Health promotion development in Australia and New Zealand

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Abstract
This paper describes and analyses the development of health promotion in Australia and New Zealand. It argues that health promotion has become an established approach to addressing public health problems in both nations over the past two decades. The paper documents the mixed progress both countries have made in improving the health of their populations and the challenges that remain for health promotion. The paper describes the health promotion infrastructure, investment in health promotion and collaboration that has occurred. It also describes innovations in structure and practice that have been implemented. The paper argues that while there has been considerable infrastructure development over the last decade there are still weaknesses in areas, e.g. workforce development and research and evaluation. While government has been the major investor in health promotion, investment has remained relatively small, in part because decision-makers have failed to be convinced of its value. Collaboration with the public, within the health sector, and with other sectors has been a strength of health promotion activity in both nations. Overall, much has been learnt over the past two decades on which to build. Key features of health promotion include increasing use of intersectoral action, the use of public policy and the mass media as health promotion strategies, and the increasing control Maori have taken over the purchase and provision of health promotion services in New Zealand. Both countries still have significant weaknesses to address, e.g. increasing our focus on the determinants of health, implementing sustainable programs and appropriately engaging the personal health sector in health promotion. Above all, the next decade of development will require increasing emphasis on effective action to reduce inequalities in health, particularly between indigenous and non-indigenous people.

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