Towong Healthy Communities Plan 2013 - 2017

Appendices

Appendix 1 - Guide to Municipal Public Health and Wellbeing Planning January 2013 Department of Health

Appendix 2 - Social Model of Health and Determinants of Health

Appendix 3 - Project Planning Method

Appendix 4 – Towong Shire Health and Wellbeing Evidence

Appendix 5 – Policy Scan and Literature Review (Local, Regional, State)

Appendix 6 - Community Engagement Strategy

Appendix 7 – Review and Evaluation Processes

Appendix 1 - Guide to Municipal Public Health and Wellbeing Planning (2013)

The Public Health and Wellbeing Act 2008 (PH&WB Act) reinforces the statutory role of councils to ‘protect, improve and promote public health and wellbeing

within the municipal district’ (s.24). The municipal public health and wellbeing plan (MPHWP) required of councils under the Act sets the broad mission, goals

and priorities to protect and promote municipal public health and wellbeing.

Encouraging people to lead healthier lives – and building environments that help them to do so – is challenging. The Victorian Health Priorities Framework

2012–2022, which sets out the government’s aspirations for the future of Victoria’s health system, identifies the major challenges facing Victoria’s health

system, especially the demand on health resources due to population growth, demographic ageing, and the rise of chronic and complex conditions. The

framework highlights the need for greater capacity to deliver prevention, primary care and early intervention.

The Victorian Public Health and Wellbeing Plan 2011–2015 complements the Health Priorities Framework and is based on evidence that illustrates how to most

effectively mitigate the challenges facing the health system. Overall its aim is to improve the health and wellbeing of Victorians by engaging communities and

strengthening systems for health protection, health promotion and preventive healthcare across all sectors and levels of government. The plan outlines the

wide range of contributors and mechanisms for coordinated planning, policy alignment and program coordination, and recognises MPHWPs as a key

mechanism for delivering a system that is responsive to people’s needs at the community level. The plan outlines a number of opportunities to further

strengthen and expand the role of local government in promoting health and wellbeing, in the context of building a more effective prevention system in

Victoria.

Other ways in which the department supports further strengthening the role of local government in promoting health and wellbeing are through:

investing in the Victorian Population Health Survey to produce population health status estimates for each local government area (LGA) every three years

developing evidence-informed health promotion resources

aligning the planning cycle for the Integrated Health Promotion Program to that of MPHWPs so that community health and women’s health services,

primary care partnerships and councils can better align their priorities

providing support through regional offices for networking, partnership development, use of research and data in planning, implementation, evaluation

and workforce development

Planning guides to support quality municipal health and wellbeing planning

Healthy Together Communities strategies

Centre of Excellence in Intervention and Prevention Science (CEIPS)

Victorian Prevention and Health Promotion Achievement Program

Victorian Healthy Eating Enterprise (VHEE) including the Healthy food charter, the Victorian Healthy Eating Advisory Service, the Victorian Healthy Food

Basket Survey and the Victorian Aboriginal nutrition and physical activity strategy.

Appendix 2 - Social Model of Health – Determinants of Health

Planners in health aim to improve health and wellbeing and reduce the burden of preventable disease. Planners consider the individual together with the

broader context of public policies and environmental influences, group and family influences and the community context as illustrated in Figure 1.

Figure 1: The World Health Organisation context of health1

There is a growing consensus that some groups in society have a much poorer chance of achieving their full health potential as a result of their life

circumstances – including political, social, economic and environmental conditions. Integrated health promotion attempts to close the equity gaps by

1 WHO 2010 Conceptual Framework for Action on Social Determinants of Health, pp 6

supporting social networks; developing and advocating healthy public policies; and strengthening community capacity. Each factor should not be considered

separately.

Differences are observed in the health status of groups according to a range of socioeconomic indicators. There is evidence the most disadvantaged groups

have the poorest health and the highest exposure to health-damaging risk factors (for example, to have poorer nutrition, less physical activity in leisure time,

greater prevalence of smoking and more damaging patterns of alcohol use). The life circumstances or determinants of health (including people’s social and

economic circumstances, indigenous status and ethnicity, stress, gender, early life development and experiences, social exclusion, work and unemployment,

and social supports) of people experiencing disadvantage highlight the greater restrictions on ‘making healthy choices the easy choices’.

Further, cultural diversity and the failure of the system to address issues of access to appropriate services and programs for diverse groups can create

inequalities in health status. The concern for Council and the Health Services are inequalities of health resulting from social inequities such as reduced access

to nutritious foods, inadequate housing, lack of access to appropriate health care, lower income levels, stressful work conditions and frequent periods of

prolonged unemployment.

Therefore, a Social Model of Health provides a framework for addressing the social and environmental determinants of health, in tandem with biological and

medical factors. In practice, working within a social model of health means investigating what determines health and wellbeing, including:

The social gradient: People’s social and economic circumstances affect health throughout life. A continuum exists from the disadvantaged to well off rather

than a binary effect at the extremes.

Stress: The individual response to stress can cause physiological changes, which affect health. It is recognised that people’s social and psychological

circumstances can affect health through stress.

Early life: The effects of early physiological and psychological development, both negative and positive, last a lifetime. The infant is dependent on their

circumstances and significant others for both physical and emotional experiences.

Social exclusion: This may be imposed by law, result from economic circumstances or from failure to supply social goods or services. Groups that are socially

excluded include the unemployed, ethnic minorities, homeless, pensioners or people with disabilities. These groups experience worse health outcomes than

the general population.

Work: Stress in the workplace increases the risk of disease. An imbalance in two aspects of workflow control when work demands are high and an imbalance

in effort in relation to reward (income, self esteem or status) – have been identified with negative health consequences.

Unemployment: Unemployment and job insecurity have a negative effect on health. Psychological and social resources are likely to increase in employment

and decline in unemployment.

Social supports: Friendships, good social support at home, at work and in the community improve both physical and mental health.

Addiction: While individuals use alcohol, drugs and tobacco, their use is influenced by a wider social setting. Addictive behaviours are generally detrimental to

health.

Food: Strong links have been established between nutrition (both under and over nutrition) and a range of diseases.

