Cancer Council WA’s Melissa Ledger argues that when it comes to controlling obesity, an ounce of prevention is worth a pound of cure.
Spending on health in WA has more than doubled in the past 10 years and if nothing is done, is projected to account for 38% of the state budget in 15 years’ time.
The Sustainable Health Review brought into sharp focus the potential of public health to turn around the current trajectory in healthcare spend. Its number one recommendation was to increase investment in public health prevention strategies to at least 5% of total health expenditure.
WA is the only Australian state, and one of the first places in the world, to design and implement a dedicated and ongoing obesity prevention campaign. The WA LiveLighter mass media campaign uses TV, radio, cinema, social media and out-of-home advertising to encourage West Australians to eat well, move more and avoid excess weight gain. The campaign is delivered by Cancer Council WA and has been funded by the WA Department of Health for the past nine years.
The WA Government has just announced that it will provide $16 million to Cancer Council WA to continue the LiveLighter campaign over the next five years.
A rigorous economic evaluation recently conducted by Deakin University has demonstrated the substantial health improvements and healthcare cost savings that the LiveLighter campaign is able to deliver.
The study found that for each year that the campaign runs, about 204 health-adjusted life years and $3.2 million in healthcare costs are saved over the lifetime of the target group (WA population aged 25-49 years). This is substantially more than the $2.46 million to air the campaign each year.
This research puts a dollar value on the impacts of “an ounce of prevention” and shows the potential for public health mass media campaigns aimed at improving dietary behaviours to have a real difference on the health of our WA population.
We know that public education campaigns can’t do all the heavy lifting and they need to be part of a broader strategy that engages environmental and policy levers for improving population health. Policy-based approaches such as regulating junk food marketing, pricing healthy food so that it is accessible to everyone and ensuring cities are walkable are vital for achieving long-term health gains.
It’s these structural and policy changes that create an environment that support people to be healthy without the burden of decision making. It’s environmental and legislative changes that make health as equally accessible for the poor as for the rich.
These changes are made at a government level, yet public health education campaigns play a vital role in affecting our community’s and decision makers’ perceptions of these policy initiatives. In 2020, most West Australians were in favour of the government taking actions to support healthy lifestyles, such as:
- • Restrictions on junk food sponsorship and advertising at children’s sporting events (85%)
- • Restricting the sale and promotion of sugary drinks and junk food at venues where children play sport (76%)
- • A health levy on soft drinks to reduce the cost of healthy foods (92%)
- • Restricting junk food promotions and advertisements on public transport and at bus stops (75%)
An equitable system doesn’t rely on individuals making changes in the face of well-planned, strategic, industry barriers that are unevenly distributed across the population. Junk food advertising has become the wallpaper of our lives; not just TV and billboards, but streaming services and social media, and all over our screens when we browse the web for work or play.
Recent research has shown that over three-quarters of the food advertisements that high school students see on their commute to school are for unhealthy foods and drinks. Furthermore, in areas of socio-economic disadvantage, the ads seen on the school commute are far more likely to be for junk food compared to those living in more advantaged areas.
Continued exposure to unhealthy food advertising influences teenagers’ junk food eating behaviours and overall kilojoule intake.
The ultra-processed food industries spend big bucks to run their campaigns, upwards of $30 million a year in WA alone, and this investment wouldn’t be made if advertising didn’t work. While it’s a bit of a David vs Goliath battle, LiveLighter tries to level the playing field by exposing the junk food industry’s marketing tactics and encouraging people to eat for health – and the Deakin report shows that despite our Goliath opponent, we are making a difference.
The dearth of campaigns targeting obesity in Australia and internationally means there are few lessons to draw on or existing campaign materials to borrow. Thanks to WA Department of Health support, LiveLighter is able to pave the way for future campaigns in other jurisdictions that aim to address overweight and obesity, halt the unsustainable rise in healthcare spending, and ultimately to support the population to live happier and healthier lives.
ED: Melissa Ledger is the Cancer Council WA’s director of cancer prevention and research.