The Value of Being Healthy John Fitzgerald Victorian Health Promotion Foundation (VicHealth)

The Victorian Health Promotion Foundation (VicHealth) Change social, economic, cultural and physical environments to improve health for all Victorians Strengthen the understanding and skills of individuals in ways that support their efforts to achieve and maintain health. The mission of VicHealth is to build the capabilities of organisations, communities and individuals in ways that:

Health Promotion Actions Create and use knowledge acquired through research and evaluation. Create environments that foster good health. Encourage the development of systems that support and sustain health. Communicate about priority health issues. Develop communities which are inclusive, accessible, equitable and safe. Support organisations to plan, implement and evaluate health promotion activity. Facilitate participation and skill development. Contribute to and advocate for healthy public policy and regulation.

Key Objective – Create environments that improve health Lifestyle factors contribute significantly to the burden of disease in Australia Health agencies have identified the need to create environments that improve health and address environments that contribute to lifestyle-related harms Changing the social, physical and economic environments that structure consumption and UV exposure can have profound impacts on health outcomes

Key findings - overall Health benefits – if we reduce risk behaviours to achievable targets Health impactIPVHigh risk alcohol Inadequate fruit and veg Physical inactivity Tobacco smoking High BMI Attributable deaths avoided ,0005, DALYs reduced5,00021,00018,90025,00071,00025,000 Related illnesses avoided 6,00098,0002,5006,000158,0009,000 Source: Cadilhac et al, (2009) The economic benefits of reducing disease risk factors. Deakin University and the National Stroke Research Institute.

Economic benefits Financial outcomes if ideal targets are achieved

High Body Mass Index (BMI) Feasible reduction in prevalence of high BMI (>25) Progressive target

Key findings – High BMI Literature review  62% men and 45% women overweight or obese (ABS, 2006).  High body mass contributed 7.5% to the overall health burden in Australia, with Type 2 diabetes (40%) and ischaemic heart disease (34%) the major risks (Begg et al. 2007).  Interventions can decrease body weight (<5kg), but long-term change is difficult to maintain.  Obesity rates are generally increasing, it may be difficult to substantially reduce the prevalence of obesity Strategies  Individual choice focussed on healthy diet  Complex community-based strategies  Industry-wide (re-formulation strategies), food system (marketing)

Key findings – high BMI Total potential cost savings reducing prevalece of high BMI

Physical Inactivity - methods Feasible reduction in prevalence of physical inactivity Progressive target

Physical Inactivity 67% of men and 74% of women were reported to be either sedentary or participate in a low level of exercise (ABS, 2006) Physical inactivity contributed 6.6% of the overall DALY health burden in Australia Community-wide campaigns can reduce the number of people who are inactive by approximately 4% points Strategies Encourage “ …abilities” Planning for choice (active transport), recreation and sport Reducing parental fear Improving community engagement etc …

Physical Inactivity Total potential cost savings from reductions in physical inactivity

An emerging area of interest … Urban forestation and health Better health Solving problems Seizing opportunities

Trees and health Problems – Urban Heat islands (cooling) – Air quality (buffering, adsorption, absorption) – Water capture – Mental health – Radiant heat and UV protection – Climate change adaptive responses Opportunities – Growth areas – aggregate effects across growing populations – Master-planned communities and precinct structure planning – Inner city councils’ ageing tree stock

Urban Heat Island Air quality Questions – Densities, patterns, types, – Bush fire prevention – Best value (iTree) – Combined benefits

The New Prevention: The Health and Wellbeing Plan Existing problems in prevention Prevention interventions and services operate in isolation from one another Duplication of effort, and an inefficient use of available staffing and funding resources Translation of state-wide initiatives to the local level is not responsive to the local context Health Promotion Poverty cycle

Health and Wellbeing Plan Attributes Align approaches across government departments in areas that could deliver health benefits such as in planning, environmental design, transport and active living Preventive health requires the same comprehensive and integrated system that healthcare requires to manage illness Focusing only on specific health risks and problems is likely to have a limited long-term effect on improving population health and reducing health disparities

Health and Wellbeing Plan New Strategic Directions Build prevention infrastructure Develop leadership and strengthen partnerships across sectors Review financing and priority-setting mechanisms to ensure available resources are based on population need and potential for impact Develop effective modes of engagement and delivery of evidence- based interventions in key settings Strengthen local government capacity Improve health service capacity to promote health and wellbeing

Conclusions We know some of the value of health in the community. There are great opportunities now to enhance public health and wellbeing Challenges that come with complex approaches – Substantial benefits Coordination / collaboration essential to plan for health Prioritise health in planning – create environments to make healthy choices, easier choices