@WePublicHealth

2019

15 July

This week we will hear about informed consent from Pip Brennan, Executive Director of the Health Consumers Council in WA (@hconcwa), an independent, not for profit organisation dedicated to ensuring the consumer voice is at the heart of health policy, service planning and review. Pip has worked in the community sector for the last 18 years. Inspired by her own experiences of the confusing maternity care system, Pip initially volunteered as a maternity consumer representative in a range of roles. She began her paid health career as an advocate working at the Health Consumers’ Council (HCC) from 2006. She has been a conciliator of health complaints, a health NGO professional and always a firm believer in the value of consumers being at the table. She took on the role of Executive Director of the Health Consumers Council in WA from 2015 and was a panel member on the state’s recent Sustainable Health Review.

8 July

1 July

24 June

Elyse Cain is Advocacy Manager at the NSW Council of Social Service @_NCOSS_. She works with the health and community sector, vulnerable groups and the NSW Government to improve outcomes in the community and reduce poverty and inequality in NSW. This week, Elyse will be tweeting about the social determinants of health off the back of the recently announced NSW Budget, including what the Budget means for people doing it tough.

17 June

Summer May Finlay RT-ed from the Lowitja Institute’s 2nd International Indigenous Health Conference on the Larrakia Nation in Darwin.

10 June

Melissa Sweet shared news and analysis of New Zealand’s Wellbeing Budget as per below:

My interest in the Wellbeing Budget was piqued last year when I had the chance to do this interview with Professor Louise Signal (@SignalLouise) about efforts to tackle child poverty in Aotearoa/New Zealand. She was participating in a Centre for Research Excellence on Health Equity meeting at the time.

According to NZ’s Prime Minister Jacinda Ardern, the Wellbeing Budget broadens “our definition of success for our country to one that incorporates not just the health of our finances, but also of our natural resources, people and communities” – see more here.

The Budget acknowledges that “just because a country is doing well economically does not mean all of its people are”.

It puts the focus on addressing challenges like the mental health crisis, child poverty, domestic violence and the environment and says “we cannot meaningfully address complex problems like child poverty, inequality and climate change through traditional ways of working…”.

“Making the best choices for current and future generations requires looking beyond economic growth on its own and considering social, environmental and economic implications together,” it says.

Overview

Here are the five priorities of the Wellbeing Budget, including ‘a sustainable and low-emissions economy’.

Here you can read about the evidence behind the Wellbeing Budget’s priorities and how the processes differed from usual budgets. Looks like it was about busting silos and fostering cross-portfolio collaboration.

Wouldn’t it be great to have some fly-on-the-wall analyses of the Wellbeing Budget processes – what were the facilitators and roadblocks for getting politicians and bureaucrats to work differently. Wonder if Professor Louise Signal or others can advise if this sort of work is being undertaken?

Here you can delve into the Living Standards Framework Dashboard, “a practical set of meaningful current and future wellbeing indicators” to assist.

It’s acknowledged this is a first iteration and that more work is needed to “improve known gaps and limitations. These include more fully and richly expressing and representing Te Ao Māori perspectives, child wellbeing, NZ cultural identity, and risk and resilience”.

These are the 12 domains of wellbeing identified in the Wellbeing Budget, including ‘civic engagement & governance’. You can read the full budget document here.

Here is a rather cautious welcome from the New Zealand National Office of the Royal Australian and New Zealand College of Psychiatrists, @ranzcp_nz.

Commentary and analysis

My first port of call is The Conversation – a very useful source for news and analyses on public policy matters (and another reminder of the importance of ensuring sustainability of public interest journalism initiatives).

In this article, Professor Troy Baisden of University of Waikato investigates the likely environmental impacts of the Wellbeing Budget, and  says that it “signals a meaningful shift, but more in intention than sufficient funding”.

He also says there has been “a persistent pattern through the past decade of underspending compared to what was announced in budgets”, so it may be a case of ‘keep watching this space’ to see what the Wellbeing Budget delivers for environmental health.

In this article, Professor Christoph Schumacher from Massey University explores whether the Wellbeing Budget deserves this title. He acknowledges the arguments for moving beyond GDP as the dominant indicator.

He writes:

GDP doesn’t tell us whether people are struggling to meet basic needs or if everyone has access to health care & education.

Neither does it give insight into whether people have social connections, feel safe, are happy…”

He lists the Budget’s investment in mental health, in Whānau Ora (a programme that puts Māori families in control of services they need), and investment in tackling family and sexual violence. Interestingly, the mental health budget provides a funding boost for Housing First.

