Making Public Policy Healthy

... a vision for our community's health

This guide has been written to foster public awareness of health. It is intended that the information will inspire you, the reader, to participate in the creation of "healthy public policy" to benefit people of the Province.

This guide is for individuals or groups seeking to either:

create a policy to benefit the health of community residents, or
support, oppose or advocate for change in a policy which may have health effects in your community.

You are encouraged to become a champion of healthy public policy in your community.

The guide covers both situations. All of this information may not apply in all circumstances, or at all times. Use the information which best suits your situation.

THOUGHTS ON HEALTH AND HEALTHY PUBLIC POLICY

Health is a physical, mental and social resource for everyday living. It is reflected in the extent to which individuals and communities are able to function optimally in their environments.

"Health" is a concern of each one of us. Your health and your community's health is your responsibility.

As concerned citizens and community members, we can work together to create solutions for problems affecting health. We can make the promotion of health our goal. It is possible to achieve health for all.

We must ensure that decisions made by those in authority consider the impact on health.

Policy is a decision or direction.

Public Policy: a decision embodied in legislation or an action of a Government, a directive made by a Board of Directors of a private company or non-profit organization with authority to make the. decision.

Healthy Public Policy a decision or actions intended to have a positive effect on the health of people.

Policies or decisions are made by politicians and people who hold positions of authority.

However, individuals and community groups can influence public policy. Maybe you can do something within your immediate environment to improve your own health or act as an advocate for others.

If there is an issue which really concerns you, you can make a difference.

The Guide will help you:

to think about "health" issues,
to consider the "health" impacts of decisions that affect all of us,
to take action to improve or establish healthy public policy in your community.

Get Involved!!

THE BIG PICTURE -

THE POLICY MAKING ENVIRONMENT

Key Concepts

Origins of Policy

The policy-making process has been described as beginning from the top down (governments) or from the bottom up (the citizens). Each depends on the other to achieve its goals.

Top Down Policy may originate from government through

legislation,
a policy direction (e.g. deficit reduction), or
policy initiative (e.g., creating a positive business climate).

As governments need electoral support, politicians are interested in satisfying citizens' concerns.

Bottom Up Policy may originate from

the community's organized efforts to create change
one person (a champion or an initiator) who organizes a working group to advance a cause.

With every policy decision taken, especially by government, there are farreaching consequences for the whole population. Every decision made has cost associated with it and support for one item may have an impact on another item.

Authority to Legislate

Each level of government in Canada - federal and provincial has defined powers under our constitution. Certain fields have been assigned to either the federal government or the provincial governments and each level can make laws in that field. Provincial governments, by way of legislation, create municipal governments and allow them to exercise certain provincial powers for the benefit of local residents.It is very important for a community organization to know to which level of government to target its efforts. Be sure to select the right player.

The Players

There are key players who are involved in policy-making and a community group must be aware of the roles of each.

Provincial Legislature or the House of Assembly - members who are politicians, that is, elected representatives of the people of the Province.Laws, in the form of legislation containing a policy, are passed by the House of Assembly. While Members may support a policy direction, policy is rarely initiated in this forum.

Cabinet - the Premier and elected representatives selected by the Premier.

The Cabinet has the ultimate decision-making power to place legislation before the House of Assembly. Many decisions related to the existing legislation are contained in Regulations which Cabinet has the power to pass without further approval from the House of Assembly.

Bureaucracy - the deputy minister, senior officials, professionals, and staffwhose direction comes from Government and legislation.The officials are members of the public service who study proposed policy initiatives, provide recommendations to the decision-makers and sometimes initiate policy development.

Community - includes municipal politicians, opinion leaders, aboriginal leaders and representatives of various interests at the community level.

Policy can be initiated at this level and support gathered for action by the legislature. Policy can also be developed andimplemented at this level.

Board of Directors - a legal body managing either a private company or a non-profit organization.

A Board can develop and implement policy affecting its own organization. A decision of a Board to support a policy advocated by another group could be helpful in trying to promote adoption of legislation by government.

