Introduction by Croakey: Health promotion professionals are gathering this week at a critical time for discussions about health and wellbeing, amid humanitarian and climate crises, conflict and war, growing inequality, and strategising in the wake of the Voice referendum defeat and the Aoetearoa/New Zealand election.
This week’s Health Promotion Symposium 2023, to be held in the regional Victorian city of Geelong on the traditional lands of the Wadawurrung peoples, is the first in-person event led by the Australian Health Promotion Association (AHPA) since before the pandemic.
Marie McInerney, who will report from the symposium for the Croakey Conference News Service, previews #hpsymposium2023 below. Also follow a tag-team of tweeters at @WePublicHealth.
Marie McInerney writes:
Experts will this week call for transformation of economic and health policies away from paradigms that are destroying the health and wellbeing of people and the planet, and towards a focus on a wellbeing economy and a “health promoting society”.
Political economist Dr Katherine Trebeck is working to craft a “tapestry” of people across multiple roles and professions to help transform Western economies from being steeped in “failure demand” — spending by governments in response to the negative impacts of the current economic system, such as the enormous cost of climate disasters.
Trebeck, who will be a keynote speaker at this week’s AHPA Health Promotion Symposium, is a global leader in thinking on wellbeing economies — “economies that are designed to serve people and planet, not the other way around”.
Wanting to recruit actors from all parts of the economy to build change, this week she will direct her call to arms to Australian health promotion practitioners and to the health sector more broadly to hold up a mirror “to the way the economic system is doing great harm to individuals”, whether because of climate, work stress, inadequate incomes, poor housing or multiple other factors.
“We need people right inside government, changing government processes, changing policies; we need people agitating on the outside; we need people within enterprises, we need scholars building the evidence base, we need activists, we need people in communities,” she told Croakey.
Another key presenter at the conference, David Towl, echoes Trebeck’s vision of a wellbeing economy when he says that one of the best descriptions he has seen of health promotion was that “a health promoting society is one that makes all of its decisions based on the impact they will have on the social and structural determinants of health”.
“Then you would have a society which would not be building more hospitals, that would not be proliferating liquor licences, that would not be enabling gambling, that would be telling schools that they have to control what food is available in their canteens, that would be ensuring you can access health services, no matter your immigration status, or level of income.”
AHPA’s fully-booked symposium will open on Wednesday with a keynote address from leading Maori health researcher Emma Rawson-Te Patu, President-Elect of the World Federation of Public Health Associations – the first Indigenous person to hold the position.
Her address on the cultural determinants of health will come amid serious threats to Aboriginal and Torres Strait Islander peoples’ rights, self-determination, programs and policies, including to treaty processes in Queensland and New South Wales, in the wake of the Voice referendum.
Momentum and pushback
Trebeck, who splits her time between Scotland and Australia, will lead the final plenary session of the two-day symposium, capping its strong focus on the social, cultural, commercial, political and ecological determinants of health.
Writer-at-large for the University of Edinburgh and consultant to the Club of Rome think tank, she co-founded the Wellbeing Economy Alliance and instigated the group of Wellbeing Economy Governments (WEGo) – comprising Scotland, New Zealand, Finland, Wales, Iceland, and Canada.
The Australian Government may be just “catching up” via its work towards the Measuring What Matters national wellbeing framework, but Trebeck says the push towards wellbeing economies has been “building a bit of a head of steam” in jurisdictions across the globe.
That’s been steered by people and governments of the left and right, including past French president Nicolas Sarkozy, who called more than a decade ago for a “great revolution” in the way national wealth is measured and value.
The work has seen the development of the Genuine Progress Indicator, which takes out the perverse incentives embedded in Gross Domestic Product (GDP), which as Senator Robert Kennedy famously said, “measures everything, except that which makes life worthwhile”.
But Trebeck is worried too that, despite the equity lessons to be learnt from the COVID pandemic and the growing threat of the climate emergency, we are now seeing “quite pronounced pushback” to the concept of wellbeing economies – living up to the adage, ‘first they ignore you, then they laugh at you, then they attack you and then you win/or they build monuments to you’.
It feels like we are in the attack phase, to be seen quite starkly in the UK, where the Conservative Government is “shredding” all sorts of green, labour rights and welfare policies, she said.
Trebeck says one of the go-to positions in that pushback is to try to paint transformational change as a luxury and, as we have seen with the Voice referendum and in the New Zealand election, to insist that people are more concerned about “bread and butter issues”.
In fact, she says, it’s the current economic system that is “not delivering on bread and butter issues for everyday people…particularly those who are most marginalised”, many having to choose between food for their children and heating or cooling their homes.
By contrast, a wellbeing economy “means that kids will have a better future, it means better houses and better jobs, more dignity at work, more say over your life, more sense of control,” she said. And crucially it should mean a planet that’s not posing existential risks to people’s lives.
Trebeck’s session at the symposium will look at the process of building a wellbeing economy through the lens of people working in health promotion, exploring ways that change happens and sending the message that “whether you’re in the economic system or the health system, whatever your role, you’ve got something to bring to this”.
She will close her address with a slide (below) that maps out some of those different roles, including Disruptor, Visionary, Activator, Connector, Amplifier and Facilitator.
She will encourage participants to look at themselves and their own sphere of influence “and think, ‘that’s me’…that’s the sort of role I can play”.
