Population Health Priorities for NSW

Population Health Priorities for NSW 2012 2017

POPULATION AND PUBLIC HEALTH DIVISION NSW Ministry of Health Locked Mail Bag 961 North Sydney NSW 2059 Copyright NSW Ministry of Health 2012 This work is copyright. It may be reproduced in whole or in part for study and training purposes subject to the inclusion of an acknowledgement of the source. It may not be reproduced for commercial usage or sale. Reproduction for purposes other than those indicated above requires written permission from the NSW Ministry of Health. State Health Publication No: CEE 120172 ISBN 978 1 74187 688 8 Suggested citation: Population and Public Health Division. Population Health Priorities for NSW: 2012 2017. Sydney: NSW Ministry of Health, 2012. Further copies of this publication can be downloaded from the NSW Ministry of Health website at: www.health.nsw.gov.au.

Message from the Chief Health Officer of New South Wales The people of New South Wales (NSW) experience very good health compared with people in other parts of Australia and around the world. However, there are still areas for improvement and there remain substantial differences in health status and life expectancy between different populations, with Aboriginal people, socio-economically disadvantaged people, and those living in rural and remote locations experiencing much poorer health than the rest of the NSW population. There is robust evidence that appropriate levels of investment in population health can substantially improve health outcomes and reduce health care costs, even in the short term, as well as provide longer term benefits. Ensuring that scarce resources are directed to where they can be most effective, in improving the health of all people, is a central task in managing the public health system. In NSW, population health services are a critical component of the health continuum and our programs provide opportunities to improve health for all and reduce the demand for acute services. This document outlines the priorities for population health in NSW. It will be used to guide the funding, planning, and delivery of population health programs and services now and over the next five years. Only through a coordinated effort and roll out of evidence based programs will we realise health benefits for all. Dr Kerry Chant Chief Health Officer and Deputy Director-General Population and Public Health August 2012 NSW HEALTH Population Health Priorities for NSW 2012 2017 PAGE 1

SECTION 1 Population health: current context The goals of the NSW public health system are to help people stay healthy and provide access to timely, high quality, patient-centred health care. One important way to keep people healthy and out of the hospital system is the effective implementation of evidence based population health programs and services. Population health programs aim to promote health, create healthy environments, enable individuals and communities to make healthy choices, and reduce differences in health among population groups. These programs focus on identifying health risks and developing ways to eliminate or reduce exposure to these risks. In NSW, our population health services are being delivered in a rapidly changing environment that presents a number of challenges and opportunities which must be carefully considered when thinking about the future direction for population health across NSW. These include: particularly for Aboriginal people, and also by socioeconomic status and place of residence. Emerging threats to public health: The threats to population health include increasing rates of some health risk factors linked to chronic diseases and newly emerging or re-emerging communicable diseases. NSW must remain vigilant for emerging diseases, global threats such as pandemic influenza, and achieve sustainable forms of health care delivery. Changing technologies that can be harnessed to improve population health: New vaccines, new communication mechanisms, new analytical tools, and capacity to access information can drive change and provide significant opportunities for enhancing population health. Health reforms: National and state health reforms have altered the structures within which population health programs and services are delivered. Health agreements: The Council of Australian Governments (COAG) Heads of Agreement, signed in February 2011, confirmed the state s responsibility and continued lead in population health. The National Partnerships for Preventive Health, Closing the Gap in Indigenous Health Outcomes, and Indigenous Early Childhood Development are providing significant additional funding to the states to deliver large scale evidence based programs. Health service demands: The ageing population, improvement in survival rates, and population growth in some areas continue to contribute to rising and changing patterns of demand for services to treat growing number of people with chronic conditions in the context of workforce and skill shortages. Health inequities: The past decade has seen considerable improvement in the health of the people of NSW, including declines in mortality and lengthening of life expectancy. Despite advances, optimal health outcomes remain unequally distributed, PAGE 2 NSW HEALTH Population Health Priorities for NSW 2012 2017

SECTION 2 Delivering population health programs and services across NSW NSW Health provides a wide range of population health policies and programs that are located within the Ministry of Health and Local Health Districts. These services work to prevent disease and illness, and to promote and protect health and wellbeing. The vision driving population health services in NSW is: Better health for all and better population health services. The achievement of this vision requires collaborative, coordinated, and consistent action across population health service providers within NSW Health and with our key partners in other government agencies and nongovernment organisations. The framework below outlines the key priorities, enablers, and principles required to be connected and linked, in order to achieve our aim. Underpinning the framework are the core values of NSW Health: Collaboration: Improving and sustaining performance depends on everyone in the system working as a team. Openness: Transparent performance improvement processes are essential to make sure the facts are known and acknowledged. Respect: The role of everyone engaged in improving performance is valued. Empowerment: There must be trust on all sides and at all levels with responsible delegation of authority and accountability. VISION: Better health for all and better population health services Priority 1 Priority 2 Priority 3 Priority 4 Close the gap in Aboriginal life expectancy Promote healthy populations Protect the population from threats to health Build and maintain healthy environments Enabler 1: Foster strong and enduring partnerships and collaboration Enabler 2: Invest in people, infrastructure and systems Enabler 3: Assess the health of the population and build the evidence Principles Respect diversity Strive for health equity Engage the community Value evidence and innovation Promote integration Be accountable, transparent, and responsive NSW HEALTH Population Health Priorities for NSW 2012 2017 PAGE 3

