Australia: the healthiest country by 2020
National Preventative Health Strategy - Overview

3. Engage communities

|TOC|next page

Local communities

There are many organisations, associations, businesses and individuals who contribute greatly to healthy community life. During the consultations, we discovered a great deal of excellent work across the three areas of obesity, tobacco and alcohol.

Local governments set and drive policies and programs, taking national and state policies to the local level and designing programs that are relevant to community need. They have the capacity to engage with people in the community, are essential sources of information and contribute to building health literacy in the community.

Chambers of Commerce engage with local business, and can reinforce and support consistent healthy policy and business practices throughout communities. Employers can provide healthy workplace programs (see below).

Schools, childcare and after-school programs can implement healthy food policy (for example, in canteens) and physical activity programs (see below).
Sporting clubs, gyms, exercise classes, walking and cycling groups provide opportunities for adults and children in the community to participate in sport and recreation.

Urban planners design environments that create healthy towns and other localities, ensuring play spaces for children, cycle paths linking home with work and schools, and road infrastructure that encourages the use of public transport.

The food industry sells its products through the retail sector in the local community, and can make a major contribution in making sure healthy food choices are easy choices for people in the community.

The police, welfare agencies and justice system play a vital role in prevention and early intervention in alcohol-related issues – and support the hospitality industry and the local community in ensuring safe and responsible drinking in public places.

Health services, especially in the primary healthcare sector, provide services, information and support on prevention and management of overweight and obesity and low-risk drinking, and assist with prevention of smoking and support for tobacco cessation.

Large community-based trials, backed by rigorous evaluation and research efforts, are required to guide us on what prevention approaches work best in local communities in Australia. Given the fact that Indigenous and low SES populations suffer the worst health and have the highest levels of unemployment, a number of these trials must therefore initially be carried out in low SES and Indigenous communities.

The importance of the workplace

There are an estimated 11 million Australians in workplaces, and approximately 70% in full-time employment.

With the growth of the knowledge and services sector, technological changes in the workplace environment, increased car dependence and the decline of manual work, it is common for most individuals to spend at least half of their waking day sitting and being inactive. Self-reported measures of sedentary time have been shown to be significantly associated with metabolic risk, independent of structured exercise taken.[32] This is an area where small but widespread changes could yield significant health improvements.

There is a growing evidence base demonstrating the efficacy and cost effectiveness of workplace-based programs.[33] In addition to the health benefits for individual workers, workplace health programs can produce a range of benefits, such as decreased illness and absence, reduction in the rate of early retirement due to ill health, improved productivity and a reduction in occupational injury and workers compensation claims.

A large number of studies now point to the economic return on investment that can accrue through investments in employee health programs, with the average rate of return estimated at between 2:1 and 5:1.

An increasing body of evidence indicates that programs which integrate intervention on ‘lifestyle’ health behaviours and working conditions are more effective in protecting and improving worker health and wellbeing than more isolated or single issue programs.[34] While often harder to implement, the studies suggest that these programs:

• Attract higher participation rates
• Are more effective at changing health behaviours
• Prevent chronic disease by improving working conditions as well as health behaviours[35]

Australian governments have taken a renewed interest in workplace health promotion to address the growing burden and associated healthcare costs of chronic disease. The Victorian Government launched its WorkHealth initiative in 2008, and the COAG National Partnership Agreement on Preventive Health has allocated $290 million to fund states and territories to facilitate delivery of healthy living programs in workplaces. Also under the Agreement, the Australian Government will develop a national healthy workplace charter with peak employer groups.

As indicated in the key action areas outlined previously, the Taskforce believes there is a major opportunity to build on and strengthen this momentum. Examples include:

• Establishment of a national accord to establish best practice in workplaces including protecting privacy of employees, workplace risk monitoring, risk assessment or risk modification programs
• Developing a voluntary industry scorecard, benchmarking and award scheme for workplace health
• Establishment of nationally agreed accreditation standards for providers of workplace health programs
• Generating a national action research project to strengthen evidence of effective workplace health promotion programs in the Australian context
• Developing a national workplace health leadership program and a series of resources, tools and best practice guidelines, through the NPA
• Commissioning a review of potential legislative changes to promote the take-up of workplace health programs.

Schools, childcare, out of school hours care and tertiary institutions

The national syllabus provides students with formal education about a range of health issues, including alcohol, tobacco and other drugs, nutrition and physical activity, as well as physical education and sports programs in schools. However, opportunities to promote health in this setting must extend far beyond the curriculum.

All schools can promote good health and wellbeing through their policies, programs and environments. We need to create school environments that are supportive of good health, and in particular promote healthy eating and adequate physical activity, by providing programs and services that build skills and knowledge, and reach people in need.

There are a number of approaches that schools can adopt, including:

• Providing adequate time for sport and recreation within school time
• Training and supporting teachers to teach physical education and sports, and to motivate and inspire children to engage in physical activity
• Encouraging children to walk or cycle safely to school
• Encouraging tap water in preference to high-energy drinks, and implementing healthy school canteens
• Providing access to school sports and playing fields to the broader community outside of school hours
• Supporting and encouraging parental efforts to promote healthy eating and physical activity, and to limit time spent watching television and playing computer games

The current approaches already being implemented at state and territory level must become a strong national approach in order to embed health and wellbeing, physical activity and healthy eating in all schools.

Out of School Hours (OOSH) care is also an important setting for preventative health. Increasingly, children are being cared for before and after school by these services due to parental work commitments. OOSH care provides a great opportunity for children to be active in a safe and supervised environment.

Childcare services provide care for children under six years prior to entering school. There is a range of legislative and policy frameworks governing the quality and standards of care that incorporate policies and programs around health, safety and nutrition. Providing quality care for young children, supporting parents and linking to health services as required ensures that childcare centres can play a role in ensuring children have a healthy start to life.

There are many very large tertiary institutions across Australia that act as educators of the preventative health workforce of the future, as employers, as leaders and as providers of a range of retail (food, alcohol and tobacco) services and activity programs. They have the opportunity to provide workplace health promotion programs for their staff, maximising the sale of healthy foods on campus, providing on-line alcohol and drug prevention programs, providing incentives for students and staff to participate in sport and active recreation, to use active transport and, finally, to ensure that future primary and secondary teachers, as well as health workers, are equipped and confident to promote health in their day-to-day work.

|TOC|next page