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  1. 1

    Jason Rostant

    Wholeheartedly support Michael’s contentions.

    If health advocates have been left in the dust by other interest groups, and I think we have, it is for many of the reasons outlined here, but more.

    Yes we have tended to a view that what we do do is inherently good and worthy, just because it is, and that this will be enough to create change. As outlined, it isn’t.

    We have rarely taken the overwhelming evidence generated by many smart and committed people and shaped it into compelling and strident messages for change. Visibly, unashamedly and unitedly.

    And while the evidence for necessary changes to public health is unequivocal, and at a policy level I’m committed to advocating for evidence based policy design and budgeting, HiAP, the central place of equity and SDOH, etc, evidence only gets us so far.

    It engages the head, generally, and depending on the kind of language used (which in health is frequently alienating), even then, only some heads will be engaged.

    Harking back to my social work training, We also need to engage the heart and hand.

    Understanding what motivates people, how that can be engaged, and then translated into action.
    Fully applying theories of change with a range of integrated strategies means our approach will necessarily look like different things for different audiences at different times. But that all three must be engaged – head, heart and hand – in the right mix, simultaneously, seems obvious..

    In many quarters, particularly in parts of community health, to get strident, to challenge systems, to be organized and sophisticated campaigners is a bit foreign, sometimes a bit corporate and at other times a bit uppity. Which is a bit odd since social equity and campaigning is where Victorian community health at least, frequently had its union organizing roots.

    Unlike other successful campaigns, like marriage equality, we have generally failed to engage and mobilize broader coalitions of partners outside of health, and within the community.

    Imagine how much more likely of success public health might be of generating a 100 days response from government if their political futures depended on it.

    Where are the full page ads showcasing the top tier corporates who support public health initiatives?

    Where are the frequent polls illustrating voters desire for change to how our health system operates and is funded?

    Why isn’t the electorate brought into a debate about how public health directions might influence their voting intentions?

    Why don’t we know what every member of parliaments view is in relation to various public health initiatives?

    These strategies and more are pretty standard campaign approaches among other more successful interest groups. If there’s conceit to be challenged, I wonder if there’s something about gelato looking a little more outside of itself.

    Fully support the introduction of Prevention 1st!

  2. 2

    Jason Rostant

    …and in the second last para, by gelato, I mean health looking a little more outside of itself… Thanks tiny iPad autocorrect window…

  3. 3
    Melissa Sweet

    Melissa Sweet

    Thanks Michael for this useful and timely challenge to public health advocacy. In response I have three (quick) related observations:

    1. It is telling that you categorise those with a concern for the environment, foreign aid, Aboriginal and Torres Strait Islander people, and women’s and marriage equality as somehow separate to public health. To my mind, these are all important public health concerns. Is there any more important public health issue than climate change? (Sometimes I wonder whether public health practitioners who are not actively working for climate change action are simply fiddling while Rome burns.) So for me, this comment highlights the pitfalls of a narrow, reductionist focus around tobacco, alcohol etc. It also reminds me, as Tim Senior has written at Croakey previously, of the potential for learning from the Aboriginal and Torres Strait Islander health sector about more holistic understandings of health and determinants of health.

    2. The difficulties of gaining policy traction are not simply issues for Australia but reflect the wider ascendancy of neoliberalism, as defined by the WHO:

    3. I agree with Jason re the disconnect between so much public health advocacy and the wider community. So much of the work of public health (with notable exceptions) seems very top-down, rather than being genuinely embedded in communities and part of communities, and responsive to communities.

    Thanks again Michael, really appreciate you sharing this article with Croakey readers. Cheers, Melissa

  4. 4

    Vern Tack

    It is a curious thing that the Liberal Party seems to think that allowing a large proportion of the population to have worse health (and education) is a path to national prosperity and harmony.

    Perhaps it’s just about being top dog – born to rule.


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