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Australian Journal of Primary Health Australian Journal of Primary Health Society
The issues influencing community health services and primary health care
RESEARCH ARTICLE

Population health planning for health equity

Helen Keleher
+ Author Affiliations
- Author Affiliations

Department of Health Social Science, Faculty of Medicine, Nursing and Health Sciences, Monash University, PO Box 197, Caulfield East, Vic. 3145, Australia. Email: helen.keleher@monash.edu

Australian Journal of Primary Health 17(4) 327-333 https://doi.org/10.1071/PY11044
Submitted: 1 April 2011  Accepted: 22 September 2011   Published: 15 November 2011

Abstract

Australia’s health reform documents make reference to the need to address health equity and strengthen population health planning. They make a stronger case about the need to address equity than policy documents that have preceded them. However, they do not make clear that health care is one of many determinants of health and equity, and that planning for health care, social care and social health outcomes are necessary for effectiveness. In other words, population health planning is much more than health care planning. Population health plans vary in their intent and design, depending on the population catchment for the plan, the remit of the organisations involved and the paradigms from which the plan is written. A stronger vision is necessary if population health plans are to affect health inequities. Comprehensive population planning is necessarily intersectoral with engagement across a wide cross-section of government department policies, portfolios and data sources, with a focus on the determinants of health and inequity, and a sound foundation of social values. This paper unpacks the elements of population health planning, the data sources that may be used and their interrogation in terms of the determinants of health, and presents core principles that distinguish population health planning from other types of planning to ensure that planning is comprehensive and able to be actioned.


References

Australian Social Inclusion Board (2009) A compendium of social inclusion indicators ‘How’s Australia Faring?’ (Commonwealth of Australia: Canberra)

Bowen S, Zwi A, Sainsbury P (2005) What evidence informs government population health policy? Lessons from early childhood intervention policy in Australia. NSW Public Health Bulletin 16, 180–184.

Braveman P, Gruskin S (2003) Defining equity in health. Journal of Epidemiology and Community Health 57, 254–258.
Defining equity in health.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD3s7jt1eksQ%3D%3D&md5=0ee2bdc7423cd357a0ba9a4bf86ecbceCAS | 12646539PubMed |

Cohen BE (2006) Population health as a framework for public health practice: a Canadian perspective. American Journal of Public Health 96, 1574–1576.
Population health as a framework for public health practice: a Canadian perspective.Crossref | GoogleScholarGoogle Scholar | 16873742PubMed |

Commission on the Social Determinants of Health (2008) ‘Closing the gap in a generation: health equity through action on the social determinants of health.’ (World Health Organization: Geneva)

Commonwealth of Australia (2009) ‘A healthier future for all Australians, final report of the National Health and Hospitals Reform Commission.’ Publications number: P3-5499. (Commonwealth of Australia: Canberra)

Commonwealth of Australia (2011) ‘Improving primary health care for all Australians.’ Publications number: D0264. (Commonwealth of Australia: Canberra)

Community Indicators Victoria (2011) Indicator inbox. Issue 1, Summer 2011. (McCaughey Centre, The University of Melbourne: Melbourne)

Dahlgren G, Whitehead M (1991) ‘Policies and strategies to promote social equity in health.’ (Institute for Futures Studies: Stockholm)

Department of Health and Ageing (2010a) Overview of the Divisions of General Practice program. (Commonwealth of Australia: Canberra)

Department of Health and Ageing (2010b) Medicare Locals discussion paper on governance and functions. (DoHA, Australian Government: Canberra)

Department of Health and Ageing (2010c) ‘Building a 21st century primary health care system: Australia’s first national primary health care strategy.’ Publications number: 6594. (Commonwealth of Australia: Canberra)

Department of Planning and Community Development (2010) ‘A right to respect: Victoria’s plan to prevent violence against women 2010–2020.’ (Government of Victoria: Melbourne)

Etches V, Frank J, Di Ruggiero E, Manual D (2006) Measuring population health: a review of indicators. Annual Review of Public Health 27, 29–55.
Measuring population health: a review of indicators.Crossref | GoogleScholarGoogle Scholar | 16533108PubMed |

European Charter for Health Equity (2010) European public health alliance.

Evans RG, Stoddart GL (1990) Producing health, consuming health care. Social Science & Medicine 31, 1347–1363.
Producing health, consuming health care.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK3M7kt1yhsw%3D%3D&md5=d414ba7a96e28f4715910e7c9425bf99CAS |

Gibson A, Asthana S, Brigham P, Moon G, Dicker J (2002) Geographies of need and the new NHS: methodological issues in the definition and measurement of the health needs of local populations. Health & Place 8, 47–60.
Geographies of need and the new NHS: methodological issues in the definition and measurement of the health needs of local populations.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD387hvVSjug%3D%3D&md5=c8bb508810a51a4681711140b091f527CAS |

