Health promotion initiatives with links to the Ottawa Charter

Closing the Gap (2008)

The World Health Organisation document provides detailed information about the global strategy to close the health gap in a generation. It calls on governments to lead immediate action on the social determinants of health to achieve health equity.

In the Australian context, the Close the Gap campaign’s goal is to close the health and life expectancy gap between Indigenous and non-Indigenous Australians within a generation. The Australian Government has set specific targets and COAG has identified a number of ‘building blocks’ that need to be in place in order to address the current state of disadvantage. The national plan of action has the goal of achieving Indigenous health equality by 2030.

Currently, the life expectation gap is 17 years. Most women in Australia can expect to live to 82 years – Aboriginal and Torres Strait Islander women can expect to live to only 64.8 years. The situation is even worse for Indigenous Australian men whose life expectancy is just 59.4 years. The main causes of this health inequality are: less access to essential health services, lack of access to primary health care, overcrowded and poor quality housing, and limited access to fresh and healthy food.

www.who.int, www.budget.gov.au  (2008/2009)  

Examples of links to action areas of the Ottawa Charter

Build healthy public policy

• The WHO has identified inequality among populations and population groups globally. In order to reduce this inequality they have developed the policy document ‘Closing the Gap in a Generation’.
• In line with the WHO policy document the Australian governments committed to change at the December 2007 Council of Australian Governments (COAG) meeting. The ‘Close the Gap Statement of Intent’ was signed by the Prime Minister in March 2008.
• Establish a national Indigenous representative body.
• Provide funding to build a skilled and professional workforce to cope with the challenges of remote Indigenous education.
• Set measurable targets for health equality.

Create supportive environments

• Train an adequate number of health professionals (preferably Aboriginal and Torres Strait Islanders) to deliver primary health care and other health care services.
• Ensure supplies of fresh healthy food are available to Indigenous people by 2018.
• Provide the necessary housing, waste supplies systems to support the achievement of health equality.
• Recruitment of Indigenous trainees by the Australian Federal Police, developing educational programs on policing in Indigenous communities and boosting the profile and work of AFP officers in Indigenous communities through community activities.
• Provide extra teachers for remote schools.

Strengthen community actions

• Involve Aboriginal and Torres Strait Islander peoples and their representative bodies as active participants in health planning at local and regional levels.
• Delivery of culturally appropriate primary health services by Aboriginal Community Controlled Health Services.

Develop personal skills

• Provide primary health care services to the Aboriginal and Islander population, particularly through Aboriginal Community Controlled Health Services, by 2018.
• Provide health care and access to early learning support for Indigenous mothers, babies and children.

Reorient health services

• Invest in primary health care where prevention and promotion are in balance with curative services.
• Provide appropriate education through health services to promote healthy, structured lifestyles and prevent the heavy onset of chronic diseases in the 34–45 age group.
• Initiate the changes that will ensure Aboriginal communities have the necessary housing, water supplies and systems to support the achievement of health equality.

National Chronic Disease Strategy (2005)

The National Chronic Disease Strategy (NCDS) has been developed to provide national policy directions to manage and improve chronic disease prevention and care across Australia. It focuses mainly on the direction to be taken by the health system. It seeks to improve health outcomes and reduce the impact of chronic disease by providing a framework of agreed national directions for improving chronic disease prevention and care across Australia.

www.health.gov.au

Examples of links to action areas of the Ottawa Charter

Build healthy public policy

• Build workforce capacity in terms of availability and skills.
• Reduce health inequalities by focusing on the needs of population groups disproportionately affected by chronic disease.
• Provide a flexible health system that can coordinate care planning across services, settings and sectors.

Create supportive environments

• With the support of health care providers, enhance people’s ability to make informed decisions and undertake the health actions necessary to maximise their wellbeing and quality of life.
• Develop infrastructure and information technology support.
• Create an environment in which care for people with chronic disease involves a multidisciplinary approach, including general practice, community health, hospitals, private providers and community and non-government organisations. It may also require community and disability support as well as support for families and carers.