Arthur Grimes, Professor of Wellbeing and Public Policy (great title!), from Victoria University of Wellington, looked at precedents for the Wellbeing Budget before it was handed down.

Surprise, surprise! He notes that the Australian Treasury had a wellbeing framework, way back in 2004 when John Howard was PM.

The Treasury wellbeing framework built on an Australian Bureau of Statistics (ABS) publication from 2001, Measuring Wellbeing: Frameworks for Australian Social Statistics.

The Australian Treasury’s wellbeing framework “never made it to the frontline of political debate”, says Grimes, citing this 2011 paper.

Grimes also notes that other conservative leaders have engaged with the concepts behind the Wellbeing Budget, including David Cameron in UK in 2006, and French president Nicholas Sarkozy in 2009. So the NZ approach is “far from new”, he says. And yet…

Meanwhile, Dominic O’Sullivan, Associate Professor of Political Science at Charles Sturt University, has written on the Budget and ‘Lessons in the politics of Indigenous self-determination’.

He says the Wellbeing Budget “makes a significant contribution to Māori self-determination”, and also notes that Māori representation in the NZ Parliament has been guaranteed since 1867.

Dr Kate C Prickett from Victoria University of Wellington laments the absence of children’s aspirations from the Wellbeing Budget. While it’s important to tackle childhood poverty, she says children’s views of wellbeing are far more wide-ranging.

She cites research asking thousands of NZ kids what makes a good life. The findings: to have enough money for the basics (but perhaps a treat once in a while), strong and healthy relationships with their families and peers, and to be accepted as they are, free of bullying, racism and discrimination.

Prickett questions whether the Wellbeing Budget includes measures to support this last aspiration of NZ children.

Her conclusion regarding the Budget and children:

If we don’t make children part of the well-being equation, above and beyond a focus on those living in poverty, they might begin to look more and more like the budget losers over time.”

But of course the impact of acting on climate change and environmental degradation also needs to be considered as acting in the interests of children, thinking of their futures, and their children’s futures…

Here is another academic identifying another gap in the Wellbeing Budget: Simon Chapple from Victoria University of Wellington says the NZ Govt “missed a major trick in not making unemployment one of their central well-being priorities”.

Views from other media

Writing for Bloomberg, Cass Sunstein, author of “The Cost-Benefit Revolution” and a co-author of “Nudge: Improving Decisions About Health, Wealth and Happiness”, wrote this article, ‘New Zealand’s Wellbeing Budget Is Worth Copying‘.

He said it had been influenced by researchers including Nobel Prize winner Daniel Kahneman and the late Alan Krueger, who offered two important findings about what increases people’s wellbeing and what reduces it.

Firstly, “focus on mental health interventions,” and secondly “focus on time allocation,” by helping people to shift away from activities that they especially dislike (such as commuting, which can take a significant toll).

This article also cites the annual World Happiness Report produced by the UN Sustainable Development Solutions Network, which highlights the importance of social support.

This is determined by how people answer: “If you were in trouble, do you have relatives or friends you can count on to help you whenever you need them, or not?”

Whether a nation’s citizens say “yes” or “no” is a significant determinant of how happy they are.

The article concludes: “New Zealand has taken an important step in the right direction. Other nations should follow its lead.”

Meanwhile, it seems chartered accountants are not so enamoured, raising a series of questions and suggesting the Budget is “more evolutionary than revolutionary”:

The Wellbeing Budget made headlines around the world. A column in The Washington Post was quite positive, titled ‘What nation isn’t obsessed with ensuring economic growth?’.

It said:

It remains to be seen how effective [the Wellbeing Budget] will be at addressing the issues it calls out, or whether the initiative will outlast the tenure of progressive Prime Minister Jacinda Ardern.

But as a statement of values and a signpost for other modern governments, it’s a major step.”

This article in The Guardian quotes extensively from NZ finance minister, Grant Robertson, who says the Wellbeing Budget:

…responds to New Zealanders’ values. Yes, we want to be a prosperous country, of course we do, but we also care about who shares in that prosperity and how it is sustainable.

I genuinely think people’s sense of wellbeing is about the broader sense of the community, of the environment, and of their family and the people around them.”

The article asks: Should the UK follow suit? After all, the Welsh government’s 2015 Wellbeing of Future Generations Act, requires public bodies in Wales to take into account the social, cultural, environmental and economic impact of decisions. (And you can read more about that Welsh Act here).

Meanwhile, the Huffington Post reports a variety of views.

