- OPINION PIECE 13 – IS HEALTH AN INDIVIDUAL RESPONSIBILITY?
The 13th PHAIWA Opinion Piece Seminar, held on Friday 31 July, provided an opportunity for three young health professionals to provide their own perspective on the complex and divisive topic, “We often hear people say that health is a personal responsibility. But is it more than that?” and how they believe it applies to the issues of obesity, alcohol consumption and gambling. With obesity and unhealthy diets now contributing to more disease and illness in Australia than smoking; alcohol misuse reported to have a total economic impact of $36 billion per annum; and problem gambling estimated to contribute 40% of gaming machine expenditure, the event captured the attention of many public health professionals and was attended by almost 50 guests.
The first presenter was Laura Hunter, a Health Promotion Research and Policy Officer from Healthway. Describing Australia as the gambling capital of the world, with an estimated 560,000 problem gamblers, Laura examined the pervasiveness of gambling in Australian sport and argued that it is difficult for individuals to gamble responsibly when they are constantly bombarded by sports betting advertisements. As televised broadcasts of sporting events are amongst the most watched television programs by children, sports betting marketing is undoubtedly influencing their attitudes towards gambling and future risk of problem gambling. Sporting codes are strongly in favour of the personal responsibility argument however, with an AFL spokesperson commenting, “Just ignore the wall-to-wall ads and don’t gamble…After all, those ads have those little ‘gamble responsibly’ messages. Just follow those”. It is clear however that industry-promoted ‘gamble responsibly’ messages are not enough to reduce the risk of problem gambling, and as Laura commented in the closing of her presentation, “Personal responsibility is an excuse for the industry to do nothing”.
Also presenting a strong argument for health as more than personal responsibility was Marc Zen from the Injury Control Council of WA. PHAIWA have always encouraged Opinion Piece presenters to engage the audience and deliver an interactive presentation, and this is something Marc definitely took on board! Introducing himself to the audience while passing around a bag of chocolates for all to share and consuming a packet of corn chips, Marc showed how decisions about the food we eat are shaped by more than hunger alone. As obesity is strongly related with food intake, Marc argued that this public health issue cannot be discussed without examining the various factors that influence people’s decisions about what they eat. Using his own Italian family as an example, he argued that food is intertwined with culture and social norms. The marketing of high-sugar, high-fat processed foods makes it difficult for people to follow a nutritious and healthy diet, with the harmful influence of this marketing evident in the rates of obesity among Australian adults and children. Marc reflected on the role of policy to regulate this marketing, closing his presentation by reflecting on the role of the health system to provide a supportive environment that makes the healthy choice the easy choice.
The final presenter was Hazel Leong from Foodbank WA. Hazel began her presentation by asking the audience if they’d ever: eaten a block of chocolate without realising; eaten way too much food at a buffet; and if they’d ever said ‘yes’ to a free drink even after already having a few too many. Hazel discussed how these decisions are all influenced by the social environment and that people are often not aware of how their choices are shaped by these external factors. Reflecting on the topic of alcohol consumption, Hazel believes that we live in a society where alcohol companies dictate our lives, with exposure to alcohol occurring at a young age, whether that be at parties, community and sporting events, or celebrations such as the annual Leavers week. Alcohol marketing is everywhere; on bus stops, public transport, social media, end of shopping dockets and even clothes. With an alcohol outlet on almost every corner, Hazel questioned how alcohol consumption can be attributed to personal responsibility alone. Citing the success of the community approach undertaken by the Alcohol Action in Rural Communities (AARC) project, Hazel concluded her presentation with a positive view for the future, “We can change our alcohol culture. Supportive environments trump individual responsibility”.
All three presenters contributed to providing a fascinating and thought-provoking session which explored many aspects of the controversial issue of personal responsibility and health. The audience engaged in a great deal of discussion at the end of the session, with many questions posed. It was evident from the session that obesity, alcohol consumption and gambling cannot be discussed without examining the impact of the broader sociocultural and environmental context. Although individuals should play an important role in maintaining their own health, they should not be held entirely responsible for it. Public health professionals must continue to advocate for a comprehensive approach to promote health and prevent disease.
- OPINION PIECE 12: MAKING AN IMPACT ON ‘SCREENAGERS’
PHAIWA’s 12th Opinion Piece was held on Friday 31 October, with 40 attendees eager to hear three up and coming Public Health leaders showcase their ideas on how health promotion may gain the attention of Gen Z (born 1995-2009). The presenters were (photos L-R):
- Rachel Murray, Keep Watch Coordinator, Royal Life Saving Society WA
- Sarah Di Cristofaro, Health Promotion Officer, South Metropolitan Population Health Unit
- Peter Martin, Preventive Health student at Notre Dame University
Hosting an Opinion Piece on Halloween is a guaranteed way for PHAIWA to encourage presenters to wear costumes!
