DISEASE PREVENTION POLICIES IN AUSTRALIA: CHRONIC DISEASE Professor Andrew Wilson Menzies Centre for Health Policy School of Public Health Samantha Hobson Bushfire 2000 Lockhardt River

2 Source: The Lancet 2012; 380: The Lancet 2012; 380: 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 10 Weaknesses

Current Prevention ‘System’  Committed Individuals  Existing infrastructure  Strong NGO sector  Flexibility thru necessity  History of Creativity 11 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 12 National Preventative Health Taskforce 2010

SUPPORTING INFRASTRUCTURE  Social marketing  Data, surveillance and monitoring  National research infrastructure  Workforce development  Future funding models for prevention 13 National Preventative Health Taskforce 2010

Australian National Preventive Health Agency

Prevention, Public Health Policy, and Health Policy.

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 PartnersHost 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.