It’s hard not to despair in the current pandemic environment when you have studied, researched and worked in social and public health spaces for nearly thirty years. People like me, and we are many, understand that factors outside of the ‘health system’ keep people healthy. Likewise, social determinants such as poverty, racism, stigma, low education, incarceration, unemployment, inadequate housing and inadequate access to primary health care impact people’s health negatively. Basically, it’s inequity.
It’s despairing because a public health approach, health promotion, prevention, is not new. We know how to make it work. Organisations like Healthy Cities Illawarra exist to address the underlying systemic economic, social and political structures that perpetuate disadvantage – but we have been here since 1986, and we are still fighting. The issues haven’t changed since I was an aspiring, ideological undergraduate student.
If we funded just a small proportion of the programs that we know work, the return on investment would be almost immeasurable. That’s part of the problem – measuring the success of complex programs that address longer term issues and require longer term investment is not given a chance when most of ‘health’ funding is focused on the ‘pointy end’ of the system and within the constraints of election cycles.
The pandemic has brought public health back into social discourse which I hope will not simply disappear again when things ‘settle down’ – health equity for the Illawarra-Shoalhaven depends on it. To quote Dr Norman Swan, ‘prevention works when you can’t see it’.
Kelly Andrews, CEO Healthy Cities Illawarra
Letters: Illawarra Mercury 11/10/2021