Publications

The Australian Health Policy Collaboration (AHPC) publishes reports and commissions research focussed on Australia's most critical health policy issues and challenges. 

Chronic diseases

Some recent publications on chronic diseases in Australia:

Getting Australia’s Health on Track

Getting Australia’s Health on Track presents 10 priority policy actions that, together, will get Australia well on track to reach the 2025 targets and significantly reduce preventable illness and disability in the population. The priority policy actions have been developed by expert working groups of Australia’s leading chronic disease scientists, researchers and clinicians. The priority policy actions complement existing national and state and territory policy measures aimed at reducing chronic disease incidence and prevalence.

View the report Getting Australia’s Health on Track.

Australia’s Health Tracker by Area

Australia’s Health Tracker by Area, an interactive website that maps data on common chronic diseases, conditions and their risk factors by Primary Health Network catchment; Local Government Area and State and Territory areas. It has been designed to enhance the use, for planning, commissioning and monitoring, of a range of data from a number of sources that relate to the risk factors for preventable chronic diseases.

The website complements the data presented in Australia’s Health Tracker that we launched in July this year. Australia’s Health Tracker is a report card on the key risk factors and indicators for preventable chronic disease. It provides an analysis of available data to track Australia’s status against health targets and indicators for a healthier Australia by 2025.

The website we now have in development, “Australia’s Health Tracker by Area” provides localised profiles of progress against those targets. It is intended to be accessible and useful to primary health networks, local hospital networks, local governments and state and federal governments. More particularly, it is designed to increase awareness of the importance of these targets and indicators in measuring the health risks in the Australian population – and their direct relevance to public policy and funding actions and responsibilities at all levels of government as well as for health service providers.

Visit Australia's Health Tracker by Area.

Find out how healthy your suburb is using these handy interactive health maps developed by The Age.

Australia’s Health Tracker

Australia’s Health Tracker, Australia’s Adult Health Tracker and Australia’s Children and Young People Health Tracker are report cards that provide a comprehensive assessment of the health of Australians in relation to chronic diseases and their risk factors. The report cards will be issued regularly and will track progress towards the targets for a healthier Australia by 2025.

Launched at a national Forum on July 5th 2016, over 50 public health organisations are signatories to Australia’s Health Tracker. The Forum’s key note speaker, Graham MacGregor, a Professor of Cardiovascular Medicine, Queen Mary University of London, has praised the work and urged that Australia follow the lead of the United Kingdom in sugar and salt reform.

Compiled through the collaborative effort and expert guidance of leading Australian public health and chronic disease experts Australia’s Health Tracker has been developed and is published by the Australian Health Policy Collaboration at Victoria University.

Download:

Targets and indicators for chronic disease prevention

Australia has an unacceptably high rate of risk factors for chronic diseases including obesity, physical inactivity, alcohol misuse, smoking and poor nutrition. This technical paper proposes a set of national chronic disease targets and indicators as a means of measuring progress and enhancing accountability for action. The paper was developed through a national working group process involving experts from across Australia.

Download: Targets and indicators for chronic disease prevention

Development of Australian chronic disease targets and indicators

The Australian Health Policy Collaboration is facilitating development of a set of targets and indicators to measure and track the prevention and management of chronic diseases in Australia. Using criteria described in this paper, the AHPC will work with health stakeholders from the public and non‐government sectors to review the WHO Global Action Plan for the Prevention and Control of Noncommunicable Diseases targets and indicators and consider suitable alternatives where necessary. The WHO 25 x 25 targets are a key set of measures for Australia to assess and draw from, however, national measures must be tailored to the Australian context.

The AHPC work on chronic disease policies for Australia, outlined in this paper, takes a broader approach to chronic diseases, including for example, mental illness.

Download: Development of Australian chronic disease targets and indicators

This paper should be read in conjunction with the technical paper Suitability of the WHO 25 x 25 chronic disease targets and indicators for Australia, for which it provides context and background.

Suitability of the WHO 25 x 25 chronic disease targets and indicators for Australia

The World Health Organization’s (WHO) Global Action Plan for the Prevention and Control of NCDs 2013‐2020 aims to reduce the burden of non‐communicable diseases by 2025, through action on nine targets measured by 25 indicators of performance. While the WHO 25 x 25 targets were cited as a key set of measures for Australia to assess and improve the health of the population, they must be tailored to the Australian context.

