Problem:
Housing supply and affordability are critical political issues, with ambitious Federal and State Governments housing targets set. While more families with children are living in apartments, high-density planning and design often overlook their needs. Navigating housing reform agendas to influence health outcomes remains a complex challenge.
What you did:
Western Sydney Local Health District’s Centre for Population Health, in partnership with City of Parramatta Council and Cities for Play, developed the Healthy Higher Density Living for Families with Children: An Advocacy, Planning and Design Guide (The Guide). Written at a critical time with major housing initiatives underway, and with input from key Local and State Government, academia and industry stakeholders, the Guide offers timely, actionable solutions at the building and neighbourhood scales, to influence policy and support families with children.
Results:
The Guide has drawn significant interest since launching in September 2024. By November, it achieved over 950 downloads; inspired presentations to government agencies, universities, the Planning Institute of Australia; and led to amendments in City of Parramatta’s Local Environment Plan and Development Control Plans. It was referenced in Transport for NSW’s new Design of Roads and Streets Manual and at the NSW Parliamentary Inquiry into Transport Oriented Development program, which recommended more family-friendly apartments. The Working Group continues to explore opportunities to pilot and embed The Guide’s principles.
Lessons:
Building on evidence and collaborating with diverse stakeholders is essential for driving positive change to shape planning controls/policies for high-density housing and preventive health outcomes for families with children.

The evidence for a link between per- and polyfluoroalkyl substances (PFAS) and cancer is conflicting, although the research on this topic is rapidly evolving. As a result of changing restrictions, the establishment of Government inquiries, and growing public interest, it is important that we understand the available evidence, allowing us to establish informed policy positions.

We began this process with expert consultation to frame the issue and to establish the scope of our evidence review. We conducted systematic literature searches to determine the available evidence, refining our search strategy and inclusion criteria using an iterative process. This evidence review was complimented by an extensive landscape analysis to understand existing regulations and policy levers which may influence PFAS-related policy decisions.

The literature review indicated that the decision to regulate PFAS should continue to be based on the evidence of persistence and accumulation in the body rather than specific evidence of cancer-related effects, of which the evidence is conflicting. We recommend further research to monitor the potential impact of PFAS in the population, including longitudinal PFAS exposure studies and biomonitoring in existing large cohort or whole-of-population studies. PFAS should be recognised as an environmental pollutant across the regulatory spectrum addressing water quality, environmental protection and remediation of any established adverse health outcomes from PFAS exposure.

This presentation discusses key learnings associated with developing policy priorities for topical prevention challenges. The development of policy positions in a rapidly evolving landscape requires us to be agile and vigilant. In such a highly technical field, we must leverage the relationships we have with trusted experts to guide our judgements and to tailor public messaging. We will maintain a watching brief over this issue, committed to serving as a sensible, trusted and evidence-based voice to the public as the science and regulatory context continue to evolve.

Introduction: Nature-based physical activity supports cardiovascular health by addressing multifactorial cardiovascular disease risk factors. Climate changes, e.g. increased air pollution, impact cardiovascular disease (CVD) risk, yet healthcare services are carbon-intensive, contributing to climate change.

Nature Prescription is a mechanism for health professionals to connect people with CVD risk factors to community-based nature activities. This approach aligns with lower carbon preventive health solutions with co-benefits for people and sustainable healthcare. Nature Prescription in Australian health settings is under-utilised, however, and barriers to implementation exist.

Methods: This research (n=40 adults) used Behavioural Design Thinking in Springfield, Queensland, to understand the barriers and enablers influencing Nature Prescription delivery to inform development and implementation of a ‘green hearts toolkit’. Working with health professionals, people with CVD risk factors, nature activity providers, and community hubs, a qualitative, co-design method was applied with a socioecological lens. This enabled exploration of barriers and enablers from individual to policy level domains. The aim was to enable health professionals to confidently connect people to structured, community-provided, nature-based physical activities to support cardiovascular health, explore sustainable healthcare practices, and encourage nature connectedness and pro-environmental behaviours in the community.

Results: Enablers for health professionals to provide a Nature Prescription include beliefs and values; self-efficacy; community connection and knowledge; risk-assessed activities; organisational culture, policies and support; and professional training. Enablers for people with CVD risk factors to connect with nature activities include ‘nature literacy’; social norms; community connectedness and knowledge; relationship with healthcare team; information/encouragement from healthcare team; green infrastructure; and welcoming activity providers.

Conclusion: Understanding enablers and barriers to Nature Prescription pathways informs development and implementation of toolkits and resources that align with the needs and aspirations of community partners. Linking Nature Prescription practice to sustainable healthcare and pro-environmental behaviours maximises its role as a lower carbon preventive health practice.

