Australian health systems will continue to deteriorate - and cost more money - unless more is done to stop people from getting sick with chronic disease, according to a new report.
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Sobering Grattan Institute research, released this month, says chronic conditions are the biggest killer in Australia contributing to nearly 90% of deaths but warns that their prevention remains vastly underfunded.
This is no surprise to the head of the Illawarra's health prevention charity, Healthy Cities Illawarra, who said her organisation's government funding had barely budged in 25 years.
"All the money and all the political noise is around hospitals and EDs and ambulances, and it's just going to get worse unless we do something at the other end of the spectrum," CEO Kelly Andrews said.
"Prevention has been completely ignored, and we're seeing the fruits of that - it's bordering on negligence."
In 1998, NSW Health gave Healthy Cities Illawarra $281,490 a year in core funding, and was now only contributing $286,800 - just over $6000 more - each year, she said.
Ms Andrews said the charity was then "left to beg for piecemeal" grants funding, which meant many of their programs were only short term measures.
"Warrawong and Bellambi are two of the most disadvantaged postcodes in our who state, and yet I have to beg to keep programs alive in those communities," she said.
The Grattan Institute highlights that burden of chronic disease is heaviest on the most disadvantaged Australians, who are twice as likely to have two or more chronic conditions.
"And the toll will keep growing, because many risk factors for chronic disease, such as obesity, are rising dramatically," the report says.
In the Illawarra chronic disease is strongly linked to socioeconomic factors, with a Mercury analysis comparing income with the prevalence of ten different long-term health conditions showing that the poorest suburbs are more likely to have conditions like heart disease, diabetes, lung conditions, kidney disease and mental health problems.
For instance, in the 2528 postcode that bridges Windang, Lake Illawarra and Warilla and has the second lowest median income, only half the residents said they did not have a chronic health issue.
Warrawong, where the average income is lowest, ranks worst in the region for diabetes and kidney disease.
The suburbs with the lowest median income were also significantly more likely to have complex health needs, with more people reporting two, or three or more, long-term conditions.
The Grattan Institute says the focus on government spending needs to shift from sickness to health to stop chronic disease from rising further in these areas.
"More than 80 per cent of a person's health is caused by factors outside health care," the report says.
"Fortunately, those factors can be changed. Many prevention initiatives have been shown to cost-effectively reduce rates of chronic disease, but Australia isn't adopting them. We have lost the leadership position we had in previous decades, with other countries now spending more, and doing more."
Ms Andrews agreed, saying better health prevention funding would need to come from a range of government departments, and not just health.
"Prevention is everything outside the health system and things that are happening in our community, at a policy level," she said.
"By the time you get to go to a GP it's too late. [Prevention] is cheap, we know how to do it, and I think it's bordering on negligence that governments aren't doing it."
She said the Public Health Association says every one dollar invested in prevention means you save $14 in the acute sector, which would mean spending on other parts of the health system would decrease.
"In NSW [health is] just in crisis, and I'm frustrated because HCI is a health promotion charity in this region and if we were funded properly, our region could be a real leader in NSW for holistic and preventative care for of chronic disease," she said.
Ms Andrews said her passion project was active transport, and said the upcoming Mount Ousley interchange projects - which is slated to cost hundreds of millions of dollars - showed how cheap preventative health measures could be.
"The World Health Organisation gives a guideline that 20 per cent of transport budget should be spent on active transport," she said.
"If we had 20 per cent of the money going into that Mount Ousley interchange - we would fix all the footpaths, and have enough infrastructure to connect our city, improve walkability and do away with the need to jump in the car for trips of 5km or less.
"We would transform the Illawarra for the cost of 20 per cent of this one small piece of road that's being funded."
"So my plea would not just be to Brad Hazzard or Ryan Park or whoever is the next health minister - but to the whole of government. It's morally reprehensible not to do something."
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Kate McIlwain
For more than a decade, I've helped the Illawarra Mercury set the news agenda across the region. Currently I'm the paper's health reporter - covering the stories of Illawarra workers and residents in the wake of a global pandemic and at a time where our health systems are stretched to the limit.
For more than a decade, I've helped the Illawarra Mercury set the news agenda across the region. Currently I'm the paper's health reporter - covering the stories of Illawarra workers and residents in the wake of a global pandemic and at a time where our health systems are stretched to the limit.
