Can the impact on health of a government policy designed to create more liveable neighbourhoods be evaluated? an overview of the RESIDential Environment Project

There is growing interest in the impact of community design on the health of residents. In 1998, the Western Australian Government began a trial of new subdivision design codes (i.e. Liveable Neighbourhoods Community Design Code) aimed at creating pedestrian-friendly neighbourhoods to increase walking, cycling and public transport use. The trial provided a unique opportunity for a natural experiment to evaluate the impact of a government planning policy on residents. Nevertheless, evaluations of this kind present a number of methodological challenges in obtaining the highest quality evidence possible. This paper describes the RESIDential Environment Project’s study design and discusses how various methodological challenges were overcome.

Transacting with citizens: Australian government policy, strategy and implementation of online tax lodgement

Many governments have shown leadership in encouraging their citizenry to conduct transactions on-line. The policies that underpin these initiatives refer to a blend of civic benefits and efficiency goals. They combine the rhetoric of customer service with social shaping through ‘government as model user’ and procedures that require online activities. Many initiatives are described as ‘electronic service delivery’, terms that indicate an intention to provide much more than an additional channel for government interaction with citizens. Australia, as an innovator in eGovernment is a good example of this approach and its national government has specified policy goals for its online strategy. In this paper we examine the case of one Australian online delivery initiative, electronic tax lodgement (e-tax) and consider how well that initiative has met the policy goals of the government. Combining insights from Rogers’ Diffusion of Innovation theory and political analysis, we outline potential difficulties that governments face in implementing ESD initiatives. Our conclusion from this case study is that the provision of good technology is only a small part of the ESD challenge. It shows how success of an ESD implementation may yield contradictory outcomes in terms of overall eGovernment strategies. This case highlights the need for long-term
implementation plans and integration of initiatives with broader government strategy.

Data infrastructure for evidence-based local government policy

This paper outlines an approach for collecting and integrating data useful for evidence based planning and decision making in the not-for-profit sector, in particular for local government policy and planning. Given the methodological advances in multi-level analysis and the nature of rigorous policy analysis, leading academics and practitioners are advocating that policy driven research to be undertaken at a number of levels of analysis. Recent years have brought an explosion of public domain data in many aspects of social, economic and cultural aspects of society (cites and examples) and with this comes the opportunity, as outlined here, to integrate relevant public domain data in order to construct community profiles for local government areas in Victoria.

Towards a new policy environment for indigenous people, culture and knowledge in Australian higher education: an examination of issues and possibilities for institutional and government policy

The purpose of this discussion paper is to stimulate an examination of critical issues in Indigenous higher education and encourage new possibilities to be explored. It invites a wide sharing of views. The paper
does not attempt to trace the full history of the policies for Indigenous higher education and the successes and failures. The focus instead is on the major contemporary issues and the key questions that might be considered by the conference participants.

Analysing health claims policy in Australia : a case study of evidence in food and nutrition policy-making

Purpose: Health claims generally describe an association between a food product and a health outcome. There is debate whether health claims promote or obstruct healthy food selection behaviour. This study investigates the role of evidence in food and nutrition policy-making. The research question is how and why was health claims policy made in Australia? The research is innovative in its critical analysis design and its focus on building theory to help improve food and nutrition policy-making processes and outcomes.

Methods: A case study design was adopted in which events, stakeholders and issues associated with the policy review were described from data generated from interviews and documentary sources. A content-analysis tool is being used to critically analyse textual data. Concepts in the text are being identified and relationships among the policy concepts, stakeholders and processes are being mapped.

Findings: The analysis of data associated with the policy review is revealing a pattern of relationships among stakeholders, processes and concepts around shared values, beliefs and interests towards food and health. Broader food regulation contexts have influenced the decision-making environment. The pattern of relationships shares common characteristics with Sabatier’s ‘Advocacy Coalition Framework’ theoretical explanation of policy-making.

Conclusions: The study findings have implications for health claims policy and practice in Australia. As a case study of evidence in food and nutrition policy-making, this research highlights the role of competing interests, beliefs and values in evidence interpretation. Challenges are identified in undertaking food policy research.

