A range of immediate and tangible health promotion strategies were employed in response to the first wave of the COVID-19 pandemic in 2020 to minimise the spread of the disease, to ensure the health and wellbeing of all Australians during the pandemic and to reduce the strain on the health system.
These strategies have included the development of educational resources and social marketing campaigns to promote hand hygiene and social distancing (Smith and Judd 2020). The kind of messaging in a pandemic needs to instruct, inform and motivate individual self-protective behaviours and encourage behaviour change. Meeting the specific communication needs of sub-populations helps the quality of the societal response (Vaughan and Tinker 2009).
More broadly, wide-ranging policy, regulatory and legislative measures were introduced, and state-legislated Public Health Acts were also invoked, which provided Chief Health Officers with additional powers to obligate citizens’ compliance with public health orders (ACT Health 2022) to prevent and contain the spread of the virus. There were also operational changes to settings where groups of people congregate, such as aged care, school classrooms and workplaces. Additionally individuals were expected to adhere to rules, such as wearing face masks in certain settings, staying at home during periods of lock down and using ‘check-in’ apps when entering a venue.
The public health protection measures have changed over time. A range of public health protection measures were implemented, adapted or eased at the discretion of jurisdictions in response to emerging evidence, new variants, and Australia’s epidemiological situation (Department of Health 2022).
Australia’s international borders were closed to all non-citizens and non-residents in March 2020 with exemptions only for immediate family (the international borders have since reopened). Under the Biosecurity Act 2015 requirements regarding air travel were introduced such as pre-flight COVID-19 testing for travellers entering Australia and requirements to wear face masks when flying internationally. The Department of Health publishes regular COVID-19 epidemiology reports which capture some of these point-in-time health protection measures.
As the pandemic progressed, safe and effective vaccines were developed and approved as another measure to protect the population against COVID-19 infection and to reduce transmission and severity of the virus. Under the Australian Government’s phased approach, those in greatest need and/or at highest risk, such as health care and frontline workers, aged care residents, older Australians, Aboriginal and Torres Strait Islander people and other priority populations such as those with a disability or with existing chronic conditions were eligible for a vaccine in the first phases of the roll-out.
As the vaccines became more available to the general adult population, large public venues were reorientated to provide preventive health services for mass ‘vaccination hubs’ in places like the Brisbane Convention and Exhibition Centre, Sydney Olympic Park and Melbourne’s Royal Exhibition Centre. This facilitated a more universal, equal and accessible approach for large-scale population vaccination. Commonwealth primary care providers, including General Practices and community pharmacies have delivered the majority of vaccinations in the program. Those people not eligible for Medicare were also included in the roll-out.
Since 8 November 2021, a third dose or ‘booster’ has become available to mitigate against waning immunity and the emergence of variants (Department of Health 2022). On 25 March 2022, a ‘winter booster’ became available to those at greatest risk of severe illness from COVID-19 (Department of Health 2022). For up-to-date information on COVID-19 vaccines, visit COVID-19 vaccines | Australian Government Department of Health (see Immunisation and vaccination).
Health promotion activities have been shown to be cost saving, whereby the cost of implementing the intervention is offset by savings associated with reductions in treating disease (Vos et al. 2010). Monitoring and evaluation are important to assess the performance of health promotion initiatives and provide the evidence that researchers, policy makers and service providers need on what works.
Evaluating the impact and cost of community and nationwide initiatives can be difficult. Directly attributing health outcomes to a specific initiative itself is a challenge, and this is further complicated when multiple strategies are being applied at once (for example, legislation, taxation and promotion campaigns). Evidence to support the effectiveness of health promotion initiatives may not be available for many years as health impacts and benefits may not manifest until years after the intervention has been implemented.
For more information on health promotion, see:
ABS (Australian Bureau of Statistics) (2018) National Health Survey: First Results, 2017–18, ABS website, accessed 5 May 2022.
ABS (2021) Microdata: National Health Survey, 2020-21, ABS website, accessed 5 May 2022.
ACT (Australian Capital Territory) Health (2022) ACT Public Health Directions, ACT Government website, accessed 4 March 2022.
