SUPPLEMENT 3 May 2021 Volume 214 No 8 www.mja.com.au Australia in 2030 What is our path to health for all? PP255003/00505 Approved Post Print Journal of the Australian Medical Association MJA2_v214_s8_cover.indd 1 4/16/2021 7:14:53 AM Australia in 2030: what is our path to health for all? Coordinating Editors: Dheepa Jeyapalan, Lewis Keane and Cara Büsst This Supplement was sponsored by Citation: Backholer K, Baum F, Finlay S, et al. Australia in 2030: what is our path to health for all? Med J Aust 2021; 214 (8 Suppl): S1-S40; doi: 10.5694/mja2.51020 MJA2_v214_s8_Title.indd S1 4/19/2021 12:44:26 PM Australia in 2030 Contents S5 Our path to health for all: Australia in 2030 Jane Shill, Cara Büsst, Kellie Horton, Kirstan Corben, Sandro Demaio S7 1. How Australia improved health equity through action on the social determinants of health Sharon Friel, Fran Baum, Sharon Goldfeld, Belinda Townsend, Cara Büsst, Lewis Keane S12 2. Aboriginal and Torres Strait Islander connection to culture: building stronger individual and collective wellbeing Summer M Finlay, Karla Canuto, Kootsy Canuto, Nadia Neal, Raymond W Lovett S17 3. Physical determinants of health: healthy, liveable and sustainable communities Billie Giles-Corti, Anthony Capon, Annemarie Wright, Patrick Harris, Anna Timperio, Andrew Butt, Melanie Lowe, Belen Zapata-Diomedi, Carmel Williams, Tahna Pettman, Lucy Gunn S22 4. Health promotion in the Anthropocene: the ecological determinants of health Rebecca Patrick, Fiona Armstrong, Anthony Capon, Kathryn Bowen, Selina N Lo, Aileen Thoms S27 5. Disrupting the commercial determinants of health Alexandra Jones, Jennifer Lacy-Nichols, Phil Baker, Anne Marie T Thow, Jane E Martin, Mike Daube, Kathryn Backholer, Belinda Townsend S32 6. Digital determinants of health: the digital transformation Kathryn Backholer, Jennifer Browne, Annemarie Wright, Robert Grenfell, Anna Peeters S36 7. Governance for health and equity: a vision for our future Fran Baum, Sharon Friel, Phil Baker, Kathryn Bowen, Cara Büsst MJA 214 (8 Suppl) MJA 214 (8 Suppl) • 3 May 2021 S3 MJA2_v214_s8_Toc.indd S1 4/19/2021 9:32:16 AM A u s t r a l i a i n 2 0 3 0 O u r p a t h t o h e a l t h f o r a l l : A u s t r a l i a i n 2 0 3 0 J a n e S h i l l1 , C a r a B ü s s t1 , K e l l i e H o r t o n1 , K i r s t a n C o r b e n1 , S a n d r o D e m a i o1,2 e currently have a once- in- a- generation opportunity Coordinated and sustained action is required across multiple sec- to reimagine life and health in Australia. The global tors, settings and all levels of government if we are to truly address W coronavirus pandemic has highlighted many public these determinants and make gains in improving the health and health issues, bringing public attention and a sense of priority to wellbeing of all Australians over the coming decade. Appropriate protecting and promoting wellbeing. action will also undoubtedly result in co- benefit for planetary health, which remains one of the greatest human health concerns. 10 All Australians have the right to access the resources and envi- ronments necessary for a long and healthy life. Yet many in our This supplement explores some of the critical opportunities that community face multiple barriers to achieving good health and we need to focus on now to improve the health and wellbeing wellbeing. For example, we live in a country where: of all Australians over the coming decade. Chapter 1 takes us on a journey to 2030 where the status quo has been challenged • one in eight Australians, including one in six children, live in and replaced with progressive, committed and genuine action to poverty and cannot afford necessities such as healthy food, address the social determinants of health. Chapter 2 challenges clothing, education and health care; 1 our understanding and acknowledgement of culture as a key • inequitable access to supportive walking and cycling in- determinant of Aboriginal and Torres Strait Islander health and frastructure, greenspace, community infrastructure and wellbeing. A call for collaborative and urgent evidence- based ac- transport options limit opportunities to live a healthy and tion to address urban planning for both human and planetary prosperous life; 2- 4 and health is made in Chapter 3. Chapter 4 explores the ecological determinants of health, presenting threats to and opportunities exposure to the marketing tactics of the alcohol, gambling and • for public health and health promotion. The commercial deter- unhealthy food and drink industries negatively influences minants of health and options for countering the negative prac- perceptions and behaviours across the life course. 