Stretton Health Equity
Stretton Health Equity leads high quality scholarship on the social and economic determinants of health and health equity.
Its researchers conduct highly relevant research that informs practice and policy development in Australia and overseas, in relation to the promotion of population mental and physical health and health equity, and the reduction of social and economic exclusion.
Stretton Health Equity’s research focus is on what can be done about the underlying factors that determine the distribution of health and well-being outcomes. We produce research knowledge on why health inequities exist, what can be done about them and how population health overall can be improved. Our research includes that on primary health care, the commercial determinants of health, Health in All Policies, and assessment of policies in a range of areas including housing, urban planning, trade and social welfare in terms of their health and wellbeing impacts. We receive funding from the ARC and NHMRC and government agencies.
For more information, contact the Stretton Health Equity Program Director, Professor Fran Baum AO.
Policy lab
Stretton Health Equity aims to produce policy relevant and engaged research on health inequities, and the social determinants of health that drive them. Our Stretton Health Equity Policy Lab brings together policy briefs and summaries of key findings from our research to inform practice and policy in Australia and internationally.
Access the Stretton Health Equity Policy Lab
People
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Professor Fran Baum AO - Program Director
Professor Fran Baum AO is a public health social scientist with a special interest in creating healthy, equitable and sustainable societies.
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Dr Toby Freeman - Director of Research
Toby Freeman is a Senior Research Fellow and the Director of Research at Stretton Health Equity, part of the University of Adelaide's Stretton Institute. His core research interest is how to redress growing health inequities. His areas of research include primary health care, Aboriginal and Torres Strait Islander health, healthy public policy, and the social determinants of health.
Toby was previously a Senior Research Fellow and Deputy Director at the Southgate Institute for Health, Society, and Equity at Flinders University, and a policy officer at the South Australian Council of Social Service.
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Dr Julia Anaf
Julia Anaf is a Research Fellow at Stretton Health Equity in the Stretton Institute at the University of Adelaide.
Her research interests focus on the social, political, and commercial determinants of health and health equity. Her most recent work explores the health impacts of the products and operations of transnational corporations. It utilises a Corporate Health Impact Assessment Framework to identify both positive and adverse health and equity impacts of transnational corporations across a range of industry sectors.
Julia is currently employed on a National Health and Medical Research Council Investigator Fellowship led by Professor Fran Baum entitled "Restoring the Fair Go: which policies and practices are likely to reverse growing health inequities in Australia post-COVID-19”. This research will provide a detailed assessment of the drivers of health inequities in Australia and determine the policies and practices most likely to reverse them.
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Dr Kim Anastasiou
Kim Anastasiou is a Research Fellow at Stretton Health Equity in the Stretton Institute at the University of Adelaide. Her research interests focus on understanding and improving the health, equity and environmental impacts of food systems. Kim is currently working on an ARC grant investigating the health and environmental impacts of Australian food policies.
Kim is a dietitian, researcher and advocate for improving food systems to achieve health, equity and environmental goals. She is a board member of the advocacy organisation ‘Healthy Food Systems Australia’. Previously, Kim has held the roles of ‘Young Scientist’ for the UN FAO’s World Food Forum (2022-23) and ‘Youth Liaison’ for the 2021 United Nations Food Systems Summit (2021). Her PhD research investigated the environmental impacts of ultra-processed foods using systems science methods at Deakin University. She previously worked on public health nutrition research projects at the CSIRO.
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Associate Professor Samantha Battams – Adjunct
Dr Samantha Battams has status as Adjunct Associate Professor at Stretton Health Equity. Dr Battams completed her PhD in public health policy (for which she was awarded an NHMRC public health postgraduate scholarship) at the Discipline of Public Health, Flinders University in 2008. She also has a Bachelor of Arts (Social Science) degree with majors in psychology and sociology (Flinders University), Honors in Sociology (University of Tasmania), Graduate Certificate in Health Service Management (Flinders University) and Diplôme d'Etudes en Langue Française-DELF (Catholic University of Lyon).
Dr Battams has worked in academic teaching and research at the Discipline of Public Health, Southgate Institute for Health Society and Equity and the National Centre for Education and Training at Flinders University, where she also had academic status as Associate Professor (2003-2022). Samantha has also worked in academic teaching and research at the University of Geneva (2013) and The Graduate Institute of International and Development Studies, Switzerland (2011-2013) and was inaugural Director of Public Health Programs and Associate Professor at Torrens University Australia (2014-2016). At the University of Geneva, she was Course Director, developing the inaugural Global Health: An Interdisciplinary Overview MOOC (Coursera platform), which has been run since its inception.