Strengthen community actions

• Provide culturally safe and appropriate approaches across all the elements of prevention and care.
• Support the contribution of family and carers.
• Encourage collaboration between health services, patients, their family and carers to provide person-centred optimal care.
• Empower population groups and communities to take control of their health status, specifically those disproportionately affected by chronic disease (ATSI, aged, socioeconomically disadvantaged, people with physical and mental disabilities).

Develop personal skills

• Provide health promotion for the whole population.
• Develop people’s self-management skills to enhance their capacity to take responsibility for their own health in areas such as risk reduction of chronic diseases, informed decision-making, care planning, medication management, etc.

Reorient health services

• Significant, targeted and coordinated action focused on risk factor prevention and reduction.
• Enhanced investment in effective health promotion and risk reduction interventions.
• Identification and implementation of evidence-based and cost-effective approaches to early detection and early treatment.

Road Safety 2010

Road Safety 2010, the framework for halving the road toll over the next decade, describes speeding as the greatest contributor to road fatalities in NSW. The speeding campaigns aim to reduce the annual cost to the community of speed-related crashes, which is more than $827 million per year.

www.transport.nsw.gov.au/operations/roads-and-waterways

Examples of links to action areas of the Ottawa Charter

Build healthy public policy

• Legislation to permit fixed digital speed cameras to operate in NSW.
• The 50 km/h urban limit is part of a nationwide strategy to reduce the incidence of injury and death on the roads. Even small reductions in vehicle speed can reduce the number of deaths and severity of injuries.
• Mandatory road safety courses will be developed to enable offenders to change their behaviour and develop safer driving habits.
• Policy reform in relation to the requirements of progressing through driver training, including hazard perception test and driver qualification test.
• Penalties have increased for drink driving, excessive speeding, and ‘road rage’ offences.

Create supportive environments

• The ‘Speeding – no one thinks big of you’ campaign (launched in 2007) aims to make speeding socially unacceptable, just as drink driving is.
• ‘P plate speeding campaign’ aims to increase awareness of the police enforcement operation targeting young drivers. It consists of two 15-second commercials advertising on bus backs and outdoor billboards.
• Fixed speed cameras at 13 primary school sites in NSW.
• Three warning signs installed on the approach to a regular fixed speed camera.
• Testing of Intelligent Speed Adaptation systems where the vehicle ‘knows’ the speed limit and is capable of using that information to give feedback to the driver or limit the vehicle’s speed.
• Upgrading existing roads and higher safety standards in new road construction to improve road safety.
• Construction of cycle ways to separate cyclists from other traffic.

Strengthen community actions

• The sponsorship of the RTA SpeedBlitz Blues is part of an ongoing campaign to raise awareness about the consequences of speeding, and to change attitudes towards speeding, particularly among young male drivers – who remain the most at-risk group on the roads.
• Continuing to work with community-based organisations to provide ‘driver reviver’ sites to combat driver-fatigue-related accidents.

Develop personal skills

• The ‘speeding campaign’ delivers a straightforward message about the actual difference in stopping distances for a vehicle travelling at 60 km/h compared to one travelling at 65 km/h. A key issue in speeding- related crashes is the fact that most motorists underestimate the distance needed to stop.
• The ‘Country speeding campaign’ aims to reduce speeding-related crashes in NSW by challenging the belief that being familiar with the road means you can drive above the speed limit and increasing drivers’ awareness of the dangers of speeding around bends.
• The ‘Notes campaign’ uses advertisements in cinemas and magazines to specifically target drivers aged 17–25 years. It aims to increase awareness of speeding as a significant killer of young drivers, make young drivers stop and think about their risk-taking behaviour, and encourage young drivers to modify their speeding habits and slow down.
• Introduction of the Graduated Licencing Scheme to increase novice drivers’ experience and to improve knowledge, driving ability and hazard perception.
• School education road safety programs for protection of children and development of long-term safe behaviours.
• Provision of adequate road crossing facilities, audio/tactile signals, and ramps for wheelchairs, prams and shopping trolleys to create a safer environment for pedestrians.

