strategic priorities - vichealth

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VICTORIAN HEALTH PROMOTION FOUNDATIONSTRATEGIC PRIORITIES 2006–2009

Victorian Health Promotion Foundation PO Box 154 Carlton South Victoria 3053 Australia Phone: +61 3 9667 1333 Fax: +61 3 9667 1375 Email: [email protected]

September 2006

www.vichealth.vic.gov.au

Shaping a SuStainable healthy future 4

Who We are & What We do 5

promoting health 6

What influenceS health? 7

ViSion & miSSion 8

ValueS 9

Setting prioritieS 9

lead, empoWer, Support, connect 10

Vichealth Strategic frameWork 2006–2009 18

integrated themeS

Innovating & Building Evidence 20 Tackling Health Inequality 21

our prioritieS

tobacco control & responsible alcohol use 22

Reducing Harm from Tobacco 22 Reducing Alcohol Misuse 23

active communities & healthy eating 24

Increasing Participation in Sport & Active Recreation 24 Encouraging Walking & Cycling 26 Promoting Healthy Eating 27

mental health & Wellbeing 28

Strengthening Policy & Practice 29 Promoting Social Inclusion 30 Reducing Discrimination 31 Reducing Levels of Violence Against Women 32 Increasing Access to Economic Resources 33

making Sure We can achieVe our goalS 34

referenceS 35

contentS

Vichealth Committed to promoting the health

and wellbeing of all Victorians. We have set ourselves ambitious goals and know that we can only achieve

them by working with others.

4 www.vichealth.vic.gov.au VicHealth Strategic Priorities 2006–2009 �

The Victorian Health Promotion Foundation (VicHealth) was established by the Victorian Parliament in accordance with the Tobacco Act 1987 with a mandate to promote good health for all Victorians.

VicHealth is an independent, statutory authority with a chair and 14 member board of governance that is responsible to the Minister for Health. The Board has a breadth of experience in health, sport, the arts, research and communication.

Our focus is on promoting good health and wellbeing and preventing ill health.

VicHealth has an acknowledged track record in drawing diverse groups together to influence individuals’ health-related lifestyles and to improve the social, cultural and environmental conditions to sustain health.

With support across the political spectrum we work in partnership with governments, organisations, communities and individuals in a broad range of sectors including sport, community, urban planning, transport, local government, education and the arts. The key to any of our successful outcomes is the strength of these partnerships. Our activities reflect national public health and state health promotion priorities and strategies.

VicHealth is in a unique position to highlight what can be achieved and influence policy change through integrating funded activities, research and rigorous evaluation. We also build opportunities for people to be informed, learn new skills, have greater access to activities that promote good health, and share healthier environments.

This innovative role allows us to lead and advocate for excellence in the development of appropriate health promoting policies and programs, as well as maintain strategic alliances with national and global public health interests that aim to strengthen health promotion action and advocacy.

There has been steady progress in our health and life expectancy over the last century in Australia and in Victoria. Much of this health gain has been due to better nutrition, housing, sanitation and education, as well as increases in wealth and employment, and prevention of infectious and non-communicable diseases.

However, we cannot be complacent. In Australia, chronic diseases cause 80% of the total burden1; and heart disease, stroke, diabetes, kidney disease and cancer all have poor nutrition and physical inactivity as important risk factors. In Victoria, the greatest burden of disease is related to illness that can be reduced or prevented through lifestyle changes and improved living conditions.2

There is a pressing need to increase investments in good health and disease prevention, especially for disadvantaged communities.

In particular we need to ensure that gains in health and life expectancy in Victoria are sustainable. Material improvements in our living conditions and lifestyles, which until now have supported gains in health and life expectancy, are becoming the source of new challenges to health.

Our health also depends on the quality of our natural, built, social and cultural environments. They determine whether we are able to walk safely, breathe easily or realise our potential physically, intellectually and emotionally. Investments in the health of our natural environment, ranging from urban parks and healthy waterways to stabilising the global climate, are also investments in the health of our community.

These challenges have shaped our focus for the next three years. We acknowledge that our strategic directions will require long-term commitment, innovative thinking, the involvement of many sectors and rigorous evaluation and research to ensure significant health improvements for Victorians, now and for future generations.

Promotion Prevention Early Intervention Treatment Rehabilitation

VicHealth’s Focus≥≥

Shaping a SuStainable healthy future

Who We are & What We do

6 www.vichealth.vic.gov.au

How much you earn, your social position, your level of education or your capacity to be involved in sporting and cultural activities that help connect you to others in your community may be as important in determining your health and wellbeing as your genes, age, sex and lifestyle choices. Social disadvantage and material deprivation are clearly linked to poor health. Poor living and working conditions, tobacco use, alcohol abuse, lack of physical activity and an unhealthy diet can all contribute to ill health.

To promote health in a population we need improvements to social, economic, cultural and physical environments in addition to developing skills and knowledge for individuals and the community.

the ottawa charter for health promotionBuilding on the Declaration of Alma Ata, the Ottawa Charter defines health promotion as: “…the process of enabling people to increase control over, and to improve, their health. To reach a state of complete physical, mental and social wellbeing, an individual or group must be able to identify and to realise aspiration, to satisfy needs, and to change or cope with the environment. Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasising social and personal resources, as well as physical capacities. Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy lifestyles to wellbeing.”3

• Behaviour. • Age. Sex. Genes.

indiVidual

family/ houSehold

• Neighbourhood facilities and infrastructure.