Rachel began the seminar by commenting that “campaigns targeting Gen Z shouldn’t look like health promotion”. She demonstrated how this concept could be realised by describing a hypothetical sun safety campaign named ‘Keep Calm, Be Cool’. Through the use of an online teen panel, Facebook page, memes, Youtube, Instagram competitions and proximity messaging to young people’s mobile phones when they’re at the beach, her project tapped into young people’s image concerns by promoting the message that being sunburnt is the opposite of being “hot”.
Sarah chose to focus her campaign on using an app for young people to share ideas about the design of an obstacle course. Sarah believes that “phone, tablet & computer screens should be used in health promotion to keep kids active, instead of these screens keeping inactive”. Using an app is a strategy to educate and promote the importance of physical activity, while also providing young people with ownership of the project idea. The use of apps hold great potential for health promotion as they assist evaluation by recording the number of people using the app, numbers attending training sessions, and participation on the day of the obstacle course event.
Peter introduced his idea by outlining the importance of using appropriate celebrities to be the face of health promotion campaigns, and that for this reason Justin Beiber wouldn’t be the best choice! Peter’s campaign idea focused on body image issues faced by young people, issues which are often made worse by messages and images promoted on social media. Rather than social media reinforcing negative body image, Peter outlined how a comprehensive social media strategy could counteract this by providing a source of positive and realistic health information.
Evaluation from the event was extremely positive, with many people commenting on how impressed they were with the creative ideas described by presenters. We can be confident that the future health of Gen Z is in good hands!
The three presenters with PHAIWA Deputy-Director Dr Mel Stoneham
PHAIWA’s very own witches!
- OPINION PIECE 11: PUBLIC HEALTH & INDUSTRY
The involvement of industry in public health is the subject of much political debate and media coverage. Dr Margaret Chan, the director-general of the World Health Organisation (WHO), has urged governments to put public health before the business of ‘Big Soda’, ‘Big Food’, and ‘Big Alcohol’, and public health researchers have called for multinational food and drink corporations to be completely excluded from public health policy development due to their use of strategies which may undermine public health interventions . Industry involvement may have benefits for public health however; with the large financial contributions provided by some of these companies enabling enhanced provision of health-promoting activities such as children’s sporting activities.
This contentious issue was the subject of PHAIWA’s 11th Opinion Piece. Three up and coming public health leaders were invited to present their own personal perspective on the question, “Should public health involve industry in health-promoting programs and initiatives? If yes, what areas of industry should be involved?”
PHAIWA Deputy-Director Dr Mel Stoneham introducing the topic
Ashleigh Doig, Nutritiouslife Coordinator for Compass Group, began the session by focusing on how close the friendship between ‘Big Food’ and public health should be. She believes the friendship needs to stop for the policy development of key public health issues, such as front of package food labelling, and standards regarding the placement of foods in supermarkets. Ashleigh recognised that industry involvement in these activities would be biased by their focus on increasing sales and profits, rather than the overall benefit to public health.
Ashleigh then presented the other side to the story, stating that public health may benefit from working with industry due to the large amounts of money these companies have to invest in public health initiatives, such as McDonalds contributing $2 million dollars to Little Athletics in 2011. She described the common view that without these sponsorships children would engage in less physical activity, a worrying thought considering that only 19% of 5-19 year olds participate in the recommended 60 minutes of daily physical activity. Ashleigh cited Live Lighter’s sponsorship of the Perth Glory and Drugaware’s sponsorship of Volleyball WA as examples of ‘healthy’ sponsorships, suggesting that there are alternatives to ‘Big Food’ providing financial assistance for these activities.
The next presenter, Michael Clow, from the Chronic Disease Prevention Directorate, Department of Health WA, provided the audience with a snapshot of why he believed industry should be involved in public health initiatives. He presented the following 4-step model as an example of the typical process which occurs in the development of public health initiatives:
1. A public health issue is identified
2. Action is taken to address the issue
3. Industry becomes involved
4. Impact of the action is limited by industry involvement
Michael commented that industry will become involved regardless of public health’s intention as these publically listed companies have a legal obligation to maximise returns for their shareholders and they have large budgets, immense power and a high level of influence. He commented that industry involvement will typically limit the impact of the intervention or even delay any further action of the public health issue. Examples of this include: the tobacco industry diverting resources and delaying the Commonwealth’s action on plain packaging of tobacco by submitting a Freedom of Information (FOI) request; and the food industry modifying and delaying action on Front of Pack labelling. The traditional 4-step model therefore gives power to industry by providing them an opportunity to respond. In contrast, Michael believes industry should be involved earlier in the process so that all affected people are considered and possible responses to opposition can be planned in advance. This would provide public health professionals with greater power over the outcomes. Michael stated that this is also where lessons learnt from past experience with industry and other health issues can be applied.