Reorient health services

• The ‘Slow Down Roadshow’ travels around the state educating the community about the consequences of speeding.

Many of the previously mentioned strategies and campaigns that increase road safety awareness promote a preventative approach to road safety issues, thereby reorienting health services towards health promotion.

National Binge Drinking Strategy (2008)

In March 2008 the Prime Minister announced a National Binge Drinking Strategy which provides $53.5 million over four years to address binge drinking among young people.

www.health.gov.au
www.drinkingnightmare.gov.au
www.healthyactive.gov.au (National Binge Drinking Strategy – media release – 19 local community initiatives)

Examples of links to action areas of the Ottawa Charter

Build healthy public policy

• Invest $14.4 million in community level initiatives to confront the culture of binge drinking, especially in sporting organisations.
• Close the dangerous tax break for alcopops, which encourages young people to binge drink.
• Receipt of Commonwealth Government support by 19 local communities for grassroots programs to help tackle binge drinking by young people.

Create supportive environments

• Investigate options in relation to closing hours, responsible service of alcohol, reckless secondary supply of alcohol and the alcohol content in ready-to-drink beverages.

Strengthen community actions

• Provision of funding (initially to 19 local communities) to develop local solutions to address youth binge drinking within their own community.
• Community organisations working with local police to address underage drinking.
• Community level initiatives to confront the culture of binge drinking, particularly in sporting organisations.

Develop personal skills

• TV, radio and internet campaign that confronts young people with the costs and consequences of binge drinking.
• $19.1 million to intervene earlier to assist young people and ensure that they assume personal responsibility for their binge drinking.
• Early intervention initiatives to focus on cultures and environments as well as placing a new emphasis on personal responsibility and improved decision-making skills.
• Interactive internet-based game, ‘Don’t turn a night out into a nightmare’, is designed to encourage teenagers and young adults to think about the choices they make about drinking, and particularly the possible negative consequences of excessive alcohol consumption. These harms may include health problems, injury, violence and social problems, including the breakdown of relationships.

Reorient health services

• Diversion programs to get young people under the age of 18 back on track before more serious alcohol-related problems emerge.
• $5.2 million to expand the Good Sports initiative of the Australian Drug Foundation to support local sporting clubs to build a culture of responsible drinking.
• Establishment of a taskforce to develop a national preventative strategy which will focus on excessive alcohol consumption as well as obesity and tobacco.

Aged Care Access Initiative (2008)

The Aged Care Access Initiative, announced in the 2008–09 Federal Budget, aims to improve access to primary care services for residents of Commonwealth-funded aged care facilities.

www.health.gov.au

Examples of links to action areas of the Ottawa Charter

Build healthy public policy

• A GP incentive payment to encourage GPs to provide increased and continuing services in residential aged care facilities.
• A payment for allied health professionals for clinical care services in residential aged care facilities, where these services are not covered by Medicare or other government funding arrangements.
• The Aged Care Access Initiative is expected to support an additional 260,000 GP consultations and provide approximately 150,000 allied health services in residential aged care facilities over a four-year period.
• Investment of $7 million over five years to encourage 1,000 qualified nurses who have been out of the health workforce for more than 12 months to come back to work in the aged care sector.

Create supportive environments

• A total of 6,525 new residential aged care beds across Australia to provide much-needed care for frail older Australians.
• Through financial incentives, provide greater access to GPs for the elderly.
• Provide allied services to enter the aged care facilities and provide support either on an individual or group basis.

Strengthen community actions

• Facilitate relationship building between GPs, divisions of general practice and residential aged care facilities.
• Shared planning and priority setting with other local organisations.

Develop personal skills

• Additional clinical services may be provided by allied health professionals, eg group psychology sessions, group exercise, falls prevention programs to develop skills and maintain the physical activity required to reduce the risk of injury and associated ageing changes.

Reorient health services

• Over five years the government will create 2,000 more transition care beds for older Australians who are currently waiting in hospital. This will help older Australians move from hospital care to more appropriate specialised aged care, or move from hospital back to home.