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Community health - the bigger picture

Friday, 22 February 2008
Author: by Michèle Nardelli, UniSA Researcher

What these reports rarely do is tell the full story - the complex anthropological, environmental and socio-political factors that contribute to changes and variations in the health and wellbeing of populations.

But for UniSA's new Research Chair in Social Epidemiology, Professor Mark Daniel, the complexities of population health are what make it eternally fascinating, frustrating and ultimately rewarding.

"When you start examining what factors influence human health and you move beyond straight medical models of disease and treatment, it opens a whole new world," Prof Daniel says.

"My research looks at a range of issues from identifying which aspects of the social and built environment are likely to have a strong association with chronic diseases, to accurately measuring those factors and evaluating their causal impact on health in different population contexts."

Prof Daniel arrived in Australia towards the end of 2007, moving from Canada and his last position as Associate Professor and Canada Research Chair for Population Health in the Département de médecine sociale et préventive, at the Université de Montréal.

In Montreal he pioneered the development of an environmental neighborhood assessment tool using geographic information systems and geospatial methodology to examine the relationships between place and socioeconomic status, and outcomes including mental health, cardiometabolic disease and HIV/AIDS.

"What we understand more and more clearly is that health education and medical care programs can't be built to a `one size fits all' recipe that abstracts individuals from their contexts," he says.

"You won't stop the prevalence of smoking just by hammering people to quit.You won't get children to eat better foods and exercise more by blaming parents for poor grocery shopping or letting their kids watch too much television.

"Health problems like obesity that evolve in a generation or two, happen because of complex social dynamics. Changes such as more parents working away from home, longer working hours, retraction of local services and facilities, will impact on that kind of problem in many complex ways from simply making certain behaviours less practical, to changing whole traditions of eating and interacting with family."

Prof Daniel says poverty, poor education, apathy and isolation from convenient services all conspire to increase the chances of poor health outcomes.

"Some of the work we were doing in Canada was aimed at developing a model to broadly predict health outcomes by postcode," he says.

"I plan to continue that research through an international collaboration that will take data from Australia, France, Canada and the US to measure and analyse environmental factors in relation to population health outcomes."

Prof Daniel will also be forging new partnerships and building on existing ones to explore population health issues with Indigenous communities, urban Adelaide populations and regional communities.

"By identifying not only the factors that influence the prevalence of a range of illnesses but also how those factors combine together or act independently in an environment to influence health, we are developing a more sophisticated understanding of health and wellbeing as something that evolves in a community and is not static," he says.

"That understanding gives us a better opportunity to make the changes and develop the resources that will improve communities' social and physical health."