Never felt better - City of Knox · The Strategy adopts a population approach to health and wellbeing, which focuses on improving the health status of the whole community, reducing

Appendix A

Never felt better...

Knox Community Health and Wellbeing Strategy 2013-17

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Knox has a vision for a healthy and connected community.

Never felt better Knox Community Health and Wellbeing Strategy 2013-17 Executive summary It’s easy to have a vision that uses words like healthy and connected. We all want that – but getting there takes more than wishful thinking. It needs a strategy, something practical and measurable. And gone are the days when it’s Council’s job to do everything. That’s not practical, sustainable or smart. Council is certainly best placed to influence and even deliver on some of the features contained within this Strategy. But being a partner with other stakeholders – influencing and supporting them – makes more sense in this era of collaboration. It repositions Council as an ally alongside others rather than directing a series of tasks that may never be realised. This Strategy articulates how we will enable health and wellbeing outcomes in the City with a focus on eight priority areas to influence and change. Why have a Strategy? Council is required by the Public Health and Wellbeing Act 2008 to deliver a ‘Municipal Public Health and Wellbeing Plan’. And the document must be presented within 12 months of a Council election. Council also has a commitment to promoting the health and wellbeing of the Knox community – now and into the future. In preparing this document, Council has taken a fresh look at the available data, the best advice from a wide range of stakeholders, and best practice in the sector to present this Strategy. Most importantly, we’re presenting this as an achievable approach to actually realising Knox’s vision of a more healthy and connected community. It’s achieved in alliance with others well placed in the City of Knox rather than apart from them.

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Contents Page

1. Our approach to achieving health and wellbeing ................................................ 5

Key features of the Strategy ................................................................................................ 5

Community health and wellbeing planning and implementation framework ......................... 6

2. The path forward ................................................................................................. 9

Priorities and key strategies for health and wellbeing in Knox ............................................... 9

Unpacking the priorities and key strategies ....................................................................... 11

3. How are we going to do it? ................................................................................ 27

Council’s ongoing community health and wellbeing work .................................................. 27

Working together with allies and partners ......................................................................... 29

Council’s implementation role .......................................................................................... 31

4. How will we know if we have made a difference? .............................................. 32

Review and evaluation ..................................................................................................... 32

5. What’s behind this Strategy? ............................................................................. 34

Methodology ................................................................................................................... 34

Alignment with Knox’s Vision and the City Plan .................................................................. 35

Frameworks, approaches and lenses utilised in the Strategy ............................................... 35

Statistical evidence ........................................................................................................... 37

Review of relevant Council research and engagement ........................................................ 38

Review of influencing policies and legislation .................................................................... 38

Stakeholder engagement ................................................................................................. 44

6. References and attachments ............................................................................. 45

References ....................................................................................................................... 45

Attachment 1 – Knox Wellbeing Report 2013 ...................................................................... 46

Attachment 2 – Health and wellbeing planning policies and resources ................................ 57

Attachment 3 - Glossary .................................................................................................... 61

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1. Our approach to achieving health and wellbeing

Key features of the Strategy The purpose of the Knox Community Health and Wellbeing Strategy 2013-17 (the Strategy) is to enhance health and wellbeing in Knox. The Strategy is a key platform for achieving the broader Knox Vision: Our City, Our Future (Knox’s Vision) and implementing the Knox City Plan 2013-17 (City Plan). The Strategy adopts a population approach to health and wellbeing, which focuses on improving the health status of the whole community, reducing inequities, and strengthening social cohesion and community participation. The Strategy is underpinned by a commitment to integrated planning, implementation, evaluation and community engagement. Informed by a comprehensive and current set of data, as well as community views, it provides a tactical guide to assist Council, community organisations, government and others in Knox to embed health and wellbeing in their work. In particular, it sets out the community health and wellbeing priorities and key strategies for Knox over the next four years and proposes that Council and its allies and partners work together towards the common goal of improved health and wellbeing in Knox. The Victorian Public Health and Wellbeing Act 2008 requires Councils to develop a four-year Municipal Public Health and Wellbeing Plan (MPHWP) within 12 months of each Council election. This Strategy is Council’s MPHWP. A MPHWP must:

· Contain an examination of data; · Contain evidence-based goals and strategies; · Involve community members in its development, implementation and evaluation; · Identify relevant partnerships with the Victorian Department of Health and other

stakeholders; · Be consistent with council plans and municipal strategic statements; · Be reviewed annually; · Be available for public inspection; and · Provide the Secretary for Health with a copy of the plan.

The principles used to guide the development of the Strategy are: · Whole of population approach – Improving the health and wellbeing status of the whole

community, reducing inequities, and strengthening social cohesion and community participation;

· Evidence-based planning – Planning and prioritisation which is informed by reliable sources of data and quality data analysis;

· Integrated planning – Combining approaches to improving health and wellbeing through partnerships and alliances, shared data and priorities, coordinated action, functions and processes, as well as avoiding duplication and maximising return on finite resources;

· Utilising existing Council and community programs to achieve community health and wellbeing outcomes – Identifying, building upon and working with and through key existing programs and services which have significant impacts upon health and wellbeing outcomes in the community;

· Community engagement – Valuing community views and opinions and facilitating their input to ensure that decision-making is better-informed; and

· Accessibility – The Strategy should be easily accessible, though the use of simple language and available on Council’s website.

Community health and wellbeing planning and implementation framework The community health and wellbeing planning and implementation framework provides the structure to enable the achievement of desired community health and wellbeing outcomes over the next four years and aligns with Knox’s Vision and the City Plan themes, objectives and relevant strategies which were developed in partnership with the Knox community

It is proposed that all the components of the framework need to be both in place and functioning at an optimum level to ensure the achievement of the Community Health and Wellbeing Strategy aspirations and objectives. . Knox’s Vision and the City Plan (2013-17) present the shared aspirations for the future of the City of Knox over the next 20 years in accordance with five themes1

· Healthy and connected community;

:

· Prosperous, advancing economy;

· Vibrant and sustainable built and natural environment;

· Culturally rich and active communities; and

· Democratic and engaged communities.

The Strategy also draws upon a range of related policy areas which identify the conditions and determinants of health and wellbeing in Knox and indicators which can be used to monitor change over time.

Eight community health and wellbeing priorities have been identified through a rigorous analysis of quantitative and qualitative data, relevant policies and stakeholder views. Three of the priorities are relative strengths in Knox (priorities 1-3) which are important things to continue to build on. Five priorities are relative weaknesses within Knox and require attention if community health and wellbeing is to be improved (priorities 4-8):

1 Informed by the Community Indicators Victoria domains

1. Personal health and wellbeing;

2. Community connectedness; 3. Leisure, recreation/arts and

cultural services; 4. Housing affordability and

choice; 5. Family violence; 6. Lifelong learning; 7. Mental health; and 8. Lifestyle risks (smoking,

nutrition, alcohol and physical exercise).

Key strategies that seek to support health and wellbeing in Knox over the next four years have been developed for each priority. These have been identified in consultation with relevant internal and external stakeholders, including members of the Knox Community Health and Wellbeing Reference Group and population health partners and allies, and strongly align with many of the strategies in the City Plan.

Implementation of the key strategies will inform the ongoing community health and wellbeing work of Council and its partners and allies over the next four years.

An implementation plan to support the achievement of each of these strategies will be developed in collaboration with the relevant partners over the first 12 months of the Strategy being approved.

The community health and wellbeing planning and implementation framework is presented in the following table.

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Community health and wellbeing planning and implementation framework 2013-17 Themes – Knox Vision: Our City, Our Future and the City Plan 2013-17 Set out the aspirations and components of health and wellbeing in Knox.

1. Healthy and connected community

2. Prosperous, advancing economy

3. Vibrant and sustainable built and natural environments

4. Culturally rich and active communities

5. Democratic and engaged communities

Policy areas Define the conditions, determinants and drivers of health and welling in Knox, as well as indicators for monitoring changes in population health and wellbeing. 26 policy areas – 23 taken from Community Indicators Victoria and 3 from Knox City Council.

1. Personal health and wellbeing

(includes lifestyle risk indicators – smoking, nutrition, alcohol and physical activity) 2. Community connectedness 3. Early childhood 4. Personal and community

safety 5. Lifelong learning 6. Service availability 7. Mental health 8. Active ageing 9. Youth

10. Economic activity 11. Employment 12. Income and wealth 13. Skills 14. Work-life balance

15. Open space 16. Housing 17. Transport accessibility 18. Sustainable Energy Use 19. Air Quality 20. Water 21. Biodiversity 22. Waste Management

23. Arts and cultural activities

24. Leisure and recreation 25. Cultural diversity

26. Citizen engagement

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City Plan objectives Informed by an analysis of data and community consultation.

1.1 The Knox community benefits from good health and wellbeing at all life stages

1.2 A safe community with strong community connections and where learning and volunteering are valued and supported

2.1 Knox has a strong local economy that supports business growth, jobs and community wealth 2.2 Improve local opportunities for people to live, work, learn and play in Knox

3.1 The changing needs of a diverse community are supported through growth and change in housing and infrastructure that respects both built form and natural systems, as well as resource availability 3.2 Biodiversity and places of natural significance, including waterways and open space are highly valued, protected and enhanced 3.3 Infrastructure networks provide transport choice, affordability and connectivity

4.1 Improve the acceptance and valuing of diversity and difference in the Knox community 4.2 Increase use of public spaces and infrastructure for the purposes of cultural expression and physical activity

5.1 Improve community leadership and participation in Knox 5.2 Increase opportunities for the Knox community to participate in public decision-making processes 5.3 Ensure Council is well governed and demonstrates effective leadership

Community health and wellbeing priorities Informed by the Strategy’s underlying principles, rigorous data analysis and community consultation.

Personal health and wellbeing (includes a focus on active ageing, early years and youth) Community connectedness Family violence Lifelong learning Mental health Lifestyle risks

Smoking Nutrition Alcohol Physical activity

Lifelong learning Housing affordability and choice

Leisure, recreation/arts and cultural activities (includes a focus on arts and culture) Community Connectedness

Community Connectedness

Key strategies to improve health and wellbeing in Knox Informed by targeted stakeholder engagement to provide high-level direction and guide core business and action plans. 26 Strategies – 18 from the City Plan and 8 others to improve specific community health and wellbeing priority issues. Infrastructure and services provided by Council and community partners and allies.

A range of services and infrastructure that support the achievement of community health and wellbeing outcomes for the City of Knox provided by Council, allies and partners (for Council services refer to pages 27 and 28 of the Strategy).

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2. The path forward

Priorities and key strategies for health and wellbeing in Knox

The implementation of 26 key strategies, as listed below, will inform the ongoing community health and wellbeing work of Council and its partners and allies over the next four years. Eighteen of these strategies are in the City Plan and eight strategies have been developed to improve specific issues relevant to the community health and wellbeing priorities. The shared City Plan strategies are identified by an asterisk (*).

In accordance with the guiding principles for the development of the Strategy, the preferred approach involves utilising and building upon existing services and programs, rather than necessarily seeking to implement new ones. Working with partners and allies, in either lead and support roles, will help to maximise our collective reach and return on finite resources.

The key strategies have been identified through engagement with stakeholders in accordance with eight community health and wellbeing priorities.

Priority 1 – Personal health and wellbeing

1. Implement measures to raise the community’s awareness of the range of services, infrastructure and activities in Knox that contribute to health and wellbeing.

2. Develop and implement collaborative approaches with key health and wellbeing partners to enable planning, implementation and evaluation of health and wellbeing initiatives across all life stages.

3. Advocate for required services that enhance health and wellbeing.

4. Consider the impact of changes to the environment on the Knox community when planning and implementing health and wellbeing initiatives, including higher temperatures, heatwaves, bushfires, long-term drought or decreased average rainfall, flood and extreme weather events.

5. *Support older adults to enjoy healthy and independent lives, in which their contribution is valued.

6. *Maintain and further enhance the range and quality of services available to Knox residents that support positive development for early childhood and young people.

7. *Significantly improved integrated and sustainable transport systems and infrastructure are provided to improve opportunity, choice and access for all.

Priority 2 – Community connectedness

8. *Improve support for community groups to operate in an increasingly regulated environment, and promote and celebrate the contribution of volunteers.

9. *Increase support for locally initiated community programs that build local capacity and opportunities for community groups to become self-sufficient.

10. *Support local community leadership programs to promote community participation and foster emerging local leaders.

11. *Increase opportunities for early, genuine and meaningful public conversations with the community on issues of interest or that directly affect them.

12. Research, plan and implement and/or advocate for the provision of public infrastructure and facilities that enhance community connectedness.

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Priority 3 – Leisure, recreation/arts and cultural activities

13. *Increase walking and cycling networks that encourage physical activity and provide viable transport choices.

14. *Use established cultural, sporting and leisure activities as a mechanism for increased community engagement and participation.

15. *Increase participation in social, cultural and economic life for people of all ages through healthy and physically active lifestyles.

16. *Promote accessible opportunities to participate in leisure and recreation, through provision of public infrastructure and support to sporting and leisure groups in Knox.

17. *Develop multi-use facilities in co-located hubs that support active participation in sporting, cultural and leisure activities.

Priority 4 – Housing affordability and choice

18. *A diversity of housing choice is provided in appropriate locations that meets the accessibility, sustainability and affordability needs of the community.

19. Implement measures to raise the community’s awareness of the health and wellbeing benefits of a diverse housing stock in Knox.

20. *Implement programs and policies to ensure that residential development better responds to the community’s current and future needs, and allows people to ‘age-in-place’.

Priority 5 – Family violence

21. Support the development of an integrated partnership approach to enable the implementation of the Together for Equality and Respect – A Strategy to Prevent Violence Against Women in Melbourne’s East 2013-17 and the Community Crime Prevention Plan.

22. *Improve personal and community safety and perceptions of safety in Knox, including addressing family violence and child abuse.

Priority 6 – Lifelong learning

23. *Increase the number of people that participate in lifelong learning opportunities and strengthen awareness of lifelong learning opportunities.

Priority 7 – Mental health

24. *Improve mental health in the Knox community, strengthen awareness and understanding about mental health issues and improve the availability of support services.

25. Advocate for preventative approaches and programs to enable strong, positive mental health in Knox.

Priority 8 – Lifestyle risks

26. *Improve health and wellbeing factors and mitigate lifestyle risks such as smoking, risky alcohol consumption and drug use, obesity, lack of physical activity and poor nutrition, through a range of services, support, education, infrastructure and partnerships.

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Unpacking the priorities and key strategies The following table explains the story behind each community health and wellbeing priority. Each priority covers the following:

· The desired outcome;

· The strategies we will implement to address the desired outcome;

· Why the issue is a priority for Knox;

· What we know now about this issue and links to health and wellbeing;

· Who has a role to play to address the issue; and

· How we will measure change.

Community health and wellbeing priority 1 – Personal health and wellbeing Desired Outcome

People in Knox have high levels of personal health and wellbeing and are able to enjoy a good quality of life.

