“Never mind the logic, give me the numbers”: Former Australian health ministers' perspectives on the social determinants of health

Baum, Fran; Laris, Paul; Fisher, M.; Newman, Lareen; MacDougall, Colin

doi:10.1016/j.socscimed.2013.03.033

Cited by 67 publications

(90 citation statements)

References 20 publications

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“…Evidence also suggests that advocacy is most successful when it advances only one or two clearly defined, specific proposals for a policy change, which also fit with a Government's political objectives (Baum et al, 2013). However, some governments, including State governments in Australia, are applying methodologies to advance cross-sectoral action on SDH, and these have been applied within an urban regional context (Kickbusch and Buckett, 2010).…”

Section: Micro: Individual and Family Circumstancesmentioning

confidence: 99%

Social determinants in an Australian urban region: a ‘complexity’ lens

Fisher¹,

Milos²,

Baum³

et al. 2014

Health Promot. Int.

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SUMMARYArea-based strategies have been widely employed in efforts to improve population health and take action on social determinants of health (SDH) and health inequities, including in urban areas where many of the social, economic and environmental factors converge to influence health. Increasingly, these factors are recognized as being part of a complex system, where population health outcomes are shaped by multiple, interacting factors operating at different levels of social organization. This article reports on research to assess the extent to which an alliance of health and human service networks is able to promote action on SDH within an Australian urban region, using a complex systems frame. We found that such an alliance was able to promote some effective action which takes into account complex interactions between social factors affecting health, but also identified significant potential barriers to other forms of desired action identified by alliance members. We found that a complex systems lens was useful in assessing a collaborative intervention to address SDH within an urban region.

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Section: Micro: Individual and Family Circumstancesmentioning

confidence: 99%

Social determinants in an Australian urban region: a ‘complexity’ lens

Fisher¹,

Milos²,

Baum³

et al. 2014

Health Promot. Int.

Self Cite

View full text Add to dashboard Cite

show abstract

“…This is a common dilemma faced by the Australian primary health care sector which often recognises social determinants, but feels obliged to follow the lead of policy makers, and provide a more biomedical, service-oriented, rather than community oriented approach. 309 However, Baum reports that despite the barriers, primary health care can play an important role in addressing social determinants of health and in advocating on behalf of their clients to policy makers. 310 Interventions to address social determinants in primary care through referral to appropriate community resources have led to improvements in social and emotional wellbeing.…”

Section: Health Assessment Ambivalencementioning

confidence: 99%

“…410 Health services like the IIHS, situated in the biomedical model of health favoured by policy makers, 309 could also use their resources to address SCEDH.…”

Section: Implications For Clinicians and The Health Servicementioning

confidence: 99%

“…309 The neoliberal emphasis on the individual marginalises holistic conceptions of health, creating difficulties for policy makers who seek to address inequitable social determinants. 309 The medical profession, with its biomedical emphasis, adds to these difficulties by constantly calling on policy makers with limited resources to invest in the acute health care sector and fee-for-service medical funding, rather than addressing SCEDH and supporting comprehensive primary health care. 309,442,443 By accepting an overly narrow, biomedical definition of health, policy makers risk misinterpreting health information and failing to put health issues in their proper context.…”

Section: Challenges For the Health System And Policy Makersmentioning

confidence: 99%

“…309 The medical profession, with its biomedical emphasis, adds to these difficulties by constantly calling on policy makers with limited resources to invest in the acute health care sector and fee-for-service medical funding, rather than addressing SCEDH and supporting comprehensive primary health care. 309,442,443 By accepting an overly narrow, biomedical definition of health, policy makers risk misinterpreting health information and failing to put health issues in their proper context. 444 For example, Boddington and Raisanen argue that a Western conception of health is unlikely to accommodate the provision of programs designed to assist…”

Section: Challenges For the Health System And Policy Makersmentioning

confidence: 99%

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Computerised Aboriginal and Torres Strait Islander health assessments in primary health care research

