Contents Health Promotion Journal of Australia …

1 Health Promotion Journal of AustraliaVolume 17, Number 3,December 2006 ContentsEditorial officePlease address all editorial correspondence,including original contributions to:The EditorHealth Promotion Journal of AustraliaPO Box 351, North Melbourne,Victoria 3051, AustraliaPhone: (03) 9329 3535 Fax: (03) 9329 3550E-mail: for authors are available in eachissue of the Journal and on the AHPA Health Promotion Journal of Australiagratefully acknowledges the support ofthe University of the Sunshine Coast inhosting the Secretariat of the AustralianHealth Promotion and the social determinants of health163 Fran Baum and Liz HarrisA global perspective on Health Promotion and the socialdeterminants of health165 David SandersThe social determinants of Health : what are the three key rolesfor Health Promotion ?167 Dennis RaphaelAre social determinants of Health the same as societaldeterminants of Health ?

2 170 Barbara StarfieldPolicyBuilding healthy and equitable societies: what Australia can contributeto and learn from the Commission on Social Determinants of Health174 Fran Baum and Sarah SimpsonSocial determinants, political contexts and civil society action: a historicalperspective on the Commission on Social Determinants of Health180 Orielle Solar and Alec IrwinThe role of the People s Health Movement in putting thesocial determinants of Health on the global agenda186 Ravi Narayan*The social determinants of Health : is there a role for healthpromotion foundations?189 Barb Mouy and Ali BarrThe role of Health Promotion : between global thinking and local action 196 Lesley KingThe Health system: what should our priorities be?210 Anne-marie Boxall and Stephen R. LeederEquity, by what measure?206 Shane HoustonSustainable communities: what should our priorities be?

3 211 Valerie A. Brown and Jan RitchieResearchFederal, State and Territory government responses to healthinequities and the social determinants of Health in Australia217 Lareen Newman, Fran Baum and Elizabeth HarrisSmoking, not smoking: how important is where you live?226 Christine Migliorini and Mohammad SiahpushEvaluation of the Outreach School Garden Project: Building thecapacity of two Indigenous remote school communities to integratenutrition into the core school curriculum233 Antonietta ViolaScoping supermarket availability and accessibility bysocio-economic status in Adelaide240 Lisel A. O Dwyer and John CoveneyHealth Promotion Journal of Australia 2006 : 17 (3)162 Health Promotion Journal of AustraliaJournal of the Australian Health Promotion Association (Inc) Australian Health Promotion Association ISSN 1036-1073 The Journal is indexed by Australian Public Affairs Information Service (APAIS), CINAHL, MEDLINE/Index Medicus, EMBASE, EMNURSING,Compendex, GEOBASE, PROQUEST, Scopus and Sociological Abstracts.

4 It has been assessed by the Commonwealth Department ofEducation Science and Training as satisfying the refereeing requirements for the Higher Education Research Data Collection (HERDC).Previous issues are available at published in the Journal does not necessarily represent the views of the Australian Health Promotion GaleaRegional Office for the Western Pacific,World Health Organization, PhilippinesBillie Giles-CortiDepartment of Public Health ,University of Western AustraliaElizabeth HarrisSchool of Public Health and CommunityMedicine, University of New South WalesT. H. LamDepartment of Community Medicine,The University of Hong KongLily O HaraFaculty of Science, Health and EducationUniversity of the Sunshine CoastMihi RatimaDivision of Public Health and PsychosocialStudies, Auckland University of Technology,New ZealandTrevor ShiltonNational Heart Foundation, WesternAustraliaLouise SignalDepartment of Public HealthUniversity of Otago, New ZealandK.

5 C. TangDepartment of Non-communicable DiseasePrevention and Health Promotion ,World Health Organization, SwitzerlandBook Review EditorBen SmithSchool of Public Health , University ofSydney, New South Wales Exploring Technical Issues EditorElizabeth ParkerSchool of Public Health , QueenslandUniversity of TechnologyContentsEditorial Advisory BoardJoint EditorsChris Rissel BSc MPH PhDHealth Promotion Unit, Sydney South WestArea Health Service, NSW, and School ofPublic Health , University of Sydney,Level 9, King George V, Missenden Road,Camperdown, New South Wales 2050E-mail: Ritchie DipPhty MHPEd PhDSchool of Public Health and CommunityMedicine, University of New South Wales,Kensington, New South Wales 2052 Adrian Bauman MBBS MPH PhD FAFPHMP rofessor of Health Promotion ,School of Public Health ,University of Sydney,New South Wales 2006 Food insecurity in three socially disadvantagedlocalities in Sydney, Australia247 Michelle Nolan, Glenys Rikard-Bell, Mohammed Mohsinand Mandy WilliamsUtility stress as a social determinant of Health :exploring the links in a remote Aboriginalcommunity255 Eileen Willis, Meryl Pearce, Carmel McCarthy,Tom Jenkin and Fiona RyanPoint of ViewThe war on obesity: a social determinant of Health 262 Lily O Hara and Jane GreggSocial determinants of Health and healthinequalities: what role for general practice?

