Participation and equity for health

1. Participation and equity for health Victorian Health Promotion Foundation

2. Health equity through action on the social determinants of health

3. About VicHealth • The Victorian Health Promotion Foundation, established 1987 under the Tobacco Act (legislation) • Statutory authority: outside of the government health department, but still reporting to the Victorian Health Minister and to Parliament with accountability to a Board of Governance. • Funding of approximately $32 million per annum for: • reducing smoking • improving nutrition • reducing harm from alcohol • increasing physical activity • increasing social and economic participation, and • reducing harm from UV exposure.

4. VicHealth: improving the health of all Victorians Our vision • VicHealth envisages a community where:  • health is a fundamental human right • everyone shares in the responsibility for promoting health • everyone benefits from improved health outcomes Our equity focus • Strategic Plan KRA 1- Health inequalities • Improve the physical and mental health of those experiencing social, economic or geographic disadvantage • Contribute to closing the health gap between Indigenous and non-Indigenous Victorians • Organisational structure

5. Health equity- concepts and definitions • Health inequalities refer to variations in health status between sub-groups in the population. • Health equity is not about removing all difference so that everyone has the same level of health. • The aim is to reduce or eliminate differences which are considered to be avoidable and unfair. • Recognition that health inequalities are largely explained by differential access to the social and economic (‘upstream’) determinants of health. • Action to achieve health equity is therefore about addressing the unequal distribution of health determinants.

6. VicHealth’s approach to health equity • ‘Health equity through action on the social determinants of health’ • Focus on creating opportunities for social and economic participation and reducing exposure and vulnerability to health damaging factors (risk factors) in a number of priority population groups: • Indigenous Victorians • Culturally and linguistically diverse groups, with an emphasis on newly arrived communities • People with a disability • People from low socioeconomic groups, with an emphasis on children

7. VicHealth’s frameworks for action • VicHealth uses strategic frameworks to conceptualise and describe our work aimed at increasing social and economic participation. • These frameworks are important because they: • Highlight that health and wellbeing is shaped by social and economic structures • Make a complex picture more available • Develop an evidence-based logic to guide practice • Are a tool to assist in setting or assessing priorities and developing evaluation plans • Allow a range of organisations and sectors to see how they can contribute to health and wellbeing outcomes

8. VicHealth’s frameworks for action • Determinants framework for mental health and wellbeing (2006) • Framework for guide primary prevention of violence against women (2007) • Reducing race-based discrimination and promoting diversity: A framework for action (2009) • Participation for health: A framework for action (2009) • Victorian Aboriginal Health Promotion Framework (with DH- to be published late 2010) • Need for specific equity framework?

9. Participation for health: a framework for action 2009-2013

10. Participation for health: a framework for action 2009-2013

11. VicHealth practice- the role of frameworks Focus on upstream social and economic determinants

12. Indigenous health: a framework for action

13. Indigenous health: a framework for action

14. Indigenous health: a framework for action

15. Indigenous health: a framework for action

16. Other frameworks (CDSH, 2008)

17. WHO Commission on the Social Determinants of Health Recommendations • Improve daily living conditions: The circumstances in which people are born, grow, live, work and age • Tackle the inequitable distribution of power, money and resources: The structural drivers of those conditions of daily life- globally, nationally and locally • Measure and understand the problem and assess the impact of action: Measure the problem, evaluate action, expand the knowledge base, develop a workforce trained in the SDOH and raise public awareness about the SDOH

18. Applying the Commission’s framework to VicHealth action • Improve daily living conditions: • Access to economic resources: workplace, education, employment, housing • Early childhood • Active communities • Tackle the inequitable distribution of power, resources and money: • Freedom from discrimination • Freedom from violence • Social connection: involvement in community /group activities, civic engagement • Measure and understand the problem and assess the impact of action: • Community Indicators Victoria and Consolidated Survey Platform • Research summaries and evidence-based resources • Research projects

19. Summarising VicHealth’s approach to equity • Taking action on the social determinants of health to: • Identify policy-relevant mechanisms to shift the distribution of the resources of daily living • Better understand and reduce exposure and vulnerability to health damaging factors in population groups most ‘at risk’ • Tackle the unequal distribution of power in our society • Measure, understand and build capacity to address the problem

20. Key messages regarding equity and participation • This is not a value-free space • Equity should be core consideration- not an ‘extra’ • Need to consider potential impact of health promotion activity on health inequalities • Often change is sought in organisations, the wider community, environments and systems, not in the ‘target group’ • Cross-sectoral action is required • Focus is on shifting the distribution of the social and economic determinants of health • Key role in advocacy • Resources are available to assist your work

21. Follow up Kellie Horton e: khorton@vichealth.vic.gov.au ph: 9667 1305 www.vichealth.vic.gov.au