Spurling¹

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There has been insufficient research involving Aboriginal and Torres Strait Islander peoples living in urban areas to inform strategies required to improve inequitable health outcomes and life expectancy for Aboriginal and Torres Strait Islander peoples. The injustice of these health inequities motivated me to investigate the use of computerised Aboriginal and Torres Strait Islander health assessments in primary care as a source of research data which can be used to respond to community priorities. I conducted this research at the Inala Indigenous Health Service, a Queensland Government funded primary health care service for Aboriginal and Torres Strait Islander peoples. Inala is a suburb in south-western Brisbane with a strong sense of community and identity, but also significant social and economic challenges. Staff at the Inala Indigenous Health Service have been using Aboriginal and Torres Strait Islander health assessments for both clinical and research purposes since their introduction in 2004 for adults, and 2006 for children.In this thesis, I used a mixed methods approach. The first two research projects of this thesis are situated in the postpositivist paradigm where researchers accept that scientific research produces evidence which helps establish the probability that a finding is true rather than truth itself. The first research project evaluated the feasibility of implementing computerised health assessments in primary care for dual clinical and research purposes.After finding that it was feasible, the second research project established that computerised health assessment data were sufficiently representative, complete, reliable, and valid to produce credible research findings.The final two research projects of this thesis are situated in the transformative paradigm with the explicit goal of improving the social world. I acknowledge that my position as a white, non-Indigenous, male, medical researcher influenced the conduct and outcome of all the research projects in this inquiry. To minimise the risk that this research would reproduce the damaging effects of research for Aboriginal and Torres Strait Islander peoples conducted by non-Indigenous researchers, I listened to community voices to inform my approach to research using computerised health assessment information.I conducted a qualitative study involving thematic analysis of semi-structured interviews with key informants in the Inala Aboriginal and Torres Strait Islander community regarding their priorities for health and research based on health assessment data. Rather than a discrete set of health priorities, key informants articulated an authoritative understanding of how interrelated, inter-generational, social, cultural, and environmental determinants of iii health operated in a "cycle" to influence the community's health. Furthermore, some key informants were ambivalent about Aboriginal and Torres Strait Islander health assessments because of their biomedical emphasis. These findings supported the addition of questions to health...

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The Syndemic of Opioid Misuse, Overdose, HCV, and HIV: Structural-Level Causes and Interventions

2018

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Advances in multi-level theory and statistical methods allow sound ecologic and multi-level analyses of the impact of structural factors on the syndemic. Studies of opioid misuse, overdoses, hepatitis C virus, and HIV demonstrate that area-level access to healthcare, medication-assisted treatment of opioid use disorders, sterile injection equipment, and overdose prevention with naloxone, as well as factors such as opioid marketing, income inequality, intensity of policing activities, and health care policies, are related to the prevalence of substance misuse, overdoses, infection risk, and morbidity. Structural variables can predict area-level vulnerability to the syndemic. The implementation of combined prevention and treatment interventions can control and reverse components of the syndemic. Recognizing and monitoring potent structural factors can facilitate the identification of areas at risk of vulnerability to the syndemic. Further, many structural factors are modifiable through intervention and policy to reduce structural vulnerability and create health-enabling environments. Evidence supports the immediate implementation of broader HCV and HIV testing and substance use screening, medication-assisted treatment, needle/syringe exchange programs, naloxone programs, increased population-level implementation of HCV treatment, and further attention to structural-level factors predicting, and contributing to, area-level vulnerability, such as degrees of opioid marketing, distribution, and prescribing.

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“Never mind the logic, give me the numbers”: Former Australian health ministers' perspectives on the social determinants of health

Cited by 67 publications

References 20 publications

Social determinants in an Australian urban region: a ‘complexity’ lens

Social determinants in an Australian urban region: a ‘complexity’ lens

Computerised Aboriginal and Torres Strait Islander health assessments in primary health care research

The Syndemic of Opioid Misuse, Overdose, HCV, and HIV: Structural-Level Causes and Interventions

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