Individual - a citizen

The individual is a citizen to whom politicians are accountable for policies of government. The individual can champion an action and encourage the involvement of others to help themselves or influence policy decisions. Individuals can make views known to an elected representative to encourage or discourage support for the policy.

STEPS FOR CREATING HEALTHY PUBLIC POLICY IN YOUR COMMUNITY

Individuals and groups are encouraged to participate in developing a healthy public policy.

Advocating change requires a plan. While every process has its unique twists, there are common steps to each process.

A champion,
Identify the issue,
Gain support - form a working group,
Conduct a needs assessment - get to know your community,
Develop an action plan,
Encourage participation - work towards success,
Communicate with the public through the media,
Implement change,
Monitor/evaluate/adjust

This is a working guide to help you successfully achieve your goal.

Step 1. The Initiator or Champion of the Cause

An idea for the development of a healthy public policy comes from both individuals and groups of citizens.

The champion or initiator identifies the nature of the issue, conducts an initial assessment and suggests potential courses of action. The champion recognizes that a number of individuals and groups need to be involved throughout the process. The initiator could be you!

Step 2. Identify the Issue

Identifying the issue is the starting point for developing healthy public policy or changing a policy in the interests of health.4

Step 3. Gain Support - Form a Working Group

No one person can answer every question. Involve people who are prepared to share their views on the subject. The working group is exactly that members who are prepared to contribute time and energy to the group's activities.

The working group should include:

consumers - people who have been directly affected by the issue and can speak from experience on the subject.
professionals/experts for example, consultants.
interested citizens

As the work progresses and directions are determined, the working group could involve others in the process, such as:

public officials
municipal politicians and opinion leaders
potential detractors (to win over likely opponents)

Step 4. Conduct A Needs Assessment - Get to Know Your Community

Use the lists which follow when compiling information and assessing needs in your community.

Where you can go for information:

Community Health Region (your local Public Health Office)
City Hall or the Town Office
Provincial Government Departments
Provincial Government publications
Statistics Canada
Community organizations
Libraries

The Think About Your Community list has been designed to help you consider the impacts of public policy on health. Whether working on general assessment of your community, designing a program to assist one group or assessing public policy, background information is required to start the planning process.

THINK ABOUT YOUR COMMUNITY

Assess the situation now and think what the likely effect will be after the proposed policy has been implemented.

Find out About:

The population

distribution by age groups
types of groups e.g. disabled

Employment

major employers, small businesses
unemployment rates
% of skilled vs. unskilled workers
opportunities available

Economic conditions

income levels
business activity
retail sales statistics

Social supports

major social problems
services in place or gaps in services, e.g. elder care, day-care, homemaker services
costs of services, subsidies available, how accessed

Health senrices

hospitals, clinics, programs, health professionals serving the population
illnesses contributing to disability, disease and death
prevention programs in place
findings of health studies about your community

Other Services

recreation
opportunities for being physically active

- availability
- accessibility

availability of nutritious foods

safety concerns

- the incidence of crime
- traffic accidents (vehicles, bicycles, ATV's)
- fire workplace accidents
- water and boat safety
- hunter safety

Find Out About:

Basic services

waste disposal (garbage pick-up, recycling depots, sewage disposal)
clean air (pollution, smog, smoking)
clean and safe water supply
green space and parkland (open to the public and safe)
wildlife conservation and preservation (protection of endangered species, sustainable)
transportation (accessible and affordable public transit)

housing
- availability of affordable housing,
- suited to individuals' needs (e.g. people with disabilities, seniors, children)
- meets safety standards and requirements

Opportunities to create awareness

public meetings
information distribution
opinion survey/questionnaire
newspapers
radio
television
display boards, e.g. town council office, grocery store, open house by community agency

Resources in the community

Community Health Regions

consumers' organizations, for example:

- Consumer's Organization for the Disabled
- Canadian Paraplegic Association
- Canadian Mental Health Association

voluntary health organizations, for example:

- Cancer Society,
- Heart and Stroke Foundation,
- Lung Association

service clubs

- Lions Club
- Kinsmen/ Kinettes

STEPS FOR CREATING HEALTHY PUBLIC POLICY IN YOUR COMMUNITY

Once the research findings have been evaluated by the working group, a goal can be set.Be careful to consider all information available and be sure of the facts. Being associated with sloppy work may undermine your constructive efforts.