Transport: Healthy transport means reducing driving and encouraging more cycling and walking, backed up by better public transport.2

2 Wilkinson R & Marmot M (eds) 2003 Social Determinants of Health: The Solid Facts 2

nd edition WHO Denmark

Appendix 3 - Project Planning Method

The project planning method used for developing the 2013 – 2017 Towong Healthy Communities Plan was the Department of Health’s 2012 Health Planning

Toolkit. This method provided a strategic and evidenced based approach towards development of the Plan.

HUME REGION HEALTH

PLANNING CYCLE

Set Context

Clear Purpose and Scope developed (Plan p7)

Aim and Strategic Directions developed (Plan p7 & 18)

Develop Leadership and Partnerships

Work within the structure of the Towong Alliance (Plan p7 & 12)

Survey Environment

Policy Context and Literature Review undertaken (Plan Appendix 6)

Analyse Data

Evidence Framework and Policy Context (Plan Appendix 4 & 6)

Establish options

Refer Strategic Directions Plan (Plan p18) Set Priorities and Implementation

Implementation plan (Plan p19)

Management (Plan p39)

Evaluate

Review and Evaluation processes outlined (Plan Appendix 7)

Appendix 4 – Towong Health and Wellbeing Evidence

The Hume Region - Health Planning Data and Evidence Framework3 was used as a guide to assess a range of data sources available to inform the development

of the Healthy Communities Plan. The Towong Shire Population Health Profile and REMPLAN (economic modeling based on ABS data) were used to assess

the determinants of health for the community under the three following categories:

Determinants of Health – includes a general context in which people live and non-medical determinants that affect the health of individuals including

behavioural, demographic, environmental and genetic determinants or risk factors.

Health Status – includes levels and patterns of health in the population including deaths, life expectancy, health conditions, human function and wellbeing.

Health System – includes a context of the health system characteristics including community perceptions, policy, resources, distribution and utilisation of

services.

Demographics4 (ABS 2011)

Population: 5,958, the project population in 2021 is expected to be 6,437

Females Males Total % total LGA population % total VIC

population

0–14 495 559 1,054 17.7% 18.2%

15–24 282 298 580 9.7% 13.9%

25–44 594 526 1,120 18.8% 29.1%

45–64 910 1,013 1,923 32.3% 24.8%

65–84 537 566 1,103 18.5% 12.1%

85+ 99 99 79 178 3.0% 1.9%

Total 2,917 3,041 5,958 100% 100%

45-64: 32.3% are aged between 45-64

65+: those aged over 65 will increase from 21.5% in 2011 to 29.1% in 2021, compared to the Victorian increase from 14% to 16.76%

3 Health Planning Toolkit http://www.health.vic.gov.au/regions/hume/toolkit.htm#framework

4 Department of Health Towong Population Health Profile 2013

Aboriginal population: 1.48% of the population identify as Aboriginal and Torres Strait Islander (ATSI) in comparison to Victoria 0.74%, Towong is ranked

15/79 LGAs in Victoria for percentage of ATSI people

Cultural diversity: 7.9% of the population have been born overseas in comparison with 27.7% in Victoria

Socio-economics, employment and education

IRSED: index of relative socio-economic disadvantage is 999.6 and identified as ‘disadvantaged’, the baseline IRSED score is 1,000

Income: 45.4% of individuals have less than $400/week income, compared to Victoria (39.9%) and Towong is ranked 15 out of 79 LGAs

Employment: Towong unemployment (4.6%) is lower than Victoria (5.4%). Total Employment in the area is estimated at 1,921 jobs.

The major contributors to employment are:

Industry Sector Jobs %

Agriculture, Forestry & Fishing 611 jobs (31.8 %)

Health Care & Social Assistance 256 jobs (13.3 %)

Education & Training 190 jobs (9.9 %)

Other 864 jobs (45.0 %)

Education: 66.1% did not complete year 12 compared with 43.7% Victorian average, Towong is ranked 13 out of 79 LGAs for non-completion

Safety, engagement & transport

Safety: Towong is ranked 1 out of 79 LGAs with 95.4% of the population feeling safe on the street after dark

Volunteering: 40.5% of the population help as a volunteer compared to Victoria (19.3%) and Towong is ranked 5th

highest out of 79 LGAs

Transport: 5.7% of the Towong population is near public transport compared to 74% in Victoria, Towong is ranked 76 out of 79 LGAs

Family violence: Towong (8.2%) is ranked 43 out of 79 local government areas for family violence incidents per 1,000 population, Victoria 9.1%

Housing: 3.6% of people over 75 years live alone; 61.3% of whom are women5

5 Women’s Health Goulburn North East, Women of the Hume: Towong 2012, www.whealth.com.au

Health behaviours

Alcohol: 11.6% are at risk of short-term harm from alcohol consumption compared to Victoria (10.2%).

Breast screening: Towong has a low participation rate (29%) and is ranked 77/79 LGAs

Diet: 44.9% did not meet the dietary requirements for fruit and vegetable intake, compared to Victoria (48.2%).

Overweight: 56.7% are overweight/obese compared Victoria (48.6%) and Towong is ranked 17 out of 79 LGAs

Physical activity: 21.3% did not meet physical activity guidelines, compared to Victoria (27.4%)

Psychological distress: 11.2% reported a high/very high degree of psychological distress compared to Victoria (11.4%).

Smoking: 17.4% of people smoke compared to Victoria (19.1%)

Health conditions

Preventable hospital admissions: diabetes complications, chronic obstructive pulmonary disease, congestive cardiac failure are the most common

reasons for preventable hospital admissions in Towong

Cancer incidence: amongst females in Towong is 582.8 per 100,000 and 1052.3 per 100,000 males, compared to 454.3 and 573.4 respectively in Victoria

Immunisation: Towong is ranked highest (1) out of 79 LGAs for having the most children immunised at 24-27 months

Life expectancy

Female: life expectancy in Towong (83.4) is lower than Victoria (84.4).

Male: life expectancy in Towong (78.6) is lower than Victoria (80.3).

