I have landed in the US – why you might ask? What on earth could I learn from the US when it comes to public and population health? A great deal is my response and experience so far.

At the mid-way point of a 20-day immersion in the US and Canada – I reflect on the emergent messages worthy of thought for our future public and population health effort in Australia. I came to the US because the insights into entrenched and layered complexity, philanthropy and endowment funding, and innovative ways are unsurpassed to the constant expectation that government fund prevention efforts as is the case in Australia – which keeps us on the short-term project funding wheel which simply isn’t working.

Maybe I could glean what it takes to shift this system that is being held in place by the very many who are a part of it – charged with the policy, leadership, research and practice to improve the wellbeing (including me!). It’s no-ones fault – it’s the very nature of systems, try intervening in them and they bounce right back into their usual shape and form. We tend to compete and be set up to do this in Australia -we need to understand this isn’t a zero sum game.

Which brings me to true transformation of the system – but which system?

The food system? The health system? The planning system? Or just the big-whole system impacting our health and wellbeing?

The work of the California Endowment Fund – Building Healthy Communities Program (see www.calendow.org), and the innovative approach to learning and the betterment of public health as real players in the system at CUNY School of Public Health (see http://cuny.is/systemschange), to the market entrepreneurs whose products are entwined with purpose (people and planet benefit – see www.s’well.com Million Bottle Project), to the messages adorning the streets of New York (“It’s time to get back to the way humans ate before industry ruined food”), to participation in the student climate strike in NYC on September 20 – how might we do better in Australia at prevention?

How might we do better in Australia at Prevention?

* Don’t give up on government, still keep at it – good people can work that system, just find them (yes I have just spent almost a decade in government but still have hope)

* I see it’s up to us to show and lead the way, us being the people who live in communities, who are parents, employee or employers, THERE IS NO PREVENTION CAVALRY ON IT’S WAY

* Hitch our wagon to the momentum of climate movement, as the Lancet states climate change, obesity, and under-nutrition are a syndemic – multiple pandemics, highly interrelated – calling on our big thinking on intervening – https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(18)32822-8.pdf .

* Re-imagine the system, and a sense of the “we” and “us”, together in that system

* Build agile prevention entrepreneurs and changemakers everywhere we can

* Make our work the re-design of the resourcing of the system and work toward this different framing, building numbers and narrators and curators of change.

* And if too hard to re-imagine our system for health and wellbeing – then refuse plastic wherever you go and plant trees whenever and wherever we can, and do it together!

Shelley