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Improving the health of all Australians: the role of preventative health

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Parliamentary library briefing book: Key Issues for the 43rd Parliament Page | 20 Page | 21 reforming social services and institutions

Preventative health, with its longer term population-based strategies to promote wellness and prevent disease, is often overlooked by both policy makers and a public more focused on personalised primary care and hospital services. this is reflected in the level of expenditure on preventative health activities in a ustralia—just 2 per cent of total health expenditure. y et, approximately 32 per cent of a ustralia’s total burden of disease can be attributed to modifiable risk factors that include smoking, alcohol abuse, physical inactivity, high blood pressure and blood cholesterol, low consumption of fruits and vegetables and overweight and obesity. i t is now widely recognised that in order to stem the growth of chronic diseases, the major risk factors that contribute to them must be addressed.

Chronic disease

successive reports continue to warn of the growth in preventable chronic diseases, the cost to the health system and the increasing burden on individuals—which is set to increase as the population ages. i t is estimated that some 431 000 hospitalisations a year might be avoided if patients

with chronic conditions were better managed through community-based primary care services.

however, although primary care plays a key role in managing chronic disease, there is clearly scope for more emphasis on actions that prevent disease or slow its development. e arly intervention can reduce or even eliminate the need for later, more intensive and costly care. Well-known examples of prevention include vaccination, cancer screening and health promotion. b y tackling disease and the risk factors of disease early, significant suffering can be averted, and costs reduced. f or example, it has been estimated that tobacco control programs in australia prevented over 400 000 premature deaths and saved over $8.4 billion between 1975 and 1995.

Physical activity and nutrition

australia has long defined itself in terms of sporting achievements, and flowing from that is a vision of a strong, healthy and athletic nation. the reality is different. t he majority of a ustralian men and women are either overweight or obese and 23 per cent of children aged between five and 17 are considered overweight or obese. y oung a ustralians in particular are ignoring advice about nutrition, smoking and alcohol and they are increasingly inactive.

Diet and nutrition play a major role in maintaining health and preventing chronic illness. i t is estimated that inadequate fruit and vegetable consumption is responsible for 2.1 per cent of the total burden of disease in a ustralia. Just 9 per cent of the adult population consumes the recommended 5 serves of vegetables per day. although 22 per cent of younger children meet the recommended vegetable consumption guidelines, only 5 per cent of 14-16 year olds meet the recommendations.

Improving the health of all Australians: the role of preventative health

amanda b iggs and Dr r honda Jolly, s ocial Policy s ection

Physical inactivity is the second most important risk factor that contributes to the burden of disease, morbidity and mortality in a ustralia. i t is widely acknowledged that regular physical activity provides a large range of health benefits, ranging from reduction in risk factors for heart disease, high blood pressure, high cholesterol, diabetes and some cancers. i ncreased physical activity delivers fitness and stamina, increased energy and reduction in stress, anxiety and depression. Participation in physical activity also helps improve social and community networks and increases community cohesion and social connectedness. i t leads to safer communities and reduces the sense of isolation many people experience in modern society. in short, it delivers a better quality of life for people of all ages.

australia has not acted as positively to redress this trend towards greater inactivity as some other nations. s ome commentators argue that sports funding continues to focus on achieving sporting greatness for an elite few at the expense of community based initiatives that could improve health outcomes for all a ustralians, regardless of their ability or background.

the World h ealth o rganisation warns that ignoring these issues will have dire consequences for health outcomes. a number of challenges will need to be addressed. t hese could include finding and initiating more suitable and equitable funding equations for elite and grass roots sports and activity programs. o ther challenges include finding the right formula to work with state, territory and local governments to improve frameworks that promote activity, such as urban planning and transport infrastructure.

Policy strategies

this growing recognition of the role of prevention in reducing the risk factors for chronic disease is

reflected in the development of two key national health strategies. i n 2009, australia’s first n ational Preventative h ealth s trategy recommended a range of measures—some controversial—to limit the consumption of alcohol and tobacco and reduce overweight and obesity. s ome of its key recommendations included: increasing the tobacco excise, requiring plain packaging of tobacco products, better nutritional information on food labels, and phased bans on junk food advertising to children and alcohol advertising during live sports broadcasts. a lthough some recommendations such as increasing the excise on tobacco have been implemented, the future of others—particularly the more contentious— remains uncertain.

Prevention is a key element of a ustralia’s n ational Primary h ealth Care s trategy, also released last year. among other recommendations, it called for more evidence-based approaches to preventative health care, initiatives to target high risk groups and expanding the scope of the m edicare b enefits schedule to support and fund more preventative health activities.

an emerging body of research now presents policy makers with a range of policy options to address the burden of chronic disease and improve the health of all a ustralians. o ne way forward might be to explore a multi-sector approach, similar to the h ealth in all Policies agenda currently being implemented in s outh australia. t his approach recognises that health outcomes can be influenced by measures that are often managed by government sectors other than health. b y addressing health across a number of policy sectors like agriculture, education, the environment, fiscal areas, housing and transport, it might be possible to improve population health and reduce the growing economic burden of chronic disease.

library publications and key documents

Preventative h ealth t askforce, Australia: the healthiest country by 2020: National Preventative Health Strategy—roadmap for action, Canberra, a ustralian g overnment, 2009, preventativehealth/publishing.nsf/Content/national-preventative-health-strategy-1l p

Department of h ealth and a geing (Do ha), Primary health care reform in Australia: report to support Australia’s first National Primary Health Care Strategy , Doha, Canberra, 2009, yourhealth/publishing.nsf/content/nphc-draftreportsupp-to c