What are the key strategies to achieve this?2

1. Implement measures to raise the community’s awareness of the range of services, infrastructure and activities in Knox that contribute to health and wellbeing.

2. Develop and implement collaborative approaches with key health and wellbeing partners to enable planning, implementation and evaluation of health and wellbeing initiatives across all life stages.

3. Advocate for required services that enhance health and wellbeing. 4. Consider the impact of changes to the environment on the Knox community when planning and implementing health and

wellbeing initiatives, including higher temperatures, heatwaves, bushfires, long-term drought or decreased average rainfall, flood and extreme weather events.

5. *Support older adults to enjoy healthy and independent lives, in which their contribution is valued. 6. *Maintain and further enhance the range and quality of services available to Knox residents that support positive

development for early childhood and young people. 7. *Significantly improved integrated and sustainable transport systems and infrastructure are provided to improve

opportunity, choice and access for all. Why is this a priority in Knox? Personal health and wellbeing provides the foundation for a good quality of life and contributes more broadly to workforce productivity, social cohesion and a strong economy. Personal health and wellbeing is a relative strength in Knox. Subjective views on personal wellbeing are strong in Knox, for example, men scored their personal wellbeing at 76.6 out of 100 and women 77.6 out of 100 in terms of satisfaction with aspects of wellbeing including standard of living, health, community connection and security. The average for Australians is 75. Indicators for child health and wellbeing are also better in Knox than for Metropolitan Melbourne and Victoria with a lower than average proportion of children 0-6 years of age who are developmentally vulnerable (Australian Early Childhood Development Index, 2009 & 2012) and high rates of participation in child health assessments and breastfeeding. What do we know about personal health and wellbeing? Most people in Knox experience relatively high levels of personal health and wellbeing. Different health and wellbeing needs arise during the phases of an individual’s lifecycle. For example, children, youth and older people have differing support, service and infrastructure requirements. Some people experience poor health, chronic conditions and acute health incidents. People’s personal, social and working lives can be compromised by ill health or disability and the associated pain, isolation and inconvenience. The financial cost of ill health arising from treatment expenses and loss of income and opportunity can have negative individual, family, social and economic impacts. Some of the determinants of personal health and wellbeing include stable and affordable housing options, economic wellbeing, work-life balance, family/social influence, community connectedness and adequate transport options etc. Risk factors include social disadvantage, material deprivation, poor living and working conditions, tobacco use, alcohol misuse, lack of physical activity and an unhealthy diet (VicHealth 2009). Community perceptions (what the community said):

· Access to services is generally good in Knox · Aged care services, residential care and programs to support ageing in place will increasing be important in Knox as the

population ages · Immunisation and maternal and child health services significantly contribute to the health and wellbeing of children, mothers

and carers. Immunisation is also important for adolescents · Good open spaces and quality leisure and recreational facilities and activities are enjoyed by people in Knox

2 * denotes strategies from the City Plan.

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· Transport options are improving in Knox but could be enhanced by new services such as a train line to Rowville and a tram service.

· Cost-of-living expenses affect the health and wellbeing of the community · Larger family homes and car-centric transport are featured in Knox, making it susceptible to environmental challenges such as

peak oil and global warming, particularly in terms of energy affordability and weather changes (heatwaves, fire danger, storm damage)

· Housing diversity and affordability needs to reflect the needs of the community, currently there are limited smaller dwellings and housing costs can be high for people on modest incomes

Who has a role3

Lead partner/s to play in driving the key strategies?

Council – Funder, provider, planner, advocate/influencer, regulator Knox Community Health Service4

influencer

– provider, planner, advocate/

Support partners/allies Primary Care Partnership – provider, planner, advocate/influencer Eastern Melbourne Medicare Local – provider, planner, advocate/influencer Women’s Health East – provider, planner, advocate/influencer Police and emergency services – provider, planner, advocate/influencer, regulator State and federal government – funder, provider, planner, advocate/influencer Local businesses – funder, provider, planner, advocate/influencer Not-for-profit community service organisations (incl. sporting, leisure, arts, multicultural groups etc.) – provider, planner, advocate/influencer Hospitals, other health services and local doctors – provider, planner, advocate/influencer Church groups – provider, planner, advocate/influencer

How will we measure changes in personal health and wellbeing? Indicator/s Subjective Wellbeing Child Health and Wellbeing Adolescent health and wellbeing

Measures/Sources Personal Wellbeing Index Score (0-100), by age and gender (VicHealth Survey, 2011) Proportion of children vulnerable on two or more development domains (AEDI, 2012) Participation rate (visits/100 enrolled children) at key ages and stages 3.5 year maternal & child health visit (Office for Children, 2011) The proportion of adolescents enrolled in Years 7, 9 and 11 with positive Mental Health – Psychological wellbeing scale score of 43 or higher5

. (Adolescent Health & Wellbeing Survey, 2009)

Knox Men 76.6 Women 77.6 18-34 yrs 78.6 35-54 yrs 75.6 55+ yrs 77.5 7.4 76.3 74.5

Metro 76.4 77.4 77.8 76.2 77.1 9.5 64.5 77.1(Vic)

How does this link to Council’s City Plan themes and objectives? City Plan theme/s

1.Healthy and Connected Community 2. Prosperous, Advancing Economy 3. Vibrant and Sustainable Built and Natural Environments

City Plan Objective/s

1.1 Knox Community benefits from good health and wellbeing at all life stages. 2.1 Knox has a strong local economy that supports business growth, jobs and community wealth. 3.3 Infrastructure networks provide transport choice, affordability and connectivity

3 Role definition

Partner/ally – developing trusting formal and informal relationships and alliances and working with others to achieve common goals;

Provider – offering a range of services, support, infrastructure and facilities to individuals and groups;

Planner – proactively planning for services and infrastructure, which respond to current and future needs and requirements;

Advocate/influencer – raising awareness of State and Federal governments and other stakeholders of the issues and needs of Knox residents and

businesses, as well as initiating or supporting campaigns for positive change; and Regulator – providing governance and regulatory controls such as local laws and health and building controls. 4 At the time of writing, Knox Community Health Service was negotiating a possible merger with Eastern Access Community Health.

5 Respondents who were at or above a cut-off score of 43 in respect to a Mental Health Inventory of 14 questions relating to happiness, relaxation,

hope for the future etc.

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Community health and wellbeing priority 2 – Community connectedness Desired outcome People in Knox feel connected to each other and their community. What are the key strategies to achieve this?6

8. *Improve support for community groups to operate in an increasingly regulated environment, and promote and celebrate the contribution of volunteers.

9. *Increase support for locally initiated community programs that build local capacity and opportunities for community groups to become self-sufficient.

10. *Support local community leadership programs to promote community participation and foster emerging local leaders. 11. *Increase opportunities for early, genuine and meaningful public conversations with the community on issues of interest

or that directly affect them. 12. Research, plan and implement and/or advocate for the provision of public infrastructure and facilities that enhance

community connectedness. Why is this a priority in Knox? Community connectedness contributes to positive individual health and wellbeing, as well as helping to build a sense of belonging, social cohesion and community resilience. It provides a strong foundation for enhancing community health and wellbeing in Knox. There is a well developed sense of community connectedness in Knox, with over 70.8% of people reporting that they feel part of the community (Vic Health Indicators Survey, 2011). 89.6% of adults also report that they are able to get help from family, friends or neighbours when needed (VPHS, 2008) and 66% report that there is a wide range of local community and support groups available in Knox, compared with 57% for Metropolitan Melbourne (VPHS, 2008). Furthermore, an increasing share of the Knox adult population (33.5 %) report that they have participated in voluntary work for an organisation or group (VPHS, 2008) and volunteer numbers between 2001 and 2006 have increased by 1,372 people (ABS Census). What do we know about community connectedness? Community connectedness encompasses the ways in which people come together and interact with each other. It involves the quality and number of connections one has with other people, such as family, friends and acquaintances, as well as broader relationships beyond one’s social circle and with other groups and communities. There are a broad range of structured and unstructured ways of connecting with each other including volunteering, involvement in community organisations, schools, churches and recreation groups, as well as attending festivals, libraries, theatres and community events etc. Technology is also increasingly utilised to connect people to each other. For example, social media can allow people to create, share and exchange information and ideas in virtual communities and networks. This presents opportunities and challenges for different social groups by enhancing community connectedness for some and possibly contributing to social isolation for others. Key determinants of healthy, connected individuals and communities include work-life balance, adequate local employment, stable and affordable housing options, economic wellbeing, technology options, accessible transport options and built environments (for example, footpaths, roads, bike tracks, parks, lighting, housing, infrastructure etc.) that meet the broad range of community needs (including for people with a disability, older people, families with small children, youth etc.). Community perceptions (what the community said):

· There are a wide variety of settings that enable people to connect in Knox including schools, faith groups, community and support organisations, and youth/seniors/indigenous/multicultural/sporting groups etc.

· Knox has a large number of support opportunities and services for groups · Public transport services are not well aligned, making connection difficult · Traditional volunteering tends to be undertaken by older people · New trends are emerging in volunteerism which are based upon the needs of volunteers, rather than the needs of

organisations. This is resulting in more dynamic and flexible models · Increasing legal obligations and red tape in volunteerism can be challenging · Stigma and stereotyping can affect people’s ability to connect with each other · There is a contradiction in utilising technology to connect with others – it connects some, but may isolate others

Who has a role to play in driving the key strategies? Lead partner/s Council – funder, planner, provider, advocate/influencer

Support partners/allies Eastern Melbourne Medicare Local – planner, advocate/influencer Knox Community Health Service – provider, planner, advocate/influencer Women’s Health East – planner, advocate/influencer Primary Care Partnership – provider, planner, advocate/influencer Schools and educational providers – provider, advocate/influencer Libraries – provider, advocate/influencer Neighbourhood houses – provider, planner, advocate/influencer Not-for-profit community groups/organisations (Bridges, Interchange, Anglicare, sports/arts/multicultural/Indigenous groups etc.) – provider, planner, advocate/influencer Church groups – provider, advocate/influencer Local businesses (e.g. Bendigo Bank) – funder, planner, advocate/influencer Citizens – advocate/influencer State government departments/authorities – planner, funder, provider


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How will we measure changes in community connectedness? Indicator/s Feeling Part of the Community Social Support Participation in Community Life Volunteering

Measures/Sources Satisfaction with feeling part of the community (Vic Health Indicators Survey, 2011) People who get help from family, friends or neighbours when needed as a % of adult population (VPHS, 2008) Adults that report a wide range of community and support groups, locally as % of adult population (VPHS, 2008) % of adults that are members of an organised group (VPHS,2008) People who help out as volunteers as % of adult population (VPHS, 2008)

Knox 70.8 89.6 66.0 54.0 33.5

Metro 70.9 90.9 57.0 59.0 28.7


1. Healthy and Connected Community 5. Democratic and Engaged Communities


1.2 A safe community with strong community connections and where learning and volunteering are valued and supported. 5.1 Improved community leadership and participation in Knox. 5.2 Increase opportunities for the Knox Community to participate in public decision making processes.

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Community health and wellbeing priority 3 – Leisure, recreation, arts and cultural activities Desired outcome

People in Knox have access to a broad range of recreation, leisure, arts and cultural activities and facilities.


13. *Increase walking and cycling networks that encourage physical activity and provide viable transport choices.

14. *Use established cultural, sporting and leisure activities as a mechanism for increased community engagement and participation.

15. *Increase participation in social, cultural and economic life for people of all ages through healthy and physically active lifestyles.

16. *Promote accessible opportunities to participate in leisure, recreation, arts and cultural activities, through provision of public infrastructure and support to sporting and leisure groups in Knox.

17. *Develop multi-use facilities in co-located hubs that support active participation in sporting, cultural and leisure activities. Why is this a priority in Knox? The personal and health benefits of participating in leisure and recreation include an increased sense of wellbeing, enjoyment, social interaction, personal achievement, physical fitness and greater confidence, as well as reduced anxiety, stress and the likelihood of illness. These factors considerably contribute to the health and wellbeing of the Knox community. Leisure and recreation is a strength in Knox. There are many opportunities to participate in sporting and recreational activities, with 90.2% of adults reporting that their area has ‘good’ or ‘very good’ access to leisure and recreation facilities in Knox, compared with 83% for Metropolitan Melbourne (VPHS, 2008). Furthermore, 56% of adolescents in years 7, 9 and 11 feel that there are accessible playgrounds, parks or gyms close to their homes, compared with 48.3% Victoria-wide (Adolescent Health and Wellbeing Survey, 2009). The Knox community also enjoys arts and cultural activities, with 67.5% of adults reporting that they have participated in arts and related activities in a three-month period, compared with 65.2% for Metropolitan Melbourne (VicHealth Survey, 2011). What do we know about leisure and recreation? Knox residents have access to an impressive range of leisure and recreation facilities both within the municipality and the broader region. Generally, whether one’s interest in is in active sport, walking with the family, a regular swim, visiting parks and playgrounds, arts and cultural activities or festivals, facilities and opportunities can be found either locally or not too far away. Leisure and recreation also allows people to recover from the pressures of work and personal life, to bond with family and community members and to reflect on their life direction and meaning. Participating in various forms of cultural expression, such as the arts, empowers people to be creative, develop and utilise new skills and contribute to the cultural identity of the community. Determinants of active participation in leisure and recreation include social connectedness, family/social influences, economic wellbeing, positive work-life balance, access to affordable housing options, health awareness, wellness and good nutrition etc. Community perceptions (what the community said):

· People are increasingly time poor – participation models need to include ‘short term’ activities · There is good utilisation of bike paths, but connectivity across the municipality could be improved · Knox tends to be car-centric, therefore, a walking culture in Knox is not strong and major roads provide walkability barriers · More places where the whole family can go (all ages) would enhance opportunities for leisure and recreation in Knox · There is a need for greater gender equity in recreation – in terms of participation opportunities and facilities (for example,

recreational opportunities in open spaces are often male dominated) · Infrastructure and participation opportunities need to reflect the broad needs of the community (including women, people

with a disability, older people and children etc.) · There is strong support for and attendance at festivals and community events in Knox · There are perceptions of gaps in gym accessibility, open space in Rowville and Lysterfield and participation rates in southern

areas of Knox Who has a role to play in driving the key strategies? Lead partner/s Council – provider, planner, advocate/influencer, funder

Support partners/allies Sports and leisure groups – provider, planner, advocate/influencer Schools – provider, planner, advocate/influencer Not-for-profit community service organisations (multicultural, youth, older people, neighbourhood houses, church groups etc.) – provider, planner, advocate/influencer Women’s Health East – planner, advocate/influencer Local businesses – advocate/influencer, planner, funder State government departments/authorities – planner, funder, provider Citizens – advocate/influencer

How will we measure changes in leisure and recreation? Indicator/s Opportunities to participate in sporting and

Measures/Sources Adults that perceive their area has having ‘good’ or ‘very good’ access to recreation and leisure facilities (VPHS, 2008)

Knox 90.2

Metro 83.0


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recreation activities Participation in arts and cultural activities

% of adolescents enrolled in years 7,9 and 11 who agreed, strongly agreed with the perception that there are playgrounds, parks or gyms close to their home that they can access (Adolescent Health & Wellbeing Survey, 2009) % of adults that have attended a local community event in the past 6 months (VPHS, 2008) % adults that have participated in arts and related activities in the last 3 months8

56.0

(VicHealth Survey, 2011)

53.4 67.5

48.3(Vic) 48.0 65.2


1. Healthy, Connected Communities 4. Culturally Rich and Active Communities


1.1 The Knox community benefits from good health and wellbeing at all life stages 4.1 Improve the acceptance and valuing of diversity and difference in the Knox Community. 4.2 Increase use of public spaces and infrastructure for the purposes of cultural expression and physical activity.