Graham H (2004) Social determinants and their unequal distribution: clarifying policy understandings. The Milbank Quarterly 82, 101–124.
Social determinants and their unequal distribution: clarifying policy understandings.Crossref | GoogleScholarGoogle Scholar | 15016245PubMed |

Illawarra Health (2005) ‘Population health plan 2003–2007: implementing healthy people 2005 in the Illawarra.’ (Illawarra Health: Unandera)

Kawachi I, Subramanian SV, Almeida-Filho N (2002) A glossary for health inequalities. Journal of Epidemiology and Community Health 56, 647–652.
A glossary for health inequalities.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD38vit1WgsQ%3D%3D&md5=ce2d5be7729939f4e44987a81206b313CAS | 12177079PubMed |

Keleher H (2011) Planning for population health in Australia’s health reforms. Australian and New Zealand Journal of Public Health 35, 106–107.
Planning for population health in Australia’s health reforms.Crossref | GoogleScholarGoogle Scholar | 21463402PubMed |

Keleher H, Round R (2005) ‘Evidence-based mental health promotion resource.’ (Deakin University for VicHealth and Department of Human Services: Melbourne)

Kickbusch I (2008) ‘Healthy societies: addressing 21st century health challenges.’ (Adelaide Thinker in Residence, Department of Premier and Cabinet: Adelaide)

Labonte R, Polanyi M, Muhajarine N, McIntosh T, Williams A (2005) Beyond the divides: towards critical population health research. Critical Public Health 15, 5–17.
Beyond the divides: towards critical population health research.Crossref | GoogleScholarGoogle Scholar |

Lalonde M (1974) ‘A new perspective on the health of Canadians: a working document.’ Cat. no. H31–1374 (Minister of National Health and Welfare: Ottawa)

McDaid D, Drummond M, Suhrcke M (2008) ‘How can European health systems support investment in and the implementation of population health strategies? Policy brief.’ (World Health Organization on behalf of the European Observatory on Health Systems and Policies: Geneva)

NSW Health (2004) ‘In all fairness: increasing equity in health across NSW.’ (NSW Department of Health: Sydney)

Nutbeam D (1991) Re-orienting health services: moving from service management to health outcomes. Health Promotion International 6, 169–171.
Re-orienting health services: moving from service management to health outcomes.Crossref | GoogleScholarGoogle Scholar |

Public Health Agency of Canada (2002) The social determinants of health: an overview of the implications for policy and the role of the health sector. Available at http://www.phac-aspc.gc.ca/ph-sp/oi-ar/01_overview-eng.php [Verified 30 March 2011]

Public Health Agency of Canada (2009) ‘What is population health?’ Available at http://www.phac-aspc.gc.ca/ph-sp/approach-approche/index-eng.php#What [Verified 30 March 2011]

Public Health Agency of Canada (2011) ‘What makes Canadians healthy or unhealthy?’ Available at www.phac-aspc.gc.ca/ph-sp/determinants/determinants-eng.php#income [Verified 5 June 2011]

Queensland Health (2011) ‘Population health plan 2007–2012.’ (Queensland Health: Brisbane)

Ruth D, Hurworth R, Sulaiman N (2005) Moving towards meaningful local population health data: the service provider perspective. Australian Journal of Primary Health 11, 113–119.
Moving towards meaningful local population health data: the service provider perspective.Crossref | GoogleScholarGoogle Scholar |

Sainsbury P (1999) Divisions of population health: quantum leap forward or rearranging the deckchairs? Australian and New Zealand Journal of Public Health 23, 119–125.
Divisions of population health: quantum leap forward or rearranging the deckchairs?Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK1M3mtV2rsA%3D%3D&md5=a68e11b710d0f29fc05eecfdafcc9098CAS | 10330723PubMed |

Solar O, Irwin A (2007) A conceptual framework for action on the social determinants of health, discussion paper for the Commission on Social Determinants of Health. WHO, Geneva.

South-West Sydney Area Health Service (2008) ‘Population health strategic directions 2007–2012.’ (SSWAHS: Liverpool)

VicHealth (2008) ‘People, places, processes: reducing health inequalities through balanced health promotion approaches.’ (Victorian Health Promotion Foundation: Carlton)

Victorian Healthcare Association (2010) ‘Population health approaches to planning.’ (VHA and Monash University: Melbourne)

Whitehead M (1990) ‘The concepts and principles of equity and health.’ (World Health Organization: Copenhagen)

Whitehead M (2005) Reflections on a rainbow. “Dahlgren and Whitehead and beyond” Society for Social Medicine Conference, Institute of Health Research, Cardiff, 21 April 2005.

World Health Organization (1978) Declaration of Alma-Ata. In ‘International conference on primary health care.’ (WHO: Alma-Ata, USSR)

World Health Organization (1986) A discussion document on the concept and principles of health promotion. Health Promotion International 1, 73–76.
A discussion document on the concept and principles of health promotion.Crossref | GoogleScholarGoogle Scholar |

World Health Organization (2008) ‘The world health report 2008: primary health care now more than ever.’ (WHO: Geneva)