Australia: the healthiest country by 2020
National Preventative Health Strategy - Overview
Prevention works; Progressive, staged and comprehensive action
Well-planned prevention programs have made enormous contributions to improving the quality and duration of our lives. The public health revolutions of the 19th century led the way, and in recent years we have seen major improvements in areas such as tobacco control, road trauma and drink driving, skin cancers, immunisation, cardiovascular disease, childhood infectious diseases, Sudden Infant Death Syndrome (SIDS) and HIV/AIDS control.
In the 1950s three-quarters of Australian men smoked. Now less than one-fifth of men smoke (see Figure 2). As a result, deaths in men from lung cancer and obstructive lung disease have plummeted from peak levels seen in the 1970s and 1980s.
Deaths from cardiovascular disease have decreased dramatically from all-time highs in the late 1960s and early 1970s to today.
Road trauma deaths on Australian roads have dropped 80% since 1970 (see Figure 3), with death rates in 2005 being similar to those in the early 1920s.
Australia’s commitment to improving immunisation levels has resulted in much higher immunisation coverage rates, eliminating measles and seeing a drop of nearly 90% in sero-group C meningococcal cases in only four years. These have come about as a result of a 34-fold increase in funding over the last 15 years.
Deaths from SIDS have declined by almost three-quarters, dropping from an average of 195.6 per 100,000 live births between 1980 and 1990 to an average of 51.7 per 100,000 live births between 1997 and 2002.[1, 19]
A study commissioned by the Department of Health and Ageing in 2003 shows spectacular, long-term returns on investment and cost savings from prevention – in tobacco control programs, road safety programs and programs preventing cardiovascular diseases, measles and HIV/AIDS. For example, this report estimated that the 30% decline in smoking between 1975 and 1995 had prevented over 400,000 premature deaths, and saved costs of over $8.4 billion – more than 50 times greater than the amount spent on anti-smoking campaigns over that period.[20, 21]
Internationally, a 2008 study, Prevention for a Healthier America, shows that for every US$1 invested in proven community-based disease prevention programs (increasing physical activity, improving nutrition and reducing smoking levels), the return on investment over and above the cost of the program would be US$5.60 within five years.
Progressive, staged and comprehensive action
The Strategy spells out key action areas in the individual obesity, tobacco and alcohol strategies. Some of these actions require new human and financial resources, some of them require enhanced regulation or legislation, while others require further evidence for progress. Many need to be scaled up at sufficient intensity, scope and duration to have a tangible effect.
Many of the actions in the Strategy have been agreed upon previously in national strategies such as Acting on Australia’s Weight, the National Alcohol Strategy 2006–2009, the National Tobacco Strategy 2004–2009 and the 1999 Wills Review of Health and Medical Research, but are yet to be fully implemented or, in some cases, implemented at all.
We have therefore designed the Strategy to focus on implementation
– a cyclical approach of ‘do, measure, report – do, measure, report
Not all approaches can or should be introduced simultaneously. In examining the Australian experience in tobacco control (Figure 2) and road trauma reduction (Figure 3), for example, it is clear that progressive, staged and comprehensive actions have been the hallmark of success.