• Local services and amenities.• Living and working conditions.

• Social networks and support.• Group and peer norms.• Participation opportunities.• Community cohesion and stress.

• Employment, income and wealth.

• Housing and living conditions.

• Family structure and relationships.

• Health related behaviours and exposures.

community

• Policy (e.g. social, education, employment, infrastructure, health, environmental sustainability).

• Distribution of power and resources.

• Economic wealth.

• Social and cultural beliefs.

• Social structures and institutions.

• Social cohesion.

Society

Adapted from Dahlgren and Whitehead (1991)

What influenceS health?

promoting health

VicHealth Strategic Priorities 2006–2009 9

VicHealth envisages a community where:

health iS a fundamental human righteVeryone ShareS in the reSponSibility for promoting healtheVeryone benefitS from improVed health outcomeS

To help us deliver on our proposed outcomes, strategy and vision we need a skilled, engaged and committed workforce. At VicHealth you’ll find a group of dedicated people who embrace a clearly defined and agreed set of values:

Work together

Adding value to each others’ work through collaborative and cooperative relationships.

be honest

Creating trust through open, straightforward communications and honest work practices.

engage others respectfully

Enhancing mutual wellbeing by treating everyone fairly and with dignity.

challenge and be challenged

Fostering innovation by encouraging robust debate.

be eco-Wise

Protecting our future health by implementing environmentally sustainable practices.

VicHealth’s 2006–2009 strategic priorities build on our previous work and focus on the major health challenges that confront us including tobacco consumption, overweight and obesity, physical inactivity, social exclusion, discrimination, violence, alcohol misuse and the links between social and economic disadvantage and poorer health.

These priorities are consistent with VicHealth’s obligations under the Tobacco Act 1987. They also align with State Government policy and program directions, and national and international health promotion priorities and policies such as the World Health Organisation (WHO) charters and declarations for Health Promotion.

VicHealth’s priorities for 2006–2009 have been guided by our vision, mission, values and a statewide consultation conducted in partnership with the Victorian Department of Human Services to establish statewide health promotion priorities for 2007–2012. We have also adopted the following criteria to help us select priorities.

Is the impact and scale of the priority significant?

Each priority and associated program activities must address the greatest burden of disease and disability where there is scope for significant health gains.

Is there collaborative advantage in addressing the priority?

Our work in each priority must complement and add value rather than merely replicate the work of State, Commonwealth and non-government organisations.

How feasible is it to achieve the priority’s stated outcomes and deliver the potential for change?

Each priority and associated program activity needs to have a significant prospect of achieving the stated outcomes.

What are the opportunities that the priority creates?

Each priority must be timely and create short- and long-term policy and program opportunities. The associated program activities need to be cost-effective.

Our mission is to build the capabilities of organisations, communities and individuals in ways that:

• change social, economic, cultural and physical environments to improve health for all Victorians

• strengthen the understanding and the skills of individuals in ways that support their efforts to achieve and maintain health.

ValueSSetting prioritieS

lead In everything we do we have a rigorous approach to finding new ways of doing things. This fits with our value of ‘challenge and be challenged’. We always want to find the best way to promote health, we never just accept the way things have always been done.

empoWer Health is created by caring for

oneself and others, by being able to take decisions and have control over

one’s life circumstances. People should feel respected, safe, secure,

that they belong and have a voice.

Support Health depends on the quality of our environment – natural, built, social and cultural – from whether we are supported to walk safely, breathe easily or realise our potential physically, intellectually and emotionally.

connect Health promotion demands

coordinated action by all concerned. This is not always easy, and we’re

working to change things.


Vichealth Strategic Framework 2006–2009

innovating and building evidence

• Test new approaches

• Build research capacity

• Integrate research, policy and practice

promoting mental health and Wellbeing

• Promote social inclusion

• Reduce discrimination

• Prevent violence

• Increase access to education and employment

reducing harm from tobacco and alcohol

• Reduce smoking

• Reduce exposure to tobacco smoke

• Reduce alcohol misuse

creating active communities and promoting healthy eating

• Increase participation in sport and active recreation

• Improve access to nutritious food

• Encourage more walking and cycling

• Promote inclusive and accessible environments

VicHealth envisages a community where health is a fundamental human right; everyone shares in the responsibility for promoting health; and everyone benefits from improved health outcomes.

tackling health inequalities

• Target disadvantage

• Ensure equity

• Influence social and economic policy

Strengthening communities and organisations

Creating healthy public policy and environments

Working with partners across sectors

Promoting participation and skills

Our mission is to build capabilities of organisations, communities and individuals in ways that:• Change social, economic, cultural and physical

environments to improve health for all Victorians• Strengthen the understanding and the skills of

individuals in ways that support their efforts to achieve and maintain health.

