Healthy People, Healthy Places, Healthy Planet: a Personal and Public Responsibility

1
Healthy People, Healthy Places, HealthyPlanet a
Personal and Public Responsibility

• Ruth Colagiuri
• The Diabetes Unit
• Menzies Centre for Health Policy

2
The Issue

Our health
3
Estimated global deaths by cause
Selected disease mortality, all ages, 2005
17.5 Million
7.6 Million
2.1 Million
2.6 Million
1.6 Million
1.1 Million
0.9 Million
HIV/AIDS
TB
Malaria
CVD
Cancer
Chronic Respiratory
Diabetes
Source WHO report, Preventing Chronic Disease
A Vital Investment, October 2005.
4
A very curious association
5
The globalisation of
bad ideas
6
The impact of the way we live on our planet?

• Around 10 of the worlds arable area is
  affected by serious degradation
• - 80 of the remaining arable area is degraded to
  some degree.
• there is a continuing loss of about 5-10 million
  hectares a year.

7
This is NOT sustainable!
Food insecurity
Flooding
Superbugs
Drought
Heat stress
Diabetes
Climate change
Heart disease
Cancers
Overconsumption / Waste
Chronic lung diseases
Obesity
Poverty
Mental ill health
Wars/conflict
Over-urbanisation
Air/water pollution
Aging/dependency
Over-population
Terrorism
Bioterrorism
Globalisation
8

Three main reactions to lethal societal threats

• Nihilism - eat drink and be merry for
  tomorrow..
• Fundamentalism weapons of mass destruction

• Activism - new conceptual framework
• - new order
• - hope rules

Richard Eckersley 2008 www.wfs.org
9

The Oxford Health Alliance
is a global coalition with one goal Confronting
the epidemic of chronic disease
10
OxHA Workstreams

Sydney Summit 2008 - www.oxha.org
11
The Sydney Resolution

Calls on UN Agencies, Govts, NGOs, business,
industry, academia to take urgent action to
achieve
Healthy People in Healthy Places on a Healthy
Planet

• Healthy places
• Healthy food
• Healthy business
• Healthy public policy
• Healthy societies

12
Grand Challenges for Chronic Diseases

• 20 policy and research priorities
• for conditions such as diabetes, heart disease
  and stroke

Published in Nature, 2007
13

http//www.diabetesaustralia.com.au
14
Key research questions/issues

• 1. Can type 2 diabetes be prevented and if yes
  - how?
• 2. How can people at high risk be identified?
• What population strategies are
• effective in reducing risk factors?
• 4. Is prevention cost effective and what are
  the socio-economic implications?

15
Guideline recommendations

• Social marketing should be considered as part
  of a comprehensive approach to reducing lifestyle
  risks at population level (GRADE C)
• Community-based interventions should be used
  in specific settings and target groups (eg
  schools, workplaces, womens groups) as a
  strategy for reducing diabetes risk factors
  (GRADE C)
• The impact of the built environment on physical
  activity, and food quality and availability
  should be considered in all aspects of urban
  planning and design (GRADE D)

16
Toxic urbanisation
Toxic transport
Toxic workplaces
Toxic food environment
17
What matters most in health?
Lifestyle Factors
Human Biology
Environmental Factors
Medical Care
Source Hinkle et al., CDC 1997
18
Level the environmental gradient
Source C.Bonfiglioni. Reporting
Obesity. COO, University of Sydney, 2007
19
Healthy people healthy planet

• Cant be done alone
• Needs whole of government and every level and
  aspect of society
• Must find productive, ethical, and mutually
  beneficial ways of government, public health and
  industry working together

20
There are solutions

• Start with ourselves
• Engage with our communities
• Engage and empower young people
• Partner with local organisations/agencies
• Lobby funders and decision makers
• Use your political power/community leadership
  role

• Adopt and implement the Sydney Resolution

21
Curly vs grid planing
vs
2.1 km
0.8 km
Images are same scale
Frank et al. 2003
22
Urban sprawl street layout
Neo-traditional street layout
Source Oregon Department of Land Conservation
and Development 2004
23
Copenhagen cycle paths
(Melbourne)


24

The Sydney Resolution
Signed by over 100 delegates at the 2008 Sydney
Summit and since then, formally adopted by

• The World Heart Federation
• The World Lung Foundation
• Diabetes Australia
• Diabetes New Zealand
• Australian Health Promotion Association
• Faculty of Public Health Medicine
• Public Health Association of Australia
• Nepean Division of General Practice
• and hopefully GP-NSW

rcolagiuri_at_med.usyd.edu.au
25
Always remember

• When theres no light at the end of the tunnel,
  you just have to march down there and turn the
  bloody thing on yourself

Sarah Henderson