1. What actions are needed to address Australia’s health priorities?
HSC - Core 1
Chapter 4

2. To address Australia’s health priorities, actions that focus on both treatment and prevention must be balanced strategically.
This means that sufficient resources must be allocated to treat the injuries, illnesses and health problems of the population, but significant funding must also be directed towards health promotion initiatives and the prevention of injuries and ill health.

3. A strategic approach to health promotion is ideal
A strategic approach to health promotion is ideal. This can involve developing broad action plans and specific initiatives based on the five ‘action areas’ of the Ottawa Charter for Health Promotion, established in 1986.

4. The five action areas are: > developing personal skills
> reorienting health services > creating supportive environments
> building healthy public policy. > strengthening community action

5. It is useful to critically analyse how these action areas can provide a framework for addressing Australia’s health priorities. These priorities include: > groups experiencing health inequities > high levels of preventable chronic disease, injury and mental health problems > a growing and ageing population.

6. In addition to reinforcing the Ottawa Charter action areas, the Jakarta Declaration of 1997 proposed an additional focus on building and expanding partnerships for health. Three years later, the Mexico Ministerial Statement of 2000 highlighted the importance of addressing the social determinants of health, particularly to improve the lives of economically and socially disadvantaged populations.

8. Levels of responsibility for health promotion
The principles of social justice underpin the approaches to promoting health, the responsibility for health promotion is shared.
Governments at federal, state and local levels have a significant role to play, as do non-government agencies, the corporate sector, community groups and individuals.

9. Australian Government
The Australian Government has a significant leadership responsibility for developing health promotion policy and for funding it.
Example - health promotion leadership funding of the Australian Institute of Health and Welfare (AIHW) to collect health-related data.
Example - the development of dietary guidelines and physical activity recommendations

10. State and local governments
NSW Government campaigns such as the Healthy Canteen Strategy and Walk It: Active Local Parks also reflect these guidelines and recommendations.
The Walk It: Active Local Parks initiative demonstrated the role that government can play at a local level. The project was a joint undertaking between Parramatta City Council, NSW Health, the Western Sydney Area Health Service and Active Australia to encourage people to use local parks for walking and other forms of physical activity.
As part of the program, audits and subsequent building works were completed to ensure that local parks and other facilities were in a condition that encouraged physical activity. Creating supportive environments for physical activity is a key function of local governments.

11. This initiative is a prime example of cross-sectional action that builds partnerships to promote health in meaningful and cost-effective ways. It also demonstrates how organisations like NSW Health and the Area Health Services, whose primary roles are usually treatment based approaches to health, have been able to adopt an approach based on health promotion as well. This is a clear example of reorienting health services.

12. Non-government and corporate strategies
Cancer Council and the Heart Foundation have very clear and specific health promotion responsibilities, and the corporate sector is increasingly recognising its responsibilities in supporting the health and wellbeing of its employees—as well as the productivity benefits of this approach

13. Individuals
Individuals have a level of responsibility for their own health, which includes making themselves aware of potentially harmful health impacts of certain lifestyle behaviours, and modifying their behaviours accordingly.
Including seeking appropriate help as early as possible when health problems arise.
The role that schools play in helping to make children and young people aware of healthy behaviours and strategies is critical for developing this individual responsibility.

14. However, taking a social justice approach to this issue identifies the difficulties that some individuals may need to overcome to make healthy decisions or adopt healthy lifestyle behaviours
For example:
Having a low level of education, particularly poor literacy skills, can make it difficult to be fully aware of health implications or early signs of health problems.
Having a low income may make it more difficult—even impossible—to make healthy choices that cost more money.
Growing up in a socio-cultural environment that instills poor health habits early, such as unhealthy eating patterns, negative attitudes to physical activity or a culture of risk taking, can make it harder for young people to break that cycle.
Living in rural or remote areas can limit access to hospitals and specialist health services.

15. The benefits of partnerships in health promotion
One significant advance in the evolution of health promotion has been in strategic partnerships. When health-promoting organisations establish a strategic partnership with another organisation, it can help them to meet their goal of improving health outcomes.
The overall outcome from the partnership is usually greater than what each organisation could have achieved alone.
In an ideal health promotion partnership, there will be benefits to all parties involved.

16. Key benefits include:
sharing responsibility for health promotion and tapping into the expertise and resources that each partner brings to the initiative
reinforcing the view that all individuals, the community and governments have a responsibility to promote health
getting ‘buy-in’, which means that partner organisations or individuals are not ‘told what to do’ or asked to simply donate their support, but rather they are actively involved in the process are committed to it;
pooling resources, which means that financial contributions, time commitments, expertise and physical resources can be shared
ensuring cost-effectiveness, as each member is typically able to provide knowledge, skills, services and/or resources at a reduced or no cost.

17. An example of successful health promotion partnerships in action can be seen in the alliances between health-based organisations and the schools sector.
These partnerships help promote the health needs of students in relation to specific issues such as injury, asthma, overweight and obesity, skin cancer and mental health.

18. How health promotion based on the Ottawa Charter promotes social justice
Basing health promotion strategies on the Ottawa Charter provides two benefits.
it increases the likelihood of positive health outcomes being achieved;
it promotes social justice.
The five action areas of the Ottawa Charter can serve as a framework upon which health promotion can be built

19. The Ottawa Charter in action
Closing the Gap
Fresh School

20. Exam Style Questions
1. Discuss the level of responsibility individuals need to accept for their own health. (5 marks)
2. Examine the significance of social justice principles to health promotion. (6 marks)
3. Critically analyse the importance of the five action areas of the Ottawa Charter to a selected health promotion initiative. (9 marks)