What is prevention?

Prevention is better than cure

The World Health Organization (WHO) defines prevention as: “approaches and activities aimed at reducing the likelihood that a disease or disorder will affect an individual, interrupting or slowing the progress of the disorder or reducing disability”. 1

Effective prevention decreases the risk of individuals experiencing a disease, condition or injury. 2  Prevention also supports people to effectively manage existing diseases or conditions, so their health does not worsen.

The Prevention Centre focuses on the prevention of chronic diseases and conditions.

What is chronic disease?

Chronic diseases, also called non-communicable diseases, are a diverse group of diseases and conditions that tend to be long lasting and persistent in their symptoms or development. 3 Examples of chronic diseases include: cancer, respiratory disease, heart disease, arthritis and diabetes.

Why do we need to prevent chronic disease?

Preventing chronic disease is a global public health priority due to the significant health, social and economic impacts of these diseases and their association with economic disadvantage.

We need prevention in order to reduce death, ill health and disability, to make our health system more sustainable, to improve health equity, and to reduce the economic burden on society more broadly.

The UN’s Sustainable Development Goals include a target to reduce premature mortality from chronic diseases by a third by 2030. 5  The World Health Organization states that that the global burden and threat of non-communicable diseases constitutes one of the major challenges for development in the twenty-first century. 6

Target

What are the effects of chronic disease in Australia?

In Australia, chronic diseases are the major cause of premature death and poor quality of life. Australia has one of the highest rates of obesity in the world and our communities have the highest number of years spent in ill health compared with other OECD countries. 7

  • A third of chronic diseases in Australia could be prevented by addressing risk factors such as poor nutrition, physical inactivity, smoking and harmful alcohol use. 8
  • Successful prevention not only reduces the personal, family and community effects of chronic disease, it results in a healthier workforce and boosts economic performance and productivity. 7
  • Chronic diseases cause or contribute to many potentially preventable hospital admissions and increased healthcare costs. 8
  • Chronic diseases and their impacts are spread inequitably across the population, with the most disadvantaged Australians experiencing higher levels of chronic disease, ill health and early death. 9
Hands holding a flower

How can chronic disease be prevented?

Chronic diseases and conditions are caused by a range of risk factors. These include behavioural, social, environmental, biological and economic risk factors. 8  Some of these we cannot change – such as people’s age and genes. But addressing risk factors that can be changed will go a long way to preventing chronic disease.

The Prevention Centre focuses on the leading risk factors for chronic diseases and conditions, and the many contributing drivers of those risk factors:

  • Overweight and obesity, and obesogenic environments
  • Tobacco use and smoking
  • Harmful alcohol consumption
  • Unhealthy built environments
  • Physical inactivity
  • Unhealthy diet
  • Food insecurity
  • Low health literacy

The reasons people experience risk factors for chronic disease are complex and varied. Telling people to change their behaviour is not enough. To effectively prevent chronic disease, we need to recognise the influences of where people live and work, their socioeconomic background and their level of education. 10, 11

The best way for governments to prevent chronic disease is by creating healthy environments that provide people with healthier options. For example, this can be done by providing more walkways and bike paths, limiting junk food advertising to children, and placing restrictions on who can buy cigarettes.

Why do we need a systems approach to chronic disease prevention?

The Prevention Centre takes a systems approach to chronic disease prevention because our research indicates that effective prevention needs to address the complexity of chronic diseases.

Taking a systems approach means we look at the many connected and inter-related factors that cause chronic disease, and explore solutions that take account of these interactions. For example, an inadequate food supply system and limited affordability and access to healthy food will all contribute to people experiencing food insecurity and eating unhealthy diets. When we examine such factors as part of a whole system, we show how changing one part of the system will influence other parts, and how relationships between risk factors and behaviours change over time. 10

A systems approach supports organisations and individuals to work together in a coordinated fashion to address the problem of chronic disease from many different angles and in dynamic, flexible ways.

Addressing the complex, interconnected risk factors for chronic disease also requires action and knowledge in sectors outside health, such as working with transport and planning departments and agencies to promote cycling and walking that increase physical activity and help prevent obesity. 12 This approach is supported by the National Preventive Health Strategy.

Photo illustration of cupped hands nurturing a network of connected people

Examples of prevention in Australia

Australia has a strong tradition of developing and investing in prevention to deliver major health gains and improve health equity. These include:

  • Reducing tobacco smoking

  • Promoting high rates of immunisation

  • Implementing road safety laws and regulations

  • Adding important nutrients to the food supply

  • Reducing risk of stillbirth and sudden infant death

However, there is much more that can be done to address chronic disease. Even when specific interventions have shown promise, they require successful population-wide implementation to realise the benefits. 13

While all Australian governments invest in the prevention of chronic disease in different ways, the main focus of health systems in Australia remains on treating ill health after it occurs.

Only 1.34% of Australia’s health budget is currently dedicated to prevention, an amount that is considerably less than OECD countries Canada, New Zealand and the United Kingdom. 14

How can we improve chronic disease prevention in Australia?

