Achieving population health goals: Perspectives on measurement and implementation from Australia

Health goals and targets have been widely used to indicate strategic direct ion and priority for health improvement on a population basis. This paper p rovides an overview of Australia's experience in using health targets and c onsiders the relevance of this experience for Canada. It gives special atte ntion to the challenge of developing a broadly based set of targets that re flect the social, economic and environmental determinants of health alongsi de more traditional measures of health status. It examines how the technica l challenge of measurement, the bureaucratic barriers between government de partments, and the political conservatism inherent in federal systems of go vernment present formidable barriers to effective action on comprehensive n ational health targets. The paper concludes with a reminder of the need for intersectoral action to address the determinants of health. Based on the Australian experience, it suggests for Canada an ideal combination of a national population health f ramework to guide direction and priority, to be implemented through action at a more local level, through well-defined partnership.