Why don’t Australians get outraged about cuts to public health services? How can the public health sector engage better with the community and citizen groups so they understand and care passionately about the concept and importance of public health?

They are questions to be raised this morning at the opening of the 42nd Annual Conference of the Public Health Association of Australia (PHAA).

They come with the warning from PHAA President Associate Professor Heather Yeatman that public health in Australia is vulnerable under the new Coalition Government and state governments that have already made big cuts.

“We are yet to embed the importance of public health within the community psyche, so that actions by governments that cut public services generate the public derision and backlash they deserve,” she says. “At the moment cuts in public health services and programs do not even generate a whimper, let alone an uproar.”

In her opening address to the conference (see below for an edited preview), Professor Yeatman says public health advocates should question “if we are removed from our communities and how we can work with them more to increase understanding of and commitments to public health and public interest actions”.

The theme for the PHAA Conference, which will run from September 16-18, is: A ‘fair go’ for health: tackling physical, social and psychological inequality.

Journalist Marie McInerney will report from the event on behalf of the Croakey Conference Reporting Service, and is this week’s guest tweeter at @WePublicHealth.

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Here is an edited version of Associate Professor Heather Yeatman’s Presidential Address to be given to the PHAA conference this morning:

In terms of public health initiatives, over the last 12 months we’ve seen some very significant advances. We have seen the introduction of plain packaging of tobacco, the introduction of the national dental reform package  and the national disability insurance scheme DisabilityCare Australia.

As an Association we have also made significant advances. We now have an equity statement within our Constitution that will be used as a guiding principle across all our policy areas and submissions.

We have participated in the development of significant key alliances – the Social Determinants of Health Alliance, the Climate and Health Alliance and the Social Inclusion and Complex Needs Alliance.

While these are still in their infancy, they are indicative of our commitments and the potential for future action in these important areas of public health. These alliances will prove critical to our future advocacy actions, as corporate and global economic interests gain even further favour within the environment of our new government.

A new political landscape

The timing of this conference is significant. We have a different national government – one that has been particularly quiet in the area of public health policies, has an alignment with economic and industry interests and has a platform to wind back action on arresting climate change and social action such as foreign aid, as well as impacting on key policy processes through promised cuts to the public service. Add to this mix a parliamentary opposition that will require some time to ‘sort itself out’ and the wild card elements of primarily conservative independents and new small parties in the Senate.

This is clearly a time for the PHAA to be active and vocal in its stance to support social and equity policies and actions that impact on societal health outcomes. All of us need to be engaged in such actions – be it within our own communities or organisations, or within wider government policies and organisational matters. The public health agendas will be the same but we will need new and perhaps more active initiatives if we are to be successful in achieving improvements in public health outcomes.

Strategic directions

During the Annual General Meeting this week, PHAA members have the opportunity to discuss and vote on our new Strategic Plan. This document sets out a five-year vision for action. We need to be thinking and acting strategically, not just responding to others’ actions and agendas. We need to get the balance right between ensuring a strong public health position is presented when responding to key policy actions of others, and the need to initiate and lead public health policy debates.

As one small example in my own area of food and nutrition policy, this would entail deciding where to place our limited resources – for example engaging in food labelling agendas to maximise access to meaningful information for individuals and families, or pursuing a strong policy agenda around the future of the food system, based on:

  • sustainable food production
  • equity of access to culturally appropriate and healthy foods (not just processed foods that have a label)
  • building food literacy in our communities, and
  • promoting enjoyment and conviviality around food.
  • Everyone is busy, we are an organisation that primarily operates through volunteer actions – we need to be very strategic about the best way to use our limited resources.

‘Embedding’ public health in the community

One area that I believe we are yet to fully engage with is that of embedding the concept and importance of public health within citizen and community groups.

The concept of public health is very broad and difficult to grasp. Is it more public health services? Is it clean water and sewerage services? What of immunisation? Physical activity? Social rights? Environmental sustainability? The list goes on.

But what is very clear to me is that public health services, actions and workforce are very vulnerable. We have witnessed this vulnerability over the last decade, as various conservative governments have wound back or, in some cases, completely unravelled aspects of public health infrastructure and services. No doubt this will also occur with our new government.

We are yet to embed the importance of public health within the community psyche, so that actions by governments that cut public services generate the public derision and backlash they deserve. At the moment cuts in public health services and programs do not even generate a whimper, let alone an uproar. We should question if we are removed from our communities and how we can work with them more to increase understanding of and commitments to public health and public interest actions.

One factor contributing to this situation occurring is the lack of understanding of public health. Apart from ourselves, there is limited understanding of its role in underpinning everyone’s lives and the essential role of public health actions in assisting individuals, families and communities to achieve fulfilling, productive, creative and healthy lives. PHAA has a creative project underway to commence to address this issue.

Where to now?

As already mentioned, PHAA members have the opportunity to vote on our next Strategic Plan at the AGM this Wednesday. Our vision remains the same, as does our mission to be the leading public health advocacy group, drive better health outcomes through health equity and sound, population-based policy and vigorous advocacy. Many of the areas will continue as strong areas of concern and action, including:

Goal 2.1 Build international networks and capacities

This has the combined foci of strengthening partnerships with the World Federation of Public Health Associations – and we have both the current President, Professor Jim Chauvin and the current CEO, Professor Bettina Borisch with us during this week. PHAA is also very mindful of both the importance of international trade agreements on health outcomes and of Australia’s role in the region and more globally to assist in aid and humane treatment of refugees – goals that are increasingly challenged by the policies of the incoming Australian Government.

Goal 2.3 Improve Public Health Profile

Some clear strategies have been outlined.

  • advocacy for adoption of ‘health in all policies’ approaches by governments
  • appropriate use of scorecards of public health action and impact
  • effective use of social media.

So in summary, the need for public health and public health advocacy is growing and continues to be challenged by broad conservative, economically-focussed changes within society. We know what are the public health priority issues. We need to adapt to the times and consider what options are available to us to strengthen our actions, and what changes we may need to make to be effective in the ever changing political, social and economic environments in which we find ourselves.

Thinking global and acting local is still pertinent to our actions. We also need to remind ourselves of the words of (former US Surgeon General) C Everett Koop:

“Health care is vital to all of us some of the time, but public health is vital to all of us all of the time.”

Thank you – and I look forward to catching up with known and new colleagues over the coming days. Welcome and be uplifted and re-energised by the conference.

• You can track all of Croakey’s #PHAA2013 coverage here. 

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