What actions are needed to address Australia’s health priorities?
Teacher Note: Students need to answer this question in relation to CVD, cancer and two other
selected health priorities by using the action areas of the Ottawa Charter as a framework for analysis.
Due to the scope of cancer, injuries and mental health as priority areas, the focus for this investigation
should be on:
skin cancer or lung cancer (cancer)
road and traffic related injuries
depression (mental health).
Students learn about:
Students learn to:
 developing personal skills
 apply the five action areas of the Ottawa Charter to
a study of CVD, cancer and two other health
- modifying personal behaviours
priority areas
- gaining access to information and
support
 investigate questions of social justice and the roles
of individuals, communities and governments under
 creating supportive environments
the new public health approach, for example:
- identifying personal support
networks and community services
- why do some population groups experience
different levels of health from others?
- identifying sociocultural, physical,
political and economic influences
- is access to health care equitable for all groups?
on health
- are services aimed at prevention, promotion or
cure?
- what power do individuals and communities have to
 strengthening community action
contribute to public policy?
- empowering communities to take
- what importance do different groups place on the
action
different health priorities?

-
reorienting health services
identifying the range of services
available
- gaining access to services
 building healthy public policy
- identifying the impact of policies
on health
- influencing policy
- deciding where to spend the
money.
Key words

-
reflect and answer the following questions for the
four health priorities studied:
which of the five action areas are of most
significance to each priority?
how do the five actions interact in relation to each
priority?
Skill
…………………………………………………………………………………….
Modifying
…………………………………………………………………………………….
Address
…………………………………………………………………………………….
Strengthening
…………………………………………………………………………………….
Policies
…………………………………………………………………………………….
www.who.int Ottawa Charter
www.nswcc.org.au/
www.hsc.csu.edu.au/
www.health.vic.gov.au/healthpromotion.
www.publish.csiro.au/
www.health.nsw.gov.au/
1
The
Ottawa Charter has
5 guidelines which if followed
will promote health + social justice.
At the time the goal was Health for All by 2000.
Assess the success of this commitment made in 1986 for…
“It’s a guideline, actually.”
o The world. ……………………………………………………………………………………….
.............................................................................................................................................................
o Australia. ………………………………………………………………………………………...
………………………………………………………………………………………………………..
o Priority population groups………………………………………………………………………..
..............................................................................................................................................................
o You ………………………………………………………………………………………………
...............................................................................................................................................................
While 2000 has come and gone the action areas (………………..) of the charter have made a
difference since in practically all areas there has been significant improvements in Australia’s health
status. It’s a work in progress (the Jakarta Declaration and other conferences - Adelaide (1988),
Sundsvall (1991), Jakarta (1997) ,Mexico (2000) and Bangkok (2005) have all been based on and
reinforce the charter.)
personal behaviours + social, economic, political, physical environment→ Health outcomes
change personal behaviour + change environment → change health outcomes