The relationship between human health and wellbeing and the environment is a dynamic, two-way connection, where both sides exert significant influence on each other. The triple planetary crises of climate change, biodiversity loss and pollution result from a complex array of human actions and inactions, with unsustainable production and consumption among the key drivers. Ongoing deterioration of the natural environment is a profound threat to the ecosystems that are the foundation of all life and critical to human health and wellbeing. Urgent action to address the diverse determinants of environmental sustainability is essential to avert further degradation of Earth’s systems and the associated health consequences. Integrated action across sectors is required to identify and implement transformative solutions for the environment.

The Environment in All Policies (EiAP) model and approach can be a practical response to tackle these issues. As with Health in All Policies, EiAP recognises that the determinants of environmental sustainability lie outside the responsibility of the environment sector. Effective application of EiAP would ensure the environment is considered at all stages of decision-making across all sectors and would support governments to identify and mitigate the potential environmental consequences (both intended and unintended) of proposed policies.

There are potential challenges to the application of EiAP, including political will, competing priorities, and the traditional siloed approach to policy problems. However, EiAP offers an opportunity to build upon the successes of HiAP, including cross-sectoral partnerships across all levels of government, the identification of common agendas, and co-designed solutions for co-benefits across sectors

The presentation will present the draft EiAP Model and share the emerging findings from research and discussions with international colleagues from the United Nation's Environment Program and the World Health Organization on the value and opportunity of adopting an EiAP approach to protect the health of people and planet.

Objective: To pilot surveillance to describe environmental, personal and behavioural risk factors for people presenting to hospital emergency departments (EDs) with heat illness.

Methods: We conducted a retrospective case series and telephone interview study of people presenting to EDs across South Western Sydney, Western Sydney and Nepean Blue Mountains Local Health Districts with heat illness over the 2017/18 and 2018/19 summer periods (1 December to 28 February). We used the Public Health Rapid Emergency Disease Syndromic Surveillance (PHREDSS) ‘heat problems’ syndrome to identify people with heat illness and medical records to find contact details. We developed a detailed questionnaire instrument to guide the telephone interview.

Results: A total of 129 individuals presented with ‘heat problems’ (57 in 2017/18 and 72 in 2018/19). The median age was 44 years (range 1–89 years). Most attended hospitals via the NSW Ambulance Service (58%) or private car (40%). Of the total, 53% were classified as triage category 3 (potentially life-threatening), 27% as category 4 (potentially serious) and 16% as category 2 (imminently life-threatening). The main supplementary codes were heat exhaustion (35%), heat syncope (39%), and heat stroke (30%). The majority were discharged from the emergency department after completing treatment (73%), with 21% requiring admission. A total of 38 follow-up interviews were completed (29% response rate). Almost all individuals were exposed to heat outside their home environment: 11 (29%) were engaged in paid work, 5 (13%) in outdoor housework, and 10 (26%) in outdoor recreational activities.

Conclusion: Our pilot surveillance study successfully collected home, local environment and behavioural risk factors on a small cohort presenting with ‘heat problems’ to EDs in Western Sydney during the summer months. Most were exposed to heat outdoors while engaged in work or recreation outside the home, and were preventable.

10 years of a Commonwealth funded concerted surveillance and control program to eliminate trachoma as a public health disease in Australia’s remote First Nations communities has demonstrated the critical importance of environmental health as primordial prevention. Working with communities by concentrating on the home environment and assessing functional health hardware – taking health into the home - has been critical to support elimination of this disease.
A Commonwealth workshop supporting trachoma elimination held in Sydney in November 2023 brought together for the first time jurisdictional leads in preventive health, environmental health and housing. It recognised that community controlled health, environmental health and housing are critical to prevention of not only trachoma, but many other preventable diseases.
Sustainable prevention of certain health conditions has been recognised through a concerted effort in WA’s Aboriginal environmental health program to improve housing conditions, promote the Healthy Living Practices and interact with community-controlled primary care services to generate clinic-based referrals for environmental health.
One of the priority reform targets for Closing the Gap is the shared access to data and information at a local level to support First Nations communities. Government departments involved with housing similarly want access to health data to demonstrate the benefits of adequate investment.
Politics is hampering how this could and should all come together. The separation between Commonwealth and jurisdictions and who funds what parts of the health, housing and environmental health nexus mean that a unified approach has not been achieved – but it is possible.
This presentation will review what has been tested to demonstrate a broader primordial prevention approach for environmental health connected to health and housing channels – along with the preventable diseases of marked disparity it is addressing in real community home settings.