8 Making or creating art including crafts either at home or in a public space eg performing, creative writing, digital or media art.

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Community health and wellbeing priority 4 – Housing affordability and choice Desired outcome

People in Knox have access to affordable, appropriate housing close to services and facilities.


18. *A diversity of housing choice is provided in appropriate locations that meets the accessibility, sustainability and affordability needs of the community.

19. Implement measures to raise the community’s awareness of the health and wellbeing benefits of a diverse housing stock in Knox.

20. *Implement programs and policies to ensure that residential development better responds to the community’s current and future needs, and allows people to ‘age-in-place’.

Why is this a priority in Knox? Access to housing which is appropriate and affordable helps to satisfy the fundamental human need for shelter, security and privacy. Housing affordability and choice are required to achieve strong community health and wellbeing in Knox. Housing affordability and choice are relative weaknesses in Knox. Housing stress, for example, is increasing among lower income households, with 9% of low income households paying 30% or more of their gross weekly income on either rental or mortgage. Only 2.1 % of housing stock in Knox is ‘social housing’, which includes government and community-owned dwellings that are available for low to medium income households on a rental basis. This compares with 2.9% for Metropolitan Melbourne. Housing choice is also limited in Knox, with only 13.1% medium or high density housing (ABS Census, 2011). This limits the options for older people to age in place, younger people to move out of the family home and smaller households to live in Knox. What do we know about housing affordability and choice? A dwelling’s physical condition, location in relation to amenities and services, and the extent to which it suits the needs of the occupants affects people’s quality of life. A home can support a person’s identify and development and relationship with others. The supply of affordable housing is a nation-wide challenge that also affects Knox residents, particularly people living on lower incomes. Social and economic determinants that influence access to affordable housing include: economic wellbeing (living on a low income – particularly statutory incomes), unemployment or under-employment, family violence, addictions (alcohol/drug/gambling), family type (lone-parent families, single-person households), disability, housing supply issues (including development risks, social discrimination and NIMBY-ism) and macro-economic conditions etc. Community perceptions (what the community said):

· Increasing purchase and rental costs are driven by a broad range of factors including: lack of supply; increased demand for housing (population growth); economic factors such as the increase in the cost of living; and government policy (government grants and taxation incentives) etc.

· A greater diversity of housing would enable people from a range of household structures to live in Knox (for example, down-sizing older couples/individuals, younger singles moving out of the family home, single-parent families, low income recipients etc.)

· Development must be respectful of existing local amenity (for example, better planning, close to services/facilities and quality designs)

· Profitability challenges for developers may limit the development of new and creative approaches to domestic construction in Knox

Who has a role to play in driving the key strategies? Lead partner/s Council – partner, planner, advocate/influencer, regulator

Support partners/allies Registered housing associations and not-for-profit housing services – planner, provider, advocate/influencer Women’s Health East– planner, advocate/influencer Developers and builders – provider, planner, advocate /influencer Eastern Affordable Housing Alliance – advocate/influencer State and Federal government – funder, planner, advocate/influencer, regulator Local businesses – advocate/influencer Knox citizens – advocate/influencer


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How will we measure changes in housing affordability and choice? Indicator/s Housing affordability Housing choice

Measures/Sources % of low income households in the bottom 40% of the national income distribution, paying 30%+ of usual gross weekly income on housing costs (mortgage or rent) (ABS, 2011) % of private rental housing that is affordable for lower income households receiving a Centrelink benefit (Office of Housing, Rental Report, June quarter, 2012) Social housing rental dwellings as % of total private dwellings (ABS Census, 2011) % housing that is medium or high density (ABS Census, 2011)

Knox 9.0 5.6 2.1 13.1

Metro 10.7 10.3 2.9 28.3


3. Vibrant and Sustainable Built and Natural Environment


3.1 Changing needs of a diverse community are supported through growth and change in housing and infrastructure that respects both built form and natural systems, as well as resource availability.

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Community health and wellbeing priority 5 – Family violence Desired outcome

People in Knox have healthy relationships that are free from violence.


21. Support the development of an integrated partnership approach to enable the implementation of the Together for Equality and Respect – A Strategy to Prevent Violence Against Women in Melbourne’s East 2013-17 and the Community Crime Prevention Plan.

22. *Improve personal and community safety and perceptions of safety in Knox, including addressing family violence and child abuse.

Why is this a priority in Knox? Family violence is a serious matter that can physically and emotionally harm women, men, young people and children – and results in mental health problems, such as anxiety, stress and depression and physical injuries, such as bruises, fractures, infections and permanent disabilities (VicHealth, 2011). Family violence must be eradicated if strong community health and wellbeing is to be achieved in Knox. There have been 1033 recorded incidents of family violence (per 100,000 population) in Knox, compared with 965 for Metropolitan Melbourne (Victoria Police, 2013) and 5.2 child abuse substantiations per 1000 children aged 0-17 years in Knox (DHS, 2009). What do we know about family violence? ‘Abuse in families and relationships is not normal, in fact, it is a crime’ (Australian Federal Police, 2009). Family violence can affect men, women, children, families and the broader community and takes various forms, such as physical, psychological, sexual and financial abuse. People subjected to family violence are unable to feel safe and live fulfilling lives. Violence against women is frequently perpetrated in the family home and by someone known to the woman (VicHealth 2011). Workplaces, educational institutions and public places etc. are other settings in which family violence can occur. Causal factors of family violence include a range of socio-economic and cultural conditions, structures and attitudes. Unequal power relations between women and men, as well as adherence to rigid gender stereotypes, are key determinants of violence against women (VicHealth, 2007). Child abuse and its long-term impacts on child development are also issues of concern. Community perceptions (what the community said):

· Gender inequality is the root cause of family violence · Alcohol and drug addiction are common contributing factors to family violence · Changes to legislation are enabling better enforcement and intervention – people are being imprisoned for their bad

behaviour · Higher reporting of the incidence of family violence indicates that the community understands that family violence is

unacceptable and that they feel empowered and willing to speak out against it · Financial abuse is an arising trend, particularly involving older people · Young people are remaining in the family home for longer which can contribute to stress – increases in ‘child’ perpetrators · Whole-of-government approach to family violence is resulting in a more integrated system involving Police, service providers

and courts etc.

· There seems to be a lack of ‘follow-up’ services to support victims of family violence and engage with offenders Who has a role to play in driving the key strategies? Lead partner/s Women’s Health East – provider, planner, advocate/influencer Council – provider, planner, advocate/influencer Victoria Police – provider, planner, advocate/influencer, regulator(law enforcement)

Support partners/allies Knox Community Health Service – provider, planner, advocate/influencer Eastern Melbourne Region Medicare Local – planner, advocate/influencer Primary Care Partnership – planner, provider, advocate/influencer Schools and other educational institutions – provider, planner, advocate/influencer Local businesses – provider, planner, advocate/influencer Not-for-profit community service organisations (including legal services etc) – provider, planner, advocate/influencer Sporting, recreation and leisure clubs – provider, planner, advocate/influencer State government (VicHealth) – funder, planner, advocate/influencer Hospitals, other health services and local doctors – provider, planner, advocate/influencer

How will we measure changes in family violence? Indicator/s Family Violence Child Abuse

Measures/Sources Recorded incidents of family violence (incidents per 100,000 population) (Victoria Police, 2013) Number of child abuse substantiations per 1000 children 0-17 years (DHS, 2009)

Knox 1033 5.2

Metro 965 7.0(Vic)


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1.Healthy and Connected Community


1.1 The Knox community benefits from good health and wellbeing at all life stages

1.2

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Community health and wellbeing priority 6 – Lifelong learning Desired outcome

People in Knox have access to a broad range of learning opportunities throughout their life.


23. *Increase the number of people that participate in lifelong learning opportunities and strengthen awareness of lifelong learning opportunities.

Why is this a priority in Knox? Lifelong learning is an important way for individuals to realise their full potential. It can contribute to personal growth and development, support full participation in social, cultural and economic life and provide a pathway to a rewarding and well paid career. The ability to participate in lifelong learning is essential to the health and wellbeing of individuals and the broader Knox community. 11.8% of young people (20-24 years) in Knox left school before completing year 11 (ABS, 2011), this is slightly higher than the Metropolitan-wide figure of 9.5%. However, only 35.8% of 20-24 year olds report participating in tertiary education. This is well below the Metropolitan average of 41% (ABS, 2011). Only 50% of people in Knox aged 15+ years hold a Year 12 or equivalent qualification. This is well below the Metropolitan average of 55%. Also, 30.7% of people in Knox aged 15+ years have no post school qualification (ABS, 2011), which is slightly higher than the 28.1% Metropolitan-wide figure. What do we know about lifelong learning? Encompassing formal and informal modes of learning, lifelong learning opportunities are offered by a variety of institutions in many settings in Knox including early childhood settings, schools, tertiary institutions, adult and community education centres, neighbourhood houses and community centres, churches, community service organisations, community groups, workplaces and many more. Key determinants of lifelong learning include stable and affordable housing options, economic wellbeing, access to effective transport, family/social attitudes and influence, positive role models, family breakdown, social isolation, gender inequity, language barriers and cultural issues etc. Community perceptions (what the community said):

· It is hard to gain meaningful employment without strong skills and recognised qualifications · People re-entering the workforce often need to be up-skilled to use new technologies · Industry/businesses contribute to lifelong learning through ongoing skills/knowledge development to comply with minimum

standards · Some tertiary institutions are not offering the types of training needed by industries in Knox · Social issues (such as, family breakdown, homelessness, misuse of alcohol and drugs etc.) can negatively affect

learning/educational opportunities, particularly for young people · Lack of life skills can limit young people’s educational aspirations · Generational/family attitudes and peer pressure influences young people’s views of education

Who has a role to play in driving the key strategies? Lead partner/s Outer Eastern Local Learning and Employment Network – provider, planner, advocate/influencer Council – funder, planner, provider, advocate/influencer

Support partners/allies Local businesses – funder, provider, planner, advocate/influencer Libraries – provider, planner, advocate/influencer Neighbourhood houses – provider, planner, advocate/influencer Not-for-profit community service organisations (church groups etc.) – provider, planner, advocate/influencer Schools – provider, planner, advocate/influencer Tertiary institutions – provider, planner, advocate/influencer

How will we measure changes in lifelong learning? Indicator/s Contemporary education outcomes Destination of school leavers Educational status

Measures/Sources % young people (20-24 years) that left school before completing year 11 (ABS, 2011) % 20-24 year olds participating in tertiary education (ABS, 2011) People aged 15-19 years ( not at secondary school ) that are fully engaged in work or study at a non-school institution (ABS, 2006) People aged 15-19 years (not at secondary school) that are not engaged at all in work or study (ABS, 2006) Share of population (15+years) with Year 12 or equivalent (ABS, 2011) Share of population (15+ years) with no post school qualification (ABS, 2011)

Knox 11.8 35.3 74.9 12.0 50.0 30.7

Metro 9.5 41.0 75.1 13.7 55.0 28.1


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1. Healthy and Connected Community

City Plan Objective/s 1.2 Safe community with strong community connections and where learning and volunteering are valued and supported.

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Community health and wellbeing priority 7 – Mental health Desired outcome

People in Knox experience a high level of social, emotional and spiritual wellbeing.


24. *Improve mental health in the Knox community, strengthen awareness and understanding about mental health issues and improve the availability of support services.

25. Advocate for preventative approaches and programs to enable strong, positive mental health in Knox.

Why is this a priority in Knox? Mental health is a state of emotional and social wellbeing. It influences how an individual copes with the normal stresses of life and whether he or she can achieve his or her potential. The state of an individual’s mental health has personal and community health and wellbeing implications for Knox. 12.2% of adults in Knox experience high or very high levels of psychological distress (VPHS, 2011-12). 13.9% of adolescents in Knox also experience high levels of psychological distress (Adolescent Health and Wellbeing Survey, 2009). The psychiatric hospitalisation rate for young people with a principal diagnosis related to a mental and behavioural category is 7.9 young people per 1000 adolescents (aged 10-17 years), compared with 6.7 Victoria-wide (DHS, VAED, 2010). What do we know about mental health? Strong health and wellbeing is built upon good mental health. Mental health involves much more that an absence of mental illness. It is ‘the embodiment of social, emotional and spiritual wellbeing. Mental health provides individuals with the vitality for active living, to achieve goals and interact with one another in ways that are respectful and just’ (VicHealth, 2005). Mental illness may cause considerable suffering to an individual through compromised social participation, lowered self-esteem, poorer physical health, diminished quality of life and reduced economic capacity. The broader social and economic costs of mental illness include negative impacts on families and the community, as well as the loss of productivity. A range of biological, social, psychological, environmental and economic factors can affect mental health. The major determinants of mental health and wellbeing include:

· Social inclusion – the nature and number of a person’s networks and social ties, their participation in community life and their access to basic human entitlements;

· Freedom from discrimination and violence – the treatment received as a member of society and feelings of safety and security; and

· Access to economic resources – such as work, education, housing and an adequate income (VicHealth 2005). Community perceptions (what the community said)

· More people are taking responsibility for their wellness by seeking to build strong and positive mental health (including involvement in recreation, leisure, work-life balance, personal/family/community relationships and support etc.)

· There is a general lack of understanding of mental health issues and the range of available services · There is an increasing awareness of the negative mental health effects of bullying and family violence on individuals, families

and the community, as these issues are now more actively reported · Stigma associated with mental health can lead to discrimination, denial, fear and feelings of shame · There is a significant proportion of children in Knox on the autism spectrum · The police and various health/support practitioners have dedicated teams to respond to people in a mental health crisis (for

example, suicide risk, self-harm and harm to others etc.) · Homelessness and housing instability can contribute to mental health problems · There is a perceived movement towards law enforcement interventions, away from prevention approaches

Who has a role to play in driving the key strategies? Lead partner/s Eastern Melbourne Medicare Local – provider, planner, advocate/influencer Primary Care Partnership – planner, advocate/influencer

Support partners/allies Police and emergency services – provider, planner, advocate/influencer Knox City Council (Family and Children’s Services, Youth Services, Active Ageing etc.) – provider, planner, advocate/influencer Women’s Health East – provider, planner, advocate/influencer Knox Community Health Service13

Schools and other educators – provider, planner, advocate/influencer – provider, planner, advocate/influencer

Specialist mental health services – provider, planner, advocate/influencer Not-for-profit community organisations and services (incl. churches, multicultural, sports, leisure groups etc.) – provider, planner, advocate/influencer Local businesses – provider, planner, advocate/influencer

12 * denotes strategies from the City Plan. 13 At the time of writing, Knox Community Health Service was negotiating a possible merger with Eastern Access Community Health.

