6. Health Policy and Promotion

6.1 Social Determinants of Health

6.1.1 The DRS recognises that equitable health outcomes are crucially dependent on the social determinants of health.

6.1.2    The DRS supports the conclusions of the WHO Commission on the Social Determinants of Health and believes they should be applied in the Australian context.

6.1.3    The DRS thus:

6.1.3.1 recognises that inequitable distribution of power, income, resources, access to education, housing, employment, justice, and protection from violence and discrimination are all factors which must be addressed in order to achieve equitable health outcomes.

6.1.3.2  supports an expansion of a population health approach at the regional, State, and Federal levels with particular emphasis on data collection and analysis to guide policy

6.1.3.3  supports a strengthening of the public sector across all areas and an increase in accountability of the private sector.

6.1.4    The DRS supports the concept of Health Equity in All Policies as a basis for working towards the goal of equitable health outcomes.

6.1.5    The DRS regards the emphasis on materialism and individualism, and the breakdown of community connectedness as significant factors adversely affecting health.

6.2  Healthy Public Policy
6.2.1  The DRS believes the goal of healthy public policy is to create a supportive environment to enable people to lead healthy lives.  In pursuit of this goal, all government sectors, including agriculture, trade, education, industry, communications, environment, housing and public works, need to take account of health as an essential factor during policy formulation.  Adequate attention should be given to health consequences and not only economic considerations as health is an essential foundation to any society and a fundamental human right.

6.2.2  The DRS believes healthy public policy should aim to close the health gap between the disadvantaged and the more advantaged in society.  Equal access to health services for equal need, in particular community health care is a vital aspect of equity in health.  Community action is central to the fostering of public health policy.

6.3  Health Promotion
6.3.1  The DRS endorses programs which incorporate:
i. the creation of environments which support health;
ii. the development of personal skills;
iii. the strengthening of community action;
iv. increased emphasis on preventive measures within health services;
v. health promotion within the community both broad-based and targeted at specific groups;
vi. cultural appropriateness for the target group;
vii. peer education;
viii. the building of healthy public policy.

6.3.2  The DRS believes health services should contribute to preventive programs along with treatment and care of medical conditions.  Health workers need to be trained in communicating about health promotion and incorporating various educative tools and techniques.

6.3.3  The DRS calls for more research into social and economic influences on health in Australia and calls for properly conducted trials to determine the effectiveness of health promotion programs in line with evidence based principles.

6.3.4  The DRS recognises the risks to health of contemporary life-styles and supports the promotion of a healthy life-style.

6.3.5  The DRS recognises the benefits to health of properly conducted mass screening programs.  The DRS supports the use of properly instituted mass screening programs and the introduction of future programs which will help reduce the impact of disease and be cost effective.

6.3.6  The DRS supports harm minimisation as an integral part of health promotion.

6.3.7  The DRS believes that the media is prone to exaggerate the impact of therapeutic measures against disease.  The DRS believes the media should adopt a code of practice that avoids sensationalism and encouraging misplaced hopes, and instead aims to help people become more aware of what they can do to promote their own health and that of their fellow Australians.

6.4  Tobacco, Alcohol and other Drug Use
6.4.1  The DRS believes prevention and harm minimisation should be the central principle underlying Australian policies with regard to drug and alcohol use.  Much greater emphasis should be given to public health strategies than to law enforcement justice approaches.

6.4.2  The DRS recognises that of all licit and illicit drugs, the use of alcohol and tobacco result in the greatest physical, psychological and social costs to the Australian community.

6.4.3  The DRS calls for a legislative ban on the promotion (through sponsorship and advertising) of tobacco and alcohol use.

6.4.4  The DRS calls for an increased diversion of revenue raised from alcohol and tobacco taxes towards strategies that aim to minimise the harms arising from the use of these drugs.

