Health in All Policies in the Australian local policymaking environment

Kara Lilly

Background/Objectives: Health in All Policies is an evidence-informed approach to address population health inequities. There is limited empirical research demonstrating the role of local government in adopting a Health in All Policies approach. Methods: This study employed an explanatory, sequential mixed method to explore the policymaking environment of Australian local governments in relation to adopting a Health in All Policies approach. On online, national survey was followed by multiple case studies. Four theories of the policy process were explicitly embedded within the research design to deconstruct and describe the otherwise ‘messy’ policy process. Survey data were analysed using descriptive statistics and factor analysis to identify enabling and challenging factors influencing the local policy environment. Non-parametric testing was undertaken to compare local government across states/territories and geographical remoteness. Case study data were themed using template analysis and triangulated with the survey data. Results: Enablers to local government adopting Health in All Policies included personal and organisational obligations to act, a broad understanding of HWB and a strong policy subsystem within local government that includes local leadership and support. Challenging factors included a perceived lack of coordination or support from higher tiers of government, limited staff and financial capacity and lack of external lobbying putting pressure on the local policy agenda. City councils reported a more favourable policy environment than their rural and regional counterparts, across nearly all factors in the policy process. Discussion: The enablers and challenges in adopting a Health in All Policies approach in Australian local governments are similar to findings internationally. This study contributes to the otherwise limited discourse regarding the role of policy actor values and beliefs, the role of media, events and lack of lobbying action in the local policy process. City councils are in a more favourable position to adopt a Health in All Policies approach than regional and remote counterparts, which raises the impact of legislative environments and adequate resources to address health equity. Finally, the application of political science frameworks provides a theoretical lens to describe key factors of the policy process that must be considered for local government to successfully adopt a Health in All Policies approach.

Health in All Policies in the Australian local policymaking environment

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