Comprehensive sector-wide strategies to prevent and control obesity: what are the potential health and broader societal benefits? A case study from Australia.

AIM: Several countries have recently established multistakeholder strategies to prevent or control overweight and obesity; however, studies have not yet been done on their effectiveness and likely impact. This study's objectives were to (i) explore sector-wide benefits and impacts likely to accrue from implementing an obesity prevention strategy in the Australian state of New South Wales; (ii) discuss the wider implications of the findings for research and practice; and (iii) strengthen the case for sustained implementation of a comprehensive, intersectoral approach. METHOD: A case study approach, including evidence reviews and illustrative epidemiological models, was used to show potential benefits from meeting selected targets and objectives specified in the strategy. RESULTS: For adults, improved health outcomes potentially include reductions in all-cause mortality, cardiovascular disease, type 2 diabetes, various cancers, osteoarthritis, infant mortality and healthcare costs. Potential benefits beyond the health sector involve disability payments, absenteeism, worker productivity, workplace injuries and insurance claims. For children and adolescents, improved health outcomes potentially include metabolic risk factors, dental health, prehypertension/hypertension, cardiovascular disease risk factors, depression, rates of mortality in hospitalised children, bullying and otitis media. CONCLUSION: Sector-wide health, social and economic benefits from successful implementation of multisector obesity prevention strategies are likely to be substantial if specified targets are achieved. Epidemiological modelling described in this paper for selected examples provides illustrative rather than comprehensive evidence for potential benefits. Process evaluation of the extent of implementation of these multisectoral strategies, together with the accumulated data on intervention effectiveness, will determine their potential population health benefit. Quantifying the health and social benefits that are likely to accrue if comprehensive sector-wide obesity prevention and control strategies are established can strengthen advocacy for their sustained implementation.

Research evidence can successfully inform policy and practice: insights from the development of the NSW Health Breastfeeding Policy.

Strengthening the bridge between research and policy has been identified as a priority if evidence-based policy is to become the norm. However, current understanding of the research-policy interface is limited. A recent policy in NSW was the first evidence-based directive with specific actions to promote and support breastfeeding within a state health system in Australia. This paper explores the development of this policy, highlighting the factors that facilitated the incorporation of research evidence into the policy. The funding of a research centre to support NSW Health policy and workforce development was significant to the process. The existing organisational linkage ensured that the research evidence was identified, synthesised and effectively communicated, with the needs of the research users in mind and within a clear framework to guide action. The research evidence was not only strong, but also relevant with regard to prevailing political interests. The process was strengthened by the commitment of key researchers and policy makers to breastfeeding. Other types of evidence were considered, including the expert opinions of senior service providers regarding the capacity to act on the research evidence.