1. Protection of Health and Environment
Aim: To explain the process of risk management and how its implementation can promote or protect health

2. The tendency towards a dual economy
Galbraith argued that the economy and its organisations develop dual tendencies
The central economy is planned and primarily reflects the interests of the power elite
In the competitive periphery prices remain paramount (the poor work in the periphery both globally and in regard to the individual organization, where they are a casual labour force)
The role of govt. should be to bring these two economic sectors into alignment

3. Environmental health risk factors
Air , water, food quality
Noise, toxic and non toxic waste disposal
Building standards
Natural disasters, war, crime
Pest infestations; pesticide and herbicide residues
Degradation of natural resources

4. Personal lifestyle health risk factors
Smoking
Alcohol abuse
Lack of exercise, obesity
Sexual practices
Safety practices
Importance of health related knowledge

5. Major risks of premature death internationally
Malnutrition
Poor water supply, sanitation, hygiene
Unsafe sex
Tobacco use
Alcohol
Occupation

6. World Health Organisation
Established 1948
‘Health for All by the Year 2000’ was goal established in 1978
The Alma-Ata declaration: 134 nations agreed that health is a fundamental human right and the highest possible level of health is a most important world wide social goal
Primary care first priority

7. International context of national risk management
1978: Alma-Ata declaration established health as a fundamental human right and stated the highest possible level of health is a most important world goal
1986: Ottawa Charter says supports include peace, shelter, food, income, a stable economic system, sustainable resources, social justice and equity

8. Ninth General Program of Work of the WHO (1996-2000)
Ten goals and targets
Goal 1 is to increase the span of healthy life for all people in such a way that the health disparities between social groups decrease
Targets: Life expectancy at birth will not be less than 60 in any country
The difference between highest and lowest group life expectancy will reduce by 50%

9. WHO Governing Body is World Health Assembly (170 nations)
WHO helps countries reinforce their health systems by building up infrastructures
Promotes appropriate research (malaria, leprosy, other tropic disease control)
Safe drinking water programs
Immunisation programs
Other appropriate programs; HIV/AIDS; river blindness, etc.

10. WHO Strategy Education about main health problems
Proper food supply and nutrition
Safe water and sanitation
Maternal and child health (family planning)
Immunisation against infectious diseases
Prevention and control of local diseases
Treatment of common diseases and injuries
Provision of essential drugs

11. International context of risk management
1992: UN Declaration on Environment and Development: Humans are at the centre of concern for sustainable development and are entitled to a health and productive life in harmony with nature.
1997: WHO called for development of health promotion as a result of cooperation between govt. and private sector

12. International context of risk management
Post 1989: Global agreement on the need for free trade
APEC principles: Equal treatment; access to information; need for cost-effective dispute resolution; no relaxation of health, safety and environmental regulations to attract investment
Aust. Competition Policy Reform Act

13. Australian competition Policy Reform
Level playing field of national standards for health and environment protection
Equal competition between private and public sector service providers
Perfect information: necessary for competition, risk identification and control; scientific advance; democratic accountability

14. Risk management standard (AS/NZ 4360:1999)
A logical and systematic method of identifying, analysing, assessing, treating, monitoring and communicating risks associated with any activity in a way that will enable organisations to minimise losses and maximise opportunities.

15. Risk Management Process (Communicate and consult)
Establish the context(strategic, organisational, etc.)(baseline data)
Identify the risks
Analyse and prioritise risks(severity/frequency)
Treat risks (reduction strategies)
Evaluate outcome (performance indicators)

16. Risk management consistent with:
Risk identification and control requirements of state OHS Acts
Health promotion: ‘preventing the causes of determinants of illness; evidence based practice; community participation in decisions affecting health’ (NHMRC)
Duty of care of health practitioner
Quality mgt. (ISO )Environmental mgt. (ISO 14004)

17. Risk management can be carried out:
In a global, national, regional, industry, or organisational context
Risk management programs can aim at promoting the health of populations, consumers, clients, or workers

18. Health Aims and Objectives
The choice of a health program aim should relate closely to the overall aims of the organisation and assist in their achievement.
The aim needs to be clear and measurable
The objectives support the aim and should relate closely to it

19. Identification of health risk leads to program aims:
The aim is based on the prior identification and prioritization of health risk, so the gathering of data to aid the identification of risk is imperative
Baseline data collected at commencement of the project is compared to data collected at the end of the project to see if improvement has occurred

20. Australian Health Goals Developed by Commonwealth and State Ministers
Access to high quality health care services regardless of financial status and place of residence
Cost-effective health improvement through a prevention related approach
Access to information which will enable individual Australians to make informed decisions (treatment outcome data)

21. Aust. National Health Priorities
Cardiovascular disease
Cancer
Injury
Mental health
Aboriginal health (plus Diabetes)

22. National Health Goals
Goal is a broad statement: ‘To reduce the impact of coronary heart disease on the health of all Australians’
Target: ‘Reduction of x% in admissions to hospital over z years
Strategy: Actions to achieve the goal
A performance indicator is a measurable way of assessing progress (e.g. admissions to hospital)

23. Criteria for Setting Goals
The public health significance of the goal
The ability to effectively implement practices to achieve it
The ability to measure its achievement
Importance of benchmarking (performance comparison based on consistent international and national data collection)

24. From global to local approaches to sustainable development
Community development should be based on the identification of major health and environment problems on an appropriate regional basis in order to prioritize and find solutions to them. State of the Environment Report ( ) from the UN Economic and Social Commission provides provides a broad context.