VH Fiscal Concerns - Irene Verins

16
Addressing the social and economic determinants of mental and physical health Fiscal considerations Irene Verins www.vichealth.vic.gov.au

description

VicHealth Fiscal Concerns

Transcript of VH Fiscal Concerns - Irene Verins

Page 1: VH Fiscal Concerns - Irene Verins

Addressing the social and economic determinants of mental and physical health

Fiscal considerations

Irene Verins

www.vichealth.vic.gov.au

Page 2: VH Fiscal Concerns - Irene Verins

Addressing the social and economic determinants of mental and physical health

Page 3: VH Fiscal Concerns - Irene Verins
Page 4: VH Fiscal Concerns - Irene Verins
Page 5: VH Fiscal Concerns - Irene Verins

1. Scoping policy, research & stakeholders for

emerging health issues of concern.

2. Establish the case research , evidence &

attitudes to inform future directions

3. Develop conceptual, evidence based

framework to guide activity

7. Identify skills gaps & strengthen capacity through

workforce development

5. Intervention design & implementation of cross

sector activity

4. Partnerships with practice, research &

strategic partnerships

9. Sustainability of change (for uptake & integration)

8. Communication of learnings through

publications, resources & tools

6. Evaluation of cross sector activity

Page 6: VH Fiscal Concerns - Irene Verins

Elements of accountability

• $36 million – $27,255,000 was disbursed to 798 grants in 2010-2011

• Sport 36%

• Arts 5%

• Research 16%

• Community 27%

• Media 1%

• Education 1%

• Workplace 7%

• Local government 7%

Brokerage of external funds: 10-15% overheads versus 30% of universities.

Page 7: VH Fiscal Concerns - Irene Verins

Population groups

–55% whole of population approaches

–10% low socioeconomic status

–10% to Aboriginal projects

–8% to Children

–7% new arrival groups

–5% people with a disability

–5% geographic disadvantage

Page 8: VH Fiscal Concerns - Irene Verins

What we won’t fund

–Individuals

–unincorporated bodies

–Capital works and major equipment

–Recurrent funding

–In receipt of tobaco or alcohol funding or sponsorship

–Recalcitrant projects

Page 9: VH Fiscal Concerns - Irene Verins

Governance

Board

• board structure was found which resembled those of University boards which enshrine representatives from all shades.

• Board is level one

• Advisory committees for each health area are level 2 dealing with grants

Page 10: VH Fiscal Concerns - Irene Verins

Transparency

• All grants are publically advertised (conflict of interest governs board and staff)

• All applications for grants are assessed by:

– Internal review & assessment

– External stakeholder assessments

• Board members must register all conflicts of interest at each bi monthly meeting

Page 11: VH Fiscal Concerns - Irene Verins

Other aspects of accountability

• Being evidence based and rigorous in a poorly evaluated discipline in which evidence is still evolving

• Exposing ourselves to open debate, cynicism

and skeptics.

• Acting independently from government and other stakeholders but with the interests of stakeholders at the fore…being representative and reflective of our stakeholders.

Page 12: VH Fiscal Concerns - Irene Verins

Building the argument for a hpf

• Context specific

• People from science, politics and then the allies…(some from sport who said that they would change their sponsorship practices)

• Bi partisan approach very important

• Moving across well established networks became an important and enduring aspect of VH..

• A campaign of well briefed media (supported and expanded the audience for the issues)

• Community attitudes surveys and polls (identified % people favored a tax)

Page 13: VH Fiscal Concerns - Irene Verins

Participation for health: a framework for action 2009-2013

Key social and economic determinants of mental and physical health

Physical activity Social connection Freedom from violence

Freedom from discrimination

Access to economic resources

Active communities

Involvement in community sport and active recreation

Supportive relationships

Involvement in community and group activities

Civic engagement

Social, emotional, physical and economic security

Equitable and respectful relationships

Valuing diversity

Physical security and respect

Equality of opportunity

Work

Education

Housing

Money

Population groups and action areas

Population groups Action areas

Children

Young people

Women and men

Older people

Indigenous communities

Culturally diverse communities

Rural communities

Research, monitoring and evaluation

Organisational development (including workforce development)

Strengthening communities and community environments

Communications and social marketing

Advocacy

Legislative and policy reform

Direct participation programs

Settings for action

Housing Community Education Workplace Sport and recreation Health Academic

Transport Corporate Public Arts Local government Justice Technology

Page 14: VH Fiscal Concerns - Irene Verins

Participation for health: a framework for action 2009-2013

Intermediate outcomes

Individual Organisational Community Societal

Projects and programs that facilitate:

• involvement in community and group activities

• self efficacy

• self determination and control

• political and civic efficacy

• taking responsibility for others

• respectful, supportive and equal relationships

• acceptance of diversity

• access to education and employment

• mental health literacy

Organisations that:

• are inclusive, responsive, safe and supportive

• work in partnerships across sectors

• implement evidence-informed approaches to their work

• sustain change

Environments that:

• are inclusive, responsive, safe and supportive

• value civic engagement

• are cohesive

• promote community responsibility

• reflect awareness of mental health and wellbeing issues

• sustain change

A society with:

• integrated, sustained and supportive policies and programs

• strong legislative platforms for mental health and wellbeing

• appropriate resource allocation

• responsive and inclusive governance structures

Long-term benefits

Individual Organisational Community Societal

• Increased sense of belonging

• Improved physical health

• Less stress, anxiety and depression

• Less substance misuse

• Enhanced skill levels

• Resources and activities integrated across organisations, sectors and settings

• Community valuing of diversity and actively disowning discrimination

• Less violence and crime

• Improved productivity

• Reduced social and health inequalities

• Improved quality of life and life expectancy

Page 15: VH Fiscal Concerns - Irene Verins

www.vichealth.vic.gov.au

What influences/determines health?

Society

Policy (e.g. social, education,

employment, infrastructure, health,

environmental sustainability)

Social and cultural beliefs

Social structures and institutions

Social cohesion

Distribution of power

and resources

Economic wealth

Community

Family/Household

Family structure

and relationships

Health related

behaviours and

exposures

Employment,

income and wealth

Housing and living

conditions

Behaviour

Age Sex

Genes

Individual

Neighbourhood facilities and

infrastructure

Local services and amenities

Living and working conditions

Social networks and support

Group and peer norms

Participation opportunities

Community cohesion and stress

Page 16: VH Fiscal Concerns - Irene Verins

Why invest in a HPF?

• Effective health promotion has the capacity to

• improve health,

• reduce the costs of treating chronic disease,

• enhance economic productivity,

• bridge the health divide between population groups, and

• add healthy years to life expectancy.