“What Jacinda Ardern is doing is groundbreaking,” said Jason Hickel, an anthropologist at the London School of Economics. “Ardern’s government is setting an example that the rest of the world can and should follow.”

“It is sobering that this is the first time we have had a national budget that explicitly focuses on well-being,” said Anna Matheson, senior lecturer in health policy, Victoria University of Wellington.

“Challenges facing humanity globally – increasing inequality, rising populism and rapid environmental degradation, including the crisis with our climate – show governments worldwide are missing the crucial and pivotal role they play in stewardship, and in creating/maintaining collective well-being.”

Not everyone is a fan, however.

“I think this Wellbeing Budget is nothing else than a public relations operation,” said Dennis Wesselbaum, director of foreign policy at Otago University. “This budget means the government does not care about economic growth and this is a worrying and dangerous development.”

Meanwhile, it is worth making time to read this detailed analysis by the Child Poverty Action Group, @childpovertynz (and thanks Dr Rhys Jones for the lead).

The CPAG congratulates the Government for reframing the Budget to reflect human wellbeing outcomes, and says its priority areas are largely needed as a result of a low wage economy, inadequate welfare support, inequality and intense personal structural pressures caused by poverty.

However, the group says that “billions are to be spent in addressing the outcomes of social injustice but little is to be spent in transforming the actual causes of the issues”.

It says the Budget “fails to be genuinely transformational because its focus is on ameliorating the impacts of poverty rather than addressing its root causes”.

And also read a range of takes courtesy of The Spin Off (which incidentally describes itself as “the mid-shelf red wine of NZ journalism”).

3 June

Associate Professor Anne Tiedemann – @AnneTiedemann1 – tweeted from The International Society of Behavioral Nutrition and Physical Activity (ISBNPA) conference in Prague, Czech Republic. A/Prof Tiedemann is an NHMRC Career Development Fellow and Principal Research Fellow at Sydney School of Public Health, The University of Sydney. She leads a program of research focussed on physical activity for healthy ageing and fall prevention. A/Prof Tiedemann’s research aims to bridge the gap between the compelling evidence of the importance of physical activity for maximising health and the very low rates of participation across the population, particularly in middle to older age. Over the past 10 years, Anne has led research exploring the design and evaluation of low cost, sustainable strategies for preventing falls and increasing physical activity for people aged 50 years and over. Follow #ISBNPA2019.

27 May

This week Marlee Silva – @Marlee_Silva – covered National Reconciliation Week. Marlee is a 23-year-old Kamilaroi and Dunghutti woman from Sydney. Monday to Friday she’s a specialist Indigenous consultant for Cox Inall Ridgeway, every other day she’s a writer and somewhere in between she balances this with being the founder and curator of Tiddas 4 Tiddas, a social media-based empowerment network dedicated to celebrating Indigenous women and girls. She’s passionate about her culture, family and building a brighter future for her people in every way possible.

20 May

This week, the @CroakeyNews team is sharing Federal election news & analysis. #AusVotesHealth

13 May

This week, @mariemcinerney covered the @RANZCP‘s annual psychiatry congress #RANZCP2019 and tweeting on #AusVotesHealth

6 May

Alison Verhoeven and a tag team from the Australian Healthcare and Hospitals Association (AHHA) covered election health matters this week. The AHHA is Australia’s national peak body for public and not-for-profit hospitals and healthcare providers. Its membership includes state health departments, Local Hospital Networks and public hospitals, community health services, Primary Health Networks and primary healthcare providers, aged care providers, universities, individual health professionals and academics. The AHHA seeks to be an independent, national voice for universal high-quality healthcare to benefit the whole community.

29 April

Mark Diamond is CEO of the National Rural Health Alliance – @NRHACEO. Mark has extensive experience in the planning, development and delivery of health, community and aged care services in regional, rural and remote settings in four state and territory jurisdictions over 35 years. During his week on @WePublicHealth, he tweeted on what matters for rural and remote health ahead of the federal election.

22 April

This week the Croakey News team shared some of the #AusVotesHealth news ahead of the Federal election.

15 April

Terry Slevin (@terryslevin), CEO of the Public Health Association of Australia, discussed the health implications of the Australian federal election.

Adjunct Professor Slevin is one of Australia’s foremost experts in public health and health promotion, currently serving in the role of Director of Education and Research at Cancer Council Western Australia following several other roles at the Council since 1994. He is also a notable member of the PHAA, being a Fellow of the Association and having previously served in the role of Vice President on the Board.

