Background

Research in Australia and overseas has shown that people who experience social and economic disadvantages tend to be sicker and die younger than others. These health inequalities are compounded by complex biological, behavioural, cultural and geographic factors. The Health Inequalities Research Collaboration (HIRC) was developed in 1999 to contribute to and guide the Federal Government's broader commitment to building a strong evidence base for the development and implementation of effective health policies, including those aimed at reducing health inequalities.

The Collaboration will involve many sectors such as health, environment, transport, and social services. It also aims to be multi-disciplinary involving fields like epidemiology, sociology, ecology and psychology.

The main goal of the Collaboration is to enhance Australia's knowledge on the causes of and effective responses to health inequalities, and to promote vigorously the application of this evidence to reduce health inequalities in Australia.

To achieve this goal the Collaboration has established three research networks. The Sustainable Communities Network is one of these networks and is based at Edith Cowan University. The other two networks are the Primary Health Care Network and the Children, Youth and Families Network.

Each of these networks has a focus on the health of rural, remote and Indigenous communities and will be involved in working towards the following HIRC strategic objectives:
Increasing the national focus on reducing health inequalities;

The Sustainable Communities Network is funded by the Commonwealth Department of Health and Ageing

Who are we?

The SCN is you, the researchers, practitioners, policy-makers and community representatives who are concerned about health inequalities and sustainability in our rural, remote and Indigenous communities and who want to be involved in SCN.

There is a Steering Committee that jointly manages the SCN. This Steering Committee includes researchers and practitioners from different disciplines who have been involved in addressing issues related to health and well-being; and environmental, social, cultural and economic sustainability of rural, remote and Indigenous communities. There is also a SCN Coordinator, who can be contacted if you require further information or have any questions. As well as this there is an International Advisory Committee.

Steering Committee

Network Manager and Network Spokesperson to the HIRC Board
Associate Professor Pierre Horwitz Director, Consortium for Health and Ecology, Edith Cowan University

Network Spokesperson to the HIRC Board
Associate Professor Ann Larson
Director, Combined University Centre for Rural Health, Geraldton, WA.

Professor Alan Black
Director, Centre for Social Research, Edith Cowan University.

Associate Professor Neil Drew
Director, Institute for Regional Development, University of Western Australia

Ms Glenda Jackson
Program Director, Health Promotion and Public Health, Centre for Public Health, Edith Cowan University

Professor Peter Kirk
Professor, Department of Family Medicine, University of Manitoba
(Chair of the International Advisory Committee)

Dr David Mildenhall
General Practitioner, Albany, WA
Immediate Past President of the Rural Doctors Association of Australia
(HIRC Board Nominated Representative)

Dr Jacques Oosthuizen
Coordinator for Environmental Health, Centre for Public Health, Edith Cowan University.

Associate Professor Sherry Saggers
Program Director, Institute for the Service Professions, Edith Cowan University

Professor Neil Thomson
Foundation Professor of Public Health, Centre for Public Health, Edith Cowan University

Associate Professor Kathryn White
Postgraduate Nursing Program Director, School of Nursing and Public Health, Edith Cowan University

Associate Professor Ted Wilkes
Chair of the Kulunga Research Network, Institute for Child Health Research

International Steering Committee

Professor Stephen J. Kunitz
Department of Community and Preventive Medicine, University of Rochester Medical Center
Associate Professor Jim Frankish
Institute of Health Promotion Research, University of British Columbia
Professor Penny Hawe
Department of Community Health Sciences, University of Calgary
Professor David Waltner Towes
Department of Population Medicine, University of Guelph

Key Definitions

So what does the SCN mean by ‘health inequalities’, ‘sustainability’, and 'sustainable communities', and how do they relate?

Health Inequalities

As with the definition of health inequalities stated by HIRC, the SCN definition considers the causes of health inequalities to include geographical, environmental, cultural, age, gender and socio-economic differences between and within communities. The SCN does not limit the notion of health inequalities to outcomes, such as morbidity and mortality rates, but also considers health policy, services and resources; health risks and environments; health behaviours, attitudes, knowledge, beliefs and culture; and related issues such as justice, equity, legislation and participation. This understanding of health inequalities is made clearer in the description of SCN’s four working areas.

Further Information

The World Health Organisation (WHO) has been central in defining health and addressing health issues and inequalities internationally. The Declaration of Alma-Ata and the Ottawa Charter are key documents to understanding WHO’s definition of health and key issues related to health. Both these documents can be found at the Department of Health Promotion, Noncommunicable Disease Prevention and Surveillance of the WHO.

Researchers from the International Centre for Health and Society have led the move to identify socioeconomic determinants of health and how they are linked with health inequalities. More information about the Centre and access to documents such as Social Determinants of Health – The Solid Facts can be found on their website.

Locally, up to date summaries and past reviews regarding the health status of Indigenous Australians can be found at the Australian Indigenous Health Infonet. Similarly the National Rural Health Alliance includes documents relating to the health status of regional, rural and remote communities.

