Evidence Informed Public Health Policy and Practice

Abstract

This thesis explores the development of evidence to inform public health policy and practice in New South Wales (NSW). Six studies are presented which I undertook as part of the NSW Public Health Officer Training Program. Each study investigates issues of public health importance, with results that underpin public health policy and practice.

Chapter 2 comprises two studies. In the first study, I describe the epidemiology of lead poisoning in NSW between 1998 and 2008, which is the first published analysis of routinely collected lead poisoning notification data in NSW. The results show the burden of lead poisoning is in adult males and young children, information that will inform the public health response. In the second study in Chapter 2, I evaluated the lead poisoning surveillance system in NSW by assessing the attributes essential to disease surveillance systems, and make recommendations for improved surveillance.

In Chapter 3, I present two studies on hepatitis A. In the first study, I analyse hepatitis A notifications in NSW between 2000 and 2009. The results highlight a change in the epidemiology of hepatitis A notifications and the risk factors associated with infections. The second study investigates post-exposure prophylaxis (PEP) uptake following changes to the NSW hepatitis A control guidelines. It is the first study in Australia to estimate the effectiveness of hepatitis A vaccine as PEP amongst contacts of notified cases of hepatitis A.

In Chapter 4, I use a qualitative design to investigate the use of evidence in Healthy Built Environments policy and practice. I focus on the understanding and use of evidence by professionals from key stakeholder organisations across government, non-government and private sectors.

The final study (Chapter 5) investigates the public health issue of falls prevention and engagement by older men in exercise programs in the Southern NSW Local Health District. The results highlight enablers and barriers to their participation, and recommendations are made to improve participation by older men in local programs.

Each of these six studies has sought to assess the evidence and broaden the knowledge base of contemporary public health policy and practice.