An analysis of local government health policy against state priorities and a social determinants framework

Abstract

Abstract Objective: Victorian local governments are required to develop Municipal Public Health and Wellbeing Plans that incorporate state‐level health planning priorities and address the social determinants of health. This paper describes a novel method for evaluating councils' performance against these requirements. Methods: Deductive content analysis was used to categorise all actions in 14 local government MPHWPs against Victorian state priorities as well as against social determinants of health policy areas. Results: More than 1,000 actions were identified. However, fewer than half directly addressed a state priority, with many actions addressing policy areas known to be broader determinants of health. In particular, there was a marked focus on leisure and culture, and on building social cohesion through changes to living and working conditions. Conclusions: Councils are working beyond state priorities and there was a clear emphasis on addressing the diverse upstream ‘causes of the causes’ of health, rather than health promotion behaviour change programs. Implications: The approach for data analysis and presentation provides a useful method for rapid appraisal of health and wellbeing actions relative to councils', and the State's, responsibility and efficacy in public health.

Keywords

• social determinants of health
• local government
• health policy