Other related websites are listed under links.

Sustainability

There are a number of definitions of sustainability available in a variety of literatures. In an article titled ‘Shifting Paradigms for sustainable development: Implications for Management Theory and Research’ (1995, Academy of Management Review, v.20, p. 874-907), Gladwin, Kennelly and Krause reviewed a number of these definitions and identified five key components for sustainable development. These five components of sustainable development are inclusivity, connectivity, equity, prudence and security.

Inclusive – decisions about development need to be inclusive of different components, space and time. Therefore in we need to consider environmental and a human component; local and global issues; and concerns for the present and the future.

Connected – is about understanding that the world’s problems are interdependent and interconnected. To ensure sustainable development ecological, social and economic systems need to be considered in conjunction and linked with each other.

Equity – there needs to be justice and fairness between and with generations as well as between species. Development should not shift the costs or ignore the rights of different communities or species today or tomorrow, without compensation.

Prudence – a focus on care and prevention of the world’s connected systems. The maintenance of resilience and capacity of systems needs to be at the forefront of political, technological and scientific decisions and every effort must be made to ensure decisions do not cause irreversible damage to the world’s system.

Security – is about current and future generations leading safe, healthy, high quality lives and being protected from chronic threats and harmful disruption. At a minimum development should incur no losses of ecosystem and social system health, natural capital, self-organisation, carrying capacity or human freedom.

As such development will be unsustainable if our decisions exclude, disconnect, promote inequity, reflect imprudence or raise insecurity.

Gladwin, Kennelly and Krause encourage debate regarding these components of sustainability, as well as other definitions of sustainablity, but these components provide us with an initial framework for the SCN to consider sustainability at this stage.

Further Information

Sustainability and sustainable development became a focus of the international agenda in 1992 at the United Nations Earth Summit. Documents regarding this summit, such as Local Agenda 21 and the Rio Declaration on Environment and Development, as well as more information about the Commission on Sustainable Development can be found at the United Nations Sustainable Development website. The Johannesberg Summit website contains information about this year’s summit, being held ten years after the original Earth Summit.

The World Health Organisation (WHO) has considered the health implications of the Earth Summit in a document called Health and Environment in Sustainable Development. This document along with other information regarding the relationship between the environment and health can be found at the Protection of the Human Environment website.

Information specific to the status of and issues around sustainability in Australia can be found on the State of the Environment website or the Ecologically Sustainable Development.

Other related websites are listed under links.

Sustainable Communities

SCN recognises that the term 'sustainable communities' encapsulates a wide array of meanings ranging from just and fair to healthy and participatory arrangements among community members. Also, sustainable communities have larger temporal, spatial, and geographic scales than stipulated by conventional conceptions of community. Sustainable communities are inclusive, learning and thus adaptive entities, which acknowledge their interconnectedness with, and dependence on, larger ecological settings. Their interactions with the environment are reflective of this recognition, meaning that social structures, dynamics, and activities are compatible with both social and environmental thresholds. They possess an equity-based sense of responsibility towards human and non-human life as well as ecosystems. The underlying communal ethic, which is extended to ecosystems and their components, shapes inter- and intra-community relations as well as communities’ attitudes towards the environment.

An inclusive/integrative definition of the term sustainable community may be put as follows:

A healthy, sustainable community is one that has an explicit systemic (adaptive) approach to the integration of ecological, social, cultural and economic features to meet the needs of the present without compromising the needs of the future. It uses principles of inclusivity, connectivity, equity, security, and precaution to make decisions about the use and distribution of resources and services.

Related to this inclusive definition, and thematic approach rather than discipline-based disaggregation, our investigations will develop along the following three themes:

• impact of government policy on service delivery, resource allocation, and community development;

• community capacity in relation to health, environmental, and socio-economic change; and

• environmental justice, environmental risk and the experience of vulnerable communities.

Further Information

A more detailed discussion will become available shortly in the form of a SCN position paper on sustainable communities.

Other related websites are listed under links.

Health, Rural, Indigenous, Research, Policy, Equity, Sustainability, Inequity, Australia, Remote, Social Determinants of Health, Vulnerability,

How to be involved in the SCN?

The identification and development of key interventions and priorities is structured around four working areas. These are described under working areas. The initial scoping papers will be drafted by the SCN Steering Committee. Through a number of processes interested researchers, practitioners, policy-makers and community members will develop these scoping papers into final documents to be presented to the HIRC Board of the Commonwealth Department of Health and Ageing. These processes will include:

Contributions made through these processes by interested researchers, practitioners, policy-makers and community members will be incorporated and recognised in the final documents.

One key way to be informed of and involved in the SCN’s activities and progress is to join the listserve. The listserve will focus on giving regular updates of the SCN’s activities and progress and related events, issues and information. Alternatively you can either simply choose to attend a national workshop or contribute to other web based activities. For more information about how to be involved in SCN, contact the SCN Coordinator.

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