City of Ballarat Municipal Public Health Plan

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City of Ballarat Municipal Public Health Plan

• Directions in Wellbeing

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Project Aim

• To provide an integrated, comprehensive,
  inclusive and dynamic approach to municipal
  health and well being planning in Ballarat based
  on principles of equity diversity and
  sustainability.

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MPHP the Health Act

• Two distinct sections
• (i) Preventing Minimising Public Health
  Dangers.
• (ii) Enabling People To Achieve Maximum
  Wellbeing.

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Healthy Ballarat 2000

• REVIEW
• Lacked ownership and accountability.
• Largely unfulfilled its potential to provide
  leadership.
• A MPHP should
• ensure proper consideration is given to the
  environmental, social and economic impacts of
  health and wellbeing .
• incorporate these elements to provide the basis
  for its integration into existing and future
  planning processes both at Corporate and
  Departmental Planning levels.

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Healthy Ballarat 2000

• RECOMMENDATIONS
• The MPHP should
• engage and sustain senior management and Councils
  interest and involvement in the process
• consistently apply access and equity principles
• provide mechanisms for effective monitoring and
  evaluation
• develop sustainable internal and external
  strategic alliances which foster leadership, and
• provide a process which considers the social,
  environmental and economic implications of health
  in all Councils policies and plans.

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Methodology

• Action Research process
• Backed by research input
• Internal ? External Consultations
• Ownership of sections by relevant B.U.s.
• Identification of Issues by
• Consensus Inconsistencies Gaps and Emergence.

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Anticipated Outcomes

• 4 Wellbeing Matrix based products.
• Research processes leading to a better
  understanding of community wellbeing.

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The Initial MPHP Framework
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The Process
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Social Issues
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Economic Development
Family Issues
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Well-being Local Government A Complex Business

• Human Service staff identified key well-being
  issues as
• Changing Family Structure
• Unemployment
• Community Development Staff identified
• Community Connectedness
• Economic Inequity
• Lack of Employment Opportunities
• Education and Training

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Well-being Local Government A Complex
Business 2

• Economic Development staff found that workforce
  issues such as child care availability went
  beyond the understood boundaries of their role.
• A survey of staff over 40 years of age indicated
  concerns about
• weight
• stress and strains on family life
• job security
• financial security for retirement.

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Council staff views on Well-being

• 131 of 144 staff believed that their department
  contributed to the health and well-being of the
  community.
• However only 66 believed this contribution was
  acknowledged.
• 10 staff had a neutral view.
• Only 3 believed they did not have a role. They
  were from Corporate Services.

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Informed Reality

• Our focus groups forced us to look at the
  structures differently.
• Encapsulating a whole of Council perspective
  forced us to reflect on a more holistic approach.
  
• and
• Our theoretical backgrounding provided a better
  way to define Well-being.

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A traditional TBL perspective does not explain
this complexity.
SOCIAL / CULTURAL
ECONOMIC
NATURAL
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The TBL Reviewed

• The TBL was an approach to assist the private
  sector better incorporate sustainable business
  practices as corporate citizens.
• Local Government on the other hand, has a
  traditional broad business focus.
• In effect using a simple TBL perpetuates a silo
  mentality.

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TBL, Wellbeing Economics

• People and society require resources to meet
  their needs and wants. (achieve well-being)
• Economics is the process of resource allocation.
• 3. Resources are limited in nature as well as
  supply and must be sustained.

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Underlying Principles
Nature Economy Society

• Sustainability
• Efficiency (for the long run)
• Meeting Social Needs and Wants

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Assessing Needs WantsMaslows Hierarchy of
Need.
FULFILLMENT
ESTEEM
SOCIAL NEEDS
SAFETY SECURITY
BASIC NEEDS
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Basic Needs / Public Health Dangers -

• Traditional Health Plan Focus
• Regulated and largely prevented in developed
  countries.
• Core of local government services
• Roads, rubbish, infrastructure in general.
• There are groups in our community that are
  vulnerable through their dependency on others to
  meet basic needs.

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Safety and Security

• Similar to basic needs
• Most vulnerable are children and young people.
• Perceptions are as important as reality.
  Therefore this is an issue for older people.

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Social Needs

• Social and economic inequality is the most
  important determinant of public health in
  developed societies
• Income inequality affects health independently of
  average living standards, of the proportion of
  the population in absolute poverty, of
  expenditure on medical care, and of the
  prevalence of smoking.
• The wealthiest societies are not the healthiest.
  High incomes do not protect from the impacts of
  relative income inequality.

