@WePublicHealth

21 October

This week, follow the news from #ISQua2019 – the 36th International Society for Quality in Health Care conference in Cape Town South Africa with the title Innovate, implement, improve: beating the drum for safety, quality and equity. A team from @AIHI_MQ – the Australian Institute of Health Innovation based at Macquarie University in Sydney – will be attending the conference which welcomes delegates from low, middle, and high-income countries around the world. Topics include how to Reduce Medication-Related Harm, a WHO Global Patient Safety Challenge.

Why is patient safety now listed as one of WHO’s top priorities? By most estimates, there’s a one in a million chance of being harmed in a plane crash—while not entirely reassuring, that figure is hardly likely to stop most people from booking a flight. But what about taking a loved one to hospital? WHO estimates that worldwide there’s a one in 300 chance of being harmed during any form of healthcare. In Australia, where we have more than 11 million hospitalisations per year, that figure is about one in ten. Researchers from the Australian Institute of Health Innovation are focussed on understanding that figure and finding ways to reduce it while also ensuring safe, equitable access to healthcare for all Australians and informing reform efforts around the world. ISQua is a member-based, not-for-profit community and organisation dedicated to promoting quality improvement in healthcare. The network includes members from more than 70 countries and 6 continents.

The Australian Institute of Health Innovation has an absolute commitment to improving healthcare services and systems in Australia and beyond. We aim to create world-class, high-impact research that makes a difference for patients, health professionals and society more broadly. We are a research-intensive organisation located within the unique campus of MQ Health at Macquarie University, Sydney, Australia. MQ Health is Australia’s first fully integrated academic health sciences centre, combing excellence in clinical care with teaching and research.

14 October

@GroundSwellAus and @PHPalCare tweeted from #PHPCI2019 – the 6th Public Health Palliative Care International Conference, held from 13 – 16 October in the Blue Mountains in NSW, with the title: Compassionate Communities in Action: Re-claiming Ageing, Dying and Grieving. A public health approach to end of life care views the community as an equal partner in the long and complex task of providing quality healthcare at the end of life. There is now a significant body of evidence about the public health approach, and this conference signals a new era for international research and practices. The Public Health Palliative Care International Conference brought together leading practitioners, researchers and innovators from across the world. Co-hosted by The GroundSwell Project, Western Sydney University and Public Health Palliative Care, it was the first time the conference had been held in the southern hemisphere – it recognises the innovative practices, policies and funding models that are emerging such as compassionate communities, person centred care, and primary health. The conference was timely as governments and citizens work towards the right care being provided to the right people in the right place and at the right time.

7 October

The National Aboriginal and Torres Strait Islander Health Worker Association’s NSW board representative David Follent – @Fuzor – tweeted from the 10-year anniversary conference: ‘A Decade of Footprints, Driving Recognition’. In a first for @WePublicHealth, he was announced as the new chair of NATSIHWA during his stint as guest tweeter. Read more about the conference in this report from NATSIHWA.

30 September

Dr Holly Northam OAM – @hollynortham – from the University of Canberra profiled #RestorativeHealthCare. Northam brings over 30 years of clinical experience to her research and teaching practice. She has a strong social justice focus that is underpinned by her professional identity as a nurse and midwife. Her PhD study, Hope for a peaceful death and organ donation, identified that more must be done to alleviate suffering caused by communication failures in healthcare. She played an instrumental role in setting up and running the ACT Organ and Tissue Donation Service and has been recognised for her expertise in this specialisation. Northam’s research and teaching approaches are framed using the lens of hope and restorative practice to identify and support vulnerable people in health settings.

23 September

This week, the @CroakeyNews team shared stories and reflections from the #CoveringClimateNow initiative:

About to wrap up our RT-ing this week of the #CoveringClimateNow news-feed with a few key articles and reflections. (But please keep following the hashtag as we and others are continuing to publish articles as part of this global media collaboration).

This story from CBS News was not part of the #CoveringClimateNow as such, but provides important context for the discussions: How North America lost nearly three billion birds over the last 50 years.

