Carmel Williams - Academia.edu (original) (raw)
Papers by Carmel Williams
Health Promotion Journal of Australia
Public Health Research & Practice
The 10th Global Conference on Health Promotion The 10th Global Conference on Health Promotion (10... more The 10th Global Conference on Health Promotion The 10th Global Conference on Health Promotion (10GCHP) 1 , held in December 2021, was a significant milestone in global efforts to bring about a more healthy, equitable and sustainable world.. The World Health Organization (WHO) designed the conference as a platform for launching a new global movement to catalyse and support the concept of "wellbeing societies". With the theme of "Health Promotion for Wellbeing, Equity and Sustainable Development" 2 , the conference was centred in Geneva, Switzerland, but was attended by around 5000 participants virtually. For WHO, the conference theme heralds a potential paradigm shift, as it situates health promotion and disease prevention strategies within the broader rubric of wellbeing. Health is a common thread in the current crises and emerging challenges the world faces. But wellbeing has increasingly come to serve as a unifying concept across the health, social, economic and environmental responses needed to meet these challenges, beyond what health can achieve alone. Adopting a wellbeing frame reflects a positive and holistic approach, in keeping with the original definition of health in the WHO Constitution. 2 Remarkably, despite 'wellbeing' being core to this definition, the 10GCHP was the first major WHO conference to have focused on wellbeing in WHO's 70plus year history. Building on this and related initiatives, in a move that further strengthens this agenda, member states took a resolution to the 75th World Health Assembly in May 2022 for the WHO to "develop, within WHO's mandate, a framework on achieving wellbeing, building on the 2030 Agenda for Sustainable Development". 3 The global context The global context for the conference provides some insight into its focus and design.
Health Promotion International
Health Promotion Journal of Australia, 2019
As we head towards a federal election in Australia, it is timely to think about the types of heal... more As we head towards a federal election in Australia, it is timely to think about the types of health policies, programs and research that are required to sustain a healthy, safe, productive, equitable and thriving society. There is strong evidence to suggest that investment
International Journal of Health Policy and Management, 2018
International Journal of Health Policy and Management
The paper by Guglielmin and colleagues1 examines the implementation of Health in All Policies (Hi... more The paper by Guglielmin and colleagues1 examines the implementation of Health in All Policies (HiAP) in a local government context in Kuopio Finland. The authors use a realist explanatory case study design to explore what has supported HiAP implementation with a focus on two specific hypotheses on what leads to success: common goals and committed leadership and staff. The paper is well argued using appropriate methodology and their findings support the importance of the success factors tested by their two hypotheses. However, the narrowed focus on just two hypotheses underrepresents the complexity of implementing HiAP at any level of government, including local government. Given its local government focus, the paper would have been strengthened by referencing the lessons gained from the Healthy Cities movement. Local government is a critical setting for action to address health and health equity and there is great potential to continue research that adds to the knowledge base on how...
International Journal for Equity in Health
Since the 2008 publication of the reports of the Commission on Social Determinants of Health and ... more Since the 2008 publication of the reports of the Commission on Social Determinants of Health and its nine knowledge networks, substantial research has been undertaken to document and describe health inequities. The COVID-19 pandemic has underscored the need for a deeper understanding of, and broader action on, the social determinants of health. Building on this unique and critical opportunity, the World Health Organization is steering a multi-country Initiative to reduce health inequities through an action-learning process in ‘Pathfinder’ countries. The Initiative aims to develop replicable and reliable models and practices that can be adopted by WHO offices and UN staff to address the social determinants of health to advance health equity. This paper provides an overview of the Initiative by describing its broad theory of change and work undertaken in three regions and six Pathfinder countries in its first year-and-a-half. Participants engaged in the Initiative describe results of ...
The South Australian (SA) Health in All Policies (HiAP) initiative provides a framework and manda... more The South Australian (SA) Health in All Policies (HiAP) initiative provides a framework and mandate for intersectoral policy work on the social determinants of health. Participation in decent and meaningful employment is a key social determinant of health, and is also an important strategy to promote ‘active ageing’ in the population. This paper reports on an intersectoral project undertaken by the Health In All Policies Unit and Country Health SA Local Health Network (CHSA LHN) in collaboration with Flinders University’s SA Community Health Research Unit and Southgate Institute for Health Society and Equity. The project Active Ageing and Employment in Regional South Australia aims to identify policy levers to increase the workforce retention and re-entry for rural people aged 45+. The project is designed to do this by building the capacity of the regional health workforce to address the social determinants of health in collaboration with agencies outside of the health system. The p...