Reinvigorate and reconnect
That mix of big picture discussions coming down to practice-level change is the objective of the Health Promotion Symposium, which has set out specifically to not be just a “talkfest”.
“AHPA hasn’t been able to host our own symposium since 2018 so it’s an amazing opportunity to get the sector back together,” AHPA President Melinda Edmunds told Croakey of the event, which has been made possible through funding under the Health Peak and Advisory Bodies program to support the strategic intent of the National Preventive Health Strategy 2021-2030
“For us it’s about having a format where we can have the big picture conversations but really bring things back to what that means for practice,” she said. The aim is for those attending to walk away, reinvigorated and reconnected, and armed with tools and tips to act on health determinants in their midst.
Plenary sessions will involve panels, curated and led by health leaders, including VicHealth CEO Dr Sandro Demaio on the commercial determinants of health and Monash Sustainable Development Institute director Professor Tony Capon on planetary health and advancing an eco-social approach to health promotion.
Digital health expert Dr Becky White will also deliver a keynote on the infodemic, followed by concurrent presentations and workshops that explore systems thinking, gender equality, mental health, vaping, and food systems, among many other topics.
Recognising that peace is the first “fundamental condition for health” listed in the Ottawa Charter for Health Promotion, the Eberhard Wenzel Oration will be delivered by Solomon Islands Chief Esau Kekeubata and Associate Professor David MacLaren from James Cook University on a peace and reconciliation journey taken recently in response to a 1927 massacre in the Solomon Islands.
Global and local
The symposium has also put the focus on local. It is being held in the Victorian regional city of Geelong, on the traditional lands of the Wadawurrung peoples, with panel session leaders encouraged to draw their panellists also from rural and regional areas.
Bek Lasky, a proud Wakaya woman who was born and raised in Geelong, will speak in Demaio’s session, providing an example of a unique business enterprise that showcases how commercial forces can nurture good health and wellbeing.
Lasky is CEO of Ngarrimili, which works to nurture and support business and entrepreneurship opportunities amongst Aboriginal and Torres Strait Islander communities across Australia. It was founded by Yorta Yorta man Cormach Evans who also established the Strong Brother Strong Sister program for Aboriginal children and young people.
Now led by Lasky, Ngarrimili is currently developing the Murran Hub in Geelong, designed with local First Nations leaders, which will feature a café, retail store offering First Nations products from across Australia, a co-working space and conference centre, plus a gallery showcasing First Nations artists and supporting them to develop marketing, financial and other skills.
Lasky says the café and shop will provide employment and training opportunities, targeting young people and young mums returning to the workforce, with the hub aiming to be “a culturally safe place for mob to come and connect and work and learn and meet new people and inspire”.
“Wellbeing is centred in everything we do,” she told Croakey, talking about the importance to Ngarrimili of working closely with and giving back to community, understanding the connections between physical, spiritual, and cultural wellbeing, providing access to supports for businesses it works with, and showcasing and nurturing culture.
Struggling for profile
Critical to many of the conversations will be a session on why health promotion and prevention struggle for profile against treatment services in an overstretched health system. This discussion will be led by David Towl, who is Executive Lead Community Impact at Melbourne’s Access Health and Community and an AHPA Vic/Tas branch committee member.
Towl has been imagining the headlines that might feature in mainstream media if there was more understanding of the value that health promotion brings to society, where every dollar spent brings a return of $14.
He has in mind media calling for “a prevention big build” (like Victoria now has in transport infrastructure) or declaring that we have “Ministers for Illness not Health”.
But the reality is that, despite all the evidence around prevention, curative treatment-based services are still seen as more important by the community and are more invested in by politicians.
That was even the case, he said, with COVID-19, where Australia delivered a “very dominant treatment focus response” compared to countries like Costa Rica and Cuba who “did arguably better than us because they have really strong primary health and prevention systems”.
His session will work towards an AHPA position paper, exploring:
- If prevention is better than the cure, why doesn’t this flow to how the health system is funded?
- How can health promotion communicate its importance in an increasingly noisy policy landscape?
- Is it our role to shift how we are heard or do we just need to raise our voices?
Career pathways
The Symposium is also actively nurturing early career practitioners who will feature on panels, in line with AHPA’s strategic priorities around building capacity, developing career pathways, and “giving voice to the next generation of leaders”. Every session being mapped against International Union for Health Promotion and Education (IUHPE) competencies.
It’s a focus much welcomed by Jane Pirouc, who is co-chair of AHPA’s student and early career practice group and will be a panellist on Trebeck’s session, sharing the results of a six-week series program she ran for people with chronic physical or mental health issues, giving participants access to expert level information, workshops and classes on the topics of exercise, mindfulness and nutrition.
Pirouc said she had felt “quite lost” after she had completed her undergraduate degree in health sciences with a focus on health promotion five years ago and ended up working outside of the sector until she got her current role with Moira, a Melbourne disability support organisation.
Health promotion “is not like nursing where you have to do placements and it’s easier to have a job lined up”, she told Croakey.
That’s why connecting with AHPA and the symposium are so important, to help early career practitioners “understand what’s out there and what health promotion involves”, she said.
• See the AHPA Health Promotion Symposium full program here. Bookmark this link to track Croakey Conference News Service coverage of the event and also follow #hpsymposium2023 on X/Twitter.