This paper reviews the nationally available data relevant to the WHO 25 x 25 targets and indicators, identifying any gaps that exist. This report will be used to provoke discussion and inform the development of targets and indicators, based on the WHO model, but tailored to Australia’s population health needs.

Download: Suitability of the WHO 25 x 25 chronic disease targets & indicators for Australia

Chronic diseases in Australia: Blueprint for preventive action

This paper, released on 1 June 2015, identifies strategic priorities for taking action to prevent chronic diseases. It is the second report by Dr Sharon Willcox for the Australian Health Policy Collaboration (formerly the Mitchell Institute Health Program) on this issue. The first report, Chronic diseases in Australia: the case for changing course, mapped out the social, economic and health costs of chronic diseases to the Australian community, as well as identifying the evidence on the effectiveness and cost-effectiveness of preventing chronic diseases.

Chronic diseases in Australia: Blueprint for preventive action moves beyond the evidence to provide a framework for action. The vision of this Blueprint is to reduce the impact and incidence of chronic diseases through preventive interventions.

Download: Chronic diseases in Australia: Blueprint for preventive action

Chronic diseases: Commitment to changing course

At a national forum in Melbourne on 1 June 2015, hosted by the Mitchell Institute, Professor Allan Fels, AO, launched the report Chronic diseases in Australia: Blueprint for preventive action and a Statement of Commitment for national action co-signed by more than 40 organisations across Australia.

The aim of the forum was to explore how targets and indicators have worked and can work in chronic disease prevention, and to strengthen a collaborative approach for preventive action. Discussion on the day was facilitated by Rosemary Calder, with Professor Maximilian de Courten.

Keynote addresses were delivered by two speakers: Professor Roger Magnusson,Professor of Health Law & Governance at Sydney Law School, University of Sydney and Commissioner Mick Gooda,Aboriginal and Torres Strait Islander Social Justice Commissioner, Australian Human Rights Commission.

This forum report summarises the key themes from the forum.

Download: Chronic diseases: Commitment to changing course policy forum report

Chronic diseases in Australia: The case for changing course

The burden of chronic disease in Australia threatens to overwhelm the health budget, the capacity of health services and the health workforce. Much of that burden is preventable through effective, evidence‐based changes to policy.

This is a background paper for the November 2014 policy forum Chronic diseases in Australia: The case for changing course. The paper, written by Dr Sharon Willcox with the Australian Health Policy Collaboration (formerly the Mitchell Institute Health Program) and a national expert advisory group, provides the case for changing course in Australian policies.

It addresses the health and non‐health factors contributing to the prevalence of chronic diseases and puts forward four major directions for change. We anticipate this paper will promote debate in the policy community and encourage new action on chronic disease.

Download: Chronic diseases in Australia: The case for changing course

Mental health

Investing in women's mental health

The AHPC policy paper Investing in women’s mental health, strengthening the foundations for women, families and the Australian economy discusses the extensive evidence that women’s mental health needs are significantly different from those of men. Certain mental illnesses are more prevalent in women, they use mental health services more frequently than men, and they want a broader range of treatment options than are currently available.

  • Mental disorders represent the leading cause of disability and the highest burden of non-fatal illnesses for women in Australia.
  • 43% of Australian women (3.5 million) have experienced mental illness at some time.
  • Australian women are more likely than men to have experienced symptoms of a mental disorder during the previous 12 months (22% of women compared to 18% of men).
  • Young women report the highest rates of mental disorder of any population group (30% for women aged 16 to 24).
  • One in five mothers of children aged 24 months or less are diagnosed with depression. This represents an estimated 111,000 Australian mothers being diagnosed with depression, and 56,000 with perinatal depression annually.
  • Women are 1.6 times as likely as men to suffer coexisting mental and physical illness. These multimorbidities are associated with increased severity of mental illness and increased disability.
  • The number of hospital admissions for specialised psychiatric care following a principal diagnosis of recurrent depressive disorders and specific personality disorders was substantially higher for females than males during 2007–08.
  • In 2007-08, females aged 35–44 were the highest consumers of Medicare-subsidised mental health-related GP services.
  • Women in Aboriginal and Torres Strait Islander communities have much poorer physical and mental health than other Australians. The suicide rate of Aboriginal and Torres Strait Islander women is highest within the 20-24 years old age group (21.8 per 100,000), which is more than five times higher than their corresponding non-indigenous counterparts (4.0 per 100,000).

