Introduction by Croakey: Public health bodies, governments and individual universities are being urged to embrace the Healthy Universities concept, and support and resource university staff to implement health promotion policies within their organisations.
Given recent criticism of Australian universities around high teaching loads and stressful work environments, “now feels like an opportunity to act” on health promoting policy, according to Dr Patricia Taylor, public health lecturer at Deakin University.
Embedding health promoting policies in universities has the potential to “increase student retention, staff wellbeing and productivity”, Taylor writes below.
Patricia Taylor writes:
Universities are the ideal setting for health promoting policy and leadership given their expertise and influence.
Universities are leaders in society, they impart knowledge and shape future generations. They are an important setting for health promotion given their direct and indirect reach – staff, students and the broader community.
Universities have a far more diverse cohort than ever before, particularly in Australia with wider participation, government supported positions and increased international student enrolment.
International setting
Globally, universities have and continue to provide environments that foster growth and wellbeing among their communities. For over a decade, the United Kingdom, Canada and Germany have embraced the Healthy Universities concept through national networks and health promoting university policies.
These networks and policies provide these institutions with on-the-ground support for those advocating for change, consistent strategies to gain broad engagement, and institutional community voice advocating to decision makers and government the need, benefits, desire and importance of health promotion within the sector.
The University of British Columbia is the envy of many university health promoters with their exemplar systems-wide settings-based approach to health promotion. UBC Wellbeing has successfully engaged senior support, students, departments, faculties and services and created a culture where health promotion is a whole of university strategic priority.
UBC and many universities in these countries have embraced the Okanagan Charter and its mandate for embedded health promotion across the sector.
Australian setting
Australia has 39 universities, over 1.5 million students and 130,000 employees. There are far more part-time students (35%) than ever before, and an increase in diverse groups, such as students with a disability and students from low socio-economic groups.
Universities are active in health promotion – some have employed health promotion staff to implement strategies and culture change, and most implement behavioural health promotion strategies, focused on nutrition, physical exercise, alcohol and drugs, sexual health and mental health.
These individual focused strategies can be effective given the collective audience universities have access to via campuses.
Although the healthy university movement has progressed within Australia, there are significant gaps in terms of policy level reform, ongoing support and resourcing. Those on the ground trying to create change within the sector are lacking support and resources due to competing priorities, a lack of senior buy-in, and health promoting policies that provide a backbone for programs that reach the determinants that create poor health outcomes.
One might question whether it is possible for neoliberal institutions to provide healthy environments. However, it is well within the purview of universities as educational settings to provide a healthy environment for their communities.
It would be remiss of universities not to consider upstream health promotion, particularly as they widen participation and expand their international enrolments. The healthy university model aligns with these neoliberal institutions, as it moves away from behavioural interventions (commonly referred to as nanny state programs) to provide environments where individuals and populations can thrive.
Settings-based health policy is smart business. Within the university setting, it has the potential to increase student retention, staff wellbeing and productivity.
Struggling to gain traction
There is no mandate for universities to do health promotion. There is no framework (aside from Okanagan Charter which is global in its nature and complex applications), no legislative or funding requirement, no accountability and no high-level senior buy-in.
Universities typically like the “showy things”, the big numbers – there is less time for the ‘invisible health promotion’ such as capacity building, culture change/shift and social capital. With competing interests and ongoing cuts to health promotion funding, it is no wonder universities are not prioritising it within their business model.
The promotion of good health extends beyond the health sector and advocates for all parts of society to consider the underlying determinants that impact health, including work and study environments.
Part of health promotion is seeking opportunity and understanding when it may be the right time to drive change. At an organisational level and particularly within complex settings like universities, this is critical. The right time and opportunity can be the difference between an embedded cultural change and a one-off individual focused health initiative.
This sector like so many is burnt out, staff are longing for validation and support, students desire flexibility, compassion, and a sense of belonging.
Given the criticism universities receive around poor work environments, over worked staff, and an increase in health-related issues among enrolled students, now feels like an opportunity to act. A commitment to health promotion is a step forward in supporting staff and students, and collaboration within universities and across universities could support this and create opportunity.
Health promotion advocacy
A recent Croakey article by David Towl highlighted the importance of opportunity and health promotion advocacy. He issued a call to action for stronger advocacy across all sectors to ensure health promotion isn’t left out of the diminishing pool of health prevention funding.
Universities are well placed to advocate and undertake health promotion as experts in public health and significant contributors to health research.
- Recommendations for action on health promoting universities include:
- National endorsement of Healthy Universities and the Okanagan Charter to support consistent health promoting policy across the sector.
- Strategic direction and strategies that support staff to implement health promotion by gaining traction at senior levels and embedding healthy cultural change.
Governments, Universities Australia and individual universities need to invest and advocate for stronger health promotion. There needs to be accountability for the health and wellbeing of these very large tertiary communities which is mandated.
Universities are well placed to be leaders in this space, they have the expertise and voice. They have an opportunity to practice what they preach in their research output and teaching and be part of the solution in tackling the wicked health issues that face our global society.
The endorsement of health promoting universities by the World Health Organization and the Healthy Universities framework from the UK network provides a basis for Australian universities to develop a refined approach. These strategies need to consider the nuances of the sector and what motivates Australian universities.
Universities compete for research accolades, funding, student satisfaction and retention. Reputation is a strong driver for change and universities are well versed at competing. As health promotion advocates, we need to seek opportunity and apply relevant strategies to engage senior representatives. We need to showcase the benefits of health promoting policy to overall business, culture and the health and wellbeing of the community.
Collectively, university change could be achieved through a group of like-minded health promoters. Many networks are already working in this space, specifically the Australian Health Promotion University network and the ANZAHPE network.
There is evidence to support such an approach, but these networks need resources to maintain momentum.
Many university staff are already trying to implement health promotion policy within their individual organisations. They need support and resourcing from our peak public health bodies, governments and individual universities.
About the author
Dr Patricia Taylor is a Lecturer and Course Director in Public Health at Deakin University. She has worked in the sector for over 11 years. Taylor’s research focus is settings-based health promotion. She is passionate about supporting settings to implement policy that targets the determinants impacting people’s wellbeing.
Taylor would like to acknowledge colleague, Melissa Yong, for contributions to article.
See Croakey’s archive of articles on health in all policies.