>

ViSion & miSSion

integrated themeS

2006-2009 prioritieS

approacheS

>>

Vichealth Strategic frameWork 2006–2009

20 www.vichealth.vic.gov.au VicHealth Strategic Priorities 2006–2009 21

By 2009 we want to see improved access to the social and economic resources required for health by people in disadvantaged groups and areas.

tackling health ineQuality

Health inequalities are disparities in the health status of different individuals and groups. Health inequalities that are considered unfair, unnecessary and avoidable result from some form of social inequity4 such as people having exposure to stressful and unhealthy living and working conditions; limited lifestyle choices; and inadequate access to essential health and other public services; along with a tendency for sick people to move down the social scale.�

Vast inequalities in health already exist in Victoria and Australia.6 While working to improve the health of all Victorians, VicHealth will target many of its activities and initiatives towards those people in disadvantaged groups and areas, such as refugee communities and people living in remote rural areas.

remote and very remote communities are locationally disadvantaged, and have very little accessibility to goods, services and opportunities for social interaction. in 2001, remoteness was associated with higher rates of avoidable mortality among males and females.7

Goal

To improve the health and wellbeing of the most disadvantaged in our community.

our objectiVeS What We Will do

Reduce health inequalities experienced by those most affected by social and economic inequality.

Fund activities:

• in disadvantaged areas in partnership with local governments

• for lower socio-economic groups, Indigenous and refugee communities, and people with disabilities

• for disadvantaged children and young people.

Improve knowledge to understand and respond to health inequalities.

Advocate for, and support the development of, systems for monitoring the extent and distribution of health inequalities in Victoria.

Prioritise public health research addressing health inequalities.

Influence social and economic policy that has an effect on health inequalities.

Highlight the relationship between disadvantage, location and poor health.

Develop partnerships with a broad range of stakeholders, in particular those representing disadvantaged groups.

Support communities and groups to undertake advocacy on issues affecting their health.

integrated themeS

innoVation & tackling health ineQuality

VicHealtH seeks a riGorous approacH to findinG new and improVed ways of doinG wHat we do. tHis fits witH our Value of ‘cHallenGe and be cHallenGed’. we want to find tHe most effectiVe ways to promote HealtH so tHat we can make a real difference to tHe HealtH and liVes of Victorians and make sure eVeryone Has tHe opportunity to reacH tHeir full potential.

By 2009 we want to see more effective and sustainable programs for promoting health by integrating research, policy and practice.

innoVating & building eVidence

Health promotion continues to change and evolve to meet new challenges. The ability to innovate is central to the change process, be it a cycle of continuous improvement or radical shift in health promotion theory or practice. At VicHealth, innovation is adapting new and old ideas, knowledge and practice to promote health. Innovation is underpinned by our internal and external processes of integrating research, evaluation, and practice across all our work.

It is important that we continue to work collaboratively with a wide range of sectors to develop ideas and test new approaches. We will also find out what works and what doesn’t by monitoring and evaluating what we do, and sharing these findings with the wider Victorian community so that this knowledge can be adopted by others. A key challenge is to identify how to intervene in common social and economic factors that influence patterns of individual behaviour, such as illicit drug and alcohol misuse.

Vichealth looks for tomorrow’s breakthroughs by supporting the development of new ideas from a wide range of sectors and disciplines, including those not traditionally linked to health.

Goal

To build a robust knowledge and evidence base for health promotion and public health interventions.


Expand the breadth and increase the quality of research and evaluation in Victoria.

Provide support for further developing policy and infrastructure options for public health/health promotion research and evaluation.

Support leadership development for researchers.

Provide funds for novel research in areas outside priority areas.

Build evidence and knowledge to inform health promotion policy and practice.

Integrate research and evaluation in all program areas.

Promote knowledge exchange between researchers, practitioners and policy-makers.

Examine and test new approaches to designing and evaluating health promotion interventions.

VicHealth Strategic Priorities 2006–2009 23

By 2009 we want to see a strong collaborative approach by stakeholders advocating changes in regulations and licensing laws that will contribute to a reduction in alcohol-related harm; and a reduction in alcohol-related harm in adolescents and young adults.

reducing alcohol miSuSe

Alcohol is a new VicHealth priority for 2006–2009. For many years we have engaged in debates around alcohol misuse and supported programs that promote responsible drinking. However, with binge drinking among young people rising10 we need to strengthen our efforts to reduce alcohol-related harm. While the social use of alcohol is widely accepted, alcohol-related harm in Victoria results in premature disability and death associated with road trauma, workplace accidents, drowning, sexual assault, domestic and interpersonal violence, and self harm.11,12

We acknowledge the task of reducing alcohol-related harm is challenging and requires the efforts of many other stakeholders over a long period of time. Our contribution will be focused on lowering risky behaviours of young people but still inclusive of wider community changes necessary to reduce alcohol-related harm.

Since 1999 the number of alcohol-related hospitalisations in Victoria has increased by 20%. in 2003–04 an estimated 21,706 people were hospitalised for reasons attributable to alcohol.13

Goal

To further reduce the harms associated with alcohol consumption.

By 2009 we want to see a reduction in the number of people who smoke regularly from 18.5% in 2005 to 15%.

reducing harm from tobacco

VicHealth was created as part of the Tobacco Act 1987 and has always prioritised action to reduce tobacco use. Through our long-standing partnership with non-government agencies and government, smoking rates have declined. More people are aware of the health implications of tobacco smoke and attitudes towards smoking in homes and public places have also changed.

However, smoking remains the biggest killer in Victoria.8 Tobacco companies are still using creative marketing strategies, and we are in need of fresh ideas if we are to continue to influence people’s behaviour to cease smoking. Continued funding of the tobacco control program at The Cancer Council Victoria is essential if we are to reduce premature deaths.

Victoria would benefit by $2,034 million over a 20 year period from a 5% reduction in smoking rates.9

Goal

To further reduce the harms associated with smoking and second-hand tobacco smoke.

our prioritieS

tobacco control & reSponSible alcohol uSe



Maintain world’s best practice in tobacco control.

