Health Systems Change in 2010

By Peter W. Harvey.

Published by The International Journal of Health, Wellness and Society

Format Price
Article: Print $US10.00
Article: Electronic $US5.00

Whilst health science, epidemiology and public health developments have forged enormous progress in understanding, prevention and cure in the health care area we still appear to lack the motivation to tackle the fundamental antecedents of many of our emerging population-based community health problems; the prevention of chronic illness being a prime example.

In spite of much progress in the area of health science, the social, economic and evolutionary forces that cast our physical being in the world still remain poorly understood or accepted in the health care arena. However, if our health care systems are to be manageable and sustainable in the future, these wider antecedents of our health status and wellbeing must be factored more fundamentally in to our management models with more effort being put into preventing lifestyle related chronic illnesses than is currently the case.

As in the past where public health infrastructure innovations such as running water and efficient waste disposal systems served to add greatly to the wellbeing of individuals and communities, we now need to make similar efforts to control preventable illnesses such as metabolic syndrome, type 2 diabetes and lifestyle related cardio-vascular disease at their source rather than waiting until the manifestation of these conditions require major medical and chemical intervention and management before we act. Our young people are at risk of early onset chronic conditions as a result of their emerging sedentary lifestyles, un-healthy dietary habits and health related behaviours, yet we continue to concentrate our health management effort on managing those with existing chronic conditions while leaving younger generations with lifestyle practices and behaviours that pre-dispose individuals to developing chronic illness earlier and earlier in their lives.

It is time we took notice of these emerging trends and began expending more effort to prevent what are essentially lifestyle related illnesses that can be eliminated before they become endemic. By concentrating more upon the social and environmental factors affecting our illness profiles as well as upon dealing more effectively with those who are already suffering from chronic illness we will reduce the need for major end-stage interventions and alleviate the impact and cost of early onset chronic disease. To achieve this new population health vision in Australia at least, we will not only need to utilize the new government funding structures more effectively; those structures that support coordination and more effective management of care, but also take a much broader, environmental and social view of cause and effect in relation to the health of populations.

Keywords: Health Systems Reform, Change Strategies, Australia

The International Journal of Health, Wellness and Society, Volume 1, Issue 1, pp.137-148. Article: Print (Spiral Bound). Article: Electronic (PDF File; 770.333KB).

Professor Peter W. Harvey

Senior Lecturer, Health Sciences, Flinders University, Adelaide, SA, Australia

Since becoming involved in health systems development in Australia I have led research into the more effective management of patients with chronic and complex illness. Currently I am involved in education and population-based prevention programmes for patients with chronic illness and our teams are developing a range of interventions to manage existing conditions better and to prevent the early onset of preventable chronic illness. In the past 10 years the Australian Government has invested heavily in the management of chronic illness and our task now is to manage our programmes for chronic illness care sustainably and within the new and innovative sources of funding now available for care planning, education and self-management support.