Mortality

Avoidable mortality: top 3 causes: lung cancer, ischaemic heart disease, colorectal cancer

Rural suicide: Close to 80 per cent of all suicides in Australia are men (1,816 of 2,361 in 2010), men living in rural and remote locations experience a higher

rate of suicide than their metropolitan counterparts (23.8 per 100,000)6, highest Australian male rates of suicide (2010): 35-49 years (27.5%), 75-84 years

(24.8%), 15-24 years (13.4%, accounts for close to one quarter of all deaths in this age bracket).

6 Beaton, S & Forster, P (2012) Insights into men’s suicide, Australian Psychological Society http://www.psychology.org.au/inpsych/2012/august/beaton/

Community Health and Wellbeing Services and Activities

Agencies listed on the right, provide

health programs marked with a * to

Towong Shire residents, (V) denotes visiting

service provider

Tallan

gatt

a H

ealt

h S

erv

ice

Walw

a B

ush

Nu

rsin

g C

en

tre

Up

per

Mu

rray H

ealt

h &

Co

mm

un

ity S

erv

ice

To

wo

ng

Sh

ire C

ou

nci

l

Oth

er

Co

mm

en

ts

Alcohol and Drug

Counselling, consulting & continuing care *

Pharmacotherapy regional outreach

Rural withdrawal

Community Aged Care

Respite – in/out home activity * * *

Flexible respite *

Carer support & respite * * *

Dementia support activities * *

Independent Living Units *(4) *(8)

Home and Community Care

Assessment * *

Care Plans * *

Delivered Meals * * *

Dietetics * *(V)

Domestic Assistance * * *

Falls Prevention Program * * *

Home Maintenance/Gardening * * *

Nursing * * *

Nursing (continence) * *

Mapping: Community Health and Wellbeing in Towong Shire

Occupational Therapy * *(V) *

Personal Care * * *

Physiotherapy *(V) *(V) *

Planned Activity Group * * *

Podiatry *(V) *(V) *(V)

Respite * * *

Speech Therapy *(V) *(V)

Volunteer Coordination * *

Primary Health

Asthma Education * *

Breast Screen Van *(V) *(V)

Childbirth Education *

Counselling/Casework * * *

Community Development * *

Community Garden * *

Diabetes Self Management * *

Dietetics * *(V)

District Nursing * * *

Domiciliary Midwifery * *

Exercise Groups * * *

FoodBank/FairShare *

Financial counselling *(V) *(V)

Health Centre/Gym/Exercise Physiologist * *

Health Promotion * * *

Healthy Eating programs * * * 0-12 years focus

Hearing Service *(V) *(V)

Hypnotherapist *

Immunisation * * *

Initial needs identification * *

Integrated chronic disease management *

Massage *(V)

Maternal & Child Health *(V) *

Medical Clinic – general practice * * *

Men’s Health/Group * *

Nurse Practitioner * * *

Occupational therapy * *(V) *

Optometrist *(V)

Paediatrics *(V)

Pathology * C * C = collection service

Palliative Care * * *

Pharmacy *

Physiotherapy * * *

Podiatry *(V) * *(V)

Radiography *

Speech therapy *(V) *(V)

Tele-Health Service * * *

Women’s Health/Clinic * *

Young people programs * *

Mental Health (community-based)

Home-based outreach support *(V) *(V)

Planned respite in home

Psychosocial rehabilitation day programs

Mental Health First Aid Program *

Acute and Sub Acute Care

Acute Care Beds Post Surgical *(15) * *(10)

Ambulance CERT CERT & RANEG

Day Procedure Unit *

Emergency/Urgent Care * * *

High Care Residential * (15) *(19)

Renal Dialysis Respite *

Residential Aged Care *(36) *(16)

Transition Care *(2) * *

Wound Care Management * * *

Social Determinants of Health: relevant services, strategies and plans

Environment NECMA

Community Facilities (Asset Plan) *

Community Transport * * *

Domestic Waste Water Plan *

Economic Development *

Emergency Management & Heatwave * * * *

Emergency Management – Vulnerable

People List * *

*

Public Land Management DEPI

Road Safety Strategy *

Safe environment – footpaths,

environmental health

*

Swimming Pools (Corryong & Tallangatta) *

Tourism Strategy *

Town & Land Use Planning *

Waste Management *

Youth Strategy *

Housing

DHS (Victoria)

Rural Housing

Network

Sources: Tallangatta Health Service, Annual Report 2012-2013

Tallangatta Health Service, Quality of Care Report 2012-2013

Towong Shire Council Plan 2013-2017

Upper Murray Health & Community Services, Service Plan 2013 – 2018

Walwa Bush Nursing Centre 2009-2012 Service Plan

Towong Wellbeing Report

Community Wellbeing Reports contain a select number of community wellbeing indicators which are used to highlight important trends and issues in

the community. These reports provide a snapshot of the wellbeing of individual municipalities with comparisons to regional and statewide results.7

Healthy Safe and Inclusive Communities - Personal Health and Wellbeing

Subjective Wellbeing

Subjective Wellbeing was measured in the 2011 VicHealth Indicators Survey using the Australian Unity Wellbeing

Index (AUWBI). Respondents were asked to rate their satisfaction with their lives on a number of domains resulting in

an aggregated Personal Wellbeing Index ranging between 0-100.

Normative data from the AUWBI indicates that the average Personal Wellbeing Index for Australians is approximately

75. In comparison, the average Personal Wellbeing Index for persons living in Towong was 80.2 in 2011, while the

Hume Region average was 79.6 and the Victorian State average was 77.5.

View this data as a Wellbeing Map

Read more about this Indicator

80.2 79.6 77.5

Towong Hume Victoria

7 Source: Community Indicators Victoria, http://www.communityindicators.net.au/wellbeing_reports/towong, accessed 6 February 2014

Healthy Safe and Inclusive Communities - Community Connectedness: Social Support

Social Support was measured in the 2008 Dept of Planning & Community Development. Respondents were asked if they

could get help from friends, family or neighbours when they needed it, either definitely, sometimes or not at all.

94.7% of persons living within Towong reported that they could definitely get help from friends, family or neighbours when

they needed it, as compared to 91.8% in the Hume Region.