DRHSC
developing personal skills
90% of all ill health can be attributed to unhealthy behaviour…
o smoking leads to ………………………………………………………………………….
o inactivity leads to … ……………………………………………………………………..
o risk taking leads to… ……………………………………………………………………..
o poor diet leads to ……………………………………………………………………………
So…..Modify the behaviour and provide inform and support the new desired behaviour and change
the health outcome.
“.....through information and education skills - enabling people to learn (throughout life) to prepare
themselves for all of its stages and to cope with chronic illness and injuries is essential. This has to be
facilitated in school, home, work and community settings.” Ottawa Charter 1988
2
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modifying personal behaviours
The skills needed by an individual to enable them to modify their behaviour are…
o decision making : what day to day decisions are made that impact on health? …………………
..............................................................................................................................................................
o Communication : …………………………………………………………………………………
..............................................................................................................................................................
o Assertiveness : …………………………………………………………………………………..
………………………………………………………………………………………………………...
o Time Management: ………………………………………………………………………………
………………………………………………………………………………………………………..
o Planning / Problem solving ………………………………………………………………………
………………………………………………………………………………………………………
-
gaining access to information and support
To make the right decisions people need to know what is right and have help choosing the right path.
Access to information and support is not equitable amongst all Australians due to
barriers – language, location, income, literacy.
What problems would a new migrant family have of knowing about and accessing
‘Neighbour hood watch’, quitline?, pap tests if only one male doctor in town?
How can these barriers be overcome? …………………………………………………
………………………………………………………………………………………….
Homework task.
Choose one area of your lifestyle that you know has / can have a negative impact on your health. E.g.
inactivity, not eating fruit or veges, drinking caffeine drinks, smoking, alcohol. And attempt to modify
this behaviour for ONE WEEK!
o My aim is change ……………………………………………………………………………….
o Describe specific behaviours you will have to modify (location, other people, alternatives)
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
o Identify the information you need to make the right decisions.
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
o Identify the support you will need to modify your behaviour.
……………………………………………………………………………………………………………
…………………………………………………………………………………………………………….
Now do it!!!
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
creating supportive environments
Creating environments where people ……………, ……………. and ………….. that make health
promoting choices easier will impact on their health outcomes.
- identifying personal support networks and community services
People need emotional, social or financial support to modify their behaviours.
These can come from personal support networks ……
e.g. “helping teenagers become safer drivers”, “home safely contract
(NRMA)”, school counselling services, parents, teachers, medical professions.
or from community groups……
AA, Weight Watchers, Cancer Council, Heart Foundation, Lifeline, Canteen,
-
identifying sociocultural, physical, political and economic influences on health
(Revise LEGLESS)
Identify then address.
……………………………………………………………………………………………………………
o Sociocultural influences : ………………………………………………………………………...
...............................................................................................................................................................
o Physical influences : ……………………………………………………………………………...
………………………………………………………………………………………………………...
o Political influences : ……………………………………………………………………………...
………………………………………………………………………………………………………...
o Economic influences : ……………………………………………………………………………
………………………………………………………………………………………………………...
Assess Warilla High school as a supportive environment.
Personal support networks / community services : ……………………………………………………..
……………………………………………………………………………………………………………
Influences : ………………………………………………………………………………………………
…………………………………………………………………………………………………………….
Non - Supportive Environment
Environment
WHS???
Supportive
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
4

strengthening community action
- empowering communities to take action
Communities usually know what they need and how they can be helped. To increase the effectiveness
of a health promotion initiative it should involve the community at every step – setting priorities,
decisions, resources, strategies, implementation and evaluation – working collaboratively with schools,
workplaces, local government, doctors, the media, and interest groups (e.g. Cancer Council)
Evaluate the initial “intervention” in the NT. (write answer on back)
“With the exception of some prominent Aboriginal commentators, Aboriginal groups strongly
condemned the NT Intervention. The authors of the Little Children are Sacred Report also
spoke out against the intervention, arguing that its heavy handed, top-down approach was
inconsistent with the recommendations in the report…… The Government’s ‘NT Intervention’
involved sending police and the army into remote communities, alcohol bans, winding back
Aboriginal land rights under the NT Aboriginal Land Rights Act, health checks for Aboriginal
children and the quarantining of welfare payments in 73 Aboriginal communities..... 40
Aboriginal organisations put forward an alternative proposal for urgent action based on
consultation and partnerships with local Aboriginal communities, welfare organisations and
women’s groups. This proposal was ignored….” Aboriginal child abuse and the NT
Intervention www.reconciliaction.org.au/
“Over the last 18 months we’ve seen sustained media coverage of child abuse and family violence,
but we’ve rarely seen or heard how Indigenous people and communities across Australia are taking
positive steps to respond to this violence, abuse and neglect.
“I have provided 19 case studies in the Social Justice Report 2007 as evidence of what can be
achieved in the fight against child abuse and family violence in Indigenous communities when
there is true engagement with Indigenous people.
“Sometimes these steps were taken because communities felt a need to take action themselves
and others developed through formal and informal partnerships with individual government
agencies, non-government organisations, the courts or police.
“But most importantly, every single one of them is striving to make a lasting difference and they
are initiatives lead by Indigenous people.” Social Justice Report 2007, Human Rights Commission.
Example of community action being empowered….
………………………………………………………………………………………………
………………………………………………………………………………………………..
………………………………………………………………………………………………..
………………………………………………………………………………………………..
……………………………………………………………………………………………..
…………………………………………………………………………………………….
……………………………………………………………………………………………..
…………………………………………………………………………………………….

