Inaugural Health and Wellbeing Queensland Board Member, Emeritus Professor Ian Lowe shares his impassioned thoughts on how we got to a point in society where more adults are overweight than not, the influence of and opportunities within social and economic conditions on people’s health, and his personal ‘aha’ moment, when he realised how accurate it is—that we are what we eat.
What are you most proud of during your time working with the Board?
I am proud of the fact that the organisation is tackling the fundamental issue of health and well-being. The traditional approach to “health” has been compared with putting an ambulance at the bottom of the cliff, rather than a fence at the top. Governments have allowed aggressive marketing of harmful substances like tobacco, sugary drinks and junk food, then lamented the increasing costs of treating the predictable illnesses.
If I had to identify a single program I am most proud of, I would nominate Pick of the Crop, for which I am the Board champion, which means I meet with the team on a regular basis for project updates and provide advice where appropriate. Helping young people to make healthy food choices is a wonderful investment in our future.
What led you to the intersection between environmental science and public health?
I became aware in the 1960s of the impact of polluted air on respiratory problems, first by reading the reports about tobacco smoke and then seeing studies showing of the frequency of particular health problems in heavily polluted urban areas. I bought Erik Eckholm’s 1977 book, The Picture of Health. It is still in my bookshelves. In the introduction, he wrote:
Individuals who enjoy good health rightly think of themselves as fortunate. But luck has little to do with the broad patterns of disease and mortality that prevail in each society. The striking variations in health conditions among countries and cultural groups reflect differences in social and physical environments. And increasingly, the forces that shape health patterns are set in motion by human activities and decisions. Indeed, in creating its way of life, each society creates its way of death.
Going on to note that “environment” includes social and economic conditions as well as the natural surroundings, he showed how health patterns within societies are directly linked to environmental conditions. A decade later in Australia, Basil Hetzel and Tony McMichael published The LS Factor, showing how our lifestyle choices strongly influence health outcomes. More recently, WHO set out the direct consequences of climate change for human health in a major report, of which Tony McMichael was a lead author (WHO/EHG/96.7), while Grant Blashki and Helen Sykes published last year Climate Health and Courage. You would now have to be living under a rock to be unaware of the environmental determinants of public health.
What role does our built environment have to play in making healthy happen for Queenslanders?
The built environment has a huge impact on the chance of living a healthy life. As a fundamental issue, the amount of vegetation in urban areas has a direct influence on air quality. There are also studies showing our mental health is better if we have natural surroundings, rather than living in a concrete jungle. Unwell people heal faster if they can see trees and grass. Other studies show that people who exercise in natural areas are healthier than those who exercise in streets or gyms.
Probably the biggest impact is the way the built environment affects transport choices. Inner city areas usually have both good public transport and walkable access to essential services. Much recent development on the peri-urban fringe, where there is little or no effective public transport, condemns residents to long car journeys, meaning they are less physically active and so more likely to be unfit and overweight.
What’s the one big change you’d like to see within our health system/health of Queenslanders?
I would like to see government prepared to take more action to limit the promotion of unhealthy practices. We used to allow tobacco companies to sponsor sporting events; that outrageous practice has been curbed, as have other measures to market that product. But we still allow junk food chains, the alcohol industry and the producers of unhealthy sugar-laden drinks to use a range of marketing techniques, including sponsorship of both major events and children’s sport. Even a simple system of colour-coding food products to indicate their healthiness has been resisted. The amounts spent marketing unwise choices and thus making unhealthy happen is likely hundreds of times greater than the funds HWQ has to make healthy happen.
What wicked questions are your pondering at the moment?
I have spent much of my time in recent years trying to work out how we can reconcile the need to slow climate change with the undoubted benefits of our energy-intensive lifestyle. Cleaning up our electricity supply is technically straightforward and now beneficial economically, but politically difficult, as is improving the efficiency of energy use. Reducing our dependence on petroleum fuels is more difficult technically, economically and politically, while the task of cleaning up agriculture and manufacturing is daunting. The likely cost of failing to act is both huge and incalculable, but our governments tend to be driven by short-term budget priorities and pressures applied by powerful interest groups.
What are your words of wisdom on balancing work and life?
My family would probably say, with some justice, that I wasn’t very good at this when I was young (or, more accurately, less old). I tended to make work my priority and other issues got less attention, although I always managed to fence off time for physical activity and take out blocks of the year for energetic recreation such as cricket tours or serious walks. I have now not had a full-time job for years so I am able to say that personal relationships, cultural activities and physical activity have central roles in my life and work is constrained to the time that is left over. I suppose the central point is that how we spend our time, like how we spend our money, is a reflection of our priorities. There will nearly always be time and money for the things we consider essential. Family should be seen as more important than the demands of our employer.
How do you stay fit and healthy?
I continue to play cricket, several decades after most players have hung up their boots. I also play golf and have undertaken long walks: all of the Great Walks of New Zealand, the Coast-to-Coast Walk across England, the tour of Mont Blanc and ten of the Caminos to Santiago de Compostela. I do Body Pump classes at a local gym a couple of times a week and try to do an hour’s walking on days when I don’t have structured exercise. I have been careful about my diet, ever since I realised that every molecule in our bodies has been produced from what we eat and drink. I also try to maintain a positive mindset, reminding myself each day that it is the first day of the rest of my life; we can’t change the past but we can, and should, make choices about what sort of future we want.