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Roving reports from the World Congress on Public Health

We asked members of the Prevention Centre network to summarise some of their highlights from the Congress

By Nick Roberts, NSW Ministry of Health
Topic: Tobacco Free Portfolios – identifying and leveraging a new angle on comprehensive tobacco control
Presenter: Dr Bronwyn King, radiation oncologist and CEO of Tobacco Free Portfolios

Dr Bronwyn King

As a clinician working with lung cancer patients, Dr King was deeply affected by the impact of tobacco on her patients. In a meeting with a representative of her superannuation fund in 2010, Dr King discovered that some of her money was flowing to tobacco companies through the “default” option. She later found this was the case with many super funds and other financial institutions, and went on to establish Tobacco Free Portfolios, an organisation focused on eliminating tobacco from investment portfolios across the globe.

Dr King said the global financial sector continues to profit from the tobacco industry. She said we could all make a difference by asking questions of our banks, super funds and other investment portfolios.

What stood out to me
Dr King’s presentation recounted a personal journey of revelation. It was engaging, confronting and inspiring. As people working in public health, we should consider our own responsibility for understanding where our investments may be detrimental to public health, and divest, reinvest or advocate for change in the financial sector, where necessary.

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By Helen Signy, The Australian Prevention Partnership Centre
Topic: Health care system and structural barriers to action in the management of childhood obesity
Presenter: Dr Penny Love, World Health Organization for Obesity Prevention, Deakin University

Dr Penny Love

Dr Love presented the findings of a Prevention Centre project that compared the implementation of two childhood obesity programs, Go4Fun in NSW and PEACH in Queensland. The study found that despite international evidence about the effectiveness of such services, there is no national universal public health service for families of children who are already overweight or obese. Childhood overweight and obesity management programs will only succeed long term if they are embedded into the health care system, Dr Love said.

What stood out to me
The project has shown programs can be vulnerable to external factors such as changes in government, funding priorities and philosophical differences. This talk highlighted the importance of a coordinated approach to tackling complex problems like childhood obesity.

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By Maria Gomez, The Australian Prevention Partnership Centre
Topic:
Taking a systems approach to achieving prevention at scale in Victoria
Presenter: Veronica Graham, Victorian Department of Health and Human Services

The presentation was about Healthy Together Victoria, which was a whole-of-system approach to prevention that looked at settings as systems, for example, schools, workplaces and community venues. The initiative was underpinned by a number of key principles that support system-wide change for good health, including policy and line of sight. Examples include the Victorian Public Health and Wellbeing Plan and collaborations for collective impact, such as initiatives for walking to school and safe drop-off zones involving input from local councils, urban planners and schools.

What stood out to me?
Veronica presented a great example of systems impact. It involved a district health service that stopped the sale of sugary drinks from across their sites (in canteens, vending machines, etc). This led to a ripple effect with 13 other district health services also removing sugary drinks across their sites. I thought it was a great example of settings and communities taking action.

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By Ainsley Burgess, The Australian Prevention Partnership Centre
Topic: World Leadership Dialogue: tobacco control
Presenters: Professor Mike Daube, Curtin University; Professor Prabhat Jha, University of Toronto; Professor Melanie Wakefield, Cancer Council Victoria; Professor Martin McKee, London School of Hygiene and Tropical Medicine; and Dr Colin Tukuitonga, Secretariat of the Pacific Community.

Professor Prabhat Jha

This World Leadership Dialogue emphasised the need for innovative approaches to address the barriers to reducing tobacco use around the world. The speakers presented both global and community perspectives. Professor Martin McKee strongly encouraged us to question the highly strategic and calculating Big Tobacco campaigns, remembering that their sole purpose is to persuade and manipulate consumer behaviour.

All presenters stressed that to successfully combat the tobacco industry, public health organisations, professionals and researchers need to emphasise that tobacco is a poisonous product designed to kill, and that a different level of intensity, purpose and strategic approach is required in advocacy, educational and research efforts.

What stood out to me?
Given the progress made with tobacco control in Australia, I was surprised at the extent of the ‘battle’ still raging between Big Tobacco and the significantly smaller public health advocacy community, and the vigilance needed to simply maintain the gains. Professor Wakefield from Cancer Council Victoria vividly described the advocacy work as taking three steps forward and one step back.