Step 5. Develop an Action PlanIn order to turn your idea into reality, you should develop an action plan. This plan outlines objectives and the activities to be undertaken to meet your goal. It lets everyone know:

what is to be done,
how it is to be done, and
who is going to do it.

Deadlines should be set

Involve people in committees but remember, there must be central coordination. This can be achieved by having one person or a small working group monitoring all activities.

For more information refer to the Community Action Pack listed in, the Readings section.

Step 6. Encourage Participation - Work Toward Success

Participation will depend on the type of activity you are planning to undertake. Once individuals express an interest, involve them in an activity so they can feel they are contributing. Be sure adequate information is available.

Any activity involving a new policy or change to one already existing will raise questions and, perhaps, opposition. This is part of the political process and change.

Step 7. Communicate with the Public Through the Media(newspapers, radio, television)

You may want to make the public aware of your group and its goals. As your activities unfold, the media should be kept informed and events presented from your perspective.

Use:

press releases
press conferences
television appearances
radio interviews
public meetings you organize and invite politicians to attend
events to draw attention to your cause

The plan should be coordinated and monitored to ensure the goal is still within sight.

Note: Not every project will want or need media attention. However, those who are seeking to introduce legislation, amend a law or stop an activity from proceeding are likely to require it.

Step 8. Implement Change - Success!... Maybe...

This is the time that policy comes into effect and the control transfers from you to others. Problems may arise and you will have to work through them.

Step 9. Monitor/Evaluate/Adjust

You can enjoy your success but your work is not over yet.The work of the champion, the initiator or the sponsor may be entering a new phase. Ensure the goal is being met.

From the early stages of the process, no matter what the goal, the working group must direct its energies toward evaluation. Maintain an interest in the progress of your success.

Ask yourself:

Has anything happened because of your efforts?
Has a policy been written or changed?
Are there resources available to implement it?
Has the policy had the desired effect?

Few things are perfected without testing and there is always potential for failure.

The more flexible and open you are to incorporating what you have learned along the way, the more likely your success.

Remember... Things take time...

HEALTHY PUBLIC POLICY IN ACTION

Achieving Health For All: The Framework for Health Promotion is used as a tool in health planning. Healthy Public Policy is one of the implementation strategies.

The examples which follow show how healthy public policy has been developed in Newfoundland and Labrador.

Example 1

the introduction of legislation to ensure building accessibility thereby promoting a healthy environment for all citizens,

Example 2

the formation of a small self-help group to assist members cope with a personal crisis,

Example 3

the establishment of a program by an employer to foster wellness in the workplace, and

Example 4

the challenging of a public policy by the community.Each activity involved making change for the benefit of our Community's health.

EXAMPLE 1:

COMMITMENT TO CHANGE TO CREATE A HEALTHIER ENVIRONMENT: THE BUILDINGS ACCESSIBILITY LEGISLATION

Issue Identification Through Needs Assessment

In 1976, the Community Services Council, a social planning and research organization, conducted a study on the housing needs of the physically disabled. Lack of wheelchair accessibility to most housing units was identified as a major problem.

Public Awareness of the Issue

A press conference was called to raise this issue.
A meeting was held with members of the St. John's City Council which identified the lack of regulation to ensure buildings were accessible. Council's support was obtained.
A public meeting was organized to which there was an overwhelming response.

Formation of a Working Group

The Accessibility Action Committee was formed. The membership of this Committee included staff from the Community Services Council, the Executive Director of the Canadian Paraplegic Association, a medical specialist and a consumer, i.e., a person with a disability who formed part of the target population.

Refining We Issues/Idendfying He Goals

As the Accessibility Action Committee began to work on this issue, it became obvious that the issue was broader than first thought.

The lack of housing for those with a physical disability was a small piece of a larger concern. The efforts undertaken should be to achieve accessibility to all buildings.
The focus had to be provincial in nature, and not limited to municipal regulation. Thus the goal became the introduction of a piece of legislation through the House of Assembly.