BMC public health, Jan 8, 2017
After publication of the article [1], it has been brought to our attention that Table 1 has been ... more After publication of the article [1], it has been brought to our attention that Table 1 has been formatted poorly in the original version so that the columns are not aligned with their corresponding information. The correct version of the table is presented below. The original version of the article has now been revised.
Australia has a rapidly ageing population and this presents a range of opportunities and challeng... more Australia has a rapidly ageing population and this presents a range of opportunities and challenges, particularly in relation to service delivery, employment and rates of chronic disease. In South Australia (SA), one in six people are aged 65 years and older, with older people and those affected by chronic disease over-represented in regional areas.1,2 This presents two significant challenges to the workforce in regional areas:
Medical Journal of Australia
Do not think that the social determinants of health equity are old hat. In reality, Australia is ... more Do not think that the social determinants of health equity are old hat. In reality, Australia is very far away from addressing the societal level drivers of health inequity. There is little progressive policy that touches on the conditions of daily life that matter for health, and action to redress inequities in power, money and resources is almost non‐existent. In this chapter we ask you to pause this reality and come on a fantastic journey where we envisage how COVID‐19 was a great disruptor and accelerator of positive progressive action. We offer glimmers of what life could be like if there was committed and real policy action on the social determinants of health equity. It is vital that the health sector assists in convening the multisectoral stakeholders necessary to turn this fantasy into reality.
BMC Public Health
Background: This paper reports on a five-year study using a theory-based program logic evaluation... more Background: This paper reports on a five-year study using a theory-based program logic evaluation, and supporting survey and interview data to examine the extent to which the activites of the South Australian Health in All Policies initiative can be linked to population health outcomes. Methods: Mixed-methods data were collected between 2012 and 2016 in South Australia (144 semi-structured key informant interviews; two electronic surveys of public servants in 2013 (n = 435) and 2015 (n = 483); analysis of state government policy documents; and construction of a program logic model to shape assessment of the feasibility of attribution to population health outcomes). Results: Multiple actions on social determinants of health in a range of state government sectors were reported and most could be linked through a program logic model to making some contribution to future population health outcomes. Context strongly influences implementation; not all initiatives will be successful and experimentation is vital. Successful initiatives included HiAP influencing the urban planning department to be more concerned with the health impacts of planning decisions, and encouraging the environment department to be concerned with the health impacts of its work. Conclusions: The theory-based program logic suggests that SA HiAP facilitated improved population health through working with multiple government departments. Public servants came to appreciate how their sectors impact on health. Program logic is a mechanism to evaluate complex public health interventions in a way that takes account of political and economic contexts. SA HiAP was mainly successful in avoiding lifestyle drift in strategy. The initiative encouraged a range of state government departments to tackle conditions of daily living. The broader underpinning factors dictating the distribution of power, money and resources were not addressed by HiAP. This reflects HiAP's use of a consensus model which was driven by (rather than drove) state priorities and sought 'win-win' strategies.
International journal of health policy and management, Oct 22, 2017
The importance of evaluating policy processes to achieve health equity is well recognised but suc... more The importance of evaluating policy processes to achieve health equity is well recognised but such evaluation encounters methodological, theoretical and political challenges. This paper describes how a program theorybased evaluation framework can be developed and tested, using the example of an evaluation of the South Australian Health in All Policies (HiAP) initiative. A framework of the theorised components and relationships of the HiAP initiative was produced to guide evaluation. The framework was the product of a collaborative, iterative process underpinned by a policy-research partnership and drew on social and political science theory and relevant policy literature. The process engaged key stakeholders to capture both HiAP specific and broader bureaucratic knowledge and was informed by a number of social and political science theories. The framework provides a basis for exploring the interactions between framework components and how they shape policy-making and public policy. ...
