Bowles Devin, Yar Elisabeth, van der Sterren Anke
ACT Council of Social Service, Canberra, Australia.
Faculty of Health, University of Canberra, Canberra, Australia.
Drug Alcohol Rev. 2025 Mar;44(3):685-695. doi: 10.1111/dar.14001. Epub 2025 Feb 17.
Governments are increasingly identifying priority populations on which to focus health policy and to measure health and wellbeing outcomes. Prioritising populations that are considered to be higher risk or to have particular needs that may not be captured within the parameters of health policy developed for the general population, is essential to health equity and efficient resource allocation. However, the criteria that governments use for prioritising populations is often vague or unspecified. To date, people who use drugs are almost never identified as a priority population in health policy, despite poor health and wellbeing outcomes.
We developed three-pronged criteria-disadvantage, prevalence/accessibility and amenability to change-for prioritising populations in government health policy. We used these criteria to compare people who access alcohol, tobacco and other drug (ATOD) services with populations which are prioritised within the Australian Capital Territory Government's Wellbeing Framework.
Use of the criteria indicates that health policy prioritisation of people who access ATOD services is warranted. People who access ATOD services experienced worse health and wellbeing outcomes across all measures.
Given increasingly explicit prioritisation of populations in health policy, there is an opportunity to advance health equity and embed policy efficiency through formal and transparent consideration of which populations to prioritise. Using set criteria for prioritising populations in health policy is possible, and could help identify populations often overlooked for prioritisation, such as people who access ATOD services.
各国政府越来越多地确定重点人群，以便将卫生政策聚焦于这些人群，并衡量健康和福祉成果。对那些被认为风险较高或有特殊需求（而这些需求可能无法在为普通人群制定的卫生政策范围内得到满足）的人群进行优先排序，对于实现健康公平和有效资源分配至关重要。然而，政府用于对人群进行优先排序的标准往往模糊不清或未明确规定。迄今为止，尽管吸毒者的健康和福祉状况不佳，但他们在卫生政策中几乎从未被确定为重点人群。
我们制定了一个三管齐下的标准——劣势、患病率/可及性和可改变性——用于在政府卫生政策中对人群进行优先排序。我们使用这些标准将使用酒精、烟草和其他毒品（ATOD）服务的人群与澳大利亚首都直辖区政府福祉框架中被优先考虑的人群进行比较。
使用这些标准表明，有必要在卫生政策中对使用ATOD服务的人群进行优先排序。在所有衡量指标中，使用ATOD服务的人群的健康和福祉状况都更差。
鉴于卫生政策中对人群的优先排序越来越明确，有机会通过正式和透明地考虑对哪些人群进行优先排序来促进健康公平并提高政策效率。在卫生政策中使用既定标准对人群进行优先排序是可行的，并且有助于识别那些在优先排序中经常被忽视的人群，例如使用ATOD服务的人群。