The final presenter, Hannah Pierce, from the McCusker Centre for Action of Alcohol and Youth, provided the audience with a strong argument for why the alcohol industry should not be involved in public health activities. Hannah began her presentation by acknowledging the viewpoint that the alcohol industry should be involved in policies and interventions if they genuinely have something to contribute. They are the developers, producers, distributers, marketers, and sellers of the product, so isn’t it only fair that they’re at the roundtable for decisions that will impact the way their business operates, particularly given that alcohol is a legal product, and it is different to tobacco? Hannah’s view supports the public health argument that alcohol is not an ordinary commodity and when consumed immoderately or irresponsibly, alcohol can and does cause a lot of harm in our community.
Hannah commented that the alcohol industry is a for-profit industry with an obligation to create value for their shareholders through maximised profits and business growth directly linked to increased consumption of their products. She compared this maximising profit goal with public health’s goal – to promote societal health and well-being by enacting efforts aimed at preventing disease and prolonging life – demonstrating a clear conflict of interest exists. Industry will be unable to accept or implement any policies that will have a significant impact on consumption levels, and therefore profit margins. Their immediate response will be to push for targeted interventions that will do little to impact on population consumption levels, and little to change the drinking culture that causes so much harm. This response from industry is not supportive of the calls from public health groups for a comprehensive approach to reduce alcohol-related harm focusing on actions in the main areas of price, promotion and availability. By reflecting on prior examples of industry involvement, and the current positions the industry take on public health interventions, Hannah provided a strong case for why the alcohol industry should not be involved in health promoting policies or campaigns.
The excellent presenters: Ashleigh Doig, Hannah Pierce and Michael Clow
All three presenters contributed to providing a fascinating and thought-provoking session which explored many aspects of this issue. The audience engaged in a great deal of discussion at the end of the session, with many questions posed. While the session may not have found a concrete answer to whether public health should involve industry in their activities, it is clear from the audience response that public health professionals are well aware of the relevance of this issue and the need for the public health community to assert greater power over the outcomes of public health interventions to prevent industry from undermining our efforts.
Disclaimer –The above content is the personal opinion of each speaker and not of their organisation.
- OPINION PIECE 10: “IS THE OTTAWA CHARTER STILL USEFUL FOR HEALTH PROMOTION PROFESSIONALS IN 2014?
In partnership with the Australian Health Promotion Association (AHPA), the 10th Opinion Piece Seminar was held on February 28, with three up and coming Public Health leaders providing their own perspective on the usefulness and relevance of the Ottawa Charter, and explanations of why/why not they believed it should be upheld as the leading framework for health promotion.
PHAIWA Deputy-Director Dr Mel Stoneham welcoming the audience to the event
The first presenter, Lorena Chapman from the Cancer Council WA, spoke in favour of the continued use of the Ottawa Charter. Lorena stated that it is still a useful and relevant document for health promotion professionals; however as a “living document” it can only continue to lead the direction of health promotion practice and policy if it is be adapted to meet the challenges of an ever changing public health landscape. With evidence suggesting that more equal societies are healthier, Lorena explored the idea that governments may work towards reducing health inequities by focussing on the Ottawa Charter’s prerequisites for health and the social determinants of health.
Providing a different perspective was Jemma Snow from the Royal Flying Doctor Service Western Operations. Jemma questioned whether it is practical to apply all strategies from the Ottawa Charter in our everyday work, stating that : as health promotion professionals we are limited in our application of all the key Charter areas due to a lack of tools for implementation (money, staffing, resources etc.); the social environment limits healthy behaviour change; the economic climate is beyond our control; and many determinants of health lay beyond the health care system so are unchangeable by health professionals. Jemma finished her presentation by outlining the need for health promotion professionals to achieve more progress, providing the audience with a concluding point to ponder about whether the health promotion community could learn more about behaviour change by examining strategies used by the alcohol industry.
