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Enregistrement W4382517721 · doi:10.1002/hpja.770

Well‐being economy in Australia: Progress, challenges and opportunities

2023· editorial· en· W4382517721 sur OpenAlex
Mark Robinson

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Notice bibliographique

RevueHealth Promotion Journal of Australia · 2023
Typeeditorial
Langueen
DomaineSocial Sciences
ThématiqueHealth disparities and outcomes
Établissements canadiensnon disponible
Organismes subventionnairesnon disponible
Mots-clésHealth economicsPopulation healthPublic healthPolitical scienceEconomic growthEconomicsBusinessMedicineHealth careNursing

Résumé

récupéré en direct d'OpenAlex

The concept of a well-being economy—defined as ‘an economic system operating within safe environmental limits, that serves the collective wellbeing of current and future generations first and foremost’1—has become increasingly recognised in Australia in recent years. This is, in part, due to the influence of now Treasurer, Dr Jim Chalmers, who first mooted the idea of a well-being budget while in opposition in 2020.2 Although derided by the Coalition government, the idea of embedding well-being as a primary purpose of government was not a new phenomenon. As outlined by Jones et al. (2022),2 the Howard government established a well-being framework in 2004, though it failed to gain any level of prominence until it was abolished by the Abbott Government in 2016. Internationally, a cohort of countries, including New Zealand, Scotland, Canada, Iceland, Finland and Wales—have been at the forefront of the well-being economy movement through their membership of the Wellbeing Economy Governments (WEGo) partnership.3 Chalmers' mission to advance a well-being economy agenda in Australia seems to be following the lead of these WEGo countries. The initial priority for the Australian Government has been consultation on a set of well-being themes and indicators, initiated through the Measuring What Matters statement in the October 2022–2023 Budget.4 The purpose of these indicators is to shift the primary focus of a country's success away from economic measures like Gross Domestic Product (described by some as ‘an economy's all’5) towards a broader range of outcomes that capture a more holistic understanding of societal well-being. These frameworks typically encompass indicators across key themes such as health, education, environment, employment and social and cultural connectedness. These themes are akin to other pre-existing frameworks in Australia, most notably the National Agreement on Closing the Gap, which includes 17 socio-economic outcome areas that have an impact on life outcomes for Aboriginal and Torres Strait Islander people.6 Indeed, the National Association of Community Controlled Health Organisations has argued that all of the Closing the Gap indicators should be incorporated into Australia's Measuring What Matters statement to ensure that it ‘measures what matters to the well-being and progress of Aboriginal and Torres Strait Islander people’.7 The New Zealand Living Standards Framework provides breakdowns for different population subgroups across most indicators, and includes specific measures on Māori connection to marae and on the percentage of Te Reo Māori speakers.8 However, while indicator frameworks are useful and important tools for governments to communicate ambition and monitor progress towards a well-being economy, they are insufficient to achieve the ‘new economic model’ and ‘democratic reform’ that Chalmers refers to in his thought-provoking essay, Capitalism after the crises.9 For the Australian economy to serve the public and planet, and to do so in an equitable way, bold action is needed. In New Zealand, for instance, the budgetary focus on well-being has evolved from guiding frameworks to legislation that mandates governments—current and future—to identify their own well-being outcomes and how the actions they are proposing will achieve them.2 In addition to advancing policy coherence, specific funding has also been allocated towards well-being priorities, informed by its overarching framework of indicators.10 Legislation to embed common well-being goals across the whole of government has also been introduced in Wales through its Wellbeing of Future Generations Act (2015).11 As in New Zealand, this mandates all government departments and public bodies to articulate how their objectives will align with these goals and what actions will be undertaken to achieve them. While this shows potential next steps for the Australian Government, moving from guiding frameworks to legislation, the effectiveness of these high-profile approaches in New Zealand and Wales remains unclear. A lack of clear accountability mechanisms, symbolic rather than transformative funding reallocation and insufficient cross-sectoral collaboration to enable bold policy reform have constrained the well-being economy's ability to realise its vision.2 Of course, actions that are likely to contribute to a population's well-being can occur in the absence of an explicit well-being economy framework or budget. In recent years, Australia has witnessed several policy examples that align well with the principles of a well-being economy approach, namely, pre-distribution, purpose, prevention and people-powered.12 The increase in welfare payments during the peak of COVID-19, for example, was estimated to reduce the number of people living in poverty by over 30%.13 Although driven by economic arguments, income is a strong determinant of health and well-being. In the most recent budget, the $300m investment to retrofit 60 000 social housing dwellings is aimed at improving energy efficiency for low-income homes.14 In doing so, it is also likely to improve health, with benefits distributed in an equitable way, an example of a ‘super policy’ that can plausibly contribute to the ‘triple-win’ of improved health, equity and sustainability.15 For those in public health, both of these examples would be characterised as representing action on the social determinants of health; upstream and preventive approaches tackling the causes of poor health and health inequities, rather than reacting to the ‘failure demand’ of their downstream effects. While the social determinants of health have provided a conceptual framework for understanding the drivers of poor population health and health inequities, Health in All Policies (and its associated tools such as Health Impact Assessment and Health Lens Analysis) offers a practical approach to addressing those determinants.16 The key principles of a HiAP approach include intersectoral collaboration, health equity, evidence-informed decision-making, sustainability (including environmental, social and economic sustainability) and public participation.17 Although primarily focused on population health, the alignment between the principles of this well-established public health approach and the well-being economy approach is apparent. This synergy between the well-being economy with other public health concepts and approaches presents both risks and opportunities. There is a danger that the term ‘well-being economy’ is captured and exploited as a cohesive yet vague concept and used superficially as a catch-all for policies and actions loosely linked to well-being; essentially a rebranding of what is already being done with a continuation of mostly incremental policy action occurring at the margins.18 In Scotland, the National Performance Framework was introduced in 2007 as part of a move to outcomes-focused planning, over a decade before it was rebranded as a well-being framework. With stalling mortality trends and widening health inequities over this time period,19 the move to a well-being economy framing has been useful to raise the profile of markers of societal well-being, but has clearly not been enough to address them. This suggests a ‘dispiriting implementation gap’,20 a disconnect between expectations and outcomes, which is a criticism also pointed at the social determinants of health21 and HiAP.17 As with ‘prevention’, it is important to avoid well-being economy becoming shorthand for a large number of often-disparate choices whose benefits and costs are necessarily distributed unequally across the population.22 The stagnation, and in some cases worsening, of human and planetary well-being in recent decades, despite well-intentioned political and policy commitments, is perhaps unsurprising when we consider the global ‘consumptogenic system’ within which these commitments are being made.18 A consumptogenic system refers to an economic system that promotes consumption as a primary driver of economic growth, often at the expense of human and planetary well-being. It has become the dominant system globally and is characterised by ‘institutions, policies, business practices and social norms that embed and entrench principles of extractive capitalism and colonialism’.18 Its key actors, including powerful commercial entities, have a profound effect on people and planet.23 By design, this system prioritises profit over health. Thus, moving towards a policy environment that prioritises well-being may be a necessary precondition for change. However, the impacts of such policies will only be maximised when introduced into a fundamentally redesigned economic system in which entrenched power inequities and vested interests are addressed.18 The momentum around the well-being economy in Australia provides those working in public health and health promotion an opportunity to collaborate with other sectors and disciplines to shape what such an economic system might look like and, more importantly, to progress action to achieve it. This opportunity is already being seized upon, as exemplified by the recent Lancet series on the commercial determinants of health led by Professor Rob Moodie at the University of Melbourne,24 the Planetary Health Equity Hothouse research agenda being led by Professor Sharon Friel,25 and the multiple contributions from VicHealth and The George Institute for Global Health.26 This special edition of the Health Promotion Journal of Australia shows further appetite to translate the well-being economy concept into tangible action, drawing on the public health lessons of the past. Thus, although somewhat late to the well-being economy movement, by using it as a mechanism to connect and leverage these other interrelated efforts, Australia can reposition itself from global follower to global leader. The author declares no conflicts of interest.

