USC Public Health: Applying Poland's Framework to Health Settings

This report provides a comprehensive analysis of health promotion settings, utilizing the framework outlined by Poland et al. It explores key components such as diversity within settings like Algester Lodge Nursing Home, emphasizing the importance of addressing socioeconomic disparities and cultural sensitivity in healthcare delivery. The report delves into the physical and psychosocial determinants of health, highlighting the influence of the built environment and psychological factors on the well-being of older adults in Australia. Furthermore, it identifies primary and secondary stakeholders in aged care, including the Australian government and various service providers, examining their roles, agendas, and understanding of health determinants. The analysis also addresses power dynamics, decision-making processes, and the meaning of health for stakeholders, emphasizing the importance of stakeholder engagement and evidence-based strategies for strengthening health promotion settings. The report also touches upon project governance and strategy planning within these settings, and the importance of adapting to changing contexts.

USC Public Health Programs. This template is a summary of the ‘Understanding Settings’ component of the health promotion setting analysis framework outlined by Poland et al. It is vital that you read the article in full for a detailed description (including examples) of each element.
1. Understanding Settings
Area of the Poland et al Framework Evidence from research process
Diversity
- How is it different and similar to settings in other categories?
- What diversity can be expected within this setting category?
The type of diversity expected within Algester Lodge Nursing Home
Research studies indicate that Australia is a country with the greatest levels of healthcare and well-
being globally with a life expectancy for men being 80 years and their women counterparts 84
years3. A bigger portion of Australians is contented with this excellence of life. However, there are
subcategories within this residents who lead considerably inferior health and welfare unlike the rest
of the Australians. For instance, the life expectancy of Torres Strait Islanders and Aboriginal
individuals is approximately 15 years lower than other Australians. Individuals that are
socioeconomically underprivileged are more likely like those who are least fortunate to stay along
health condition period. Also, low levels of literacy influence how successfully an individual can
relate to the health care system to manage their health. Studies show that more than 50% of
Australians have below the minimum health literacy expected standards3. As a result, Algester
Lodge Nursing Home should work to ensure that there is diversity in its service delivery to old
people in Australian regardless of their socioeconomic status. The facility should ensure that
equality is always upheld both all people including the gays, lesbians, bisexual, transgender and
intersex (LGBTI) 15.
In the recent past, the National Health and Hospitals Reform Commission has initiated reforms in

USC Public Health Programs. This template is a summary of the ‘Understanding Settings’ component of the health promotion setting analysis framework outlined by Poland et al. It is vital that you read the article in full for a detailed description (including examples) of each element.
the aged care system with the target to achieve the challenge associated with the rapidly
skyrocketing diverse population of Australia.
Knowledge
- What assumptions are made about setting?
- How has role of setting changed over time?
Localised determinants
- How does the setting interact with external environments?
- How does the setting interact with other settings?
- What are the physical and built environmental determinants of health in
this setting?
- What are the psychosocial environmental determinants of health in this
setting?
Physical and built environmental determinants of health
The built environment is linked to health outcomes. Environmental health is concerned with the
influence of biological, physical, social and chemical aspects to individuals within their settings4.
Consequently, the relationships between the built environment and health are different based on
age groups particularly between children and adults, and between the mid-age and older adults. For
example, the health of Aboriginal and Torres Strait Islander people has been influenced by
environmental factors8. Health environments have to be established and maintained by individuals,
government, communities and non-governmental organisations6. Therefore, the Australian
government should ensure that it provides enough infrastructure such as sewage systems, water
supply, and housing as well as minimising environmental health risk factors.
Psychological factors for influencing healthy aging among adults in Australia
Every individual marks every human development stage with specific accomplishments, and each

USC Public Health Programs. This template is a summary of the ‘Understanding Settings’ component of the health promotion setting analysis framework outlined by Poland et al. It is vital that you read the article in full for a detailed description (including examples) of each element.
phase gets affected by the initial stage while also keep on impacting the next10. Consequently, the
quality of life in old age is thus influenced by a person’s lifestyle during adulthood. Therefore,
preparation for senescence should be made during adulthood since these preparations are vital in
determining the quality of life during old age.
Stakeholders
- Primary and secondary stakeholders
- Agendas, access to resources
- Functions of setting for different stakeholders
- Who is absent from this setting?
- What is the meaning of health for stakeholders?
- To what degree do stakeholders understand the determinants of health in
the setting?
Primary and Secondary stakeholders of Aged care in Australia
As a result of the increasing demand for aged care populace, it means a corresponding upsurge in
the Australian government expenditure. Therefore, the Australian government is the chief source of
funding to manage and control the aged care system. In this case, the Australian government is the
primary stakeholder in support for aged care system5. Similarly, apart from the government, there
are other secondary stakeholders where care is administered in people’s homes or residential
nursing homes environments such as Algester Lodge Nursing Home. Also, there are over 2,000
not-for-profit as well as for-profit government providers offering aged care services to Australians.
Power, influence and social change (sociopolitical environment)
- How are power relations formed?
- Who controls access?
- Who sets the agenda?
- Who participates in decision making?
- Who has voice?
- Who/what drives/blocks change?
- Identify stakeholders who may be supportive, resistant and neutral to
proposed changes
The meaning of health for stakeholders
Health is the most significant thing to healthcare stakeholders. Consequently, stakeholders have
initiated aged care nursing homes where they provide support to the aging people to ensuring their

USC Public Health Programs. This template is a summary of the ‘Understanding Settings’ component of the health promotion setting analysis framework outlined by Poland et al. It is vital that you read the article in full for a detailed description (including examples) of each element.
health is guaranteed.
Participants in aged care decision making
The primary participants in the aged care decision-making process include the government, the
public and health providers. The role of the government is to ensure the administration of health
care services by making a budget and other healthcare related expenditures. Also, the government
proactively involves itself in controlling the healthcare sector2. On the other hand, the public has a
role to play in healthcare in various perspectives. As the main users of health care services, the
public is concerned with cost, quality, and access to care. Accordingly, healthcare is a right hence
it has to be universally available to all inhabitants regardless of the cost.
2. Frameworks
(list the appropriate frameworks, models and/or other resources that you will utilise to make recommendations to strengthen your health promoting setting)