Conducting a rapid health promotion audit in suburban Adelaide, South Australia: Can it contribute to revitalising health promotion?

Abstract

Issues addressed: How health promotion is implemented varies and it is often not clear what activities are in place in a region. Understanding the extent of health promotion activities helps planning activities.Methods: This research involved a rapid audit of the types of health promotion activities in a suburban region of South Australia. This analysis was guided by the WHO Ottawa Charter's principles. To better understand population needs and which health promoting activities may help, an epidemiological, demographic and social determinants of health profile of southern Adelaide described disease patterns and health inequities.Results: While there was evidence of a range of health promoting activities, most concerned individual or behavioural services. A key finding was the small number of activities that the state health department and local health system were responsible for. Alongside local government, NGOs provided the bulk of health promotion activities. In addition, there were no overarching health promotion strategies or coordinating bodies to evaluate the activities. The epidemiological, demographic and social determinants of health profile found persistent health and social inequities. Conclusion: This rapid audit of health promotion in a region enabled a quick assessment of the current health promotion situation and provided evidence of gaps and areas where policy change should be advocated. So what?: The key findings distilled from this research were designed to inform policy priorities to shift health promotion in southern Adelaide onto a trajectory consistent with the Ottawa Charter and prevent further focus on individualised behaviour change strategies known as 'lifestyle drift'. K E Y W O R D S health promotion, health status disparities, public policy, social determinants of health | 489 ROESLER Et aL.

We cannot keep doing what we have always done and expect that things will be different: A scoping review of the lifestyle drift concept

“…The biomedical model has remained dominant over other paradigms within health systems (19,21,29,36,37) in spite of substantial levels of ill health in the population broadly and persisting and profound health inequities (45). Although these two factors are intertwined in their contribution to lifestyle drift and frequently appear in combination within government and institutional approaches (33,34), they are often de ned separately in the literature and re ect largely distinct mechanisms of in uence.…”

“…Another factor that is closely related to neoliberalism and lifestyle drift is the commercial determinants of health. Researchers identi ed that lifestyle-focused interventions were a strategy that is often endorsed by the corporate sector (25,33) and that these strategies have been used to align industry with healthcare (48). Corporate involvement on institutional boards can also serve to maintain strategic focus on lifestyle factors (25).…”

“…The biomedical model featured as a key issue across many of the included papers (19)(20)(21)23,25,29,33,34,36,40). Schrecker (35) describes how medical disciplines and what they privilege as evidence, supports the dismissal of recommendations to promote health equity:…”

“…This medicalization was recognized as affecting efforts focused on reducing obesity (20), people with disabilities (21), Indigenous peoples (19,50), pain management (24), men's health (25), children and youth (29), heart disease (33), and the general population (35,37,40,41,49).…”

“…Finally, supporting participation of priority populations was identi ed as a recommendation within ten of the publications. These strategies ranged from including the voices of priority populations in governance (33), collaboration with patients and co-creation with children and youth (32), community empowerment (16,30,39), consultation with people with disabilities (21), partnership with Indigenous communities (19), partnership with citizen groups (11), giving disadvantaged citizens a voice (13) and building trust with residents (31).…”