As Victoria's Chief Health Officer, and on behalf of the Department of Health and Human Services, I acknowledge and respect Victoria's Traditional Owners as the original custodians of Victoria's land and waters. I honour Elders past and present whose knowledge and wisdom have ensured the continuation of culture and traditional practices. 

Chief Health Officer Brett Sutton

Welcome to Your health: Report of the Chief Health Officer, Victoria, 2018.

This is the seventh biennial report published by the Chief Health Officer of Victoria, and the first since I commenced in this role in 2019. 

This report, a requirement of the Public Health and Wellbeing Act 2008, provides a snapshot of the health of Victorians in 2018. It presents information from several sources and highlights key topics to paint a broad picture of the health of Victorians. The articles in each section are not an exhaustive examination of each topic; rather they present an overview of each topic with links to other reports if readers would like a more detailed understanding of the topic.

For the first time, this report is presented in an online format. This allows us to link to other reports and to provide digital content. In some cases, this digital content is updated daily, which means you can obtain up-to-date and specific data.

Determinants of health

The health of Victorians is shaped by a complex interaction between genetic inheritance, health behaviours, access to quality healthcare and the social determinants of health. 

The social determinants of health are the social and economic factors – the material, social, political and cultural conditions – that shape our lives and our behaviours. Some researchers refer to the social determinants of health as 'the causes of the causes' – that is, the reasons behind why people experience relatively better or poorer health outcomes. 

This means that, for example, a person on a low income may be more likely to choose cheaper, unhealthier food. This increases the risk of overweight and obesity compared with a person on a higher income. 

These 'causes of the causes' should not, however, be mistaken for 'personal choices' or 'poor motivation'. They are structural or systemic issues that impact our health in many significant ways and are responsible for many of the health inequalities experienced by Victorians. 

Global challenges: climate change and antimicrobial resistance

This Chief Health Officer report also identifies two key global challenges facing Victorians: climate change and antimicrobial resistance. 

The World Health Organization rightly refers to climate change as 'the defining issue for public health in the 21st century'. 

Victoria is already experiencing the effects of climate change, and these will increase unless significant, urgent and sustained action is taken to address greenhouse gas emissions. 

The Lancet Commission on Health and Climate Change – a multidisciplinary grouping of experts in public and global health, environment, science, engineering, earth system science, agriculture and public policy – is explicit about the impacts of climate change. It states that 'the effects of climate change are being felt today, and future projections represent an unacceptably high and potentially catastrophic risk to human health.' 

Climate change is indeed the greatest existential threat to our health and wellbeing in this era. 

Antimicrobial resistance, which leads to decreasing effectiveness of antibiotics, also affects how we manage many infectious diseases. 

Some micro-organisms are now resistant to several antibiotics and may even become completely resistant to antibiotics in the coming years. 

This threatens routine care and important treatments to keep us well, such as surgery and chemotherapy. Treatments can become less effective, more expensive and more likely to cause side effects. 

We need a comprehensive approach across human and animal health, food production and environmental health to address it. 

The continuing importance of public health

Public health is not always visible. Certainly, it can struggle to be recognised for the important work is does to keep people healthy and well.

At some level this is entirely understandable – it’s in the business of 'making things not happen', after all. 

Immunisation, food safety measures and keeping our drinking water safe are key public health activities that we can sometimes take for granted. 

At a broader level, public health strategies also aim to promote healthier eating and active living and reduce the harm caused by smoking, alcohol and drug use. 

Although often unseen, public health benefits all aspects of life, and we must work hard to ensure a robust and well-resourced public health system can move forward as the world continues to face significant challenges. 

I encourage readers of this Chief Health Officer report to explore the public health activities and measures outlined in the many linked reports and data sources that form part of this report.

Brett Sutton

Adj Clin Prof Brett Sutton, Chief Health Officer.