Protection of Health and Environment Aim: To explain the process of risk management and how its implementation can promote or protect health

The tendency towards a dual economy Galbraith argued that the economy and its organisations develop dual tendencies The central economy is planned and primarily reflects the interests of the power elite In the competitive periphery prices remain paramount (the poor work in the periphery both globally and in regard to the individual organization, where they are a casual labour force) The role of govt. should be to bring these two economic sectors into alignment

Environmental health risk factors Air , water, food quality Noise, toxic and non toxic waste disposal Building standards Natural disasters, war, crime Pest infestations; pesticide and herbicide residues Degradation of natural resources

Personal lifestyle health risk factors Smoking Alcohol abuse Lack of exercise, obesity Sexual practices Safety practices Importance of health related knowledge

Major risks of premature death internationally Malnutrition Poor water supply, sanitation, hygiene Unsafe sex Tobacco use Alcohol Occupation

World Health Organisation Established 1948 ‘Health for All by the Year 2000’ was goal established in 1978 The Alma-Ata declaration: 134 nations agreed that health is a fundamental human right and the highest possible level of health is a most important world wide social goal Primary care first priority

International context of national risk management 1978: Alma-Ata declaration established health as a fundamental human right and stated the highest possible level of health is a most important world goal 1986: Ottawa Charter says supports include peace, shelter, food, income, a stable economic system, sustainable resources, social justice and equity

Ninth General Program of Work of the WHO (1996-2000) Ten goals and targets Goal 1 is to increase the span of healthy life for all people in such a way that the health disparities between social groups decrease Targets: Life expectancy at birth will not be less than 60 in any country The difference between highest and lowest group life expectancy will reduce by 50%

WHO Governing Body is World Health Assembly (170 nations) WHO helps countries reinforce their health systems by building up infrastructures Promotes appropriate research (malaria, leprosy, other tropic disease control) Safe drinking water programs Immunisation programs Other appropriate programs; HIV/AIDS; river blindness, etc.

WHO Strategy Education about main health problems Proper food supply and nutrition Safe water and sanitation Maternal and child health (family planning) Immunisation against infectious diseases Prevention and control of local diseases Treatment of common diseases and injuries Provision of essential drugs

International context of risk management 1992: UN Declaration on Environment and Development: Humans are at the centre of concern for sustainable development and are entitled to a health and productive life in harmony with nature. 1997: WHO called for development of health promotion as a result of cooperation between govt. and private sector

International context of risk management Post 1989: Global agreement on the need for free trade APEC principles: Equal treatment; access to information; need for cost-effective dispute resolution; no relaxation of health, safety and environmental regulations to attract investment Aust. Competition Policy Reform Act

Australian competition Policy Reform Level playing field of national standards for health and environment protection Equal competition between private and public sector service providers Perfect information: necessary for competition, risk identification and control; scientific advance; democratic accountability

Risk management standard (AS/NZ 4360:1999) A logical and systematic method of identifying, analysing, assessing, treating, monitoring and communicating risks associated with any activity in a way that will enable organisations to minimise losses and maximise opportunities.

Risk Management Process (Communicate and consult) Establish the context(strategic, organisational, etc.)(baseline data) Identify the risks Analyse and prioritise risks(severity/frequency) Treat risks (reduction strategies) Evaluate outcome (performance indicators)

Risk management consistent with: Risk identification and control requirements of state OHS Acts Health promotion: ‘preventing the causes of determinants of illness; evidence based practice; community participation in decisions affecting health’ (NHMRC) Duty of care of health practitioner Quality mgt. (ISO 9004.1)Environmental mgt. (ISO 14004)

Risk management can be carried out: In a global, national, regional, industry, or organisational context Risk management programs can aim at promoting the health of populations, consumers, clients, or workers

Health Aims and Objectives The choice of a health program aim should relate closely to the overall aims of the organisation and assist in their achievement. The aim needs to be clear and measurable The objectives support the aim and should relate closely to it

Identification of health risk leads to program aims: The aim is based on the prior identification and prioritization of health risk, so the gathering of data to aid the identification of risk is imperative Baseline data collected at commencement of the project is compared to data collected at the end of the project to see if improvement has occurred

Australian Health Goals Developed by Commonwealth and State Ministers Access to high quality health care services regardless of financial status and place of residence Cost-effective health improvement through a prevention related approach Access to information which will enable individual Australians to make informed decisions (treatment outcome data)

Aust. National Health Priorities Cardiovascular disease Cancer Injury Mental health Aboriginal health (plus Diabetes)

National Health Goals Goal is a broad statement: ‘To reduce the impact of coronary heart disease on the health of all Australians’ Target: ‘Reduction of x% in admissions to hospital over z years Strategy: Actions to achieve the goal A performance indicator is a measurable way of assessing progress (e.g. admissions to hospital)

Criteria for Setting Goals The public health significance of the goal The ability to effectively implement practices to achieve it The ability to measure its achievement Importance of benchmarking (performance comparison based on consistent international and national data collection)

From global to local approaches to sustainable development Community development should be based on the identification of major health and environment problems on an appropriate regional basis in order to prioritize and find solutions to them. State of the Environment Report (1985-2000) from the UN Economic and Social Commission provides provides a broad context.