2.1 Delivering our key priorities NSW Health designs and delivers a diverse range of population health policies, programs, services, and activities to achieve the vision of better health and better population health services. While it is important that the full range of programs, services, and activities continues to be provided, there are four key priority areas for investment and focus over the next five years. PRIORITIES KEY ACTIONS MEASURES OF SUCCESS Priority 1: Close the gap in Aboriginal life expectancy Improve Aboriginal health Ensure all population health programs consider the impact of the program on Aboriginal people All population health programs undergo an Aboriginal Health Impact Assessment Provide programs that keep Aboriginal people healthy and manage disease, including tobacco control Smoking rates for Aboriginal people Smoking rates among pregnant Aboriginal women Age-standardised rates of potentially preventable hospitalisations for Aboriginal and non-aboriginal people Provide culturally appropriate programs, such as the Aboriginal Maternal Infant Health Service, to ensure a healthy start to life The proportion of women who identify as having an Aboriginal baby who receive antenatal care before 14 weeks gestation The gap between Aboriginal and non-aboriginal infant mortality rates by 2018 The gap between Aboriginal and non-aboriginal infant mortality rates by 2018 Advocate and support the rest of the system Support implementation and evaluation of cultural competency frameworks that improve access to culturally appropriate services Aboriginal inpatients who Discharge Against Medical Advice Support programs that focus on increasing the accurate reporting of Aboriginal people in NSW datasets Completeness of reporting of Aboriginality in key health data collections Support workforce strategies to increase the numbers of Aboriginal people working in population health services in NSW Health Proportion of the NSW population health workforce who identify as being an Aboriginal person Priority 2: Promote healthy populations Promote healthy weight Design, deliver and evaluate the Healthy Children s Initiative in early childhood, school, family and community settings Proportion of children at a healthy body weight (Aboriginal and non-aboriginal) Proportion of childcare and schools adopting programs Number of children 7 13 years who complete the Targeted Family Healthy Eating and Physical Activity Program Deliver and evaluate the NSW Get Healthy Information and Coaching Service Number of participants Participant outcomes (BMI, waist circumference) Design, deliver and evaluate the Healthy Workers Initiative in and through the workplace setting Proportion of adults at a healthy body weight (Aboriginal and non-aboriginal) Lead, develop and evaluate social marketing initiatives to support healthy weight initiatives Campaign awareness and reach Improved knowledge and health behaviours Reduce tobacco use Deliver and evaluate Population Health interventions under the NSW Tobacco Strategy 2012 2017 Smoking rates (Aboriginal and non-aboriginal) Smoking rates (pregnant Aboriginal women) Attitudes to smoking PAGE 4 NSW HEALTH Population Health Priorities for NSW 2012 2017

Priority 2: Promote healthy populations (continued) PRIORITIES KEY ACTIONS MEASURES OF SUCCESS Prevent and respond to BBVs and STIs Design, implement and evaluate HIV prevention programs for priority populations Rate of newly diagnosed HIV notifications HIV testing treatment management: occasions of service Implement and evaluate initiatives to increase the number of sterile needles and syringes distributed across NSW, including diversifying sites and distribution models Number of needles and syringes distributed Proportion of people who inject drugs who report using another person s needle and syringe Promote increased safe sex practices and regular STI testing, particularly among young people Proportion of secondary school students who report using a condom STI testing treatment management: occasions of service Prevent falls and injury for older people Deliver and evaluate Population Health interventions under the NSW Health Plan to Prevent Falls in Older People 2011 2015 Age standardised rates of falls hospitalisations in persons aged 65 years and over Proportion of people aged 65 and over (or 45 and over for Aboriginal people) participating in appropriate falls prevention physical activity programs Priority 3: Protect the population from threats to health Prevent, control and respond to public health threats from: communicable diseases the environment Investigate and control outbreaks of communicable disease Investigate and respond to new and re-emerging health threats Monitor and enforce public health legislation Implement strategies and programs that maintain and improve immunisation in children and adults Number of locally acquired cases of hepatitis A, measles and meningococcal disease Completion of a state-wide audit of regulated premises Age-standardised rate of potentially preventable hospitalisations for vaccine preventable diseases Proportion of Aboriginal and non-aboriginal children aged 12 15 months fully immunised The number of Year 7 girls receiving the third dose of the human papillomavirus vaccine Respond to public health emergencies Maintain capacity to respond to public health emergencies Percentage of new public health employees completing introductory public health emergency preparedness online modules within six months of employment Percentage of public health units participating in emergency response or practise response annually Priority 4: Build and maintain healthy environments Prevent, control and respond to public health threats from: communicable diseases the environment Influence the approach of NSW Government agencies to healthy built environments and healthy public policy Support activity to build evidence and facilitate development, review and implementation of healthy public policy The consideration of health impacts in all public policies Increased evidence base to support decision making Ensure safe drinking water supply Participate in cross-government processes to promote healthy built environments The number of drinking water utilities that have risk management plans NSW HEALTH Population Health Priorities for NSW 2012 2017 PAGE 5