Investigating health, economic and socio-political factors that need consideration when establishing Victorian Aboriginal land management projects

This article focuses on three Victorian Aboriginal¹ groups (Bangerang, Boonwurrung and Yorta Yorta) to explore elements that provide or discourage development of land management projects. Results from this small qualitative study show that a number of distinct health, socio-political and economic factors need to be considered when developing Aboriginal land management projects. This study indicates that a greater involvement in Aboriginal land management projects -- critical to Aboriginal peoples' health, economic and social structures - will only occur through increased community consultation, respect, training, consistency between all stakeholders involved, resources and the provision of employment opportunities. Further research is required to strengthen this evidence, allowing policy-makers to be progressive when developing land management projects for Aboriginal Victorian people as a health promoting tool.

Assessing cost-effectiveness in mental health: helping policy-makers prioritize and plan health services

Objective: We assessed, from a health sector perspective, options for change that could improve the efficiency of Australia's current mental health services by directing available resources toward 'best practice' cost-effective services.

Method: We summarize cost-effectiveness results of a range of interventions for depression, schizophrenia, attention deficit hyperactivity disorder and anxiety disorders that have been presented in previous papers in this journal. Recommendations for change are formulated after taking into account 'second-filter criteria' of equity, feasibility of implementing change, acceptability to stakeholders and the strength of the evidence. In addition, we estimate the impact on total expenditure if the recommended mental health interventions for depression and schizophrenia are to be implemented in Australia.

Results: There are cost-effective treatment options for mental disorders that are currently underutilized (e.g. cognitive–behavioural therapy (CBT) for depression and anxiety, bibliotherapy for depression, family interventions for schizophrenia and clozapine for the worst course of schizophrenia). There are also less cost-effective treatments in current practice (e.g. widespread use of olanzapine and risperidone in the treatment of established schizophrenia and, within those atypicals, a preference for olanzapine over risperidone). Feasibility of funding mechanisms and training of staff are the main second-filter issues for CBT and family interventions. Acceptability to various stakeholders is the main barrier to implementation of more cost-effective drug treatment regimens. More efficient drug intervention options identified for schizophrenia would cost A$68 million less than current practice. These savings would more than cover the estimated A$36M annual cost of delivering family interventions to the 51% of people with schizophrenia whom we estimated to be eligible and this would lead to an estimated 12% improvement in their health status. Implementing recommended strategies for depression would cost A$121M annually for the 24% of people with depression who seek care currently, but do not receive an evidence-based treatment.

Conclusions: Despite considerable methodological problems, a range of cost-effective and less cost-effective interventions for major mental disorders can be discerned. The biggest hurdle to implementation of more efficient mental health services is that this change would require reallocation of funds between interventions, between disorders and between service providers with different funding mechanisms.

The politics of 'sustainability': a critical discourse analysis of Victorian Government policy discourse, 1999-2006

Since its emergence during the 1980s the idea of sustainability has come to provide the dominant frame within which environmental policy is debated. Thus, for many ‘sustainability’ represents the best way to address the economic, social and environmental effects of the myriad of environmental issues facing human societies, including biodiversity loss, soil erosion, pollution of waterways, ozone depletion and climate change. There are however, widely divergent views advocated as to what sustainability means, which has important implications for how serious environmental issues are understood to be, why they are important, what has caused them, and what needs to be done to address them. Given the diversity of such views, the consequences for policy making, and the likelihood of effective responses being developed, are self evident. Within this context, this thesis investigates the politics of sustainability, focussing particularly on the way in which it is defined, because of the implications this has for the way in which environmental issues are understood and addressed. Following a review of various approaches to analysing environmental policy (traditional, mainstream, ecopolitical and discursive), Norman Fairclough’s approach to discourse analysis (Critical Discourse Analysis) was identified as having particular merit. Fairclough’s approach avoids the assumption that policy issues exist independently of the way they are framed and offers a perspective on discourse that links the social theoretical concerns of Foucault with the micro level concerns of linguistics. It also provides a means for taking environmental policy analysis in directions that that have attracted relatively limited attraction, namely the detailed analysis of the ideological effects of language on environmental policy. In this thesis Fairclough’s approach is used to explore how three storylines of sustainability (sustainable development, environmentally sustainable growth and transforming society) and their associated discourses shaped environmental policy making in Victoria, Australia, between 1999 and 2006. In undertaking this analysis, I examined the political and institutional context informing policy making (social practice); the contested process of text production (discourse practice), and; the detailed wording of a policy text (textual analysis). A major policy statement on environmental sustainability released by the Victorian Government in 2005 is subjected to detailed analysis. Based on the analysis undertaken, the substantive finding from this research is that rather than moving beyond neoliberalism, the Victorian Government embraced an approach to sustainability that was informed by neoliberalism and (weak) ecological modernisation, which constructs sustainability in ways that limit its importance and constrain the types of responses that could be advocated. In doing so, it drew heavily on notions of natural assets and ecosystems services as ways to make sense of the environment and why it is important. The Victorian Government also highlighted that environmental issues are caused by the cumulative effects of individual choices, and emphasized the importance of individual choice and behavioural change as central features of sustainability, while restricting opportunities for more transformative ideas to be heard. The broader conclusion arising from this research is that approaches to environmental policy that rely on neoliberal and (weak) ecological modern discourses are flawed, because, in commodifying nature, limiting the nature and magnitude of change required, and placing responsibility onto individuals they offer a constrained understanding of the challenge of sustainability and what needs to be done about it. The overall contribution made by this research is an improved understanding of the discursive nature of the politics of sustainability and the influence of neoliberalism and ecological modernisation, the use of a methodology that has attracted relatively limited attention within environmental policy (despite its widespread use in other areas of policy) and the documentation of a period of significant environmental policy reform in Victoria.