Gaining Participation of Various Interests

The Committee recognized that their membership had to be expanded to include:

provincial public servants who could advise on the process of policy-making,
representatives of the sectors which would be affected by the changes in building requirements, for example, the engineering profession, the construction industry.

Working with the Key Players to Make the Goal a Reality

From the public meeting in 1976 through to 1978 the Committee worked on a policy that would result in legislation. In 1979, legislation was introduced in the Newfoundland House of Assembly. Once regulations were drafted under the legislation, the Buildings Accessibility Act was proclaimed into law in 1981

Monitoring Progress

Under the legislation, the Buildings Accessibility Advisory Board was established to advise the Minister on, and to hear appeals from, any person who felt wronged by the application of the Act. Over time, it became evident that there were difficulties with the enforcement of the Act.

Learning Through Experience/Making Adjustments

In 1987, the Government acknowledged that there were definite problems as expressed by consumers, builders and the public. A Committee was appointed by the Minister to review the Act and recommend change. They consulted widely with municipalities, interest groups and the public. Subsequently an Implementation Committee was appointed by the Minister to oversee legislative amendments.

Attainment of the Goal

The Newfoundland Buildings Accessibility Act is considered to be one of the most comprehensive pieces of legislation of its kind in Canada.

Ongoing Evaluation

As of 1993 media attention regarding inaccessible public buildings and the enforcement of the legislation continues. Consumer and other groups within the community have taken ownership of the issue of building accessibility and are committed to the intent and spirit of the Act.

Observations on the Process

Public awareness of an issue cannot be assumed.
The need for ongoing education is the key. Once the Act was law, all concerned had to be educated on the specific features of the changes.
There must be at least one or two members of the working committee to sustain momentum and keep the activities moving forward.
The committee invited potential detractors to participate in its activities. They became supporters.
Consumer representation is vital.
Know where the decision-making point is and target it.
Involve the policy makers from the outset and get them committed to the issue.
Constant monitoring and vigilance is necessary.

EXAMPLE 2:

THE INDIVIDUAL INITIATOR OF SELF-HELP: RECLAIMING A LOST CHILDHOOD

Crisis Resulting From Personal Tragedy

Carol, a woman in her mid-forties, made a complaint of sexual assault against a relative. She alleged this abuse occurred when she was a child. Her family was torn apart by the charge. Unable to cope with the stress of her situation as the court date approached, she contemplated suicide.

Reaching Out To C.HAN.N.A.L (Consumers HealthAwareness Network of Newfoundland and Labrador)

C.H.A.N.N.A.L. is a group of consumers of mental health services. Their purpose is to prevent isolation of individuals through offering support and to advocate for improvements in the mental health system.

Carol learned about C.H.A.N.N.A.L. and attended a meeting. She did not feel comfortable enough to speak but she listened and she could identify with many individuals. She continued to attend meetings regularly. Through the safety and encouragement provided by the group, she was able to open up.

Formation Of A Survivor's Group

For survivors of child sexual abuse, safety is an overriding concern. Carol suggested a smaller group of survivors begin to meet away from the main group. They could begin to feel at ease and speak freely about their issues.

There was support for her idea. The Canadian Mental Health Association (CMHA) assisted by funding training for Carol. A contract between CMHA and a social worker was arranged to provide intensive training for Carol to lead survivors groups and to do other work on behalf of C.H.A.N.N.A.L.

Participation and Benefits of Self-Help

Carol took leadership of the group. Regular meetings centered on:

Educating the Members

Reading materials regarding sexual abuse and healing were distributed to the members to help understand their behaviours and feelings. CMHA helped with copying costs and meeting space.

Consciousness Raising

Through the sharing of feelings they thought they alone experienced, the members realized that the feelings were common to the others. The survivors started to accept and trust their feelings. They learned how to let go of destructive coping techniques and replaced them with new healthier ones.