Collaborate effectively with the tobacco control program – a joint initiative of The Cancer Council Victoria, VicHealth, the Department of Human Services and the National Heart Foundation (Victoria).

Provide funding, expert advice and contribute to activities of the tobacco control program by sharing resources and risks.

Promote changes to legislation and regulation, packaging, advertising and display, and smoke-free environments (workplaces, pubs, clubs).

Strengthen our advocacy by building inter-sectoral and inter-governmental relationships.

Collaborate on the development of advocacy campaigns.

Improve the evidence for effective tobacco control strategies.

Support high quality research that focuses on the legal, social and economic issues of tobacco control.

Identify strategies for disadvantaged groups.

Disseminate new knowledge to relevant decision-makers, programs and sectors.


Facilitate a consolidated approach to reduce alcohol misuse.

Build stronger public advocacy on issues relating to alcohol- related harm.

Work with government to establish a coalition of key Victorian stakeholders and develop a united vision.

Advocate for stronger controls on advertising and licensing laws.

Support programs aimed at increasing local community action to reduce harm.

Build evidence on the social impacts of alcohol consumption and identify effective interventions for reducing alcohol- related harms.

Fund research to build knowledge and evidence on alcohol-related behaviours, and effective interventions.

Develop programs to reduce alcohol- related harms.

Lead the development of new approaches that tackle the underlying determinants of alcohol misuse among young people.

Continue to develop and strengthen programs that promote responsible drinking and shift cultural norms around drinking.

24 www.vichealth.vic.gov.au VicHealth Strategic Priorities 2006–2009 2�

People seek participation opportunities in organised sport and active recreation for three key reasons – fun, friends and fitness. The challenge for the sport and active recreation sector is to develop more flexible and inclusive opportunities to increase participation. VicHealth will continue working with state and community-based organisations to better understand how opportunities for participation can be strengthened.

it is estimated that in 2002, 1.63 million children aged 5–14 years (62%) participated in organised sport out of school hours.20

Goal

To increase participation in community sport and active recreation, particularly for people with disabilities and those from low socio-economic, Indigenous and new arrival communities.


Increase individuals’ access and opportunities to participate in sport and active recreation.

Continue to support organised sport to implement diverse and flexible participation opportunities.

Fund community sport and active recreation activities that focus on population groups and communities with low participation rates.

Increase the knowledge of sport and active recreation organisations about the physical and mental health benefits of participation.

In collaboration with government and non-government agencies, provide resources and/or workforce development to organisations providing sport and active recreation.

Educate organisations and communities to recognise the role of sport and active recreation in enhancing social inclusion.

By 2009 we want to see an increase in: the percentage of Victorian adults participating in sufficient physical activity for health gain by 4% from 58% in 2004 to 62%; the frequency of school-aged children participating in physical activity; and the consumption of vegetables and fruit per capita by one serving per day.

Physical activity along with healthy eating protects people against obesity and many illnesses. Being physically active can also reduce feelings of stress and depression. In safe, attractive and vibrant communities, people are more likely to be physically active and experience a better quality of life. In turn, people being active in their community contributes to the amenity and safety of their neighbourhoods.

The challenge is to ensure people eat enough nutritious food and do enough physical activity to achieve a health benefit. We are living more sedentary lives as a result of passive forms of entertainment and increased reliance on labour saving devices and changes to our built environment. Over many years, urban sprawl has seen suburbs built in ways that promote car dependency and offer fewer facilities and infrastructure to encourage walking, cycling or playing.14

Linking improved access to nutritious foods with greater opportunities to be physically active is one of the most effective ways to promote better health for all Victorians. Creating the right policy, and social and physical environments, to make this happen is a key focus of our work. To do this we will continue to collaborate with many groups in different sectors.

people who do less than the recommended amount of physical activity have an increased risk of mortality and morbidity from a range of diseases and conditions. low levels of physical activity have been estimated to have accounted for 6.7% of the burden of disease in australia in 2003.15

increasing vegetable and fruit consumption in australia by just one serve a day would save between $8.6 million and $24.4 million in direct health costs associated with cardiovascular disease.16

overall goal

To increase the proportion of Victorians who participate in sufficient physical activity17 and eat nutritious food.18

By 2009 we want to see an increase in: the percentage of Victorian adults experiencing social and economic disadvantage who participate in sport and active recreation; and Victorian school-aged children (primary and secondary) who participate in sport and active recreation.

increaSing participation in Sport & actiVe recreation

Participating in a sports club or active recreation activities (such as performing arts or bushwalking) has positive social and psychological effects. These include increased self-esteem, better development of life skills, decreased involvement in risky behaviours such as drug taking, and an increase in academic achievement.19 Sport and active recreation activities can also be part of the glue that holds communities together. They can build community pride and loyalty and connect people across age groups and backgrounds.

our prioritieS

actiVe communitieS & healthy eating


Create physical and social environments that are inclusive, safe, responsive and which support participation.

Fund community sport and active recreation organisations to implement policy and practices that increase participation, particularly by those people who wouldn’t normally participate.

Support local government to adopt an integrated approach to planning by considering the health impacts of built, natural, economic and social environments.

Build evidence and transfer knowledge to influence policy, practice and advocacy activity.

Identify patterns of participation and explore the reasons for variances.