Dr Battams’s research interests span the social determinants of health, social determinants of Indigenous Health, health equity, mental health, alcohol and other drugs, mental health and housing policies, justice sector and crime prevention, NGO and consumer participation in policy processes, global health governance, European Union’s role in global health, trade and health and critical public policy analysis. She has used a range of critical public policy theories in her work (e.g. Kingdon, Sabatier & Jenkins-Smith, Bacchi).
Dr Battams has also worked in senor roles in the health and community services sector, for government, and as a senior management and research and evaluation consultant. Dr Battams was previously Director (Research & Evaluation) at Health Outcomes International and is currently Senior Manager at ZED Management Consulting. Her current research with the Brightwater Research Centre, WA explores the impact of COVID-19 on the residential aged care sector, with a particular focus on the workforce from culturally and linguistically diverse backgrounds and residents with cognitive impairment.
Dr Battams was previously co-convenor of the Public Health Association of Australia’s mental health special interest group, Panel Member (Community) of the District Court of SA hearing appeals under the mental health and guardianship acts (Governor appointed) and on the Occupational Therapy Board of South Australia.
Samantha is also an author of non-fiction historical books, and the SA Convenor for Sisters in Crime Australia, a network of female crime writers. -
Dr Matt Fisher
Dr Matt Fisher is a Senior Research Fellow in Public Health, with the Stretton Health Equity research unit, part of the Stretton Institute and School of Social Sciences at The University of Adelaide. Dr Fisher completed his PhD in political philosophy in 2010, before taking up a research role with the Southgate Institute for Health, Society and Equity at Flinders University. Since that time, his research has focused on two broad issues: 1) how and why public policy does or does not address social determinants of health and health equity (SDH-HE); and 2) how policy action on social determinants can be improved to promote public health and reduce health inequities.
Dr Fisher’s work has focused mainly on public policy and public health in an Australian context and investigated policy in a range of areas including Australian health policy, Indigenous health, primary health care, telecommunications, urban planning and urban environments, environmental policy, early childhood education, and justice. Dr Fisher’s research on policy has applied a range of theoretical concepts from policy studies to explain policy action or inaction on SDH/HE, such as power, political will, the policy cycle, Kingdon’s three streams model of policy development, and the role of Ideas, Interests, and Institutions in determining policy. He has also contributed to theory development, for example in developing and applying a framework to assess Indigenous cultural safety in public policy and publishing work on the role of universal and targeted policies in advancing health equity. With colleagues, Dr Fisher has also conducted research on digital health services, and on the role of transnational corporations as commercial determinants of health.
Dr Fisher had a particular interest in understanding the social factors that affect chronic stress and mental illness, and what they mean for public policy and social change to prevent mental ill-health and promote human wellbeing. In 2019 he published ‘A theory of public wellbeing’ in BMC Public Health, which defined seven wellbeing abilities and showed how these can be promoted or inhibited by social conditions. In 2021 he developed this theoretical work further in an article on ‘Moving social policy from mental illness to public wellbeing’ published in the Journal of Social Policy. In 2020, with Indigenous colleagues, he published research investigating ‘Theories of Indigenous and non-Indigenous wellbeing in Australian health policies’ in Health Promotion International.
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Dr Joanne Flavel
Joanne Flavel is a Research Fellow at Stretton Health Equity in the Stretton Institute. She has qualifications and experience in economics and public health, and expertise in quantitative analysis. She worked at the Southgate Institute for Health, Society & Equity prior to joining Stretton Health Equity, and prior to that worked at the National Institute of Labour Studies.
She is a scholar in social epidemiology and public health but her quantitative skills and social science background are interdisciplinary. Her research focuses primarily on health equity and social determinants of health. She is a member of the international Punching Above Weight (PAW) Network, formed to advance thinking and research about why some countries do much better in terms of health outcomes than would be predicted by their economic status. She is also a Global Burden of Disease Collaborator.
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Ms Sue Gibbons
Sue is a Research Support Officer for the Stretton Health Equity Programs.
Sue has decades of experience in research administration and executive support in various universities.
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Associate Professor Emma Miller – Adjunct
Emma Miller is an epidemiologist with particular expertise in hepatitis C, sexually transmitted infections (STI) and substance use. More recently, her research focus has been in the area of alcohol behaviour and its links with cancer, smoking cessation in lower socioeconomic populations and gonorrhoea in young people living in lower socioeconomic areas.
In various government and academic roles, as including in communicable disease surveillance in Victoria and South Australia, Emma has worked extensively with vulnerable populations primarily affected by substance use issues, including prisoners in the South Australian correctional system.
