Australia in 2030: what is our path to health for all?

We currently have a once- in- a- generation opportunity to reimagine life and health in Australia. The global coronavirus pandemic has highlighted many public health issues, bringing public attention and a sense of priority to protecting and promoting wellbeing. All Australians have the right to access the resources and environments necessary for a long and healthy life. Yet many in our community face multiple barriers to achieving good health and wellbeing. For example, we live in a country where: ^aEURc one in eight Australians, including one in six children, live in poverty and cannot afford necessities such as healthy food, clothing, education and health care; 1 ^aEURc inequitable access to supportive walking and cycling infrastructure, greenspace, community infrastructure and transport options limit opportunities to live a healthy and prosperous life; 2- 4 and ^aEURc exposure to the marketing tactics of the alcohol, gambling and unhealthy food and drink industries negatively influences perceptions and behaviours across the life course. 5- 8 The pandemic has affected every Australian; however, research highlights that the impacts have occurred inequitably across the community. For example, in Victoria during the second wave of restrictions, one in four Victorians receiving JobSeeker or JobKeeper government payments experienced high psychological distress, compared with one in six people overall; and one in ten Victorians aged 18– 24 years ran out of food and could not afford to buy more, compared with one in 20 people overall. 9 Now is the time to rethink our vision for health and wellbeing, aiming for a state of health for all, where every Australian has equal opportunity to realise their full potential by 2030. For this vision to be realised, we need to accelerate action that focuses on the multiple, complex and often intersecting determinants of health, and harness opportunities that offer progressive policy and practice change. The chapters in this supplement outline a post- pandemic pathway to health for all, focusing on issues and opportunities relating to the social, physical, cultural and commercial determinants of health as well as the increasingly recognised and understood fields pertaining to the ecological and digital determinants of health – all of which influence the environments in which we live, work, play, grow, learn and age. Coordinated and sustained action is required across multiple sectors, settings and all levels of government if we are to truly address these determinants and make gains in improving the health and wellbeing of all Australians over the coming decade. Appropriate action will also undoubtedly result in co- benefit for planetary health, which remains one of the greatest human health concerns. 10 This supplement explores some of the critical opportunities that we need to focus on now to improve the health and wellbeing of all Australians over the coming decade. Chapter 1 takes us on a journey to 2030 where the status quo has been challenged and replaced with progressive, committed and genuine action to address the social determinants of health. Chapter 2 challenges our understanding and acknowledgement of culture as a key determinant of Aboriginal and Torres Strait Islander health and wellbeing. A call for collaborative and urgent evidence- based action to address urban planning for both human and planetary health is made in Chapter 3. Chapter 4 explores the ecological determinants of health, presenting threats to and opportunities for public health and health promotion. The commercial determinants of health and options for countering the negative practices of the private sector are discussed in Chapter 5. In Chapter 6 we look at the implications of the digital revolution for public health. Finally, in Chapter 7 we again fast forward to 2030 where transformative change in governance has occurred to achieve health, sustainability and equity outcomes and, ultimately, a better Australia. The supplement outlines a bold vision for the future of health and health promotion in Australia. A vision that will be vital for a healthy, equitable and prosperous Australia in the decade to come. A vision requiring brave, bold and effective leadership. The time to act is now. As you read through the chapters that make up this supplement, we challenge you to consider what you can do now to ensure health for all Australians by 2030.