6.4.5  The DRS recognises that the abuse of prescription drugs contributes significantly to drug related harm.  Prescribers have a key responsibility in preventing prescription drug abuse.  Attention should be given to education and training of both prescribers and the community, monitoring mechanisms and structural factors in the medical workforce that contribute to prescription drug abuse.

6.4.6  The DRS recognises that a considerable amount of the harm associated with illicit drugs arises from the illegal status of these substances.  In particular, serious consideration should be given to the legal status of all currently illicit substances including the decriminalisation of cannabis and controlled heroin or substitution drug trials.

6.4.7  The DRS supports the promotion and adequate resourcing of prevention, early intervention and effective treatments for individuals with drug related problems. These should include counselling services, residential treatment services and substitution pharmacotherapies for opioid and psychostimulant dependent people.

6.4.8  The DRS supports the promotion and adequate resourcing of strategies that reduce the transmission of blood borne viruses (including HIV, Hepatitis B and C) in the high risk population of injecting drug users.  This should include free Hepatitis B vaccination for at risk users.  In addition the DRS supports the expansion and adequate funding of primary and secondary needle syringe exchange services including the provision of these services in all hospital emergency departments and in the prison setting. (see also Prisons 10.4 and HIV/PLWAIDS 11.3.5 and 11.3.6)

6.5  Nutrition
The DRS supports:
6.5.1  The continuing development and implementation of national nutrition policy.

6.5.2  Stringent food and hygiene standards monitored by federal government inspectors and not by the food processing industry.

6.5.3  Compulsory content labelling of food, including clear identification of additives, genetically manipulated food stuffs, fat, sugar, salt and animal content and whether irradiation has occurred.

6.5.4  Access to healthy foods for all people. There should be no financial or geographical barriers.

6.5.5  Measures to increase successful breastfeeding including accreditation of “Baby Friendly” maternity hospitals and restrictions on the promotion of breast milk substitutes.

6.5.6  Measures to improve prenatal nutrition.

6.5.7  Nutritional education from an early age.

6.5.8  Healthy food policies for school tuckshops.

6.5.9 Tight restrictions on the advertising and sale of high energy density drinks, foods and confectionery to children (e.g. in the media, sports events, school fund raising).

6.5.10 A tax on sugar, subject to evaluation of its effectiveness and impact on vulnerable populations. This should be combined with provision of adequate alternatives in areas of disadvantage. Money raised should directly support the health of vulnerable populations.

6.6   Immunisation
6.6.1  The DRS believes that the community benefits of routine childhood immunisation significantly outweigh the risks to individual vaccine recipients.

6.6.2  The DRS believes that parents/guardians need good access to information regarding the comparative risks and benefits of immunisation.

6.6.3  The DRS supports current National Health and Medical Research Council immunisation regimens as minimal requirements.

6.6.4  The DRS supports the role of general practitioners, nurses and health workers as immunisation providers.

6.6.5  The DRS supports the involvement of Federal, State, and Local governments in initiatives which improve access to and provide incentives for routine childhood immunisations.

6.6.6  The DRS believes that child care centres which provide care for children too young to have been fully immunised should be able to exclude older unimmunised children.

6.6.7  The DRS believes that, except during outbreaks of vaccine-preventable disease, unimmunised children should be allowed to attend school if their parents have been counselled and maintain objection to immunisation

6.7  Housing and Habitat
6.7.1  The DRS believes people have the right to live in safe and acceptable housing.  Housing should be developed with attention to the environmental and architectural effects on social and community development.

6.7.2  The DRS believes that with the involvement of residents, environmental, social and architectural principles should be applied to the mitigation of existing problems in inappropriate developments such as some high density multi-story housing.

6.7.3  The DRS believes incentives need to be enacted to encourage the use of renewable energy sources and to maximise recycling.  Building materials should be selected which will not place residents at risk. (see also Environmental Health 13.6 and 13.11)

6.7.4  The DRS supports the expansion of low cost  publicly owned housing.