The continued importance of a feminist analysis: gendered inequalities visible through a critique of Howard government policy on domestic violence

This paper argues that feminist analyses remain crucial to any critical analysis of social policy. From the outset, it needs to be said that we are not suggesting that other critical analyses are less important, such as anti-racist analysis, for example (Dominelli 2002a, 2002b). We also acknowledge the significance of intersectionality theory which identifies the ways in which race and racism may compound gender inequality to shape experiences of oppression or privilege (Mullings & Schultz 2006; Weber 2006). Having said this, in this paper we argue that feminist analyses remain as important as ever, in challenging dominant patriarchal/capitalist discourse currently informing social policy in Australia.

As a counter discourse, feminism puts women’s experiences and the unequal relationships of patriarchy at the forefront of analysis, highlights gender inequalities entrenched in social institutions and policy, and draws attention to the organisation of society along gender specific lines and the inequalities resulting from the relegation of women to the private sphere (Dominelli 2002a).

Specifically, we will demonstrate that the Howard government’s policy responses to the issue of family violence have reflected a renewed attack on previous gains made by women, and exemplify a neo-liberal, neo-conservative approach to social policy that demands a critical feminist analysis. Given the recent federal election, it seems particularly timely to reassert the importance of a feminist analysis of social policy and to direct the attention of the new federal government towards reversing recent trends to de-politicise violence towards women.

Home based business in suburban peripheral regions and government policy: a case study of Casey, Melbourne, Australia

Home based businesses (HBB) are increasingly becoming an alternative to salaried employment. This research explores the potential for HBB to contribute significantly to the economic development of peripheral metropolitan centres. Without economic development, these centres remain dormitory suburbs with unresolved associated social and ecological issues. By mapping the diversity and limitations of HBB in the City of Casey, an outer suburban peripheral area of Melbourne, Australia, this study aims to evaluate what exists and the response by governments at all levels to further business development. This study finds that the role of government is restricted to broad initial start-ups, with no programs or support for the type of innovative HBB that need to be husbanded and encouraged to grow outside of the narrow confines of their home base.

'Emergenza nomadi' : institutional continuities in Italian government policy towards the Romanies

The Romani peoples today occupy a marginalised position in Italian society. A small number of these peoples live in ‘camps’ in conditions of extreme decay and abandonment. In order to address this situation and to improve these peoples’ lives, the Italian government has recently decided to implement an ‘extraordinary intervention.’ In 2008, in continuity with previous centre-left governments, the Berlusconi right-wing coalition implemented the so called ‘Emergenza Nomadi’ (nomad emergency). The state of emergency aimed to solve an issue that had been already categorised in the 1970s as the ‘problema nomadi’ (nomads problem), and was now described and handled as a ‘natural disaster.’ Based on interviews with Romani individuals, institutional and Third Sector representatives, participant observation and a broad range of secondary sources, this article argues that the enactment of an extraordinary measure was both disproportionate to the real degree of threat, and perpetuated an institutional tradition of racism and control of the Romani peoples. It was not, as the declaration of an ‘emergency’ might imply, the result of a sudden, unexpected situation which required an immediate action. The ‘emergency’ and the premises for the implementation of a ‘state of exception’ were created by protracted institutional immobility and political vacuum.