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.
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
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