Creating change in government to address the social determinants of health: how can efforts be improved?

BMC Public Health

Table 2 Five factors aiding joined-up approaches and how these compare to HiAP and the Fairness Agenda

	Factors found to aid joined up approaches	HiAP	Fairness Agenda
Operational Level	Target multiple levels: [33, 34, 68–76]	Government – managerial	Strategic government
	Strategic government
	Managerial
	Practitioner
	Community
Top-down/ Bottom-up	Top-down & bottom-up [33, 34, 68–76]	Top-down	Top-down
Nature of control	Decentralised [33, 34, 68, 70, 71, 76–78]	Centralised	Centralised
Focus	Designed based on both the purpose and the context [20, 34, 70, 71, 74]	Embedding health in all policies	Promoting equity
Instruments & their functions	Fulfil a range of functions depending on objectives. For example:
	Governance & structure (e.g. committees/ taskforces, creation of shared leadership) [34, 68, 69, 71, 72, 74–76, 78]	Governance & structure: interdepartmental committees/taskforce, leadership (Taskforce located in Premier & Cabinet)	Governance & structure: interdepartmental teams
	Managerial changes (e.g. to improve relationships) [73, 74, 77–80]	Managerial: efforts to improve relationships between departments	Adjusted processes: Health Equity Impact Assessments
	Adjusted systems, processes & finances [34, 69–72, 77, 81]	Adjusted processes: Health Lens Analysis	Culture: policy current, political leadership
	Cultural & institutional change [20, 34, 70, 71, 75–78, 80]
Membership	Reflects the multiple levels targeted for change [20, 33, 34, 68, 70–75, 77]	Government departments	Government departments, politicians

ISSN: 1471-2458