I find it hard to fathom numbers and losses like these. Where should we focus our attention/action/energy when there is so much terrible news about the state of planetary health?

The climate crisis entails so much injustice at so many levels. This is one powerful example, from Bhutan:

While the rest of the world is struggling to reduce its carbon emissions, Bhutan has long achieved and maintained its ‘carbon negative’ status. The majority of its electricity comes from hydropower, and over 70% of the country comprises protected forests.

As per the Energy and Climate Intelligence Unit’s “carbon comparator” tool, its forests absorb at least three times the amount its population emits”. But of course that does not protect the country and its people.”

On related, listen to environmentalist and former Prime Minister of Bhutan Tshering Tobgay on the devastating implications of glacier melting in the Hindu Kush Himalaya region for one-fifth of humanity.

He says:

If you can’t care for those affected by the melting of glaciers then you should at least care for yourselves…That’s because the Hindu Kush Himalaya region…is like the pulse of the planet. The entire planet will eventually suffer.”

Why should the rest of the world care? Former Prime Minister of Bhutan Tshering Tobgay raises the prospect of conflict over water, and political destabilisation in a region with three nuclear powers.

As part of the #CoveringClimateNow initiative, at Croakey, we have been seeking to bring the hashtag into wider conversations, in order to share stories/ideas/connections across different Twitter threads and groups. #ConnectiveTheory

As we did with this story: ACT upstages the federal government with low-cost carbon policy.

This story is also a reminder of the importance of having some focus on solutions in our coverage.

#CoveringClimateNow has also been an opportunity for critique, reflection and examination of media and journalism practices around the climate crisis, and it’s been informative to follow some of these conversations around the world.

As an aside, was this the best headline about the IPCC Special Report on the Ocean and Cryosphere in a Changing Climate? Climate change: UN panel signals red alert on ‘Blue Planet’.

The BBC reported: “In a nutshell, the waters are getting warmer, the world’s ice is melting rapidly, and these have implications for almost every living thing on the planet.”

It is clearly no time for business as usual. As you may have seen, we have launched a campaign to raise funds for public interest journalism to put a sustained focus on health and the climate crisis – please support if you can.

16 September

This week, a tag team of guest tweeters from the NHMRC Centre for Research Excellence in the Social Determinants of Health Equity tweeted from #CREHealthEquity, the Centre’s final policy symposium, titled Promoting health equity: From knowing to action. They also covered #AustPH2019, the 50th anniversary conference of the Public Health Association of Australia, the #climatestrike in Adelaide, and a People’s Health Movement event, including a tribute to the late Professor David Sanders. Guest tweeters included @BelTownsend @baumfran @SharonFrielOz @drtobyfreeman. (Read more from #AustPH2019 here).

9 September

This week, a tag team previewed some of the key climate and health issues as part of Croakey’s contribution to #CoveringClimateNow, a global media collaboration leading up to a summit in New York City on 23 September. A PDF of the coverage can be downloaded here here.

2 September

Hazel Bucher (@NPHazel) is a Hobart-based aged care/mental health Nurse Practitioner. She tweeted from the Australian College of Nurse Practitioners National Conference in Melbourne. https://www.acnp.org.au/conference-2019. Read more about Hazel here.

26 August 

This week @BronwynHemsley was in the chair for Speech Pathology Week. She is Chief Investigator of the SafetyCATCH project, for “Keeping People with Communication Disability Safe in Hospital”.

19 August

@NTShelterInc, NT Shelter, is the Northern Territory’s peak body for affordable housing and homelessness, Our vision is appropriate and affordable housing for ALL Territorians, especially those with low income, and those particularly vulnerable and disadvantaged in the housing market.

NT Shelter will be utilising the @WePublicHealth platform to share resources and statistics about the housing+health intersects in the Territory (particularly as related to rheumatic heart disease and for dialysis patients), in the context of the homelessness crisis in the Territory – where 13,717 people are experiencing homelessness right now, at a rate of12 times the national average.

88.5% of homeless persons are Aboriginal (despite representing just one third of the Territory’s population); 83% live in severely overcrowding dwellings; and 71% live in remote communities.