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How will we measure changes in mental health? Indicator/s Prevalence of Mental Health Issues Adolescent Mental Wellbeing

Measures/Sources Mental health-related public hospital emergency department presentations per 1000 population (DHS, VEMD, 2010) Proportion of adults with high/very high psychological distress level (Kessler 10 score 22 or higher) (VPHS, 2011-12) The proportion of adolescents enrolled in years 7, 9 and 11 with positive indicators of mental wellbeing. (Adolescent Health and Wellbeing Survey, 2009) -Perceived access to mental health services -High psychological distress -Report bullying Psychiatric hospitalisation rate for young people (per 1000 adolescents 10-17 years) admitted to hospital with principal diagnoses related to a mental & behavioural category (DHS, VAED, 2010)

Knox 5.8 12.2 69.6 13.9 46.2 7.8

Metro 6.5(Vic) 11.1(Vic) 70.4(Vic) 13.0(Vic) 44.6(Vic) 6.7(Vic)




1.1 Knox community benefits from good health and wellbeing at all life stages.

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Community health and wellbeing priority 8 – Lifestyle risks Desired outcome

People in Knox make healthy lifestyle choices.


26. *Improve health and wellbeing factors and mitigate lifestyle risks such as smoking, risky alcohol consumption and drug use, obesity, lack of physical activity and poor nutrition, through a range of services, support, infrastructure and partnerships.

Why is this a priority in Knox? While people in Knox generally experience high levels of personal health and wellbeing, a number of lifestyle risks remain prominent including smoking, poor nutrition, alcohol misuse and lack of physical activity. These issues must be addressed to achieve an optimum level of community health and wellbeing in Knox. While 42.7% of adults in Knox self-report that their health as ‘excellent’ or ‘very good’ (VPHS, 2011-12), a significant percentage participate in behaviour that poses health risks. For example, 17.6% of adults in Knox smoke, compared with 15.7% Victoria-wide and 55.5% of adults are overweight or obese in Knox, compared with 49.8% Victoria-wide. The proportion of adults not meeting physical activity guidelines (25.5%) is lower than the Victorian average (26.6%), which is a positive for Knox. What do we know about lifestyle risks? Lifestyle risks, such as smoking, poor nutrition, alcohol misuse and lack of adequate physical activity, can negatively affect the health and wellbeing of individuals, families, the community and the economy. Key determinants of lifestyle risks include access to affordable housing options, education levels, economic wellbeing, employment/local employment, work-life balance, quality built environments (for example, footpaths, roads, bike tracks, open spaces/parks, lighting and infrastructure etc.) that meet the broad range of community needs (including people with a disability, older people, families with small children and youth etc.), social norms, peer pressure and levels of involvement in the community. Community perceptions (what the community said):

· Knox has good access to open spaces, leisure and recreational opportunities, both passive and active · Male dominated activities are often featured in open spaces in Knox, not as much available for females · Substantial manufacturing industry in Knox correlates with higher incidence of smoking · Family patterns can influence behaviour – children learn from parents · Take-away and processed foods are cheap and highly accessible · People working outside of Knox can have long commute times and may lack time and energy to prepare meals · Alcohol is very accessible in Knox – there are many outlets, making alcohol highly available · Alcohol can be used as a ‘coping mechanism’

Who has a role to play in driving the key strategies? Lead partner/s Council – planner, provider, advocate/influencer, funder, regulator Knox Community Health Service15

– planner, provider, advocate/influencer

Support partners/allies Primary Care Partnership – planner, advocate/influencer Eastern Melbourne Medicare Locals – planner, advocate/influencer Women’s Health East – planner, advocate/influencer Leisure, arts, sporting clubs/organisations – planner, provider, advocate/influencer Schools and educators – planner, provider, advocate/influencer Not-for-profit community service organisations – planner, provider, advocate/influencer Police – regulator, planner, advocate/influencer

14 * denotes the strategies from the City Plan. 15 At the time of writing, Knox Community Health Service was negotiating a possible merger with Eastern Access Community Health.

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How will we measure changes in lifestyle risks? Indicator/s Self-reported health Prevalence of Health Risk Behaviour

Measures/Sources Adults self-reporting health as ‘excellent’ or ‘very good’ as % of adult population (VPHS, 2011-12) Adults that engage in key health risk behaviours (SNAP) as a % of adult population (VPHS, 2008) -current smokers -at risk of short term harm from alcohol consumption -overweight or obese -not meeting fruit & veg. dietary guidelines -not meeting physical activity guidelines % of young people engaged in risky alcohol use (Victorian Alcohol Statistics Series, 2010) – alcohol related hospitalisations – alcohol-related assaults

Knox 42.7 17.6 42.2 55.5 54.3 25.5 48.3 22.6

Metro 46.6(Vic) 15.7(Vic) 45.3(Vic) 49.8(Vic) 51.1(Vic) 26.6(Vic) 49.4(Vic) 31.1(Vic)




1.1 The Knox community benefits from good health and wellbeing at all life stages.

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3. How are we going to do it?

Council’s ongoing community health and wellbeing work Over the next four years Council will continue to embed health and wellbeing across its core business. Health and wellbeing outcomes are expressly defined in Knox’s Vision and the City Plan, the Council Plan, the associated strategies, action plans (public documents) or business plans (internal documents) and achieved through a wide range of programs and services across all four Council directorates comprising: Community Services; City Development; Engineering and Infrastructure; and Corporate Development. These programs and services support the achievement of the five City Plan aspirations influencing the social economic, built and natural environments. Council will achieve its health and wellbeing objectives for the community through a range of roles including:

· Partner/ally – developing trusting formal and informal relationships and alliances and working with others to achieve common goals;

· Provider – offering a range of services, support, infrastructure and facilities to individuals and groups;

· Planner – proactively planning for services and infrastructure, which respond to current and future needs and requirements;

· Advocate/influencer – raising awareness of State and Federal governments and other stakeholders of the issues and needs of Knox residents and businesses, as well as initiating or supporting campaigns for positive change; and

· Regulator – providing governance and regulatory controls such as local laws and health and building controls.

Examples of Council’s ongoing, core health and wellbeing business is outlined below. Directorate Examples of services

Impact on health and wellbeing

Community Services

Youth Leisure and Cultural services · Youth services · Library services · Arts and cultural opportunities · Community events and

festivals · Recreation and sporting

facilities · Open space planning

· Enhances liveability · Physically active and socially connected communities · Community learning, sharing, meeting and

engagement opportunities across age groups · Enhanced understanding of cultural diversity · Youth are engaged, active and participate in the

community · Facilities and open space support participation in

health-supporting activities · Accessible facilities for visual and performing arts · Educational opportunities are enhanced

Active Ageing services · Home care services · Meals on wheels · Senior citizens centres · Transport services

· Independent living opportunities and benefits for older people

· Provision of healthy living support programs and information that enhance health and wellbeing

· Families and primary carers are supported in their carer role

· Isolation and loneliness are addressed through accessible meeting spaces and social engagement opportunities

· Transportation is more accessible

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Family and Children’s services · Maternal and child health

services · Early Childhood Education

and Care Services

· Improved social, educational and physical outcomes through effective learning, development and social programs

· Universal primary health care services for families and babies via effective screening and early detection, immunisation and health and wellbeing advice and support

Community Wellbeing services · Community grants · Social and facility planning · Community safety · Cultural diversity · Disability access and inclusion · Health prevention · Access and equity · Community strengthening

· Safer communities · Fair and accessible access to services · Resources to support community development

projects · Celebration of diversity and inclusion across cultures · Greater awareness of the health impacts of smoking,

poor nutrition, alcohol and insufficient physical activity

· Culturally diverse groups better connected to the community

· Community needs are enhanced by the well planned services and facilities

City Development

City Safety and Health services · Local laws · Food and health premises

registration and inspections · Tobacco compliance with

legislation · Immunisation · Emergency management

· Infectious disease is controlled and prevented · Health protection via safe food and healthy premises · Reduced harm arising from tobacco · People are supported through emergency situations

City Planning · Planning approvals · Economic development · Sustainability and

environment planning · Strategic land use planning · Residential, commercial and

community planning · Place management

· Core community facilities available within local community

· Environmentally sustainable development · Stronger economy provides opportunities to prosper · Enhanced liveability · People have more employment opportunities which

contributes to financial stability · Vibrant and revitalised ‘places’ in Knox · More affordable and diverse housing options

provide the basis upon which people can access life opportunities

· Mix of lifestyle and local living opportunities · Pleasant streetscapes · More education and lifelong opportunities

Engineering and infrastructure

Community Infrastructure · Open space and landscape

design · Biodiversity · Waste management · Road services · Drainage · Park services · Hazard inspections · Traffic and transport · Asset management

· Positive environmental amenity and healthy natural environments

· Safe disposal of waste · Parks, tracks, playgrounds that offer health,

community ‘play’ and relaxation opportunities · Public safety through safe and effective pedestrian,

cycling and road networks and public buildings · Opportunities to access a range of transport options

and increase physical activity · Community health and wellbeing assets are well

managed and maintained

Corporate Development

Corporate Support services · Community information and

support · Council property management · Governance and democratic

support

· People are better informed through a range of information methods (including website, telephone, counter services etc.)

· Customers can access Council services quickly and efficiently

· Council processes, meetings and advisory committees encourage participation

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Working together with allies and partners The Strategy has a municipal-wide focus on health and wellbeing. Accordingly, it seeks to identify ways to continue to build on our strengths and mitigate our weaknesses across Knox. This is a vast and complex task, given the breadth of factors and influences that impact upon individual and community health and wellbeing. There is no doubt that Council has a major role in advancing health and wellbeing in Knox, but it cannot do this on its own. Council’s major roles are as a provider, planner, advocate/influencer, partner/ally and regulator. These roles are not boundless, however, as Council must strategically consider where it should focus its attention and expend its finite resources to achieve the best possible outcomes for the Knox community. There are many individuals, groups, organisations and businesses that can help to enhance community health and

wellbeing in Knox through formal or informal roles. Council recognises the important contribution that these players can make to health and wellbeing in terms of their knowledge, expertise, practical experience, influence, community connections and networks. Some of these players have similar roles to Council, others have vastly different roles, but more often than not these roles are complementary. Accordingly, Council is keen to work with its allies and population health partners, in a lead or support role, to achieve positive health and wellbeing for all people who live and work in Knox.

Allies Council has a broad range of alliances with individuals, community groups, businesses, educational institutions and government representatives to enable strong community health and wellbeing in Knox. Allies that contribute to addressing the identified health and wellbeing priorities are identified below.

Council roles

•lead •support

Allies roles

•lead •support

Partner roles

•lead •support

Community Health and Wellbeing Strategy

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Population health partners There are a number of organisations that hold a primary role in supporting population-wide health and wellbeing approaches and programs in Knox. These organisations are committed to a partnership approach which integrates planning, implementation and evaluation to enhance community health and wellbeing outcomes in Knox over the next four years. These partners are identified below.

Note: Healthy Together Knox is a partnership between Knox City Council and Knox Community Health Service to improve people’s health in selected communities by addressing the underlying causes of chronic preventable disease.

The Knox Community Health and Wellbeing Reference Group brings together the population health partners, key service provider allies, Councillors and council officers to support health and wellbeing in Knox and advise Council. The Reference Group has worked closely with Council to develop the Strategy and will continue to pursue opportunities to build partnerships and alliances with a range of relevant stakeholders over the life of the Strategy.

Details of the roles and priorities of the population health partners are presented in the section entitled What’s behind this Strategy?

Health and Wellbeing Reference

Group

Knox City Council

(Healthy Together Knox partner)

Knox Community

Health Service (Healthy Together

Knox partner)

Outer East Primary Care Partnership

Eastern Metropolitan

Medicare Local

Department of Health Eastern

Metropolitan Region

Women's Health East

Knox residents Council services

Community and not-for-profit organisations

Arts, leisure, recreation, environmental, housing,

neighbourhood houses, legal etc

Community health service providers

Hospitals, other health services and local

doctors

Gender and age specific organisations

Educational institutions ,

preschool, primary, secondary and tertiary

Local businesses

Multicultural organisations

Churches and faith groups

State and federal government departments

Libraries

Indigenous organisations Neighbouring Councils Police and emergency

services Others

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Council’s implementation role

Supporting alliances and partnerships Well-targeted alliances and partnerships will help to drive the success of the Strategy. Internal and external alliances and partnerships can be enhanced through a common understanding of issues and priorities, as well a commitment to integrated health and wellbeing planning, implementation and evaluation. Council will play a key role in supporting partnership arrangements to plan, design and implement actions relevant to the eight community health and wellbeing priorities and their related key strategies. This approach is consistent with the City Plan which has a strong focus on achieving the City Plan objectives through partnerships within the community.

Supporting the implementation of the Strategy The success of the Strategy as a tactical guide to enable health and wellbeing in Knox hinges upon a program to raise internal and external stakeholders’ awareness of the Strategy and to identify the most effective way to implement the specific strategies on priority health and wellbeing issues over the coming four years as well as implementing actions which improve overall population health and wellbeing in general. This program will aim to assist stakeholders to understand how to

use the Strategy, and to develop more specific action and business plans that will address the health and wellbeing priorities and embed health and wellbeing outcomes across the municipality. Council will coordinate a process to identify actions for each priority area strategy. Some of these actions will be led by our partners, others will be led by Council.

Enhancing evaluation through better integrated reporting systems As the Strategy focuses upon evaluation methods to inform a continuous cycle of learning and improvement and measure changes in health and wellbeing status across Knox, Council will continue to undertake monitoring and evaluation of the Strategy, as well as promoting evaluation and skill development in Council and with partners. The roll-out of an integrated reporting system across Council will help to build knowledge of Council’s extensive range of health and wellbeing services and provide information to appraise their impact on target groups and the community. Linking-up organisations that have already developed effective evaluation methods and skills with organisations seeking to learn from these experiences will also help to strengthen a culture of evaluation in Knox.

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Implement

Evaluate

Reflect

Plan

4. How will we know if we have made a difference?

Review and evaluation Evaluating strategic outcomes can be challenging as it is often difficult to accurately attribute a particular strategy, action, program or approach with an identified change on the ground or in the community. This challenge can be managed by adopting a range of evaluation methods to corroborate findings. The evaluation of the Strategy will include two major evaluation approaches including:

· formative evaluation – which focuses on ‘processes’ to determine how things are done and how they could be done better; and

· summative evaluation – which investigates ‘outcomes’ by seeking to determine the results of activities.

Process, impact and outcome evaluation will feature in the evaluation methods, as well as quantitative and qualitative techniques to enhance the quality and reliability of the findings. Baseline data has been collected to describe the current status of health and wellbeing in Knox, against which it will be possible to monitor any improvement to or diminution of health and wellbeing over-time. This baseline data will form a part of the State of Knox report which will be used to monitor and assess changes related to the City Plan, the Strategy and other key strategic action plans for the City. The evaluation findings will also inform a continuous cycle of learning and improvement for Council and partner organisations.

