Buckle up, it’s time to fund our futures

In the 1970s, a government-driven public health campaign making seatbelt use mandatory changed our lives for the better. Now, it’s time to buckle up again to fund our futures, says AMA (NSW) policy assistant Jasmine Digges.

In 1970, Victoria became the first jurisdiction to mandate wearing a seatbelt. In 1971, NSW followed suit and by 1972, it was adopted across Australia, with other nations soon to follow.  As technology improved, seatbelts kept pace. Pretensioners, audible and visual alerts, and government campaigns have continued to strengthen the equipment’s effectiveness in the context of modern motoring.

Today, most people buckle up without a second thought. The humble seatbelt is more likely considered a mindless function of daily routine than one of Australia’s most successful preventive health measures, responsible for a 78 per cent reduction in lives lost on NSW roads.

Seatbelts are just one example of what governments can achieve when they invest in prevention. Vaccinations, tobacco control, cancer screening, hand hygiene campaigns, gun law reform and SunSmart initiatives tell a similar story.

Frightening forecasts

While these historical successes exemplify the power of preventive health, sadly, they do not reflect the reality of our government’s broader approach to healthcare. In 2023-24, just 2.9 per cent of total government health expenditure was directed to public health and preventive activities.

Our populations are changing and ageing. Already, one in five NSW residents is aged 65 or over. That figure is projected to grow by more than a third over the next 15 years. Meanwhile, 70 per cent of the total disease burden is now due to chronic conditions and at least 36 per cent is linked to modifiable risk factors.

Australians are living for longer, both in periods of ill health and overall, and the cost to our health system is only set to augment. Forecasts like these promise challenging decades ahead – for NSW people and those responsible for their care.

That is unless the seesaw swings. Continuing to fund and resource NSW as a reactive system will see forecasts come to fruition, but being proactive has the power to shift the needle.

At AMA (NSW), we are calling for the establishment of a Preventive Health Investment Fund to be a core commitment ahead of the 2027 NSW election. To put it bluntly, we are urging the NSW Government to prioritise the future prosperity of residents, before it is too late.

 Prevention at every stage

Growing evidence shows that there are important opportunities for prevention at each and every stage of life.

The First 2000 Days framework acknowledges that a child’s experiences from conception to age five affect lifelong health outcomes. Even before birth, antenatal screening and maternal health programs can identify or reduce risks. Targeted interventions in childhood can address leading contributors to disease, namely abuse and neglect, and overweight (including obesity) for the current child cohorts.

During adolescence, critical development is still underway. Research shows that 65 per cent of the adult disease burden is driven by behaviours which emerge in adolescence, including smoking, alcohol and drug use, mental health conditions and risk-taking. Strong public health programs can help identify risk factors early and shape healthier habits before they become entrenched.

Even by mid-life, there is still time for impactful prevention to occur. Almost 50 per cent of dementia cases could be negated by addressing modifiable risk factors in mid-life, particularly high cholesterol, depression, physical activity and hearing loss. Other leading contributors to disease burden in this life stage include, tobacco and alcohol use, overweight (including obesity), dietary risks and high blood glucose.

Investment in preventive health across every life stage promises high returns by compounding the benefits delivered over time. Further, many modifiable factors are interconnected, meaning one effective intervention can improve multiple health metrics simultaneously. For example, a sugar levy would directly address dietary risks whilst also targeting interrelated conditions such as overweight, type 2 diabetes and high blood glucose.

Funding the future

Funding is imperative to implementing a prevention focus.

AMA (NSW) is advocating for a dedicated Preventive Health Investment Fund of $55 million annually over at least four years, modelled against VicHealth. The fund would provide every local health district with resources to deliver prevention initiatives tailored to local needs while helping NSW move closer to the National Preventive Health Strategy target of allocating five per cent of health expenditure to prevention by 2030.

Importantly, a quarantined funding structure also aligns with multiple recommendations from the NSW Government’s own report, the Special Commission of Inquiry into Healthcare Funding, which ultimately urges that preventive care becomes a whole-of-government priority.

The evidence in favour of preventive healthcare has been served to our state and federal governments on a silver-platter. Now we need strong leaders, who recognise their decision-making power and have the confidence to wield it with a vision of the future.

More than 50 years ago, governments backed a simple preventive measure that changed the trajectory of road safety in Australia. Thousands of lives have been saved because leaders chose prevention over complacency. Investment in preventive health must keep pace with the public health challenges of today and the ones we know will arise in years to come.

Future generations deserve to benefit from today’s decisions without even thinking twice, just like you do each time you buckle up your seatbelt.