Grand challenges for public health

What is the future for public health in the twenty-first century? Can we glean an idea about the future of public health from its past? As Winston Churchill once said: ‘[T]he further backward you look, the further forward you can see.’ What can we see in the history of public health that gives us an idea of where public health might be headed in the future? (Gruszin et al. 2012). In the twentieth century there was substantial progress in public health in Australia. These improvements were brought about through a number of factors. In part, improvements were due to increasing knowledge about the natural history of disease and its treatment. Added to this knowledge was a shifting focus from legislative measures to protect health, to the emergence of improved promotion and prevention strategies, and a general improvement in social and economic conditions for people living in countries such as Australia. Gruszin et al. (2012) consider the range of social and economic reforms of the twentieth century as the most important determinants of the public’s health at the start of the twenty-first century (Gruszin et al. 2012 p 201). The same could not, however, be said for second or third world countries, many of whom have the most fundamental of sanitary and health protection issues still to deal with. For example, in sub-Saharan Africa and in Russia the decline in life expectancy can be said to be related to a range of interconnected factors. In Russia, issues such as alcoholism, violence, suicide, accidents and cardiovascular disease could be contributing to the falling life expectancy (McMichael & Butler 2007). In sub-Saharan Africa, a range of factors, such as HIV/AIDS, poverty, malaria, tuberculosis, undernutrition, totally inadequate infrastructure, gender inequality, conflict and violence, political taboos and a complete lack of political will, have all contributed to a dramatic drop in life expectancy (McMichael & Butler 2007).

Doing something about it: Representations of NAPLAN in the public domain

Since 2008 all Australian school students have sat standardised tests in Reading, Writing, Language Conventions (Spelling, Grammar and Punctuation) and Numeracy in years 3,5,7 and 9. NAPLAN tests report individual students' attainment of skills against a set of standards. Individual student results are communicated to parents. Schools are then ranked against other schools depending upon the aggregate of their NAPLAN results. The process is explained to parents and community members as “improving the learning outcomes for all Australian students” (MCEETYA, 2009). This paper will examine NAPLAN as it is being played out in a mediated space through analysing unsolicited comment found in new media such as Twitter and online forums. NAPLAN intersects with contemporary debates about Australian education policy: the roles schools should play in improving national productivity, the relationship between state and federal government interest in education, the role and expectations of the teacher, what curriculum and pedagogy should be and look like and how limited financial resources can best be spread across education sectors and systems. These are not new considerations, however, what has changed is that education policy seems to have become even more of a political issue than it has before. This paper uses Ball's 'toolkit' approach to education policy analysis to suggest that there are multiple 'effects' of NAPLAN culminating in a series of disconnected conversations between various stakeholders.