Implementing Health in All Policies - WHO

1 ImplementingHealth in All PoliciesAdelaide 2010 Edited byProfessor Ilona Kickbusch and Dr Kevin BuckettImplementing Health in All Policies Adelaide 2010 Implementing Health in All Policies : Adelaide 2010 Edited byProfessor Ilona Kickbusch Director, Global Health Programme, Graduate Institute of International and Development Studies, GenevaDr Kevin Buckett Director, Public Health , Department of Health , South AustraliaEditorial committee:Professor Ilona Kickbusch, Director, Global Health Programme, Graduate Institute of International and Development Studies, GenevaDr Kevin Buckett, Director, Public Health , Department of Health , South Australia Health in All Policies Unit, Department of Health , South Australia: Carmel Williams, Manager, Health in All Policies Unit, Public Health , Department of Health , South Australia Danny Broderick, Senior Policy Officer, Health in All Policies Unit, Public Health , Department of Health , South Australia Deb Wildgoose, Senior Project Officer, Health in All Policies Unit, Public Health , Department of Health , South Australia Amy Sawford, Project Officer, Health in All Policies Unit, Public Health , Department of Health , South AustraliaEditorial adviserAgnes Maddock, Office of Public Health , Department of Health , South AustraliaCopy editorJo Mason, Mason EditGraphic design and communications support Communications Division, Department of Health , South Australia This volume, Implementing Health in All Policies .

2 Adelaide 2010 was produced for the Adelaide 2010 Health in All Policies International Meeting co-hosted by the Government of South Australia and the World Health Organization. Adelaide 2010 Health in All Policies International Meeting was funded by the Department of Health , Government of South Australia, with financial support from: Adelaide Thinkers in Residence Program, Department of the Premier and Cabinet The Department for Transport Energy and Infrastructure The Department of Planning and Local Government The Department of Trade and Economic DevelopmentThe Australian Government Department of Health and Ageing Implementing Health in All Policies : Adelaide 2010 is published by the Department of Health , Government of South Australia. Department of Health , Government of South Australia, 2010 All rights reserved. Please address any correspondence to: Health in All Polices UnitSA Department of HealthPO Box 6, Rundle Mall, SA, The views expressed in this publication represent the views of the authors and not necessarily those of the Minister for Health or the Department of Health .

3 No responsibility is accepted by the Minister for Health or the Department of Health for any errors or omissions contained within this 978-1-74243-033-1 ContentsForewordIntroduction: 3 Ilona Kickbusch and Kevin Buckett Section 1: Health in All Policies : setting the scene1 Health in All Policies : the evolution of the concept of horizontal Health governance 11 Ilona Kickbusch2 Improving Health equity: action on the social determinants of Health through Health in All Policies 25 Fran Baum and Paul Laris3 Health is not just the absence of illness: Health in All Policies and all in Health Policies 39 Geoff MulganSection 2: Health in All Policies : international perspectives4 Health in All Policies in Europe 53 Matthias Wismar and Kelly Ernst5 Health impact assessment in Thailand: a learning tool for addressing Health in All Policies 65 Decharut Sukkumnoed and Kuametha ReukpornpipatSection 3: Health in All Policies in SA: theoretical and methodological perspectives 6 Navigating through the policy territory of other sectors: South Australia s Health in All Policies approach 75 Carmel Williams and Danny Broderick7 South Australia s Strategic Plan and Health in All Policies 87 Sandy Pitcher, Dan Jordan and Kevin Buckett8 Towards the integration of Health in All Policies : a Qu bec South Australia comparison 93 Caroline Druet, Genevi ve Lapointe and Marjolaine Pigeon9 Role of Health Impact Assessment in Health in All Policies 101 Robert QuigleySection 4: Implementing Health in All Policies in SA.

4 Case studies on practice10 An introduction to the Health lens analysis 111 Carmel Williams, Deb Wildgoose, Amy Sawford and Lauren Williams11 Water security Health lens project: alternative water sources 119 Linda Carruthers and Angela Lawless12 Regional migrant settlement: a Health lens approach 125 Tyson Miller, Italia Mignone and Louise Thornley13 Digital technology access and use as 21st century determinants of Health : impact of social and economic disadvantage 133 Wendy Golder, Lareen Newman, Kate Biedrzycki and Fran Baum14 Reflections on the Health lens process 145 Health in All Policies Unit, Department of Health , South AustraliaList of Conceptual framework of social determinants of Health South Australian model of HiAP South Australian Health lens process Links between use of digital technology and Health and wellbeing outcomes 141 List of tables Improving daily living conditions Tackling the inequitable distribution of power, money and resources The foundations of Health in All Policies in South Australia Comparative analysis of Qu bec and South Australia 97 Appendices1 Declaration of Alma Ata, 1978 1532 Ottawa Charter for Health Promotion, 1986 1573 Adelaide Recommendations on Healthy Public Policy.