BMC public health, Oct 16, 2017
This paper examines the extent to which actors from sectors other than health engaged with the So... more This paper examines the extent to which actors from sectors other than health engaged with the South Australian Health in All Policies (HiAP) initiative, determines why they were prepared to do so and explains the mechanisms by which successful engagement happened. This examination applies theories of policy development and implementation. The paper draws on a five year study of the implementation of HiAP comprising document analysis, a log of key events, detailed interviews with 64 policy actors and two surveys of public servants. The findings are analysed within an institutional policy analysis framework and examine the extent to which ideas, institutional factors and actor agency influenced the willingness of actors from other sectors to work with Health sector staff under the HiAP initiative. In terms of ideas, there was wide acceptance of the role of social determinants in shaping health and the importance of action to promote health in all government agencies. The institutiona...
Social Science & Medicine, 2015
Health systems have long been criticised for focussing on curing rather than preventing disease. ... more Health systems have long been criticised for focussing on curing rather than preventing disease. This paper examines to what extent the Adelaide Thinkers in Residence (ATiR) scheme contributed to the change in norms whereby promoting well-being and a strategy to achieve this - Health in All Policies (HiAP) - was adopted by the South Australian (SA) State Government from 2007. The data presented in this paper are drawn from a five year (2012-2016) detailed mixed methods case study of the SA HiAP initiative which involved document analysis, interviews and workshops with public servants and political actors. We adapt the framework used by Finnemore and Sikkink (1998) which explains how norm changes can lead to political changes in international affairs. We also use Kingdon's concept of policy entrepreneurs to determine whether these ideas moved to an implementable initiative with the help of both a specific ATiR program on HiAP and the broader TiR scheme which promoted a series of innovations relevant to health. The process involved the ATiR reinforcing the work of local norm entrepreneurs with that of powerful external policy entrepreneurs, adapting the discourse about the value of prevention and promoting well-being so that it fitted with the dominant economic one. The powerful organisational platform of the ATiR, which was under the Department of the Premier and Cabinet and linked to the South Australian Strategic Plan (SASP) was used to advance these ideas. The case study offers important lessons for other jurisdictions on how to shift policy to encourage intersectoral approaches to health.
Health Promotion and the Policy Process, 2013
In C Clavier and E deLeeuw (eds.) Health Promotion and the Policy Process: Practical and Critical... more In C Clavier and E deLeeuw (eds.) Health Promotion and the Policy Process: Practical and Critical Theories (pp. 188-217). Oxford: Oxford University Press.
Australia and New Zealand health policy, Jan 21, 2006
To assess the social capital profile of a known disadvantaged area a large cross-sectional survey... more To assess the social capital profile of a known disadvantaged area a large cross-sectional survey was undertaken. The social capital profile of this area was compared to data from the whole of the state. The overall health status of the disadvantaged area was assessed in relation to a wide variety of social capital related variables. Univariate and multivariate analysis were undertaken. In the univariate analysis many statistically significant differences were found between the respondents in the disadvantaged area and the state estimates including overall health status, perceived attributes of the neighbourhood, levels of trust, community involvement and social activities. In the multivariate analysis very few variables were found to be statistically significantly associated with poorer health status. The variables that jointly predicted poorer health status in the disadvantaged area were older age, lower income, low sport participation, non-seeking help from neighbours and non-att...
Canadian journal of public health = Revue canadienne de santé publique, 2012
Health in All Policies (HiAP) has been promoted as a means of embedding concern for health impact... more Health in All Policies (HiAP) has been promoted as a means of embedding concern for health impacts in the policy-making process. In South Australia, specific structures and processes to achieve this have been developed and tested. The HiAP approach is designed to engage policy officers and managers in all sectors of government. South Australia, one of six Australian states, which operates under a system of cabinet government. There are 15 government departments. The primary mechanism of the South Australian HiAP approach is the health lens analysis (HLA) - an intersectoral, partnership process drawing on public health research methods. It has been applied to three separate public policy issues: water security, digital technology and migration. Evaluation findings to date suggest that the HLAs have resulted in the following: increased understanding by policy-makers of the impact of their work on health outcomes; changes in policy direction; development and dissemination of policy-rel...