View this data as a Wellbeing Map

Read more about this Indicator

94.7 91.8 91.7

Towong Hume Victoria

Healthy Safe and Inclusive Communities - Community Connectedness: Volunteering

Volunteering was measured in the 2008 Dept of Planning & Community Development. Respondents were asked whether

or not they helped out as a volunteer.

62.3% of persons living within Towong reported they helped out as a volunteer, as compared to 48% in the Hume Region.

View this data as a Wellbeing Map

Read more about this Indicator

62.3 48 40.8

Towong Hume Victoria

Healthy Safe and Inclusive Communities - Personal and Community Safety: Crime

Crime statistics are produced annually by Victoria Police. Summaries of offences are reported per 100,000 population

to enable comparisons across different areas.

In Towong, there were 552 recorded crimes against the person per 100,000 population in 2012-13 compared to

1161.1 in the Hume Region and the Victorian State average of 1026.7.

In Towong, there were 2275 recorded crimes against property per 100,000 population in 2012-13, compared to

3676.3 in the Hume Region and the Victorian State average of 4640.7.

View this data as a Wellbeing Map

Read more about this Indicator

552 1161.1 1026.7

Towong Hume Victoria

Person

2275 3676.3 4640.7

Towong Hume Victoria

Property

Healthy Safe and Inclusive Communities - Lifelong Learning

Home Internet Access

Home Internet Access was measured in the 2011 Australian Bureau of Statistics. Respondents were asked to indicate

if the Internet could be accessed from their dwelling, and if so, whether access was via a dial up or broadband

connection.

In Towong, 69.7% of persons lived in households that had Internet access of any form at their dwelling, compared to

72.3% in the Hume Region and the Victorian State average of 79.6%.

Of the total population of Towong, 62.9% lived in households that had home Internet access via a broadband

connection, compared to 64.4% in the Hume Region and the Victorian State average of 72.4%.

View this data as a Wellbeing Map

Read more about this Indicator

69.7 72.3 79.6

Towong Hume Victoria

Internet

62.9 64.4 72.4

Towong Hume Victoria

Broadband

Dynamic Resilient Local Economies - Income and Wealth: Income

Median Equivalised Household Income has been calculated from the 2011 Australian Bureau of Statistics. Equivalising

income adjusts the total income of the household according to the number of persons and household type.

Median Equivalised Gross Weekly Household Income for Towong was $560, compared to $629 in the Hume Region and

the Victorian State average of $749.

View this data as a Wellbeing Map

Read more about this Indicator

560 629 749

Towong Hume Victoria

Sustainable Built and Natural Environments - Transport Accessibility: Transport Limitations

Transport Limitations were measured in the 2011 VicHealth Indicators Survey. 29.3% of persons living in Towong had

experienced transport limitations in the previous year, compared to 22.6% in the Hume Region and the Victorian State

average of 23.7%.

View this data as a Wellbeing Map

Read more about this Indicator

29.3 22.6 23.7

Towong Hume Victoria

Appendix 5 - Policy Scan and Literature Review (Local, Regional, State)

The following policies and literature have been identified as crucial to informing the Towong Healthy Communities Plan 2013 - 2017.

Local

Community

Strategies

Strategy Key Points What does this mean to Towong and

the Towong Alliance

Tallangatta

Tomorrow (2013)

A strategy to help Tallangatta become a thriving town.

Extensive community consultation through focus groups and

community workshops (300) community survey (400), website (2000

hits) and information displays, blog, and newsletter.

450 Big Ideas were identified with major themes focusing on housing,

tourism, open spaces (including streets & triangles), Lake Hume &

foreshore reserve, community facilities & services and the town

identity.

Community planning provides a clear

understanding of the values, needs of

individual communities within the

Towong Shire. This information will

significantly contribute to the

development of the health and

wellbeing plan actions.

These plans also provide opportunity

for agencies to develop and strengthen

relationships within communities to

achieve integrated and successful

interventions and initiatives.

Our Bellbridge The project is intended to see the town grow, be sustainable and

bring together the needs of the visitors and community with the

outcome being to set goals and initiatives that can be developed over

the next 5 – 15 years with some projects identified as priorities for the

shorter term.

Mitta Valley:

Our Valley Our

Future 2013 – 2016

Vision:

Creating a strong sustainable and vibrant community for everyone

The nine biggest challenges and priorities facing the Mitta Valley were

identified through visitor (41) and community (97) surveys, a

community planning day (100) and local research: Business and

employment, Farming, Tourism, Community infrastructure,

Communication, Housing, Our young people, Our ageing population,

and Social cohesion.

Local:

Council

Strategies

Strategy Key Points What does this mean to Towong and

the Towong Alliance

Council Plan 2013 -

2017

Our Vision

We will be a World Class small Council and Towong Shire will be the

ideal place to live

Our Mission

To provide leadership and service to the Towong Shire Community

that adds value and enhances social, economic and environmental

wellbeing now and into the future.

Towong Shire is currently experiencing

an ageing and declining population.

The Health and Wellbeing Plan has

opportunity to influence positive

health and wellbeing outcomes that

also contribute to the sustainability

and potential growth of the Shire.

Strategic objectives:

Organisational improvement: Embed organisational excellence into

our governance and management processes in order to deliver the

best possible outcomes for our residents and ratepayers.

Community Wellbeing: To assist Towong Shire residents in the

attainment of a high level of health and safety, resilience and

connectedness to their communities

Asset management: Maintain and improve our Shire’s infrastructure

to meet agreed levels of service

Land-use planning: Develop a strategic and sustainable long-term

land-use direction for the Shire based on an integrated approach to

the natural and built environment

Environmental sustainability: Integrate sustainable natural resource

management into all of our business activities

Economic and tourism development: Expand long-term employment

and economic opportunities whilst continuing to maintain and

promote our natural environment and the lifestyle our municipality

offers.

Municipal Public

Health and Wellbeing

Plan

...we must plan in advance to make informed decisions around social,

economic and physical environments that directly affect the health

and wellbeing of all communities.

