Healthy settings : past, present and future

Based on previously published work and data from elite interviews, this thesis identifies four challenges for settings-based health promotion - clarifying theory; building bridges; reconfiguring for the 21st century; and promoting a culture of evaluation, learning and development. It concludes by mapping future directions for health settings research, policy and practice.

Identification and quantification of cholesterol oxides in foods

The types and levels of nine major cholesterol oxidation products was determined in a variety of foods. An estimate was made of the possible levels of cholesterol oxides in the Australian diet. These levels have been shown to cause endothelial damage in the coronary arteries of laboratory animals in previous studies. The health implications of these observations to humans is unknown.

Evidence-informed process to identify policies that will promote a healthy food environment in the Pacific Islands

Objective: To implement a systematic evidence-informed process to enable Fiji and Tonga to identify the most feasible and targeted policy interventions which would have most impact on diet-related non-communicable diseases.

Design: A multisectoral stakeholder group of policy advisers was formed in each country. They used participatory approaches to identify the problem policies and gaps contributing to an unhealthy food environment. Potential solutions to these problems were then identified, and were assessed by them for feasibility, effectiveness, cost-effectiveness and side-effects. Data were gathered on the food and policy environment to support the assessments. A shortlist of preferred policy interventions for action was then developed.

Results: Sixty to eighty policy problems were identified in each country, affecting areas such as trade, agriculture, fisheries and pricing. Up to 100 specific potential policy solutions were then developed in each country. Assessment of the policies highlighted relevant problem areas including poor feasibility, limited effectiveness or cost-effectiveness and serious side-effects. A shortlist of twenty to twenty-three preferred new policy options for action in each country was identified.

Conclusions: Policy environments in these two countries were not conducive to supporting healthy eating. Substantial areas of potential action are possible, but some represent better choices. It is important for countries to consider the impact of non-health policies on diets.