Health promotion international, 2014
Public policy strategies impact on population health by acting on the effectiveness, availability... more Public policy strategies impact on population health by acting on the effectiveness, availability and distribution of the social determinants of health. Reducing obesity and promoting healthy weight is a key focus of governments, health promoters and researchers, and can benefit from a systems approach with 'upstream' policy action beyond the health sector. Although the literature identifies many areas for hypothetical non-health policy action, and in particular relating to food and activity environments, few have identified practical, politically viable and relatively cost-free processes by which non-health sectors would want to commit to such action. This article details how the Government of South Australia used the Health in All Policies (HiAP) approach in the SA HiAP Healthy Weight Project. It mapped the core business and policy directions of 44 state departments against research on 'what works' to address obesity. Negotiations then developed high-level policy c...
Public policy strategies impact on population health by acting on the effectiveness, availability... more Public policy strategies impact on population health by acting on the effectiveness, availability and distribution of the social determinants of health. Reducing obesity and promoting healthy weight is a key focus of governments, health promoters and researchers, and can benefit from a systems approach with 'upstream' policy action beyond the health sector. Although the literature identifies many areas for hypothetical non-health policy action, and in particular relating to food and activity environments, few have identified practical, politically viable and relatively cost-free processes by which non-health sectors would want to commit to such action. This article details how the Government of South Australia used the Health in All Policies (HiAP) approach in the SA HiAP Healthy Weight Project. It mapped the core business and policy directions of 44 state departments against research on 'what works' to address obesity. Negotiations then developed high-level policy commitments to address factors promoting healthy weight which predominantly changed ways of working rather than requiring new expenditure and also assisted departments in meeting their own goals; departmental chief executives endorsed the commitments. By starting from departmental documents, and not restricting the project to departments with more 'obvious' obesity prevention potential, we gained commitment to a broader range of policy actions than identified elsewhere; for example, for prisons, environment and botanic gardens, housing and vocational education. The SA HiAP Healthy Weight Project provides one example of a workable, evidence-based systems approach to increase commitment to practical and politically viable opportunities across government to address the non-health environments supporting healthy weight.
Health Promotion Journal of Australia
Public Health Research & Practice
The 10th Global Conference on Health Promotion The 10th Global Conference on Health Promotion (10... more The 10th Global Conference on Health Promotion The 10th Global Conference on Health Promotion (10GCHP) 1 , held in December 2021, was a significant milestone in global efforts to bring about a more healthy, equitable and sustainable world.. The World Health Organization (WHO) designed the conference as a platform for launching a new global movement to catalyse and support the concept of "wellbeing societies". With the theme of "Health Promotion for Wellbeing, Equity and Sustainable Development" 2 , the conference was centred in Geneva, Switzerland, but was attended by around 5000 participants virtually. For WHO, the conference theme heralds a potential paradigm shift, as it situates health promotion and disease prevention strategies within the broader rubric of wellbeing. Health is a common thread in the current crises and emerging challenges the world faces. But wellbeing has increasingly come to serve as a unifying concept across the health, social, economic and environmental responses needed to meet these challenges, beyond what health can achieve alone. Adopting a wellbeing frame reflects a positive and holistic approach, in keeping with the original definition of health in the WHO Constitution. 2 Remarkably, despite 'wellbeing' being core to this definition, the 10GCHP was the first major WHO conference to have focused on wellbeing in WHO's 70plus year history. Building on this and related initiatives, in a move that further strengthens this agenda, member states took a resolution to the 75th World Health Assembly in May 2022 for the WHO to "develop, within WHO's mandate, a framework on achieving wellbeing, building on the 2030 Agenda for Sustainable Development". 3 The global context The global context for the conference provides some insight into its focus and design.
