DISEASE PREVENTION POLICIESIN AUSTRALIA: CHRONIC DISEASE

Professor Andrew WilsonMenzies Centre for Health PolicySchool of Public Health

Samantha Hobson Bushfire 2000 Lockhardt River

2Source: The Lancet 2012; 380:2197-2223

Global disability-adjusted life year ranks for the top 25 causes in 1990 and 2010

The Era of Chronic Disease

The recent Reform Agenda

Commissions of Inquiry – National Health and Hospitals Reform Commission

(NHHRC) Preventative Health Taskforce (PHT) Primary Health Care External Reference Group

2020 Summit State-based reform with emphasis on coordinated care Is incrementalism our only choice?

Reforms to Action

National Health Reform

Health and Hospitals Reform Commission

Commonwealth-state relations

Current Prevention ‘System’

Reflects the broader health system Fragmented Loosely coordinated Multiple and discontinuous funding sources

Largely communicable disease focussed Largely health system focussed Poor Continuity of Effort

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Weaknesses

Current Prevention ‘System’

Committed Individuals Existing infrastructure Strong NGO sector Flexibility thru necessity History of Creativity

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Strengths

General Strategies

1. Shared responsibility – developing strategic partnerships

2. Act early and throughout life

3. Engage communities

4. Influence markets and develop connected and coherent policies

5. Reduce inequity through targeting disadvantage

6. Indigenous Australians – contribute to ‘Close the Gap’

7. Refocus primary healthcare towards prevention

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National Preventative Health Taskforce 2010

SUPPORTING INFRASTRUCTURE

Social marketing Data, surveillance and monitoring National research infrastructure Workforce development Future funding models for prevention

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National Preventative Health Taskforce 2010

Australian National Preventive Health Agency

Prevention, Public Health Policy,and Health Policy.

Trends in death rates for Ischaemic heart diseases (ICD10 I20-I25), Australia, 1968–2005

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ASR – Males ASR – FemalesLinear (ASR – Males) Linear (ASR – Females)

Australia’s OECD Ranking, Changes 1988 and 2007 (AIHW 2012)

Prevalence of measured obesity for adults aged ≥ 15 years in five OECD countries

What we can expect from Prevention

The principal forms of prevention are very different in concept, cost and dollar yield

Prevention as a cost-saver must be seen in the context of a complex health system

Prevention is principally about keeping people well or health-stable, and not fundamentally about saving costs (though it might).

Role of Policy in CD Prevention Health Policy

Re-Orientation of Primary Health Care Social media campaigns Risk Factor Screening (pharmacies)

Public Health Policy Smoking restrictions Television Advertising of Energy Dense Foods to

children

Role of Policy in CD Prevention Food Policy Taxation Policy

Tobacco and Alcohol taxes ‘Fat’ Taxes

Building and Environment Policy Building design regulations Open/Green Space Planning Laws Public Transport

Health Policy and Prevention Research at University of Sydney.

Charles Perkins Centre Mission = To ease the burden of obesity, diabetes and

cardiovascular disease by generating collaborative interdisciplinary research and education that translates into real-world solutions.

Charles Perkins Centre

Four interlinked domains:

Prevention Research Centre (PRC)

• PRC has specialised expertise in population-wide, applied, prevention research

• translational and dissemination research

• generating evidence on scaled up population-wide prevention programs

• The PRC research portfolio includes • physical activity• public health nutrition• obesity prevention• other : tobacco control ; chronic disease prevention.

PRC: aims and objectives• The PRC seeks to achieve excellence and relevance in relation

to its research focus areas:– Public health research on chronic disease prevention, including

physical activity, nutrition , obesity and tobacco

– Applied public health research, specifically assessing prevalence, trends, surveillance system for chronic disease, measurement studies and research translation, population-wide dissemination research

– Policy-relevant and technical research for government, non government and international agencies

– Development of research methods for prevention and program evaluation and evaluation

The Australian Prevention Partnership Centre

Result in....

A greater appreciation of the value of prevention among governments and the community

Tools, systems and methods to underpin a national prevention system

Internationally significant new research in prevention of chronic disease

New partnerships, collaborations and methods for researchers, policy and program practitioners working together

Increased people capacity

Will...

Strengthen the research base for prevention

Synthesize evidence and make readily available what is known

Help activate an effective and efficient prevention system

Partners in Collaboration

The work of the NHMRC Centre is supported through partnership with following groups and organisations:

• Funding Partners• Host Research Centres & Institutes• Universities• Government Departments, Institutes &

Agencies• Non-Government& Industry Agencies

Funding Partners Host Institutes

• Australian National Preventative Health Agency (Commonwealth)

• NSW Ministry of Health• ACT Health, ACT• The HCF Health and Medical Research

Foundation• National Health and Medical Research

Centre (Commonwealth)

• The SAX Institute, NSW• Centre of Excellence in Intervention &

Prevention Science (CEIPS), VIC

Universities and Research Institutes

Government Departments, Institutes & Agencies

Non-Government and Industry Agencies

• University of Sydney, NSW• University of Newcastle, NSW• Queensland University of Technology,

QLD• University of Melbourne, VIC• University of NSW, NSW• Australian National University, ACT• Deakin University, VIC• The George Institute of Global Health,

NSW• The Menzies Centre for Health

Research, NT

• Department of Health, VIC• Department of planning and

infrastructure, NSW• NSW Treasury, NSW• Department of Premier & Cabinet, NSW• Major Cities Unit, Department of

Infrastructure and transport (Commonwealth)

• The Cancer Council of Australia, NSW• The National Health Foundation of

Australia, VIC• The Hospitals Contribution Fund of

Australia Limited • Hassell Architects, VIC

Questions

Thank-you

Lena Nyadbi 2013 “Dayiwul Lirlmim” (Barramundi Scales). Musee du quai Branly, Paris.