Wilkinson R. G,. (2001) Mind the Gap,
Hierarchies, Health and Human Evolution, New
Haven Yale University Press
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Esteem Needs

• People need a stable, firmly based, high level of
  self-respect, and respect from others in order to
  feel satisfied, self confident and valuable.
• The environments where this occurs are home
  school and the workplace.
• Failure to meet these needs lead to feelings of
  inferiority, weakness, helplessness and
  worthlessness.
• www.connect.net/georgen/maslow

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Fulfilment

• People primarily involved in a cause beyond their
  own needs.
• They are devoted, work at something, something
  very precious to them some calling or vocation.
• Very fine and healthy people, strong people,
  creative people, saintly people, .... You ask how
  tall can people grow, what can a human being
  become?
• Fulfilment is not really a need it is the
  satiation of needs something to aim for.

www.connect.net/georgen/maslow
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Underlying Principles

• Nature
• Economy
• Society

• Sustainability
• Efficiency
• Prevention
• Equity
• Conviviality Diversity
• People living well together.
• Vitality

Derived from LGCSAA (2001) Just, Vibrant and
Sustainable Communities A framework for
progressing and measuring community wellbeing.
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Priorities
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Elements Indicators of Well-being
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Natural Environment

• Sustainability principles based on United
  Nations, Agenda 21.
• Encompasses
• Air
• Water
• Land
• Biodiversity
• This is the basis for Councils Conservation
  Strategy.

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The Economy

• Based on ABS definitions and indicators of
  Economic Wellbeing.
• Encompasses
• Economic Resource Development
• Workforce Development
• Education Training

Source ABS Measuring WellbeingFrameworks for
Australian Social Statistics (2001)
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The Social Hierarchy

• Basic Needs
• Safety Security
• Social Needs
• Esteem Needs
• Fulfillment

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12 Indicators of Wellbeing

• Water Quality
• Air Quality
• Land Quality
• Biodiversity
• Basic Human Needs
• Safety Security

• Social Needs
• Esteem Needs
• Fulfilment Needs
• Economic Resources
• Workforce
• Education Training

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WELL-BEING
FULFILMENT
ESTEMM NEEDS
SOCIAL NEEDS
SAFETY SECURITY
BASIC NEEDS
RESOURCE DEVELOPMENT
WORKFORCE DEVELOPMENT
EDUCATION TRAINING
BIODIVERSITY
AIR QUALITY
WATER QUALITY
LAND QUALITY
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The Well-being Framework in the Planning Cycle
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Planning

Goals / Visions
Environmental Scan
Evaluation
Implementation
Strategic Analysis
Tasking
Strategic Choice
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The Preventative Goal
1. Preventing or minimising public health dangers
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The Protective Goal

• 2. Societies should ensuring that vulnerable and
  dependant people have equitable access to meet
  their basic needs, safety and security and social
  support. This is fundamental to the well-being of
  our community.

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The Development Goal

• 3. As a developed society our major focus for
  wellbeing is to ensure that people have the
  opportunities, skills and recognition to live
  well together accepting and celebrating
  differences in culture.

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The Aspirational Goal

• 4. A vision arises of a community where peoples
  needs are met, belief in self and others is
  evident and people strive for fulfilment.

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Local Government's Role

• Local Governments role in achieving these
  well-being goals is through leadership including
• Representation of community interests
• Strategic alliances
• Investment in people
• Infrastructure and planning
• Community education
• Monitoring of the communities well-being .
• It can also involve various elements of service
  delivery.
• VicHealth (2002) Leading the Way Councils
  creating healthier communities. State Government
  of Victoria

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Assessment of Key Public Health Well-being
Issues
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Two Types of Issues

• 1. Social Phenomena
• Social phenomena that currently, or will in the
  future, impact significantly on community
  well-being.
• or
• Issues that may lie across a number of business
  unit responsibilities or that are not adequately
  identified in business planning.

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Two Types of Issues

• 2. Social Vulnerabilities
• Issues identified using the wellbeing framework
  that could potentially arise or require ongoing
  maintenance.
• They tend to be perennial issues and require
  operational as much as strategic responses and in
  most instances dedicated services and mechanisms
  are provided to systematically respond to these
  issues.

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Key Phenomenal Well-being Issues

• Inactivity Diet
• Aging
• Population Maintenance
• Wealth Inequity

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Vulnerabilities

• Environmental Degradation
• Infrastructure Provision
• Maintenance of Public Health Standards
• Basic Needs Safety of Dependants
• Support for Families and Carers
• Under Employment
• Over Employment
• Social Diversity