Stopping the river of illness at its source

Despite all the sophistication of our healthcare system, and our high living standards, we are a country facing some very serious health problems.

Ever increasing girths, more people requiring treatment for life-threatening illnesses such as diabetes and cancer, an explosion in alcohol related injury, and increasing rates of depression. How come we didn’t get on top of these “epidemics” before they emerged?

For all the surgery, weight-loss programs, vitamin supplements, appetite suppressants, anti-depressants, marketing campaigns for low fat foods, and all manner of therapies, the evidence is staring us in the face … many of these problems are getting bigger.

Like many countries, the issue is we waited until the problems emerged and now we are scrambling to put into place the prevention approach required. And because we are dealing with large numbers of people at immediate risk of illness and disability, our prevention efforts are focused on keeping these people out of hospital.

What can we learn from the successful prevention efforts of the past to rein in the health problems of today?

We have shining examples of success: HIV-AIDS prevention efforts of the 80s and 90s contained the spread of a virus that in other parts of the world had a devastating impact on their populations; our road safety programs have reduced the road toll by about two-thirds over the past 30 years; our tobacco control efforts have been shown to keep people out of hospitals and save the healthcare system at least $500 million every year; and coronary heart disease deaths have fallen by more than 60 per cent in the past three decades.

More than $50 billion is spent nationally on coping with chronic diseases, many of them largely preventable, such as depression, heart disease, cancer and diabetes.

If we start to apply the lessons we have learnt from past prevention efforts to the big health issues of today, we might actually be able to turn around the health prospects of Australians.

These successful prevention programs applied a mix of awareness and education campaigns, policy and legislation changes to help protect people from exposure to harm, and provided additional counselling and support for people who needed it. We used the tax system to discourage use of harmful products like tobacco and kept taxes off products like condoms which saved lives.

Importantly, they were all funded at significant levels over a long period of time, and were carefully monitored and evaluated for their results.

These efforts also involved strong partnerships between governments and with the non-government organisations like AIDS Councils, the Heart Foundation, Quit and statutory organisations like VicHealth and the TAC.

If we really want to get serious about prevention of illness, we need to increase resources dedicated to prevention and health promotion programs. According to the Australian Institute for Health and Welfare only a tiny fraction of Australia’s 2005-06 health budget was spent on public health (2 per cent), despite the fact that many of the most cost-effective approaches are the prevention approaches.