In other words the 'social determinants ' of health are becoming a large factor in the general (ill)health area;  After all clean water solved many health problems in the past. In today's environment another factor is the impact of mental health. Stress levels have been shown to drive people to alcohol; in a  recent study  'work' was shown to be an instigator for rising levels of stress. Mental ill health as a result is rife in many societies. In Australia there was a suggestion that depression was at epidemic levels in 2010.

Boy, you're asking a question that has at least a million responses! My 30,000 foot answer  is that every aspect of an individual's interaction with the environment should be optimized for healthly behaviors in order to have an impact on population health. If we take for example obesity, we know that environmental factors as well as socio-economic factors (as well as genetic factors) play a role. At the community level, we know that underserved communities have higher numbers of fast-food restaurants, poor access to fresh produce, virtually no safe community playgrounds or walking trails, and environmental stressors that generate sustained stress on the organism. Put this together and there is no reason to expect that obesity rates in such environments will decrease. 

I will stop here since this is a topic that has no limit...

I think that if policy makers and professionals regard their work as a political intervention in people's lives it may make a difference; The reason for this is that professionals implement policies, regulations, legislation concocted by government; we also follow professional standards set by colleagues; Often we find that we have to follow policies even if it is out of date or is against research findings; climate change is a classic where science is rejected or ignored for political purposes and most of us know why ( at least I think we do); may be its high time we looked at politics as a a weapon used by others to achieve some positive impact for the people we serve/care for;

Vehicle for intersectoral programmes

Different sectors may have different value bases, success criteria and management cultures . Individual policy networks tend to approach programmes from “different worlds”, drawing from distinct vocabulary, ideology and modes of communicating new ideas. Multisectoral interventions in MFIs are reported to face challenges in the way different agencies are structured and function. Tensions may arise if roles are not clarified disrupting trust. The longer time frames required to see programme effects may create tensions and call for processes that manage diversities in institutional culture and sustain cooperation.

http://www.actionsdh.org/site/DefaultSite/filesystem/documents/Examples/Collection%20of%20Summaries%20of%20Case%20Studies%20from%20Three%20Regional%20Projects.pdf

Greetings Lalitha Chelliah, Dr. Ariel Linden, & Dr Umachandran,

        Thank you for your input on this noteworthy topic. In agreement, with the members of the roundatble, I believe that the selection, development, intergration, and rise of , “conveners,” in order to sustain engagement and trust that resonates among all participants. The characteristics, attributes, & illuminating spectrum of skills, will provide the catalyst, formulating the health bridge for cross-sector collaboration.  A supportful advocate, for the insightful information, pertaining to the, “convener,” it is essential highlight for all to see. Vice President for Community Health at Kaiser Permanente, Lee Solmon described, “that a good convener has the ability to understand the complexity of this work, to live in the middle space and not drive a specific agenda, but drive a co-benefits agenda. The convener makes sure that information is translated and shared with other decision makers. The ability to tell the difference between what is a distraction in the conversation and what is the true problem to be addressed, is a specialized skill. Solomon cited the role that Policy Link has played with the Convergence Partnership as an example of a successful convening organization. The Policy Link team understands enough of the depth in all of the different policy areas to have complete credibility with the various agencies they are working with, he said. Co-Director of the Center for Climate Change and Health at the Public Health Institute, Linda Rudolph, “stressed the importance of taking the time to get to know each member agency individually, and demonstrate interest in understanding their concerns, fears, and priorities. Listening with humility and respect, and looking for the touch points in individual conversations that offer opportunities for bringing people together. Chief of the Policy Unit in the Office of Health Equity at the Californai Department of Public Health, Connie Mitchell referred participants to a forthcoming guide on HiAP that answers some of the questions about the nature of the team and the specific skills needed to be an effective convener (Rudolph et al., 2013b).

      Additionally,  within the publication, of the work shop summary several members noted the importance of a strategic messaging plan. How can the message about HiAP be framed so that it resonates with all stakeholders, and draws them together to work toward co-benefits? The convener can also play a role in gathering the scientific evidence and building the framework, including the business case, for the HiAP approach. Among the issues to be addressed is how to finance the role of the convener.

     One member reiterated the points made about how bringing health into the picture sometimes helps raise the acceptability or credibility of a non-health initiative, and that those health implications can be extra leverage to help other sectors move their policies or initiatives forward. Several roundtable members observed that there was a lot of discussion about the public sector role in the Health in All Policies (HiAP) approach, and they suggested that further discussion the role of the private sector, as both stakeholder and partner.

     I would be thrilled to hear all your answers, ideas, and thoughts on these ideas. I sincerely appreciate your input, look forward to reading and speaking with you all in the future. Hope that your having and continue to have a wonderful day/evening.

Sincerely,

Lars Lafferty