1. New directions in public health in Victoria: joining the dots
Colin Sindall, Director, Prevention and Population Health, Department of Health

2. Overview of presentation
Introduction
International perspective
National developments
Policy context in Victoria
Municipal Public Health and Wellbeing Planning
Opportunities and challenges

4. Beginnings of modern public health
Sir Edwin Chadwick, social reformer and central actor in the sanitary movement in the 1840s. Secretary to the Poor Law commissioners.
During the 1854 Cholera outbreak in London, Dr John Snow plotted the cholera cases on a map of Soho and showed that a high concentration of cholera cases around a water pump on Broad Street.

5. Tuesday 30 November 2010
White paper hands responsibility for public health to local authorities
Health secretary Andrew Lansley … called the white paper a radical plan to tackle the causes of premature death and ill health. Public health was also about the environment, poverty, education and housing, which were key concerns of local authorities. "People's health and wellbeing will be at the heart of everything local councils do. It's nonsense to think that health can be tackled on its own," he said. "Directors of public health will be able to champion local co-operation so that health issues are considered alongside housing, transport, and education”.
“Great expectations - public health is coming home”

6. “Building on local government’s long and proud history of public health leadership, our vision is for local authorities to use their new responsibilities and resources to put health and wellbeing at the heart of everything they do, thereby helping people to lead healthier lives, both mentally and physically…
Local authorities are democratically accountable stewards of their local populations’ wellbeing. They understand the crucial importance of “place” in promoting wellbeing. In other words, the environment within which people live, work and play, the housing they live in, the green spaces around them, and their opportunities for work and leisure, are all crucial to their health and wellbeing…
Local authorities can fulfil their duties in a wide range of ways, including the way they operate the planning system, policies on leisure, key partnerships with other agencies for example on children’s and young people’s service ...promoting community renewal and engagement, development of social networks…
Local political leadership will be critical in ensuring that public health receives the focus it needs”.

7. National context Health Reform
National Partnership Agreement on Preventive Health
Australian National Preventive Health Agency
Medicare Locals
National Health Performance Authority: Healthy Communities reports
Healthy Communities Reports will…provide contextual information about each local area, allowing comparisons with Australian averages, and preventive health risk factors and other measures of community health and wellbeing
Major Cities Unit reports eg
Creating Places For People: an urban design protocol for Australian Cities

8. POLICY CONTEXT FOR PREVENTION IN VICTORIA

9. Victorian Public Health and Wellbeing Plan 2011-2015
Goal: To improve the health and wellbeing of all Victorians by engaging communities in prevention and by strengthening systems for health protection, health promotion and preventive healthcare across all sectors and levels of government.
The Victorian Public Health and Wellbeing Plan was released on September 1, 2011.
Victoria’s first public health and wellbeing plan – it is both a response to the legislative requirement under the Victorian Public Health & Wellbeing Act that a plan to identify public health priorities for the state be developed every four years, and an important companion document to the overarching Victorian Health Priorities Framework which articulates the long-term planning and development priorities for Victoria’s health system.
The plan aims to build on the current strengths of public health in Victoria, while at the same time providing a solid foundation to meet future challenges
The Plan represents a cross-government, cross-sector approach to prevention, and sets the agenda for improving health and wellbeing across the state over the next four years.

10. UK Faculty of Public Health Three key domains of public health practice
The science and art of promoting and protecting health and well-being, preventing ill-health and prolonging life through the organised efforts of society.
Health Improvement
Health Protection
Improving services

11. Policy Priorities
The plan identifies opportunities for actions in five policy priorities:
strengthen the prevention system – through governance and leadership, information systems, financing and resource allocation, partnerships, and workforce development
support priority settings for action an engagement – with a focus on local communities, workplaces, early childhood and education settings, and health services
continue to protect the health of Victorians – including communicable disease control, immunisation, environmental health, food safety, and incident and emergency response
keep people well – focussing on healthy eating, physical activity, tobacco control, oral health promotion, reducing misuse of alcohol and drugs, sexual health promotion, mental health promotion, injury prevention, and skin cancer prevention
strengthen preventive healthcare – including cancer screening, newborn screening, and early detection and intervention services