Health Promotion International
Health Promotion Journal of Australia, 2019
As we head towards a federal election in Australia, it is timely to think about the types of heal... more As we head towards a federal election in Australia, it is timely to think about the types of health policies, programs and research that are required to sustain a healthy, safe, productive, equitable and thriving society. There is strong evidence to suggest that investment
International Journal of Health Policy and Management, 2018
International Journal of Health Policy and Management
The paper by Guglielmin and colleagues1 examines the implementation of Health in All Policies (Hi... more The paper by Guglielmin and colleagues1 examines the implementation of Health in All Policies (HiAP) in a local government context in Kuopio Finland. The authors use a realist explanatory case study design to explore what has supported HiAP implementation with a focus on two specific hypotheses on what leads to success: common goals and committed leadership and staff. The paper is well argued using appropriate methodology and their findings support the importance of the success factors tested by their two hypotheses. However, the narrowed focus on just two hypotheses underrepresents the complexity of implementing HiAP at any level of government, including local government. Given its local government focus, the paper would have been strengthened by referencing the lessons gained from the Healthy Cities movement. Local government is a critical setting for action to address health and health equity and there is great potential to continue research that adds to the knowledge base on how...
International Journal for Equity in Health
Since the 2008 publication of the reports of the Commission on Social Determinants of Health and ... more Since the 2008 publication of the reports of the Commission on Social Determinants of Health and its nine knowledge networks, substantial research has been undertaken to document and describe health inequities. The COVID-19 pandemic has underscored the need for a deeper understanding of, and broader action on, the social determinants of health. Building on this unique and critical opportunity, the World Health Organization is steering a multi-country Initiative to reduce health inequities through an action-learning process in ‘Pathfinder’ countries. The Initiative aims to develop replicable and reliable models and practices that can be adopted by WHO offices and UN staff to address the social determinants of health to advance health equity. This paper provides an overview of the Initiative by describing its broad theory of change and work undertaken in three regions and six Pathfinder countries in its first year-and-a-half. Participants engaged in the Initiative describe results of ...
The South Australian (SA) Health in All Policies (HiAP) initiative provides a framework and manda... more The South Australian (SA) Health in All Policies (HiAP) initiative provides a framework and mandate for intersectoral policy work on the social determinants of health. Participation in decent and meaningful employment is a key social determinant of health, and is also an important strategy to promote ‘active ageing’ in the population. This paper reports on an intersectoral project undertaken by the Health In All Policies Unit and Country Health SA Local Health Network (CHSA LHN) in collaboration with Flinders University’s SA Community Health Research Unit and Southgate Institute for Health Society and Equity. The project Active Ageing and Employment in Regional South Australia aims to identify policy levers to increase the workforce retention and re-entry for rural people aged 45+. The project is designed to do this by building the capacity of the regional health workforce to address the social determinants of health in collaboration with agencies outside of the health system. The p...
BMC public health, Jan 8, 2017
After publication of the article [1], it has been brought to our attention that Table 1 has been ... more After publication of the article [1], it has been brought to our attention that Table 1 has been formatted poorly in the original version so that the columns are not aligned with their corresponding information. The correct version of the table is presented below. The original version of the article has now been revised.
Australia has a rapidly ageing population and this presents a range of opportunities and challeng... more Australia has a rapidly ageing population and this presents a range of opportunities and challenges, particularly in relation to service delivery, employment and rates of chronic disease. In South Australia (SA), one in six people are aged 65 years and older, with older people and those affected by chronic disease over-represented in regional areas.1,2 This presents two significant challenges to the workforce in regional areas:
Medical Journal of Australia
Do not think that the social determinants of health equity are old hat. In reality, Australia is ... more Do not think that the social determinants of health equity are old hat. In reality, Australia is very far away from addressing the societal level drivers of health inequity. There is little progressive policy that touches on the conditions of daily life that matter for health, and action to redress inequities in power, money and resources is almost non‐existent. In this chapter we ask you to pause this reality and come on a fantastic journey where we envisage how COVID‐19 was a great disruptor and accelerator of positive progressive action. We offer glimmers of what life could be like if there was committed and real policy action on the social determinants of health equity. It is vital that the health sector assists in convening the multisectoral stakeholders necessary to turn this fantasy into reality.