5- 8 tices of the private sector are discussed in Chapter 5. In Chapter The pandemic has affected every Australian; however, research 6 we look at the implications of the digital revolution for public highlights that the impacts have occurred inequitably across the health. Finally, in Chapter 7 we again fast forward to 2030 where community. For example, in Victoria during the second wave transformative change in governance has occurred to achieve of restrictions, one in four Victorians receiving JobSeeker or health, sustainability and equity outcomes and, ultimately, a bet- JobKeeper government payments experienced high psycholog- ter Australia. ical distress, compared with one in six people overall; and one The supplement outlines a bold vision for the future of health in ten Victorians aged 18– 24 years ran out of food and could not and health promotion in Australia. A vision that will be vital afford to buy more, compared with one in 20 people overall.9 for a healthy, equitable and prosperous Australia in the decade to come. A vision requiring brave, bold and effective leadership. Now is the time to rethink our vision for health and wellbeing, The time to act is now. As you read through the chapters that aiming for a state of health for all, where every Australian has make up this supplement, we challenge you to consider what equal opportunity to realise their full potential by 2030. For this you can do now to ensure health for all Australians by 2030. vision to be realised, we need to accelerate action that focuses on the multiple, complex and often intersecting determinants of Acknowledgements: This supplement was funded by the Victorian Health Promotion Foundation (VicHealth). VicHealth is a pioneer in health promotion. It was established health, and harness opportunities that offer progressive policy by the Victorian Parliament as part of the Tobacco Act 1987 and has a primary focus on and practice change. promoting good health for all and preventing chronic disease. The chapters in this supplement outline a post- pandemic path- Competing interests: No relevant disclosures. way to health for all, focusing on issues and opportunities relat- Provenance: Commissioned; externally peer reviewed.႑ ing to the social, physical, cultural and commercial determinants of health as well as the increasingly recognised and understood How to cite this editorial: Shill J , Büsst C , Horton K , et al. Our path to health for all: fields pertaining to the ecological and digital determinants of Australia in 2030 . Med J Aust 2021 ; 214 ( 8 Suppl ): S5-S6 . health — all of which influence the environments in which we live, work, play, grow, learn and age. © 2021 AMPCo Pty Ltd MJA 214 (8 Suppl) 1 D a v i d s o n P , B r a d b u r y B , W o n g M . P o v e r t y i n environment on early child health and and walking for transport in Brisbane, Australia . Australia 2020: Part 2: Who is affected? ACOSS/ development: a review and call for research . Environ Health Perspect 2018 ; 126 : 057003 . UNSW Poverty and Inequality Partnership Health Place 2 0 1 5 ; 3 3 : 2 5 – 3 6 . 5 W h i t e V , A z a r D , F a u l k n e r A , e t a l . A d o l e s c e n t s ’ Report No. 4 . Sydney : ACOSS , 2020 . http://pover 3 M u r p h y M , B a d l a n d H , J o r d a n H , e t a l . L o c a l f o o d exposure to paid alcohol advertising on tyand inequ ality.acoss.org.au/wp- conte nt/uploa environments, suburban development, and BMI: television and their alcohol use: exploring ႛ ds/2020/05/Pover ty- in- Austr alia- 2020- Part- a mixed methods study . Int J Environ Res Public associations during a 13- year period . Addiction 3 May 2021 2 - % E 2 % 8 0 % 9 3 - W h o - i s - a f f e c t e d _ F i n a l . p d f Health 2018 ; 15 : 1392 . 2 0 1 7 ; 1 1 2 : 1 7 4 2 – 1 7 5 1 . (viewed Oct 2020). 4 B e n t l e y R , B l a k e l y T , K a v a n a g h A , e t a l . A 6 P i t t H , T h o m a s S L , B e s t m a n A , e t a l . F a c t o r s 2 C h r i s t i a n H , Z u b r i c k S R , F o s t e r S , e t a l .