Navigating the health landscape

One of the key themes to emerge from the Forum focused on the shifting contemporary health landscape, where health care policy makers, providers and consumers are increasingly grappling with the fallout of ballooning rates of chronic diseases. The grave economic, social and personal impacts involved have driven significant debate and change, not least of which is a reorienting of the health system toward preventive health approaches, framed on a number of occasions during the forum as a welcome shift from an ‘illth' to a ‘health' based primary health care system. Central to this perspective is a major focus on how to keep communities healthy, and much comment and debate in sessions was directed at the role of general practice in driving and managing change in this context.

One aspect that came to the fore in a number of sessions was the need for individuals to take greater responsibility for their health, given the major contribution of lifestyle factors to burgeoning chronic disease. A number of debates emerged on how to motivate or 'incentivise' people to assume greater responsibility, including the use of adult learning techniques, a clever use of data at the ‘right time', looking at health insurance models and learning from the past success of immunisation incentives. However, there was also a significant focus on deeper systemic issues contributing to poor lifestyle choices, and corresponding systemic strategies to improve matters. Professor Rob Moodie identified the intersection of industry supply and consumer demand, interpolated by canny marketing strategies, as a key factor driving up the incidence of obesity and rates of alcohol and tobacco consumption. Associate Professor Ruth Colagiuri highlighted the importance of urban environmental design, and the degree to which it provides or depletes opportunities for healthy choices. Both speakers suggested that for health education programs to be effective, they need to be underpinned by key structural processes (regulation, public policy, urban design) that support people to make and maintain healthy choices in their lives. A call was extended to general practitioners to exert their considerable public standing and influence to lobby for systemic change to support improved population health outcomes. Notably, some delegates on the floor disagreed with the notion that GPs have a broader public health responsibility other than treating their patients on a one-to-one level, indicating that the debate is ongoing.