9 April

Dr Melissa Stoneham – @DrMelStoneham –  covered the 23rd IUHPE World Conference on Health Promotion, Rotorua, Aotearoa/New Zealand 7-11 April. Hosted by the Health Promotion Forum of NewZealand . Follow #iuhpe2019.

1 April

Lyn Morgain – @MsLynM –  the Chief Executive of cohealth, Victoria’s largest community health organisation, was in the chair. Lyn attended the What Works Summit in Reykjavik Iceland. This invitation event brought together diverse leaders from all over the world to consider the latest thinking on advancing social progress to achieve the Sustainable Development Goals.

Anchored by the Social Progress Index, a powerful bench-marking tool to connect decision makers with fresh perspectives on social performance, the third What Works global summit will bring together leaders and change makers from business, government, and civil society. Through focused case studies, debate and interactive workshops, participants will leave with new tools and innovative solutions, along with a strengthened network and prospective partners to help drive social change. The summit will consider how the SPI tools can be used to achieve the SDGs and create positive policy change at every level of government, and how all stakeholders can work together to advance social progress. The summit represents a great opportunity to learn from thought leaders about best practice social impact measurement, knowledge sharing and research to generate social change.

Lyn has been an executive leader in public policy, not for profit organisations and government over the past twenty five years, holding community well being, planning, governance and community service portfolios. She is a sought after facilitator, chair and speaker and has published numerous journal articles on primary care and the social determinants of health. She is passionate about strength based approaches that engender community ownership and control over service design, development and delivery. As part of the leadership of cohealth she is responsible for supporting the delivery of a diverse range of complex social and clinical service models that engage communities with poor health status, utilising a social model of health. Increasingly these programs are integrated, locally orientated and designed in partnership with consumers. Her interests include the impact of discrimination, stigma and marginalisation on health and the role of advocacy in the development of equitable public policy and consumer led practice. Lyn has extensive experience in the initiation and execution of community alliances aimed at effecting change, at the local, state and national level. Lyn is a member of the Victorian Justice Health Ministerial Advisory Committee and the Community Health Taskforce. She sits on the board of the Footscray Community Arts Centre.

25 March

@CroakeyNews retweeted the news from the 15th National Rural Health Conference in nipaluna/Hobart (#ruralhealthconf), and the Equally Well conference in Melbourne, with a focus on the physical health of people with mental illness (#EquallyWellAust).

#EquallyWellAust

#RuralHeathConf

18 March

Dr Tim Senior – @timsenior – tweeted about the NSW election and health, and Close the Gap Day.

He is a GP who works in Aboriginal health, and who crowdfunded the Wonky Health columns at Croakey, investigating the impacts of policies upon health. He is a contributing editor at Croakey, and also a contributor to the #JustJustice project. He is also a regular columnist with the British Journal of General Practice and won the inaugural Gavin Mooney Memorial Essay Competition, writing about climate change and equity.

Please read his 2013 article: The difference between Close the Gap and Closing the Gap and why it matters https://croakey.org/the-difference-between-close-the-gap-and-closing-the-gap-and-why-it-matters/

Also, read his compilation and article about his tweets https://croakey.org/the-nsw-election-whats-health-got-to-do-with-it/

12 March

Indigenous Eye Health – @IEHU_UniMelb – is a research group within the Melbourne School of Population and Global Health. IEH was established by Professor Hugh Taylor in 2008 with the aim to Close the Gap for Vision for Aboriginal and Torres Strait Islander peoples through world-leading research, policy formation, advocacy and implementation. Research has established the state of Indigenous eye health in Australia and current service availability and explored barriers and enablers to the delivery of eye health services for Indigenous peoples. The evidence gathered has guided the development of a comprehensive policy framework – The Roadmap to Close the Gap for Vision – that is supported by the Indigenous and mainstream health sectors and government.

IEH is currently actively engaged in supporting implementation of the Roadmap by providing the necessary advocacy and technical support to Close the Gap for Vision.

@IEHU_UniMelb covered The Close the Gap for Vision by 2020 National Conference 2019 (#CTGV19) in Alice Springs on March 14-15. It is co-hosted by Indigenous Eye Health at University of Melbourne and Aboriginal Medical Services Alliance Northern Territory (AMSANT). The conference was also supported by our partners, Vision 2020 Australia, Optometry Australia and the Royal Australian and New Zealand College of Ophthalmologists.

4 March

Dr Megan Williams – Senior Lecturer in Aboriginal Health and Wellbeing at the Graduate School of Health, UTS – previewed some of the key health issues ahead of the NSW election.