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Dr Maria Neira

By Helen Signy, The Australian Prevention Partnership Centre
Plenary session: Are we at a turning point in public health?
Presenter: Dr Maria Neira, Department of Public Health and Environment at the World Health Organization

Climate change is threatening the decades of progress we have made in public health, Dr Neira said. In a rallying call to spread the word beyond the public health community to other sectors who could make a difference, she called for public health to be a central focus of the Sustainable Development Goals and Paris Agreement. She said there is an urgent need for action because:

  • 92% of the global population lives where pollution targets are not met
  • If we reduce environmental risk, the global burden of disease will drop by 23%
  • Household air pollution kills 4.5 million a year, with 41% of the world’s population still relying on dirty fuels
  • Open defecation is still practised by almost 1 billion people. If this were fixed, 89% of deaths due to diarrhoea could be averted
  • Exposure to chemicals, endocrine disruptors and e-waste are emerging crises.

What stood out to me?
In our focus on obesity and chronic disease, it’s easy to forget how far we’ve come and how far so much of the world’s population still has to go. Health inequities globally are increasing, and the stark facts that Dr Neira laid out should give us all pause for thought.

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By Ainsley Burgess, The Australian Prevention Partnership Centre
Topic: Social counter-marketing map for a new generation of activism and notes from the field
Presenters: Professor Bill Bellew, Dr Becky Freeman and Mr James Kite, University of Sydney; and Professor Sandra Jones, Australian Catholic University

This panel provided fascinating insights into the techniques that multinational companies use to promote their unhealthy products. Social counter marketing (SCM) draws on advocacy and social marketing techniques to oppose industry tactics – in short, playing the industry at their own game. It draws on the power of individual citizens and community coalitions, such as crowd-funded campaigns. Rather than simply raising awareness of the cause of an issue, it aims to persuade governments to reduce or end harmful industry marketing practices.

An example of a SCM campaign in Australia is Booze Free Sport. This campaign is gathering community support to remove unhealthy alcohol sponsors from professional sports.

What stood out to me?
How important it is to question and determine the vested interests of each player before countering an issue; and to watch for industry pushback in all its different forms, for example campaigns in the guise of social philanthropic efforts.

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By Bronwyn McGill, University of Sydney
Topic: Addressing the challenges of public health scientific publication
Chair: Professor John Lowe

This panel presented the perspectives of editors of a number of national and international health promotion and public health journals. The panel discussed the value of the peer-review process, with differing opinions on open review. My key points from the session were:

  • The importance and obligation of authors to review for journals and to provide thorough and thoughtful reviews. Their general guideline was that if three reviewers review your paper that is published, you should review three papers in return.
  • A well-crafted cover letter is important. All editors said they read and valued the cover letter to provide the context of the work within the scope of the journal, as well as in relation to your other published work.
  • The debate over the use of impact factors and citation indexes for academic promotion versus the importance of publishing a range of research in a range of journals.

What stood out to me?
This discussion humanised journal editors and drew attention to the difficulties they face in their volunteer roles for journals.

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By Dr Anne Grunseit, University of Sydney
Topic: Reducing population-wide sugary drink consumption: a unique partnership approach
Panellists: Alison McAleese, Cancer Council Victoria; Jane Martin, Obesity Policy Coalition; Veronica Graham, Victorian Department of Health and Human Services; Professor Anna Peeters, Deakin University; Ariana Kurzeme, YMCA Victoria; and Kirstan Corben, Alfred Health

Alison McAleese

This session reported on activities in Victoria where government health departments are working with other government departments such as sport and recreation, jobs and transport, parks and education on the three priority areas of increasing fruit and vegetable intake, reducing sugary drinks consumption, and improving access to nutritious food.

Panellists presented examples of how they have been working in partnership to reduce the sale of sugary drinks. The first example was at Alfred Health, which changed the practices of the in-house café and vending machines to move sugary drinks out of sight. The second example was a similar intervention with YMCAs. In both settings, there was no change in total sales, but up to 71% reduction in the sales of “red” (high sugar) beverages and up to 36% increase in “green” (no sugar) drinks. This was despite the latter venues having access to free water in water fountains.

What stood out to me?
I was impressed with the way in which health promotion was able to address the issue of profitability, as well as the enormous impact achieved with simple, easy-to-implement initiatives.