Sienna Crabbmor, a final year public health student at Monash University who is currently on placement at Croakey, took the reins of @WePublicHealth last week for wide-ranging discussions.
She covered some of the intersections between health equity, sustainability, justice and housing, and what the concept of ‘eudaimonia’ offers public health.
Sienna Crabbmor writes:
I’m going to tell you a bit about why I love public health and what I think the field needs to do in the future. Some topics I’ll cover include housing, sustainable development, mental health and COVID.
Before introducing myself, I would like to acknowledge the Traditional Owners of the land we live on. I would also like to pay my respects to Elders past, present and emerging. This week, I am on the land of the Gunditjmara people in southwest Victoria.
While I’ve enjoyed my public health studies, I’m looking forward to hopefully working in the field after I graduate.
I originally chose to study public health because while I’ve always been interested in health, I decided I wanted to work further upstream than as a medical practitioner. I believe that good health is a key building block, and public health is a way to reduce social inequities.
@jessaroo writes: “It’s not just happiness, though that’s important, but it means living well: leading a life with meaning and purpose – a virtuous life that is in line with your values, achieving your potential, in whatever way you define that.”
Eudaimonia is such a useful and inspiring word for public health, which is all about helping people to achieve their potential. How can we ensure that this concept is at the centre of the work we do?
Human flourishing is deeply connected to the environment as well – a healthy environment supports healthy people. Achieving eudaimonia would also reduce inequity – a major health issue globally.
It can feel like there are a lot of global challenges going on – climate change, international relations, and a pandemic. But the pandemic also gives us an opportunity to reflect. What do we want to achieve? What are our priorities?
I would argue that putting eudaimonia at the centre is a great place to start. This is something that public health may already do, but it’s time this was spread across disciplines. From politics to business, to urban design. What do you think?
I’d like to first acknowledge the longstanding work that Aboriginal and Torres Strait Islander people and organisations have been doing in this area – raising awareness about housing as a critical determinant of health, and the need to address poor housing issues
Housing is connected to health on a range of levels – from incarceration and discrimination to thermal comfort and COVID. It’s also an issue that is easily overlooked because many of us, including myself, have always had a safe anf stable place to call home.
Evidence shows strong communities prevent crime, and appropriate, affordable housing is key to strong communities. Local people also need to be involved in the design of local solutions to meet local needs. @Change_Record source: https://bit.ly/3gOmAtH
Building healthy and environmentally friendly housing can also help us fight this pandemic. Poor and overcrowded conditions make it hard to isolate – increasing the risk of COVID.
Read the article mentioned below here.
COVID exploits public health weaknesses and shows us what needs to be done, we just need to listen. Read the ABC story here.
Family violence is the leading cause of homelessness for women and children. Thousands of women return to violent partners because they have nowhere to live.
Building social housing for women would create jobs, save money and increase safety.
Housing also impacts people’s mental health. In Italy, students in small apartments with poor indoor quality had more depressive symptoms during lockdown. @AmerioAndrea and colleagues suggest a shared approach to urban planning and public health.
The three core principles of sustainable development are social inclusion, economic prosperity and environmental sustainability. These are a great start, but I think they could go further. For example, it’s not enough to simply have inclusion when there is injustice.
Again, it’s not enough to have environmental sustainability when environmental impacts are felt disproportionately. This is where climate justice comes in – ensuring that the countries and industries responsible for environmental destruction are the ones who bear the costs.
Read the article on climate justice here.
There are also environmental costs. Our planet is warming due to pollution, and there are waste piles the size of small mountains. It’s clear that we cannot continue in this way, but what can we do?
What’s also interesting is looking at what Australia doesn’t report on. For example, we don’t report on women making informed decisions regarding sexual relations, child labour, or child marriage/unions. Are we hiding something?
In working towards these goals, Australia also needs to achieve the Closing the Gap targets. But again, we need to go further than that. Indigenous Australians lived sustainably with this country for 60,000+ years before colonisation. It’s crucial that Aboriginal and Torres Strait Islander people’s rights to self-determination are respected.
@JeffDSachs suggests that to achieve sustainable development we need to engage all stakeholders, move finances towards achieving the goals, and increase accountability.
My final focus is on interdisciplinary approaches to health promotion and disease prevention. A key takeaway from my public health degree is that everything is connected and working together can be the best way to improve health.
Moving forward, I think this is an area of public health that could be improved in the future – working in greater collaboration both inside and outside the public health field.
The 2015 Australian Burden of Disease Study found that five risk factors were responsible for 35.5 percent of the total burden of disease. The table below shows these risk factors and how they contribute to selected disease types.
Looking at the proportion of disease group burden above shows how the diseases are connected. For example, overweight and obesity contribute to burden from each disease group. Rather than each area trying to reduce obesity, they could pool their resources and work together to do so.
I also note that the above table has a downstream view of the causes of disease – it doesn’t recognise the underlying factors that lead to those risk factors. However, it’s important that prevention is mostly targeted towards upstream factors to have the greatest impact.
An interdisciplinary approach can also be used to promote health – for example, in the urban environment.
Interdisciplinary approaches in communities can look like schools, sports clubs, community organisations, local businesses and local government working together towards a common goal. Benefits may include a broader reach and repeated exposure – leading to better outcomes.
This approach can also be seen as systems thinking. It’s about viewing everything as part of a larger system, working to address the underlying factors that lead to poor outcomes, engaging all stakeholders, and learning along the way.
If you would like to reach out about this article or anything else, please feel free to contact and follow me on my personal account: @siennacrabbmor
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