Mutual Aid

One of the most important benefits of membership in a selfhelp group is the support received from other participants. The group brings people together who come to understand that they are not alone. Someone could say "I understand" and really mean it.

Personal Benefits for Carol

The involvement with C.H.A.N.N.A.L. and the self-help group has had personal benefits for Carol. Participation allowed Carol to develop her self-esteem as she began to believe in herself.

Help in Healing

The process of healing from childhood sexual abuse is painful. The group can help by accepting each person in spite of their behaviours. Judging the person is not helpful but helping the person accept accountability for behaviors assists healing.

Moving Beyond The Self-Help Group

Carol no longer considers herself a victim having moved from victim to survivor to a person who has survived abuse. Carol has reclaimed her childhood and has learned that important aspects of childhood were denied her because of the abuse.

Advocate For C.H.A N.N.A.L.

Carol is an active C.H.A.N.N.A.L. advocate for the recognition of the benefits of mutual aid. She seeks to educate the community and professionals alike about the place of self- help and mutual aid in co-operation with the traditional health care system.

Advocacy For Survivors

Carol has begun to speak out and gradually attain a leadership role in the community as an advocate for survivors of child sexual abuse. She notes that "knowing she has the support of the group inspires her to take risks by speaking in public about child sexual abuse and to advocate for change."

Carol's Suggestions For Starting A Self-Help Group

The need for a coordinator to lead the group is important.
A person who acts as a coordinator has to be aware that the group members may begin to become dependent on him/her. The coordinator must be able to say "no" with sensitivity instead of fostering an unhealthy relationship.
Although group members are connected, every individual is unique. Respect for each person is important as they progress in theirjourney of healing.

EXAMPLE 3:

HEALTHY PUBLIC POLICY IN A BUSINESS ENVIRONMENT: A CHAMPION OF A HEALTHY LIFESTYLE PERSONALLY AND PROFESSIONALLY

The Business Environment

The St. John's Transportation Commission operates the public bus system in St. John's. Of the 150 employees, approximately 90 are bus drivers. Among the newly appointed General Manager's first observations was the visible poor physical condition of the bus drivers. Most were overweight, smoked and inclined toward inactivity.

Awareness of Health Concerns

The general manager was accountable to the Board of Commissioners for the operation, including the financial state of the company. He became aware of the rising costs associated with the company's health benefits package. The use of the benefits, such as cost sharing of prescription drugs, was high. A bus driver is classified as a high risk occupation so that longterm disability insurance is expensive at the best of times. There were a high number of drivers on leave (long-term disability) and insurance premiums were escalating.

Issue Identification

The General Manager learned that there were several factors that contributed to the driver's health status:

Drivers worked irregular hours. This had an impact on lifestyle.
Drivers had poor eating habits. Due to the schedule, many drivers tended to consume food that was prepackaged, quick to eat but not necessarily nutritious.
The job was stressful. Unhealthy coping mechanisms, such as the consumption of tobacco products or overeating were being relied upon.

The general manager felt that the situation could be resolved with the employees and the company co-operating to encourage self-care behaviours.

Formation of a Working Group of Employees

With the support of the Commission, a meeting was called in 1990 to seek solutions by involving employees in planning. Initially, the response was guarded. A working group sought information from other Transit Commissions and agencies which were addressing similar problems. As the working group became more involved, they took ownership of the activities.

Conducting a Needs Assessment

With the help of professionals employed by the Provincial Government, a survey was conducted within the Transportation Commission. Results indicated that employees were concerned about specific health issues, such as body weight, blood pressure and cholesterol levels. Other issues raised were dependence on tobacco, the need for stress management and nutrition counselling. Using the information gathered from the survey and the suggestions brought forward from the working group, a presentation for the Commission was planned.

Approval of the Identified Goal

The presentation coincided with the premature deaths of several employees and the onset of disability (caused by strokes) of several employees. The adoption of an Employee Health and Wellness Program within the Transportation Commission was advocated.

