Health in All Policies in South Australia—Did It Promote and Enact an Equity Perspective?

Abstract

Mobilising cross-sectoral action is helpful in addressing the range of social determinants that contribute to health inequities. The South Australian Health in All Policies (SA HiAP) approach was implemented from 2007 to stimulate cross-sector policy activity to address the social determinants of health to improve population wellbeing and reduce health inequities. This paper presents selected findings from a five year multi-methods research study of the SA HiAP approach and draws on data collected during interviews, observation, case studies, and document analysis. The analysis shows that SA HiAP had dual goals of facilitating joined-up government for co-benefits (process focus); and addressing social determinants of health and inequities through cross-sectoral policy activity (outcomes focus). Government agencies readily understood HiAP as providing tools for improving the process of intersectoral policy development, while the more distal outcome-focused intent of improving equity was not well understood and gained less traction. While some early rhetorical support existed for progressing an equity agenda through SA HiAP, subsequent economic pressures resulted in the government narrowing its priorities to economic goals. The paper concludes that SA HiAP’s initial intentions to address equity were only partially enacted and little was done to reduce inequities. Emerging opportunities in SA, and internationally, including the UN Sustainable Development Goals, may revive interest in addressing equity.

COVID-19, Equity and Men’s Health

“…176,177 This is about working smarter; and has significant potential to save government expenditure over the longer-term. [178][179][180] In addition, to required action on the social determinants of health already noted above, there is also a need to influence environments through improved urban planning processes that address gender-specific needs. For example, numerous countries have turned to temporary urban design measures to quickly create new forms of space for their citizens that enable safe physical activity and commuting within cities.…”

Designing a toolkit for the assessment of Health in All Policies at a national scale in Iran

“…19,20 Van Eyk et al indicated that HiAP in South Australia had dual goals; the facilitation of joined-up government for the common benefit of all citizens and consideration of the social determinants of health and inequities via cross-sectoral policies. 21 The southern Australian experience in implementing HiAP shows that a focus on intersectoral collaboration and participation are requirements for implementation. In a report on the details of implementing an HiAP model to address regional migration in Adelaide, Australia in 2010, a tool entitled "Health Lens Analysis" was introduced, with the aim of maximizing health and wellbeing.…”

Legitimising Inter-Sectoral Public Health Policies: A Challenge for Professional Identities?

“…Inspired by new institutionalism, we regard organisations and their agents to be dependent on their institutional environment and on gaining legitimacy not only to succeed economically but also to survive [8][9][10]. To examine HiAP, other scholars have used institutional perspectives, such as path dependency and rationalised myth [11][12], institutional logics [13] and translation of organisational ideas [14][15]. By contrast, studies that apply a legitimacy perspective have been difficult to find.…”