Creating change in government to address the social determinants of health: How can efforts be improved?

Background The evidence base for the impact of social determinants of health has been strengthened considerably in the last decade. Increasingly, the public health field is using this as a foundation for arguments and actions to change government policies. The Health in All Policies (HiAP) approach, alongside recommendations from the 2010 Marmot Review into health inequalities in the UK (which we refer to as the ‘Fairness Agenda’), go beyond advocating for the redesign of individual policies, to shaping the government structures and processes that facilitate the implementation of these policies. In doing so, public health is drawing on recent trends in public policy towards ‘joined up government’, where greater integration is sought between government departments, agencies and actors outside of government. Methods In this paper we provide a meta-synthesis of the empirical public policy research into joined up government, drawing out characteristics associated with successful joined up initiatives. We use this thematic synthesis as a basis for comparing and contrasting emerging public health interventions concerned with joined-up action across government. Results We find that HiAP and the Fairness Agenda exhibit some of the characteristics associated with successful joined up initiatives, however they also utilise ‘change instruments’ that have been found to be ineffective. Moreover, we find that – like many joined up initiatives – there is room for improvement in the alignment between the goals of the interventions and their design. Conclusion Drawing on public policy studies, we recommend a number of strategies to increase the efficacy of current interventions. More broadly, we argue that up-stream interventions need to be ‘fit-for-purpose’, and cannot be easily replicated from one context to the next.

Sharing social space with strangers: Setting, signalling and policing informal rules of driving etiquette

Recent research suggests that aggressive driving may be influenced by driver perceptions of their interactions with other drivers in terms of ‘right’ or ‘wrong’ behaviour. Drivers appear to take a moral standpoint on ‘right’ or ‘wrong’ driving behaviour. However, ‘right’ or ‘wrong’ in the context of road use is not defined solely by legislation, but includes informal rules that are sometimes termed ‘driving etiquette’. Driving etiquette has implications for road safety and public safety since breaches of both formal and informal rules may result in moral judgement of others and subsequent behaviours designed to punish the ‘offender’ or ‘teach them a lesson’. This paper outlines qualitative research that was undertaken with drivers to explore their understanding of driving etiquette and how they reacted to other drivers’ observance or violation of their understanding. The aim was to develop an explanatory framework within which the relationships between driving etiquette and aggressive driving could be understood, specifically moral judgement of other drivers and punishment of their transgression of driving etiquette. Thematic analysis of focus groups (n=10) generated three main themes: (1) courtesy and reciprocity, and the notion of two-way responsibility, with examples of how expectations of courteous behaviour vary according to the traffic interaction; (2) acknowledgement and shared social experience: ‘giving the wave’; and (3) responses to breaches of the expectations/informal rules. The themes are discussed in terms of their roles in an explanatory framework of the informal rules of etiquette and how interactions between drivers can reinforce or weaken a driver’s understanding of driver etiquette and potentially lead to driving aggression.

Promoting articulated action from diverse stakeholders in response to public policy scenarios: A case analysis of the use of ‘scenario improvisation’ method

In this paper we present a novel application of scenario methods to engage a diverse constituency of senior stakeholders, with limited time availability, in debate to inform planning and policy development. Our case study project explores post-carbon futures for the Latrobe Valley region of the Australian state of Victoria. Our approach involved initial deductive development of two ‘extreme scenarios’ by a multi-disciplinary research team, based upon an extensive research programme. Over four workshops with the stakeholder constituency, these initial scenarios were discussed, challenged, refined and expanded through an inductive process, whereby participants took ‘ownership’ of a final set of three scenarios. These were both comfortable and challenging to them. The outcomes of this process subsequently informed public policy development for the region. Whilst this process did not follow a single extant structured, multi-stage scenario approach, neither was it devoid of form. Here, we seek to theorise and codify elements of our process – which we term ‘scenario improvisation’ – such that others may adopt it.

Key change: The role of the creative industries in climate change action

The role of the creative industries – arts and artists – in helping to drive the changes in laws and behaviours that are necessary to tackle climate change, while not superficially obvious, is a deep one. Arts and artists of all kinds, as cultural practitioners, have been closely entwined with social change and social control since time immemorial, in large part because they help shape our understanding of the world, framing ideas, prefiguring change, and opening hearts and minds to new ways of thinking. They have played a major role in campaigns for law reform on many issues, and climate change should be no exception. Indeed, with climate change increasingly being seen as a deeply cultural issue, and its solutions as cultural ones to do with changing the way we understand our world and our place in it, the role of cultural practitioners in helping to address it should also increasingly be seen as central. It is curious, then, how comparatively little artistic engagement with climate change has taken place, how little engagement with the arts the climate movement has attempted, and how little theoretical and critical analysis has been undertaken on the role of the creative arts in climate change action. Through a literature review and a series of interviews with individuals working in relevant fields in Australia, this study examines and evaluates the role of the creative industries in climate change action and places it in a historical and theoretical context. It covers examples of the kind of artistic and activist collaborations that have been undertaken, the different roles in communication, campaigning for law reform, and deep culture change that arts and artists can play, and the risks and dangers inherent in the involvement of artists, both to climate change action and to the artist. It concludes that, despite the risks, a deeper and more thoughtful engagement of and by the creative industries in climate action would not only be useful but is perhaps vital to the success of the endeavours.