The 2009 - 2013 Healthy Communities

Plan identified strategies around the

Environments for Health, however, with

“Healthy

Communities Plan”

2009 - 2013

...looks at the bigger picture of what is going on in our community

that influences or even contributes to local health problems. By

addressing these concerns through strategic planning, policy making

and partnerships, we can build a stronger, healthier community into

the future.

a broader view on health and

partnerships greater positive outcomes

will be able to be achieved.

Municipal Strategic

Statement

Responds to requirements of the Planning and Environment Act 1987

requiring a MSS is consistent with the current corporate plan of

Council.

Towong Shire’s current Council Plan vision is “We will be a world class

small Council and Towong Shire will be the ideal place to live.”

Therefore, the MSS recognises that population, economy,

environment and settlement play a significant part in influencing how

our community looks. The MSS outlines the current situation, key

issues for each and identifies objectives and strategies for

contributing to achieving Council’s Vision.

There is opportunity for the Health and

Wellbeing Plan to support the

achievement of objectives relating to

increasing the health and wellbeing of

the community. For example,

promoting cultural diversity,

addressing issues relating to the

ageing population, employment and

training opportunities for young

people.

Recreation Plan Increasing participation in sport and recreation:

1. Supporting participation by older adults

2. Supporting volunteers

3. Building participation by strengthening partnerships

4. Developing cycling and walking in the Shire

Towong Shire has a low rate of physical

activity compared to the State;

therefore, it is crucial initiatives support

people to be active throughout their

life.

The Healthy Communities Plan can

inform a review of the Recreation Plan

by contributing an analysis of new

census data, health data, government

health policy and community feedback.

Developing recreation facilities within available resources:

1. Assessing requests for capital works

2. Monitoring changing market demand in sport and recreation

3. Refining Municipal Grants Program

4. Supporting Reserve Committees of Management

Creating positive images of sport and recreation in the Shire

Towong Community

Access and Inclusion

Plan 2011 - 2014

In response to the Disability Discrimination Act 1992, the Towong

Community Access and Inclusion Plan provides a tool for addressing

rural and regional access and inclusion needs of the Towong Shire

community. It provides the basis for strategic direction to embrace

The underlying principles of the

Disability Discrimination Act 1992 are

that people with a disability have the

same fundamental rights as people

and include all community members experiencing access and

inclusion issues.

The plan outlines numerous barriers and provides a core principle and

action plan for:

1. Mobilizing and supporting people with a disability to

optimize participation in the life of their community

2. Building and strengthening the communities to provide

support to people with a disability and their communities

3. To facilitate integrated local Council planning and

coordination which engages and involves people with a

disability and their families, disability service providers and

community organizations

4. To work with existing disability support providers to enhance

their capacity to provide relevant and appropriate supports in

the community

5. To provide access to information about relevant services and

community activities to people with a disability in their

communities

without disabilities in the community.

Towong Shire has approximately 27%

of its population living with a disability.

This is significant together with an

ageing population, remote landscape

and limited services compared to that

of city and regional city based areas.

Towong Youth

Strategy and Annual

Activities Plan 2014

Vision: To be Victoria’s most supportive Council for Young people

where young people are valued and worthy contributors to our local

community. They are treated with equal respect and represent a

broad demographic ranging from 10 years to 25 years of age (and

their respective families). Young people give support where support is

needed and accept assistance when it’s called for. Young people

demonstrate leadership.

Goals include:

Increasing participation in achieving youth goals, this includes

the expansion of stakeholder groups from Council and young

people to a range of health service support agencies,

Centrelink, and local health services

Towong Shire has 1054 (17.7%) people

0-14 years old and 580 (9.7%) people

15 – 24 years old.

Programs for young people include but

are not limited to, the following 5

themes: Health, Self Esteem & Personal

Development, Education and

Employment, Arts and Cultural

Development, and Community.

The Towong Alliance will take a lead

Enabling young people to have more control and power of

their destiny through the development of program ideas

Enabling young people to experience success in their school

and home lives

Activities 2014:

Youth Development and leadership workshop, Open Air Movie Nights

(Corryong and Tallangatta), Dance Choreography and Workshops,

Skate Competition (National Youth Week), Battle of the Bands

(Freeza), Safe food handling- Master chefs of the Upper Murray, L2P

Program,

role in addressing the health aspects of

the youth strategy i.e. Towong Healthy

Communities Plan - Strategic Action

Plan, Strategy 4: To address the needs

of youth and young families.

Local:

Health Service

Plans

Strategy Key Points What does this mean to Towong

Upper Murray Health

and Community

Services 2013-2018

Annual Report

2012/2013

Vision

Better practices that lead to better health and a sustainable future

Mission

To work with our community for a responsible and innovative

framework of sustainability that supports sound social, economic and

environmental health practices

The health services located within

Towong Shire are partners in the

Towong Alliance and crucial to

community health and wellbeing.

The service plans clearly articulate the

importance of addressing community

need through a strategic planning

approach based on sound data and

evidence.

The Towong Healthy Communities Plan

provides an opportunity for identifying

and collaborating on issues of mutual

concern and action for the benefit of

the Towong community.

The challenges of helping rural people

Key issues and opportunities:

1. Population Health – Services and programs responsive to

need and build on community strength

2. Multipurpose Service Sustainability – Maintain MPS/RHS

status for maximum community benefit

3. Service Integration – maximise through links/pathways at

service and client interface

4. Our People – Support our ageing

workforce/training/challenges of an isolated community

5. Asset and Risk Management – improve efficiency and

effectiveness

Need for increased allied health services, improved access to

transport and the urgent need for a public dental service. to be well and healthy can be more

effectively addressed when the

responsible agencies work together to

provide integrated programs and

services linking healthy environments,

health promotion, early intervention,

primary care, sub-acute and acute care

sectors.

The Towong Healthy Communities Plan

includes commitments from all

Towong Alliance partners to lead

strategic action to address common

issues.

Tallangatta Health

Service

Annual Report 2012-

2013

Strategic Plan

(Summary) 2012 -

2017

Vision

To Excel as a Rural Community Health Provider.

Mission

To Provide High Quality and Effective Health Services.

