A new Hazelwood Mine Fire Inquiry report makes strong recommendations for place-based, community building approaches to help improve the health and wellbeing of people living in the Latrobe Valley, and reduce the level of social disadvantage they face.
Following on from findings that people living in the Latrobe Valley are experiencing poorer health and greater levels of disadvantage than the rest of the state, the report states there are “key health improvements that require immediate attention” and that an innovative place-based approach is needed.
The report tabled in Victorian Parliament this week, two years on from the fire, reaffirms 2014 Hazelwood Mine Fire Inquiry findings that:
“There is a strong case for the health of the population of the Latrobe Valley to be substantially improved. Based on current health status information, this was justified before the Hazelwood mine fire and is even more necessary after it……the population of the Latrobe Valley already has significant health challenges and does not enjoy the levels of health and social wellbeing of most other Victorians. Latrobe Valley is also socially and economically disadvantaged relative to the rest of Victoria, which further exacerbates health condition (p. 22).”
The new report, Hazelwood Mine Fire Report 2015/16: Volume III Health Improvement, contains key findings in relation to chronic disease management, mental health, early detection and high-risk screening, health behaviours, healthy workplaces, healthy environments, the health of children and young people, the effect of social disadvantage on health, and Aboriginal health in the Latrobe Valley. Its findings were based on public submissions, community consultations, Health Improvement Forums and expert reports.
Key findings include:
- The healthcare system in the Latrobe Valley needs to change. Innovation is needed to improve health outcomes and this requires significant support and additional funding from state and Commonwealth governments.
- Improvements to the health of Latrobe Valley communities requires participation from all members of the community, local health practitioners, local and state agencies and authorities, and state and Commonwealth governments.
- There is a strong causal relationship between social disadvantage and health; this needs to be addressed more overtly in future health improvements to reduce inequity.
- A concerted effort is needed to plan for and project a positive and healthy future for the Latrobe Valley, which builds pride in the local community and its natural environment.
- There are key health improvements that require immediate attention, such as integrating chronic disease management, addressing associated mental health conditions, promoting mental wellbeing (including the prevention of family violence), and promoting the cessation of smoking.
- Community access to health professionals needs to be improved for those requiring investigations, treatment and ongoing care, both locally and outside of the Latrobe Valley.
- Improvements in leadership and governance are required to enhance and integrate the variety of health responses undertaken by multiple agencies in the Latrobe Valley.
- New mechanisms are required to ensure that health initiatives are sustainable and longer lasting, and not so susceptible to changes in the political and financial landscape.
The 2015/16 report recommends the most effective catalyst for improving the health of the Latrobe Valley is for the state government to formally designate and resource the Latrobe Valley as a Health Innovation Zone for a minimum of eight years, with a focus on innovation, integration, and community engagement. It identifies five main areas relevant to progressing health improvements in the Latrobe Valley:
- Strengthening health services
- Promoting healthy living
- Reducing health inequities
- Building pride of place
- Strengthening leadership and sustainability.
The report also recommends that any health improvement strategies:
- are informed by a strong community engagement process
- focus on reducing health inequities
- draw on the capacity, goodwill and opportunities present
- integrate actions across relevant providers
- are evaluated for their wider applicability across Victoria.
It also recommends that any initial health improvement programs be focused on innovative ways to deliver:
- social marketing programs which build pride of place
- integrated care for people with chronic diseases, especially those with related mental health conditions
- tele-medicine services to reduce the barriers of access to medical specialists and other health practitioners
- promotion of mental wellbeing, including the prevention of family violence
- smoking cessation programs which are effective for priority groups.
Importantly the report acknowledges that the Aboriginal population in the Morwell region experiences significantly poorer health, education and employment outcomes than the non-Aboriginal population. They are less likely to access mainstream community and health services, and are at particular risk of detrimental impacts on health in times of emergency. The report recommends establishing an independent community controlled health organisation for the Latrobe Valley Aboriginal community and a new culturally appropriate health and community facility which will help with the engagement of Aboriginal young people.
VCOSS provided an initial submission to the reopened Inquiry and was also invited by the Board of Inquiry to attend its Health Improvement Forum on Social Disadvantage as specialist participant. VCOSS also provided a Supplementary Submission to clarify issues raised at the Health Improvement Forum.
At the forum, VCOSS outlined the way community sector organisations build direct relationships with the most disadvantaged members of a community through the services they provide. These organisations can therefore play a significant role in informing the community about support services and health initiatives, particularly in an emergency, provided they have adequate resources to undertake this role. VCOSS suggested opportunities exist to improve community engagement by building on existing networks, and that “vulnerable people aren’t hard to reach; the system finds it hard to access them”’ and therefore “decision makers must acknowledge and support the unique role that community sector organisations play in the region through filling service gaps” (p. 87). VicHealth similarly recommended an approach to community engagement that builds on and incorporates existing community services and service providers. The Inquiry report agreed that building on the strengths of existing organisations should be further considered. There is merit in the suggestion that agencies should collaborate to strengthen the existing networks and relationships between community sector agencies and the more vulnerable. The report states:
“The Board was encouraged by the discussion in submissions and during the Health Improvement Forums that there were opportunities to learn from existing place-based approaches that have been used to reduce health inequity across the world and in Australia. The Board considers that approaches such as Healthy Cities and Go Goldfields offer an opportunity for similar models to be implemented in the Latrobe Valley. The Board considers there is real merit in such an approach in terms of working towards better health and reducing inequity. Given the sustained history of the Healthy Cities approach and the promising results obtained across the world, the Board suggests that the model provides a source of examples for the Latrobe Valley, and that Latrobe City Council consider adopting a similar approach in the longer-term (p 92).”
The report states that the VicHealth Fair Foundations Framework is an excellent tool that should be used by other community agencies to inform action and future work concerning social disadvantage. It states that the framework should influence all decisions relating to health improvements in the Latrobe Valley so that more equitable outcomes are achieved
VCOSS submitted to the Inquiry that the Morwell community has a strong appetite to re-establish a sense of place and pride, including among its residents, businesses, community organisations, schools, local government and industry. It stated that the aftermath of the mine fire presents a unique and significant opportunity to take a new approach that acknowledges Morwell’s past contributions to the state of Victoria, recognises its strengths and challenges, and provides an innovative and collaborative way forward. VCOSS stressed the particular need to focus on education, strengthen the community sector, and invest in collaborative social initiatives to address the complex social problems faced by the Morwell community.
VCOSS welcomes the strong recommendations made by the Hazelwood Mine Fire Inquiry and looks forward to responses from the Commonwealth and Victorian governments.