Emma has held academic posts at The University of Adelaide, Deakin University, La Trobe University, Flinders University and has now returned to The University of Adelaide as an adjunct Associate Professor in Stretton Health Equity, the Stretton Institute.
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Dr Connie Musolino
Connie Musolino is a Research Fellow at Stretton Health Equity in the Stretton Institute. She is an early career researcher with expertise in social science, gender studies and public health. Connie completed a PhD in Social Science with a focus on young women with eating disorders and examined the gendered and socio-cultural factors of their experiences to understand why they were reluctant to seek therapeutic help.
Connie previously worked at the Southgate Institute for Health, Society and Equity in the College of Medicine and Public Health at Flinders University from 2017-2022 as a Research Fellow and Project Manager. Connie is currently a Research Fellow on Prof Fran Baum's NHMRC Investigator Fellowship entitled "Restoring the Fair Go: which policies and practices are likely to reverse growing health inequities in Australia post-COVID-19". She is working across a range of projects examining health inequities, the social determinants of health, gender and health, health promotion and community health services, and civil society and social movements.
Connie has experience in a wide range of research methods including semi-structured interviewing, focus groups, community consultation, observations, diary writing, world cafe and surveying. She is also experienced in project managing complex and interdisciplinary teams, including organising project advisory committees, and community and policy engagement to enhance evidence translation. -
Ms Sharna Pearce
Sharna is a Project Support Officer supporting the “Decolonising Practice in Aboriginal and Torres Strait Islander Primary Health Care” Project within the Stretton Institute.
Sharna has decades of experience in project leadership, administration and executive support in various non-profit organisations and universities. She is passionate about improving outcomes in the many areas on the social justice agenda. -
Dr Miriam Vandenberg
Miriam is currently based in Tasmania but grew up and studied in South Australia. Miriam has a background in public and environmental health, having worked in these areas is South Australia, Western Australia and Tasmania. Following a career working for both local and state governments, she completed additional studies in health promotion and public health through Curtin University in WA. She undertook a PhD at Flinders University in SA which explored how working in the informal economy affects workers’ health and wellbeing. Miriam has worked as a public health consultant for 15 years, working on a range of research, evaluation, policy and advocacy projects for many government and non-government organisations in Tasmania, as well as the World Health Organisation. Miriam has worked for Flinders University and the University of Tasmania. Her research interests are social determinants of health equity – particularly to do with work, food security and housing. Miriam also has research experience in areas related to anticipatory care, mental health, positive aging and the criminal justice system.
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Dr Helen van Eyk - Adjunct
Helen van Eyk is Adjunct Senior Lecturer at Stretton Health Equity after retiring from the University of Adelaide in 2022. She is interested in research into the social determinants of health and health equity, in Health in All Policies and in the translation of research into policy and practice.
Prior to university research roles, she had an extensive career in the South Australian public sector, working in health policy and legislative roles to an executive level.
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Ms Kristen Foley
Kristen Foley is a Research Fellow at Stretton Health Equity. Her research explores how health and illness outcomes are structured across and amongst populations; with a strong emphasis on the sociopolitical realities and affective economies of value that give rise to these patternings. She uses predominantly qualitative methods to consider interplays between people, science, culture, emotion, market, policy, and place; and has contributed methodological innovations to both public health and social science disciplines.
She is an invited guest lecturer to students in allied and public health fields. Kristen holds an NHMRC funded post-doctoral scholarship (allied health priority stipend) to explore the commercial determinants of alcohol consumption for Australian women in midlife through Torrens University, and works on the MRFF-funded Work, Unemployment, and Suicide Prevention project at Stretton Health Equity.
Projects
Stretton Health Equity's key projects include:
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Restoring the Fair Go
Australia has long prided itself on being the land of the “fair go” yet in the last two decades and particularly since the onset of Covid-19, this claim has been under threat. While life expectancy has continued to grow in Australia, the distribution of health has grown more unequal. Prof. Fran Baum’s five year NHMRC Investigator Grant (2022-2026) seeks to produce compelling evidence so that policy makers will see the value of adopting new policies to reduce inequality in the context of building back from Covid-19. It will do this by providing a detailed assessment on the pattern of inequities, policies and practices driving inequities and determine those likely to reverse it. The research will engage policymakers and citizens in co-developing these strategies.
Contact: Prof Fran Baum, fran.baum@adelaide.edu.au
HELLO webinars
Stretton Health Equity, University of Adelaide, has establishing a Health Equity Learning Lab Oz (HELLO) as part of the National Health and Medical Research Council funded ‘Restoring the Fair Go’ research initiative to bring together civil society, public servants, policy makers, and academics who seek to achieve policy change for a healthier and more equitable society. We foster HELLO through a range of strategies, including regular webinars.