BMC Public Health
Background: This paper reports on a five-year study using a theory-based program logic evaluation... more Background: This paper reports on a five-year study using a theory-based program logic evaluation, and supporting survey and interview data to examine the extent to which the activites of the South Australian Health in All Policies initiative can be linked to population health outcomes. Methods: Mixed-methods data were collected between 2012 and 2016 in South Australia (144 semi-structured key informant interviews; two electronic surveys of public servants in 2013 (n = 435) and 2015 (n = 483); analysis of state government policy documents; and construction of a program logic model to shape assessment of the feasibility of attribution to population health outcomes). Results: Multiple actions on social determinants of health in a range of state government sectors were reported and most could be linked through a program logic model to making some contribution to future population health outcomes. Context strongly influences implementation; not all initiatives will be successful and experimentation is vital. Successful initiatives included HiAP influencing the urban planning department to be more concerned with the health impacts of planning decisions, and encouraging the environment department to be concerned with the health impacts of its work. Conclusions: The theory-based program logic suggests that SA HiAP facilitated improved population health through working with multiple government departments. Public servants came to appreciate how their sectors impact on health. Program logic is a mechanism to evaluate complex public health interventions in a way that takes account of political and economic contexts. SA HiAP was mainly successful in avoiding lifestyle drift in strategy. The initiative encouraged a range of state government departments to tackle conditions of daily living. The broader underpinning factors dictating the distribution of power, money and resources were not addressed by HiAP. This reflects HiAP's use of a consensus model which was driven by (rather than drove) state priorities and sought 'win-win' strategies.
International journal of health policy and management, Oct 22, 2017
The importance of evaluating policy processes to achieve health equity is well recognised but suc... more The importance of evaluating policy processes to achieve health equity is well recognised but such evaluation encounters methodological, theoretical and political challenges. This paper describes how a program theorybased evaluation framework can be developed and tested, using the example of an evaluation of the South Australian Health in All Policies (HiAP) initiative. A framework of the theorised components and relationships of the HiAP initiative was produced to guide evaluation. The framework was the product of a collaborative, iterative process underpinned by a policy-research partnership and drew on social and political science theory and relevant policy literature. The process engaged key stakeholders to capture both HiAP specific and broader bureaucratic knowledge and was informed by a number of social and political science theories. The framework provides a basis for exploring the interactions between framework components and how they shape policy-making and public policy. ...
BMC public health, Oct 16, 2017
This paper examines the extent to which actors from sectors other than health engaged with the So... more This paper examines the extent to which actors from sectors other than health engaged with the South Australian Health in All Policies (HiAP) initiative, determines why they were prepared to do so and explains the mechanisms by which successful engagement happened. This examination applies theories of policy development and implementation. The paper draws on a five year study of the implementation of HiAP comprising document analysis, a log of key events, detailed interviews with 64 policy actors and two surveys of public servants. The findings are analysed within an institutional policy analysis framework and examine the extent to which ideas, institutional factors and actor agency influenced the willingness of actors from other sectors to work with Health sector staff under the HiAP initiative. In terms of ideas, there was wide acceptance of the role of social determinants in shaping health and the importance of action to promote health in all government agencies. The institutiona...
Social Science & Medicine, 2015
Health systems have long been criticised for focussing on curing rather than preventing disease. ... more Health systems have long been criticised for focussing on curing rather than preventing disease. This paper examines to what extent the Adelaide Thinkers in Residence (ATiR) scheme contributed to the change in norms whereby promoting well-being and a strategy to achieve this - Health in All Policies (HiAP) - was adopted by the South Australian (SA) State Government from 2007. The data presented in this paper are drawn from a five year (2012-2016) detailed mixed methods case study of the SA HiAP initiative which involved document analysis, interviews and workshops with public servants and political actors. We adapt the framework used by Finnemore and Sikkink (1998) which explains how norm changes can lead to political changes in international affairs. We also use Kingdon's concept of policy entrepreneurs to determine whether these ideas moved to an implementable initiative with the help of both a specific ATiR program on HiAP and the broader TiR scheme which promoted a series of innovations relevant to health. The process involved the ATiR reinforcing the work of local norm entrepreneurs with that of powerful external policy entrepreneurs, adapting the discourse about the value of prevention and promoting well-being so that it fitted with the dominant economic one. The powerful organisational platform of the ATiR, which was under the Department of the Premier and Cabinet and linked to the South Australian Strategic Plan (SASP) was used to advance these ideas. The case study offers important lessons for other jurisdictions on how to shift policy to encourage intersectoral approaches to health.
