Academic journal article Australian Health Review

What Will It Take to Improve Prevention of Chronic Diseases in Australia? A Case Study of Two National Approaches

Academic journal article Australian Health Review

What Will It Take to Improve Prevention of Chronic Diseases in Australia? A Case Study of Two National Approaches

Article excerpt

Introduction

Australia is, by international standards, a very healthy country.1 But this status is increasingly at risk from the growing epidemic of chronic diseases that affect almost half of all Australians2 and are responsible for 85% of the total burden of disease.3

In efforts to control the increasing burden of chronic diseases, including heart disease, stroke and heart failure, chronic kidney disease, lung disease and Type 2 diabetes, the Australian Government has over the past decade released several strategies, including the Australian Better Health Initiative,4 Type 2 Diabetes Initiative5 and the National Healthcare Agreement,6 all of which fundamentally aimed to improve health outcomes and reduce pressure on the Australian health system. Several strategies specifically focusing on prevention were also released over this period, including, but not limited to, Eat Well Australia (EWA): An Agenda for Public Health Nutrition 2000-2010,7 National Tobacco Strategy 2004-2009: The Strategy,8 Be Active Australia: A Framework for Health Sector Action for Physical Activity 2005-20109 and Healthy Weight 2008 - Australia's Future: The National Action Agenda for Children and Young People and Their Families.10 Importantly, across this period two large-scale national initiatives, the National Chronic Disease Strategy (NCDS)11 and the National Partnership Agreement on Preventive Health (NPAPH),12 were also released, both with overarching, country-wide approaches to addressing chronic disease.

The current landscape of national preventive health strategy and action looks comparatively bare compared with previous years. Arguably, the NCDS has lost currency and programs made possible through the NPAPH have lost momentum or ceased following its cancellation in 2014. However, chronic diseases remain Australia's greatest health challenge.13 As such, the current Australian Government is embarking on a new national strategy for chronic diseases.14

To ensure current, planned and future population preventive health initiatives, including the new national strategy, are informed by past experiences, it is important to better understand how the previous NCDS was used, whether it was relevant and whether it informed governments across Australia. In addition, it is important to consider how the NCDS and the NPAPH may have worked together as two different but complementary approaches to chronic disease prevention.

By analysing the NCDS and the NPAPH as a case study of national approaches to driving the preventive health agenda in Australia, the purpose of the present study was to explore the views of practitioners, policy makers, advocates, thought leaders and researchers with regard to: (1) the significance of the 2005 NCDS and its potential for achieving improvements to the prevention of chronic disease; (2) the approach to future national chronic disease strategies; and (3) the significance of the NPAPH and its potential for achieving improvements to the prevention of chronic disease.

Methods

Data collection consisted of individual and small group semistructured interviews undertaken by an independent consultant recruited to minimise potential bias due to existing professional relationships between the research team and respondents. Published standards for designing, undertaking and reporting qualitative research guided the methods and reporting of the research, including elements such as who the research team were, what the context of the study was, how participants were recruited, the use of a discussion guide and the reporting of quotations in the results.15

Participants were recruited using a combination of purposive and snowballing sampling techniques, whereby invitees were individually identified by the research team on the basis of their likely ability to provide an informed contribution to the study, or to nominate other suitable candidates from their organisation. Participants included senior public health managers and program implementation staff from state and territory health departments senior academics; as well as thought leaders and public health advocates from key agencies across the country. …

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