The aims of the Centre for Research Excellence in the Social Determinants of Health Equity (CRE-SDHE) are to:
Although evidence shows the power of policy interventions that target the social determinants indeed improve health, translation of this evidence into policy has been slow.
We believe this is because a focus on social determinants and health inequities raises many political and policy challenges which occur throughout the policy cycle – getting an issue onto the agenda, formulating, implementing and evaluating policy.
For example, addressing the social determinants requires buy-in from a range of groups, including politicians, policymakers, communities and business. Sometimes these groups can have different and even conflicting objectives and some will have more power than others to influence policy.
The existing evidence base does not address these challenges. It is largely at the technical level, focused on the ‘facts’ of health inequities rather than understanding the political and policy dimensions.
There is increasing concern from political leaders, policy-makers and the public about the growing gap in the financial, social and health status of Australia’s most advantaged and disadvantaged peoples.
The social, cultural and economic forces that shape people’s daily living conditions are called the ‘social determinants’ or the ‘causes of the causes’ of health.
When these determinants result in an unfair and avoidable distribution of health in society, for example between the rich and poor, between men and women, or between Indigenous and non-Indigenous peoples, they are considered health inequities.
Many of these determinants and health inequities are affected by political and policy processes outside of the health sector. For example, education, employment, the built environment, access to healthful commodities (e.g. nutritious food), as well as health care all affect the distribution of health in society.
To achieve and maintain good health, people not only need sufficient financial resources and control over their lives, but also representation in the policy processes that affect their health.
Health inequities are such an important issue internationally that the World Health Organisation established the Commission on the Social Determinants of Health to identify what could be done to improve global health.
The Commission identified that improvements in health inequities can be achieved through an integrated approach of public policy in health and non-health sectors. This is sometimes called a ‘health-in-all-policies’ or ‘whole-of-government’ approach.
An optimal policy mix would include actions to improve the daily living conditions of disadvantaged groups within populations (targeted interventions), as well as actions to address the distribution of health across populations (universal interventions).
The NHMRC CRE in the Social Determinants of Health Equity presented the key findings from its 5-year research program at its final symposium on 16 September 2019: Promoting health equity: From knowing to action.
The symposium included sessions on:
The event provided rich empirical data about the opportunities and challenges in policy agenda setting, formulation, implementation and evaluation. Drawing lessons from across the policy case studies, the symposium discussed issues relating to power and the political determinants of health. Not only did the event highlight ways forward for policy and research, the final session of the day will be an advocacy ideas panel that will examine civil society as a force for enabling healthier and more equitable societies.
A recording of the event will be available soon.
Funded by the National Health and Medical Research Council
NEXT STEPS FOR PAID PARENTAL LEAVE: ADVANCING LEAVE POLICY IN AUSTRALIA
The story so far and reasons for changing the script.
PUBLIC PANEL DISCUSSION
The First 10 Years of Paid Parental Leave – what have we learned and where are we heading?
22 August 2019, 10 – 12pm
McDonald Room, Menzies Library, McDonald Road, ANU, Canberra, ACT
Keynote Address by Ásdís Aðalbjörg Arnalds, University of Iceland
The Nordic countries have a long history of placing emphasis on policies providing mothers and fathers with the opportunity to work and care. Iceland is a Nordic country which enacted a leave scheme providing both parents with three months of non-transferable leave in 2000 (a so-called mother’s and father’s quota). As Iceland has the longest experience of equal quota rights for both parents, it is of great interest to investigate whether the law has met is aim of ensuring children care from both parents. I will present findings on childcare and labour market participation of children under the age of three in order to provide an example of how the law changed the behaviour of parents in Iceland. Surveys conducted among parents who had their first child before and after the law was enacted revealed that the division of care between parents has become more equal. There is a correlation between the length of leave taken by fathers and their involvement in care after the leave is over.
