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
Global disability-adjusted life year ranks for the top 25 causes in 1990 and 2010
2
Source: The Lancet 2012; 380:2197-2223
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

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
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’
10
Weaknesses

Reflects the broader health system
 Fragmented
 Loosely
 Multiple
coordinated
and discontinuous funding sources

Largely communicable disease focussed

Largely health system focussed

Poor Continuity of Effort
Current Prevention ‘System’
11
Strengths

Committed Individuals

Existing infrastructure

Strong NGO sector

Flexibility thru necessity

History of Creativity
General Strategies
12
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
National Preventative Health Taskforce 2010
SUPPORTING INFRASTRUCTURE
13

Social marketing

Data, surveillance and monitoring

National research infrastructure

Workforce development

Future funding models for prevention
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
ASR – Males
Linear (ASR – Males)
ASR – Females
Linear (ASR – Females)
700
Deaths per 100,000
600
500
400
300
200
100
0
1965
1970
1975
1980
1985
1990
Year
1995
2000
2005
2010
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
Will...
Result in....
Strengthen the research base
for prevention
A greater appreciation of the value of
prevention among governments and the
community
Synthesize evidence and
make readily available what
is known
Tools, systems and methods to underpin a
national prevention system
Help activate an effective and
efficient 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
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
•
•
•
•
•
Universities and Research
Institutes
•
•
•
•
•
•
•
•
•
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
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)
Host Institutes
•
•
Government Departments,
Institutes & Agencies
•
•
•
•
•
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 SAX Institute, NSW
Centre of Excellence in Intervention &
Prevention Science (CEIPS), VIC
Non-Government and Industry
Agencies
•
•
•
•
The Cancer Council of Australia, NSW
The National Health Foundation of
Australia, VIC
The Hospitals Contribution Fund of
Australia Limited
Hassell Architects, VIC
Thank-you
Questions
Lena Nyadbi 2013 “Dayiwul
Lirlmim” (Barramundi
Scales). Musee du quai
Branly, Paris.