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Abstract
While ‘evidence-based’ decision making in public health is the gold standard to
which public health policy makers ascribe, theoretical as well as practical constraints
have been acknowledged. A broader concept of ‘data-informed’ decision making, of
which evidence is a key component, may be more relevant to support rigorous public
health decision making.
Four case studies from NSW are presented in this thesis, each reflecting different
ways in which data are collected, analysed and reported to inform public health
decision making.
The first case study presents a segmented time series analysis of emergency
department presentations over a 15-year period to explore the relationship between
taxation changes affecting the price of ready-to-drink alcoholic beverages (alcopops)
and alcohol related harm in NSW.
The second case study relates to HIV in NSW and is in two parts. The first part
presents the 2013 annual HIV data report from the NSW Ministry of Health
measuring progress against targets set in the NSW HIV Strategy 2012-2015. The
second part of this HIV case study presents an evaluation report from the first
Australian ‘pop-up’ HIV testing site in Oxford Street, Sydney on World AIDS day in
2013.
The third case study stays with the theme of sexually transmitted infections with an
analysis of demographic and geographic risk factors for chlamydia and gonorrhea
infections among the culturally diverse population of greater Western Sydney. In the
fourth case study, a report is presented on the burden of cardiovascular disease
among Aboriginal people and access to cardiac procedures.
The case studies provide a basis for discussion of data-informed decision making
and the factors that may affect how effectively data is used to improve health
outcomes. Areas of focus are suggested to further enhance and embed the better
use of data in the field of public health policy and practice.