Assessing the integrated sustainability of a public rental housing project from the perspective of complex eco-system

Public rental housing (PRH) projects are the mainstream of China's new affordable housing policies, and their integrated sustainability has a far-reaching effect on medium-low income families' well-being and social stability. However, there are few quantitative researches on the integrated sustainability of PRH projects. Our study tries to fill this gap through proposing an assessment model of the integrated sustainability for PRH projects. First, this paper defines what the sustainability of a PRH project is. Second, after constructing the sustainable system of a PRH project from the perspective of complex eco-system, the paper explores the internal operation mechanism and the coupling mechanism among the ecological, economic and social subsystems. Third, it identifies fourteen indices to represent the sustainability system of a PRH project, including six indices of ecological subsystem, five of economic subsystem and three of social subsystem. Fourth, it qualifies the weights of three subsystems and their internal representative indices. In addition, an assessment model is established through expert surveys and analytic network process (ANP). Finally, the paper carries out an empirical research on a PRH project in Nanjing city of China, followed by suggestions to enhance the integrated sustainability. The sustainability system and its evaluation model proposed in this paper are concise and easy to understand and can provide a theoretical foundation and a scientific basis for the evaluation and optimization of PRH projects.

Creating healthy food environments in NSW: A knowledge and evidence synthesis to inform advocacy and action: Food composition

Reviews and synthesizes evidence to produce evidence-based recommendations on policy actions to improve food composition for NSW Health

Creating healthy food environments in N.S.W.: A knowledge and evidence synthesis to inform advocacy and action: Food pricing

Reviews and synthesizes evidence to produce evidence-based recommendations on policy actions to improve food pricing for NSW Health

Creating healthy food environments in N.S.W.: A knowledge and evidence synthesis to inform advocacy and action: Food provision

Reviews and synthesizes evidence to produce evidence-based recommendations on policy actions to improve food provision for NSW Health

Creating healthy food environments in NSW: A knowledge and evidence synthesis to inform advocacy and action. Seven separate documents across the domains: Food retail

Reviews and synthesizes nutrition policy actions to improve food retail for NSW Health

Creating healthy food environments in NSW: A knowledge and evidence synthesis to inform advocacy and action. Seven separate documents across the domains: Overview

Summaries evidence across seven domains of potential food policy action to improve food environments and food supply to prevent obesity for NSW Health

Social interaction and reflection for behaviour change

This article introduces the theme issue on social interaction and reflection for behaviour change. A large body of research exists on systems designed to help users in changing their behaviours, for instance, to exercise more regularly or to reduce energy consumption. Increasingly, these systems focus on multiple users, often to encourage open-ended reflection rather than prescribing a particular course of action. As background for this theme issue, this article presents a literature review on behaviour change support systems that focus on social interaction and reflection. The review highlights five key approaches amongst these systems: social traces, social support, collective use, reflection-in-action, and reflection-on-action. Each approach offers unique benefits, but also challenges for the design of behaviour change support systems. We highlight how the articles in this theme issue contribute to our current understanding of these five approaches, and beyond that, set out some broad directions for future work.

Being online, living offline: The influence of social ties over the appropriation of social network sites

Research on social network sites has examined how people integrate offline and online life, but with a particular emphasis on their use by friendship groups. We extend earlier work by examining a case in which offline ties are non-existent, but online ties strong. Our case is a study of bodybuilders, who explore their passion with like-minded offline 'strangers' in tightly integrated online communities. We show that the integration of offline and online life supports passion-centric activities, such as bodybuilding.

Pivotal principles for digital earth development in the 21st century

Reductionist thinking will no longer suffice to address contemporary, complex challenges that defy sectoral, national, or disciplinary boundaries. Furthermore, lessons learned from the past cannot be confidently used to predict outcomes or help guide future actions. The authors propose that the confluence of a number of technology and social disruptors presents a pivotal moment in history to enable real-time, accelerated and integrated action that can adequately support a ‘future earth’ through transformational solutions. Building on more than a decade of dialogues hosted by the International Society for Digital Earth (ISDE), and evolving a briefing note presented to delegates of Pivotal2015, the paper presents an emergent context for collectively addressing spatial information, sustainable development and good governance through three guiding principles for enabling prosperous living in the 21st Century. These are: (1) open data, (2) real world context and (3) informed visualization for decision support. The paper synthesizes an interdisciplinary dialogue to create a credible and positive future vision of collaborative and transparent action for the betterment of humanity and planet. It is intended that the three Pivotal Principles can be used as an elegant framework for action towards the Digital Earth vision, across local, regional, and international communities and organizations.

Sustainable housing development through integrated strata utility and transport infrastructure

A comprehensive study was conducted on potential systems of integrated building utilities and transport power solutions that can simultaneously contain rising electricity, hot water and personal transport costs for apartment residents. The research developed the Commuter Energy and Building Utilities System (CEBUS) and quantified the economic, social and environmental benefits of incorporating such a system in future apartment developments. A decision support tool was produced to assist the exploration of the CEBUS design variants. A set of implementation guidelines for CEBUS was also developed for the property development industry.

Disclosures of social value creation and managing legitimacy: A case study of three global social enterprises

This study seeks to fill the gap in the existing literature by examining at how and whether disclosure of social value creation becomes a part of legitimation strategies of social enterprises. By using Suchman’s (1995) moral dimension of legitimacy theory this study sets out that three global social organizations, Grameen Bank, Charity Water, and the Bill and Melinda Gates Foundation, disclose social value creation as if they conform to expectations of the broader community. The study finds that there is an apparent disconnection between disclosure and actions by social enterprises. With references to few incidents highlighted in this study, social enterprises, use disclosures as their managerial efforts, rather than creating moral legitimacy. The notion of apparent disconnection between disclosure and real action by the case social enterprises is common with the notion of the motivation behind disclosure practices by corporations as captured in extant disclosure literature. The finding suggest that when an organisation (whether it is a corporation or a social enterprise) face legitimacy crisis, it appears to disclose good news than bad news questioning organizational moral legitimacy.