In 2017-18, 4,494 people were turned away from services. And despite the highest rates of homelessness in the country, the NT receives the least amount of funding support from the Federal Government. We know that access to appropriate and affordable accommodation is critical for preventing a range of health conditions, as well as for supporting the recovery of many others.

12 August

The GroundSwell Project vision is that when someone is dying, caring or grieving, we all know what to do. GSP undertakes a range of community initiatives to help develop #DeathLiteracy. Every year in August Dying to Know Day (#D2KDay) is held and it’s become a people powered movement that talks about, plans for and celebrates community knowledge around death, dying and grief.  It’s become Australia’s biggest conversation about death. Hosting the @WePublic Health account, we talked about #D2KDay, #DeathLiteracy and why it matters, along with ideas on how we can all contribute to creating more compassionate communities around end of life care, including palliative care. Plus we shared some of the highlights of the upcoming Public Health Palliative Care International (#PHPCI2019) conference we are cohosting in Oct. Follow: @GroundSwellAus

5 August

Dr John Hall – @JHRural – is the current President Elect of RDAA and has been the Vice President from 2014 – 2017. Dr Hall Graduated from the University of QLD in 2000. He worked as a Rural Generalist Obstetrician in Stanthorpe for 4 years before moving to Oakey as the Medical Superintendent, where he worked in that role until 2016. In 2014 Dr Hall became the sole director of the private practice in Oakey, Downs Rural Medical. DRM, employs 20 doctors across three sites including Oakey, Kingsthorpe and Toowoomba. He continues to practice as a GP Obstetrician as a VMO in St George QLD and Cooma, NSW. Dr Hall was one of the founding members of the QLD rural Generalist Pathway team. He served as RDAQ president in 2008. He is currently a director on the board of AMAQ. He has a passion for teaching the next generation of rural doctors, currently as a senior lecturer in rural medicine for Griffith and UQ. His practice currently educates doctors at all levels including medical students, hospital based residents, and GP registrars. He was an early adopter of social media, founding the RDAQ and RDAA Twitter handles @Ruraldocsq and @RuralDoctorsAus and Facebook pages, and managing them in the early years. He has a passion for rural medical research and health policy development and advocacy. John is currently studying towards his Masters of Public Health and Masters of Business Administration at JCU.

29 July

Adjunct Associate Professor Christopher Carter, CEO of the North Western Melbourne Primary Health Network, covered the #NavigatingHealth #CroakeyGO that was held in Melbourne on 1 August, profiling patient journeys through mental health services. Chris is a broadly skilled leader in health and primary healthcare with extensive experience in managing complexity, driving transformational change and delivering organisational outcomes. His experience encompasses strategic planning of services, service and system redesign, organisational development, redesigning and implementing new models of care or service delivery and building organisational capacity through collaboration and partnerships with a variety of organisations. Chris’ career has included work as an allied heath practitioner, an educator and policy maker, an international development and evaluation consultant, and as an advocate for young people and marginalised populations in a variety of roles. Chris’ qualifications include a Master of Business Leadership, Graduate Diploma in Health Promotion, Bachelor of Social Work, and an Executive Certificate in Leadership and Management. Read more about the #NavigatingHealth #CroakeyGo.

22 July

The Mental Health Victoria’s Ageing and Mental Health Summit, held in Melbourne on 24 July, sought to put mental health firmly on the aged care reform agenda while planting aged care in the minds of mental health reformists. Dave Peters, @dPeters1977, live-tweeted the discussions, which were also reported for Croakey Conference News by Marie McInerney.

15 July

This week we heard 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

Based at the Indigenous Studies Unit at the University of Melbourne, @DataIndigenous provides coordinating support to organisations collecting and storing data about Indigenous Australians, and guest tweeted about Indigenous Data Sovereignty. Read more: http://bit.ly/30sf7qB. The text below is taken from a series of detailed Twitter threads:

“Over the course of the week we will be working from the ground up, starting with a background on Indigenous data generation and management in both colonial and non-colonial settings, followed by an incremental elaboration of contemporary objectives.

