Public health advocates need to look for opportunities to work with the new Parliament and restructured federal Ministry, the former Federal Health Minister Nicola Roxon noted recently.
They will need to be nimble given that Minister Peter Dutton is set on slashing the federal health bureaucracy, with the latest reports (see also here) suggesting the Australian Institute of Health and Welfare and the National Health Performance Authority are under threat, along with the Australian National Preventive Health Agency.
However, there must be some opportunities arising from Sport becoming part of the Health Ministry (even though many in public health might prefer to focus broadly on promoting physical activity rather than simply sport).
It is, after all, going to be quite awkward for Minister Dutton to be promoting the health benefits of sport while it remains such a platform for alcohol marketing, as outlined in Croakey earlier this year by public health advocate Professor Mike Daube.
There are also plenty of “opportunities” for public health advocacy arising from PM Tony Abbott’s plans for building new roads and cutting rail projects (as outlined here).
Brendan Gleeson, professor of urban policy studies and director of the Melbourne Sustainable Society Institute at Melbourne University, has written about why freeways are not the solution to congestion, and in the compilation post below Croakey contributors highlight some of the health concerns involved.
They suggest that plans for new roads should be subjected to health impact assessments, and that the roads budget should include the costs of an associated increase in obesity rates.
Mark Harris, UNSW Scientia Professor and Executive Director Centre for Primary Health Care and Equity
The major implication is a reduction in physical activity as there is a positive relationship between public transport use and physical activity (in country and region comparative studies).
Maybe if rail was combined with cycle ways (as in parts of western Sydney), they might be more appealing to the prime minister.
A medical leader who wishes to remain anonymous
A. Let’s ensure the new roads delivered are all pedestrian and bicycle friendly – no point having new roads if people cannot walk or cycle if they choose rather than drive – need to support pedestrian mobility which most freeways do not.
B. Deliver on the election promise to provide infrastructure support to expand general practices to allow for more teaching and supervision.
C. More rainbow pedestrian crossings in the lead up to a conscience vote on same sex marriage. Discrimination against any one group of Australians is bad for public health.
John Dwyer, Emeritus Professor, University of NSW
The social determinants of health are broad as we all know and no major infrastructure program should proceed without the full health implications (positive and negative) being explored.
Some new road infrastructure is genuinely needed to improve access to health care and goods like fresh foods in regional and remote Australia, as well as to get trucks off the streets in low-income inner city areas. But major investment is needed in train and light rail systems to get cars off the streets and reduce stress in high density residential areas. The Melbourne Metro project should be funded — again, the Prime Minister has an opportunity to drop the election campaign rhetoric around ‘sticking to our knitting’.
Heather Yeatman, President, Public Health Association of Australia
The implications for public health are significant. Research indicates that with more roads comes more cars. More cars mean more pollution and more accidents – at a significant cost to human health and health care resources. We need more public transport to get people, cars and trucks off roads – but these plans are being cut, cut, cut. This is very short sighted, provides economic incentives to car manufacturers and fossil fuel providers and damages human and environmental health. Bad public health policy.
Lewis Kaplan, CEO, General Practice NSW
By going back to the Ottawa Charter on Health Promotion (1986 but still completely relevant) and the UN High Level Meeting on Non-Communicable Disease in 2011 to both of which Australia signed up. Costings need to include the projected increases in obesity and concomitant costs on the health system of not addressing the issue at government level. Didn’t the Coalition also promise a new National Diabetes Strategy? This would be better focussed on a National Chronic Disease Strategy. We had one of these quite recently (last Coalition government) but little of it was implemented due to lack of funding commitment. It was a well-crafted document with disease specific improvement frameworks, so no need to re-invent it, just fund it adequately with continuity for at least 10 years!
Lea McInerney, writer, researcher and facilitator
There’s a problem persuading the new PM about public health when he doesn’t accept the reality of climate change, the planetary limits to growth (economic, anyway) and the urgent need for significant structural change to make sure that we humans can continue to survive and thrive. Mr Abbott is strong on his commitment to family and his own played a big role in the election campaign (whatever you might think about that little trend). Perhaps some projections about climate scenarios his daughters and their generation are likely to face in 10, 20, 30, 40 and 50 years’ time – analysed through economic and wellbeing lenses – might help him formulate his thinking about this with more rigour than we’ve seen so far.
Dr Peter Parry, child & adolescent psychiatrist
Diesel particulate exhaust matter is a cause of much disability and early death. Phasing out of diesel to gas/lpg conversion is possible and, from a macro-economic viewpoint, cost-effective. Trucks on roads, however, remain a health risk from road safety and noise pollution aspects. Commuting by car for greater than 45 minutes has been associated with raised stress levels such as raised cortisol, trains offer a way to read/relax whilst commuting. Rail projects can have a health benefit that is cost-effective.
Carol Bennett, Consumers Health Forum
New roads that provide for safer travel can be an important public health measure but the importance of public transport in promoting public health through physical and social impacts cannot be understated. Let’s hope that there will be some investment in rail in the not too distant future.