School of Population Health

A ‘preventive’ health strategy must confront hard truths to improve health and wellbeing

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The National Preventive Health Strategy is a critical initiative to creating a healthy Australia. UNSW School of Population Health is pleased to have made a submission to the consultation process for this Strategy.

The School welcomes the commitment to an expert- and evidence-informed Strategy, increased investment in prevention, a non-disease specific focus, and life-course approach, which are all critical.

However, according to Professor Rebecca Ivers, Head of UNSW School of Population Health, concerning misses in the current approach set the Strategy up to fail.  

“The very notion of ‘preventive’ health is flawed – health is something to be promoted not prevented - it’s a basic human right; not just the absence of disease,” says Professor Ivers. “A population health lens - which recognises the social, historical, economic, cultural, and environmental impacts on a person’s and community’s health and wellbeing – is concerningly absent throughout the Strategy.”

Professor Evelyne de Leeuw, Director of the Centre for Health Equity Training, Research & Evaluation says inequities are one of the biggest obstacles to improving population health.

“While Australia has one of the best health systems in the world, there are some hard hitting truths that we must confront as a nation,” says Professor de Leeuw. “Systemic racism and discrimination has resulted in the disproportionate burden of disease and injury impacting Aboriginal and Torres Strait Islander People - addressing this is paramount to the success of the Strategy.”

Dr Adrienne Withall, Senior Research Fellow and ageing and mental health expert from UNSW School of Population Health says the mechanics of Australia’s ‘new’ prevention health system need to be clearly outlined from the onset.

“Fostering collaboration beyond the health sector and two-way engagement with diverse communities and people with lived experience are core to improving population health and wellbeing,” says Dr Withall.

“The Strategy must explicitly address the structural, policy and socio-economic levers that require government intervention and accountability, reduce system fragmentation and duplication, and enable an integrated, determinants-based approach to health,” she says.  

Associate Professor Xiaoqi Feng, urban health and environment expert at UNSW School of Population Health, says the impact of rapid urbanisation on health outcomes and inequities is one of the biggest challenges of the 21st century.

“Lacking from the Strategy is a clear plan for preventing and mitigating harms from environmental injustices, such as the broad reaching impact of climate change, that exacerbate health inequities,” says Associate Professor Feng.  

“The links between the built environment, climate change and chronic conditions are well established - we need meaningful action with a multi-pronged approach and most importantly, we need to act now,” she says.  

The COVID-19 pandemic has magnified health inequities, the burden of chronic conditions and gender-based/domestic violence, as well as fragmented and out-of-date health systems; yet, the full extent of its health, economic and social consequences remain unknown.

Promoting health and wellbeing is not only common sense because it is proven to help people live longer and healthier lives and to save health costs – it is the right thing to do with tremendous humanitarian, social, environmental and community benefits.

The UNSW School of Population Health looks forward to contributing further to the development of the National Preventive Health Strategy to ensure the best possible health and wellbeing for all Australians.

A successful National Preventive Health Strategy -   

  • Applies a population health lens (including language used) and engages with communities from development through to implementation of the Strategy
  • Explicitly prioritises health inequities and outlines pathways within and beyond the health sector to address these (including the role of historical, social, cultural, and environmental determinants of health)
  • Addresses the priorities of Aboriginal and Torres Strait Islander People at every step (by directly consulting and partnering with Aboriginal and Torres Strait Islander People and Aboriginal community-controlled organisations)
  • Incorporates currently missing major population health challenges - impacts of rapid urbanisation, the climate change emergency, gender-based/domestic violence, injury and poor mental health (especially given links to inequities, alcohol, tobacco and drug use, chronic disease, and premature mortality for this group).

Read our submission here. 


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