The ten things Australia needs to do to improve health

In Australia, one in every two people has a chronic disease. These diseases, such as cancer, mental illness and heart disease, reduce quality of life and can lead to premature death. Younger generations are increasingly at risk.

Crucially, one-third of the disease burden could be prevented and chronic diseases often share the same risk factors.

A collaboration of Australia’s leading scientists, clinicians and health organisations has produced health targets for Australia’s population to reach by the year 2025.

These are in line with the World Health Organisation’s agenda for a 25% global reduction in premature deaths from chronic diseases, endorsed by all member states including Australia.

Today the collaboration is announcing its top ten priority policy actions in response to a recent health report card that identifies challenges to meeting the targets. The actions will drive down risk factors and help create a healthier Australia.

1. Drink fewer sugary drinks

One in two adults and three out of four children and young people consume too much sugar. Sugary drinks are the main source of sugar in the Australian diet and while many other factors influence health, these drinks are directly linked to weight gain and the risk of developing diabetes.

Putting a 20% tax on sugary drinks could save lives and prevent heart attacks, strokes and diabetes. The tax would also generate A$400 million each year that could be spent on much needed health programs.

2. Stop unhealthy food marketing aimed at kids

Almost 40% of children and young people’s energy comes from junk food. Children are very responsive to marketing and it is no coincidence almost two-thirds of food marketing during popular viewing times are unhealthy products.

Restricting food marketing aimed at children is an effective way to significantly reduce junk food consumption and Australians want action in this area. Government-led regulation is needed to drive this change.

3. Keep up the smoking-reduction campaigns

Smoking remains the leading cause of preventable death and disease in Australia, although the trends are positive.

Campaigns that highlight the dangers of smoking reduce the number of young people who start smoking, increase the number of people who attempt to quit and support former smokers to remain tobacco free.

4. Help everyone quit

About 40% of Aboriginal people and 24% of people with a mental illness smoke.

To support attempts to quit, compliance with smoke-free legislation across all work and public places is vital. Media campaigns need to continue to reach broad audiences. GPs and other local health services that serve disadvantaged communities should include smoking cessation in routine care.

5. Get active in the streets

More than 90% of Australian young people are not meeting guidelines for sufficient physical activity - the 2025 target is to reduce this by at least 10%.

Active travel to and from school programs will reach 3.7 million of Australia’s children and young people. This can only occur in conjunction with safe paths and urban environments that are designed in line with the latest evidence to get everyone moving.

6. Tax alcohol responsibly

The Henry Review concluded that health and social harms have not been adequately considered in current alcohol taxation. A 10% increase on the current excise, and the consistent application of volume-based taxation, are the 2017 priority actions.

Fortunately, the trends suggest most people are drinking more responsibly. However approximately 5,500 deaths and 157,000 hospital admissions occur as a consequence of alcohol each year.

7. Use work as medicine

People with a mental illness are over-represented in national unemployment statistics. The 2025 target is to halve the employment gap.

Unemployment and the associated financial duress exerts a significant toll on the health of people with a mental illness, and costs an estimated A$2.5 billion in lost productivity each year.

Supported vocational programs have 20 years of evidence showing their effectiveness. Scaling up and better integrating these programs is an urgent priority, along with suicide prevention and broader efforts.

8. Cut down on salt

Most Australian adults consume in excess of the recommended maximum salt intake of 5 grams daily. This contributes to a high prevalence of elevated blood pressure among adults (23%), which is a major risk factor for heart diseases.

Around 75% of Australian’s salt intake comes from processed foods. Reducing salt intake by 30% by 2025, via food reformulation, could save 3,500 lives a year through reductions in heart disease, stroke and kidney disease.

9. Promote heart health

Heart disease is Australia’s single largest cause of death, and yet an estimated 970,000 adults at high risk of a cardiovascular event (heart attack or stroke) are not receiving appropriate treatment to reduce risk factors such as combined blood pressure and cholesterol-lowering medications. Under-treatment can be exacerbated by people’s lack of awareness about their own risk factors.

National heart risk assessment programs, along with care planning for high-risk individuals, offer a cost-effective solution.

10. Measure what matters

A comprehensive Australian Health Survey must be a permanent and routine survey every five years, so Australia knows how we are tracking on chronic disease.

All of these policies are effective, affordable and feasible opportunities to prevent, rather than treat, Australia’s biggest killer diseases.

Rebecca Lindberg works for the Australian Health Policy Collaboration.

Kevin Mc Namara receives funding from the Department of Health, and has previously received funding from the National Heart Foundation of Australia, for preventative health research. Kevin Mc Namara is rapporteur for an Australian Health Policy Collaboration working group, and a member of Standards Review Group Subcommittee F developing pharmacy practice standards around screening and risk assessment on behalf of the Pharmaceutical Society of Australia.

Sharleen O'Reilly receives funding from National Health and Medical Research Council.