She has over 20 years’ experience combining health service delivery and research, particularly focusing on Aboriginal peoples’ leadership to improve the health and wellbeing of people in the criminal justice system and post-prison release. Megan is a Wiradjuri descendent, and also has Anglo-Celtic heritage. She is a contributing editor at Croakey and a member of the #JustJustice project.

25 February

Dr Liz Sturgiss – @LizSturgiss – discussed primary healthcare; what is it and how does it function alongside public health? Is primary healthcare a function of public health? Are we on different paths heading to the same destination? 

Primary health care was recently re-affirmed by the WHO in the Declaration of Astana at the Global Conference of Primary Healthcare in Kazakhstan. Strong primary healthcare – available to all members of a community – is recognised as the most efficient, effective, and cost-effective way of achieving high levels of population health.

Liz is a GP and primary care researcher at the Department of General Practice at Monash University. She has an interest in obesity and particularly how the condition is influenced by the environment we live in. She is passionate primary care researcher who wishes she had a dollar for every time she’s heard, “I didn’t know GPs could do research.” 

Liz opened up the world of primary care to compare the goals of public health and primary care, sharing a look behind the scenes at how primary care research happens, introducing some of the talented researchers in Australia, and exploring the important health issues that are being tackled right now by primary care researchers.

Liz also live-tweeted from the International Medicine in Addiction conference in Melbourne (1-3 March), which focused on behavioural addictions and addiction in marginalised/complex populations.

18 February

The Council for Intellectual Disability (CID @nswcid) shared the history of deadly disability discrimination and outlined the health inequalities faced by people with intellectual disabilities. 

Council for Intellectual Disability is a NSW based disability rights organisation led by people with intellectual disability. For more than 60 years we have been working to ensure a community where all people with intellectual disability are valued. We speak up on the big issues, we provide information and learning opportunities, we empower individuals and communities.

People with intellectual disability experience stark health inequalities including the research showing that up to 50% of deaths of people with intellectual disability are potentially avoidable. This is three times the rate of avoidable deaths for the general population.

CID has been advocating for action on this issue for many years and there have been major advances in NSW with the State government funding intellectual disability health services around the state to provide specialist backup to mainstream services.

Now, it is time for action at a national level. This week we will be launching our campaign for commitments by the major parties. We will be calling for specific actions to improve doctor and nurse training and primary health care for people with intellectual disability.

This is a joint campaign with our national body Inclusion Australia. Collaborators in the campaign are Down Syndrome Australia, the Australian Association of Developmental Disability Medicine and the Department of Developmental Disability Neuropsychiatry at UNSW.

11 February

Korina Richmond and Wendy Watson (@BustJunkAds) covered food marketing to children, how food marketing influences children, what’s the link with obesity and cancer, what are the current issues with food marketing regulations (or lack thereof) and what can be done at a state government level, highlighting our current advocacy work calling on the NSW Government to remove junk food advertising from state-owned property.

We work within the Cancer Prevention and Advocacy Division @CCNewSouthWales.  With one in three cancers being preventable, we are passionate about helping people lead healthy lifestyles through building knowledge and creating an environment where it’s easy to make healthy choices.  Our food policy work includes strategic research and advocacy into food marketing to children.

4 February

Croakey editor Dr Ruth Armstrong – @DrRuthAtLarge – shared stunning views and public health news from a family road trip across national parks in the United States.

28 January

Dr Melissa Stoneham – @DrMelStoneham – director of the Public Health Advocacy Institute of WA gave an overview of critical public health issues and events for 2019.

21 January

19-20 January

Simone Cameron (@simone_cameron_), a member of the Home to Bilo group, and a registered migration agent who has previously worked with asylum seekers and refugees in Biloela, covered a series of rallies held on behalf of a Tamil family and their Australian-born children who are facing deportation. Read more here.

14 January

Kicking off a national conversation on alcohol and health this week – FARE – @FAREAustralia – an independent, not-for-profit organisation.

7 January

Kicking off 2019 for @WePublicHealth is Associate Professor Lilon Bandler – @DrLilon. As an Associate Professor in the Indigenous Health Education Unit, Sydney Medical School (University of Sydney), Lilon is responsible for the development, integration and implementation of comprehensive Indigenous health learning and teaching resources for the Sydney Medical Program, as well as providing personal and academic support of Indigenous medical students, and increasing the recruitment of Aboriginal and Torres Strait Islander students to medicine. She has broad teaching experience, across the spectrum of undergraduate and postgraduate medical education. A/Prof Bandler has worked in general practice for over 20 years, and continues to work part-time in rural, remote and very remote western New South Wales.