Incorporate findings from physical activity and obesity-related research and evaluations into future program activities.

Test and implement innovative strategies that will foster sustained participation, particularly for those who are disadvantaged.


By 2009 we want to see an increase in the supply of and access to a variety of food options; and an increase in the consumption of vegetables and fruit in the local government areas we are supporting.

promoting healthy eating

Good eating habits play a central role in maintaining good health and preventing obesity, diabetes, heart disease and some cancers. But Victorians, like all Australians, have changed their eating patterns substantially over the past few decades23 and adult and childhood obesity is on the increase.24

People are more likely to consume food outside the home and there is now a greater reliance on pre-packaged and energy-dense foods (those high in sugar and fat) and less on consumption of vegetables and fruit.2�,26 People in lower socio-economic groups are less likely to eat a diet consistent with dietary guidelines.27-30

Poor nutrition rarely results from a lack of knowledge; it’s more to do with the social, cultural, environmental and economic factors influencing the choices people make. We need to work together to find ways to improve access to food for healthy eating and advocate for policies and legislation that encourage nutritious food choices.

less than 6% of Victorian males and 11% of females consume the recommended amount of vegetables and fruit each day.31

Goal

To increase the number of Victorians eating nutritious food, particularly those experiencing social, economic or geographic disadvantage.

By 2009 we want to see an increase in the percentage of children walking and cycling to school on most days from 20% in 2003 to 35%.

encouraging Walking & cycling

Car usage and car dependency have risen dramatically over the past 20 years with more trips being made in the car and less on foot, bikes or public transport.21 Increasing the number of people who walk and/or cycle as a means of transport to work, school or for recreation has benefits for the individual, community and the environment.

The challenge is to reverse the trend and create neighbourhoods, communities and a culture where people choose sustainable, safe and healthy transport options. This task requires building new and strengthening existing relationships across a range of organisations and sectors, such as transport, planning and environment.

70% of children aged 5–12 years are driven to school even though 80% of them live within 3km of their school. in the 1980s, 80% of children walked to school.22

Goal

To increase the number of people who walk and/or cycle as a means of transport, including the number of primary school children walking and cycling to and from school.


Establish a coordinated and integrated approach to promoting walking and cycling.

Build partnerships with and between government and non-government organisations.

Develop a model for the coordination and implementation of initiatives at a state and community level.

Advocate for statewide surveillance and monitoring of active transport patterns for children, youth and adults.


Increase the knowledge and skills of organisations, communities and sectors to promote walking and cycling.

Work in partnership with relevant organisations to support the development of children’s pedestrian and road safety skills.

Develop resources and provide workforce development for health promoters, urban and transport planners, teachers, and road and traffic engineers.

Increase community awareness of the health, environmental, social and economic benefits of walking and cycling.

Implement public awareness campaigns to promote walking and cycling for transport and for recreation.

Develop tools that measure the environmental, social and economic benefits of walking and cycling.

Create safe physical and social environments that encourage children to walk and cycle to and from school.

Collaborate with major stakeholders such as VicRoads, Department of Infrastructure, Department of Sustainability and Environment, and Planning Institute of Australia (Victorian Division).

Review relevant legislation, policies and regulations that restrict or enhance walking and cycling.

Support local government and primary schools to deliver active transport initiatives to promote walking and cycling.

Increase understanding of facilitators and barriers to walking and cycling.

Fund research that investigates factors that influence walking and cycling for transport across different population groups and communities.


Increase awareness, knowledge and skills within organisations, communities and sectors to promote healthy eating.

Provide resources and workforce development to local government, planners and community agencies.

Create built, natural, social and economic environments that encourage healthy eating.

Support local government to improve supply and access to nutritious foods.

Work in partnership to advocate for and support:

• Law and policy reform in areas of food retail, marketing, advertising, access and availability.

• Social and economic policy change that will promote healthy weight.

Identify effective strategies that will improve the consumption of vegetables and fruit, and promote healthy weight.

Fund research and pilot new interventions to increase consumption of vegetables and fruit.

our prioritieS

actiVe communitieS & healthy eating


By 2009 we want to see evidence-informed mental health promotion embedded into the planning and activities of a range of sectors and organisations.

Strengthening policy & practice

Mental health promotion is a relatively new field of work and the concepts underpinning practice are not widely known. We need to fill the gaps in knowledge about how to promote mental health and find a common language that is easily understood and accepted across all sectors, not just in health. We will continue to work with practitioners from diverse sectors, focusing on the most powerful factors that influence mental health and ensuring that they recognise how to promote mental health and wellbeing.

Goal

To increase the skill and knowledge of disciplines and sectors to develop, implement and sustain mental health promotion.

By 2009 we want to see an increase in access to supportive relationships and a reduction in levels of violence and discrimination experienced within the Victorian population.

Mental health is essential to our wellbeing. It provides individuals with the vitality necessary for active living, to achieve personal goals, and to interact with one another in ways that are respectful and just. Unfortunately, mental health problems are common32 and the human, social and economic consequences are great.

Our focus is on promoting mental health rather than treating mental ill health, which is about mental disorders, symptoms and problems.33 One of the most important concepts of our work in promoting mental health is the notion of community wellbeing and the role of cohesive, equitable communities in preventing mental illness.

