ORCID Profile
0000-0002-8573-4235
Current Organisation
University of Adelaide
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Publisher: Springer Science and Business Media LLC
Date: 18-01-2019
Publisher: CSIRO Publishing
Date: 13-07-2022
DOI: 10.1071/PY21285
Abstract: Background Studies show widespread widening of socioeconomic and health inequalities. Comprehensive primary health care has a focus on equity and to enact this requires more data on drivers of the increase in inequities. Hence, we examined trends in the distribution of income, wealth, employment and health in Australia. Methods We analysed data from the Public Health Information Development Unit and Australian Bureau of Statistics. Inequalities were assessed using rate ratios and the slope index of inequality. Results We found that the social gradient in health, income, wealth and labour force participation has steepened in Australia, and inequalities widened between the quintile living in the most disadvantaged areas and the quintile living in the least disadvantaged areas. Conclusion Widening income, wealth and employment inequalities have been accompanied by increasing health inequalities, and have reinforced and lified adverse health effects, leading to increased mortality inequality. Effective comprehensive primary health care needs to be informed by an understanding of structural factors driving economic and health inequities.
Publisher: Cambridge University Press (CUP)
Date: 23-11-2023
DOI: 10.1017/S0047279421000726
Abstract: Early childhood education (ECE) and development is internationally recognised as important to child health and wellbeing and to enabling children to become healthy productive adults. This paper analyses Australian ECE policy current in 2019. It uses the institutional framework of ideas, actors and institutions to determine the extent to which ECE policy recognises and acts on social determinants of health and health equity. We found that the policies supported integrated approaches, intersectoral collaboration and partnerships with parents and families. Evidence was important in formulating the ideas underpinning ECE policy. ECE was widely recognised as a social determinant of health, and the impacts of other social determinants of health and health equity were acknowledged. The ECE policies tended to be future-focused and not respond to social determinants that influence children and their families in the present time. The policies lacked strategies to address social determinants, or to engage with other sectors for this purpose. While some policies focused on breaking the cycle of disadvantage, they did not explore potential policy responses to pathways from intergenerational disadvantage to reduce poverty. Despite this, Australian ECE policy has achieved significant coherence, with shared understandings of the purpose and benefits of ECE.
Publisher: Wiley
Date: 12-07-2022
DOI: 10.1002/HPJA.517
Abstract: How health promotion is implemented varies and it is often not clear what activities are in place in a region. Understanding the extent of health promotion activities helps planning activities. This research involved a rapid audit of the types of health promotion activities in a suburban region of South Australia. This analysis was guided by the WHO Ottawa Charter's principles. To better understand population needs and which health promoting activities may help, an epidemiological, demographic and social determinants of health profile of southern Adelaide described disease patterns and health inequities. While there was evidence of a range of health promoting activities, most concerned in idual or behavioural services. A key finding was the small number of activities that the state health department and local health system were responsible for. Alongside local government, NGOs provided the bulk of health promotion activities. In addition, there were no overarching health promotion strategies or coordinating bodies to evaluate the activities. The epidemiological, demographic and social determinants of health profile found persistent health and social inequities. This rapid audit of health promotion in a region enabled a quick assessment of the current health promotion situation and provided evidence of gaps and areas where policy change should be advocated. SO WHAT?: The key findings distilled from this research were designed to inform policy priorities to shift health promotion in southern Adelaide onto a trajectory consistent with the Ottawa Charter and prevent further focus on in idualised behaviour change strategies known as 'lifestyle drift'.
Publisher: Springer International Publishing
Date: 2022
Publisher: SAGE Publications
Date: 02-2003
Abstract: The authors describe the contribution of a series of focus groups and a progressively revised discussion paper to the evaluation of health care reform in South Australia. The focus groups informed the evaluation about participants' experiences of the impact of reform on their agencies while enabling increased understanding about change in the health system. A discussion paper describing global health service trends and emerging findings from our evaluation was prepared prior to the first focus group and subsequently revised to incorporate participants' comments before being sent to the next group. The result was a paper that enhanced participants' discussion, and reflected their views. As an action research-based method, this iterative process was valuable for participants and the evaluation, and supported organizational learning.
Publisher: Oxford University Press (OUP)
Date: 16-09-2020
Abstract: The Health in All Policies (HiAP) approach aims to create coherent policy across government that will improve population health, wellbeing and equity while progressing the goals of other sectors. The quest to achieve policy coherence across government has focused interest on processes that facilitate collaboration between health and many other sectors. Health and education sectors have long been seen as natural partners with mutually beneficial goals. This article focuses on a case study of HiAP work, undertaken between health and education in South Australia to increase parental engagement in children’s literacy among lower socio-economic families. It draws on a document analysis of 71 documents, seven in-depth interviews with senior policy actors and a programme logic model. The project began with the intention of using policy levers to improve long-term health outcomes through addressing child literacy, a proven social determinant of health. Because of the context in which it was operating, the project extended from a focus on policy to working directly with four schools implementing strategies to facilitate parental engagement, with the intention of finally influencing system-wide education policy. We use an institutional framework to support our analysis through a discussion of ideas, actors and institutions and how these influenced the project. The article provides insight into the facilitators and impediments to intersectoral efforts to progress shared educational and health goals and achieve sustainable change, and identifies lessons for others intending to use this approach.
