• Levels of responsibility for health promotion
• The benefits of partnerships in health promotion, eg government sector, non-government agencies and the local community
• How health promotion based on the Ottawa Charter promotes social justice
• The Ottawa Charter in action

Levels of Responsibility for Health Promotion

• The hierarchy can be laid out based on the organization type who’re responsible for delegating and deploying health related activities.
• Federal Government:
  • Formulating national health policies and implementing national health campaigns for disease awareness on a national scale.
  • Solely or jointly fund different healthcare services (e.g. Emergency care units, Pharmaceutical Benefits Scheme, Rehabilitation centres, Nursing homes etc.)
  • Analysing data obtained from reports published by the World Health Organization and other public health experts and assessing beforehand what actions and strategies should be implemented for disease awareness and prevention.
  • Taking steps to ensure containment of contagious and communicable diseases as well as minimization of environmental hazards.
  • Working with the state government to facilitate their protocols of implementing health promotions.
  • Examples of associated organizations: Australian Institute of Health and Welfare (AIHW), Australian Dietary Guidelines and Physical Activity Recommendations, Go for 2&5, Breast Screening etc.
• State Government:
  • Responsible for implementing health policies directed by the Federal government.
  • Responsible for organizing health campaigns and promoting treatment-based approaches to health.
  • Service-wise distribution and allocation of funds.
  • Ensuring the presence of adequate infrastructure to allow maximum physical movement of individuals for meeting health goals (e.g. parks, health centres).
  • Examples: Healthy Canteen Strategy, Walk it: Active Local Parks (and local), NSW Department of Health, Breast Screening, PDHPE Curriculum (and individuals).
• Local Government:
  • Monitoring Workplace Health and Safety.
  • Eradication and management of garbage and sewage wastes.
  • Town infrastructure planning.
  • Organizing and implementing health campaigns on a community level.
• Non-government Organizations (NGOs):
  • Disease specific awareness campaigns.
  • Broad spectrum promotional activities majorly on community level.
  • Example: Cancer Council Australia, Heart Foundation.

The Benefits of Partnerships in Health Promotion, e.g. Government Sector, Non-Government Agencies and the Local Community

• Shared responsibility of health promotion distributed among different authorities.
• Reduced burden of expenditure on one single governing body.
• Cumulative approach which promotes multi-disciplinary health awareness and promotion.
• Creation of a network of resources in terms of finance, projects, expertise and data.
• Joint ventures can be taken to effectively minimize and eradicate severe health concerns which would otherwise be difficult for only one organization to control.
• Duplicative programs across different organizations can be avoided, creating opportunities for a nuance of activities.

How Health Promotion Based on the Ottawa Charter Promotes Social Justice

• Founded in 1986 by WHO.
• Ottawa Charter encourages multiple organisations to work in unison towards common public health goals.
• Consists of 5 action areas:
  • Developing Personal Skills (DPS)
    • Equity: Creating opportunities for all children to attend school and develop a broad range of health knowledge and skills
    • Diversity: Community based approaches helping all Australians access health care through Medicare. Details and documentations are available in multiple languages to provide multicultural support.
    • Supportive Environments: Awareness campaigns launched by public media which make people aware of different signs and symptoms and also refer to healthcare facilities people can contact.
  • Creating Supportive Environments (CSE)
    • Equity: Offering protective equipment such as hats, sunglasses, clothing for employees who work outdoors for a prolonged time.
    • Diversity: Social destigmatizing of certain health conditions like mental illness, and assisting people to seek help at the right place for disease management.
    • Supportive Environments: Banning smoking on public transport and points of confluence (like parks, clubs etc.).
  • Strengthening Community Action (SCA)
    • Equity: Addressing health inequities among different groups and regions through public and private initiatives.
    • Diversity: Maximising healthcare facilities in areas who do not have instant access to healthcare facilities.
    • Supportive Environments: Increasing police patrols, lighting arrangements in areas that have been dubbed unsafe.
  • Reorienting Health Services (RHS)
    • Equity: Reducing health inequality by proportionally allocating funds for all communities.
    • Diversity: Minimizing the barrier of language in terms of seeking and providing healthcare facilities. For example, the NSW Multicultural Health Communication Services work to ensure the conveyance of high-quality health information to culturally and linguistically diverse communities (CALD).
    • Supportive Environments: Promoting healthcare from the aspects of both prevention and treatment. In certain cases, alternative therapeutic approaches may also be suggested.
  • Building Healthy Public Policy (BHPP)
    • Equity: Reduction of the burden of medical bills through bulk-billing, a part of the Medicare service.
    • Diversity: Supporting education of the Aboriginal and Torres Strait Islander people, which indirectly contributes in eradicating health inequities.
    • Supportive Environments: Campaigns regarding road safety and safe-driving protocols, especially in targeted cohorts who tend to reckless driving can prevent roads to be unsafe.

The Ottawa Charter in Action

• National Tobacco Strategy
  • BHPP
    • Elevated tax rates on tobacco products, making them less affordable.
    • Banning advertisement and promotion of tobacco.
  • CSE
    • Turning indoor and public places eg, stations, public swimming pools, sports grounds, public buildings, clubs, cinemas etc. into “no smoking” zones.
    • Promoting methods that can help people quit smoking.
  • SCA
    • Spreading the word about the harmful, irreversibile health implications of smoking.
    • Providing safe places, devoid of tobacco smoke for families and children.
  • DPS
    • The National Tobacco Strategy provides images and information on cigarette packages for encouraging smokers to quit.
  • RHS
    • Prescription pads to assist GP’s in discussing Quit-smoking programs with patients.
    • Ongoing research about clinical implications and outcomes of tobacco use.
  • Cardiovascular disease (CVD) Management
    • BHPP
      • Detailed breakdown of nutritional information for food products so that people are aware of what amount of each nutrients they might intake if a specific food is consumed.
      • Imposed taxes on alcohol and tobacco.
    • CSE
      • Activities promoting physical fitness for free or subsidised costs in the workplace.
      • Promoting low-fat diet options in canteens in workplace and school
    • SCA
      • Creation of support groups in schools, workplaces, and community.
      • Promotion campaigns for healthy weight loss and its benefits.
    • DPS
      • Choosing food that are rich in nutrients over comfort food that is disproportionate in nutrients.
      • Following health related blogs and articles through the internet or other media supplements.
      • Self assessment of CVD through available resources and seeking help from experts.
    • RHS
      • Assessment of early signs and symptoms as well as clinical indicators.
      • Promoting good heart wellness strategies (e.g. Healthy Harold and the Jump Rope for Heart).