The burden of poor mental health amongst women results in adverse social and economic consequences, including disability, reduced life expectancy, impoverishment of individual women, unemployment, reduced productivity, and increasing costs of healthcare and welfare.

Women’s mental health is influenced by biological, psychosocial, economic and environmental factors. The high prevalence of mental distress amongst women and girls of all ages is bound up in the totality of women’s experiences including social and economic inequality. There is an urgent need to counter the gender-blindness of current mental health policy which serves to make these experiences invisible. Policies which reinforce this invisibility are not only ineffective; they are part of the problem.

This paper argues that it is time for a new approach aimed at tackling these gendered risks and enhancing protections across the life course.

Download: Investing in women's mental health

Costs and impacts of serious mental illness with concurrent chronic disease

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) and the AHPC have jointly commissioned new data: The economic costs of serious mental illness and comorbidities in Australia and New Zealand.

This report highlights the significant inequalities, including substantially shorter lives, experienced by people with severe mental illnesses. Some estimates suggest that the lives of both men and women with severe mental illness are up to 30% shorter than those of the general population. Whilst higher rates of suicide account for some of this burden, most of this excess mortality is a consequence of physical diseases including diabetes, respiratory illness, cardiovascular disease and cancer. A proportion of this burden is potentially avoidable.

These figures illuminate the scale of the human suffering caused by the crisis of poorly managed chronic disease amongst people with severe mental illnesses. There is an urgent, humanitarian need for action to transform these outcomes. There is also an economic case to be made. The RANZCP report estimates that in 2014, the additional cost of the physical illness burden of people with severe mental illnesses was $56.7 billion in Australia. This represents 3.5% of GDP. The outcomes discussed in this report appear to reflect very poor value for money from this expenditure.

The economic data discussed in this report extends the analysis of the recent AHPC report Beyond the Fragments. These reports add to the growing body of evidence about the strength of the associations between mental and physical health and the need for a radical, new policy agenda to create a more integrated and effective approach to prevention and management of concurrent diseases. Turning the spotlight on the poor health outcomes of people with both long-term physical and mental health problems marks an important beginning to a radical change process. Pointing to the lives and billions of dollars wasted because of a failure to coordinate mental and physical health needs becomes a compelling ambition when healthcare resources are so tight.

The AHPC has summarised the key policy issues arising from the RANZCP report in a short paper.

Download: The costs and impacts of a deadly combination: Serious mental illness with concurrent chronic disease

Preventing the costs and consequences of chronic physical and mental diseases

Chronic and complex health conditions are now the predominant health burden for Australians – affecting education and employment, individual and family wellbeing as well as the national costs of health care and the impact of these on the national economy.

Beyond the Fragments: Preventing the Costs and Consequences of Chronic Physical and Mental Diseases highlights the strong link between chronic physical and mental ill health. Australian Bureau of Statistics figures show almost 12 per cent of Australians aged between 16 and 85 years – an estimated 1.9 million people – have both a mental disorder and a physical condition.

People with chronic conditions, such as diabetes or cardiovascular disease, have significantly raised rates of depression, anxiety and other mental health problems.

The paper follows the release of The Australian Health Policy Collaboration report Targets and Indicators for Chronic Disease Prevention in Australia encompassing both chronic physical and mental ill health. These targets and indicators are to support, guide and track Australian progress in reducing preventable chronic diseases and their impact on the Australian population.

Beyond the Fragments calls for an integrated approach to the prevention, treatment and management of chronic physical and mental conditions.

Integrated care needs to be supported by national health funding arrangements capable of providing ‘packaged’ care services to people with complex care needs. The AHPC recently has called for the establishment of a national health insurance scheme to enable Australian health services to provide adequate and effective prevention and treatment of chronic health conditions.

In The Case for Change Towards Universal and Sustainable National health Insurance and Financing for Australia: enabling the transition to a chronic condition focused health care system, published by AHPC, authors Francesco Paolucci of Murdoch University and Manual Garcia-Goni of the University of Madrid propose a model of health financing for Australia that would best support efficient and effective health services focused on prevention, treatment and management of chronic diseases.

Download: Beyond the fragments: Preventing the costs and consequences of chronic physical and mental diseases

Health care

Pathways towards a universal and sustainable chronic care finance model

Australian governments have maintained a strong focus on health policy over many years. Much of that focus addresses the pressures on funding, hospitals and health workers, and the pressures arising from an ageing population.

The Australian Health Policy Collaboration commissioned this paper to consider how best to inform health funding and financing policies in Australia, with regards to prevention, treatment and management of chronic disease.

Download: The case for change towards universal and sustainable national health insurance and financing for Australia

Early childhood

The influence of childhood circumstances on adult health

Early childhood is acknowledged as the most crucial developmental period in a person’s life; it creates a foundation for the later years and offers a critical opportunity to establish good health and learning outcomes for a lifetime.

As part of our broader focus on chronic disease prevention policy, the Australian Health Policy Collaboration is looking at the costs and benefits of action (and inaction) in early childhood and the evidence that indicates a much-needed shift in health policy.

To inform this work, the AHPC (formerly Mitchell Institute Health Program) commissioned Dr Kim Sweeny of the Victoria Institute of Strategic Economic Studies to look at what is currently known about the relationship between socio-economic disadvantage in early childhood and poor health and education outcomes in adulthood.

Download: The influence of childhood circumstances on adult health

Summary report: Influence of childhood circumstances on adult health

Roundtable summary: On 30 October 2014, the Mitchell Institute Health Program (now the Australian Health Policy Collaboration) hosted a policy roundtable to consider the evidence outlined in Dr Kim Sweeny’s report, The influence of childhood circumstances on adult health. The paper explores the importance of early childhood in establishing lifetime advantages for health and education.

A group of 25 experts were brought together to discuss the policy barriers and opportunities to achieve much needed reform.

Download: Influence of childhood circumstances on adult health summary report

Brimbank Collaboration

The Collaboration aims to lift health and education outcomes in Brimbank by harnessing the City of Brimbank’s strengths and tackling the challenges through a place based program. This will enable policy makers, service providers, funders and residents to work together towards building a more successful and prosperous community.

The following publications focus on the case for change, the priority risks and indicators, the program building blocks and program outline. 

Growing Brimbank

The report Growing Brimbank: A collaborative approach to lifting health and education outcomes summarises the key findings of the Brimbank Atlas and Physical Activity reports. The Growing Brimbank reports were released on 26 March 2015.

Download: Growing Brimbank: A collaborative approach to lifting health and education outcomes

The Brimbank atlas of health and education

The Brimbank Atlas maps the influences on health and education in the Brimbank community.

This atlas, prepared by the Public Health Information Development Unit at The University of Adelaide for the AHPC (formerly the Mitchell Institute Health Program), provides a range of information for decision-makers, planners, service providers, researchers and communities.

It is hoped its production will bring a better understanding of the complex interactions between individuals and families, their environments and social structures over a lifetime, and how these factors influence the health, education and ultimately, the flourishing of current and future generations of Brimbank residents.

Download: The Brimbank atlas of health and education

Physical activity, sport and health in the City of Brimbank

This report, prepared by Sport and Recreation Spatial, provides a summary of key indicators of participation in physical activity and sport, together with potentially related key demographic characteristics and indicators of health and education, for the City of Brimbank, a local government area in Melbourne, Australia.

The indicators for the City of Brimbank are benchmarked against other local government areas in Melbourne and the state of Victoria. The report analyses the value of physical activity and sport for health and education.

Download: Physical activity, sport and health in the City of Brimbank

Discussion with Professor Joseph Stiglitz

On 24 June 2014, the Mitchell Institute Health Program (now the Australian Health Policy Collaboration), in association with the Victoria Institute of Strategic Economic Studies (VISES) hosted a policy discussion with Nobel Laureate and Columbia University Professor, Joseph Stiglitz and 25 invited guests.

This roundtable fostered discussion across a range of sectors and disciplines with a view to informing the Indicators Project.

Download: Policy discussion with Professor Joseph Stiglitz

Workshop with Professor Pekka Puska

The Mitchell Institute Health Program (now the Australian Health Policy Collaboration) hosted a workshop on 7 May 2014 with Professor Pekka Puska, Finnish professor and international expert on public health and policy.

The session brought together a small group of leading academic experts, clinical leaders and policy makers to discuss the central principles of chronic/non-communicable disease prevention and management, and to inform the strategy and development of the AHPC research program, which is focused on chronic disease.

Professor Puska is the Director General of the Finish Institute of Health and Welfare and the President of the World Heart Foundation. He is recognised around the globe for his many public health achievements including an 80 per cent reduction in cardiovascular disease mortality among the working age population in Finland.

Download: Workshop with Professor Pekka Puska