6 264 John FurlerThe NSW Social Determinants of Health Action Group:influencing the social determinants of health266 Suzanne Gleeson and Garth AlpersteinBook ReviewCommunity Research in Environmental Health :Studies in Science, Advocacy and Ethics268By Doug Brugge and H. Patricia by Cordia ChuIndexHealth Promotion Journal of AustraliaVolume 17, 2006 Author Index269 Health Promotion Journal of AustraliaVolume 17, 2006 Subject Index271 ReviewersHealth Promotion Journal of AustraliaReviewers in 2006273 Health Promotion Journal of Australia 2006 : 17 (3)163 Guest EditorsThis theme issue of the Journal focuses on a critical butsurprisingly neglected aspect of Health Promotion practice,the social determinants of Health . As Guest Editors, Liz Harrisand Fran Baum have done an absolutely outstanding job inattracting high quality papers and overseeing the reviewingand revision processes.

7 They have delivered, on time, notonly the largest ever issue of the Journal , but a substantialcontribution to the international Health Promotion , many thanks from the Joint Editors!Chris Rissel, Adrian Bauman and Jan RitchieEquity and the socialdeterminants of healthFran Baum and Liz HarrisThis special issue comes at a time when interest in the socialdeterminants of Health is increasing internationally. In the faceof rapid economic globalisation and the emergence of significantinfectious and chronic Health problems of potentially pandemicproportions, the social and economic effects of public andprivate sector policies on Health and its determinants arebecoming too stark to the 20th Century life expectancy increased 1901 and 2001, life expectancy at birth rose by 23years for men and 24 years for women in Yet whilethere have been absolute increases in life expectancy for mostgroups around the world, considerable inequalities remainbetween people from different social classes, ethnic backgroundsand gender.

8 Many of these differences result from differentialaccess to the conditions that promote Health , such asemployment, education and basic Health hardware such as safedrinking water, waste disposal and sanitation systems, thesedifferences can be considered unfair or inequitable. Thepromotion of Health across populations and ensuring that this isdone in a manner that reduces these inequities is crucial. Weagree with Starfield s editorial that much of the research andcomment on the social determinants of Health does not havean equity focus and that it should do of the importance of the social determinants ofhealth is not new. The public Health reformers of the 19thCentury clearly recognised their importance. Among the mostprogressive, the Silesian doctor Virchow, was clear that the healthof workers in the 1840s was directly related to the workingconditions they The sanitary reforms in 19th-Century Britain were based on an understanding thatenvironmental conditions had a direct affect on Health .

9 Thework of McKeown noted that the 20th-Century life expectancyimprovements had more to do with changing living conditionsthan to do with medical s analysis added further to the understanding that localgovernment civic reforms played a crucial role in theenvironmental These reforms did not just happenas a matter of course, but often resulted from significant socialand class ,6 That there is a new focus on socialdeterminants in the early 21st Century may reflect the fact thatthe current form of economic globalisation is tending to increaseinequities within and between countries,7,8 and the logic offocusing on social and economic change is Health has largely assumed that life expectancy wouldcontinue to rise. The experience of several regions of the worldnow negate that expectation and, from a global perspective,sustainable and equitable Health advancement is not yet Africa, an HIV/AIDS pandemic has resulted in falls in lifeexpectancies in many In eastern Europe, followingthe fall of the Soviet Union and the rapid introduction of marketreforms, life expectancies of men Predictions are beingmade that in the rich countries younger generations mayexperience falling life expectancies compared with their babyboomer parents because of increased chronic diseases.

10 Partlyattributable to the impact of the ways in which the social andbuilt environment are affecting physical activity and formation of the Commission on the Social Determinantsof Health by the World Health Organization in 2005 is a clearsign of the recognition that there needs to be greater focus onthese upstream determinants or, as the Commission has calledthem, the causes of the causes .11 The Commission haspositioned itself as emerging from the tradition of Alma Ata andthe Ottawa Charter, as Solar and Irwin make clear in their paperon the historical legacy inherited by the Commission. This legacyis also noted by Baum and Simpson in their paper, which citesas examples of early actions on social determinants the work ofpast Australian governments such as Menzies federally andDunstan at the State level in South Australia . The Commissionwill report in 2008 and is challenging countries to base theirpublic Health policies on an understanding of the importanceand centrality of the social determinants of Health to improvinghealth social determinants approach poses many challenges for healthpromoters.