To this end, we will focus on key factors that have a particular influence on mental health: breaking down social isolation, reducing violence and discrimination, and improving access to economic resources for disadvantaged groups. This involves initiatives in different sectors with the emphasis on one or more of the key factors listed above rather than a focus on disease prevention.

in contrast to the overall health gains of the world’s population in recent decades, the burden of mental illness has grown.34

overall goal

To improve the mental health and wellbeing of all Victorians, in particular those who are most vulnerable because of their social, economic or geographic circumstances.

our prioritieS

mental health & Wellbeing


Integrate applied research, policy and practice in mental health promotion.

Establish the Centre for the Promotion of Mental Health and Community Wellbeing.

Identify models of good practice to increase social inclusion, reduce discrimination and prevent violence by supporting intervention research.

Support up to four new Research Fellows.

Strengthen mental health promotion practice across sectors.

Deliver the Mental Health Promotion Short Course.

Host the 2008 World Conference on Mental Health.

Gain greater support for mental health promotion activities across government sectors.

Contribute to and inform the development of government policy.

Establish partnerships to develop projects across sectors.

Support five Policy Fellows to be located in relevant departments.

Secure cross-government resources to support mental health promotion activity within the field.


By 2009 we want to see a 5% increase in people who think that multiculturalism makes life in their area better from 57% in 2005 to 62%.

reducing diScrimination

Promoting contact and cooperation between different groups in our community is an effective way of overcoming prejudice to create a more tolerant and cohesive society.37, 38

VicHealth is keen to promote respect for diversity by supporting activities that involve different groups, such as cross-cultural community kitchens, sports, arts and education-based projects. We will also support leadership development in Indigenous communities to assist them to address discrimination and create strong and healthy communities.

in a review of 47 population-based research studies addressing discrimination, 38 found an association between racial and ethnic discrimination and mental illness.39

Goal

To increase the percentage of people who value cultural diversity and actively discourage discrimination.

By 2009 we want to see a 10% increase in people participating in community events from 54% in 2005 to 64%; the percentage of people who are members of one or more community groups increasing by 5% from 73% in 2005 to 78%; and proportionally greater improvement in these indicators in disadvantaged areas and amongst disadvantaged population groups.

promoting Social incluSion

Belonging to and participating in social networks, such as community events and groups, where people feel respected, safe, secure, that they belong, and have a voice, has positive effects on health.3� VicHealth’s long-time partnerships with groups from the arts, sport and community sectors are a vital foundation for identifying and sustaining social inclusion strategies.

Patterns of use of new information and communication technologies challenge many of our past assumptions about people’s social networks and their ability to participate in social and cultural activities. It’s important that we better understand the impact on (and potential for) social relationships, particularly among young people.

people who are socially isolated or disconnected from others have between two and five times the risk of dying from all causes compared to those who maintain strong ties with family, friends and community.36

Goal

To increase access to supportive relationships, particularly for those experiencing disadvantage.


Increase participation rates in sport, arts, recreation and community activities.

Facilitate access to sport and active recreation and community arts activity for targeted groups.

Support celebrations that are developed by community members and local organisations.

Support organisations and communities to be inclusive, safe and supportive.

Assist sports and arts organisations to become accessible to all community members.

Contribute to the development of school environments which are supportive of young people, their families and staff.

Identify the impact of interactive and communication technologies on social inclusion and civic engagement for young people.

Support activity to strengthen refugee and new arrival communities.

Facilitate the development of railway stations as community hubs.


Support the development of leadership skills of Indigenous people.

Provide Fellowships for established and emerging Indigenous leaders.

Support Indigenous youth leadership activities.

Identify community attitudes to racial diversity.

Survey community attitudes and use the findings to inform policy and program development.

Increase meaningful contact across cultural groups to reduce discrimination.

Implement the Building Bridges program to promote positive contact and cooperation in education and community settings.

Determine the most effective strategies for reducing discrimination experienced by migrants and refugees.

Undertake research to identify models of good practice and use the findings to inform policy and program development.

Increase community understanding of the contribution made to society by diverse cultural groups.

Promote the strengths and positive contributions of migrants and refugees.

Disseminate images demonstrating the strengths and contributions of Indigenous people to Australian society.

our prioritieS



By 2009 we want to see the needs of Indigenous, vulnerable young people and refugees reflected in the programs of education and training providers; and a significant reduction in the gap between the unemployment rate for the general population and the rates for Indigenous Victorians, young people and new arrivals from refugee backgrounds.

increaSing acceSS to economic reSourceS

Access to economic resources such as a good education and adequate income enables people to have a reasonable standard of living and the opportunity to participate more fully in community life. People with low education levels, low status occupations and low incomes have relatively poorer mental health compared with their higher status and more affluent counterparts.44, 4�

VicHealth will seek to add value to those organisations already working with unemployed and underemployed groups by supporting, evaluating and promoting effective strategies and identifying evidence of what works and what does not.

We will also work collaboratively to improve the understanding of practices and policy and program reforms required to increase the responsiveness of education and training systems to young people and refugees at risk of developing mental health problems.

continuing anxiety, insecurity, low self-esteem, social isolation and lack of control over work and home life can have powerful effects on health. Such psychosocial risks accumulate during life and increase the chances of poor mental health and premature death.46

Goal

To increase access to education and employment for those who experience disadvantage.

