Policies, Politics, and Paradigms: Healthy Planning in Australian Local Government

Factors of the policy process influencing Health in All Policies in local government: A scoping review

Objectives

This review aimed to identify factors in the policymaking environment that influence a Health in all Policies approach in local government, how these vary across different municipal contexts, and the extent that theories of the policy process are applied.

Methods

A scoping review was conducted to include sources published in English, between 2001 and 2021 in three databases, and assessed for inclusion by two blind reviewers.

Results

Sixty-four sources were included. Sixteen factors of the policy process were identified, expanding on previously reported literature to include understanding and framing of health, use of evidence, policy priority, and influence of political ideology. Eleven sources applied or referred to theories of the policy process and few reported findings based on different local government contexts.

Conclusion

There are a range of factors influencing a Health in All Policies approach in local government, although a limited understanding of how these differ across contexts. A theory-informed lens contributed to identifying a breadth of factors, although lack of explicit application of theories of the policy process in studies makes it difficult to ascertain meaningful synthesis of the interconnectedness of these factors.

Barriers and Enablers for Integrating Public Health Cobenefits in Urban Climate Policy

Urban climate policy offers a significant opportunity to promote improved public health. The evidence around climate and health cobenefits is growing but has yet to translate into widespread integrated policies. This article presents two systematic reviews: first, looking at quantified cobenefits of urban climate policies, where transportation, land use, and buildings emerge as the most studied sectors; and second, looking at review papers exploring the barriers and enablers for integrating these health cobenefits into urban policies. The latter reveals wide agreement concerning the need to improve the evidence base for cobenefits and consensus about the need for greater political will and leadership on this issue. Systems thinking may offer a way forward to help embrace complexity and integrate health cobenefits into decision making. Knowledge coproduction to bring stakeholders together and advance policy-relevant research for urban health will also be required. Action is needed to bring these two important policy agendas together.

Missed opportunities for improving oral health in rural Victoria: The role of municipal public health planning in improving oral health

ISSUE ADDRESSED

People in rural areas have poorer oral health than their urban counterparts due to a range of factors. Local governments (LGs) have a key role in addressing health issues that impact on local communities.

METHODS

Publicly available oral health profile (OHP) data and Municipal Public Health and Wellbeing Plans (MPHWPs) (2017-2021) were downloaded from Dental Health Services Victoria and LG websites for 48 Victorian local government areas (LGAs) containing predominately rural areas. OHP data were collated to provide an overview of the oral health status of the communities and a content analysis of the MPHWPs undertaken.

RESULTS

Despite poor oral health in rural Victorian LGAs, oral health was not often in MPHWPs. Twenty of the MPHWPs had some mention of oral health but only four included specific actions or strategies that would be used to improve oral health. None of the plans contained any specific targets for action or details of evaluations that might be used to assess success.

CONCLUSIONS

Poor oral health in rural Victorian communities continues to be demonstrated through local OHPs and is due to modifiable risk factors and poor access to water fluoridation. LGs have a key role to play in improving oral health through utilisation of OHP data in their MPHWPs. SO WHAT?: Oral health remains a low priority for LG action. This represents a missed opportunity for prioritising oral health prevention and promotion activities that improve oral health in rural Victoria.

Urban Climate Policy and Action through a Health Lens-An Untapped Opportunity

Motivated by a growing recognition of the climate emergency, reflected in the 26th Conference of the Parties (COP26), we outline untapped opportunities to improve health through ambitious climate actions in cities. Health is a primary reason for climate action yet is rarely integrated in urban climate plans as a policy goal. This is a missed opportunity to create sustainable alliances across sectors and groups, to engage a broad set of stakeholders, and to develop structural health promotion. In this statement, we first briefly review the literature on health co-benefits of urban climate change strategies and make the case for health-promoting climate action; we then describe barriers to integrating health in climate action. We found that the evidence-base is often insufficiently policy-relevant to be impactful. Research rarely integrates the complexity of real-world systems, including multiple and dynamic impacts of strategies, and consideration of how decision-making processes contend with competing interests and short-term electoral cycles. Due to siloed-thinking and restrictive funding opportunities, research often falls short of the type of evidence that would be most useful for decision-making, and research outputs can be cryptic to decision makers. As a way forward, we urge researchers and stakeholders to engage in co-production and systems thinking approaches. Partnering across sectors and disciplines is urgently needed so pathways to climate change mitigation and adaptation fully embrace their health-promoting potential and engage society towards the huge transformations needed. This commentary is endorsed by the International Society for Environmental Epidemiology (ISEE) and the International Society for Urban Health (ISUH) and accompanies a sister statement oriented towards stakeholders (published on the societies' websites).

European Countries Ranking and Clustering Solution by Children’s Physical Activity and Human Development Index Using Entropy-Based Methods

The aim of the present study is to propose a new approach for evaluating and comparing European countries using indicators of the children physical activity and the human development index. The Global Matrix 3.0 on physical activity for children and youth and human development index data on the 18 European countries were used. MADM (multi-attribute decision making) approach was applied for this task. The criteria weights calculated by applying the weight balancing method—weight balancing indicator ranks accordance (WEBIRA). New methodology of interval entropy is proposed for determining the priority of criteria separately in each group. The novel approach of α-cuts for recursive procedure of ranking the alternatives was used. For comparison, three alternative entropy-based methods—entropy method for determining the criterion weight (EMDCW), method of criteria impact LOSs and determination of objective weights (CILOS) and integrated determination of objective criteria weights (IDOCRIW) were applied to address this MADM problem. Cluster analysis of European countries carried out using results obtained by all above methods. Comparison of the MADM methods revealed that three alternative methods assigned negligible values to whole group of criteria. Meanwhile, WEBIRA family methods performed the ranking of European countries according to the interrelation of the two groups of criteria in a balanced way. Thus, when addressing MADM tasks with two or more naturally related sets of criteria, it is appropriate to apply criteria adapted for that purpose, such as WEBIRA.