Page 3301 - Week 08 - Tuesday, 16 August 2011
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If the ACT government were to adopt a social determinants of health framework, it would deal with consumers’ health problems by also looking at those other factors which impact on their wellbeing, such as housing and employment. At a high policy level, we must recognise that almost every aspect of government and the economy has the potential to affect health and health equity. Treasury, education, housing, employment, transport and health are some of these portfolios. While health may not be the main aim of policies in those other portfolios, they have a strong bearing on health and health equity.
Policy coherence is crucial. Different government departments’ policies must complement, rather than contradict, each other in relation to health equity. For example, transport policy should actively encourage other active transport other than just car use, as it is contradictory to health policy.
Obesity is a public health challenge which cannot be solved by the health system alone. Prevention requires an approach that ensures a sustainable, adequate and nutritious food supply, participation in physical activity, and a family, educational, and work environment that positively reinforces healthy living. Very little of this action sits within the capabilities or responsibilities of the health sector.
If we use the South Australian government as an example, in 2008 it introduced a health in all policies approach, emphasising that health and wellbeing are largely influenced by measures that are often managed by government sectors other than health.
The process is similar to a health impact assessment. The key difference between the traditional health impact assessment approach and the health in all policies approach is that health impact assessments tend to be applied after a policy, plan or proposal has been developed but before it has been implemented. The health in all policies approach usually commences prior to a policy or proposal being developed. To quote the government webpage:
Implementation of Health in All Policies provides a system which enables governments to respond in a coordinated way to the health and wellbeing needs of the population. Health in All Policies also aims to bridge the gap in health inequities, especially those seen within the Aboriginal and Torres Strait Islander populations.
There are examples from South Australia showing how the South Australian strategic plan was linked with the health in all policies approach. This could be done in the ACT, for example, with the Canberra plan and social plan.
By adopting a social determinants of health approach to policy development and service provision, we are acknowledging that people require a range of supports and services to improve wellbeing and health outcomes. The investment in such an approach to planning could contribute to an increase in the health outcomes of people in the community who are experiencing disadvantage and require the most assistance.
As I have noted, while the ACT is a community with higher than average incomes, we have people experiencing significant social disadvantage which then translates to poor
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