Health Promotion and the Policy Process, 2013
In C Clavier and E deLeeuw (eds.) Health Promotion and the Policy Process: Practical and Critical... more In C Clavier and E deLeeuw (eds.) Health Promotion and the Policy Process: Practical and Critical Theories (pp. 188-217). Oxford: Oxford University Press.
Australia and New Zealand health policy, Jan 21, 2006
To assess the social capital profile of a known disadvantaged area a large cross-sectional survey... more To assess the social capital profile of a known disadvantaged area a large cross-sectional survey was undertaken. The social capital profile of this area was compared to data from the whole of the state. The overall health status of the disadvantaged area was assessed in relation to a wide variety of social capital related variables. Univariate and multivariate analysis were undertaken. In the univariate analysis many statistically significant differences were found between the respondents in the disadvantaged area and the state estimates including overall health status, perceived attributes of the neighbourhood, levels of trust, community involvement and social activities. In the multivariate analysis very few variables were found to be statistically significantly associated with poorer health status. The variables that jointly predicted poorer health status in the disadvantaged area were older age, lower income, low sport participation, non-seeking help from neighbours and non-att...
Canadian journal of public health = Revue canadienne de santé publique, 2012
Health in All Policies (HiAP) has been promoted as a means of embedding concern for health impact... more Health in All Policies (HiAP) has been promoted as a means of embedding concern for health impacts in the policy-making process. In South Australia, specific structures and processes to achieve this have been developed and tested. The HiAP approach is designed to engage policy officers and managers in all sectors of government. South Australia, one of six Australian states, which operates under a system of cabinet government. There are 15 government departments. The primary mechanism of the South Australian HiAP approach is the health lens analysis (HLA) - an intersectoral, partnership process drawing on public health research methods. It has been applied to three separate public policy issues: water security, digital technology and migration. Evaluation findings to date suggest that the HLAs have resulted in the following: increased understanding by policy-makers of the impact of their work on health outcomes; changes in policy direction; development and dissemination of policy-rel...
Health promotion international, 2014
Public policy strategies impact on population health by acting on the effectiveness, availability... more Public policy strategies impact on population health by acting on the effectiveness, availability and distribution of the social determinants of health. Reducing obesity and promoting healthy weight is a key focus of governments, health promoters and researchers, and can benefit from a systems approach with 'upstream' policy action beyond the health sector. Although the literature identifies many areas for hypothetical non-health policy action, and in particular relating to food and activity environments, few have identified practical, politically viable and relatively cost-free processes by which non-health sectors would want to commit to such action. This article details how the Government of South Australia used the Health in All Policies (HiAP) approach in the SA HiAP Healthy Weight Project. It mapped the core business and policy directions of 44 state departments against research on 'what works' to address obesity. Negotiations then developed high-level policy c...
Public policy strategies impact on population health by acting on the effectiveness, availability... more Public policy strategies impact on population health by acting on the effectiveness, availability and distribution of the social determinants of health. Reducing obesity and promoting healthy weight is a key focus of governments, health promoters and researchers, and can benefit from a systems approach with 'upstream' policy action beyond the health sector. Although the literature identifies many areas for hypothetical non-health policy action, and in particular relating to food and activity environments, few have identified practical, politically viable and relatively cost-free processes by which non-health sectors would want to commit to such action. This article details how the Government of South Australia used the Health in All Policies (HiAP) approach in the SA HiAP Healthy Weight Project. It mapped the core business and policy directions of 44 state departments against research on 'what works' to address obesity. Negotiations then developed high-level policy commitments to address factors promoting healthy weight which predominantly changed ways of working rather than requiring new expenditure and also assisted departments in meeting their own goals; departmental chief executives endorsed the commitments. By starting from departmental documents, and not restricting the project to departments with more 'obvious' obesity prevention potential, we gained commitment to a broader range of policy actions than identified elsewhere; for example, for prisons, environment and botanic gardens, housing and vocational education. The SA HiAP Healthy Weight Project provides one example of a workable, evidence-based systems approach to increase commitment to practical and politically viable opportunities across government to address the non-health environments supporting healthy weight.