Leading thinkers reveal new frontier of public health: Big Tech, racism, climate change & vested corporate interests

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Australia has a “once-in-a-lifetime” opportunity to create a healthy, sustainable, equitable and prosperous future by taking bold action to build back better, fairer and greener after the coronavirus pandemic. 

Writing in the Medical Journal of Australia (MJA) today, VicHealth CEO Dr Sandro Demaio wrote that “change is in the air”. 

“Since the pandemic was declared by the World Health Organization in March 2020, we have witnessed significant social policy reforms in Australia with the rapid introduction of evidence-based (and at times, long-debated) policy change, including free childcare, accommodation for people experiencing homelessness, wage subsidies, widespread uptake of flexible and remote working arrangements, and the rollout of telehealth,” he wrote. 

“Public support has increased in some critical areas, including support for action to protect and promote health, the use of scientific evidence to inform decision making, and the leadership role of governments.” 

One focus area of the supplement is how new technologies, such as robotics and artificial intelligence, are groundbreaking for public health. 

Kathryn Backholer, Associate Professor at Deakin University’s Institute for Health Transformation, and co-author of chapter 6: Digital determinants of health: the digital transformation, said while there are many benefits to tech, there are also risks and challenges. 

“The digital revolution is no doubt an extraordinary enabler of public health. A recent example is Harlie, a human-centred chatbot application developed by the CSIRO and others, which can provide therapy education and virtual companionship for those who have special needs, are living with a health condition or are lonely,” Ms Backholer said. 

“The clinical usefulness of Harlie is being tested in various trials. Regardless of the outcome, it is almost certain that use of such human-like chatbots for health and wellbeing will become increasingly common in the future. 

“While the digital transformation has the potential to raise income levels and profoundly influence public health research, policy and practice in the future, balancing opportunities with risks will be crucial. We need to ensure equal and ethical use.” 

The supplement also highlights the importance of culture and connection for improving the health and wellbeing of Aboriginal and Torres Strait Islander communities. 

Dr Summer May Finlay is a proud Yorta Yorta woman and University of Wollongong Lecturer, who co-authored chapter 2: Aboriginal and Torres Strait Islander connection to culture: building stronger individual and collective wellbeing. 

“Aboriginal and Torres Strait Islander people have long understood the role that culture plays in health and wellbeing,” Dr Finlay said. 

“All programs and policies aimed at Aboriginal and Torres Strait Islander people need to take a cultural determinants approach. This can only be done through Aboriginal and Torres Strait Islander leadership. All organisations funded to deliver services to Aboriginal and Torres Strait Islander people need to be resourced to engage Aboriginal and Torres Strait Islander communities and their representative bodies in the development of the programs and policies. 

“When the cultural determinants of health become core to policy and programs, trauma and racism will likely decline, and we will see a significant shift in the health and wellbeing of Aboriginal and Torres Strait Islander people.  

“Without acknowledgement of the cultural determinants of health, we will probably never see justice or ‘close the gap’.”  

Dr Demaio wrote that the coronavirus pandemic had exposed health inequities, and therefore heightened “dissatisfaction about the lack of progress” to redress those inequities. 

“We know that a healthy, sustainable, equitable and prosperous Australia is possible, because we know what causes good health and wellbeing, and the foundations for action are already in place,” he wrote. 

“There is nothing holding us back and no excuses for complacency, inaction or practice not informed by evidence or based on principles of equity and sustainability,” wrote Dr Demaio. 

“In order to achieve these profound shifts, the health sector and public health workforce must also evolve. Investment in the workforce is essential, and existing health promotion frameworks need revising to support the shifts and guide subsequent action to build back better, fairer and greener. 

“It is time for bold action and systemic change. We must work together to seize this opportunity to create a post-pandemic pathway to health for all by 2030.”

Dr Demaio’s editorial coincides with a VicHealth-produced supplement to the MJA also published today, entitled Australia in 2030: what is our path to health for all. 

The 7-chapter supplement outlines how “health and wellbeing for current and future generations can be achieved with evidence-based action on the multiple and complex determinants of health” including: 

  1. How Australia improved health equity through action on the social determinants of health;
  2. Aboriginal and Torres Strait Islander connection to culture: building stronger individual and collective wellbeing; 
  3. Physical determinants of health: healthy, liveable and sustainable communities; 
  4. Health promotion in the Anthropocene: the ecological determinants of health; 
  5. Disrupting the commercial determinants of health; 
  6. Digital determinants of health: the digital transformation; and, Governance for health and equity: a vision for our future. 

Read the full supplement for free here: https://www.mja.com.au/journal/2021/214/8/australia-2030-what-our-path-health-all.  
Dr Demaio’s editorial is free to access at: mja.com.au  


Hear some of the authors including Dr Demaio at a free public event on Wednesday 5 May 2021. Register to attend online or in person at: sforce.co/3tBOnSI 


Media contact

Shannon Crane

0432 157 270 scrane@vichealth.vic.gov.au