5 1988 1634 South Australia s Strategic Plan, Summary of Targets, 2007 1715 Health in All Policies : the 10 principles, 2007 183 ContributorsFran Baum, Director, Southgate Institute for Health , Society and Equity, and South Australian Community Health Research Unit, Flinders University of South AustraliaKate Biedrzycki, Research Officer, South Australian Community Health Research Unit, Flinders University of South AustraliaDanny Broderick, Senior Policy Officer, Public Health , Department of Health , South AustraliaKevin Buckett, Director, Public Health , Department of Health , South AustraliaLinda Carruthers, Manager, Policy and Strategy, Office for Water Security, South AustraliaCaroline Druet, Planning and Research Officer, Directorate of Public Health Planning, Evaluation and Development, Public Health Branch, Minist re de la Sant et des Services sociaux (Ministry of Health and Social Services)

6 , Qu becKelly Ernst, Associate Researcher, European Observatory on Health Systems and Policies , World Health Organization European Centre for Health PolicyWendy Golder, Principal Policy Officer, Information Economy, Department of Further Education, Employment, Science and Technology, South AustraliaLyne Jobin, Director, Directorate of Public Health Planning, Evaluation and Development, Public Health Branch, Minist re de la Sant et des Services sociaux (Ministry of Health and Social Services), Qu becDan Jordan, Director, Office of the Executive Committee of Cabinet, Department of the Premier and Cabinet, South AustraliaIlona Kickbusch, Director, Global Health Programme, Graduate Institute for International and Development Studies, GenevaGenevi ve Lapointe, Coordinator, Public Policy Unit, Institut national de sant publique du Qu bec (Qu bec National Public Health Institute)

7 Paul Laris, Paul Laris and Associates, Adelaide, South AustraliaAngela Lawless, Deputy Director, Training and Development, South Australian Community Health Research Unit, Flinders University of South AustraliaItalia Mignone, Community and Government Relations Officer, Multicultural SA, Department of Justice, South AustraliaTyson Miller, Senior Policy Officer, Workforce Population and Migration, Department of Trade and Economic Development, South AustraliaGeoff Mulgan, Director, The Young Foundation, United KingdomLareen Newman, Senior Research Fellow, Southgate Institute for Health , Society and Equity, Flinders University of South AustraliaMarjolaine Pigeon, Planning and Research Officer, Directorate of Public Health Planning, Evaluation and Development, Public Health Branch, Minist re de la Sant et des Services sociaux (Ministry of Health and Social Services)

8 , Qu becSandy Pitcher, Executive Director, Office of the Executive Committee of Cabinet, Department of the Premier and Cabinet, South AustraliaRobert Quigley, Director, Quigley and Watts Ltd, New ZealandKuametha Reukpornpipat, Editor, Thailand Green World FoundationAmy Sawford, Project Officer, Health in All Polices Unit, Public Health , Department of Health , South AustraliaLouise St-Pierre, Senior Policy Analyst, World Health Organization Collaborating Centre on Non Communicable Disease Policy Decharut Sukkumnoed, Lecturer, Kasetsart University and Director of HIA Coordination Centre, National Health Commission Office, ThailandLouise Thornley, Senior Research Associate, Quigley and Watts Ltd, New ZealandDeb Wildgoose, Senior Project Officer, Health in All Polices Unit, Public Health , Department of Health , South Australia Lauren Williams, Graduate Officer, Policy and Intergovernment Relations Division, Department of Health , South Australia Carmel Williams, Manager, Health in All Polices Unit, Public Health , Department of Health , South AustraliaMatthias Wismar, Health Policy Analyst, European Health Observatory, World Health OrganizationImplementing Health in All Policies : Adelaide 2010 ForewordThe report of the Commission on Social Determinants of Health , published in 2008, challenged conventional public Health thinking on several fronts.

9 The report responded to a situation in which the gaps, within and between countries, in income levels, opportunities, Health status, life expectancy and access to care are greater than at any time in recent history. As the report argued, improving the Health of populations, in genuine and lasting ways, ultimately depends on understanding the causes of these inequities and addressing Commission found abundant evidence that the true upstream drivers of Health inequities reside in social, economic and political environments. These environments are shaped by Policies , which make them amenable to change. The new challenge for the Health sector is to study the logic of the decisions of other sectors. Then it is our responsibility to take what we know about equity and the social determinants of Health and apply it to their frameworks, using their language, based on their desired outcomes.

10 This is the different logic referred to in the World Health Organization s 2008 World Health Report on Primary Health World Health Assembly Resolution, Reducing Health Inequities through Action on the Social Determinants of Health (2009), challenges governments to improve their efficacy in tackling the determinants of Health inequities through a Health in All Policies approach, and for WHO to provide the necessary assistance and guidance to enable this action. Moving towards intersectoral action for Health and beyond the Health sector were core recommendations of the Declaration of Alma Ata (1978) and the Ottawa Charter (1986). Yet we know that the Health sector has struggled with this very approach. This volume addresses a number of important implementation challenges for Health in All Policies .