Publisher: Wiley
Date: 08-04-2022
DOI: 10.5694/MJA2.51495
Publisher: Oxford University Press (OUP)
Date: 11-11-2022
Abstract: Globally health promotion has remained marginalized while biomedical health systems have maintained and even increased their dominance. During 2019–2021 we drew on the local and historical knowledge of actors from multiple sectors through semi-structured interviews and focus groups, to assess the implications of the withdrawal of the state from health promotion in a suburban region of South Australia. Institutional theory enabled in-depth analysis of the ideas, actors, and institutional forces at play in the institutional field, and how these elements come together to maintain the dominance of medicine. We found that the ideas, actors and institutional forces supporting health promotion in the study region have weakened and fragmented. This has happened as biomedicine has increased its dominance in the region’s health system, mirroring international trends. The results point to a withdrawal of state and federal governments from health promotion, which has led to severe gaps in leadership and governance, and locally, to a decline in capacity and resources. The state health department reallocated resources to focus on in idual behavioural change rather than more structural factors affecting health. While some activities aimed at the social determinants of health or community development strategies remained, these had minimal institutional support. The establishment of a state government wellbeing agency in 2020 prompted an exploration to determine whether the agency and the international wellbeing movement presents an opportunity for a revival of more comprehensive health promotion.
Publisher: Springer Science and Business Media LLC
Date: 16-10-2017
Publisher: Wiley
Date: 06-2004
Publisher: Springer Science and Business Media LLC
Date: 14-10-2020
Publisher: Springer Science and Business Media LLC
Date: 12-10-2019
DOI: 10.1007/S00038-019-01302-4
Abstract: This paper examines the opportunities and barriers that the South Australian Health in all Policies (SA HiAP) approach encountered when seeking to establish a whole-of-government response to promoting healthy weight. The paper draws on data collected during 31 semi-structured interviews, analysis of 113 documents, and a program logic model developed via workshops to show the causal links between strategies and anticipated outcomes. A South Australian Government target to increase healthy weight was supported by SA HiAP to develop a cross-government response. Our analysis shows what supported and hindered implementation. A combination of economic and systemic framing, in conjunction with a co-benefits approach, facilitated intersectoral engagement. The program logic shows how implementation can be expected to contribute to a population with healthy weight. The HiAP approach achieved some success in encouraging a range of government departments to contribute to a healthy weight target. However, a comprehensive approach requires national regulation to address the commercial determinants of health and underlying causes of population obesity in addition to cross-government action to promote population healthy weight through regional government action.
Publisher: Wiley
Date: 25-04-2019
Publisher: Maad Rayan Publishing Company
Date: 11-11-2019
Publisher: Hindawi Limited
Date: 27-06-2002
DOI: 10.1046/J.1365-2524.2002.00369.X
Abstract: Interagency collaboration has increasingly been viewed as an important strategy to encourage the co-ordination of healthcare. It is seen to have a number of positive outcomes, including: improved service delivery for people requiring multiple services more efficient use of healthcare resources and a means for managers to share the responsibility of community care and reduce organizational stress caused by pressures of increasing demand for services within a climate of cost containment. However, establishing collaborative interagency relationships can be a challenging, long-term and complex process. The present article describes some of the findings of a research project that evaluated collaborative strategies adopted and trialed by a group of four publicly funded healthcare agencies in the southern metropolitan area of Adelaide, South Australia. Key findings from the literature about the factors supporting and impeding collaboration are discussed in the light of some of the findings from the evaluation project. Some of the themes emerging from the Adelaide study include: the need for resources for change experience of multidisciplinary work professional barriers to collaboration the importance of agreed aims, agendas and project ownership and the importance of supportive leadership. This article concludes with a discussion of the difficulties and opportunities for collaboration between community-based primary healthcare agencies and acute care hospitals. The development of partnerships which are either based on trust, or on the open negotiation of power differences and professional territories, and the management of mistrust are found to be important foundations for achieving greater genuine collaboration between primary and tertiary level healthcare.
Publisher: SAGE Publications
Date: 10-2001
DOI: 10.1177/13563890122209856
Abstract: Evaluators in the health sector struggle to develop effective mechanisms with which to evaluate healthcare reform programmes. Evaluation of these programmes is difficult because they are entangled in complex, inherently political processes and often shift away from their original aims and objectives as a result of policy changes within the health system. This article describes the evaluation of a healthcare reform process occurring in South Australia and discusses some of the methodological challenges encountered in evaluating a case study of continuous change with shifting policy objectives. It describes how the evaluators have attempted to address these challenges through a flexible and dynamic action-research approach. The article concludes by discussing the role of the evaluator, as intelligent observer, in reflecting on and documenting change in the highly political and complex field of healthcare reform.
Publisher: MDPI AG
Date: 25-10-2017
Publisher: Maad Rayan Publishing Company
Date: 22-10-2018
No related grants have been discovered for Helen van Eyk.