Evaluation methods A number of methods have been identified to evaluate the Strategy.

Annual review

A review of the Strategy will be undertaken on an annual basis to appraise the progress of the Strategy and check for ongoing relevance to the Council and the community. The Knox Community Health and Wellbeing Reference Group and key Council staff will drive this review process.

Evaluation of key strategies and actions

Key Strategies The key strategies will be monitored and reviewed on an annual basis by Council and the partners responsible for leading these strategies across the municipality over the next four years. This process will also focus on the identified actions for each key

strategy.

Council’s action Council’s action is informed and directed by the City Plan, the Council Plan and the Strategy. Council has a lead role in seven of the eight community health and wellbeing priorities and their related key strategies. Where Council has a lead role, the actions for these Council-led strategies will be incorporated into Council’s business planning process. Specific sections of Council will have responsibility for implementing and contributing to the evaluation of actions relevant to their areas of responsibility. Action and business plans will be implemented and progress monitored by the relevant Council business

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units and, ultimately, by Council. Each plan will be evaluated to determine whether the identified outputs and outcomes have been achieved and to assess the effectiveness of the approach taken. This evaluation will be used to inform the development of new action and business plans and any revision to the key strategies which may be required over time. Evaluations will generally involve the collection and analysis of quantitative data, as well as qualitative data, such as feedback from community agencies, service users or other stakeholders. Process evaluation, which focuses upon the strengths and weaknesses of the process and how things can be done better in the future, will be included. Where possible, impact evaluation will also be undertaken to assess health and wellbeing changes attributable to the implementation of actions. Overall this implementation, monitoring and evaluation process will be integrated with Council’s broader leadership and coordination of the City Plan to ensure there is a well coordinated and holistic approach to addressing the key health and wellbeing priorities in the community

Quantitative evaluation of the status of community health and wellbeing in Knox

The evaluation of the status of community health and wellbeing in Knox will involve measuring the change in health and wellbeing data between two points in time. Accordingly, quantitative data will be collected at the end of the four-year period of the Strategy and compared with the baseline data collected at the commencement of the Strategy. This will measure changes in the status of community health and wellbeing over the life of the Strategy.

Community health and wellbeing indicators Two suites of community health and wellbeing indicators have been developed to help monitor population health changes in Knox. One is focused on the eight community health and wellbeing priorities (Personal health and wellbeing, Community

connectedness, Leisure, recreation/arts and cultural activities, Housing affordability and choice, Family violence, Lifelong learning, Mental health and Lifestyle risks) and the other has a more general focus across the City Plan themes (Healthy and connected community, Prosperous, advancing economy, Vibrant and sustainable built and natural environments, Culturally rich and active communities and Democratic and engaged communities). The indicators have primarily been drawn from the Community Indicators Victoria framework16

16 In 2006 Community Indicators Victoria established an agreed framework and sustainable process for the development and use of community wellbeing indicators at the local government level across Victoria.

to help focus upon the top-priority areas and issues for Council and the community. Council will report against the indicators at the end of the life of the Strategy using the descriptors: Stable; Improved; and In decline. Refer to the Knox Wellbeing Report 2013-17 at attachment 1. The State of Knox report, which is an integrated monitoring report for the City Plan, will also be utilised to track health and wellbeing outcomes in Knox.

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strategy

Alignment with City

Vision and Plan

Utilisation of identified

frameworks, approaches and lenses

Review of relevant Council

research and engagement

Review of influencing policies and legislation

Stakeholder engagement

Analysis of robust

statistical evidence

5. What’s behind this Strategy?

Methodology A comprehensive methodology comprising six components was utilised to develop the Strategy. The Strategy aligns with Knox’s Vision and the City Plan and adopts the same themes and strategic objectives. The City Plan and the Strategy strongly draw upon the Community Indicators Victoria framework17

, with modifications in accordance with Knox’s issues and needs.

The Strategy has also utilised the Results Based Accountability approach and relevant planning lenses. Quantitative and qualitative evidence has been analysed from a broad range of sources, including findings from recent relevant Council research and engagement activity (such as the Knox @ 50 project and the redevelopment of actions plans), surveys, Census and Community Indicators Victoria etc. A review of local, state, federal and international health and wellbeing policies, approaches and legislation has been undertaken to align where possible or fill gaps. Finally, but most importantly, stakeholders views of health and wellbeing in Knox have been considered. This has included reflection upon feedback from over 7,600 participants of the Knox @ 50 project, surveys of Knox residents and targeted stakeholders’ views of key strategies that respond to the health and wellbeing strengths and weaknesses in Knox. The six components of the methodology are discussed in more detail below.

17 In 2006 Community Indicators Victoria established an agreed framework and sustainable process for the development and use of community wellbeing indicators at the local government level across Victoria.

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Alignment with Knox’s Vision and the City Plan Council has a hierarchical planning approach to ensure that all policies and plans are informed by higher-order decisions and directions. The Health and Wellbeing Strategy is one of Council’s strategic implementation plans and, accordingly, aligns with Knox’s Vision and the City Plan themes and objectives. Similarly, annual and business planning will be expected to take account of this Strategy and other higher-order plans. A summary of Council’s planning hierarchy is below.

Frameworks, approaches and lenses utilised in the Strategy Council has utilised the Community Indicators Victoria (CIV) framework and Results Based Accountability (RBA) planning approach to develop the Strategy.

A risks and benefits analysis of these approaches was undertaken in 2011 to test their suitability for the Strategy. The research showed that there was strong alignment between the approaches and the benefits of adopting the CIV and RBA frameworks significantly outweighed any identified risks. Council has modified the CIV framework, including the domains (or themes), policy areas and indicators, to better reflect Knox’s issues and needs.

Community Indicators Victoria framework The CIV framework comprises five domains (or themes) with narratives, as well as policy areas and indicators. The CIV approach was developed through rigorous academic research and broad stakeholder input (including Council staff) and highly recommended in recent research (Olesson et al 2012). The framework is being utilised by a range of Councils in Victoria and NSW and is being piloted in Queensland. Council also referred to it in its State of Knox and Knox@50 projects. Additionally, the majority of the data linked to the indicators is available on the CIV website, which simplifies population health monitoring and reporting.

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Results Based Accountability (RBA) approach RBA strongly aligns with CIV and its indicators. It is a disciplined way of thinking and taking action to improve the lives of children, families and the community. RBA adopts a step-by-step approach to population and performance planning and accountability. It starts with ‘the results we want for our community’ and also addresses:

· Population accountability – the wellbeing of whole populations – communities, cities, countries, states and nations; and

· Performance accountability – the wellbeing of client populations –programs, agencies and service systems.

The RBA approach was particularly utilised in the community engagement component of the Strategy’s development.

Health and wellbeing planning lenses Improvements to health and wellbeing can only be achieved by addressing the many social, cultural, environmental, biological, political and economic determinants that operate within the built/physical, social, economic and natural environments. The Social Determinants of Health and the Environments for Health frameworks provide conceptual frameworks for thinking about and addressing health and wellbeing issues. The components of these planning lenses have influenced the Strategy’s framework and provide a rigorous method for analysing health and wellbeing issues and developing solutions. Social Determinants of Health – Dahlgren and Whitehead (1991) developed the Social Determinants of Health Rainbow, which has been widely utilised by the World Health Organisation to explain the processes and elements that contribute to the health of populations. In particular, the Rainbow shows the layers and interconnectedness of the various sociological, environmental and health-related factors that influence health and perceptions of wellbeing. These factors are based around: • Healthy living conditions (including access to food, water and sanitation); • Education, literacy and health literacy; • Stress; • Early life; • Social exclusion;

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Built/physical Social

Economic Natural

• Employment and unemployment; • Age, sex and heredity factors; • Culture, racism and discrimination; • Access to information and appropriate health care; and • Social supports and access to transport. Environments for Health – The Victorian Government’s Environments for Health Framework (2001) seeks to address health and wellbeing across the built, social, economic and natural environments. These four key dimensions of community health planning are identified in the diagram. The environments for health are embedded in Council’s planning framework through the utilisation of five City Plan themes:

1. Healthy and connected communities (social, built/physical);

2. Prosperous, advancing economy (economic);

3. Vibrant and sustainable built and natural environment (built/physical, natural);

4. Culturally rich and active communities (social, built/physical); and

5. Democratic and engaged communities (social). The City Plan themes are interlinked and work to ensure that all environments for health are considered in the planning process.

Statistical evidence A community health and wellbeing profile was developed from a suite of over 100 reliable data sources (for example, Community Indicators Victoria and the Australian Bureau of Statistics etc.). This comprehensive evidence base informed the formulation of the community health and wellbeing priorities and key strategies. The themes arising from the data analysis include:

· Strengths: issues and areas in which Knox is doing well that Council wishes to maintain and build upon –

o Personal health and wellbeing; o Community connectedness; o Leisure, recreation/arts and cultural activities.

· Weaknesses: areas where extra effort needs to be made to reverse negative trends – o Housing affordability and choice; o Family violence; o Lifelong learning; o Mental health; and o Lifestyle risks (smoking, nutrition, alcohol and physical exercise).

Refer to the Knox Wellbeing Report 2013-17 at attachment 1.

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Review of relevant Council research and engagement Findings from recent community research and engagement undertaken by Council have informed the Strategy.

Knox @ 50 The Knox @ 50 project was undertaken in 2012 to engage the community in conversations about their aspirations for the future of Knox. The focus of the engagement was to: raise awareness of the drivers of change facing Knox to 2030; engage with a broad and diverse range of people; and stimulate dialogue and debate to inform Knox’s Vision and the development of policy options. A wide range of issues were raised by participants including: housing; servicing an ageing population; living locally; diversity and local identity; health and wellbeing; community connections, involvement and participation; transport; productive economic places and local employment; and resource use/natural resources. Two surveys conducted in December 2012, as part of the Knox @ 50 project, confirm that Knox residents have very positive perceptions of their health and wellbeing. The online and telephone surveys involving almost 700 people revealed that a large majority of participants felt that they had a high or very high quality of life overall (telephone 88%, online 77%), with high rankings also noted in response to questions about feeling part of the community, standards of living, general health and personal safety.

Other Council plans and policies The review and development of a number of Council’s plans including, the Knox Community Safety Plan, Knox Gathering, Multicultural Strategic Plan 2012-17, Knox Liveable Streets Plan 2012-22, Knox Open Space Plan 2011-22, Knox Youth Plan, Municipal Early Years Plan 2011-15 and Knox Arts and Cultural Plan, have also identified a range of issues pertinent to the Strategy. For example, concerns about young people, family violence and alcohol and drug addictions were some of the matters raised during the redevelopment of the Knox Community Safety Plan.

Annual reviews of the previous Strategy Finally, the annual reviews of the previous Strategy (2009-13) have shown that health and wellbeing practitioners and organisations find the Knox Community Health and Wellbeing Strategy useful and they utilise the data, priorities and key strategies for action and business planning.

Review of influencing policies and legislation There are a broad range of policies that have been considered in the development of the Strategy. Where possible, alignment to key local, state, federal and international policies contribute to an integrated planning approach to enhance health and wellbeing through collaboration, shared data and priorities, coordinated roles and functions and efficient use of resources. Key policies and legislation are presented below. A broader list of policies, legislation and resources is provided in the References and resources section.

Local level – Population Health Partners There are a number of organisations that have a primary role in the provision of population-wide health and wellbeing programs in Knox. These organisations are committed to a partnership approach which integrates planning, implementation and evaluation to enhance community health and wellbeing outcomes in Knox. These partners are identified below.

Knox City Council Knox City Council is a major contributor to strong community health and wellbeing in Knox through its role as provider, planner, advocate/influencer, partner/ally and regulator. Community health and wellbeing outcomes are expressly defined in Knox’s Vision and the City Plan, strategies, action plans (public documents) or business plans (internal documents) and achieved through a wide range of programs and services across all four Council directorates.

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Knox Community Health Service Knox Community Health Service (KCHS)18

was established in 1996 to provide community care and health education programs in Knox, which includes a range of services that improve the physical, mental and social wellbeing of individuals, families and communities. The Service has developed a Health Promotion Plan which complements this Strategy.

KCHS’s priorities for 2013-17 are: · Prevention of violence against

women; · Smoking, nutrition, alcohol and

physical activity; · Chronic disease; · Childhood development · Eating disorders; · Oral health; · Co-occurring mental health; and · Substance abuse issues.

Healthy Together Knox Healthy Together Knox is a collaborative partnership between the Victorian State Government’s Department of Health (DOH), Knox City Council and Knox Community Health Service (KCHS) which aligns the health promotion and strategic planning expertise of the two organisations to link with the development and implementation of the Healthy Together initiative and Community Health and Wellbeing Strategy.

Healthy Together Knox is strengthened by a robust governance model, an agreed memorandum of understanding and regular management meetings between Council and KCHS and DOH to coordinate local preventive health efforts. It builds upon an existing and very active partnership between KCHS and Council which has seen the two organisations working collaboratively on food access, social inclusion, violence against women, alcohol, young people, and the Knox Innovative Sexual Health Strategy.

18 At the time of writing, Knox Community Health Service was negotiating a possible merger with Eastern Access Community Health.

Healthy Together Victoria is funded by the Victorian Government to improve people’s health in selected communities by addressing the underlying causes of chronic preventable disease. It aims to improve people’s health where they live, learn, work and play and focuses on smoking, nutrition, alcohol use and physical activity. Healthy Together Victoria recognises that local governments, not only have a legislated responsibility for the health and wellbeing of their community, but are also ideally placed to influence many determinants of health, including transport, land use planning, recreation and culture. Knox is one of fourteen municipalities that are funded to implement the Healthy Together initiative.

The Healthy Together Knox priorities include:

· Smoking; · Nutrition; · Alcohol; and · Physical activity.

The program will also assist Council to become a ‘health promoting organisation’ and embed physical activity across the municipality through VicHealth’s ‘Be Active’ program.

Outer East Primary Care Partnership (OEPCP) Thirty-two Primary Care Partnerships operate in Victoria through the establishment of voluntary alliances with over 800 service providers. The partnerships seek to address any fragmentation of primary health service delivery, establish systems to improve health and wellbeing outcomes and improve service coordination and integrated health promotion (DoH, 2009).

Knox City Council is a member of the Outer East Health and Community Support Alliance (the Alliance), which is a voluntary alliance of agencies from the municipalities of Knox, Maroondah and Yarra Ranges that guide the OEPCP. The Alliance is committed to collaborative thinking, planning and action which improve the experiences and

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outcomes of people who access the primary care system. It is currently developing a Community Health Plan for the Outer East region. The OEPCP’s health promotion priorities are:

· Access to nutritious food and healthy eating; and

· Mental health, particularly prevention of violence against women.

