VCOSS recently published its 2016-17 State Budget Submission: Putting people back in the picture. A series of blogs will examine some of the proposals in the submission.
VCOSS’ 2016-17 State Budget Submission: Putting people back in the picture recommends the Victorian government improve people’s health by investing in preventative programs, including Healthy Together Victoria.
It is far more efficient and effective to invest in preventative health programs than to treat later consequences of health issues presenting in hospitals. Victoria’s health system would benefit from a greater focus on preventing disease and poor health and building healthy communities, as well as managing disease.
Prevention initiatives improve the conditions and environments where people live, and tackle the risk factors that can lead to poor health. Good health across the community can be achieved if the basic, social factors that lead to poor health are also addressed. This includes access to safe and affordable housing, education, adequate and secure income, employment, or meaningful daily activity, social connections and food security, to achieve and maintain good health.
In recent years Australia has invested a lower proportion of its health expenditure in preventative health than most other OECD countries. In 2014, the federal government terminated the National Partnership Agreement on Preventive Heath (NPAPH) four years early. As a result, many successful programs are being forced to wind up, including those funded through the Healthy Together Victoria program.
Many preventative health programs tackle the growing rate of chronic disease. Chronic diseases are significant contributors to illness, disability and premature death, causing nine out of 10 Australian deaths. It is anticipated that the rate of chronic disease in the community will continue to grow, and the health system will struggle to cope.
The burden of chronic disease falls particularly on communities already facing disadvantage, including people on lower incomes and people in rural and regional areas.
Australians aged 25-44 in the lowest socioeconomic group are nearly five times more likely to have a chronic health condition as those in the highest.
Preventative interventions aimed only at modifying individual lifestyle and behavioural risk factors associated with chronic disease, like smoking and alcohol use, have limited success. This is because lifestyle choices are made within the social, cultural and economic contexts in which people live, work, and play. For example, obesity is often considered a result of individual behaviours. But food choices depend on a balance of factors, including access to affordable and nutritious food, trends in portion sizes, marketing and advertising of unhealthy foods, understanding of food labelling, and increased access to fast-food and highly-processed foods.
In our submission to the Health 2040 consultation, VCOSS recommended a broad approach to prevention that recognises addressing community level risk factors and the social determinants of health most effective at preventing chronic disease and keeping people well in the community.
Primary care providers, community health services, local government and other community organisations are all important partners in this approach.
In 2015 the Victorian government released its Public Health and Wellbeing Plan 2015-19 with the vision of “a Victoria free of the avoidable burden of disease and injury, so that all Victorians can enjoy the highest attainable standards of health, wellbeing and participation at every age”.
VCOSS welcomes this vision, and the overarching aim of the plan to reduce inequalities in health and wellbeing. The plan identifies three core strategic directions:
- promoting health and wellbeing across six priority areas: healthier eating and active living; tobacco free living; reducing harmful alcohol and drug use; improving mental health; preventing violence and injury and improving sexual and reproductive health
- focusing on improvements in health and wellbeing across all stages of life
- delivering platforms for change including healthy and sustainable environments, place-based approaches, and people-centred approaches.
This plan, provides an opportunity to increase Victoria’s commitment to preventing disease and poor health and building healthier communities. In the upcoming 2016-17 budget, the Victorian government can begin implementing the plan by further investing in programs that tackle health inequities and address risk factors for chronic disease and poor health.
In addition to increasing investment in preventative health programs, the VCOSS State Budget Submission 2016-17 also calls on the government to:
- Provide capital investment to help community health services meet the needs of Victoria’s growing population
- Enhance population health planning capacity
- Give community organisations the tools to help vulnerable people quit smoking
- Provide a culturally safe health system for Aboriginal people by developing a ‘cultural safety strategy’.
 NATSEM, Health lies in wealth: Health inequalities in Australians of working age, Report No 1/10, September 2010, p. x.
 Provincial Health Services Authority, Towards reducing health inequities: A health system approach to chronic disease prevention, Canada, 2011.
 Mitchell Institute, Chronic disease in Australia: the case for changing course, 2014, p 12.