Throughout this week-long elaboration on Indigenous data governance, we will be referring to a number of co-lateral issues relating to health, education, economics, justice system engagement, and cultural heritage preservation in Australia.

If at any point you would like a quick background on the @DataIndigenous initiative, please head over to our website. In particular, have a look at our Resources page, where you will find a number of accessible information sheets addressing key aspects.

In order to properly articulate the objectives of @DataIndigenous, we need first to explain what we mean by ‘Indigenous data’, and at a more general level, what we mean by ‘data’. These terms and definitions have very specific meanings.

At a very general level, in a day-to-day sense, ‘data’ has a loose meaning: A plural for ‘datum’ – some unit of information or knowledge that has been reduced to some degree of granularity. But what degree? At what point does information transform into data?

Thankfully, the answer is pretty simple: Information is transformed into data when it becomes useful to measure the *occurrence* of some part of information. This means that data emerges from information, when that information has been reduced to point that it can be *counted*.

The important part of this explanation here, is *usefulness*: We are talking about the the *utility* of counting information at a particular level of specificity. What is the point of counting ‘parts’ of information, such that data is generated as a result?

It is self-evident that different fields of expertise use information in different ways: For example, information about temperature is used by meteorologists measuring weather, but also by medical doctors in measuring responses to infection.

Variation in the utility of meteorological vs medical information about temperature correlates with variation in the the transformation of temperature *information* into temperature *data*.

We might say that we ‘feel hot’, knowing that such a statement expresses information. But *data* measuring a 40ºC temperature means something very different about that statement, depending on whether we are measuring a human body, or the weather.

Everyone generates data whenever we measure aspects of information. We learn to do this as children when we are taught how to describe our experiences using metric concepts: How hot or cold something is; how big or small; how fast or slow; how many of something we can count, etc.

A tacit understanding of how to transform information into data is a universal feature of all human language development, and of all cultures.

All cultures also maintain their own specialised languages for generating information about specific domains of experience. These include, for example, astronomy, engineering, music, art, religion, etc.

Because of distinctive histories and environmental conditions, many cultures also maintain specialised languages for generating information that is relatively unique. Obvious examples include information on how to survive in extreme environments, such as deserts, or the arctic.

One such relatively unique language, which belongs most distinctively to Europe, is that of colonialism. This is a specialised language that has developed to generate information about the invasion of foreign lands, and the seizure of other peoples’ resources.

The specialised language of colonialism, and the information to which it gives rise, is not strictly discrete, but rather assembled from a collection of other specialised languages that have subfields for generating information about Indigenous peoples.

Many of these subfields can be identified by the prefix ‘ethno-‘, e.g. ethnomusicology, ethnobotany, etc. The most specialised colonial language is that of the freestanding field of ethnography, and its elaborated form, social anthropology, also known as cultural anthropology.

In colonial contexts such as Australia, other attendant expert fields are also adapted for the purposes of ‘Indigenous Affairs’ administration, including especially health, education, economics, law, and more broadly, demography.

Cumulatively, these fields give rise to large bodies of specialised information, which in turn encode vast quantities of data about Indigenous individuals and communities.

Although this data appears to be the direct product of colonial administration, which is typically implemented by non-Indigenous people, it is in fact the property of Indigenous people from whom it is extracted, since without their input, it could not exist.

This is one type of Indigenous data. The other type is of course, that generated by Indigenous peoples independently of colonial administration, in the course of exercising autochthonous domains of expert knowledge, e.g. in astronomy, religion, art, music, economics, trade, etc.

So to conclude this thread, Indigenous data is generated both by colonial administration and by Indigenous cultural institutions, via the use of specialised languages to develop discrete domains of specialised knowledge. Data is the quantifiable tertiary product this information.

In the next thread, we will discuss the definition of data as a form of property, which underpins the international movement known as ‘Indigenous Data Sovereignty’, or #IDSov.

In this thread we will talk about the definition of data as a type of property. But before we do that, a good datum point for orienting the conversation is the edited volume ‘Indigenous Data Sovereignty: Toward an agenda’ (2016).