By 2009 we want to see a decrease in the number of Victorian women experiencing physical or sexual violence in the previous 12 months, from the current figure of 7%; a 10% decrease in the number of Victorians who believe that in some circumstances domestic violence can be excused; and a 20% increase in the number of women who definitely feel safe to walk in their street alone after dark from 44% in 2005 to 64%.

reducing leVelS of Violence againSt Women

Intimate partner violence is common, and often trivialised. One in 3 women have experienced physical violence and nearly 1 in � have experienced sexual violence at some time in their adult lives.40

A significant underlying cause is the unequal distribution of power and resources between men and women.41, 42 To reduce the levels of violence perpetrated against women a shared cooperative approach involving both men and women is required. We also need preventative approaches at all levels (individual, organisation, community and societal) and a stronger evidence base about violence prevention that will lead to better health.

In collaboration with our partners we will make the incidence and health impact of this violence more visible and support preventative strategies.

intimate partner violence is responsible for more ill health and premature death in Victorian women aged 15– 44 than any other of the well-known preventable risk factors.43

Goal

To reduce the levels of violence perpetrated against women.


Strengthen organisations and communities to be inclusive, safe and supportive for women.

Support community-based activity to prevent violence against women.

Develop a resource to guide government and community prevention strategies.

Support Australian Rules Football clubs to adopt procedures that are conducive to women’s participation and safety.

Increase understanding of community attitudes to violence against women.

Survey community attitudes to violence against women and use the results to inform policy and program development.

Increase community understanding of the impacts of violence against women and the need for shared responsibility.

Work in partnership to develop a communication strategy to reduce violence against women.

Support campaigns which encourage men to take responsibility for violence against women.


In conjunction with others, increase opportunities for skill development and employment for specific population groups.

Support young people to transit from correctional facilities to education, training or work.

Establish and maintain a network to support youth education training and employment.

Implement education programs for refugees.

Develop policy advice to assist the State’s response to refugee resettlement.

our prioritieS


34 www.vichealth.vic.gov.au VicHealth Strategic Priorities 2006–2009 3�

1 Australian Institute of Health & Welfare 2002, Chronic disease and associated risk factors in Australia, AIHW, Canberra.

2 Adapted from Australian Institute of Health & Welfare 2004 and Deakin University 2004.

3 WHO 1986, The Ottawa Charter for Health Promotion, World Health Organisation, Geneva.

4 Kawachi I, Subramanian SV & Almeida-Filho N 2002, ‘A glossary for health inequalities’, Journal of Epidemiology & Community Health, �6, 647-�2.

� Whitehead M 1990, The concepts and principles of equity and health, World Health Organisation Regional Office for Europe, Copenhagen.

6 Victorian Health Promotion Foundation 200�, Background Paper to VicHealth Position Statement on Health Inequalities, VicHealth, Melbourne, p3.

7 Department of Human Services 200�, ‘Your Health – A report on the health of Victorians 200�’, DHS, Melbourne.

8 Department of Human Services 200�, Victorian Burden of Disease Study, DHS, Melbourne.

9 Collins DJ & Lapsley HM 2006, Counting the costs of tobacco and the benefits of reducing smoking prevalence in Victoria, Victorian Department of Human Services, Melbourne.

10 White V & Hayman J 2004, Australian secondary students’ use of alcohol in 2002, National Drug Strategy Monograph Series No. ��, Australian Government Department of Health & Ageing, Canberra.

11 Department of Human Services 200�, Burden of Disease Study, DHS, Melbourne.

12 Drugs And Crime Prevention Committee 2006, Inquiry Into Strategies to Reduce Harmful Alcohol Consumption, Final Report, Parliament of Victoria.

13 Turning Point Alcohol & Drug Centre 200�, The Victorian Alcohol Statistics Handbook 07 – A summary of alcohol-related harm for Victoria Local Government Areas, Melbourne.

14 Victorian Health Promotion Foundation 2003, VicHealth Letter Issue No. 19, ‘Planning for Health’, VicHealth, Melbourne, p10.

1� Australian Institute of Health and Welfare 2006, Australia’s Health 2006, AIHW, Canberra.

16 Australian Chronic Disease Prevention Alliance 2004, Chronic Illness: Australia’s Health challenge – The Economic Case for Physical Activity and Nutrition in the Prevention of Chronic Disease.

17 Children and young people should participate in at least 60 minutes (and up to several hours) of moderate to vigorous intensity physical activity every day (source: Department of Health and Ageing 2004, Australia’s Physical Activity Recommendations for Children and Young People, Australian Government, Canberra). Adults should aim for at least 30 minutes of moderate intensity physical activity on most days (source: Department of Health and Aged Care 1999, National Physical Activity Guidelines for Adults, Australian Government, Canberra).

18 VicHealth considers the term ‘nutritious foods’ to:

• Refer to a wide variety of foods, in accordance with the Dietary Guidelines for Australians;

• Be balanced against the body’s requirement for growth, metabolism and physical activity across the life stages;

• Be consumed regularly and consistently without periods of over consumption or severe restriction as evident in patterns of extreme dieting or hunger (Victorian Health Promotion Foundation 200�, VicHealth’s Position Statement on Healthy Eating, VicHealth, Melbourne.)

19 Australian Institute of Health & Welfare 2004, Australia’s Health 2004, AIWH, Canberra.

20 Australian Bureau of Statistics 2003, Children’s Participation in Cultural and Leisure Activities, Australia, Cat. No. 4901.0, ABS, Canberra.

21 Mason C 2000, ‘Transport and Health: En route to a healthier Australia?’, The Medical Journal of Australia, Vol. 172. No. �.

