http://hdl.handle.net/2328/25216 2013-05-25T17:33:19Z 2013-05-25T17:33:19Z Baum, Frances Elaine Laris, Paul Fisher, Matthew Newman, Lareen Ann MacDougall, Colin James http://hdl.handle.net/2328/26785 2013-05-23T17:30:31Z 2013-04-03T00:00:00Z

Title: “Never mind the logic, give me the numbers”: Former Australian health ministers’ perspectives on the social determinants of health Authors: Baum, Frances Elaine; Laris, Paul; Fisher, Matthew; Newman, Lareen Ann; MacDougall, Colin James Abstract: The articulation of strong evidence and moral arguments about the importance of social determinants of health (SDH) and health equity has not led to commensurate action to address them. Policy windows open when, simultaneously, an issue is recognised as a problem, policy formulation and refinement happens and the political will for action is present. We report on qualitative interviews with 20 former Australian Federal, State or Territory health ministers conducted between September 2011 and January 2012 concerning their views about how and why the windows of policy opportunity on the SDH did or did not open during their tenure. Almost all ex-health ministers were aware of the existence of health inequalities and SDH but their complexity meant that this awareness rarely crystalised into a clear problem other than as a focus on high needs groups, especially Aboriginal people. Formulation of policies about SDH was assisted by cross-portfolio structures, policy entrepreneurs, and evidence from reviews and reports. It was hindered by the complexity of SDH policy, the dominance of medical power and paradigms and the weakness of the policy community advocating for SDH. The political stream was enabling when the general ideological climate was supportive of redistributive policies, the health care sector was not perceived to be in crisis, there was support for action from the head of government and cabinet colleagues, and no opposition from powerful lobby groups. There have been instances of Australian health policy which addressed the SDH over the past twenty five years but they are rare and the windows of opportunity that made them possible did not stay open for long.

2013-04-03T00:00:00Z Browne-Yung, Kathryn Ziersch, Anna Marie Baum, Frances Elaine http://hdl.handle.net/2328/26698 2013-05-13T01:25:43Z 2013-05-01T00:00:00Z

Title: 'Faking til you make it': Social capital accumulation of individuals on low incomes living in contrasting socio-economic neighbourhoods and its implications for health and wellbeing Authors: Browne-Yung, Kathryn; Ziersch, Anna Marie; Baum, Frances Elaine Abstract: People on low-income living in low socio-economic neighbourhoods have poorer health in comparison with those living in advantaged neighbourhoods. To explore neighbourhood effects on health and social capital creation, the experiences of low-income people living in contrasting socio-economic neighbourhoods were compared, in order to examine how low-income status and differing levels of neighbourhood resources contributed to perceived health and wellbeing. Quantitative and qualitative data were analysed: survey data from 601 individuals living in contrasting socio-economic areas and in-depth interviews with a new sample of 24 individuals on low-incomes. The study was guided by Bourdieu's theory of practice, which examines how social inequalities are created and reproduced through the relationship between individuals' varying resources of economic, social and cultural capital. This included an examination of individual life histories, cultural distinction and how social positions are reproduced. Participants' accounts of their early life experience showed how parental socio-economic position and socially patterned events taking place across the life course, created different opportunities for social network creation, choice of neighbourhood and levels of resources available throughout life, all of which can influence health and wellbeing. A definition of poverty by whether an individual or household has sufficient income at a particular point in time was an inadequate measure of disadvantage. This static measure of ‘low income’ as a category disguised a number of different ways in which disadvantage was experienced or, conversely, how life course events could mitigate the impact of low-income. This study found that the resources necessary to create social capital such as cultural capital and the ability to socially network, differed according to the socio-economic status of the neighbourhood, and that living in an advantaged area does not automatically guarantee access to potentially beneficial social networks.

2013-05-01T00:00:00Z Osborne, Katy Newman, Lareen Ann Ramanathan, Rama Williams, Carmel Wildgoose, Deborah Foote, Amy Ludford, Isobel http://hdl.handle.net/2328/26692 2013-05-13T02:10:29Z 2013-04-15T00:00:00Z

Title: Active ageing and employment in rural SA: a Health in All Policies project Authors: Osborne, Katy; Newman, Lareen Ann; Ramanathan, Rama; Williams, Carmel; Wildgoose, Deborah; Foote, Amy; Ludford, Isobel Abstract: The South Australian (SA) Health in All Policies (HiAP) initiative provides a framework and mandate for intersectoral policy work on the social determinants of health. Participation in decent and meaningful employment is a key social determinant of health, and is also an important strategy to promote ‘active ageing’ in the population. This paper reports on an intersectoral project undertaken by the Health In All Policies Unit and Country Health SA Local Health Network (CHSA LHN) in collaboration with Flinders University’s SA Community Health Research Unit and Southgate Institute for Health Society & Equity. The project Active Ageing and Employment in Regional South Australia aims to identify policy levers to increase the workforce retention and re-entry for rural people aged 45+. The project is designed to do this by building the capacity of the regional health workforce to address the social determinants of health in collaboration with agencies outside of the health system. The project partners have adopted a ‘learning by doing’ strategy with the focus on employment and ageing.

2013-04-15T00:00:00Z Street, Jackie M Delany, Toni http://hdl.handle.net/2328/26392 2012-10-30T06:23:33Z 2012-01-01T00:00:00Z

Title: Guidelines in disrepute: a case study of influenza vaccination of healthcare workers Authors: Street, Jackie M; Delany, Toni Abstract: Practice guidelines are an important support tool for health behaviour change, but effective implementation of guidelines can be difficult and the gaps between guidelines and practice may be intractable. This paper examines a neglected but important area; namely, the reasons why problems may develop in the implementation and uptake of practice guidelines. We explore the existence of gaps in the translation of evidence into practice-based guidelines for health promotion. Approach: Drawing on relevant literature we examine influenza vaccination, in particular, guidelines that advise influenza vaccination for all healthcare workers. We highlight gaps between the actions advised within these guidelines and the relevant evidence, and explore some of the processes that have amplified and obscured this evidence during the development of guidelines. Implications: The processes that underlie the translation of evidence into practice guidelines risk the loss of the nuanced and rich information needed for individual decision-making. Where evidence is limited, the propagation of evidence guidelines gaps, without transparency as to the basis of decision-making, compromises the credibility of guidelines and puts at risk the benefits that guidelines can provide. Conclusion: We argue that evidence guideline gaps may arise because of a range of problems with the nature of the evidence used to justify the guidelines and the way in which that evidence is applied and interpreted. We suggest that these problems may bring potentially useful guidelines into disrepute.

2012-01-01T00:00:00Z