The Public Health Association of Australia condemned this month’s “terribly disappointing” coronavirus recovery-focused Federal Budget federal budget for its failure to invest in preventive and public health at such a critical time for the nation.
That makes it even more important for the next Queensland Government to invest in health promotion, disease prevention and wellbeing and to focus on community recovery, resilience, mental health and employment, writes Letitia Del Fabbro, President of the PHAA Queensland branch, in this third of a series of articles on #QldVotesHealth. See the other stories here.
In a statement released on Friday, ahead of tomorrow’s Queensland election, Del Fabbro asked: “Why aren’t we hearing about preventive health?”, noting:
“The COVID-19 pandemic has really shown us the value of this work force at this crucial time.Without an established, well-resourced and adequately funded public health workforce, the state of Queensland is vulnerable to pandemics and other major public health issues.”
Croakey readers may also be interested in this article from The Conversation: Queensland is making election history with two women leaders, so why is the campaign focused on men?
Letitia Del Fabbro writes:
Now more than ever the public health workforce in Queensland needs ongoing support and funding, and an investment needs to be made to reinvigorate, sustain and support this workforce.
A diverse range of disciplines work toward public health objectives including epidemiology, health communication, health promotion, research and policy.
It is necessary to have these diverse and skilled public health and health promotion workers ready and available to pivot to emerging public health threats, such as the global COVID-19 pandemic, bushfires and floods.
Strategic workforce planning with the allocation of dedicated funding is required. Into the future the Queensland government should be a focused on sustaining Queensland’s good COVID-19 control outcomes with continued investment in public health and health protection.
A well-resourced preventive health workforce is also essential for continuing to address concerns of ongoing chronic disease (including cardiovascular disease, diabetes, mental health and cancer care).
The long term strategic work of evidence based non-communicable disease control needs to continue throughout work surges, such as the current COVID-19 pandemic.
When considering the lay of the land in terms of health funding in Queensland, it is difficult not to hark back to the dismantling of preventive health services that occurred following the 2012 election, as it did at that time in other Australian jurisdictions.
Ongoing investment in public health will result in long term benefits.
Examples of public health prevention programs that have demonstrated return on investment include: programs to reduce tobacco consumption, programs to reduce lead exposure, programs to reduce coronary heart disease and road safety programs.
Since its election in 2015 the Palaszczuk Government has reconstituted the health promotion workforce with substantial investment in health and wellbeing including the establishment of an independent Health and Wellbeing Queensland agency with a focus on obesity, and numerous other health and wellbeing strategies.
These kinds of investments in health promotion and illness prevention, aimed at addressing risk behavior, have positive impacts on population health and provide longer-term savings, including on expensive higher-level hospital care down the track.
There is however further potential for preventive programs to improve the health and wellbeing of the community and create resultant savings for health budgets. A key factor in the success, and return on investment, of programs is the inclusion of public policy interventions.
Action across the lifespan
A recent analysis from the Global Burden of Disease Study highlights that ‘the record of reducing exposure to harmful risks over the past three decades is poor’ and for most populations, certainly in Queensland, Body Mass Index (BMI) is increasing year-on-year.
The Global Burden of Disease Study also highlights the ‘power of taxation and regulation’.
A case in point is the recommendation to increase the tax on sugar sweetened drinks, this kind of intervention would not only accrue significant health benefits in terms of chronic condition prevention (e.g. heart disease and stroke), it would also generate hundreds of millions of dollars in revenue each year.
Recent snapshots of the foods routinely consumed by the average Australian family indicate that an alarming amount of processed foods are being consumed week to week, including a large quantity of sugar sweetened drinks.
Preventive health is important across the lifespan, from childhood (e.g. immunisation and healthy food advertising) to aged care (e.g. walkable streets and availability of nutritious food).
Indeed Australia’s Royal Commission into Aged Care Quality and Safety has painted a grim picture, highlighting that Australia needs to do much more to protect and provide for this vulnerable group.
Healthy settings for older people are healthy settings for us all.
Active transport has had some media attention lately with the development of new bike ways in Brisbane but more need to be done in other parts of Queensland to improve access to safe cycle and walking pathways: walking improves health and cuts pollution.
Now is the time
To be prepared for and to respond to the breadth of health challenges today requires multifaceted evidence-based and population-health approaches, which address health inequities, social determinants of health, and are underpinned by capacity for strong leadership across all levels of government.
Effective public policy that aims to influences health outcomes needs a whole of government approach, it must be inclusive of community consultation and be undertaken in partnership with Aboriginal and Torres Strait Islander communities.
Now is the time for the Queensland Government to invest in health promotion, disease prevention and wellbeing, to focus on community recovery, resilience, mental health and employment, particularly in light of the lack of funding commitment for preventive health in the recently released federal budget.
An investment of 5% of the Queensland health budget dedicated to public health and health promotion, would bring the state closer to other OECD countries including New Zealand and Canada, and in line with Western Australia.
The Queensland Government has shown leadership in its management of the COVID-19 pandemic, but we should be hearing from all parties about how they intend to invest in public health and health promotion.
The question that everyone in the public health community is asking in this election is ‘why aren’t we hearing about preventive health?’ This is a significant omission in the parties’ policies and is out of step with public expectation.
The Queensland branches /chapters of the Public Health Association of Australia, Australian Health Promotion Association and the Queensland Epidemiological Association have joined forces this election to urge all political parties to show their leadership and commit to:
- Invest 5 per cent of the health budget in the resources of comprehensive preventive health.
- Reinvigorate, sustain and support a diverse and skilled public health and promotion workforce, capable of pivoting to emerging challenges such as COVID-19.
- Invest in infrastructure and policy that enhances community wellbeing, including good urban design for safe walking and cycling and by reducing carbon emissions.
Now is the time for candidates to speak up about preventive health plans. If not this year, when?
Letitia Del Fabbro is Qld Branch President of the Public Health Association of Australia, a PhD candidate with The Hopkins Centre: Research for Rehabilitation and Resilience and a Lecturer in Nursing at Griffith University. You can follow on Twitter: @letitia_df and the PHAA Queensland branch: @PHAAQldbranch