Promoting healthy environments

Healthy environments facilitate healthy eating and living areas designed to avoid injury and promote health.

When we talk about healthy living environments, we mean a physical and social environment that facilitates health. Some of the biggest killers and challenges facing the world today relate to how we eat and get injured. Our research, collaboration with stakeholders, and development of effective policy is geared towards creating safe and healthy living and working environments.

Questions we ask include what changes need to happen in our environment to support healthier behaviours? How can we prevent injuries from drowning, burns, and road crashes? How do we influence decisions about the nutritional quality of foods? How can we engage decision makers to introduce policies that lead to healthy improvements in our living environments?

Our approach

We work with industry, governments, non-government organisations and other research organisations across the globe to reduce rates of death, disease and long-term disability caused by unhealthy eating or injury. 

Road safety

Our researchers are working to reduce road traffic injuries globally through measures such as laws on speed, seatbelt wearing, motorcycle helmet use and driver licensing.

In Australia, our research teams are working with Aboriginal and Torres Strait Islander people in urban and rural communities to deliver community based programs that increase access to driver licensing. One example includes a body of work around driver licensing and road safety for Aboriginal and Torres Strait Islander people in collaboration with colleagues from The University of Wollongong, Flinders University and key government, non-government and Aboriginal Community Controlled Organisations (see Driving Change).  Another is working in partnership with communities to deliver child car seat programs across New South Wales.

India has the highest number of road traffic deaths and injuries in the world, especially among adolescents aged 10-18 years, costing Rs 4.07 lakh crores (US$59.5 billion), accounting for approximately 3% of the country’s GDP. Target 3.6 of the United Nations Sustainable Development Goals sets an ambitious goal of halving the number of global deaths and injuries from road traffic crashes by 2020. 

Several initiatives undertaken by the government, civil society organisations, industries, and other road safety partners in India include data improvement (a new crash report form), vehicle standards, road infrastructure upgrading, road user behaviour as well as the post-crash response. The passing of the Good Samaritan law in India is an important step and can bring road safety policy in the country in line with global good practices. 

At The George Institute for Global Health we have been designing, developing, and generating a body of evidence around road traffic injury prevention and safety by implementing high quality and impactful programs in Australia and South East Asian countries, which can be scaled up at sub national and national levels in India.

Burns

Burns contribute significantly to the global burden of death and disability, resulting in at least 300,000 deaths annually, and are one of the leading causes of disability-adjusted life-years lost in low- and middle-income countries. Burns have been described by the World Health Organization (WHO) as the ‘forgotten global public health crisis’. In 2004, the incidence of burns severe enough to require medical attention was nearly 11 million people and ranked fourth in all injuries, higher than the combined incidence of tuberculosis and HIV infections. 

Our researchers are investigating methods to better prevent and treat burns in Australia, India, Nepal and Bangladesh. 

In Australia, Aboriginal and Torres Strait Islander children experience more burns than other children, and having consistent access to high-quality care is fundamental to good outcomes in burns care. A recent study led by the UNSW Centre for Big Data Research in Health, supported by researchers at The George Institute for Global Health put Aboriginal and Torres Strait Islander children and serious burns injuries in the spotlight. It found Aboriginal and Torres Strait Islander children are less likely to be treated in a hospital with a paediatric burns unit, despite needing more intensive treatment and a longer stay. 

Building on this work, our researchers are exploring the care of Aboriginal and Torres Strait Islander children with burns through a cohort study in Queensland, New South Wales, South Australia and the Northern Territory. The study is following children for at least two years post burn to understand the impact and cost of burns. It will culminate in a roundtable to develop a new model of care, planned for late 2018. 

In India and Nepal our work has included research into developing home and community based rehabilitation for burns survivors, and identifying priority policy issues and health system research questions associated with recovery outcomes for burns survivors.

India has one of the largest burdens of burns with an estimated seven million burn injuries per year, disfigurement and permanent disability in 250,000 people annually. Burns survivors are financially distressed, vocationally challenged and socially excluded. Our researchers have found that the biggest challenge for recovery is the stigma and social exclusion associated with burns disfigurement, both within the healthcare system, as well as in the community. 

Currently in low- and middle-income countries the risk of burns disfigurement is increased as few patients with burns in these regions receive appropriate first aid or immediate acute care, and this issue is compounded by limited access to rehabilitation. We’re working to develop acceptable models of burns care from consumer, provider and health manger perspectives to help improve access to appropriate care and rehabilitation.