As outlined in this volume, the United Nations Declaration on the Rights of Indigenous Peoples (UNDRIP) forms a cornerstone for Indigenous Data Sovereignty concerns. Chapter 2 by Professor Megan Davis is especially pertinent to this point.

Professor Davis notes that in 2004, within the UN Permanent Forum on Indigenous Issues (UNPFII), “Indigenous participants identified culturally specific data and standardised data to ensure that indigenous peoples were provided with data that were *useful for them*” (2016:28).

The UNPFII argued that, “Research should be carried out in partnership with indigenous peoples” and that, “Case studies allowing for the use of both qualitative and quantitative data [would] provided a holistic view of the welfare of distinct peoples” (Ibid.).

“On the other hand, there was caution expressed that case studies could be problematic because of the paucity of standardised data to compare with the non-indigenous population” (Ibid.).

“The outcomes of the expert group meeting included the following questions relevant to data sovereignty: • For whom are we collecting data? • How do we collect the data? • What should be measured? • Who should control information? • What are the data for?” (2016:29)

Professor Davis goes on to note: “It is important to stress that the [UNPFII] expert group observed that … many of the discussions were ‘intertwined’ with the issue of racial discrimination. …

And that “… Indigenous participants were concerned that statistics, ‘although seemingly neutral’, could be applied for the benefit and the detriment of indigenous peoples” (2016:31).

These points regarding the utility of data both in the service of racial discrimination and in the service of Indigenous liberation *from* discrimination, take us back to the previous thread in this series:

#IDSov added,

This is where the classification of data as a form of property becomes critical. Diane Smith observes in the same volume, citing Martin Nakata & Marcia Langton (2006), and Jodi Bruhn (2014): “The ownership of, access to and control over the use of data are governance issues…

“.. Contrary to contemporary Western conceptualisations of corporate governance and ‘big data’ management systems, indigenous peoples’ governance … of data is not simply about the data. It is about the people who provide and govern an *asset* that happens to be data” (2016:130)

Such conceptualisations of corporate governance, which are a major feature of the Web 2.0 data economy, have emerged as an increasing problem for Western jurisdictions. In response, the EU recently issued the General Data Protection Regulation (GDPR): https://eugdpr.org

Contrary to the trending dominance of corporate monopolies in the quasi-secret trade in personal data, the GDPR explicitly defines data as an asset that belongs to the people who generate it.

This definition of data as a personal asset reinforces a corollary classification by the World Economic Forum (https://www.weforum.org/reports/personal-data-emergence-new-asset-class …), and by the International Financial Reporting Standards Foundation (https://www.ifrs.org/issued-standards/list-of-standards/ias-38-intangible-assets/ …)

Although no legislation comparable to the GDPR yet exists in Australia, especially with regard to Indigenous data, these legal instruments establish an international precedent that, like the UNDRIP, provides a datum point for policy objectives in this national jurisdiction.

In keeping with the work of the UNPFII and the UNDRIP, @DataIndigenous was established partly in order to propagate standardised terms and definitions with this level of formalisation.

Establishing a formal, technically coherent language, consistent with the principles of #IDSov, is considered a pre-requisite for the the legal and functional implementation of Indigenous data governance *by* Indigenous peoples.

In the previous two threads in this series, we worked through …

… the technical definitions of data generally and Indigenous data more specifically, and discussed leading international legal instruments governing rights to data as a form of property, situated within the broader context on the UN Declaration of Rights of Indigenous Peoples.

Today we will be discussing some of the leading community-controlled data governance initiatives around Australia, that are setting a standard for government engagement with Indigenous peoples on an equal footing.

Before we start however, a little bit of house keeping: Yesterday, a question was raised about what the @DataIndigenous initiative is, who it is led by, and who its staff are.

Most of the answers to these questions are available in the first couple of tweets in this week’s thread series, as well as on the @DataIndigenous web site: https://mspgh.unimelb.edu.au/centres-institutes/centre-for-health-equity/research-group/indigenous-data-network.