2.2 Our key enablers Population Health priority programs and services are supported through key enablers. PRIORITIES KEY ACTIONS Assess the health of the population and build the evidence Develop Health Statistics NSW as the primary site for reporting population health information to health professionals and the public Add value to population health information through increased use of record linkage Increase the use of research evidence in NSW Health population health policies and practice Implement the NSW Population Health Research Strategy Influence research agendas of major Population Health academic groups to promote policy relevant research and translation of research evidence into practice Invest in people, infrastructure, and systems Invest in systems and human resource capacity for data collection, analysis, and reporting, and harnessing technological advancements and IT systems Successfully manage and further develop population health training, including the NSW Public Health Officer, Biostatistical Officer Training, Aboriginal Population Health Training Initiative, and Aboriginal Environmental Health Officer Programs Implement the NSW Population Health Surveillance Strategy Develop and implement a workforce plan to build the capability of the population health workforce Foster strong and enduring partnerships and collaboration Develop strategic partnerships with key agencies, universities, researchers, non-government organisations, advocates, local councils, multicultural health agencies, providers of primary healthcare, and other stakeholders Maintain and strengthen the partnership between NSW Health and the Aboriginal Health and Medical Research Council of NSW SECTION 3 Monitoring The tools to monitor the implementation of our priorities are already in existence and are: National Agreements NSW 2012: A plan to make NSW number one Local Health District Service Agreements Specific project funding agreements. PAGE 6 NSW HEALTH Population Health Priorities for NSW 2012 2017

SECTION 4 Key policy documents NSW 2021: A plan to make NSW number one A plan that sets immediate priorities for action and guides NSW Government resource allocation in conjunction with the NSW Budget. www.2021.nsw.gov.au Aboriginal Health Plan for NSW A plan being developed to achieve Aboriginal health equity, find new ways of working together, and to design the services Aboriginal people need and want to use. www.health.nsw.gov.au/pubs/2012/aboriginal_hlth_pln_ discu.html NSW Tobacco Strategy 2012 2017 An overarching framework for the actions that the NSW Government will lead to reduce smoking and tobacco related harm in NSW. www.health.nsw.gov.au/pubs/2012/ nsw_tobacco_strategy_2012.html Prevention of Falls and Harm from Falls among Older People: 2011 2015 A policy directive that describes actions that NSW Health will undertake to support the prevention of falls and fallrelated harm among older people. www.health.nsw.gov.au/ policies/pd/2011/pd2011_029.html The NSW Government Plan for Preventing Overweight and Obesity in Children, Young People and their Families 2009 2011 A portfolio of initiatives to be implemented by the NSW Government to stop the growth in childhood obesity. www.health.nsw.gov.au/pubs/2009/obesity_action_plan.html The NSW HIV/AIDS Strategy: Overview and Action Plan A framework for HIV/AIDS prevention, treatment, care and support, research and workforce development in NSW. www.health.nsw.gov.au/policies/pd/2006/pd2006_072.html The NSW Hepatitis C Strategy A state wide strategic framework for the prevention and management of Hepatitis C. www.health.nsw.gov.au/ policies/pd/2007/pd2007_093.html Population Health Surveillance Strategy NSW 2011 to 2020 A framework for the development of information and knowledge, human capacity and technical infrastructure for surveillance. www.health.nsw.gov.au/pubs/2011/pdf/ surveillance_strategy_201.pdf Promoting the generation and effective use of population health research in NSW: A Strategy for NSW Health 2011 2015 A framework to facilitate the conduct of high-quality, relevant, population health research and the use of research evidence in policy and practice in NSW Health. www.health. nsw.gov.au/pubs/2011/pdf/pop_health_research_strat.pdf NSW Immunisation Strategy A strategy that sets directions and provides state wide leadership to minimise the incidence and prevalence of vaccine preventable diseases through maximising immunisation coverage in infants, children, adolescents, healthcare workers and older people. www.health.nsw.gov.au/immunisation Notification of Infectious Diseases under the NSW Public Health Act 2010 Under the provisions of the Public Health Act 2010 and the Public Health (General) Regulation 2012, doctors, hospital chief executive officers (or general managers), pathology laboratories, directors of child care centres and school principals are required to notify medical conditions listed on the Ministry of Health website. www.health.nsw.gov.au/ phact NSW Health Influenza Pandemic Plan A policy directive that aims to minimise the adverse health impacts of an influenza pandemic on the NSW community and minimise disruption to the NSW health system by articulating the health management arrangements for a potential or confirmed influenza pandemic in NSW. www. health.nsw.gov.au/policies/pd/2010/pd2010_052.html The NSW Sexually Transmissible Infections Strategy A policy directive for STI prevention, treatment, care and support, research and workforce development in NSW. www.health.nsw.gov.au/policies/pd/2006/pd2006_071.html NSW HEALTH Population Health Priorities for NSW 2012 2017 PAGE 7

