OPINION

A health election? If so, what's absent is serious national disease prevention

So far at least, we're in an election campaign largely about health. That's a good thing.

The Coalition has announced some measures on mental health, although not transformative, as part of its otherwise small spending budget. Labor is offering more, focusing on cancer with promises to reduce out-of-pocket costs for cancer patients.

These efforts are no doubt very welcome, but doing more to prevent cancer and mental health problems occurring should be a high priority. The emphasis needs to shift from diagnosis and treatment to prevention.

More investment is needed in preventative health initatiaves.

More investment is needed in preventative health initatiaves.

We have a mountain to climb. We are seeing increases in chronic diseases, cancer, heart disease, diabetes, kidney disease, stroke dementia and more. This is largely due to more people getting older because we are doing better in safety (for example, in transport) and treating acute health problems more successfully.

So we'll have to manage, and find money to pay for, more older people being diagnosed with chronic diseases that are caused by largely preventable factors.

Smoking rates are still over 10 per cent, despite 50 years of strong tobacco control. The Coalition announced $20 million in the April budget for an "anti-smoking campaign over four years". It's light-on but a start. Labor has committed double that.

Labor has also pledged $8.6 million for a skin cancer prevention campaign over two years and $10 million to boost participation in bowel cancer screening. So, there are signs that there is some recognition of the value of investing in prevention rather than exclusively focusing on cure.

Further, the federal ALP is offering positive measures aimed at giving at-risk Aboriginal and Torres Strait Islander communities greater control of their health. On Easter Thursday it announced a $115 million plan to tackle youth suicide, rheumatic heart disease, vision loss, hepatitis C and poor nutrition with an emphasis on health awareness and promotion to close the gap.

The Coalition has committed $15 million for a youth suicide program aimed at Aboriginal people and $35 million for research on a rheumatic heart disease vaccine.

But to put all of this in perspective, as a nation, prevention efforts remain piecemeal and a very modest part of the overall investment in our health.

Most are shocked to learn that less than 2 per cent of Australia's health funding goes to anything under the banner of public health, with prevention efforts being a modest subset of that 2 per cent.

For every $50 we spend on health, less than $1 is spent on aiming to keep us healthy. It is unsustainable and makes no sense. It would be far more efficient to spend more on prevention.

Conspicuous by its absence - at least as of the time of writing - is any announcement by any party, to do anything substantial about two of the major drivers of ill health in Australia, obesity and alcohol consumption.

As a nation, prevention efforts remain piecemeal and a very modest part of the overall investment in our health.

A whopping 42 per cent of Australian adult men are overweight, and an additional 28 per cent are obese. For women the numbers are less dramatic but still a worry.

Put another way, less than a third of men and less than half of women are in the healthy weight range. And we are paying the price.

This is contributing to more asthma, cancer, dementia, diabetes, gout, osteoporosis, back pain and diseases of the kidney, heart and gallbladder. An increasing number of health problems are due to being too fat and costs are ballooning.

Then there's a chunk of health problems due to excess alcohol consumption. Alcohol is linked to immediate problems, including accidents, injury, violence and crime as well as chronic diseases like cancer, heart disease, mental health problems and more. While the drinking trends for under 45-year-old are heading in the right direction, older people are drinking more. One in every five adults is drinking at risky levels.

And like most health issues, those most vulnerable, those people with the least resources or capacity to look after their own health or push back against forces promoting ill health, are over represented in the disease and death statistics.

With alcohol and obesity accounting for more than one in 10 health problems we have seen precious little committed to address them in the wider community.

Could that be considered a win for those who run businesses who sell alcohol and unhealthy food? Have these industry sectors blunted any government efforts to make a real difference in these measures? I have watched it happen up close.

If this truly is to become the health election, let's hope over the next few weeks we can see some movement, by both sides of politics, in the direction of prevention. A target of investing one in every 20-health dollars into prevention is a common-sense benchmark.

This is about our future; not burdening our young people to premature ill health. Everyone wants to save the life of someone they love. Critically ill family and friend tug at our heart strings - and they should.

But we need to think ahead and help those close to us before they get diagnosed with cancer, mental health problems or chronic diseases linked to obesity. Those diseases, those affected lives, are just as real and just as important.

  • Terry Slevin is the chief executive officer of the Public Health Association of Australia based in Canberra.