The program would:

be overseen by a Committee of employees, both non-union and union.
subsidize individual memberships in fitness programs cost-shared by the company.
organize Company sponsored health days, 2 or 3 times a year, on the job site; activities could include a blood pressure clinic, weight control information, displays by outside agencies such as Cancer Society, Lung Association, Heart and Stroke Foundation.
organize Company sponsored fitness activities for the employees such as ski trips, ice hockey games, ball hockey games, bowling tournaments.
consider health initiatives such as adopting a Company smoking policy and providing nutritious snacks in the onsite vending machines.

In spite of some reservations, the program was approved by the Commission.

Implementation/Measuring Successes

This program has been operating since 1989 and is over seen by the Employee Health and Wellness Committee (now Active Care Today). The program is viewed by the Committee as being a success.

The Commission has been pleased with the program's operation and realizes that the investment in the employees is a long-term venture. The benefits of maintaining good health and participating in health enhancing programs is to everyone's advantage.

Evaluation

The Committee continues to meet on regular basis. The Chair of the Committee has identified planning and monitoring activities to be undertaken to ensure the program is supported within the organization. The ongoing commitment of the Committee members, the General Manager and the Commission, is vital for the Active Care Today Program's ultimate success.

Suggestions To Other Businesses If Undertaking A Program

Commitment to fitness and wellness must start at the top of the organization.
Encouraging participation may be difficult initially but it is a matter of heightening health awareness, e.g., sponsoring health fairs.
Use the resources available in the community to help research your ideas, develop a plan and program.

EXAMPLE 4:

A PROGRAM FOR FAMILIES TESTED: THE DAYBREAK CHILD CENTRE

A Program For Troubled Children Becomes A Family Service

The Daybreak Child Centre began its operation in 1972. Its mandate was to assist disadvantaged children, ages 2 - 6 years, through the provision of a nurturing environment in which behavioural problems could be addressed.

As with other programs for disadvantaged children, it became apparent that families themselves also need support to help their children. In 1979, Daybreak shifted its focus from intervention with the children to providing family services.

Funding Arrangements

The funding for the Centre involved contributions by both the federal and provincial levels of government. The provincial contribution, made available through a Daycare Subsidy Program, covered costs involved with the Preschool and Family Support Program. Daybreak did raise funds from other sources.

Evaluations of The Program

In 1990-91, through an external evaluation, a positive report was made on the program offered to these families. Although Daybreak was more expensive than other daycare, the extra services offered to individual children and their families were considered cost effective by the evaluators.

In 1992, an evaluation was conducted by provincial government officials as was an audit of the financial management of the Centre. It recommended a service agreement between Daybreak and the Minister of Social Services.

Working With Child Welfare

In 1992, Daybreak staff began working with the members of the Child Welfare and Daycare Divisions in hopes of entering a service agreement with the Department. This service agreement outlined how Daybreak supports the Minister's role in the safety and well-being of children and preservation of the family.

The Realities of the Economy

In March 1993, the provincial government was faced with major economic difficulties. As a result, funding for certain programs and services could not be continued. Daybreak was advised that the services would not receive funding in the next fiscal year. Closure was to occur within weeks.

Reaction by the Board, Staff, Parents and the Community

Upon receiving notification of the impending loss of funding, the Board, parents and staff reacted quickly to save Daybreak. Politicians and opinion leaders were contacted for advice. Daybreak was advised to take advantage of any opportunity to talk publicly about the value of the services and what the loss would mean for the children, their families, and the community.

Mobilization and Action

Those involved with Daybreak, including the parents and graduates of the program, fought to keep the Centre. Their activities included:

circulating petitions
organizing a letter writing campaign
contacting the media, and
organizing a rally that was attended by 450 people.

All efforts were taken to ensure that the decision-makers were made aware of the support for, and importance of, Daybreak in the community.

The Board, the parents and staff analyzed the implication of the decision. They concluded that the decision-makers were not seeing the whole picture.

Persuading Decision-Makers

The Board, staff and the parents together met with the key decisionmakers of Government in order to:

present convincing financial details highlighting that the closure did not represent a budgetary saving immediately or in the long-term.
offer personal histories showing the positive benefits of Daybreak to the children's lives and family life.
impress upon them the importance of this program to the disadvantaged members of our community.

