1. Developing the Evidence Base for Community-Governed Health Promotion and Prevention 21st ANZAM Conference 2007 managing our intellectual and social capital Sydney, Thursday 6 th December Ms Vicky Totikidis Centre for International Corporate Governance Research, Faculty of Business and Law, Victoria University, Melbourne. National Health and Medical Research Council Public Health Postgraduate Research Scholarship 405101

2. Community Centered Health Promotion and Prevention in an Australian Context National Health and Medical Research Council Public Health Postgraduate Research Scholarship 405101 Stage Three: Evaluation of Community Centered Health Promotion Stage One: Community Health Evidence Base Stage Two: Community Health Information Collaboration Communit y Centered Health Promotion

3. Rationale Community governance of health promotion together with evidence about the health of a community is essential to the success of community health collaborations and to community empowerment and change. Community governance of health promotion together with evidence about the health of a community is essential to the success of community health collaborations and to community empowerment and change. National Health and Medical Research Council Public Health Postgraduate Research Scholarship 405101

4. What is Community Governance ? Community governance can be distinguished from corporate governance by its focus on communities rather than corporations and health & wellbeing rather than profits Community governance can be distinguished from corporate governance by its focus on communities rather than corporations and health & wellbeing rather than profits Can be defined as community level management and decision-making that is undertaken by, with, or on behalf of [for] a community, by a group of community stakeholders Can be defined as community level management and decision-making that is undertaken by, with, or on behalf of [for] a community, by a group of community stakeholders National Health and Medical Research Council Public Health Postgraduate Research Scholarship 405101

5. Evidence Based Health Promotion: What Is It And Where Did It Come From? Need for EBHP recognised by the World Health Organization & governments, researchers & public health & health promotion professionals around the world Need for EBHP recognised by the World Health Organization & governments, researchers & public health & health promotion professionals around the world EBHP is difficult to define and is often debated EBHP is difficult to define and is often debated Evidence assists decision making Evidence assists decision making Origins in evidence-based medicine (mid 19th century, Paris) Origins in evidence-based medicine (mid 19th century, Paris) National Health and Medical Research Council Public Health Postgraduate Research Scholarship 405101

6. Guiding And Evaluative Evidence National Health and Medical Research Council Public Health Postgraduate Research Scholarship 405101 Guiding Evidence: Evidence about the health issues that need to be addressed in the intervention Evaluative Evidence: Evidence about the effectiveness of interventions Community Health Intervention Figure 1. Guiding and evaluative evidence in community health interventions

7. Evidence for Community Governance of Health Promotion Should be: Educative, informative & empowering for community members - Knowledge is Power Should be guided by knowledge of: National Health Priority Areas National Health Priority Areas Community health status Community health status Determinants of health Determinants of health Inequalities Inequalities National Health and Medical Research Council Public Health Postgraduate Research Scholarship 405101

8. National Health Priority Areas Arthritis and musculoskeletal conditions Arthritis and musculoskeletal conditions Asthma Asthma Cancer control Cancer control Cardiovascular health Cardiovascular health Stroke Stroke Diabetes mellitus Diabetes mellitus Injury prevention and control Injury prevention and control Mental health Mental health National Health and Medical Research Council Public Health Postgraduate Research Scholarship 405101

9. Determinants, Differences and Community Health Status Model National Health and Medical Research Council Public Health Postgraduate Research Scholarship 405101 Health Differences Inequalities Disparities Inequities (should not exist) Person/ Communit y A Health Status Determinants Person/ Communit y C Health Status Determinants Person/ Communit y B Health Status Determinants

10. Determinants of Health The range of personal, social, economic and environmental factors which determine the health status of individuals or populations (Nutbeam 1998:6) The range of personal, social, economic and environmental factors which determine the health status of individuals or populations (Nutbeam 1998:6) Hundreds of determinants or factors that impact on ones health, either negatively or beneficially Hundreds of determinants or factors that impact on ones health, either negatively or beneficially Examples include: age, weight, gender, culture, drugs, nutrition, poverty, heredity and environmental conditions Examples include: age, weight, gender, culture, drugs, nutrition, poverty, heredity and environmental conditions Determinants can also be categorised as risk and protective factors Determinants can also be categorised as risk and protective factors National Health and Medical Research Council Public Health Postgraduate Research Scholarship 405101

11. Health Status The level of illness or wellness of a population at a particular time, measured through life expectancy, mortality, disability and disease prevalence rates The level of illness or wellness of a population at a particular time, measured through life expectancy, mortality, disability and disease prevalence rates Level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures Level of health of the individual, group, or population as subjectively assessed by the individual or by more objective measures The National Health Priority Areas may be viewed as several of numerous indicators of health status The National Health Priority Areas may be viewed as several of numerous indicators of health status National Health and Medical Research Council Public Health Postgraduate Research Scholarship 405101

12. Differences in Health Inequalities, disparities and inequities in health all refer to differences in health among individuals and communities Inequalities, disparities and inequities in health all refer to differences in health among individuals and communities The term inequity has a moral and ethical dimension. It refers to differences which are unnecessary and avoidable but, in addition, are also considered unfair and unjust (Whitehead, 1991:5) The term inequity has a moral and ethical dimension. It refers to differences which are unnecessary and avoidable but, in addition, are also considered unfair and unjust (Whitehead, 1991:5) National Health and Medical Research Council Public Health Postgraduate Research Scholarship 405101

13. Conclusion National Health and Medical Research Council Public Health Postgraduate Research Scholarship 405101 Health Differences Inequalities Disparities Inequities (should not exist) Person/ Communit y A Health Status Determinants Person/ Communit y C Health Status Determinants Person/ Communit y B Health Status Determinants Detailed information on National Health Priority Areas, Community health status, Determinants of health and Inequalities would provide an important evidence base to guide the community governance of health promotion and improve community health and wellbeing

14. National Health and Medical Research Council Public Health Postgraduate Research Scholarship 405101 Improved community health and wellbeing Person/ Community C Health Status Person/ Community B Health Status Person/ Community A Health Status