We need to find better ways of building prevention into the health system and health financing.

We need to better implement, scale and evaluate prevention interventions to improve the lives of our population, and we need to involve other sectors such as transport, education and town planning.

Australian governments can also support prevention through increasing investment in prevention research. For example, the Prevention Centre is funded by the NHMRC, MRFF, several state and territory governments, and Cancer Council Australia.

Aerial birds-eye view of suburban housing

How can research support prevention?

Prevention policy and practice should be based on evidence of what works and what does not work, why, for whom and how. Greater investment in prevention research can help governments and communities understand, quantify and make the case about the value of prevention for improving Australians’ health.

The Prevention Centre and its related networks of researchers and Centres of Research Excellence are Australia’s leaders in prevention research that is impactful and relevant to the needs of policy makers, practitioners and the community. We have identified that prevention research should:

  • Use systems thinking

  • Address inequities in health

  • Understand the core drivers of disease

  • Partner with other sectors to focus on the co-benefits of prevention

  • Offer concrete and actionable solutions for policy and practice

  • Overcome the implementation challenges of preventive action

Is there public support for prevention in Australia?

Our research shows there is growing public support for governments to take action to protect people’s health. For example, 63.5% of people believe the government has a large or very large role to play in maintaining health.

For specific data on public support for prevention, find out about our Australian Perceptions of Prevention Study (AUSPOPS).

People holding different coloured speech bubble cardboard cutouts

Find out more

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  1. WHO Global Forum IV on Chronic Disease Prevention and Control. Ottawa, Canada; 2004. Prevention. http://apps.who.int/iris/bitstream/handle/10665/43208/9241593164_eng.pdf
  2. NCI Dictionary of Cancer Terms. Bethesda, Maryland: National Cancer Institute; 2019. Prevention. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/prevention
  3. Department of Health 2021. National Preventive Health Strategy 2021-2030. Canberra: Commonwealth of Australia. https://www.health.gov.au/resources/publications/national-preventive-health-strategy-2021-2030
  4. Australian Bureau of Statistics. Health Conditions Prevalence. https://www.abs.gov.au/statistics/health/health-conditions-and-risks/health-conditions-prevalence/latest-release. Accessed 28 July 2022.
  5. Bennett J E et al 2020 NCD Countdown 2030: pathways to achieving Sustainable Development Goal target 3.4 Lancet 396 918–34 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7470795/
  6. World Health Organization. Global action plan for the prevention and control of noncommunicable diseases 2013-2020. https://www.who.int/publications/i/item/9789241506236
  7. Productivity Commission 2017, Shifting the Dial: 5 Year Productivity Review, Report No. 84, Canberra https://www.pc.gov.au/inquiries/completed/productivity-review/report
  8. Australian Institute of Health and Welfare 2020. Australia’s health 2020 data insights. Australia’s health series no. 17. Cat. no. AUS 231. Canberra: AIHW. https://www.aihw.gov.au/reports/australias-health/australias-health-2020-data-insights/summary
  9. Australian Institute of Health and Welfare 2021. Australian Burden of Disease Study 2018: key findings. Australian Burden of Disease Study series 24. Cat. no. BOD 30. Canberra: AIHW. ISBN 978-1-76054-871-1 (Online) ISBN 978-1-76054-872-8 (Print) https://doi.org/10.25816/6jf9-kh03
  10. Friel S, Pescud M, Malbon E, Lee A, Carter R, Greenfield J, Cobcroft M, Potter J, Rychetnik L, Meertens B. Using systems science to understand the determinants of inequities in healthy eating. PLoS One. 2017 Nov 30;12(11):e0188872. doi: 10.1371/journal.pone.0188872. PMID: 29190662; PMCID: PMC5708780
  11. Cockerham WC, Hamby BW, Oates GR. The Social Determinants of Chronic Disease. Am J Prev Med. 2017 Jan;52(1S1):S5-S12. doi: 10.1016/j.amepre.2016.09.010. PMID: 27989293; PMCID: PMC5328595.
  12. Howse, E, Crosland, P, Rychetnik, L, Wilson, A. The value of prevention: An Evidence Check rapid review brokered by the Sax Institute for the Centre for Population Health, NSW Ministry of Health. Sydney, Australia: The Australian Prevention Partnership Centre, 2021.
  13. Wilson A, Wutzke S, Overs M. The Australian Prevention Partnership Centre: Systems thinking to prevent lifestyle-related chronic illness. Public Health Res Pract. 2014 Nov 28;25(1):e2511401. doi: 10.17061/phrp2511401 PMID: 25828440.
  14. Shiell A, Jackson H. How much does Australia spend on prevention and how would we know whether it is enough? Health Promot J Austr. 2018 Jul;29 Suppl 1:7-9. doi: 10.1002/hpja.165 Epub 2018 May 2. PMID: 29667784.