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Imitation des enseignants

Ni prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.

score de la tête « metaresearch » (Codex)0,007
score de la tête « metaresearch » (Gemma)0,001
Version: codex-gemma-dda1882f352aStatut de validation: machine_predicted_unvalidated
Catégories candidatesMéta-épidémiologie (sens strict)
Catégories consensuellesaucune
DomaineSignal candidat: aucune · Signal consensuel: aucune
Devis d'étudeSignal candidat: Sans objet · Signal consensuel: Sans objet
GenreSignal candidat: Éditorial · Signal consensuel: Éditorial
Score de désaccord entre enseignants0,190
Score d'incertitude au seuil1,000

Scores Codex et Gemma par catégorie

CatégorieCodexGemma
Métarecherche0,0070,001
Méta-épidémiologie (sens strict)0,0000,000
Méta-épidémiologie (sens large)0,0010,000
Bibliométrie0,0010,000
Études des sciences et des technologies0,0000,000
Communication savante0,0000,001
Science ouverte0,0000,000
Intégrité de la recherche0,0010,002
Charge utile insuffisante (le modèle a refusé de juger)0,0000,000

Scores machine (provisoires)

Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.

Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.

Tête enseignante Opus0,237
Tête enseignante GPT0,451
Écart entre enseignants0,214 · la distance entre les deux têtes enseignantes sur ce seul travail
Statut de validationscore_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle