There is a very strong need in our community for a refreshing whole-of-government approach to confronting the major health issues of our day. This starts with the recognition that many of our political institutions were developed for an Industrial Age era, where a silo approach to delivering policy, exacerbated by a federated service delivery model, is no longer capable of dealing with the most pressing health issues of our time. These include the unconstrained tragedy of preventable non-communicable disease proliferation; which, according to a PwC study commissioned by Australian Unity, will be unsustainable in Australia as early as 2025.
The PwC report Practical innovation: closing the social infrastructure gap in health and ageing, paints a very sorry picture of the inadequacy of resources and political understanding and leadership as Australia’s population rapidly ages, calling for the need for a “truly holistic approach to health and wellbeing, this should cover all aspects of government, not just be restricted to health”.
There is a particular need for a major governmental shift from a predominantly reactive mindset, which is focused on dealing with crises after they have happened; to a preventative mindset, i.e. finding ways to dealing with the causes at their root. This is further complicated by the fact that attempting any major reform in health is a very risky political proposition which needs to be fashioned beyond electoral cycles or territorial dysfunction.
As a co-founder of a preventative health promotional NFP organisation called the Cognercise Foundation, I am looking to do something about the spread of non-communicable disease. Comprised of like-minded thinkers, our Foundation is also wanting to focus discussion on the need for a more coordinated preventative approach supported by all our institutions.
We see it as unacceptable that; according to Associate Prof. Michael Murray, President of the National Ageing Research Institute, “people are arriving at geriatric hospitals with preventable chronic conditions earlier in life and with more advanced vascular risk factors than ever before”. It is increasingly evident that our ageing population, which although living longer, is now more likely to prematurely suffer from preventable chronic medical conditions, disability and dependency than at any time in our history.
Moreover, Emeritus Professor John Dwyer, who tirelessly campaigns for a National Health Reform Commission (P&I, July, 2018, et al), estimates that more than 650,000 admissions per annum (75%) to our Australian hospital system, could be avoided if we kept treatment of chronic diseases at the primary or community care level and took more preventative care.
Increasingly, we believe that a large part of the responsibility for our looming health crisis is due to the disconnection between our health system and our education system. Put simply, our population is not being sufficiently well educated or inspired from a young enough age to consistently and proficiently manage their own functional health and wellbeing. As a result, they are more susceptible to chronic disease, disability and dependency through poor lifestyle choices such as physical inactivity, increasing obesity and metabolic risk. We believe these awful outcomes can, and must, be stemmed through improved understanding of the causes and the application of emerging concepts like Functional Wellbeing to help prevent them.
Functional Wellbeing is a means by which individuals can be demonstrably self-empowered to meet the physical, mental and social challenges of life through better coordination of mind and body and a process of lifetime learning. We know that effective solutions on an individual level exist, but there are few effective government interventions in place anywhere in the world.
The good news is that we are greatly encouraged that Australia may be leading the way. The first “green shoots” of Functional Wellbeing are being witnessed in the emerging concept of Physical Literacy, recently publicly supported by the Federal Sport Minister.
As a first step, we applaud the work on Physical Literacy, which has been led by Sport Australia, through their engagement of a committee of academics focused on the four domains of Physical, Psychological, Social and Cognitive health and the inter-relationship necessary to develop a holistic lifelong learning approach to health and wellbeing. Their Draft Australian Physical Literacy Standard Definition, complete with valuable work on the essential elements within each domain, is thoroughly commendable and provides a fine base on which our health and education systems can potentially be integrated to promote Functional Wellbeing.
Some very positive encouragement for the concept of embedding Physical Literacy within education environments was enthusiastically backed by the Federal Minister for Sport, Bridget McKenzie, in mid–July this year. Minister McKenzie has publicly stated that “sport would be compulsory in schools under a federal government push to make Australian children physically literate, healthier and performing better in class”. She has stated that the government plans to lobby the states for mandatory physical education in schools.
We are under no illusions as to the enormity of this task given the federated nature of our education delivery system. We believe that Sport Australia’s promotion of Physical Literacy, through what we call small “s” sport (i.e. de-emphasising intense competition and elitism), is on the right track by encouraging self-empowered Functional Wellbeing as a universal concept.
The time has come for action on changing the emphasis of our health system from a reactive to a preventative stance and this must be done as early in life as possible, preferably through the education system. The Cognercise Foundation’s Functional Wellbeing Initiative is seeking to provide solutions and connect with all people who believe such systemic change is essential.
Ian Tresise is a co-founder of the Cognercise Foundation which has established the Functional Wellbeing Initiative and promotes Cognercise methodologies and programs.