Fruit and vegetables in baskets next to scales.

The key to our future: increased investment in prevention

The key to our future: increased investment in prevention

Allyson Todd, former PHAA intern, University of Sydney

It is well known that investing in preventative health is necessary to reduce Australia’s disease burden, improve health equity, and build a resilient health system.

The importance of public health and investing in prevention has been well recognised throughout the COVID-19 pandemic. We saw the benefits of preventing the spread of COVID-19 through individual behaviour changes such as social distancing, mask wearing, and vaccination to protect our most vulnerable, including those with compromised immune systems and the elderly.

The COVID-19 pandemic has highlighted many gaps in Australia’s preparedness and ability to respond to new health challenges. This was evident through an understaffed and overworked health workforce, supply shortages of PPE, delays in quarantine measures, and in vaccination rollout.

However, it is uncertain whether lessons have been learned from the ongoing challenges of the COVID-19 pandemic, as politicians largely remain silent on how to manage health challenges such as new zoonotic disease outbreaks, and the increasing chronic disease burden.

As PHAA’s CEO Adjunct Professor Terry Slevin asks, “Why isn’t public health a hot election issue?”

The PHAA is calling for seven priority action areas to spark Australia’s health and economic recovery, all of which encompass the principle of preventive health. These are:

  1. Aboriginal and Torres Strait Islander Health
  2. Invest in preventive health
  3. Invest in the national public health workforce
  4. Establish a Centre for Disease Control & Prevention
  5. Protect against unhealthy products
  6. Climate and health
  7. Healthy democracy and public policy-making

These action areas collectively align to promote and protect the health of everyone in Australia.

The establishment of a Centre for Disease Control (CDC) & Prevention would increase national surveillance and preparedness to respond efficiently to future threats including climate change and the emergence of infectious diseases. Additionally, investing in prevention will help protect population health from chronic diseases.

Preventing chronic disease burden

The COVID-19 pandemic brought greater attention to how chronic disease presence influences health outcomes for other conditions. For example, people with chronic diseases such as diabetes were found to be at greater risk of severe illness from COVID-19.

Almost one in five Australians have a chronic disease. This has significant costs on our society including decreased quality of life for millions of people, increased demand on the health system, and greater burden on the Australian economy. A recent Australian Institute of Health and Welfare (AIHW) report found that obesity is now the top risk factor contributing to health spending ($4.3 billion) which now overtakes tobacco use ($3.3 billion).

Approximately two in three Australian adults (67%) are overweight or obese. However, a large proportion of risk factors leading to obesity and related co-morbidities could be forestalled through preventive interventions.

Current health expenditure is primarily spent on treating diseases, which is why the PHAA is advocating for greater investment in prevention. Every dollar invested in evidence-based prevention programs will lead to greater return on investment than treatment. A healthy society also leads to a more productive workforce.

The National Preventative Health Strategy 2021-2030 has stated that the government will increase preventative health funding to 5% by 2030. Yet, there has been limited commitment to achieving this in the Coalition Government’s 2022-23 Australian Budget.

The National Obesity Strategy 2022-2032 has proposed ambitious targets to reduce our chronic disease burden. It recognises the importance of building a supportive environment and food system that promote healthy lifestyle behaviours, such as increasing access to bike lanes and public transport to promote physical activity and walking.

Recognising the role of the upstream determinants of health is also crucial for disease prevention. Individual lifestyle behaviours such as poor diet and physical inactivity are often blamed on individuals, without recognition of external influences beyond an individual’s control. This includes socio-economic status, exposure to unethical marketing of unhealthy products, and the food environment that influences the accessibility and affordability of unhealthy food and beverages.

The food system has been put under strain from the COVID-19 pandemic and recent floods, threatening food security. Increasing cost of living pressures and inflation has affected the affordability  of healthy products, exposing people of a lower socio-economic status to greater risk of chronic disease. A recent, disturbing example, is a report that iceberg lettuce had become more expensive than buying 10 chicken nuggets.

The National Obesity Strategy highlights the importance of using economic incentives to influence healthier consumer decisions. Increasing taxes on unhealthy products could lead to significant reductions in healthcare costs, and raise revenue to fund prevention programs.

For example, the PHAA highlight that by increasing taxes “on tobacco (up 30%), alcohol (up 30%) and unhealthy foods and beverages (up 20%), alongside mandatory salt limits on processed foods, it has been estimated that more than $6 billion of net savings could be made to the health system through a reduction in direct healthcare costs.

Greater commitment is needed to achieve the goals set out in the National Obesity Strategy and National Preventative Health Strategy. If enacted appropriately, these strategies will lead to a healthier society and build our resilience to future health challenges.

In the lead up to the election, we urge everyone to  think about the importance of investing in prevention to protect population health, and #VoteForPublicHealth.

Further resources:

 

Image: Unsplash/Iñigo De la Maza

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