Lastly, Tom Shalders from the Royal Life Saving Society WA (RLSSWA) offered an engaging presentation, even complete with otter animal photos to link in with the Ottawa Charter theme! Tom provided a well-balanced examination of the Ottawa Charter, using his work with the RLSSWA’s Don’t Drink and Drown program to address the strengths and weaknesses of applying the Charter to real-life practice. He provided evidence of how the program employs the Charter to inform program activities, such as engaging with local communities to strength community action and develop personal skills. He also provided a great example of building healthy public policy through the introduction of legislation regarding pool fencing. Despite Tom’s portrayal as a ‘fence-sitter’ on the topic, the presentation provided a realistic examination of the implementation of the Charter and gave the audience an insight into how the Charter is currently being used to achieve health promotion goals.
Jemma Snow, Tom Shalders & Lorena Chapman PHAIWA Deputy-Director Dr Mel Stoneham with the speakers
Event and RSVP details are available in the attached flyer.
- OPINION PIECE SEMINAR 9: “IMAGINE PERTH IN 2033…WHAT KEY ACTIONS DO YOU THINK HAVE HAPPENED OUTSIDE OF THE HEALTH SECTOR TO PROMOTE WELLBEING IN WA?”
As improvements in public health for the future will require actions from outside of the health sector, the focus of PHAIWA’s 9th Opinion Piece Seminar was on the role and influence of these other sectors on wellbeing in WA. The Seminar was held on Thursday 21 November 2013 and featured three emerging Western Australian public health professionals; Catherine Walker from Compass Group, Simon Pham from the Department of Health’s North Metropolitan Health Service, and Toyah Tinworth from City of Wanneroo. Our presenters offered their perspective on the question, “Imagine Perth in 2033…what key actions do you think have happened outside of the health sector to promote wellbeing in WA?”.
PHAIWA’s Deputy-Director Dr Melissa Stoneham welcomes the audience to the seminar
Our first speaker, Catherine Walker from Compass Group, titled her presentation “The Good Corporate Citizen in 2033” and spoke about the impact of business on wellbeing. Catherine provided some innovative examples of strategies employers will use in the future such as, “yogaployment”, “googlisation”, and “corptasticness”.
Catherine believes that by 2033 the traditional concept of the workplace will no longer exist, people will instead work in unconstrained settings and timeframes, and the workplace will become a vibrant location to meet, communicate, learn and play. As a large number of Australians are engaged in employment, and the impact of the workplace also extends to their family and friends, these changes in the workplace will lead to not just happier and healthier staff, but also greater wellbeing for the entire community.
Simon Pham from the Department of Health’s North Metropolitan Health Service, discussed the role of technology in improving the future wellbeing of West Australians. He provided an insightful look into the role that social media, gaming, and portable device applications will play in changing the way people live, interact, and achieve wellbeing. Simon presented a view of WA in 2033 as characterised by online applications which will motivate us to stick to health goals by allowing us to track our health behaviours, and online interactions will be a key mode for engaging with health professionals.
Simon’s presentation identified futuristic applications for health, even exploring the concept of a driverless car. Potential harms due to the misuse of technology were also addressed, providing the audience with much to contemplate about how we can best balance these risks whilst still gaining from the immense benefits which technology may offer to our future wellbeing.
Toyah Tinworth from the City of Wanneroo, provided an excellent overview of actions at the local and community level which will improve wellbeing. She outlined how people’s behaviour is strongly linked to their local neighbourhood, and that modifying the built environment will therefore have positive carry-on effects for health and wellbeing.
Toyah’s presentation explored actions which integrated numerous sectors, outlining that professionals working within local government, urban design, planning, transport, and food supply all playing a key role. Actions which she believed will occur over the next 20 years to improve wellbeing for West Australians included: construction of a cycle network to connect people with their neighbourhood, major transport hubs and activity centres; a subsidised bus network that reduces the cost for increased use and therefore encourages use and consequently reduces cars on the road; and allocating land for leasing to community groups to develop community gardens so that each neighbourhood has the responsibility of producing fruit and vegetables to supply to local people.
The 50 people who attended the Opinion Piece learnt that it is not just the actions of the health sector which will influence the future wellbeing of West Australians. The seminar offered unique perspectives from three young public health advocates whose contributions sparked a lively debate on innovative strategies to improve wellbeing. The overarching message of the day was that as public health professionals, acknowledging the contributions of other sectors and including these groups in discussions and decisions about important public health outcomes is essential to ensuring the wellbeing of Western Australians, even in twenty years’ time!
(L-R) Toyah Tinworth, Simon Pham, Catherine Walker