The focus in recent years on runaway health costs ignores one important fact: most of the illnesses that are threatening the sustainability of our health system can be prevented.
Chronic disease is Australia’s greatest health challenge. According to the Australian Institute of Health and Welfare (AIHW), half of all Australians – more than 11 million of us – have at least one long lasting, incurable disease such as arthritis, cancer, respiratory disease, cardiovascular disease or diabetes. A quarter of us have two or more.
These diseases are the leading cause of premature death and disability in Australia and affect how millions of us live and work every day. Yet as many as 80% of all heart disease, stroke and type 2 diabetes and 40% of cancers could be prevented if known risk factors such as smoking, harmful alcohol consumption, obesity and physical inactivity were eliminated.
That’s why it’s significant that one of the first disbursements of the Medical Research Future Fund (MRFF) is for research into the prevention of chronic disease – funding that could transform the way we think about prevention, lead to innovation in public health, and ultimately improve lives.
The Budget announced $10 million over four years for The Australian Prevention Partnership Centre, a national research collaboration based at the Sax Institute that brings together researchers, policy makers and practitioners from across Australia to find smarter ways of preventing chronic disease.
This funding will enable the Prevention Centre to scale up our work and generate sustainable, evidence-based solutions that will support Australians to live more active, healthy lives, prevent disease, and keep people out of hospital.
Beyond personal responsibility
Since the Prevention Centre was first funded by the NHMRC and others, it has grown to comprise more than 150 individuals from 28 agencies across Australia. All of our 37 projects involve academics working collaboratively with the end users of their research − policy makers − to accelerate the translation of evidence into policy and practice.
This partnership approach is a highly innovative attempt at reducing the risk factors for chronic disease. We are not only working together, but looking at the whole system that influences people’s health decisions. Our work recognises that there are many factors that affect people’s health, and that intervening in one area of people’s lives might have unexpected consequences in another.
For example, there are numerous research projects in Australia trying to find ways of addressing the urgent problem of childhood obesity. Our contribution has been to pull these many strands together – to look at factors like access to fresh food and a built environment that supports physical activity so we can inform a coordinated plan for governments, communities and individuals to work together and make a difference. It’s not much use teaching children what to eat if all that’s available is fast food and there’s no place for them to kick a ball.
We have developed sophisticated computer models to support decision making for complex population health problems and we are looking at the value of behavioural economics to ‘nudge’ people to make better lifestyle choices, for example by giving people financial incentives to maintain weight loss after they have been on a diet.
The MRFF funding will allow our work to scale up. For example, we will focus on how to create smart, liveable and connected communities in which different people and organisations come together with a shared agenda to prevent chronic disease.
Other work will address risk factors for at-risk populations like Aboriginal and Torres Strait Islander communities, and how risk factors for chronic disease such as obesity and smoking influence the development of dementia and change the health outlook for our offspring.
An important element of our work will involve looking at new approaches to increasing physical activity and identifying its role in the prevention system. Our research will understand how much governments need to do to make a difference to health, and help them to implement effective programs at population level.
Chronic disease is a highly complex, ‘wicked’ problem. That’s why we need to be smart and united about the solutions to this issue. Understanding how the many causes interconnect and influence each other is necessary to show us where and when we should intervene to create change.
This funding will allow the Prevention Centre, and others working in the field of prevention, to understand what works and what doesn’t when it comes to preventing chronic disease. The MRFF was designed to disrupt and innovate, and the funding for prevention is fulfilling that purpose. The results will benefit us all.