5

reorienting health services
Focus / emphasis:
curative /
clinical.
Diagnosis /
treatment,
rehab.
…………………………………………………………………………
Promotes health,
prevents ill-health,
supports well being.
Well being of whole
person.
…………………………………………………………………………
…………………………………………………………………………………………………………..
Delivery:
Medical
profession
…………………………………………………………………………
Health professionals
working with schools,
workplaces, non-govt.
organizations.
Attitudinal changes in
professional education /
training.
…………………………………………………………………………
…………………………………………………………………………………………………………..
-
identifying the range of services available
Primary health care is the ideal place for health promotion (…………………………….) – the services
are widespread plus large numbers of people at risk visit.
They can provide clinical services (……………………), patient education (………………….),
support (………………………), information (……………………), links with other services
(…………………) and ensuring equitable access ………………….).
e.g. G.P.’s………………………………………………………………………………………………..
-
gaining access to services
Health care is now concerned with ensuring that all Australians can easily utilise their facilities and
services.
o
Physical Location – …………………………………………………………………..
................................................................................................................................................
o
Community awareness – ……………………………………………………………….
………………………………………………………………………………………………..
o
Affordability – …………………………………………………………………………
Has the reorientation gone far enough?
Dental care? ………………………………………………………………………………………….
Rural and remote? ……………………………………………………………………………………
Specialists? ……………………………………………………………………………………………
Youth services? ………………………………………………………………………………………..
Mental Health ? ………………………………………………………………………………………..
6

building healthy public policy
Government decisions (…………………………………………………………..) can have a dramatic
effect on all areas of a nations health and so a commitment to decisions that benefit health result in
positive health outcomes.
-
identifying the impact of policies on health
Policies made in any area of public concern can have a health impact. To achieve health improvement
all government decisions, not just those directly relating to health, must take into consideration their
impact on health.
‘Non-health’ specific
Government decision
Reopening Port Kembla Copper
smelter
possible health outcome
healthy public policy
GST on all foods
Police only able to test for BAC
after accident
BAC was 0.08
Other examples of policies which have been made to achieve specific health outcomes…
Healthy Public Policy
Positive Health outcomes
Learner driver hours
Smoke free pubs and clubs
Compulsory wearing of seatbelts
40 km speed limits
OHS rules in the workplace
Alcoholic soda tax increases
‘no hat, no play’
Railway police, blue light carriages
Child safety restraints in cars
Why not ban tobacco outright? …………………………………………………………………………..
……………………………………………………………………………………………………………
Why not making the minimum driving age 25 years? Make junk food illegal?
7
-
influencing policy
The NPHA encourages community participation. The Ottawa Charter requires the strengthening of
community action. The community must be given the opportunity and the power to influence public
policy in the area if health. This is known as …………………………..
It is difficult for an individual to gain access to and to influence policy makers. Community groups are
more successful in lobbying for change since they represent a broader range / larger number of people
(voters??) or a specific informed source (Cancer Council, Asthma Foundation).
Federal Parliament hears push for
Wollongong MRI licence
Posted Tue Sep 13, 2005 10:45am AEST
The campaign for a Medicare licence for a Magnetic Resonance Imaging
(MRI) machine at Wollongong Hospital has been raised in Federal
Parliament.
The Member for Cunningham, Sharon Bird, has delivered a petition with
more than 16,000 signatures urging Federal Health Minister Tony Abbott to
grant the licence.
The MRI machine has been operating for nearly two years at the hospital,
with the help of State Government funding.
Ms Bird says she believes Mr Abbott cannot ignore such a display of public
concern.
"I'm hoping it will be impossible for him to ignore us in the next round
because ... close to 16,500 people have signed the signature in the Illawarra
region and my claim to the Minister is that that makes it clear that this is a
serious health issue for our area," she said.
What was the outcome? ..................................................................
.........................................................................................................
-
cure
deciding where to spend the money.
At present health expenditure is predominately spent on health care (………). To
achieve health for all more money must be directed to health promotion which in the
long run is more cost effective. What % is currently spent on HP? ………….
The National Health Priority Areas must also be targeted in this shift to a health
promotion focus due to their significant contribution to Australia’s burden of disease.
How much is spent on CVD of total health budget? ………….
Finally those suffering the most disadvantage (priority population groups) must also be
targeted for extra funding allocation. Being ‘unfair to be fair’!
How much more is spent on ATSI health than the average Australian? …………..
PS How did you go with your behaviour modification task?????
8

