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Prevention, promotion and the pandemic: where next?

Marie McInerney writes:

Former Labor Health Minister Nicola Roxon has urged Australian governments to respond to the early lessons of the coronavirus pandemic by investing in the foundations of health prevention – strengthening health literacy and fostering trust in experts and government – and to make sure primary care can “at last assert its ascendancy”.

Speaking at a VicHealth webinar last week, Roxon, who steered Australia’s world first tobacco plain packaging laws in 2012, also implored health promotion advocates to be “activists”.

While government leadership is important, it is also up to communities to create “fertile ground” for government action, including by “actually bothering to ring up a radio station, raise something with a local MP, (being) prepared to campaign on things”.

“That actually doesn’t happen as much as you would think and governments do listen to it,” she told the event, which discussed: Where do we go next with prevention? Adopting a transilient approach as we learn from coronavirus.

As well as being united on the need for transdisciplinary action, the panel also embraced the concept of ‘transilience’, outlined in a paper written for the event by Melbourne academics Professor Anna Peeters, Director of the Institute for Health Transformation at Deakin University, and Professor Lisa Gibbs, Director of the Child and Community Wellbeing Program in the Centre for Health Equity at Melbourne University.

Urging action on the opportunities to “build back better” from the pandemic, Peeters said:

I think many of us have remarked on the fact that there’s this now kind of general societal understanding and recognition of that inherent interconnection between health and all the other facets of our lives, including employment, income, (and) housing.

We’ve understood that to respond to COVID-19, we actually have to connect all those dots in a way that I don’t think we’ve really articulated collectively…for other complex health and social problems.”

This could really make “inroads on health inequities in Australia”, she said.


More equitable, sustainable, healthy

The webinar was the fifth and final event in the VicHealth series on Health and Life ReImagined. You can watch the one-hour event here, or the whole series via the links here.

The series had intended, VicHealth CEO Dr Sandro Demaio said, to prompt discussions as Australia emerged from pandemic lockdowns, to “look at life beyond the coronavirus”.

Instead, the final webinar took place with Victoria back in Stage 3 lockdown, and announcing on Sunday that face masks will be mandatory in Melbourne and the Shire of Mitchell as part of growing, targeted actions to stem record numbers of daily cases over the past week.

Nonetheless, Demaio said the pandemic was creating a “once in a generation opportunity” to rethink the ways that health professionals worked together and the various political, social, commercial, cultural and other dimensions of life that shape health and wellbeing.

“As we look to recovery, we need to make sure that we are indeed building back better, that we’re thinking about a world post-coronavirus that is more equitable, more sustainable and more healthy than the one we had just a few months ago,” he said.

Two key issues underlined the final discussion, including that the pandemic had only further underlined the need for cross-disciplinary work on the social, political, and commercial determinants of health.

Panelists also agreed on the need for urgent work, globally and in Australia, on non-communicable diseases (NCDs), amid growing concerns that people with chronic diseases are at higher risk for and from COVID-19.

As well, fear or reluctance to seek treatment and disruptions to services have dramatically reduced the take up of prevention measures like cancer screening.

Panelist Dr Selina Lo, Senior Research Fellow at the Monash Sustainable Development Institute and a Consulting Editor at The Lancet, urged action on two fronts in response to Australia’s “pretty traumatic 2020”, that began with the devastating summer bushfires.

One is the need to protect the health and safety of healthcare workers, she said, referring to the recent UCL-Lancet Lecture 2020, where Dr Muhammad Pate, Global Director for Health, Nutrition and Population at the World Bank Group, said countries should be looking at preparing a strategic national stockpile going forwards for personal protection equipment (PPE) and other commodities.

The second is in recognising that COVID-19 and climate change “have got a lot in common”, she said.

Each involve the communication of complex science, global international cooperation, and inequity, where “the most vulnerable are the most affected”. Where they differ, has been the failure of governments and nations to respond to climate change with the same scale and commitment as many have to the pandemic, she said.

Tope Adepoyibi, Head of the Achievement Program, Cancer Council Victoria, welcomed the webinar paper’s focus on equity, raising the question that “yes, we’re all in this together, but who is this ‘we’?”.

“COVID-19 has really brought inequity to the forefront,” Adepoyibi said, pointing to the influence of financial insecurity, job losses, access to the internet, walkability of neighborhoods, domestic violence, aggressive industry marketing tactics, languages spoken at home, and postcodes on the pandemic’s effects on different communities.

Those broader health determinants helped drive the United Nations transition from Millennium Development Goals (MDGs) to Sustainable Development Goals, which really placed health “in the midst of the development agenda”, said Dr Guy Fones, from the Secretariat of the Global Coordination Mechanism on NCDs at the World Health Organization.

The inclusive ‘leave no one behind’ philosophy of the SDGs is critical to responding to the pandemic, as has been the elevation of the NCD agenda for “really upacking the intersections of health, wellbeing and the social determinants of health”, he said.


Health needs to be everybody’s business


Are we all in this together?


Foundation blocks, not icing on the cake


Leave no-one behind


Focusing on planetary health


That’s a #HealthReImagined Wrap


#HealthReImagined analytics

According to Symplur analytics, 813 Twitter accounts participated in the #HealthReImagined discussion between 15 June and 16 July, sending 4,286 tweets, and creating 42.7 million Twitter impressions.

Read the Twitter transcript here.


Bookmark this link to follow our coverage of #HealthReImagined.

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