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 impact IPV High risk alcohol

Inadequate fruit and veg

Physical inactivity

Tobacco smoking

High BMI

Attributable deaths avoided

74 380 1600 2,000 5,000 5000

DALYs reduced 5,000 21,000 18,900 25,000 71,000 25,000

Related illnesses avoided

6,000 98,000 2,500 6,000 158,000 9,000

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