Charting the Course of Change: Tasmania's response to addressing the social determinants of health

Elvie Hales

Director Primary Health Services

Maree Gleeson

Manager Social Determinants of Health & Health Risk Factors

Funded through the Australian Government Department of Health

Tasmania – A Great Place !!

Here is where we live ….

Great scenery …. but….

About 500,000 people in the state

Two main population centres (Launceston in north and Hobart in south) with most decentralised population in all other regions

Very little public transport between population centres

But…

We will die sooner Life expectancy is lower than other states (by average 2 years)

We are older Over 65 - (16.3 % over 65) compared with (SA 16.1%, VIC 14.2% and NSW 14.7%) Others are lower

We are sicker (3 or more chronic diseases – Tasmania 44.9% compared with lowest NSW at 37.4 %)

And …

We smoke more (second highest at 21.8% Tasmania, NT 23.9% - lowest ACT 13.4%)

We are poorer Approximately one third of population on a benefit or pension

And …

We are less educated A report by the Australian Bureau of Statistics for 2011-2012 shows half of all Tasmanians aged 15 to 74 are functionally illiterate, and more than half are functionally innumerate—meaning they don’t have the skills needed to get by in the modern world, like filling out forms, or reading the instructions on their prescription

Also concerning is the number of young people who are not earning or learning, often described as disengaged. Tasmania is second only to the Northern Territory with 33.4% of 17-24 year olds not engaged

Tasmanian Health Assistance Package

Australian government announced assistance package in mid 2012.

Approx. 400 million to the state (over 4 years).

(July 2012 – June 2016)

Most money went to state government to assist with hospital waiting times as well as some prevention programs.

About 12% of the total to Tasmania Medicare Local for a number of initiatives, including Social Determinants of Health

Social Determinants of Health project

Department of Health

“As part of the Tasmanian Health Assistance Package this project will focus on improving the health of Tasmanians through addressing the social determinants of health such as, but not limited to, social disadvantage, transport, housing, health literacy and education”

Knowledge speaks, but wisdom listens.

Jimi Hendrix

Principles for how we work

Using an equity lens

Building stronger workers and communities

Partnerships with communities and organisations

Adding value, filling gaps

Investing in the future and addressing the ―hard stuff‖ – resourcing Tasmanian solutions

Acting as advocates for change

Try not to become a man of success but a man of value.

Albert Einstein

Social Determinants of Health project

“The causes behind the causes”

The art of living lies less in eliminating our troubles than in growing with them.

Bernard M. Baruch

Timelines for Development of the Plan

3

Great spirits have always encountered violent opposition from mediocre minds. Albert Einstein

Social Determinants of Health project

Stage 1 - Community consultation

Stage 2 - A visioning and priority setting workshop with the Steering Group and project team

Stage 3 - A scan of the literature, data and other policies and programs.

All are lunatics, but he who can analyse his delusion is called a philosopher. Ambrose Bier

In developing the Social Determinants of Health project a three-staged approach was taken to inform the content and process of the Plan. This involved:

Social Determinants of Health project

Some clear themes emerged to inform development of the Plan. These include:

1) Undertaking a place based approach to working with communities across the State

2) Identifying ―Communities of Priority‖ based on need and readiness

3) Resourcing communities to assist them in identifying and addressing the social determinants of health relevant to their circumstance so as to support long term sustainability and building stronger communities

4) Building capacity within communities and across the State to harness sustainability beyond the life of the project.

The time is always right to do what is right.

Martin Luther King Jr

Social Determinants of Health project

Feb 2014 April 2016

May to June 2016

Place Based Activities

Activities informing and complementing each other Final

Evaluation Phase

State-wide Capacity Building Activities

Feb 2014 June 2016

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Sometimes it is not enough to do our best; we must do what is required.

Winston Churchill

Social Determinants of Health project

a range of socio-economic criteria, (including state and national data)

assessment of ability/capacity to implement a project

in consideration of other initiatives that may already be in operation in the region

a defined list of social determinants of health

additional determinants that may be more relevant for the local community.

The thing always happens that you really believe in; and the belief in a thing makes it happen.

Frank Lloyd Wright

The thing always happens that you really believe in; and the belief in a thing makes it happen. Frank Lloyd Wright

Place-based activities Communities of Priority may be funded across the state and identified in relation to:

Social Determinants of Health project

Training:

project management, strategic planning, governance structures and Bridges Out of Poverty

Community Forums

Asset Reviews

Other as identified

There’s always free cheese in the mouse traps – but the mice there ain’t happy.

Unknown

State-wide workforce and community capacity building activities could include:

Social Determinants of Health project

Evaluation and Promotion

An important aspect of the

project is to:

undertake a meaningful evaluation

tell ―everyone‖ about our story

The thing always happens that you really believe in; and the belief in a thing makes it happen. Frank Lloyd Wright

Some mornings it just doesn’t seem worth it to gnaw through the leather straps. Emo Phillips

Social Determinants of Health project

“The causes behind the causes”

Promotional Video

http://youtu.be/POKT4Yp71PA

The person born with a talent they are meant to use will find their greatest happiness in using it.

Johann Wolfgang Von Goethe

Charting the Course of Change: Tasmania's response to addressing the social determinants of health

Funded through the Australian Government Department of Health