Introducing the Health Equity Learning Lab Oz (HELLO) – Prof Fran Baum and Prof Jennie Popay
Punching Above their Weight Network’s research framework for comparative analysis of country health and health equity outcomes / Preliminary findings from the Restoring the Fair Go mapping of civil society organisations in Australia who are advocating for health equity – Dr Toby Freeman and Dr Connie Musolino
The role of ACCHOs in pursuing health equity for Aboriginal and Torres Strait Islander people – Assoc Prof David Scrimgeour and Mr Michael Larkin
Restoring the Fair Go social epidemiology analysis of the nature of health inequities in Australia (including during the COVID-19 pandemic) and the social determinants of health that underpin growing socio-economic inequities - Dr Joanne Flavel / Reflections on the policy implications of the findings from a civil society perspective - Robert Sturrock.
Governing for planetary health equity – Professor Sharon Friel / The politics of planetary health equity in Australia - Chelsea Hunnisett.
A public health approach to the reform of South Australia’s Child and Family Support System – Dr Charlie Murray, Dr Dana Teusner, Dr Kelly Jones.
Housing as a social determinant of health, and the policy and advocacy landscape responding to the inequalities in housing affordability and housing conditions in Australia – Professor Emma Baker, Dr Amy Clair, Ms Bernie Barret.
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History of Community Health in Australia
This Australian Research Council Special Research Initiative grant funded project (2020-2023) aims to complete a comprehensive history of the development of community health centres and services in Australia, including Aboriginal community controlled organisations. It is intended to be significant in showing how the Aboriginal, women's, workers' and other social movements interacted with social and political institutions in crafting the variety of community health services now existing in Australia. It is intended to trace the changing meanings of 'community' and 'health' over the past fifty years. It is anticipated the research will enhance understanding of cultural, political and institutional influences on healthcare in Australia, thereby assisting in improving interventions promoting community health and well-being.
Contact: Dr Connie Musolino, Project manager, connie.musolino@adelaide.edu.au
Policy Forum: Celebrating the Whitlam Community Health Program: Lessons for the Future
On 3 November 2023, the Whitlam Institute hosted a special policy forum that presented the findings from an ARC project compiling the history of the Whitlam Community Health Program. We were grateful to be joined by the Hon. Mark Butler for a keynote address as well as many knowledgeable and distinguished speakers. This ARC project is a partnership between investigators and researchers from Stretton Health Equity, the University of Adelaide, Flinders University, La Trobe University, the University of Sydney, and partner organisations the National Aboriginal Community Controlled Health Organisation, and the Sydney Local Health District.
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Decolonising Practice in Aboriginal and Torres Strait Islander Primary Health Care
The NHMRC funded Decolonising practice in Aboriginal and Torres Strait Islander primary health care project (2018-2023) is partnering with five Aboriginal and Torres Strait Islander primary health care services around Australia to understand and establish an evidence base for decolonising practice in primary health care to address the negative health effects of ongoing colonisation for Aboriginal and Torres Strait Islander peoples.
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Punching Above Their Weight Network
The international Punching Above Their Weight Network was established to advance thinking and research about why some countries do much better or much worse in terms of life expectancy than would be predicted by their economic status.
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Health in All Policies
Health in All Policies (HiAP) is a strategy promoted by the World Health Organization to encourage intersectoral action on social determinants of health. It has been implemented in South Australia since 2007. We have conducted a 5 year NHMRC project (2012-17) to evaluate the state's HiAP approach. The key messages from this research are outlined in the policy brief.
In 2022, Stretton Health Equity produced a review of intersectoral collaboration models to address social determinants.
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Work, Unemployment, and Suicide Prevention Project
The ‘Work and unemployment: vital to effective suicide prevention’ project (2024-2026) is a collaboration between Stretton Health Equity, the Robinson Research Institute, and the Pro Vice-Chancellor Indigenous Engagement at the University of Adelaide, funded by the Medical Research Future Fund. Partners include the Australian Unemployed Workers Union, the South Australian Council of Social Service, the Anti-Poverty Network SA, and the Healing Centre for Griefology.
This project seeks to expand the scope of suicide prevention in Australia by emphasising the social determinants of suicide. Taking a social determinants approach to suicide prevention emphasises how economic conditions, employment, poverty, social exclusion, and discrimination all affect suicide rates.
This approach provides opportunities for more population-based prevention strategies that have the potential to reduce deaths by suicide by addressing the upstream causes of suicide risk. However, a social determinants approach to suicide prevention has been absent from current efforts in Australia.
