Matt Thistlethwaite (NSW, Australian Labor Party) Share this | Hansard source

Australia, like the rest of the world, is facing an ageing population. Over the last few decades we have seen tremendous advances in medical research and greater public awareness of and information campaigns about healthy lifestyles, which have seen, on average, Australians live much longer lives. That is something that is positive, but it also puts added pressure on government services and our health system.

Between now and 2050 the number of older people, aged 65 to 84 years, is expected to more than double. The number of very old people, aged 85 and over, is expected to more than quadruple from 0.4 million people today to 1.8 million people in 2050. At the same time, the proportion of working age people in the total population is expected to fall by seven per cent, to 60 per cent of the population. As a consequence, there will be relatively fewer people of working age to support an increasing number of older Australians, which will translate into slower rates of economic growth. This throws up many challenges, the most fundamental of which, according to Dr Andrew Penman, the CEO of the Cancer Council of New South Wales, lies in the willingness to challenge and change our most basic health goals. In a recent blog, Dr Penman argued that the time had come to shift our focus from longevity to prolonging our productive potential well into older age. Dr Penman has said that chronic disease has replaced infectious disease as our greatest disease burden. It erodes productive potential in later life by limiting function while, when facing chronic disease, many people heavily discount the merits of work for future gain or reward.

Health policy should centre on the preservation of a healthy life expectancy. Chronic disease increases with age, but it is possible to defer the onset and confine its impacts to a shorter period at the end of life—a so-called compression of morbidity. First and foremost, morbidity compression calls for a greater focus on healthy living. Even if we cannot eliminate all cancer, diabetes, mental illness or heart disease, we can delay the onset by many years. Policies that encourage unbridled hazardous consumption may be good for economic activity now but carry a terrible, long-term price.

Dr Penman has said that in confronting obesity and inactivity we must learn from the hard measures that were required to turn around the tobacco epidemic. While it is important to remain realistic, there are a number of ways of achieving the goals that we set ourselves for more healthy, enjoyable and productive later years. For instance, compared to women, men are 80 per cent more likely to die from mostly preventable cancers that are common to both genders. The reason for the discrepancy is quite simply the fact that women live less risky lifestyles and use health services more effectively. So is it too much to imagine that men might readily achieve what women already have?

Obesity has become a huge problem in Australia and indeed we are fast becoming the most obese nation on earth. Australia's rates of overweight and obesity have more than doubled in the past two decades and currently affect two in three adults and one in four Australian children. Being overweight or obese increases the risk of developing chronic disease such as heart disease, type 2 diabetes, arthritis and some cancers. But there are some very simple things we can do to combat the expanding Aussie waistline and other chronic diseases. One valuable health initiative that I would certainly encourage the public to take part in is the Swap It, Don't Stop It campaign. Arriving at just the right time of the year, the campaign developed by the Australian National Preventive Health Agency provides a free, online, 12-week interactive planner to help Australians make changes toward a healthier lifestyle. The interactive planner features tools to help you organise your food and activity swaps, including alerts, checklists and a progress report. The activity planner uses GPS technology to identify local facilities such as swimming pools, parks and sporting fields, and includes a shopping list that can be sent directly to your iPhone. The online, 12-week interactive planner is a great tool to help people plan and track their nutrition choices and physical activity. This is part of the government's commitment to take action on preventative health. It represents a record investment of $872.1 million over six years—the biggest investment in health promotion that the government has ever made. Funding will be invested in a range of preventive health activities including health promotion and healthy living programs in workplaces, communities, schools and early childhood settings. Programs focus on reducing rates of overweight and obesity, increasing levels of physical activity and intake of fruit and vegetables, reducing harmful levels of alcohol consumption, and smoking cessation.

In Australia, around 68 per cent of adult men and 55 per cent of adult women are overweight or obese. Obesity is the cause of almost one-quarter of type 2 diabetes and osteoarthritis and around one-fifth of cardiovascular disease. It is also a cause of colorectal, breast, uterine and kidney cancer. That is why a large part of this funding, some $622 million, is for the Healthy Workers and Healthy Children initiatives. Under the Healthy Children initiative, $325.5 million over four years will be provided to state and territory governments to deliver programs for children aged zero to 16 years to increase levels of physical activity and improve the intake of fruit and vegetables in settings such as childcare centres, preschools and schools. The Healthy Workers initiative will provide $294.6 million to support workplace health programs that focus on decreasing rates of overweight and obesity, increasing levels of physical activity and intake of fruit and vegetables, smoking cessation and reducing harmful levels of alcohol consumption. There is also $71.8 million over four years supporting the Healthy Communities initiative, which aims to help reduce the prevalence of overweight and obesity by engaging local governments in proven and innovative physical activity and healthy eating programs.

Whilst it is illusory to think that expenditure on health will go anywhere but up, we should have firm expectations about the social returns we should gain from health expenditure. Compressing morbidity to a short period within a long and vigorous life would generate handsome returns indeed. An interesting study currently being undertaken on the issue is the 45 and Up study, which aims to inform policy on healthy ageing into the future. Its mission is to improve health through facilitating high-quality research and increasing the impact of this research on health policy and services. More than 265,000 men and women from across New South Wales aged 45 and over—over 10 per cent of this age group—have agreed to participate in the study and have their health followed over the coming decades. Study participants provide demographic, lifestyle and health information through a brief baseline questionnaire and surveys at least once every five years.

The study is now fully established as a collaborative resource for internationally leading research and will help us understand how we can remain healthy and independent as we age. For instance, the study notes that in Australia there are some unique characteristics of our ageing population. Australia has a relatively heterogeneous population with a large migrant community, an Indigenous population with an average life expectancy 17 years less than for non-Indigenous Australians, some remote and sparsely populated regions and a mixed health-care system with responsibility shared between the national and state governments. There is therefore a need for research that addresses issues specific to the Australian population and makes a feature of giving opportunity to provide insights of international relevance. The 45 and Up study was conceived as a long-term collaborative resource to investigate healthy ageing, in response to the gaps in existing knowledge and the needs of researchers. It is with the aid of vital research like the 45 and Up study and initiatives such as the Swap It, Don't Stop It campaign that we will ensure that our approach to the challenges of an ageing population will be with a full understanding of all of the implications and complexities, which should enable us to emerge on the other side with a healthier, more productive and happier Australia. (Time expired)

Senate adjourned at 22:40