Tweets from the @DataIndigenous account and from accounts that the IDN has been invited to curate, are the responsibility of the @DataIndigenous initiative and its leadership. If you have any questions or concerns, please feel free to contact us via the details on the web site.

These tweets are being authored by me, James Rose. I am the non-Indigenous technical coordinator of the IDN at the Indigenous Studies Unit, headed by Professor Marcia Langton, within the School for Population and Global Health at the University of Melbourne.

Details about my qualifications and professional experience are publicly available here: https://www.linkedin.com/in/james-w-w-rose-bb6b302a/?originalSubdomain=au … and here: https://unimelb.academia.edu/JamesRose

If you are interested in recent public seminars that I have given on the work of @DataIndigenous, including with Professor Langton, two of the most recent can be viewed here: https://arts.unimelb.edu.au/research/digital-studio/projects/indigenous-australia-and-digital-futures/indigenous-data-network … and here.

Speaking of videos, an especially excellent overview of the importance of community-controlled data governance was recently delivered by @Klick22, @DataIndigenous Steering Committee member and Scientia Fellow at the UNSW Centre for Big Data Research:

https://youtu.be/75G3TNUiRHc

During her recent curation of @IndigenousX, Dr Kalinda Griffiths @Klick22 also delivered an incisive argument in support of Aboriginal and Torres Strait Islander leadership and research excellence in the use and reporting of community data:

https://indigenousx.com.au/lets-talk-about-counting-our-mob/

@DataIndigenous currently works to coordinate community-controlled data governance and research excellence across five primary community service delivery domains, including health, education, employment, justice system engagement, and cultural heritage preservation.

During the 2017 Data Sovereignty Symposium hosted by @IndigenousUoM, leading initiatives from across these domains were presented. This included the work of business intelligence analyst, GIS expert and @DataIndigenous member @darrenclinch.

In this excellent seminar, @darrenclinch explains how existing GIS technologies, which have been used historically to suppress and marginalise Indigenous population data, can be harnessed by Indigenous communities and used as a countermeasure.

Also presented at the 2017 symposium was the work of the Yawuru Knowledge and Wellbeing Project, which developed out of the Yawuru people’s successful native title claim in the Kimberley region of Western Australia

Here, Kimberley Institute CEO Eunice Yu, and Dr Mandy Yap of of The Centre for Aboriginal Economic Policy Research ANU, explain the precedent-setting outcomes of the project’s data collection, modelling and analysis priorities, which were set by Yawuru people themselves.

As also outlined in their contribution to ‘Indigenous Data Sovereignty: Toward and Agenda’ (2016), this community-controlled research project revealed demographic patterns in the Yaruwuru population at a level of detail and accuracy never before achieved: https://press.anu.edu.au/publications/series/caepr/indigenous-data-sovereignty.

Another excellent example of a precedent-setting deployment of immunity-controlled data governance comes from the Maranguka Justice Reinvestment Project in Bourke, far-western NSW:

http://www.justreinvest.org.au/justice-reinvestment-in-bourke/

The development and success of this program was documented in the @ABCTV @4Corners program ‘Backing Bourke’:

https://www.abc.net.au/4corners/backing-bourke:-four-corners/7849600

As the Justice Reinvest team themselves state, the success off the program is based on “Data [that] has been collected to tell a very big story about a young person’s passage through the criminal justice system in Bourke …

“… Data has also been collected on the community’s outcomes in early life, education, employment, housing, healthcare, child safety, and health outcomes including mental health and drugs and alcohol. …

“… The data has been handed over to community members through community conversations held by local facilitators, and community feedback was recorded and fed back to the Bourke Tribal Council. …”

“… This feedback, together with the data, informed the development of goals, measures and strategies for the Maranguka Justice Reinvestment Project reflected in the document Growing our Kids Up Safe, Smart and Strong, was developed by the Bourke Tribal Council.”

1 July

Local, national and global perspectives on food systems were shared by organisers of the Food Governance 2019 conference at the University of Sydney. See more tweet coverage of the event here.

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.