Change of Policy

Within a short period of time, the government was persuaded to continue its support of Daybreak into the next fiscal year.

Benefits of the Effort

There have been several positive outcomes of the process:

Government has a new understanding of Daybreak and there is solidarity between the parties.
The parents have come to realize that they can make a difference for the lives of their families.

Observations on the Process

Make sure the issue is clear and do your homework.
Ensure your issue is of interest to the decision-makers. Show them how it will impact their community.
Personal contact with decision-makers is key.
Consumer participation is needed especially in times of crisis. Often the most powerful spokespersons are those who have a personal interest in the issue. These people can show the importance of the issue from a personal perspective.

Conclusion

By the time you have finished reading this booklet, you will have realized that there are many factors influencing health. But most importantly, your health is within your control.

Responsibility for health care is placed with the individual, the community, organizations and businesses.
Citizen action can make a positive contribution in preserving, maintaining and enhancing our health.
Encouraging our leaders to adopt healthy public policies which promote health is essential.

By using this guide, you and other interested citizens may be able to work toward achieving healthy public policy in your community for the benefit of all residents.

You can make a difference!!

Readings

A. References Cited in this Booklet

Epp. J. Achieving Health for All: A Framework for Health Promotion, Ottawa: Supply & Services Canada, 1986.

B. References Used to Develop this Booklet

Guide for Developing Healthy Public Policy

B.C. Ministry of Health and Social Planning and Research Council of B.C. A guide for Communities to Enact Health-Promoting Policies, Victoria 1991.

Community Health Needs Assessment

B.C. Ministry of Health Community Health Impact Assessment for Local Governments, March, 1993.

National Health and Welfare Community Action Pack, Canada, 1992.

(A kit developed for community groups which contains information, on a step-by-step basis, to guide a group through the process of creating healthy public policy. This resource is available through the public health units in the province.)

Self-help and Mutual Aid

St.-Amand, N. And Cluvette, H. Self-help and Mental Health, Beyond Psychiatry, Ottawa: Canadian Council on Social Development, 1992.

Wellness Programs in the Workplace

Charest, J. Getting Started, Fitness and Lifestyle at the Workplace, Ottawa, 1988.

Cooper, E. Wellness Programs Slow Rising Costs, Safety and Health pp. 46-48 April 1990.

C. References on Healthy Public Policy Generally

Milio, N. Public Policy as the Cornerstone for a New Public Health: Local and Global Beginnings, Family and Community Health Vol. II No. 2 pp. 57-71, 1988.

Tesh, S. et al. The Meaning of Healthy Public Policy, Health Promotion, Vol. 2, No. 3 pp. 257-262, 1988.

A Framework for Health Promotion Policy: A Discussion Document, Health Promotion Vol. 1, No. 3 pp. 335-340, 1986.

Contributors to the Making Public Policy Manual

Researcher/Writer

Colleen Hanrahan, M.S.W., LL.B.

Contributors

Adrian Battcock (deceased)
Chair, Canadian Paraplegic Association
Newfoundland and Labrador Division

Carol Crocker
Consumers' Health Awareness Network
Newfoundland and Labrador (C.H.A.N.N.A.L.)

Michelle Hedderson
Chair, Active Care Today Committee
St. John's Transportation Commission

Shannon Moeser
Psychology Department
Memorial University of Newfoundland

Melba Rabinowitz
Program Director Daybreak Parent-Child Center

Penelope M. Rowe
Executive Director Community Services Council

Robert Sexty
Faculty of Business Administration, Memorial University of Newfoundland

Arthur Sullivan
Psychology Department, Memorial University of Newfoundland

Bill Thistle
General Manager, St. John's Transportation Commission

Members of the Public Policy Subcommittee
Ron Day
Catherine Donovan
Roy Manuel
Eleanor Swanson
Gerri Thompson
Wendy Williams

Sponsors
The Newfoundland and Labrador Heart Health Program
c/o Health Promotion Division
Department of Health and Community Services
P.O. Box 8700
St. John's, NL A1B 4J6

Contact the above address for additional copies.

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1995