Listen to the BBC Health Check story on burns in India including stigma and recovery, featuring Dr Jagnoor, Senior Research Fellow, The George Institute for Global Health.

Within the Barisal region of Bangladesh, nine children drown each day.

Drowning

Of the 372,000 drowning deaths reported globally each year, over 90% occur in low- and middle-income countries. Here, people have a high exposure to natural open water bodies and often rely on ponds, canals and lakes within communities for daily tasks such as washing and bathing. As a result, drowning events often occur close to home. Within Bangladesh, most drowning cases of children under five occur within 20 meters of where they live. A lack of basic water safety education results in a limited awareness on effective approaches to mitigating drowning risk. 

We are currently working with partners on the development and implementation of drowning reduction strategies in low- and middle-income countries, such as Project Bhasa in Bangladesh. Within the Barisal region of Bangladesh, nine child deaths due to drowning occur each day. This is partly due to the density of the population and the high percentage of land affected by water. With a population of over eight million, the Barisal Division is one of the most vulnerable areas in Bangladesh. Each of its six districts are affected by water-related hazards and disasters, with 72% of the land area of Bangladesh under water each year. To reduce the incidence of drowning, we are working on large scale multi-sectoral interventions with our partners, the Royal National Lifeboat Institution and the Centre for Injury Prevention and Research Bangladesh. Our community intervention will be providing supervision to 10,000 children, aged two to five years for three years (2017- 2019) and teaching basic water survival skills to 30,000 children aged six to 10 years. These community interventions are further supplemented with strong stakeholder engagement and policy interventions for sustainability of the program.

With strong partnerships, we aim to end the drowning epidemic.

Project Bhasa

Ending the drowning epidemic in
Barishal division, Bangladesh
It is estimated that 321,000 drowning deaths occur globally each year; a global drowning rate of one person every 80 seconds. More than 90% of drownings occur in low and middle income countries .

However, little is known about the impact of drowning on communities, both socially and economically.

In this document, we report on the findings of a household population-based cross-sectional survey to understand the burden and context of fatal drowning in the Barishal division of Bangladesh.

Working in collaboration with The Centre for Injury Prevention and Research, Bangladesh (CIPRB), and with the support of the Royal National Lifeboat Institute (RNLI), United Kingdom, we investigated drowning cases by demographic characteristics and features of the drowning event.
We also report on the qualitative findings, which helped us understand the context, beliefs and behaviour that influence water safety practices in the Barishal division.

Read the full report

Healthy eating

Poor diets that are high in salt and sugar or excess energy and don’t include sufficient quantities of fresh fruits and vegetables are contributing to a whole host of non-communicable diseases. That’s why we’re undertaking research that supports healthier food choices.

Our main areas of focus are food reformulation, monitoring changes in the food supply, and developing and testing innovative approaches to support consumers to make better food choices.

How can we improve our diets?

Maintaining a healthy diet is challenging when we’re surrounded by processed foods laden in sugar, salt and saturated fat. It’s also challenging our health system with excess weight a major risk factor for cardiovascular disease, type 2 diabetes, some musculoskeletal conditions and some cancers.

Creating healthy food environments

So how can we eat better when our supermarket shelves are full of products that are making us sick?

We’re working with governments around the world to develop strategies to improve the food environment, including helping to develop reformulation targets for processed foods, improving food labelling, engaging the food industry to reduce levels of salt and sugar in foods and meals, and improve the quality of food available in schools and hospitals.

Our programs reducing salt in Fiji and Samoa have already influenced policy and practice. Our teams are working with the World Health Organization, universities and governments to build advocacy and find the most effective ways to make the food we eat less harmful for our health.

It’s also about ensuring the public is armed with knowledge about know how to pick the healthiest choice. That’s why we launched the FoodSwitch phone application which helps supermarket shoppers find out what’s in food products and directs them to healthier options.

Such food awareness programs are proving successful not just in Australia but around the world. Our researchers in China are encouraging people to read the labels on packaged foods to see what they are buying.

With obesity, diabetes and hypertension levels reaching epidemic status in almost every corner of the world, it’s vital that policies to improve the food supply are introduced.

Polly Huang talks about The George Institute China' Salt Substitute and Stroke Study, which aims to lower blood pressure across China by using a salt substitute.

Polly Huang talks about The George Institute China' Salt Substitute and Stroke Study, which aims to lower blood pressure across China by using a salt substitute.