Healthy minds, healthy bodies, healthy nation : connecting education and health

Includes bibliographical references

No longer shut away, people with a disability are still shut out

A candid report into a broken system is the first step to fixing it writes Rhonda Galbally in The Age. THE trouble with disabilities is that most Australians think they happen to someone else. Recently I was talking to a man whose partner was disabled by a recent accident and he told me: "I just didn\u27t realise how bad things were for people with a disability - until it happened to us." He is not alone. Without first-hand experience of disability, most people assume things are better than they used to be - or at least that they are getting better. Rhonda Galbally discusses the result of the report Shut out: The experience of people with disabilities and their families in Australia  from the National People with Disabilities and Carer Council.   Read the full article in The Age onlin

The national disability insurance scheme

The federal Government recently announced that it will go ahead with a National Disability Insurance Scheme. But what will this scheme really mean for people with disability and their carers throughout Australia? To answer those and other questions, Disability and Race Discrimination Commissioner, Graeme Innes is joined in this instalment of Pod Rights by Dr Rhonda Galbally AO.  Dr Galbally is the chair of the National People with Disability and Carers Council, which prepared the Shut Out report which led to the reference to the Productivity Commission, and has personally lobbied hard for the scheme. Audio - 22 August 2011: Dr Rhonda Galbally AO (MP3, 28 minutes) Transcript of episode 1

Leading the NDIS (Swinburne Leadership Dialogues - panel discussion)

Full title: Leading the NDIS: Australia's greatest social reform in the 21st century. Meet the two people who imagined and then drove the creation of the National Disability Insurance Scheme (NDIS). In this Leadership Dialogue from Swinburne Leadership Institute, Bruce Bonahady AM (NDIA Board Chair) and Dr Rhonda Galbally AO (NDIA Board member and Principal Member of NDIA's Independent Advisory Council) will discuss how they dreamt up, and then steered the NDIS through its many stages to become Australia's most significant social reform this century. The two reformers explain how they harnessed support for such an ambitious project. They discuss how they sustained the political goodwill of both major parties to create lasting change for the public good. From its strange inception, and through its many trials, the NDIS provides lessons in the art of reform and political persuasion. Recorded 23 July 2015

Psychosocial disadvantage and residential remoteness is associated with Aboriginal women’s mental health prior to childbirth

Introduction: Optimal mental health in the pre-conception, pregnancy and postpartum periods is important for both maternal and infant wellbeing. Few studies, however, have focused on Indigenous women and the specific risk and protective factors that may prompt vulnerability to perinatal mental disorders in this culturally diverse population. Objectives: To assess mental health contacts in the period before childbirth among Australian Aboriginal and Torres Strait Islander women, the association with socioeconomic factors and whether it differs by geographic remoteness. Methods: This is a retrospective cohort study of 19,165 Aboriginal mothers and includes all Aboriginal mothers and their children born in Western Australia from January 1990 to March 2015. It draws on population-level, linked administrative data from hospitals and mental health services, with a primary focus on the mental health contacts of Aboriginal women in the 5 years leading up to childbirth. Results: The prevalence of maternal mental health contacts in the five years prior to birth was 27.6% (93.6% having a single mental health disorder), with a greater likelihood of contact in metropolitan areas compared with regional and remote settings. There was a positive relationship between socioeconomic advantage and the likelihood of a mental health contact for women in metropolitan (β = 0.044, p=0.003) and inner regional areas (β = 0.033, p=0.018), and a negative association in outer regional (β = -0.038, p=0.022), remote (β = -0.019, p=0.241) and very remote regions (β = -0.053, p\u3c0.001). Conclusions: The findings from this study provide new insights on the dynamic relationship between SES, geographic location and mental health issues among Aboriginal women in the five years leading up to childbirth. The results underscore the need to apply location-specific approaches to addressing the material and psychosocial pathways that lead to mental health problems and the provision of culturally safe, appropriate and accessible services for Aboriginal women

Prioritising and Financing Health Promotion in Australia

This report was prepared to contribute to the 'Health Australia Initiative' on the issue of prioritisation and financing for health promotion. Research presented here is focused on the two tasks of: (i) proposing preferred approach(es) to priority setting; and (ii) funding mechanisms which would support the preferred health promotion activity. The criteria adopted in assessing these issues were: (i) the need for technical and allocative efficiency; (ii) equity between different population groups; (iii) 'dynamic efficiency', that is, a framework which encourages experimentation and progressive improvement; (iv) 'sustainability', that is, a funding mechanism which, while encouraging allocative efficiency, ensures continuity of funding for health promotion activities; and (v) 'manageability', that is, for reasons of financial management, expenditures should, at least in the short run, be containable. With respect to the first task of the report, the principle conclusion is that priority setting should be 'evidence based'. There is no possibility of achieving social objectives unless the relationship between program activities, objectives and outcomes is understood to the point where informed judgements are possible. In this respect the logic of the economic approach to decision making for the achievement of technical and allocative efficiency is compelling and it is the approach recommended. The economic approach is based on the logical principle that health outcomes will be maximised for a given health budget if the marginal benefit cost ratio is equalised across programs or projects. This requires resources to move to activities which generate greater benefits for those yielding lower levels of benefit. Two applications of the 'economic model' are advocated; viz Program Budgeting and Marginal Analysis (where the time frame for decision making is limited) and the 'Disease Based Framework', (where there is greater capacity for long term research and planning and a focus on resource allocation between disease stages and health delivery settings)

Prioritising and Financing Health Promotion in Australia

This report was prepared to contribute to the 'Health Australia Initiative' on the issue of prioritisation and financing for health promotion. Research presented here is focused on the two tasks of: (i) proposing preferred approach(es) to priority setting; and (ii) funding mechanisms which would support the preferred health promotion activity. The criteria adopted in assessing these issues were: (i) the need for technical and allocative efficiency; (ii) equity between different population groups; (iii) 'dynamic efficiency', that is, a framework which encourages experimentation and progressive improvement; (iv) 'sustainability', that is, a funding mechanism which, while encouraging allocative efficiency, ensures continuity of funding for health promotion activities; and (v) 'manageability', that is, for reasons of financial management, expenditures should, at least in the short run, be containable. With respect to the first task of the report, the principle conclusion is that priority setting should be 'evidence based'. There is no possibility of achieving social objectives unless the relationship between program activities, objectives and outcomes is understood to the point where informed judgements are possible. In this respect the logic of the economic approach to decision making for the achievement of technical and allocative efficiency is compelling and it is the approach recommended. The economic approach is based on the logical principle that health outcomes will be maximised for a given health budget if the marginal benefit cost ratio is equalised across programs or projects. This requires resources to move to activities which generate greater benefits for those yielding lower levels of benefit. Two applications of the 'economic model' are advocated; viz Program Budgeting and Marginal Analysis (where the time frame for decision making is limited) and the 'Disease Based Framework', (where there is greater capacity for long term research and planning and a focus on resource allocation between disease stages and health delivery settings)