apply the five action areas of the Ottawa Charter to a study of CVD, cancer and two
other health priority areas
ACTION AREA
D

eveloping personal skills
- modifying personal behaviours
- gaining access to information
and support
R

eorienting health services
- identifying the range of services
available
- gaining access to services

Healthy public policy
(building)
- identifying the impact of policies
on health
- influencing policy
- deciding where to spend the
money

Supportive environments
(creating)
- identifying personal support
networks and community
services
- identifying sociocultural,
physical, political and economic
influences on health

community action
(strengthening)
- empowering communities to take
action
CVD
CANCER
(skin & lung)
MENTAL HEALTH
(depression)
DIABETES
INJURIES (traffic
accidents)
Making healthy food
choices
Increase use of sporting
fields
Having regular health
checks
PDHPE lessons
Heart health check vans to
identify risk factors
Stress tests at Shellharbour
hospital
Quitting smoking, not
taking it up
Slip, slop, slap behaviour
Change in personal opinion
of people with depression
Education about Type II
diabetes and its risk factors
Acting on info about
decreasing obesity and
inactivity
Knowledge of risk
assessment and avoidance
Wearing helmets, seatbelts
Free breast screening
Skin cancer clinics covered
by Medicare
Regular skin checks by
GP’s
Advertisements by Mental
Health Strategy, Beyond
Blue
Diabetes health checks
Advanced driver training
Shift CD from RTA
Smoke free environments
No GST on fresh food
PDHPE mandatory subject
Restriction on cigarette
advertising
Smoke free pubs and clubs
Jobstart (↓ depression from
unemployment
Funding of Beyond Blue
Incentives for private health
insurance e.g. exercise bikes
Pool fencing
Reduced tax on low alcohol
beer
Increase tax on alcohpops
Low fat food options
Provision of parks,
cycleways
Healthy tick
Gyms
Shade structures in schools
Cancer Council initiatives
Smoke free areas,
information service
Free skin checks in
shopping centres
OHS requirements for
outdoor workers
Provision of family and
stress leave from work
Sexual harassment
legislation
Gay meeting area at UOW
Healthy tick
Healthy food canteen
Seatbelts in busses
Traffic calming devices
airbags
cycleways
40 km zones
Demands for manufacturers
to use standards for ‘lite’ or
‘low fat’
Health promoting schools,
canteen
Support groups for cancer
sufferers (Canteen)
Pink ribbon day
Support groups for mentally
ill
‘Mind Matters’ kit in
schools
Vinnies youth worker
(WHS)
Post natal visits by nurses
Support groups for diabetes
sufferers
Driver Reviver by Lions
clubs
Rotary teen driver ed days
9

investigate questions of social justice and the roles of individuals, communities and
governments under the new public health approach, for example:
- why do some population groups experience different levels of health from others?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
- is access to health care equitable for all groups?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
- are services aimed at prevention, promotion or cure?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
- what power do individuals and communities have to contribute to public policy?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
- what importance do different groups place on the different health priorities?
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………
……………………………………………………………………………………………………………

-
reflect and answer the following questions for the four health priorities studied:
which of the five action areas are of most significance to each priority?
National
Priority
Areas
CVD
Most significant
Action Areas
Explain
Cancer
10
-
how do the five actions interact in relation to each priority?
Developing personal
skills
Reorientating
Health Services
Healthy Public
Policy
Supportive
Environments
Community Action
11