Health equity and policy

The Australian Health Inequities Program was an NHMRC-funded capacity building project addressing social and economic determinants of health. The project had two main aims:

1. To build capacity in multidisciplinary population health work by increasing understanding of the complex social, economic and environmental factors contributing to health inequities.
   
2. To improve policy, program and practice designed to reduce these inequities.

Key features of AHIP

• Building the capacity of individual researchers in the health inequities field to work in a multidisciplinary framework by employing a number of postdoctoral researchers and offering PhD scholarships in key areas of research.
• Creating a broad network of Australian researchers working in health related areas, bringing them together in forums and in national/international conferences on health inequities.
• Strengthening links with the international research community focused on health inequities in the UK, Canada, South Africa, the USA and Ireland.
• Close working relationships with the South Australian Department of Health and VicHealth and Department of Human Services in Victoria to improve policy responses to health inequities.

The researchers

The team assembled for the project had backgrounds in mainstream geography, housing and labour market economics as well as considerable experience in public health research. Researchers were from Flinders University and a researcher from Melbourne University.

AHIP projects

• Changing Patterns of Employment and Unemployment: Impacts on Physical and Mental Health and the Meditating Role of Social Capital - provided original insights into what aspects of employment help or harm health; and into what enables some people to escape the harm that others experience. This provided vital information to underpin policies designed to gain the benefits of a flexible workplace with minimum harm to workers.
• Location and Health - examined the differences in levels of social capital, mental and physical health between people living in four postcode areas with contrasting socio-economic status within metro-Adelaide. A central focus was with the impact that neighbourhoods characteristics have on the health and well-being of local communities.
  
• Mitsubishi - "Children's account of the closure of a car factory".
• VicLanes - A multilevel 3-year study funded by VicHealth - collected individual, household and environmental information from 4913 households in 50 areas across Melbourne to examine the relationships between the individual, household and environmental factors that impact on health.
  
• Australian Governments and Health Inequities - an analysis of key documents from each state/territory/federal health department to assess the extent to which documentary evidence suggests that each jurisdiction is aware of, and working to reduce, health inequities.
  
• Social capital and public policy - examined the way in which social capital theory is being used in public policies and programs to improve health and wellbeing in South Australia. It was concerned with the ways in which networking and trust between people in communities (what we call 'social capital') are developed through local, community-based initiatives.
  
• Case Study of South Australia 's Social Inclusion Initiative - A report commissioned by the Social Exclusion Knowledge Network (SEKN) of the WHO's Commission on Social Determinants of Health to act as one of 14 background papers informing the SEKN's final report to the Commission. 

For more information

For more information about the project, please contact us.

The Southgate Institute for Health, Society and Equity, in collaboration with SA Health and other South Australian, interstate and international investigators, undertood research to examine a policy initiative that is intended to stimulate inter-sectoral action to address social determinants of health. This research examined the adoption and implementation of the policy initiative, which is called Health in All Policies (HiAP), to determine its effectiveness in motivating action across sectors to improve population health and health equity. This project was funded by the NHMRC.

Research questions

• To what extent is the SA HiAP approach an effective method of building healthy public policy in order to modify the determinants of population health, well-being and health equity?
• To what extent does the application of policy agenda setting and implementation theory explain the strengths and weakness of the HiAP model as a means of bringing about action on the determinants of health, well-being and health equity across sectors of government?
• How effective is the combination of a program logic and action research as a framework for determining the impact of a complex multi-sectoral policy initiative on population health?

For more information

For more information about the project, please contact us.

Neighbourhoods, communities, housing, and health was interdisciplinary in approach, crossing boundaries that included urban planning, housing studies, sociology and public health. Led by Associate Professor Kathy Arthurson, our focus was on cities and neighbourhoods and investigating the pathways by which characteristics of particular areas are interrelated with achieving health equity, community resilience and social inclusion.

The relocation tool kit: a guide for implementing relocation policies that enhance residents’ health and wellbeing and social inclusion (ARC Linkage)

Background: Over the five decades since its construction, the Carlton Public Housing Estate gained a negative reputation in an increasingly gentrified locality; yet, for its many residents, the estate was their long-term home and social nexus. The 11-year, phased plan, to redevelop the estate’s three sites (Lygon, Elgin and Keppel Street precincts) into a mixed private and public living space started in 2006 with the aim of: increasing housing capacity; improving safety; and integrating public housing with the wider community. This study collected the opinions and experiences of non-returning and returning residents to the Lygon precinct post redevelopment. We partnerned with VicHealth and Brotherhood of St Laurence for this project.

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For more information about the project, please contact us.

The project examined the way in which social capital theory is being used in public policies and programs to improve health and wellbeing in South Australia.

It focused on the ways in which networking and trust between people in communities (what we call ‘social capital’) are developed through local, community-based initiatives.

Public servants and how they intepret the concept of social capital and put their interpretations into practice were examined.

Our partners were the SA Department of Health, Arts SA and the City of Onkaparinga.

For more information

For more information about the project, please contact us.

This longitudinal research project aimed to understand how the loss of employment arising from the closure of Mitsubishi at Lonsdale – a significant manufacturing plant – affected the well-being of workers and their families.

The research examined the processes of adjustment and change – health impacts, loss of job and possible loss of income – affecting workers and their families who were made redundant or accepted voluntary redundancy packages.

Our partners were Australian Housing and Urban Research Institute.

For more information

For more information about the project, please contact us.

This research project examined uptake of evidence on social determinants of health and health inequities (SDH/HE) in Australian health policy. We examined uptake of evidence in all Australian governments’ strategic health policy documents current circa 2012-13. We also conducted eight case studies to examine the policy agenda setting process; interviewing policy actors involved in the development of eight policies that we had identified as good practice on addressing SDH/HE.

Our document analysis found that, while recognition of evidence on SDH/HE was very widespread in health policy, the strategies proposed were confined predominantly to medical care or individualised programs to encourage healthy behaviours. This process within policy of shifting the focus from SDH to individualised interventions is sometimes referred to as ‘lifestyle drift’.

Our case studies identified a range of factors influencing agenda setting processes, to get SDH into health policy in a meaningful way. The most successful policy in this regard was the National Aboriginal and Torres Strait Islander Health Plan. Here, Aboriginal and Torres Strait Islander non-government organisations in the health sector collaborated to shape the agenda setting process and insist on a partnership approach with government. In our assessment, the resultant document was the first in national Aboriginal and Torres Strait Islander health policy to fully take account of social determinants of Indigenous health and put culture at the centre.