Key issues and opportunities

Tallangatta Health Service has identified the following areas where

they can improve the efficiency and effectiveness of the services

being delivered to the community:

1. Work in partnership with Towong Alliance to identify options

for service coordination and alignment, new service models,

efficiencies through integrated corporate services, etc

2. Work in partnership with the PCP and Towong Shire to plan

for integrated approach to improving healthy eating and

increasing physical activity for residents of the Shire

3. Review current service configuration for residential aged care

and develop a 5-year plan for increasing community aged

care, improving infrastructure, addressing changing demand

and increasing occupancy

4. Review primary care service delivery in partnership with Hume

Medicare Local to identify opportunities to increase or re-

configure service delivery through use of MBS items, through

greater integration with the GP service, through new funding

opportunities from the ML and through shared planning.

Walwa Bush Nursing

Centre

Service Plan 2009-

2012

Vision

To be a valued, rural hub inspiring community health and wellbeing.

Mission

Annual Service Plan

2013

To be innovative and proactive in WBNC endeavors.

We are committed to making our district a great place to live by

delivering accessible, responsive, caring and sustainable health and

community services.

Strategic objectives:

Build capacity of clients and their families in the instance of

ageing, disability or dementia

Provide flexible and accessible services and opportunities that

will impact positively on the health of our community

Expand health education and healthy lifestyle programs for

clients, community and staff

Be responsive to clients social, spiritual, cultural, nutritional

and physical needs by providing a range of diversely active

and inclusive programs

Be responsive to the needs of clients in the community by

providing flexible HACC, DN and Palliative Care services

Local:

Community

Strategy Key Points What does this mean to Towong

Upper Murray

Community Needs

Assessment 2008

UMHCS Workshop

2012

Community consultations identified the following major health issues:

1. Transport within the region and to Albury/Wodonga

2. Access and affordability of dental care

3. Access to podiatry

4. Lack of visiting specialists

5. More GP and Physiotherapy appointments needed

6. More support groups/services wanted

7. Aged care facilities/services

8. Better services for particular groups/needs (women’s health,

disability services, youth etc)

Community consultation identified the following priorities:

The Upper Murray Community Needs

Assessment (2008) and Community

Consultation (2012) provide

community level information on issues,

values and priorities for action in

regards to the health and wellbeing of

Upper Murray communities.

Increase availability of suitable housing for seniors

Seal the Benambra Road – resulting in connectivity and

increased economic activity

Increase connectivity to Wodonga from Corryong, and from

smaller outlying towns

Provide safe walking and bike tracks – to increase

connectivity and provide opportunities for tourism, recreation

and fitness

Regional:

Strategy Key Points What does this mean to Towong

Upper Hume

(Towong/Indigo)

Primary Care

Partnership

Integrated Health

Promotion - Healthy

Eating and Physical

Activity Planning

The Upper Hume Primary Care Partnership Integrated Health

Promotion Plan is a collaborative approach between Indigo and

Towong to address issues of obesity and healthy eating.

Towong Shire data shows high rates of

obesity and low rates of healthy eating.

Effects of these factors on an

individual’s health and subsequent

factors that then have an influence on

the whole community are significant.

Collaborative work with shared

expertise across Indigo and Towong

will provide the community with

interventions that am to impact over

the long term for increased health and

wellbeing and community

strengthening.

Healthy Eating

By June 2014 children aged 0 – 12 years living in Towong and Indigo

Shires will increase their consumption of healthy foods in line with

recommended dietary guidelines.

There will be a 20% increase in the number of children aged 0 – 12

years living in Towong and Indigo Shires who increase their

consumption of healthy foods in line with recommended dietary

guidelines, as a result of Healthy Eating health promotion

interventions delivered under the UHPCP IHP Catchment Plan.

Physical Activity

Objective and measure yet to be developed during 2013

Hume Integrated

Aged Care Plan 2010

- 2015

Hume region has developed an Integrated Aged Care Plan to identify

opportunities and strategies for improving access to person-centred,

aged care services across the region.

With Towong Shire’s rapidly ageing

population the Hume Integrated Aged

Care Plan provides support in the

delivery of innovative and flexible

5 key priority areas:

1. Promote effective collaboration between aged care providers

through further development of Hume Region’s partnership

approaches, planning structures and processes.

2. Improve mechanisms to provide and share information

among providers and ensure service information is accessible

to consumers.

3. Facilitate innovative approaches to building and maintaining

capacity and capability in the aged care workforce to meet

current and projected demand.

4. Promote innovative and flexible service models to enable

service providers to better respond to the needs of older

people and their carers.

5. Promote health and well being for older people.

services and promoting health and

wellbeing to our residents as they age.

The Hume Integrated Aged Care

network has been established to

support implementation of the plan at

a local level. The network provides a

platform for sharing ideas, identifying

collaborative projects and a support

network to those working in the area

of aged care.

Hume Region

Chronic Care Strategy

A Chronic Care Strategy has been developed to encourage

coordinated action in response to the growing impact of disease in

Hume Region.

Vision

The vision of the Chronic Care Strategy is that people with chronic

health conditions in Hume Region have access to high quality services

that work in partnership to provide person-centred care.

The health service plans in Towong

Shire are strongly aligned

Principles

The principles of the strategy reflect a quality and person centred

approach:

Access Service delivery models address potential barriers to access -

including geography, cultural diversity, health literacy, social

economic status, disability, transport and service availability.

Appropriateness Chronic care services are provided consistent with

relevant best practice guidelines.

Efficiency Service providers work together to develop agreed

coordinated approaches to service delivery.

Effectiveness People with chronic health conditions are supported to

be active partners in achieving their desired health outcomes.

Priorities

1. Adopt the National Chronic Disease Strategy and the service

improvement frameworks in all local services, to support

consistent evidence based practice.

2. Develop agreed service delivery frameworks, roles and

pathways for care across the continuum.

3. Embed self-management approaches in all aspects of care.

4. Provide clear and consistent information for people with

chronic conditions and their carers.

5. Maximise information technology opportunities.

6. Align workforce development and capacity across all strategic

priorities.

7. Explore opportunities for new and innovative service models

and/or funding and reporting mechanisms to support

improved care.

Upper Hume Primary

Care Partnership

Implementation Plan

2012 - 2013

Vision

Partnership members working collaboratively, building capacity to

achieve resilient communities, strong families and healthy individuals.

