Introduction by Croakey: Key politicians will be grilled about their intentions for public health at a New South Wales election debate to be hosted by the Public Health Association of Australia (PHAA) NSW in Sydney on 27 February.
The debate, to be held at the Westmead Innovation Quarter and live-streamed, will feature Minister for Health and Medical Research Brad Hazzard, Shadow Minister for Health Ryan Park, NSW Greens Health and Wellbeing spokesperson Cate Faehrmann, and independent candidate for Lane Cove, Victoria Davidson.
The debate will be moderated by PHAA CEO Adjunct Professor Terry Slevin, and can be expected to feature questions on gambling and vaping, junk food advertising to children, wider preventive health strategies and the impact of climate change on health.
One key ask from public health advocates is that the next NSW Government hold a Health and Climate Summit.
The Summit should centre and empower Indigenous knowledges in government planning processes and climate adaptation, write Associate Professor Kate McBride, President of the Public Health Association of Australia, NSW, and public health communication researcher Joshua Karras.
Kate McBride and Joshua Karras write:
As the New South Wales state election approaches, the state is facing a range of public health challenges affecting many groups who experience social and economic challenges. At the same time, NSW must address the long-standing public health issues of obesity, gambling addiction, and climate change, which affects every resident.
This election, the Public Health Association of Australia (PHAA) NSW is actively seeking to work with the next NSW Government to combat some of the major public health issues facing the state, by highlighting measures that be contribute towards addressing them effectively.
Vaping among young people
Daily and regular use of e-cigarettes among 16-24 year olds has more than doubled between 2019/20 and 2020/21 (4.5 percent to 11 percent), with one in three people who vape estimated to take up cigarette smoking.
While the vaping industry has touted e-cigarettes as a safer alternative to traditional cigarettes, the reality is they are far from safe. Studies have shown that e-cigarettes can have negative effects on the cardiovascular and respiratory systems, as well as harm the brain development of young people. Additionally, 21 percent of so-called non-nicotine disposable vapes have been found to contain nicotine.
Considering this, PHAA NSW is calling on the next NSW Government to take a proactive approach. This means protecting children and young people from nicotine addiction and reducing the risk of smoking uptake by making it an offence to supply or sell non-nicotine e-cigarette products.
Also, the next NSW Government should apply greater pressure on the Australian Government to immediately strengthen its enforcement action to intercept illegally imported vaping products.
Promote healthy weight among children
Obesity is an urgent concern within our state, with one in four children experiencing overweight or obese. This puts them at increased risk of developing serious health problems later in life, including heart disease, diabetes, and certain types of cancer as well as being at risk of immediate psychosocial effects.
Research has shown children’s exposure to food marketing influences their food decisions, brand awareness, preferences, eating habits, weight and health outcomes. Restrictions on food marketing are one of the most cost-effective interventions for obesity prevention in children.
The next NSW Government can play an active role in reducing children’s exposure to unhealthy food and beverage advertising by banning it on NSW Government owned or controlled assets, starting with public transport. A multi-pronged approach focusing on both individual and systemic changes has been shown to effectively address this serious issue.
Minimise gambling harms
One in six people in NSW experience gambling harm, leading to devastating effects on individuals, families, and communities, including financial difficulties, relationship problems, and mental health issues.
Fortunately, there is a solution to minimise the harms.
PHAA NSW proposes specific and effective measures to be put in place by the future NSW Government. These include the implementation of a universal pre-commitment cashless card system with upper limits per day, month and year, a one-button self-exclusion, and prohibitions on inducements, advertising and marketing; and penalties for regulation and legislation breaches.
Additionally, we are seeking improved public gaming policy from the next Government by refusing pre-election agreements with the gaming industry.
Act boldly on climate change
Climate change is one of the greatest public health challenges of our time, and is likely to have a profound impact on the health of all Australians.
The effects of climate change, including heatwaves, droughts, and extreme weather events, can lead to a range of health problems, including respiratory difficulties, heat exhaustion, and the spread of infectious diseases. Extreme heat events are already the leading cause of natural-disaster related deaths in Australia and are associated with increased premature births in NSW.
Any future government must take bold action to reduce Australia’s greenhouse gas emissions and prepare for the impacts of a changing climate by banning new coal and gas mines as well as any mine expansions.
Additionally, the NSW Government should hold a NSW-focused Health and Climate Summit to determine actions that protect health and safety across workplaces, neighbourhoods and communities. The Summit will improve the evidence-base we need to adapt and protect the public’s health and community support for government action. It should centre and empower Indigenous knowledges in Government planning processes and climate adaptation.
Make prevention a health system priority
Preventing diseases and promoting health is critical to ensuring a healthy and thriving population.
Despite this, much of the focus in Australia’s healthcare system has been on treating illness, rather than preventing disease. This approach is not only costly, but it also leaves many people struggling with avoidable health problems. One in two people in hospital are there with a disease that could have been prevented. For every dollar invested in disease prevention, $14 is returned.
NSW must make prevention a priority by expanding and diversifying the public health workforce to stop less people from becoming sick and to ensure the health needs of marginalised communities are met.
Additionally, we encourage the incoming government to develop a strategy to comprehensively embed prevention across primary, secondary and tertiary care to enhance patient level care. Disease prevention should be part of every healthcare encounter, not just within the public health domain.
In line with the national target, and what other state governments have already committed to, NSW governments should work towards achieving budgeting five percent of state health expenditure be put towards preventive health investments by 2030.
The health and prosperity of NSW can be strengthened through an organised and measured approach to addressing these key public health issues.
Dr Kate McBride is an epidemiologist, with broad expertise in public health and the improvement of health at a population level through the prevention of and reduction of chronic disease. Her research focusses on the prevention and management of chronic disease within high risk, marginalised populations through the optimisation of healthcare access among these individuals. Kate spent a number of months on secondment during the height of the pandemic assisting with COVID control measures. Kate is also the President of PHAA, NSW.
Joshua Karras is a 3rd year PhD candidate specialising in Public Health Communication. He is the UNSW Postgraduate Representative on University Council, Postgraduate Council President and an elected member of the university’s Academic Board. Joshua’s primary focus is to drive cross-sectoral and cross-cultural partnership and collaboration to deliver real-world results, which maintain relevance on a local, state, national and international scale. Joshua is also a PHAA NSW member.
See previous articles in this ongoing Croakey series, #NSWVotesHealth2023.