Eastern Melbourne Medicare Local (EMML) Medicare Locals is a national network of primary health care organisations. The establishment of Medicare Locals seeks to build upon the strength of the Divisions of General Practices Network, provide a broader range of health care activities and streamline services. Each Medicare Local is an independent legal entity that is responsible for assisting patients and service providers to navigate their way through the health care system, encourage integration between primary health care, aged care sectors and hospitals and improve relationships within the primary health care system. The objectives of the Eastern Melbourne Medicare Local are to: develop and implement population-based approaches to health; support new models of service delivery; streamline the system through multi-sectorial engagement (public/private); build clinical excellence; strengthen the primary care sector across EMML area; and build consumer driven service models. Its priorities for 2013-17 are:

· Early childhood development; · Healthy ageing; · Mental health; · Health literacy; and · Chronic disease.

Department of Health Eastern Metropolitan Region Knox City Council will work closely with the Victorian Department of Health to address health and wellbeing in Knox. Council values the participation of an officer from the Eastern Metropolitan Regional Office in the Knox Community Health and Wellbeing

Reference Group who provides regular updates on Victorian Government policy, as well as other information and advice. The Local Government Health Planners Regional Meeting, hosted by the Department of Health and held on a quarterly basis, also provides opportunities to share information and plan in partnership.

Women’s Health East Women’s Health East is a regional women’s health promotion agency working across the Eastern Metropolitan Region of Melbourne to improve the health and wellbeing of girls and women. Key health promotion objectives include:

· Working in partnership with other health and community agencies to promote gender-based planning in health promotion and service delivery, and to improve service system access and responsiveness for women;

· Training and education programs for service providers on women's health issues and gender awareness in planning and service deliver;

· Research into women's health needs; · Advocacy and consultancy within the

health and community sector to promote women's health and wellbeing;

· Raising awareness of health and wellbeing issues experienced by women; and

· Partnerships with service providers and establishing networks to improve services for women.

Its priorities for 2013-17 include:

· Gender equity for health outcomes in –

o Health literacy; o Financial literacy; o Social inclusion in a digital

age; o Climate change; and o The implementation of the

prevention of violence

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against women regional strategy19

State level – Victorian Government

.

Victorian Public Health and Wellbeing Plan 2011-15 The Victorian Public Health and Wellbeing Plan 2011-15 (Victorian Department of Health, 2011) was released by the State Government in September 2011. It sets out the public health priorities for Victoria and seeks to: Improve the health and wellbeing of all Victorians by engaging communities in prevention and by strengthening systems for health protection, health promotion and preventative e-healthcare across all sectors and levels of government. The strategic directions include:

· Build prevention infrastructure to support evidence-based policy and practice;

· Develop leadership and strengthen partnerships to maximise prevention efforts across sectors;

· Review financing and priority-setting mechanisms to ensure available resources are based on population need and potential for impact;

· Develop effective modes of engagement and delivery of evidence-based interventions in key settings;

· Strengthen local government capacity to develop and implement public health and wellbeing plans;

· Improve health service capacity to promote health and wellbeing;

· Integrate statewide policy and planning to strengthen public health and wellbeing interventions;

· Increase the health literacy of all Victorians and support people to better manage their own health; and

· Tailor interventions for priority populations to reduce disparities in health outcomes.

Interventions include:

19 This strategy is entitled Together for Equality and Respect – A Strategy to Prevent Violence Against Women in Melbourne’s East 2013-17.

· Continue to protect the health of Victorians – communicable disease prevention and control, immunisation, environmental health, food safety, and incident and emergency response;

· Keep people well – healthy eating, physical activity, tobacco control, oral health, alcohol and other drug use, sexual and reproductive health promotion, mental health promotion, injury prevention, and skin cancer prevention;

· Strengthen prevention healthcare – cancer screening, newborn screening, and early intervention.

Victorian Health Plan – Victorian Health Priorities Framework 2012-2022: Metropolitan Health Plan The Victorian Health Plan identifies the Victorian Government's commitment to delivering the best healthcare outcomes possible and ensuring people are as healthy as they can be.

The foundation of the Victorian Health Plan is the Victorian Health Priorities Framework 2012–2022 (Victorian Department of Health, 2011). The purpose of the framework is to present an agenda for the future of the Victorian health system. It provides principles to guide decision making and prioritisation of innovation, investment and actions. The framework is the basis for three supporting plans: the Metropolitan Health Plan; the Rural and Regional Health Plan; and the Health Capital and Resources Plan.

The Victorian Health Priorities Framework 2012-2022: Metropolitan Health Plan sets out seven priority areas for the development and operation of the Victorian health system for the future:

· Developing a system that is responsive to people’s needs;

· Improving every Victorian’s health status and experiences;

· Expanding service, workforce and

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system capacity;

· Increasing the system’s financial sustainability and productivity;

· Implementing continuous improvements and innovation;

· Increasing accountability and transparency;

· Utilising e-health and communications technology.

It also proposes planning and development priorities for metropolitan health services:

· To deliver a system that is responsive to people’s needs;

· To improve every Victorian’s health status and health experiences;

· To expand service, workforce and system capacity;

· To increase the system’s financial sustainability and productivity;

· To implement continuous improvements and innovation;

· To increase accountability and transparency;

· To improve utilisation of e-health and communications technology.

VicHealth – Strategy and Business Plan 2009-13 A key strategic priority of VicHealth's Strategy and Business Plan 2009-2013 is to reduce health inequalities. In particular, the Plan focuses on increasing participation in physical, social and economic environments, and the role they play in relation to priority health issues. Major health challenges are identified as including:

· Tobacco consumption;

· Overweight and obesity;

· Physical inactivity;

· Social exclusion;

· Discrimination;

· Violence;

· Alcohol misuse;

· The links between social and

economic disadvantage and poorer health;

· UV protection.

Charter of Human Rights and Responsibilities Act 2006 The Charter of Human Rights and Responsibilities is a Victorian law that sets out the basic rights, freedoms and responsibilities of all people in Victoria. It aims to build a fairer, more inclusive community by requiring that the Victorian Government, local councils and other public authorities to consider human rights when they make laws, develop policies and provide services. The Charter gives legal protection to 20 fundamental human rights:

· Recognition and equality before the law;

· Right to life;

· Protection from torture and cruel, inhuman or degrading treatment;

· Freedom from forced work;

· Freedom of movement;

· Privacy and reputation;

· Freedom of thought, conscience, religion and belief;

· Freedom of expression;

· Peaceful assembly and freedom of association;

· Protection of families and children;

· Taking part in public life;

· Cultural rights;

· Property rights;

· Right to liberty and security of person;

· Right to humane treatment when deprived of liberty;

· Rights of children in the criminal process;

· Right to a fair hearing;

· Rights in criminal proceedings;

· Right not to be tried or punished more than once;

http://www.victorianhumanrightscommission.com/www/index.php?option=com_k2&view=item&layout=item&id=905&Itemid=520�

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· Retrospective criminal laws.

Climate Change Act 2010 Section 14 of the Climate Change Act 2010 requires local government to ‘have regard to’ climate change in Municipal Public Health and Wellbeing Plans. Having Regard to Climate Change (DoH, 2012) directs Councils to consider the health and wellbeing impacts of climate change (such as, higher temperatures, heatwaves, bushfires, long-term drought or decreased average rainfall, flood and heavy rainfall events and extreme weather events) and the vulnerable groups affected by these types of events (including, children, older people, people with illnesses, obese and overweight people, outdoor workers, low-income householders, emergency workers, rural and coastal communities).

Federal level – Australian Government

National Health Reform Agreement In August 2011 the Council of Australian Governments (COAG) agreed on the National Health Reform Agreement to deliver major reforms to the organisation, funding and delivery of health and aged care. The Agreement sets out the shared intention of the Commonwealth, State and Territory governments to work in partnership to improve health outcomes for all Australians and ensure the sustainability of the Australian health system.

The reforms are designed to achieve better access to services, improved local accountability and transparency, greater responsiveness to local communities and provide a stronger financial basis for our health system into the future through increased Commonwealth funding.

The Agreement provided, amongst other things, an extra $16.4 billion (to 2019-20) for public hospitals and the establishment of Medicare Locals to promote coordinated GP and primary health care service delivery.

Australian National Preventive Health Agency The Australian National Preventive Health Agency (ANPHA) was established in January 2011 following the commencement of the

Australian National Prevention Health Agency Act 2010. In partnership with the Commonwealth and the state and territory governments, ANPHA seeks to improve health outcome for Australians by driving the national capacity for change and innovation around preventive health policies and programs. ANPHA’s establishment was a key recommendation of the National Health and Hospitals Reform Commission and the National Preventive Health Taskforce to strengthen Australia’s investment in preventive health and to mitigate the increasing prevalence of preventable chronic diseases. ANPHA supports the development and implementation of evidence-based approaches to preventive health initiatives targeting obesity, harmful alcohol consumption and tobacco. The projects and campaigns currently being undertaken by ANPHA include:

· The National Tobacco Campaign;

· The Measure Up - Swap it, Don’t Stop it obesity prevention campaign; and

· The roll-out of the National Binge Drinking Strategy expansion measures.

International level – World Health Organization

World Health Organisation (WHO) The World Health Organisation (WHO) was established as an agency of the United Nations in 1948 and operates as a coordinating authority on international public health. It broadly defines wellbeing as:

... the state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity. The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief or economic and social conditions

http://www.who.int/healthpromotion/en/�

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(2008).

It also identifies the major functions of governments as:

...to promote, in cooperation with specialised agencies where necessary, the improvement of nutrition, housing sanitation, recreation, economic or working conditions and other aspects of environmental hygiene (2009).

Stakeholder engagement The community engagement for the Strategy builds upon extensive community engagement conducted by Council in 2012 for the Knox @ 50 project and the development of action plans and policies, with the explicit intention of avoiding consultation fatigue.

Collaboration with internal and external stakeholders The Strategy was developed through internal and external stakeholder collaboration. The Community Health and Wellbeing Reference Group was a major

contributor to the Strategy. The Reference Group comprises population health partners, key service provider allies (that work to address the identified health and wellbeing priorities), Councillors and Council officers who support health and wellbeing in Knox. The Reference Group has met on a bi-monthly basis and worked closely with Council officers to develop the Strategy and advise Council. Also, regular meetings with population health partners, allies and key stakeholders have informed the development of the Strategy, as well as input from Councillors and Council representatives.

Targeted community engagement to refine key strategies Community engagement sessions were held in June 2013 with key stakeholders, comprising Councillors, Council managers and officers, population health partners and health and wellbeing allies, to test and analyse findings and develop key strategies for the municipality.

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6. References and attachments

References

Australian National Preventive Health Agency, www.anpha.gov.au, accessed 2012 Council of Australian Governments, National Health Reform Agreement, August 2011

Dahlgren G and Whitehead M (1991) Policies and strategies to promote social equity in health, Stockholm: Institute for Future Studies

Knox City Council, – Knox Vision: Our City, Our Future – Knox City Plan 2013-17 – City Plan Major Issues Paper, February 2013 – Knox @ 50 Final Report, March 2013

Medicare Locals, www.medicarelocal.com.au, accessed 2012 Olesson, E., Albert, E., Coroneos, R., Leeson, R., and Wyatt, R. (2012) Options for a local government framework for measuring liveability, Australian Centre of Excellence for Local Government, University of Technology, Sydney. Victorian Department of Health, – Municipal public health and wellbeing planning, Having regard to climate change, December 2012 – Victorian Health Priorities Framework 2012–2022, May 2011 – Victorian Public Health and Wellbeing Plan 2011-15, 2011 – Environments for Health – Promoting health and wellbeing through built, social, Economic and natural environments, 2001 World Health Organization, –Social determinants of health, www.who.int/en/, accessed 2012 –Closing the gap in a generation – Health equity through action on the social determinants of health, 2008, www.who.int/en/, accessed 2012

http://www.anpha.gov.au/�

http://www.medicarelocal.com.au/�

http://www.who.int/en/�

http://www.who.int/en/�

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Attachment 1 – Knox Wellbeing Report 2013

Knox Wellbeing Report 2013 The Knox Wellbeing Report 2013 provides the most up-to-date information on community health and wellbeing available in 2013 and comprises two parts as follows.

· The Knox Wellbeing Report 2013 – City Plan themes sets out the key policy areas, indicators, measures and baseline data in accordance with the City Plan themes.

This permanent suite of data and indicators will remain the same from strategy to strategy and will be utilised to monitor the ongoing changes in community health and wellbeing in Knox over time.

· The Knox Wellbeing Report 2013 – Community health and wellbeing priorities sets out the key policy areas, indicators, measures and baseline data in accordance with the eight community health and wellbeing priorities for the 2013-17 period.

This suite of data and indicators will be utilised to monitor changes in the community health and wellbeing priority areas for the 2013-17 period and will vary from strategy to strategy in accordance with the changing needs and priorities in Knox.

Knox Wellbeing Report 2013 Comparison Symbols

↑ better than the Melbourne metropolitan average

↓ lower than the Melbourne metropolitan average

_ similar to the Melbourne metropolitan average

Refer to Pages 47 to 56.

Page 47

Knox Wellbeing Report 2013 – City Plan themes Healthy, Connected Communities The future Knox is:

- An active, vibrant, resilient and sustainable community. It has the support it needs to be strong and is motivated to shape its own future.

- A community where each member enjoys good health, both physically and mentally, feels safe, is connected to others and has access to excellent health and leisure facilities and services.

- A place that nurtures its children and young people, and values and supports its older adults. The community embraces learning for all ages, is engaged in meaningful work – be it paid or unpaid – and values the efforts of its volunteers.

Baseline data

How do we compare to Melbourne Metro Average?

Policy area Indicator Measures/Sources Knox Metro

Personal health & wellbeing

Self-reported health Subjective wellbeing

Adults reporting health as excellent or very good as % of adult population (VPHS, 2011-12) Personal Wellbeing Index Score (0-100), (VicHealth Survey,2011)20

42.7 77.1

46.6 (Vic) 76.9

↓

_

Mental health Prevalence of mental health issues

Mental health-related public hospital emergency department presentations per 1000 population (DHS, VEMD, 2010)

5.8 6.5 (Vic) ↑

Community connectedness

Feeling part of the community Social support Volunteering

Satisfaction with feeling part of the community (VicHealth Survey,2011) People who can get help from family, friends or neighbours when needed (VPHS, 2008) People who help out as volunteers (VPHS, 2008)

70.8 89.6 33.5

70.9 91.0 28.0

_

_

↑

Early childhood Child health assessments

Participation rate per 100 MC&CH enrolled children in the 3.5 year visit (Office for Children data, 2011)

76.3 64.5 ↑

Youth Adolescent health & life satisfaction

Adolescents that describe themselves as having good health (Adolescent Health and Wellbeing Survey, 2009) Adolescents that are satisfied with their quality of life (Adolescent Health and Wellbeing Survey, 2009)

85.7 74.5

89.2(Vic) 77.1 (Vic)

↓ ↓

Active ageing Perception of health & wellbeing-seniors

Personal Wellbeing Index Score (0-100), population aged 55+ years (VicHealth Survey, 2011)21

77.5

77.0 _

Personal and community safety

Perceptions of safety Crime

Adults that feel safe when walking alone in their local area during the day (VicHealth Survey, 2011) Adults that feel safe when walking alone in their local area at night (VicHealth Survey, 2011) Recorded offences ‘against the person’ per 100,000 population (Victoria Police, 2013) Recorded offences ‘against property’ per 100,000 population (Victoria Police, 2013)

98.0 62.4 779 3969

98.4 68.4 953 4784

_

↓ ↑ ↑

20 The Index is based on the average of seven aspects of wellbeing –standard of living, health, achievements in life, community connection, personal relationships and future security 21 As above

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Lifelong learning Home internet use Destination of school leavers

Adults with home internet access (ABS,2011) Adults with broadband access at home (ABS,2011) People aged 15-19 years (not at secondary school) that are fully engaged in work or study at a non-school institution (ABS,2006) People aged 15-19 years (not at secondary school) that are not engaged at all in work or study (ABS, 2006)

90.8 86.3 74.9 12.0

87.9 82.1 75.1 13.7

↑

↑

_

↑

Prosperous, Advancing Economy The future Knox is:

- A city where innovation and creativity are valued, and local economies thrive, recognising that work is vital for community wellbeing. Whether inside or outside the home, work makes a valuable contribution to our individual wellbeing and the economy.

