To what extent do Australian child and youth health policies address the social determinants of health and health equity?: a document analysis study

Abstract

BackgroundThere is a significant body of evidence that highlights the importance of addressing the social determinants of child and youth health. In order to tackle health inequities Australian governments are being called upon to take action in this area at a policy level. Recent research suggests that the health and well-being of children and youth in Australia is ‘middle of the road’ when compared to other OECD countries. To date, there have been no systematic analyses of Australian child/youth health policies with a social determinants and health equity focus and this study aimed to contribute to addressing this gap.MethodsDocument analysis of seventeen strategic level child/youth health policies across Australia used an a priori coding framework specifically developed to assess the extent to which health departments address the social determinants of child/youth health and health equity. Policies were selected from a review of all federal and state/territory strategic health department policies dated between 2008 and 2013. They were included if the title of the policy addressed children, youth, paediatric health or families directly. We also included whole of government policies that addressed child/youth health issues and linked to the health department, and health promotion policies with a chapter or extensive section dedicated to children.ResultsAustralian child/youth health policies address health inequities to some extent, with the best examples in Aboriginal or child protection policies, and whole of government policies. However, action on the social determinants of child/youth health was limited. Whilst all policies acknowledge the SDH, strategies were predominantly about improving health services delivery or access to health services. With some exceptions, the policies that appeared to address important SDH, such as early childhood development and healthy settings, often took a narrow view of the evidence and drifted back to focus on the individual.ConclusionsThis research highlights that policy action on the social determinants of child/youth health in Australia is limited and that a more balanced approach to reducing health inequities is needed, moving away from a dominant medical or behavioural approach, to address the structural determinants of child/youth health.

The impact of differing frames on early stages of intersectoral collaboration: the case of the First 1000 Days Initiative in the Western Cape Province

“…Previous studies [39,40] that have examined intersectoral action on social determinants of health have shown the dominance of the biomedical and behavioural perspectives on health and illness. This has been associated with an individualised approach to health, which focuses on promoting the change of individual behaviour.…”

“…A qualitative documentary analysis [37,38] of ideas and underlying frames was adopted for this study. The analysis of documentary sources is recognised as a valuable qualitative analysis method and has been used, amongst others, to examine policy responses to the social determinants of health [37][38][39][40]. Although examining written text may not reveal negotiations and contestation during policy-making, policy documents illustrate the outcomes of a policy process and can provide insights into underlying values, ideas or meanings that influence policy action.…”

Social Determinants of Indigenous Health and Indigenous Rights in Policy: A Scoping Review and Analysis of Problem Representation

“…Collaboration across sectors was shown as an essential component in policy implementation; however, policy actors face challenges working together. The inclusion of social determinants of health in policy has been researched by Carter et al (2009), Fisher et al (2016), and Phillips et al (2016), but a specific analysis on social determinants of Indigenous health would add depth to this field of policy analysis. In addition, research on the realisation of Indigenous of rights in policy implementation would explore the ways in which rights have been written into policy but action has been limited (Cooper, 2011;Shewell, 2016;D.…”

Validity and reliability of the Neurobehavioral Evaluation of Infant Development (VANEDELA). Screening Instrument from one to 24 months in primary health care in Mexico

“…In Mexico, a 6% prevalence of childhood disability has been reported (Economic Commission for Latin America, 2016;World Health Organization, 2012;World Health Organization, 2009;Watkins, 2016;Walker et al, 2011;National Institute of Statistics and Geography [INEGI], 2016), with 25% of children under five years of age showing mild or moderate developmental delays due to socioeconomic risk factors such as poverty, inadequate health services, lack of health equity, and a culture of prevention that could affect their school and work performance. All of these perpetuate the cycle of lack of opportunities for them (Phillips et al, 2016;Alvarado-Ruiz, Martínez-Vázquez, & Sánchez-Pérez, 2013;Grantham-McGregor et al, 2007). It is important for health personnel at the primary health care level to have an instrument with development indicators for reliable screening that will enable them to monitor the first two years of life, and provide timely care and prevention in order to achieve optimal development.…”

“…It is important for health personnel at the primary health care level to have an instrument with development indicators for reliable screening that will enable them to monitor the first two years of life, and provide timely care and prevention in order to achieve optimal development. To this end, the American Academy of Pediatrics proposes the use of reliable, validated screening instruments for the detection of child development risks (Rydz et al, 2006; Committee on Children with Disabilities, 1994; Bright Futures Steering Committee and Medical Home Initiatives for Children with Special Needs Project Advisory Committee, 2006;Hamilton & Woodbury, 2006;Phillips et al, 2016). Bearing this in mind, at the Subdirectorate of Rehabilitation of the National System for Integral Family Development, Benavides, Sánchez, and Mandujano (1985) have designed and used the Neurobehavioral Assessment of Infant Development (VANEDELA) for the detection and timely care of risks of neurological sequelae during the process of childhood growth and development.…”