Professor Marian Baird AO, University of Sydney, Work + Family Policy Roundtable – ‘Gender Equality over the employment life cycle’
Dr Elizabeth Hill, University of Sydney, Work + Family Policy Roundtable - ‘The Work and Family Policy Roundtable: 15 years of advocacy’
Dr Belinda Townsend, Menzies Centre for Health Governance, School of Regulation and
Global Governance, ANU – ‘ lessons from agenda-setting for PPL in Australia’
Dr Liana Leach, Research School of Population Health, ANU - ‘Gaps in Australia’s PPL system
– inequities and opportunities’
Ásdís Aðalbjörg Arnalds, University of Iceland - ‘Policy development in Iceland’.
The CRE Policy Symposium in 2018 was held in Canberra on Thursday 29 November.
It’s been 10 years since the WHO Commission on the Social Determinants of Health reported on how to reduce inequities in power, money and resources and people’s daily living conditions in order to improve health equity. The progress has been patchy reflecting the many political and policy challenges which occur throughout the policy process - how issues get onto the agenda, policy formulation, implementation and assessment. Understanding and acting on these challenges will be a key step forward to acheiving more equitable health outcomes for all Australians. The National Policy Symposium is an opportunity for politicians, government officials, non-government organisations, media, researchers and the general public to engage on these topics, which are addressed in the CRE-SDHE.
The Symposium focused on what works and why in the commercial determinants of health, trade and investment, Indigenous affairs, urban environments, social protection/paid parental leave and health systems, offering a range of national and international speakers.
The Symposium concluded with a panel discussion entitled “The 10-year Rollercoaster of Global Health Equity: Power, Progress and Pitfalls” hosted by Paul Barclay, Big Ideas, ABC Radio National. This discussion and was broadcast on the Big Ideas radio program. Listen now.
#SDOHfuture was the conference hashtag.
In the lead up to the symposium, the researchers gathered together in Bungendore to discuss findings from the CRE. You can read more on this and view related videos here.
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The Southgate Institute organised a series of policy events to present research findings on primary health care, including from the CRE, to stimulate discussion on promoting a comprehensive PHC approach in Australia, and to revive the comprehensive vision of primary health care (PHC) set out in the World Health Organization’s Alma-Ata Declaration.
Videos from the Canberra symposium are available here.
Prof Fran Baum (CRE Co-director) and Prof David Sanders (CRE Associate Investigator) co-organised a meeting at the Rockefeller Foundation study centre in Bellagio Italy and this resulted in and formation of a research and policy networks which is described here.
CRE Policy Symposium titled 'De-industrialisation: Employment, health and equity impacts for people and communities' was held on Thursday 21st September 2017 at the Adelaide Pavilion, Cnr South Tce and Peacock Road, Adelaide, 9.00 - 5.00pm. For further information please click
The CRE showcased a workshop "Generating priority for health equity in government policy agendas: Concepts, recent examples and skills development" at the recent 15th World Congress on Public Health held in Melbourne 3-7 April 2017. Professor Sharon Friel introduced the CRE and outlined the aims of work package one on
agenda setting (PDF 173KB) . Dr Phillip Baker outlined the importance of political science theory to
understanding agenda setting and policy change (PDF 509KB) . Professor Lyndall Strazdins presented tentative findings on the
paid parental leave case study (PDF 1MB) .
The workshop also focused on skills development and participants worked in groups to brainstorm how they can influence government agendas drawing on policy theories. Workshop handout slides are available here (PDF 697KB) .
This one day forum was an initiative of the National Health & Medical Research Council Centre for Research Excellence on the Social Determinants of Health Equity (CRE-SDHE) and was an opportunity for politicians, government officials, non-government organisations, media researchers and the general public to engage on topics that are addressed in the CRE-SDHE programme of work . The forum focussed on policy areas that powerfully influence the 'social determinants of health' including Indigenous affairs, urban environments, social protection and health systems. Please click flyer (PDF 628KB) for the full program.
Conceptual framework of the social determinants of health equity