Applying Health in All Policies to obesity in South Australia

Abstract

Public policy strategies impact on population health by acting on the effectiveness, availability and distribution of the social determinants of health. Reducing obesity and promoting healthy weight is a key focus of governments, health promoters and researchers, and can benefit from a systems approach with 'upstream' policy action beyond the health sector. Although the literature identifies many areas for hypothetical non-health policy action, and in particular relating to food and activity environments, few have identified practical, politically viable and relatively cost-free processes by which non-health sectors would want to commit to such action. This article details how the Government of South Australia used the Health in All Policies (HiAP) approach in the SA HiAP Healthy Weight Project. It mapped the core business and policy directions of 44 state departments against research on 'what works' to address obesity. Negotiations then developed high-level policy commitments to address factors promoting healthy weight which predominantly changed ways of working rather than requiring new expenditure and also assisted departments in meeting their own goals; departmental chief executives endorsed the commitments. By starting from departmental documents, and not restricting the project to departments with more 'obvious' obesity prevention potential, we gained commitment to a broader range of policy actions than identified elsewhere; for example, for prisons, environment and botanic gardens, housing and vocational education. The SA HiAP Healthy Weight Project provides one example of a workable, evidence-based systems approach to increase commitment to practical and politically viable opportunities across government to address the non-health environments supporting healthy weight.

Developing a Framework for a Program Theory-Based Approach to Evaluating Policy Processes and Outcomes: Health in All Policies in South Australia

“…A HiAP HLA project to support healthy eating and increase physical activity identified 35 specific policy recommendations for action in 10 SA Government departments, which were subsequently incorporated in the State’s Eat Well Be Active Strategy 2011-2016. 49 The Planning and Transport Department committed to 8 actions, one being to increase “Active Transport and public transport.” Implementation is demonstrated by completion of dedicated walking and cycling routes; bike boulevards which provide a low-speed environment on low-traffic streets for cyclists; and changes to Road Traffic Regulations which removed restrictions on riding on footpaths and widened the defined overtaking space for cars overtaking bicycles. These constitute an ‘investment in social determinants’ (see Outcomes section in Figure 1 ) and ‘within Government’ changes as represented in the framework.…”

Stakeholders’ engagement in co-producing policy-relevant knowledge to facilitate employment for persons with developmental disabilities

“…This affects the potential policy options each stakeholder group envisions for solving the problem [4,87] and showcases the importance of further engagement strategies for defining a 'wicked' problem and its policy solutions [88]. Coframing of a problem and policy solutions by multiple stakeholders has been shown to be one of the keys to successful collaborations [87,89]. Using consensusbuilding methods during our stakeholder policy dialogues, our multiple stakeholders co-framed barriers and co-produced policy solutions in a holistic way that span through (1) PWDD and their families/caregivers, (2) employers and (3) society.…”

Sumber Daya Lokal Sebagai Dasar Perencanaan Program Gizi Daerah Urban

“…25 Lingkungan yang bersifat negatif (merugikan), maupun lingkungan yang merupakan potensi untuk dimanfaatkan. Sektor di luar kesehatan perlu menjadi bahan pertimbangan dalam menentukan kebijakan dan program perbaikan gizi, karena pendekatan sistemik terhadap program akan lebih tepat dibandingkan hanya fokus terhadap program yang menekankan perilaku individu, seperti hasil penelitian tentang program South Australia HiAP Healthy Weight yang melibatkan banyak institusi terkait dan mendapatkan hasil peningkatan komitmen antar instansi non kesehatan yang dilakukan melalui penyelarasan dan harmonisasi dengan kebijakan yang ada di instansi tersebut sehingga mencapai tujuan tanpa banyak anggaran yang dikeluarkan 26 . Dalam penelitian ini maka institusi atau lembaga yang potensial saat ini yang perlu dilibatkan adalah perguruan tinggi kesehatan, pemerintah daerah setempat, lembaga sosial keagamaan (Aisyiah), dan perusahaan yang ada disekitar daerah Mijen.Dalam hal ini SDM instansi kesehatan merupakan aktor utama dan dukungan politik dari lembaga tertinggi juga menjadi faktor penentu.…”