title: Public social monitoring reports and their effect on a policy programme aimed at addressing the social determinants of health to improve health equity in New Zealand.
abstract: The important role that monitoring plays in advancing global health is well established. However, the role of social monitoring as a tool for addressing social determinants of health (SDH) and health equity-focused policies remains under-researched. This paper assesses the extent and ways in which New Zealand's (NZ) Social Reports (SRs) supported a SDH- and health equity-oriented policy programme nationally over the 2000-2008 period by documenting the SRs' history and assessing its impact on policies across sectors in government and civil society. We conducted key-informant interviews with five senior policy-makers and an e-mail survey with 24 government and civil society representatives on SRs' history and policy impact. We identified common themes across these data and classified them accordingly to assess the intensity of the reports' use and their impact on SDH- and health equity-focused policies. Bibliometric analyses of government publications and media items were undertaken to empirically assess SRs' impact on government and civil society. SRs in NZ arose out of the role played by government as the "benevolent social welfare planner" and an understanding of the necessity of economic and social security for "progress". The SRs were linked to establishing a government-wide programme aimed at reducing inequalities. They have been used moderately to highly in central and local government and in civil society, both within and outside the health sector, but have neither entered public treasury and economic development departments nor the commercial sector. The SRs have not reached the more universal status of economic indicators. However, they have had some success at raising awareness of, and have stimulated isolated action on, SDH. The NZ case suggests that national-level social monitoring provides a valuable tool for raising awareness of SDH across government and civil society. A number of strategies could improve social reports' effectiveness in stimulating action on SDH.
authors.affiliation: Department of Public Health, University of Otago, PO Box 7343, Wellington, New Zealand; Department of Social and Behavioral Sciences, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, United States. Electronic address: frank.pega@otago.ac.nz.
authors.forename: Frank
authors.initials: F
authors.lastname: Pega
authors.affiliation: Department of Ethics and Social Determinants of Health, Health Systems and Innovation Cluster, World Health Organization, 20 Avenue Appia, CH-1211 Geneva 27, Switzerland.
authors.forename: Nicole B
authors.initials: NB
authors.lastname: Valentine
authors.affiliation: Centre for Public Health Research, Massey University - Wellington Campus, Private Box 756, Wellington, New Zealand.
authors.forename: Don
authors.initials: D
authors.lastname: Matheson
authors.affiliation: Health Section, United Nations Children's Fund (UNICEF), 3 UN Plaza, New York, NY 10022, United States.
authors.forename: Kumanan
authors.initials: K
authors.lastname: Rasanathan
mesh_terms: D006291:Health Policy; D054624:Health Status Disparities; D006801:Humans; D009520:New Zealand; D011050:Policy Making; D011159:Population Surveillance / Q000379:methods*; D015397:Program Evaluation; D036301:Qualitative Research; D064890:Social Determinants of Health
keywords: Health equity; Health policy; New Zealand; Social determinants of health; Social monitoring; Social reporting