VicHealth Fiscal Concerns

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

2. Addressing the social and economic determinants of
mental and physical health

5. 1. Scoping policy, research
& stakeholders for
emerging health issues of
concern.
2. Establish the case
9. Sustainability of change research , evidence &
(for uptake & integration) attitudes to inform future
directions
8. Communication of 3. Develop conceptual,
learnings through evidence based
publications, resources & framework to guide
tools activity
7. Identify skills gaps & 4. Partnerships with
strengthen capacity through practice, research &
workforce development strategic partnerships
5. Intervention design &
6. Evaluation of cross
sector activity implementation of cross
sector activity

6. 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.

7. 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

8. 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

9. 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

10. 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

11. 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.

12. 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)

13. 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 Freedom from Access to economic
violence discrimination resources
Active communities Supportive relationships Social, emotional, physical Valuing diversity Work
and economic security
Involvement in Involvement in community Physical security and Education
community sport and group activities Equitable and respectful respect Housing
and active recreation relationships
Civic engagement Equality of opportunity Money
Population groups and action areas
Population groups Action areas
Children Indigenous communities Research, monitoring and evaluation Communications and social marketing
Young people Culturally diverse Organisational development (including Advocacy
Women and men communities workforce development) Legislative and policy reform
Rural communities Strengthening communities and
Older people Direct participation programs
community environments
Settings for action
Housing Community Education Workplace Sport and recreation Health Academic
Transport Corporate Public Arts Local government Justice Technology

14. Participation for health:
a framework for action 2009-2013
Intermediate outcomes
Individual Organisational Community Societal
Projects and programs that facilitate: Organisations that: Environments that: A society with:
• involvement in community and group • are inclusive, responsive, safe • are inclusive, responsive, safe • integrated, sustained and
activities and supportive and supportive supportive policies and programs
• self efficacy • work in partnerships across • value civic engagement • strong legislative platforms for
• self determination and control sectors • are cohesive mental health and wellbeing
• political and civic efficacy • implement evidence-informed • promote community • appropriate resource allocation
approaches to their work responsibility • responsive and inclusive
• taking responsibility for others
• sustain change • reflect awareness of mental governance structures
• respectful, supportive and equal
relationships health and wellbeing issues
• acceptance of diversity • sustain change
• access to education and employment
• mental health literacy
Long-term benefits
Individual Organisational Community Societal
• Increased sense of belonging • Resources and activities • Community valuing of diversity • Reduced social and health
• Improved physical health integrated across organisations, and actively disowning inequalities
sectors and settings discrimination • Improved quality of life and life
• Less stress, anxiety and depression
• Less violence and crime expectancy
• Less substance misuse
• Improved productivity
• Enhanced skill levels

15. What influences/determines health?
Society
Distribution of power
and resources
Policy (e.g. social, education, Social and cultural beliefs
Economic wealth
employment, infrastructure, health, Social structures and institutions
environmental sustainability) Social cohesion
Community
Neighbourhood facilities and Social networks and support
infrastructure Group and peer norms
Local services and amenities Participation opportunities
Living and working conditions Community cohesion and stress
Family/Household
Employment, Family structure
income and wealth and relationships
Housing and living Health related
conditions behaviours and
Individual exposures
Behaviour
Age Sex
Genes
www.vichealth.vic.gov.au

16. 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.