The growing burden of chronic disease in Australia is one of the health sector’s biggest challenges, but the Australian Health Policy Collaboration (AHPC) has laid out a blueprint to highlight the way forward on managing it.
The AHPC, based at Victoria University, has said chronic disease threatens the health of individuals, communities, and even Australia’s future economic prosperity. Australia has an unacceptably high rate of risk factors for chronic diseases, including high levels of obesity, physical inactivity, alcohol misuse and poor nutrition. Action is urgently required in relation to modifiable risk factors that contribute to disease and disability in Australia.
Chronic diseases are responsible for nine out of ten deaths in Australia. Many people living with chronic diseases such as diabetes, mental illness and cancer, experience reduced quality of life and disability over many years. Chronic diseases result in a significant economic burden because of the combined effects of healthcare costs and lost productivity. It has been estimated by the Business Council of Australia that eliminating chronic diseases could increase the workforce by 10 per cent and thus boost the productivity of the Australian economy.
Although cost-effective interventions to prevent chronic diseases are available, Australia has a mixed record when it comes to implementing a thorough approach to prevention. Spending on public health (including prevention) is 1.5% of total recurrent health spending, and the system focuses on treating illness, rather than keeping people well.
AHPC’s Blueprint for preventive action, by Dr Sharon Willcox, lays out three strategic priorities and a number of action areas. The Blueprint is based on several principles including a systemic approach, evidence based action, tackling inequity and taking a life course approach. At a forum hosted by AHPC in November last year, participants focussed on the strategic priority of creating accountability for action and monitoring progress. A tailored Australian set of chronic disease targets and indicators were produced by working groups prior to the meeting. The working groups accepted many of the World Health Organization’s global indicators for noncommunicable disease prevention, but also added new indicators including the national suicide rate; selected emergency department presentations for injury; and one-year survival rates for specified cancers.
The forum supported the development of a chronic disease report card, to highlight the size of the problem and urgent need for action. Participants discussed what “success” in chronic disease prevention could look like in 12 months’ time — November 2016 — in the areas of accountability, community engagement and prevention. In an ideal world, participants, who included health experts from a variety of areas, wanted to see:
- A comprehensive national chronic disease surveillance system that enables the systematic collection of primary health data against targets and indicators
- Bipartisan commitment for another Australian Health Survey and a commitment to measure health literacy (the last Health Literacy Survey was conducted in 2006)
- Adoption by the National Strategic Framework for Chronic Conditions and NGOs of the chronic disease targets and indicators
- Primary Health Networks KPIs incorporating the indicators and systematically collecting data
- The burden of premature deaths converted to an “Australian lives saved” figure and timeline with a multi-pronged campaign and strategy.
- Prevention and health promotion as part of all political party agendas
- Tobacco continuing to have sustained political and policy attention
- The Commonwealth Government’s Healthy Food Partnership holding bi-partisan support
- A national bi-partisan commitment to front-of-pack labelling for all foods and improved public awareness
- Bi-partisan support to regulate and/or tax sugar sweetened beverages and regulate salt
- Practice Improvement Payments reflecting increased uptake of health screenings
To achieve these goals, a number of “intervention options” were considered. Among the more audacious was a proposal to fund government health promotion campaigns through a tax on industry marketing and advertising of unhealthy products. Participants also suggested directing all tax raised on sugar-sweetened drinks and alcohol to prevention efforts.
Community mobilisation was also identified as a key area of chronic disease prevention. Publicity campaigns through social media to share information comparing the health of respective communities was one option floated, along with the publishing of the impact of chronic disease on children. More than one in four Australian children are now overweight or obese, and 95% of children do not meet the guidelines for fruit and vegetable intake. This is likely to have adverse long term consequences for these children and the health system.
The benefits of reducing the incidence and impact of chronic diseases are nationally significant. The AHPC will pursue the development of the report card in 2016, to present an overall summary of the status of chronic disease in Australia, and promote action to address risk factors and improve health.
This article was written by the Australian Health Policy Collaboration for April edition of The Health Advocate. To view current and previous editions of The Health Advocate, CLICK HERE.