This is the first report to present a systematic approach to monitor prevention in Australia. Using a new conceptual framework, this report focuses on prevention of the modifiable risk factors for the three closely related conditions of cardiovascular disease, diabetes and chronic kidney disease. These diseases account for around a quarter of the burden of disease in Australia, and just under two-thirds of all deaths. The risk factors discussed include smoking, high blood pressure, high blood cholesterol, obesity and physical inactivity. Drawing on data from a wide range of sources, the report covers three aspects of prevention: the prevalence of the risk factors, initiatives aimed at the whole population and services provided to individuals.
Risk factors (Chapter 2)
Most of the risk factors are common:
- physical inactivity, overweight and obesity, and high cholesterol affect over 50% of adults
- smoking and high blood pressure affect 20–35% of adults.
The prevalence of some risk factors is increasing, notably obesity, which rose from 11% of adults in 1995 to 24% in 2007–08. Indigenous Australians and people from lower socioeconomic groups are particularly affected more than others.
Population-level interventions (Chapter 3)
There are many population-level interventions aimed at these risk factors. The most commonly used are public awareness campaigns and community interventions such as school-based programs. Interventions are delivered by many groups, including the Australian, state and local governments, as well as by non-government organisations. However, there is currently a lack of systematic data available on these interventions.
Individual-level services (Chapter 4)
Almost half a million health checks, which can be used to identify these risk factors, were done through Medicare in 2007–08 and the rate is increasing. Medications also play an important role in managing the risk factors. Around a fifth of all medicines supplied in the community in 2007 were for lowering blood pressure, and another 8% were for lowering cholesterol.
There is clearly a need for ongoing monitoring in the area of prevention. However, better data are needed, in particular those based on measurement rather than self-reported data, as well as systematic data on population-level initiatives.