It seems counterintuitive. That in a country as rich as ours, and with a world-class health system, 50 per cent of Australians now live with chronic disease.
Now, it’s easy to think this is a failure of individual will power, on a macro scale, but consider this.
If I had a class of 30 students and one was getting poor grades, it would make sense to look to that individual for their reasons for falling behind.
But if half the child’s class was failing, we wouldn’t hesitate to look at the classroom, the curriculum or the wider environment.
It would seem totally illogical to point the finger at half the class, individually.
When it comes to our personal health, the cards are stacked against us in Australia.
At almost every point throughout our day, things make it harder for us to be healthy — and easier for us to increase our disease risk.
The good news is there are things we can each do to rebalance the deck of cards for us and our communities.
The power of digital marketing
From the moment we wake up and turn to our screens, we’re being harvested for data.
It’s estimated that by the age of 13, the average Australian child will have had 72 million data points collected about them — everything from our address, age and gender to our friends, preferences, emotions and habits.
Even the things we “like” online, and the products we just look at or consider buying.
This data is used to sell specific products tailored to our individual tastes and desires. It even targets us when we are more emotionally vulnerable — or hungry.
This marketing from an early age shapes our norms and preferences. From as early as 3, children can begin to learn — and in essence, become hooked — to brands.
We know that the habits we form in childhood tend to stick with us for life. This is why so much time and money is spent on tracking, marketing and influencing our kids.
Why your postcode matters
One of the strongest predictors of our life expectancy is our postcode. The built environment around us shapes our health in many ways.
In wealthier suburbs of Melbourne like St Kilda, for example, the average distance to a fresh food store is 400 metres.
Compare this to the 14 kilometres you’ll find in some lower-income postcodes.
Access to green space and parks, healthcare services, public transport, education, and employment, all affect our ability to access and achieve good health.
The wide variation in these services sees almost 2.5 times as many junk food outlets in poorer postcodes compared to wealthier ones.
The more or less our neighbourhood enables our health shows up in our risk of chronic disease.
Supermarkets are designed to trick us
Ever gone into a supermarket with two essential purchases in mind, but left with a basket overflowing with foods you didn’t need and weren’t great for your health?
You’re not alone, and it’s not all your fault.
More science goes into building a supermarket than your average PhD thesis, and the modern supermarket has more in common with a casino than a traditional market.
In fact, the supermarket design is based on decades of behavioural studies.
The height and length of the aisles, the lighting used, and even the music, are all designed to keep you in the store longer and buying more.
We spend more time at the end of the aisles, and so this real estate costs more. This results in a bias for highly profitable and ultra-processed foods.
Unhealthy foods are twice as likely to be on sale and typically attract “buy one, get one free” discounts (which are illegal in some countries, by the way).
The result? We buy more things we didn’t come for, and really don’t need.
Who can even decipher food labels?
Then there’s food labelling. Even if we can navigate the manipulative environment, we still need to make sense of the food itself.
Now, I’m a doctor with a PhD in public health and even I find it difficult to navigate the tiny text and long lists on the back of foods.
We have a system that’s difficult to understand, and optional to the manufacturer. Compare this with some countries that have clearly labelled, coloured and mandatory food labels that interpret and communicate the healthiness of the products.
It’s little surprise many of the unhealthier products make it into our baskets and onto our homes when you consider this:
- There are more than 30 names for added sugar
- There’s no restrictions around the amount of sugar or salt that can be added to foods
- Even foods on the market that say “no added sugar” can be 30 per cent sugar by weight
Perhaps cost is the most significant and growing barrier for many of us when we look to put healthier food on our plates.
While ultra-processed foods high in salt, fat and sugar are getting cheaper, fresh food seems to be getting more expensive.
Factor in the time needed to buy, prepare and cook fresh food, and it becomes unattainable and unrealistic for busy families.
Rebalancing the deck of cards
Unfortunately, there’s no single solution.
While it would be easy to think that we can simply build more hospitals and medicalise ourselves out of this situation, it requires a deeper commitment to reshaping the factors that sit outside health care.
The good news is that it’s possible.
Countries like Denmark have taken bold steps to limit advertising to children, made biking and walking the paths of least resistance, and strengthened their welfare systems.
This ensures families on the poverty line don’t have to choose between putting a roof over their heads and putting fresh food on the table. This has led to an obesity rate in Denmark of around half of ours in Australia.
What’s required is a rethink — and some action
There are things we can each do at home to rebalance the deck of cards for us and our communities.
Knowledge is a great first step. Arming ourselves with the information to understand what an ultra-processed food is, or how the supermarket influences our brains, or the power of digital marketing, might allow us to take small steps to better protect ourselves.
Above all though, levelling the steep barriers that many Australians now face when it comes to accessing and affording good health will require action from all of us, along with our governments.
While this seems daunting, systems change always starts with a single step — or a single conversation.
So, talk to your family, your neighbours and leaders in your community about the changes you’d like to see.
When it comes to Australians and our health, don’t we all deserve a fair go?
Sandro Demaio is a globally renowned public health expert and medical doctor who is the CEO of VicHealth.
He writes for ABC Health and ABC Everyday, co-hosted ABC TV show Ask the Doctor and is currently appearing on Magda’s Big National Health Check.