- Where local employment is highly desired and encouraged as it minimises the personal and environmental costs of travel. Because people work locally they are embedded in the local community and are more inclined to contribute to the social life of the community.

- Where businesses benefit from strong collaborative networks and increased skills and capabilities created locally, and Knox is well regarded as a business and investment destination. Knox businesses are also well recognised as being leaders in corporate social responsibility and because of this Knox is a place of choice for business and talent.

Baseline

data

How do we compare?

Policy area Indicator Measures/Sources Knox Metro Economic activity

Highly skilled workforce

People employed in highly skilled occupations (ABS,2006)

51.4 58.1 ↓

Employment Employment rate

People who are employed as a proportion of the population aged 15+ years (ABS, 2011)

65.8 62.4 ↑

Income and wealth

Income Food security

Median equivalised gross weekly household income (ABS, 2011) Adults who ran out of food in the last 12 months and could not afford to buy more (CIV Survey, 2007)

805 7.4

802 6.0

_

↓ Skills Educational

qualifications

People aged 25 years and over with tertiary or TAFE qualifications (ABS, 2011)

56.9 58.5 ↓

Work-life balance

Adequate work-life balance

Proportion of employed residents that perceive a good balance of work and family life (VicHealth Survey, 2011)

51.1

54.6

↓

Page 49

22 Transport limitations with respect to access to public or private transport options. The reasons for transport limitations were not collected.

Vibrant and Sustainable Built and Natural Environments The future Knox is:

- A place where residents identify with and strongly value Knox being made up of a series of villages with access to a full range of urban facilities and services. Growth and change through development occurs at a rate and type that is responsive to Knox’s character while meeting the needs of a changing community.

- Where community and businesses are leaders in sustainable management and living, valuing and protecting significant environmental assets, celebrating a healthy local environment, a green and leafy municipality, and sustainable living opportunities for all.

- Through continued advocacy and increased investment, public transport networks in Knox are reliable and accessible. Knox has a strong functioning network of bicycle and walking paths, thereby reducing the reliance on the car and minimising greenhouse gas emissions.

Baseline data

How do we compare? Policy area Indicator Measures/Sources Knox Metro

Transport accessibility

Transport limitations

Adults that experienced transport limitations22

in the previous 12 months (VicHealth Survey, 2011)

18.1 23.2 ↑

Water Waste water recycling

Adults that live in households that collect waste water (VicHealth Survey, 2011)

38.1 42.4 ↓

Waste management

Household waste recycling

Proportion of recyclables and green organics that are recycled (Sustainability Victoria, 2010)

56 44 (Vic) ↑

Housing Housing affordability

Proportion of households spending more than 30%+ of gross household income on rent or mortgage (ABS, 2011)

18.5 21.8 ↑

Page 50

Culturally Rich and Active Communities The future Knox is:

- A community that values diversity, creativity and artistic expression and enjoys a range of major and local events and festivals.

- A place where public open space is accessible and plentiful, and public are is a valued aspect of community life. Diverse leisure and recreational activities are abundant, and people have access to shared open spaces and facilities.

- A city whose unique local character is valued and preserved, through celebration of local heritage sites, villages and neighbourhoods. The contribution and role of the local indigenous community is recognised and celebrated.

- A place that encourages participation, physical activity and connection and supports an active community life through its transport infrastructure.

Baseline data

How do we compare?

Policy area Indicator Measures/Sources Knox Metro Arts and cultural activities

Participation in arts & cultural activities

Adults that participated in arts & related activities in the last month (VicHealth Survey, 2011)

67.5 65.2 ↑

Leisure and recreation

Opportunities to participate in sporting and recreational activities

Adults that perceive their area as having ‘good’ or ‘very good’ access to recreation and leisure facilities (VPHS, 2008)

90.2 83.0 ↑

Cultural diversity

Community acceptance of diverse cultures

Adults that agree that it is a good thing for a society to be made up of people from different cultures (CIV Survey, 2007)

88.6 90.5 ↓

Democratic and Engaged Communities The future Knox is:

- Engaged and values opportunities to be actively involved in community life. Community members regularly participate in community groups and organisations, and have a genuine opportunity to influence decision-making.

- Where the community has confidence that Council and other key local agencies will work in partnership to make decisions for the greater good of the community.

- A city with a Council that operates in an efficient and effective manner, applies contemporary practices, has processes that are transparent and accountable, and exercises sound financial management.

Baseline data

How do we compare?

Policy area Indicator Measures/Source Knox Metro Citizen engagement

Participation in citizen engagement

Adults that participated in citizen engagement activities (VicHealth Survey,2011)

46.3 47.5 ↓

Page 51

Knox Wellbeing Report 2013 – Community health and wellbeing priorities Priority 1 – Personal health and wellbeing

Desired outcome People in Knox have high levels of personal health and wellbeing and are able to enjoy a good quality of life.

How will we measure changes in personal health and wellbeing? Baseline data How do we compare?

Policy area Indicator/s Measures/Sources Knox Metro Personal health & wellbeing Early childhood Youth

Subjective wellbeing Child health and wellbeing Adolescent health and wellbeing

Personal Wellbeing Index Score (0-100)23

, by age and gender VicHealth Survey, 2011)

% children vulnerable on two or more development domains (AEDI , 2012) Participation rate (visits/100 enrolled children) at key ages and stages 3.5 year maternal & child health visit (Office for Children data, 2011) The proportion of adolescents enrolled in Years 7, 9 and 11 with positive Mental Health – Psychological wellbeing scale score of 43 or higher24

(Adolescent Health & Wellbeing Survey, 2009)

Men 76.6 Women 77.6 18-34 yrs 78.6 35-54 yrs 75.6 55+ yrs 77.5 7.4 76.3 74.5

76.4 77.4 77.8 76.2 77.1 9.5 64.5 77.1(Vic)

_

↑

↑

↓

23 The Index is based on the average of seven aspects of wellbeing – standard of living, health, achievements in life, community connection, personal relationships and future security 24 Respondents who were at or above a cut-off score of 43 in respect to a Mental Health Inventory of 14 questions relating to happiness, relaxation, hope for the future etc.

Page 52

Priority 2 – Community connectedness Desired outcome People in Knox feel connected to each other and their community.

How will we measure changes in community connectedness? Baseline

data How do we compare?

Policy area Indicator/s Measures/Sources Knox Metro Community connectedness

Feeling part of the community Social support Participation in community life Volunteering

Satisfaction with feeling part of the community ( Vic Health Indicators Survey, 2011) People who get help from family, friends or neighbours when needed as a % of adult population (VPHS, 2008) Adults that report a wide range of community and support groups, locally as % of adult population (VPHS, 2008) % of adults that are members of an organised group (VPHS,2008) People who help out as volunteers as % of adult population (VPHS, 2008)

70.8 89.6 66.0 54.0 33.5

70.9 90.9 57.0 59.0 28.7

_

_

↑

↓

↑

Priority 3 – Leisure, recreation/arts and cultural activities Desired outcome People in Knox have access to a broad range of recreation, leisure, arts and cultural activities and

facilities.

How will we measure changes in leisure, recreation/arts and cultural activities? Baseline data

How do we compare?

Policy area Indicator/s Measures/Sources Knox Metro Leisure, recreation/arts and cultural activities

Opportunities to participate in sporting and recreation activities Participation in arts and cultural activities

Adults that perceive their area has having ‘good’ or ‘very good’ access to recreation and leisure facilities (VPHS, 2008) % of adolescents enrolled in years 7,9 and 11 who agreed, strongly agreed with the perception that there are playgrounds, parks or gyms close to their home that they can access (Adolescent Health & Wellbeing Survey, 2009) % of adults that have attended a local community event in the past 6 months (VPHS, 2008) % adults that have participated in arts and related activities in the last 3 months25

(VicHealth Survey, 2011)

90.2 56.0 53.4 67.5

83.0 48.3(Vic) 48.0 65.2

↑

↑

↑

↑

25 Making or creating art including crafts either at home or in a public space eg performing, creative writing, digital or media art.

Page 53

Priority 4 – Housing affordability and choice Desired outcome People in Knox have access to affordable, appropriate housing close to services and facilities.

How will we measure changes in housing affordability and choice? Baseline


Policy area Indicator/s Measures/Sources Knox Metro Housing

Housing affordability Housing choice

% of low income households in the bottom 40% of the national income distribution, paying 30%+ of usual gross weekly income on housing costs (mortgage or rent) (ABS, 2011) % of private rental housing that is affordable for lower income households receiving a Centrelink benefit (Office of Housing, Rental Report, June quarter, 2012) Social housing rental dwellings as % of total private dwellings (ABS, 2011) % housing that is medium or high density (ABS, 2011)

9.0 5.6 2.1 13.1

10.7 10.3 2.9 28.3

↑

↓

↓

↓

Priority 5 – Family violence Desired outcome People in Knox have healthy relationships that are free from violence.

How will we measure changes in family violence? Baseline


Policy area Indicator/s Measures/Sources Knox Metro Family violence

Family violence Child Abuse

Recorded incidents of family violence (incidents per 100,000 population) (Victoria Police, 2013) Number of child abuse substantiations per 1000 children 0-17 years (DHS, 2009)

1033 5.2

965 7.0(Vic)

↓

↑

Page 54

Priority 6 – Lifelong learning Desired outcome People in Knox have access to a broad range of learning opportunities throughout their life.

How will we measure changes in lifelong learning? Baseline


Policy area

Indicator/s Measures/Sources Knox Metro

Lifelong learning

Contemporary education outcomes Destination of school leavers Educational status

% young people (20-24 years) that left school before completing year 11 (ABS, 2011) % 20-24 year olds participating in tertiary education (ABS, 2011) People aged 15-19 years ( not at secondary school ) that are fully engaged in work or study at a non-school institution (ABS, 2006) People aged 15-19 years (not at secondary school) that are not engaged at all in work or study (ABS, 2006) Share of population (15+years) with Year 12 or equivalent (ABS, 2011) Share of population (15+ years) with no post school qualification (ABS, 2011)

11.8 35.3 74.9 12.0 50.0 30.7

9.5 41.0 75.1 13.7 55.0 28.1

↓

↓

_

↑ ↓ ↓

Page 55

Priority 7 – Mental health Desired outcome People in Knox experience a high level of social, emotional and spiritual wellbeing.

How will we measure changes in mental health? Baseline


Policy area

Indicator/s Measures/Sources Knox Metro

Mental health

Prevalence of mental health issues Adolescent Mental Wellbeing

Mental health-related public hospital emergency department presentations per 1000 population (DHS, VEMD, 2010) Proportion of adults with high/very high psychological distress level (Kessler 10 score 22 or higher) (VPHS, 2011-12) The proportion of adolescents enrolled in years 7, 9 and 11 with positive indicators of mental wellbeing (2009) -perceived access to mental health services -high psychological distress -report bullying Psychiatric hospitalisation rate for young people (per 1000 adolescents 10-17 years) admitted to hospital with principal diagnoses related to mental & behavioural category (DHS, VAED, 2010)

5.8 12.2 69.6 13.9 46.2 7.8

6.5 11.1 70.4(Vic) 13.0(Vic) 44.6(Vic) 6.7(Vic)

↑

_

_

_

Page 56

Priority 8 – Lifestyle risks Desired outcome People in Knox adopt a healthy lifestyle.

How will we measure changes in lifestyle risks? Baseline


Policy area Indicator/s Measures/Source Knox Metro Personal health and wellbeing

Self-reported health Prevalence of health risk behaviours

Adults self-reporting health as ‘excellent’ or ‘very good’ as % of adult population (VPHS, 2011-12) Adults that engage in key health risk behaviours (SNAP) as a % of adult population (VPHS, 2011-12) -current smokers -at risk of short term harm from alcohol consumption -overweight or obese -not meeting fruit & veg. dietary guidelines -not meeting physical activity guidelines % of young people engaged in risky alcohol use (Victorian Alcohol Statistics Series, 2010) – alcohol related hospitalisations – alcohol-related assaults

42.7 17.6 42.2 55.5 54.3 25.5 48.3 22.6

46.6(Vic) 15.7(Vic) 45.3(Vic) 49.8(Vic) 51.1(Vic) 26.6(Vic) 49.4(Vic) 31.1(Vic)

↓

↓ ↑ ↓

↓

_

_ ↑

Page 57

Attachment 2 – Health and wellbeing planning policies and resources VicHealth · Leading the Way – Councils creating healthier communities. A resource

guide for Councillors · Food for all project – Sets out 10 ways local government can act on food

security · Preventing violence against women project – Local government capacity

building project · Localities enhancing arts participation (LEAP) project – encourages greater

social engagement through arts and cultural activities · Localities Embracing and Accepting Diversity (LEAD) project – is a pilot

program to prevent discrimination and support cultural diversity within local communities and organisations

· Healthy Sporting Environments project – seeks to reduce the prevalence of chronic disease through community sports clubs, by adhering to minimum standards for: responsible use of alcohol; healthy food choices; reduced tobacco use; protection from harmful effects of UV; creation of an inclusive, safe and supportive environment for women, girls, people from CALD backgrounds and Indigenous people; and injury prevention management

· Local Government Action Guides – produced to support MPHWP planning, includes sample council strategies to address 10 priority areas

· Vic Health Strategy and Business Plan 2009-13 – seeks to reduce health inequalities and focuses on increasing participation in physical, social and economic environments, and the role they play in priority health issues

· Be Active program – Aims to address the lack of safe, accessible and inclusive environments restricting capacity to participate in physical activity, as well as to strengthen Health Together Victoria to increase physical activity

· Increasing physical activity participation: A framework for action – A method for embedding physical activity in planning