We will target employment factors such as unemployment, underemployment, precarious employment, work-related stress and financial distress that have been identified as leading contributors to suicide in Australia.
The objectives of this research are to:
- Identify opportunities in Australia to contribute to suicide prevention related to employment at different points in the suicide prevention system - from government policy and initiatives, to employers, to primary health care workers and frontline social security workers.
- Provide feasible, targeted recommendations for multiple opportunities for action to reduce suicide related to employment and unemployment.
- Develop a training package for primary health care workers to support their capacity to identify and intervene to address employment-related social determinants of suicide, and to further pilot it with frontline social security workers.
Contact: Dr. Toby Freeman, toby.freeman@adelaide.edu.au
Reports from completed projects
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Priority Populations
Priority Populations in Mental Health and Suicide Prevention
The Priority Populations in Mental Health and Suicide Prevention Project was conducted by Stretton Health Equity researchers over 12 months, concluding in June 2023. The project was funded by the National Mental Health Commission.
The aims of the research were to:
- Critically assess the concepts, processes, and evidence used in the mental health and suicide prevention sectors in Australia to identify priority populations (PPs).
- Make recommendations to policy makers about identification of PPs as a means to improve mental health outcomes and reducing inequities in mental health in Australia.
- Develop and share a Decision-Making Tool to support policy makers or other organisations to identify PPs in the contexts in which they work.
Based on our research, we defined a priority population in mental health/suicide prevention policy as a group of people defined according to a shared characteristic (e.g., socioeconomic status, gender, Indigeneity, ethnicity, sexual orientation, age, location, occupation) who:
- Experience higher risks of mental ill-health, suicide or suicidal distress compared to others, because of the conditions in which they live and work, because of social inequities and discrimination, and/or because of poor access to mental health care services or supports.
- Are identified by an organisation working in mental health and/or suicide prevention as a specific focus of their policy and/or practice.
Need for the research
A number of population groups in Australia experience higher rates of mental ill-health and/or suicidal distress compared to the population at large. These include people subject to socioeconomic disadvantage and groups subject to systemic discrimination in one form or another. Some population groups may also have relatively poor access to mental health care services. Mental health and suicide are both strongly influenced by social determinants of mental health.
The general intent of naming PPs in mental health and suicide prevention policies is to recognise such groups in order to implement specific strategies to better meet their needs. However, there are significant questions about the processes used to recognise PPs, and whether the naming of PPs is tied to effective strategies likely to improve outcomes and reduce inequities.
Project Report and Decision-Making Tool
Project Report: Outcomes from the research and recommendations to policy makers were compiled in a Project Report available here:
Decision-Making Tool & Workbook: We also produced a Decision-Making Tool and companion Workbook for organisations working in mental health or suicide prevention. The Tool is freely available for use by organisations to select PPs relevant to the contexts in which they work. The Decision-Making Tool is available here and the companion Workbook is available here:
Further information about the research and the Decision-Making Tool are available by emailing: matt.fisher@adelaide.edu.au
Stretton Health Equity Research Team
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The Food Security System in South Australia
Developing a Systems View of the Wellbeing SA – Department of Human Services Food Security Initiative
In 2023, Stretton Health Equity was funded by Wellbeing SA (now Preventive Health SA) to collaborate on a preliminary qualitative examination of the work conducted as part of the Wellbeing SA and Department of Human Services public health partnership agreement centring on food security.
Stretton Health Equity conducted interviews and systems model building workshops with stakeholders to understand the broad and complex food security system in South Australia, and identify opportunities to strengthen work on reducing food insecurity.
Project Report: Outcomes from the research and recommendations to policy makers were compiled in a Project Report available here.
Stretton Health Equity Team
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Health Equity Impact Assessment Tools
Building Equity into Public Policies Designed to Promote Health: A study of health equity impact assessment tools
In 2023, Stretton Health Equity partnered with Wellbeing SA (now Preventive Health SA), the Department of Health Tasmania, and Carmel Williams, Centre for Health in All Policies Research Translation to review current tools to assess the health equity impact of public policies, and to develop a new tool and framework for these agencies.
Fifty-five HEIA tools were reviewed to determine the intended use of the tools in the policy development process, to compare the theoretical orientation of tools, to consider public and practitioner involvement in the tools, and to identify the extent of the tools’ application and evaluation. A co-design process was used to develop a Health Equity Impact Assessment Tool (Wellbeing SA) and a Health Equity Impact Assessment Frame (Healthy Tasmania). These are included in the project report below.
Project Report: Findings from the research, and the co-designed outputs are included in the Project Report available here.
Stretton Health Equity Team