SECTION 5 Supporting infrastructure Office of Preventive Health Based in South Western Sydney Local Health District, the Office of Preventive Health was established to manage the planning, implementation and evaluation of priority state-wide preventive health programs (in the first instance, the Healthy Children s Initiative and the Get Healthy Coaching Service), report on outcomes of these programs and support the NSW Local Health District-based health promotion workforce to deliver key state wide preventive health programs. Health Statistics NSW Health Statistics NSW is an interactive, web-based application that allows users to access data and tailor reports about the health of the New South Wales population for their own use. Health Statistics NSW provides information on: the health status and demography of the NSW community health inequalities and the determinants of health the burden of disease and current health challenges trends in health and comparisons between age groups and geographic locations. www.healthstats.nsw.gov.au The Centre for Health Record Linkage (CHeReL) CHeReL links multiple sources of data and maintains a record linkage system that protects privacy. www.cherel.org.au Secure Analytics for Population Health Research and Intelligence (SAPHaRI) SAPHaRI is a data warehouse that provides an environment that enables users to discover information through the exploration of data. SAPHaRI provides powerful statistical tools that enable users to manipulate and carry out analysis on key population health datasets. Through this tool users can access GOPHER (Geocoder Optimised for Population Health and Epidemiological Research). GOPHER geocodes data so that it can be visualised and spatially analysed. New South Wales Population Health Surveys These surveys provide ongoing information on health behaviours, health status and other factors that influence the health of the people of NSW. The three main population health surveys conducted by the Ministry of Health are the Adult Population Health Survey, the Child Population Health Survey and the NSW School Students Health Behaviours Survey. The NSW Adult Health Survey and the NSW Child Population Health Survey are collected through a telephone survey of about 15,000 people from all over NSW. www. health.nsw.gov.au/publichealth/surveys/index.asp NSW Public Health Officer Training Program A three-year workplace based training program offering supervised experience for people who have completed postgraduate studies in public health and who are committed to a career in public health. Learning is guided by a competency framework and the strategic priorities of the NSW health system. www.health.nsw.gov.au/training/phot/index.asp NSW Biostatistical Officer Training Program A three-year program that provides a career path for biostatisticians working in public health. The Program offers supervised on-the-job training. The trainees are supported leave to undertake a Masters degree in Biostatistics parttime through distance learning. During their training, the Biostatistical Officers rotate through a range of placements throughout the NSW public health system. www.health.nsw.gov.au/training/botp NSW Aboriginal Population Health Training Initiative A workplace based training program delivered through partnerships between the Population and Public Health Division at the NSW Ministry of Health and the Local Health Districts of NSW, the aim is to expand the Aboriginal workforce in population health in NSW and strengthen preventive measures. Over three years trainees undertake work placements within population health services while completing a Master of Public Health by coursework parttime. www.health.nsw.gov.au/training/aphti Aboriginal Environmental Health Officer Training Program A program that aims to develop an Aboriginal workforce with the leadership and technical skills to progress environmental health. Trainees are employed by regional Public Health Units and actively participate in a wide range of environmental health issues and play a lead role in driving and ensuring the success of a number of public health projects. Trainees undertake a five to six year Bachelor of Applied Science (Environmental Health) degree by distance learning through the University of Western Sydney. www.health.nsw.gov.au/publichealth/environment/ aboriginal/ateho.asp PAGE 8 NSW HEALTH Population Health Priorities for NSW 2012 2017

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