· Evidence-base for mental health promotion resource 2005-07 – provides a framework for mental health and wellbeing and is intended to serve as an information resource for practitioners from diverse sectors who are seeking to maximise opportunities to promote mental health and wellbeing through their research, policies and programs

Heart Foundation

· FSPUD Food-sensitive planning and urban design – an approach to planning and urban design that addresses the critical intersects between public health nutrition; planning and urban design; and environmental sustainability. FSPUD builds on the healthy built environment focus pioneered by the Heart Foundation over the past 15 years

· Healthy by Design – a planners’ guide to environments for active living - containing a matrix of design considerations for safe and healthy communities and site assessment audit tool

· Blueprint for an Active Australia – Local government actions for increasing physical activity

· Increasing Density in Australia – maximising the benefits and minimising the harm

· Active Transport – information and resources on active transport and required urban design and planning

· Healthy Parks, Healthy People – provides the latest international research, innovations and programs that focus on the health benefits of human contact with the natural world

· Creating heart healthy communities – working with local government – guides health planning in relation to the Heart Foundation’s priority areas of food and nutrition and active living.

http://www.vichealth.vic.gov.au/leadingtheway�

http://www.vichealth.vic.gov.au/Publications/Healthy-Eating/Healthy-Eating-Programs/Food-For-All---Resources-for-Local-Governments.aspx�

http://www.vichealth.vic.gov.au/Programs-and-Projects/Freedom-from-violence.aspx�

http://www.vichealth.vic.gov.au/Programs-and-Projects/Social-Connection/LEAP.aspx�

http://www.vichealth.vic.gov.au/Programs-and-Projects/Freedom-from-discrimination/Localities-Embracing-and-Accepting-Diversity.aspx�

http://www.vichealth.vic.gov.au/Programs-and-Projects/Healthy-Sporting-Environments.aspx�

http://www.vichealth.vic.gov.au/Research/VicHealth-Indicators/Local-government-action-guides.aspx�

http://www.heartfoundation.org.au/driving-change/current-campaigns/local-campaigns/Pages/food-sensitive-planning.aspx�

http://www.heartfoundation.org.au/driving-change/current-campaigns/local-campaigns/Pages/victoria-healthy-design.aspx�

http://www.heartfoundation.org.au/SiteCollectionDocuments/Blueprint-for-an-active-Australia.pdf�

http://www.heartfoundation.org.au/active-living/built-environment/Pages/Density-and-Health.aspx�

http://www.heartfoundation.org.au/active-living/built-environment/Pages/active-transport.aspx�

http://www.hphpcentral.com/�

Page 58

Sunsmart Victoria

· Sunsmart: Sun Protection for Local Government – Strategies for local government to address skin cancer in the community. Tools include planning guides, sample policy, and audit tool

Federation of Community Legal Centres

· Smart Justice factsheets – Suggested actions for safer communities, including reducing alcohol-related violence and preventing family violence

Victoria Walks · Victoria Walks Strategy 2012-15 – a walking-for-transport health promotion charity – Resources and advocacy for active transport

Australian Drug Foundation

· Under the Influence – What local governments can do to reduce drug and alcohol related harms in their communities

Australian Institute of Health and Welfare

· Health and the environment - a compilation of evidence – Health impacts of the natural and built environments

Planning Institute of Australia

· Healthy Spaces and Places – A national guide to designing places for healthy living

Department of Health (Vic)

· Victorian Public Health and Wellbeing Plan 2011-2015 – A plan to improve the health and wellbeing of all Victorians by engaging communities in prevention and by strengthening systems for health protection, health promotion and preventative e healthcare across all sectors and levels of government

· Victorian Health Priorities Framework 2012-2022: Metropolitan Health Plan – Sets out seven priority areas for the development and operation of the Victorian health system for the future

· Healthy Together Victoria – A community-based health promotion program, statewide health promotion, marketing and development initiative and research and evaluation centre. Knox is one of 14 Councils in Victoria to partner with the State Government to implement this local health promotion program over four years, which focuses upon improving health outcomes in the community and reduce unhealthy weight in children and adults, increase fruit and vegetable intake, increase physical activity and reduce smoking rates and alcohol use

· Guide to municipal public health and wellbeing planning – To assist local government planners to consider the Victorian Public Health and Wellbeing Plan and local needs and context

· Municipal public health and wellbeing planning: Having regard to climate change – To assist local government to meet their obligations under the Climate Change Act 2010.

· Including public health and wellbeing matters in the council plan or strategic plan: A resource for local government planners – To assist councils to systematically consider the benefits and risks of including municipal public health and wellbeing planning in their council plan or strategic plan.

· Climate Change and Health – A resource guide for planning for climate change adaptations

· Planning for healthy communities: reducing the risk of cardiovascular disease and type 2 diabetes through healthier environments and lifestyles – Policy initiatives, interventions, and land use approaches

· Using policy to promote mental health and wellbeing: a guide for policy makers – A guide with examples of settings and actions for mental health planning

· Department of Health Eastern Region Mental Health Strategic Plan 2011-13 – Strategies include local government involvement in Youth mental health service provision, mental health training for HACC workers

http://www.sunsmart.com.au/workplaces_and_local_government/in_local_government�

http://www.smartjustice.org.au/cb_pages/factsheets.php�

http://www.victoriawalks.org.au/Assets/Files/VW_Strategy%202012.pdf�

http://www.druginfo.adf.org.au/reports/prq-under-the-influence-local-government�

http://www.aihw.gov.au/publication-detail/?id=10737418534�

http://www.healthyplaces.org.au/site/�

http://www.health.vic.gov.au/localgov/downloads/enviro_climate_change.pdf�

http://www.health.vic.gov.au/healthpromotion/downloads/healthy_communities.pdf�

http://www.health.vic.gov.au/mentalhealthpromotion/resources.htm�

http://www.oehcsa.org.au/sites/www.oehcsa.org.au/files/EMR%20Mental%20Health%20Strategic%20Plan%202011-13.pdf�

Page 59

Office of Women’s Policy, Dept of Human Services (Vic)

· Victoria’s action plan to address violence against women and children – Providing initiatives and funding for prevention work such as ‘Preventing Violence against Women in our Community’ project

Department of Planning and Community Development (Vic)

· Safer Design Guidelines for Victoria – Developed to assist planners and designers apply design principles that will improve the safety of the built environment, minimise the opportunity for crime and promote safe, accessible and liveable places

· Ageing in Victoria: a plan for an age-friendly society, 2010-2020 – Includes suggestions relevant to local government age-friendly wellbeing planning on dementia, heatwave plans, age-friendly urban design and housing

· Metropolitan Planning Strategy for Melbourne’s Discussion Paper: Melbourne, let’s talk about the future – Responds to such matters as social and economic participation, strong communities, and affordably living and seeks to prompt debate about the challenges and ideas Melbourne’s next Metropolitan Planning Strategy.

Municipal Association of Victoria

· Creating a more inclusive community for people with a disability: A Strategic Framework for Local Government - Councils to reflect their commitment to improving access and inclusion in their key strategic policy and planning documents such as the Council Plan, MPHWP and MSS

· Gender and Local Government project – Resources and prevention plans for local government to advance gender equity for women

Victorian Local Government Association

· Resilient Neighbourhoods: Integrated Approaches to Urban Change Project · Liveable and just toolkit: Addressing social impacts of climate change · GLOVE project on preventing violence - Gender, Local Government and

Violence Prevention – Resources including planning strategies (completed in 2009)

· Food Security project - Includes a local government and food security evidence review, municipal scanning tool, and report on integrating land use planning with community food security.

Department of Infrastructure and Transport (Vic)

· Walking, Riding and Access to Public Transport Discussion Paper – A draft report exploring how the Australian Government can work with other governments to encourage and support walking and riding as part of the transport system

Department of Human Services (Vic)

· Draft Victorian State Disability Plan 2013-16 – Includes strategies to build local government capacity to consider disability in land use and transport planning and liveable housing design; increase support for people with disabilities and their carers

· Pathways to a fair and sustainable social housing framework – Discussion paper – Presents several options to change current public housing system, including limited tenure and public private partnerships.

· Victoria’s Action Plan to address violence against women and children 2012-2015 - Provides initiatives and funding for prevention work such as ‘Preventing Violence against Women in our Community’ project

· Local solutions for Public Drug Use – A study that looked at public injecting and possible responses

· Resource Guide for planning effective community drug prevention – A resource guide for planning effective community drug prevention using the E4H framework

· Environments for Health – Promoting Health and Wellbeing through Built, Social, Economic and Natural Environments – sets out a framework to ensure that planning considers the built, social, economic and natural environments

http://www.dhs.vic.gov.au/__data/assets/pdf_file/0009/736056/preventing_violence_against_women_and_children_action_plan_102012.pdf�

http://www.dpcd.vic.gov.au/planning/urbandesign/guidelines/safer-design-guidelines�

http://old.daru.org.au/publications/items/2010/08/344077-upload-00001.pdf�

http://www.mav.asn.au/policy-services/social-community/disability/Pages/default.aspx�

http://www.mav.asn.au/policy-services/social-community/gender-equity/prevention-plans-resources/Pages/default.aspx�

http://www.vlga.org.au/Projects___Campaigns/Resilient_Neighbourhoods_Project.aspx�

http://www.vlga.org.au/Resources/Liveable_Just_Toolkit.aspx�

http://www.vlga.org.au/Resources/The_GLOVE_Project.aspx�

http://www.vlga.org.au/Projects___Campaigns/Climate_Change/Food_Security4.aspx�

http://www.infrastructure.gov.au/infrastructure/mcu/urbanpolicy/activetravel.aspx�

http://www.dhs.vic.gov.au/about-the-department/plans,-programs-and-projects/plans-and-strategies/disability-services/state-disability-plan�

http://www.dhs.vic.gov.au/about-the-department/plans,-programs-and-projects/plans-and-strategies/housing-and-community-building/Pathways-to-a-new-Victorian-social-housing-framework/Pathways-to-a-new-Victorian-social-housing-framework�



http://www.health.vic.gov.au/vdapc/archive/local_sol_compendium.pdf�

http://www.health.vic.gov.au/vdapc/archive/drug_prev_guide.pdf�

Page 60

Australia and New Zealand Health Policy Journal

· Moving beyond 'rates, roads and rubbish': How do local governments make choices about healthy public policy to prevent obesity? – A discussion of the issues relating to health policy in councils

Victorian Auditor General’s Office

· Beyond the Triple Bottom Line: Measuring and reporting on sustainability as social and economic as well as environmental

Victorian Parliament/ Government

· Inquiry into Environmental Design and Public Health in Victoria – Explores the role of health in planning. Findings included the importance of quality open space, and provision of active transport networks

· Climate Change Act 2010 – Section 14 requires local government to ‘have regard to’ climate change in Municipal Public Health and Wellbeing Plans

· Charter of Human Rights and Responsibilities – Is a Victorian law that sets out the basic rights, freedoms and responsibilities of all people in Victoria. It aims to build a fairer, more inclusive community by requiring that the Victorian Government, local councils and other public authorities consider human rights when they make laws, develop policies and provide services. The Charter gives legal protection to 20 fundamental human rights, such as the right for people to have a fair trial, the right to say what they think, the right to join groups and meet freely, and the right to enjoy their culture.

Community Indicators Victoria

· Measuring wellbeing, engaging communities – Developing Community Indicators Framework for Victoria: The final report of the Victorian Community Indicators Project – Provides a comprehensive framework for planning which enables an outcomes focused approach

Australian Government

· National Health Reform Agreement – Sets out the shared intention of the Commonwealth, State and Territory governments to work in partnership to improve health outcomes for all Australians and ensure the sustainability of the Australian health system

· Australian National Preventive Health Agency – Seeks to improve health outcome for Australians by driving the national capacity for change and innovation around preventive health policies and programs

· Living Longer Living Better package – Seeks to create a flexible and seamless system that provides older Australians with more choice, control and easier access to a full range of services, where they want it and when they need it

World Health Organization

· Global Age-friendly Cities: A Guide – Seeks to enable age-friendly cities that optimise opportunities for health, participation and security to enhance quality of life as people age

· Social Determinants of Health – Are the conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels

Centre for Community Child Health Royal Children’s Hospital Melbourne

· Platforms Service Redevelopment Framework – Is based on research about the importance of early years and their impact on the life course, in addition to evidence about how communities can make a difference for children and their families.

· Australian Early Development Index – Is a population measure of five key areas of early childhood development: physical health and wellbeing; social competence; emotional maturity; language and cognitive skills (school-based); communication skills and general knowledge

http://www.anzhealthpolicy.com/content/6/1/20�

http://download.audit.vic.gov.au/files/20040615-Reporting-Measuring-Sunstainability.pdf�

http://www.parliament.vic.gov.au/committees/legislative-council-committees/standing-committee-on-environment-and-planning/article/1521�

http://www.victorianhumanrightscommission.com/www/index.php?option=com_k2&view=item&layout=item&id=905&Itemid=520�

Page 61

Attachment 3 - Glossary

Allies – individuals, community groups, businesses, educational institutions and government representatives etc that work alongside Council to help address the identified community health and wellbeing priorities.

City Plan themes – shared aspirations for the future of the City of Knox identified in the City Plan. These are: Health and connected community; Prosperous, advancing economy; Vibrant and sustainable built and natural environment; Culturally rich and active communities; and Democratic and engaged communities.

City Plan objectives – clear goals for the medium to longer term (four-years) that describe the outcomes required to progress the City of Knox toward achieving its City Plan aspirations.

Community health and wellbeing planning and implementation framework 2013-17 – provides the structure to enable the achievement of desired community health and wellbeing outcomes over the next four years. The key components include the City Plan themes, policy areas, City Plan objectives, community health and wellbeing priorities and key strategies.

Community health and wellbeing priorities – eight key issues towards which Council will direct attention and resources to enhance health and wellbeing in Knox. There community health and wellbeing priorities are: Personal health and wellbeing; Community connectedness; Leisure, recreation/arts and cultural activities; Housing affordability and choice; Family violence; Lifelong learning; Mental health and Lifestyle risks (smoking, nutrition, alcohol and physical exercise).

Indicators – specific data measures to monitor population-level health and wellbeing changes in Knox over the life of the Strategy.

Key strategies – Twenty-six methods designed to enhance community health and wellbeing in Knox over the next four-years.

Knox Wellbeing Report 2013 – provides the most up-to-date information on community health and wellbeing available in 2013 and comprises two parts: City Plan themes and Community health and wellbeing priorities.

Lead partner – an organisation that is currently operating in a community health and wellbeing priority space (providing services, programs, advocacy and/or planning etc) and committed to working with other relevant partners and allies to support the implementation of the community health and wellbeing key strategies.

Policy areas – define the conditions, determinants and drivers of health and wellbeing in Knox. The Strategy identifies 26 policy areas, for example, Personal health and wellbeing, Economic activity and Transport accessibility etc.

Population health partners – organisations that hold a primary role in supporting population-wide health and wellbeing approaches and programs in Knox. These organisations are committed to a partnership approach which integrates planning, implementation and evaluation to enhance community health and wellbeing outcomes.