Mission

To provide a platform that brings a diverse range of service providers

together in partnership to support the delivery of coordinated,

integrated care and improved health literacy.

Objectives

To facilitate and support a strong, diverse partnership, in order to:

1. Identify local shared interests and issues and act as a conduit

for these to be raised with government.

The Upper Hume Primary Care

Partnership is a platform for

collaborative and integrated planning

with resulting initiatives that will have

benefit across the region.

The network is made up of a variety of

agencies with key roles in supporting

improved health and wellbeing of

individuals and communities.

2. Build the capacity of partner organisations.

3. Support and build on partnerships and collaboration.

4. Ensure effective and efficient partnerships with a focus on

transparency and quality.

5. Support the alignment of local, regional, state and national

priorities.

6. Enable communication, coordination and cooperation

between organisations that influence the health and

wellbeing of our communities.

7. Be flexible and responsive to change.

8. Address issues in accordance with the social model of health.

9. Encourage and support improvements in health literacy,

consumer empowerment and self-management.

To achieve together what can’t be achieved alone.

Young Families

0-8 Network

The 0-8 Information Day aims to raise awareness of services available

to support young families across the Towong Shire. Family Fun Days

are proving a positive means to engage with the community, network

with stakeholders and enable informed planning.

The 0-8 Network is a Council initiative to support and strengthen

partnerships with key agencies, and Council with the objective of

delivering positive outcomes to the community.

The objectives of the 0-8 framework is to work cooperatively with

various authorities, state agencies and local community organisations,

to plan and implement strategies and projects which support the local

Council conducts surveys at the Family

Fun and Information days to inform

program delivery. Information

gathered by council contributes to the

evidence base of the THCP.

community and 0-8 age group with specific emphasis on event based

activities that integrate service and target markets across the Shire.

North East Transport

Connection Project

(NTCP)

Vision:

The social, economic and civil participation of people and

communities is increased through having improved accessibility

options available to them.

The NTCP brings together a network of

agencies with an interest in addressing

transport issues across the Hume

Region. The NTCP recognises the

importance of access to transport to

individuals and communities.

Towong Shire has the highest rate

from across the State of people not

having access to transport.

The Better Together Network website

provides a foundation for ongoing

collaboration to address transport

issues in Towong.

To support communities to work together to develop innovative and

efficient responses to the needs of people with limited transport

options and to improve access to services, resources, employment

and community opportunities.

1. Develop innovative transport and non- transport solutions to

enhance access and participation by people with limited

access to transport, excluding public transport, as a response.

2. Develop more effective and efficient use of existing transport

resources

3. Establish sustainable local and regional partnerships for

delivering accessible and sustainable outcomes

4. Increase the capacity of communities to participate in

decision making and priority setting outcomes to improve

social and economic outcomes.

NTCP main activity areas include:

1. Community transport and access

2. Local community projects

3. Community linkages and connections

4. Transport information

5. Transport behavioral change

6. Advocacy

State:

Strategy Key Points What does this mean to Towong

Victorian Health and

Wellbeing Plan 2011

- 2015

To improve the health and wellbeing of all Victorians by engaging

communities in prevention and by strengthening systems for health

protection, health promotion and preventative healthcare across all

sectors and levels of government.

Outlines the Victorian Public Health

and Wellbeing Plan 2011-2015, which

aims to develop an effective prevention

system, along with a strong and

responsive healthcare system, to help

reduce the growing burden of chronic

disease and injury we are now facing,

and support people to enjoy a greater

sense of wellbeing.

Build prevention infrastructure to support evidence-based

policy and practice

Develop leadership and strengthen partnerships to maximise

prevention efforts

across sectors

Review financing and priority-setting mechanisms to ensure

available resources are

based on population need and potential for impact

Develop effective modes of engagement and delivery of

evidence-based interventions

in key settings

Strengthen local government capacity to develop and

implement public health

and wellbeing plans

Improve health service capacity to promote health and

wellbeing

Integrate statewide policy and planning to strengthen public

health and

wellbeing interventions

Increase the health literacy of all Victorians and support

people to better manage

their own health

Tailor interventions for priority populations to reduce

disparities in health outcomes

Rural and Regional

Health Plan 2012 -

The Rural and Regional Health Plan provides health services and their

governing boards with directions to set out their planning and service

The rural and Regional Health Plan is

the overarching strategic document for

2022 delivery strategies.

Many of the actions outlined in this plan require health services to

work more closely together, embrace innovation and support their

staff to adapt to new models and ways of delivering healthcare. Some

of these changes require a commitment of time and effort. However,

many will build on work that rural and regional health services already

have in place.

The government has set a 10-year timeframe to allow health service

providers to embed actions into routine service delivery and enable

changes in the health status of Victorians to be measured over time.

Victoria in relation to improving health

service delivery.

This document provides strategic

guiding principles for health services

over the next 10 years, and will only

strengthen the direction and work of

the Towong Alliance Municipal Public

Health and Wellbeing.

Victorian Health

Indicators Survey

2011

Victorian based population level survey with a focus on the social

determinants of health. Topics covered include wellbeing; alcohol;

smoking policy; work, life and time; healthy eating and sedentary

behavior; green space and community safety; community

engagement; social attitudes that influence health; arts and new

media.

Refer Appendix 4

The document provides a great

resource for how these topics have

influence on people’s lives and the

health and wellbeing of communities.

It also provides tips when considering

programs in these areas.

A useful guide when developing more

detailed actions under the Towong

Healthy Communities Plan.

Municipal public

health and wellbeing

planning: Having

regards to climate

change

The Climate Change Act 2010 (the Act) recognises that Victoria’s

climate is changing and s. 14 of the Act introduces a duty that

requires a number of key government decision-makers to take

climate change into account when making specified decisions.

Local government is identified as one of the decision makers that

must consider climate change when preparing a municipal public

health and wellbeing plan (MPHWP).

Considering climate change using a framework that systematically

It is expected that local government

will state in the MPHWP how they have

had regard to climate change, in order

to demonstrate they have met their

obligations under the Climate Change

Act 2010.

considers the impact of climate change on the determinants of health

(natural, built, social and economic) will address the range of impacts

identified above.

