomes, which is explained by region-specific factors and a lack of governmental coordination. The analysis shows that local policy core values and the related logic of appropriateness predict local outcomes of implementation of general global policies.