Prescriptions for a healthy Australia
It’s sobering to know that Australia has now joined the ranks of nations lining up to grapple with the obesity epidemic affecting its citizens.
Equally dismal is the news relating to mental health, that tells us that suicide is now the number one killer of all Australians under 35.
What does this say about the image of ‘the lucky country’ and the land of the ‘fair go’ that we hold so close to our national identity? What has happened over the last decades that has brought us to this point, and most importantly, how can we move forward in creating a healthier Australia?
The good news is that as a nation we are now beginning to recognise that we need a similar kind of ‘revolution’ in healthcare as we do in education. The bad news is that we are still thinking of this in terms of increasing doctors, nurses and hospital beds to meet demand, rather than creating a more dispersed system of preventive health embedded in community and recalling the ‘self-help’ ethic that surfaced some 40 years ago.
Building more institutional infrastructure and attracting greater numbers of staff to the medical profession may well be needed, but is not a sustainable solution within the context of a population that is both ageing and increasing at a rapid rate.
Instead, we need to consider a broader reorganisation and redistribution of roles and relationships associated with supporting physical and mental health, taking the focus away from treating the symptoms within the walls of hospitals and clinics and supporting the family to play a greater, more informed role in addressing the root causes of obesity and mental health.
The findings of the latest Australian Social Trends report released by the Australian Bureau of Statistics suggest that disadvantaged communities are a critical place to start.
We have known for many years that there are significant disparities in the health outcomes of different populations within Australia, and that people who live in areas with poorer socioeconomic conditions tend to have worse health - including higher levels of disease risk factors and lower use of preventive health services – than those who experience socioeconomic advantage. This disparity persists because the burden of addressing it has been focused squarely on the health care sector rather than society as a whole.
This approach has failed and indeed will continue to fail because the health of individuals is today dependent not on treating isolated symptoms with particular medicines, but on lifestyles and deeply ingrained behaviours that are influenced and maintained by a range of social and market forces over which health care providers have no control.
We all understand that as the first and most influential role models of future generations, it is parents who sow the seeds of positive healthy behaviours and attitudes from the pre-natal period well into their children’s teenage and adult lives.
And yet the way we have organised our society hinders disadvantaged parents from doing exactly that – pricing fresh food beyond the means of their limited disposable income and instead allowing cheap fast-food outlets to proliferate in low SES communities as the most convenient alternative.
With few opportunities to improve their own typically poor levels of education or to role model positive nutrition to their kids, it becomes clear why unhealthy behaviours quickly become embedded across family generations.
We need to put these families back at the centre of social change and recognise that health is a peculiarly social as well as physical phenomenon.
It is not the provision of more doctors and nurses, needed though they may be, that will create a healthier Australia, but rather increasing the capacity of all individuals to engage in the responsible, collaborative maintenance of their own health through self-help.
While disadvantaged communities may be overly represented in the cohort of unhealthy Australians, the challenges encompass all of us, regardless of background. Many parents today spend long hours commuting into congested and polluted cities, where expensive fitness clubs jostle for access to the half-hour of free time these people may have to get active in their day.
Art, sport and music programs are being cut from school budgets across the country, depriving kids of opportunities to develop the self-esteem and emotional literacy they need to help them develop into effective and contributing adults.
And as safe, outdoor spaces shrink as we rush towards an ever more urbanised, high-rise society, there are fewer opportunities and incentives for kids to leave the various digital screens of the tv, computer or mobile phone and engage in outdoor physical activity (often not encouraged by time-poor parents juggling the work life balance).
Are we really surprised at the unhealthy lifestyles and impacts this kind of society is creating?
Responsibility for a healthier Australia also rests with our corporate community. In an era of transparency enabled by technology and the Internet, how companies are seen to respond to the social impact of their work is becoming increasingly important.
We now need them to demonstrate a longer-term perspective and take responsibility for the impacts they have on the world for which they are not necessarily obliged under law to be accountable for.
Some companies have already recognised the importance of this approach, proactively changing their practice with a view to avoiding community backlash, such as the swift move by members of the food industry in the last decade to remove trans-fats from their products well before legislation came in to enforce such a move.
The status quo in Australia is not an option. If this situation is to change, we need to redistribute healthcare responsibilities, resources and expertise across communities and households, rather than concentrating them solely within the walls of institutions.
We need to use these resources collaboratively to share ideas, provide mutual support and give voice to user needs; and we need to recognise and act upon the responsibility we all share in creating a healthier, happier and more harmonious Australia.
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