12. Strategic directions 2011-2015
Build prevention infrastructure to support evidence-based policy and practice
Develop leadership and strengthen partnerships to maximise prevention efforts across sectors
Review financing and priority setting mechanisms to ensure available resources are based on population need and potential for impact
Develop effective modes of engagement and delivery of evidence-based interventions in key settings
Strengthen local government capacity to develop and implement public health and wellbeing plans
Improve health service capacity to promote health and wellbeing
Integrate statewide policy and planning to strengthen public health and wellbeing interventions
Increase the health literacy of all Victorians and support people to better manage their own health
Tailor interventions for priority populations to reduce disparities in health outcomes
There are nine strategic directions which consolidate all of the opportunities for progress identified within the plan

13. Monitoring & Review
Governance – Prevention and Population Health Advisory Board (includes other portfolios, VicHealth, CCV, Heart Foundation, MAV)
Monitoring and reporting on public health and wellbeing & the determinants of health and wellbeing: eg Victorian Population Health Survey; Chief Health Officer’s report; State of Victoria’s Children report; CIV.
Evidence translation and brokerage – The Centre for Excellence in Intervention and Prevention Science (CEIPS): links to research and evaluation expertise in Victoria (VicHealth, universities etc), nationally (eg NH&MRC, ANPHA, AIHW), and internationally

14. Other related initiatives include
NPAPH: State initiatives (incl PCM) and Healthy Communities (Commonwealth)
Metropolitan Planning Strategy
Positive Ageing in Local Communities/Age friendly communities
Pedestrian Advisory Council (DoT)
Sports Injury Prevention Taskforce
Parliamentary Inquiry into Environmental Design and Public Health
WorkHealth
Various initiatives: VicHealth, Heart Foundation etc

15. Prevention Community Model: Linking state policy & local community action on health
Universal – Whole of State
Health Promoting Early Childhood Settings & Schools Policy + Accreditation Model
Hospital food & drink guidelines
Healthy Eating Advisory Service
Environments for HP Workplaces
Department of Health as a HP org
Prevention Workforce Innovation Strategy (Networks of Practice)
Healthy Living Web 2.0
Life! Chronic disease prevention
Victorian Prevention Achievement Program
Health checks & health coaching
Community
Digital community engagement
Healthy Living Programs
Targeted social marketing in local settings
Leadership for Health
Health Promoting Early Childhood
Health Promoting workers & workplaces
Health Promoting Schools
Health Promoting Local Government
Enabling Infrastructure
Prevention Partnership
Networks of practice
Prevention Area Workforce
Prevention Funding
CEIPS

16. Lead role of local government at the community level
Public Health and Wellbeing Act 2008
The function of a Council under this Act is to seek to protect, improve and promote public health and wellbeing within the municipal district by:
(a) creating an environment which supports the health of members of the local community and strengthens the capacity of the community and individuals to achieve better health
(b) initiating, supporting and managing public health planning processes at the local government level
(c) developing and implementing public health policies and programs within the municipal district…
In preparing a municipal public health and wellbeing plan, a Council must have regard to the State Public Health and Wellbeing Plan.
Victorian Health Priorities Framework
All local governments will have Municipal 'Healthy Communities‘ Public Health and Wellbeing Plans that are well known to their local communities and that promote healthy living.

17. VPH&WP: Priority settings for action and engagement: local communities and environments
For all communities, the primary strategic planning mechanism for public health and wellbeing efforts is the MPHWP
Build on the Environments for Health framework to support next wave of municipal health and wellbeing planning
Build on the experience of Positive Ageing in Local Communities Project, and the Improving Liveability for Older People initiative
Link to opportunities to improve health and wellbeing in development of a Metropolitan Planning Strategy.

18. New Planning Guide
Meeting the requirement under section 26(3) of the Public Health and Wellbeing Act 2008 that councils developing MPHWPs ‘have regard to the Victorian Public Health and Wellbeing Plan’
Meeting requirements under section 14 of the Climate Change Act (2010) (section 14) which requires decision makers to have regard to climate change
Understanding the legislated provisions for the requirements, timing and annual review of MPHWPs, and
The essential elements of good practice in planning for healthy communities
Importance of an integrated approach

19. Additional Resources
Resource for including public health and wellbeing matters into Council Plans
A tool to guide annual reviews of MPHWP was developed by the Southern Metropolitan Region
Ongoing resources
Access to data
Regional office support