AIHW (Australian Institute of Health and Welfare) (2018) Australia’s health 2018, AIHW, Australian Government, accessed 5 May 2022.
AIHW (2021) Australian Burden of Disease Study: impact and causes of illness and death in Australia 2018, AIHW, Australian Government, accessed 5 May 2022.
BITRE (Bureau of Infrastructure, Transport and Regional Economics) (2010) Road deaths in Australia 1925–2008,BITRE, Australian Government, accessed 5 May 2022.
BITRE (2020) Road trauma Australia 2020 statistical summary, BITRE, Australian Government, accessed 5 May 2022.
Brown G, O’Donnell D, Crooks L and Lake R (2014) ‘Mobilisation, politics, investment and constant adaptation: lessons from the Australian health-promotion response to HIV,’ Health Promotion Journal of Australia, 25(1):35–41, doi:10.1071/HE13078
Department of Health (2018a) Eighth National HIV Strategy, Department of Health, Australian Government, accessed 5 May 2022.
Department of Health (2018b) Tobacco control—key facts and figures, Department of Health, Australian Government, accessed 5 May 2022.
Department of Health (2021) National Preventive Health Strategy 2021-2030, Department of Health, Australian Government, accessed 9 May 2022.
Department of Health (2022a) Australian Health Protection Principal Committee (AHPPC), Department of Health website, accessed 9 May 2022.
Department of Health (2022b) Coronavirus disease 2019 (COVID-19) epidemiology reports, Australia, 2020–2022, Department of Health, Australian Government, accessed 5 May 2022.
Department of Parliamentary Services (2020) National emergency and disaster response arrangements in Australia: a quick guide, Department of Parliamentary Services, Australian Government, accessed 5 May 2022.
Ghebrehewet S, Stewart AG and Baxter R (2016) ‘Chapter: What is health protection?’, in Health Protection Principles and Practice, Oxford University Press, Oxford.
Guerin N and White V (2018) ASSAD 2017 statistics & trends: Australian secondary students’ use of tobacco, alcohol, over-the-counter drugs, and illicit substances, 2nd edn, Cancer Council Victoria, accessed 5 May 2022.
Howat P, Maycock B, Cross D, Collins J, Jackson L, Burns S and James R (2003) ‘Towards a more unified definition of health promotion’, Health Promotion Journal of Australia, 14(2):82–85, doi:10.1071/HE03082.
Kirby Institute (2021) HIV, viral hepatitis and sexually transmissible infections in Australia annual surveillance report 2021, Kirby Institute, University of New South Wales, accessed 9 May 2022.
McIntyre R (2022) 'Raina MacIntyre: Why COVID-19 will never become endemic', Opinion – The Saturday Paper, No. 382.
Smith JA, Crawford G and Signal L (2016) ‘The case of national health promotion policy in Australia: where to now?’, Health Promotion Journal of Australia, 27(1):61–65, doi:10.1071/HE15055 .
Smith JA and Judd J (2020) ‘COVID-19: Vulnerability and the power of privilege in a pandemic’, Health Promotion Journal of Australia, 31(2):158–160, doi:10.1002/hpja.333.
Vaughan E and Tinker T (2009) ‘Effective health risk communication about pandemic influenza for vulnerable populations’, American Journal of Public Health 99(S2): S324–S332, doi:10.2105/AJPH.2009.162537.
Vos T, Carter R, Barendregt J, Mihalopoulos C, Veerman JL, Magnus A, Cobiac L, Bertram MY and Wallace A (2010) Assessing cost effectiveness (ACE) in prevention study, ACE–Prevention Team, University of Queensland and Deakin University, accessed 5 May 2022.
White V and Williams, T (2016) Australian secondary school students’ use of tobacco, alcohol, and over-the-counter and illicit substances in 2014, Cancer Council Victoria for Department of Health, accessed 5 May 2022.
World Health Organization (WHO) (2016) Promoting health in the sustainable development goals: report on the 9th Global Conference for Health Promotion, Shanghai, China, 21–24 November 2016: all for health, health for all,World Health Organization, Geneva, accessed 5 May 2022.