22 Harten N & Olds TS 2004, ‘Patterns of active transport in 9 to 12- year-old Australian children: Summary of changes in active transport to school’, Australian and New Zealand Journal of Public Health, 28(2), 167-172.

23 WHO 2003, Diet, Nutrition and the Prevention of Chronic Diseases, Report of a WHO/FAO Expert Consultation, Geneva.

We have set ourselves ambitious goals and know that we can only achieve these with the engagement and energy of others. We recognise the need for a highly responsive but disciplined approach and a supportive organisational culture. The internal systems, style and structures required to fulfil this strategic plan include:

• A creative organisational culture based on clearly defined and agreed values;

• Continuous assessment of our programs, processes and policies to ensure we are doing what we say we will do; and

• Being receptive to feedback and reflecting on our practices to continually improve.

Goal

To nurture our people and creative culture to achieve our goals.


Foster collaborations and partnerships across disciplines and sectors.

Strengthen and broaden existing partnerships with community groups and leaders, organisations, governments and academics.

Work with the Department of Human Services and stakeholders to establish and implement Victorian health promotion priorities for 2007–2012.

Facilitate ‘Communities of Practice’ to promote cross-disciplinary thinking and generate solutions.

making Sure We can achieVe our goalS referenceS


Lead the way in advocacy across all our priority areas.

Develop, implement and monitor advocacy and communications plans.

Promote VicHealth as an excellent source of professional expertise and knowledge.

Capture information, generate new knowledge, and extract learnings for improved practice.

Further develop skills to interpret and assess information.

Impart learnings to staff and external partners and stakeholders.

Access and store information in a timely and systematic manner.

Maintain excellence in financial, corporate and operational management.

Measure and monitor compliance with all legislative, performance, fiscal and organisational policies and procedures.

Implement strategies to become an ‘employer of choice’ with an engaged, efficient and effective workforce.

Continue to monitor satisfaction and respond to the opinions of stakeholders.

Maintain high professional standards in everything that we do.


24 Healthy Weight 2008, Australia’s Future, Commonwealth of Australia.

2� Guthrie JF 2004, ‘Understanding Fruit and Vegetable Choices, Economic and Behavioural Influences’, United States Department of Agriculture (USDA), Bulletin No. 792-1.

26 Stanton RA 2006, ‘Nutrition problems in an obesogenic environment’, Medical Journal of Australia, 184 (2): 76-79.

27 Department of Human Services 2003, Victorian Population Health Survey, Melbourne.

28 Food and Agriculture Association 2004, Fighting hunger today could help prevent obesity tomorrow, www.fao.org.

29 Turrell G, Oldenburg B, McGuffog I & Dent R 1999, Socioeconomic Determinants of Health: Towards a National Research Program and Policy and Intervention Agenda, Canberra: Queensland University of Technology School of Public Health, Ausinfo.

30 Mancino L, Lin BH & Ballenger N 2004, The Role of Economics in Eating Choices and Weight Outcomes AIS – 791 USDA/ERS, www.ers.usda.gov.

31 Department of Human Services 2004, Victorian Population Health Survey, DHS, Melbourne.

32 World Health Organisation 200�, Promoting Mental Health: Concepts, Emerging Evidence, Practice, WHO, Geneva.

33 Ibid.

34 Ibid.

3� Berkman LF & Glass T 2000, ‘Social integration, social networks, social support and health’ in Social Epidemiology, eds. Berkman LF & Kawachi I, Oxford University Press, New York.

36 Ibid.

37 Pettigrew TF & Tropp LR 2000, ‘Does inter-group contact reduce prejudice? Recent meta-analytic findings’ in Oskamp S (ed) Reducing Prejudice and Discrimination, Chapter �, pp 93–114, Lawrence Erlbaum Associates, New Jersey.

38 Allport G 19�4, The Nature of Prejudice, Doubleday, Garden City, NY.

39 Williams DR, Neighbours HW & Jackson JS 2003, ‘Racial/ethnic discrimination and health: Findings from community studies’, American Journal of Public Health 93:200-208.

40 Australian Bureau of Statistics 2006, 2005 Personal Safety Survey, Cat. No. 4906.0, ABS, Canberra.

41 World Health Organisation 2002, World Report on Violence and Health, WHO, Geneva.

42 Office of Women’s Policy 2002, A Policy Framework: A Coordinated Approach to Reducing Violence Against Women, Women’s Safety Strategy, OWP, Melbourne.

43 Victorian Health Promotion Foundation 2004, op. cit.

44 Astbury J 2001, Gender Disparities in Mental Health, World Health Organisation, Geneva.

4� Schwabe AM & Kodras JE 2000, ‘Race, class and psychological distress: Contextual variations across four American communities’, Health, 4:234–60.

46 Wilkinson R & Marmot M (eds) 2003, Social Determinants of Health: The Solid Facts, 2nd edn, World Health Organisation, Geneva.

referenceS

LEAD EMPOWER SUPPORT CONNECT

VICTORIAN HEALTH PROMOTION FOUNDATIONSTRATEGIC PRIORITIES 2006–2009

Victorian Health Promotion Foundation PO Box 154 Carlton South Victoria 3053 Australia Phone: +61 3 9667 1333 Fax: +61 3 9667 1375 Email: [email protected]

September 2006

www.vichealth.vic.gov.au

strategic priorities - vichealth

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