North East

Greenhouse Alliance

Climate Change in

North East Victoria:

Vulnerability

Assessment and

Resilience Planning

2011

North East Victoria is likely to be warmer in the future, with rainfall

becoming less reliable and more extreme. These climate changes

could result in a range of impacts – some positive, but many negative

– to the region’s natural and physical assets, as well as to major

industries and infrastructure within the region. These impacts will, in

turn, have indirect economic and social effects and implications for

the delivery of local community services.

Climate change projections for the region also indicate that there will

be an increase in the frequency of high and extreme fire risk days of

up to 66% by 2050. Projections also point to increase and in length of

the fire season (extending into spring and autumn). Vegetation cover

is a major factor contributing to bushfire exposure in the region, with

Alpine Shire in particular having a large extent of bushfire prone

areas.

Paradoxically, because the areas to the north of the region tend to be

low lying and subject to inundation, they are more exposed to intense

rainfall events and associated flooding than the slopes in central and

southern areas. Available projections point to likely increases in

maximum rainfall intensities (of different durations) in many parts of

the region in the future.

In general terms, the local economies of the Hume region are

reasonably well placed to cope with ‘shocks’ in the future including

those that could arise from climate change and variability. Towong

would appear to be an exception to this general rule of thumb having

a relatively low level of economic diversity and high level of climate

dependent industries compared with other parts of the region and

Victoria.

Climate Change vulnerability research

in North East Victoria highlights

specific vulnerabilities i.e. flooding and

bushfire events, lack of economic

diversity; and resilience factors i.e.

volunteerism and access to support

from family and friends.

Two indicators relevant to building strong community networks and

cohesiveness are ‘levels of volunteerism’ and ‘access to support from

family, friends and neighbours’. Data for the region shows that,

generally speaking, the region performs strongly against both

indictors, especially on levels of volunteerism.

Victorian Public

Health and Wellbeing

Act 2008

The Victorian Public Health and Wellbeing Act 2008 seeks to achieve

the highest attainable standard of public health and wellbeing by:

1. Protecting public health and preventing disease, illness,

injury, disability or premature death

2. Promoting conditions in which people can be healthy

3. Reducing inequalities in the state of public health and

wellbeing

The Towong Shire Council is legislated

through the Victorian Public Health

and Wellbeing Act to develop a

Municipal Public Health and Wellbeing

plan and review this plan every four

years with newly elected Councils.

Department of

Health

Strategic Directions,

2010

The 2010 Strategic Directions statement from the Department of

Health outlines activities the Department has indicated it will

champion, including:

• Collaborative relationships

• Appropriate and effective governance

• Responsive leadership

• Community focus with a special responsibility to

disadvantaged Victorians

• Our workforce

• Accountability and effectiveness, to include evidence-based

decisions and integration of resources

The establishment of the Towong

Alliance and the integrated nature of

the Towong Healthy Communities Plan

2013-2017 are well aligned and

supported by the strategic directions of

the Department of Health.

Appendix 6 - Community Engagement Strategy

The key to successful planning is the understanding of issues that need to be considered b y asking the right questions to the right groups who may

experience health and wellbeing inequalities. The consultation processes undertaken by Towong Alliance partners in the planni ng of their services,

programs, strategies, activities and community infrastructure has involved a broad array of opportunities for community members to identify local

needs, priorities and ideas for potential solutions.

For example, community consultation has been undertaken as part of health and wellbeing related projects in Towong Shire e.g. Upper Murray Needs

Assessment, Towong Shire Council’s Municipal Strategic Statement, Tallangatta Tomorrow, Towong Recreation Plan, Healthy Agein g Demonstration

Project, Improving Liveability of Older People, 0-8 network days, Mitta Valley Advancement Project, Our Bellbridge, Corryong Recreation Reserve –

Towong Recreation Futures, Walwa Community Recovery Centre, and Our Valley Our Future (Mitta).

These project based consultations have provided local level information regarding health an d wellbeing across the Towong Shire.

The Upper Murray Community Workshop (2012), Aged Care Priority Survey and Consultation (2012) community advisory groups and s urveys conducted

by health service providers to obtain feedback from health consumers and the general community have all contributed to the content of the THCP.

The draft Towong Healthy Communities Plan 2013 – 2017 was released to the general public for feedback through a Public Exhibition Period from 4

April to 2 May 2014.

It is anticipated that further development of collaborative community engagement and planning processes across the Towong Alliance will result in

local community benefits, including:

A greater awareness of local issues and solutions

An opportunity for comparison of local knowledge with data and statistical information

An opportunity to gain an understanding of the needs of vulnerable people and build on strengths in the community

Development of targeted and innovative community health and wellbeing strategies and programs

Appendix 7 – Review and Evaluation Processes

Department of Health (2012) A practical guide to conducting annual reviews of Municipal Public Health and Wellbeing Plans, Southern Metropolitan Region

Review Questions:

Have we done what we said we would this year?

Is the THCP Implementation Plan on track?

Are the results to date what we might expect?

Has the context changed this year? (demographics, health risks, partners, opportunities, systems or personnel changes)

What do we need to keep doing well and what needs to be done differently for the year ahead?

Department of Health approved Annual Review stages and templates will be used to undertake review8.

Evaluation Framework

The six steps in the evaluation framework for health promotion and disease prevention programs are:

1. Describe the program

2. Evaluation preview

3. Focus the evaluation design

4. Data collection

5. Data analysis and interpretation

6. Disseminate lessons learned9

Objectives Have we

done

what we

said we

would?

Are we having

the influence

we expected?

Have we

achieved the

change we

sought?

What worked

well and what

needs

improvement?

Impact of Towong

Alliance member

agency actions on

local behaviours

and environments

Notes for what might

be done differently in

the next MPHWP

cycle

Communication of

evaluation findings with

external and internal

partners and the

community

8 Department of Health (2012) A practical guide to conducting annual reviews of Municipal Public health and Wellbeing Plans, Southern Metro Region

9 Department of Health (2010) Evaluation Framework for Health Promotion and Disease Prevention Programs