Problem
Community water fluoridation (CWF) is internationally recognised as one of the most successful public health measures with around 80% of the Australian population having access to fluoridated water. In Victoria, around 13% of the population in rural areas does not have fluoridated water despite government recommendations. Non-fluoridated areas suffer from a disproportionate burden of disease with higher rates of dental caries (particularly in children), high rates preventable hospital admissions for dental conditions and report difficulty accessing public, or often any form of timely and affordable dental services, making them more vulnerable to both an increased likelihood and severity of dental disease.
What we did
A sub-committee of the Victorian Oral Health Alliance (VOHA) was established to develop a targeted advocacy campaign to raise awareness of the water fluoridation status of rural Victoria and to increase awareness of decision makers at local government level of the importance of community access to fluoride as key to the prevention of oral disease. A range of information was provided that enabled local governments to understand a range of mitigation strategies that could reduce the risk of dental decay in their communities
Results
A list of the top 10 target towns in terms of population size, water fluoridation status, disadvantage and rurality was established and all local governments contacted and invited to meet with VOHA representatives. Seven local governments requested meetings to discuss strategies for reducing their community’s risk of dental caries (e.g. advocating for water fluoridation, accreditation programs, health and wellbeing programs). A range of data and resources was provided at each meeting to support action at the local level.
Lessons
Local governments have a key role to play in advocating for improved oral health outcomes for their communities and with appropriate resources and support for prevention are well placed to do so.

Background
Evidence suggests that oral health is associated with cardiovascular diseases (CVDs). However, care for these conditions remains siloed. Integrating oral health into primary and specialist care, particularly cardiac services, presents a potential to improve early detection, and health outcomes.

Aim
This review examines oral health strategies implemented in primary and cardiovascular care settings, focusing on their impact on health outcomes, service delivery, and medical-dental collaboration.

Methods:
A systematic review of peer-reviewed studies was conducted following the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis and reported in line with the PRISMA 2020 checklist. Review included 21 studies with diverse research methodologies including systematic reviews, quasi-experimental designs, mixed-methods and service evaluations. Guided by the PICO framework data were extracted based on populations, interventions, settings, outcomes, and implementation. Study quality was assessed using appropriate JBI tools. A combination of narrative and thematic analysis was used.

Findings:
Findings highlighted key integration strategies such as upskilling non-dental providers (GPs, nurses, cardiology staff), implementing oral health screening in non-dental settings, formalising referral pathways, and co-locating oral care within general medical settings. Reported outcomes from integration included improved access, earlier detection of oral disease, enhanced provider confidence, and improved oral health knowledge in health professionals.

Conclusion:
Integrated care models can bridge the oral-CVD care divide, improving equity and outcomes. However, sustainable implementation will require policy support, workforce training, and evaluation of long-term cost-effectiveness and impact.

Introduction: Emerging evidence suggests that cardiovascular risk originates in childhood. Strengthening early health knowledge related to cardiovascular health (CVH) may be important for maintaining ideal CVH across the life course.

Aim: To examine whether health knowledge related to CVH in childhood are associated with better CVH in childhood (cross-sectional) and adulthood (longitudinal).

Methods: Data were from the Childhood Determinants of Adult Health (CDAH) that started with the 1985 Australian Schools Health and Fitness Survey (ASHFS) with follow-up 34 years later in CDAH-3 (2014–2019). A health knowledge score (continuous, range 0 [low] -15 [high]) was derived from 15-items on the knowledge and importance of cardiovascular health behaviours and outcomes, completed by 10-15-year-olds in 1985. In adulthood, validated questionnaires assessed, diet, physical activity, smoking and sleep, with clinic-measured or self-reported height and weight measured for body mass index to give a CVH score (continuous, range 0 [poor] to 100 [ideal]; categorical, ideal >80 and non-ideal <80). Associations between the health knowledge score and CVH were examined using linear and logistic regression models adjusted for age, sex, language spoken at home, highest maternal education level and socioeconomic status quartile in RStudio (v4.1.0).

Results: Of the 8,498 children initially recruited, there were 953 for longitudinal analyses with complete data. In childhood, the mean health knowledge score was 13.21±1.21. In adulthood, 38% had ideal and 62% had intermediate or poor CVH. Longitudinally, each unit increase of childhood health knowledge was associated with higher adulthood CVH (β= 0.89, 95% CI = 0.09, 1.69) and increased odds of ideal CVH (OR = 1.09, 95% CI = 0.97,1.21), after adjustment for covariates.

Conclusion: Childhood health knowledge related to CVH, is positively associated with better CVH in both childhood and adulthood. Prevention strategies that develop CVH knowledge in childhood may support higher CVH over the life course.

Introduction: The Big Three asset managers (BlackRock, Vanguard, State Street) are among the top shareholders in thousands of listed companies worldwide. Accordingly, they have considerable influence on corporate decision-making in diverse industries. This paper aimed to examine the influence of the Big Three on the governance of leading corporations in key health-harming commodity industries responsible for a large burden of preventable death and disease worldwide (i.e., industrial epidemics).

Methods: We used an innovative combination of methods and data sources. First, we analysed share-ownership in 40 selected corporations across 10 major health-harming commodity industries. Second, we examined the voting behaviour of the Big Three with respect to 61 proposals put to vote at the 2024 shareholder meetings of these corporations (28/40). These proposals related to public health, social and environmental issues, as well as shareholder payouts and political lobbying and expenditure. Third, we explored key characteristics of the ‘environmental, social, and governance’ (ESG) funds marketed by the Big Three.

Results: The Big Three were the most prominent shareholders across the selected corporations. In 2024, the Big Three overwhelmingly voted against proposals calling for the incorporation of social and environmental objectives into the policies and strategies of these corporations, and invariably voted in favour of proposals seeking to boost shareholder payouts and authorise political activities. The majority (54/73) of the Big Three’s identified ESG funds included one or more of the identified corporations.

Conclusions: The Big Three appear to be reinforcing shareholder primacy in health-harming commodity industries, including by undermining many shareholder-led social and environmental initiatives. Despite positioning themselves as stewards of sustainability, the behaviour of the Big Three risks perpetuating widespread health inequities. States need to take greater action to address industrial epidemics, including through regulating private finance in ways that prioritise health, equity, and sustainability.

Introduction: Occupational lung diseases (OLDs) is the term given to describe a range of lung conditions caused by breathing in dusts, fumes, gases and other hazardous agents in the workplace. There has been a resurgence of OLDs in Australia, including a recent epidemic of silicosis.
Method: To build awareness of OLDs within at-risk workplaces, Lung Foundation Australia (LFA) released the Healthy Lungs at Work Quiz. The Quiz is an online tool designed to prompt knowledge of lung health hazards and safety practices used in the workplace. It takes the respondent on a journey to identify their exposure to hazardous agents, the types of safety practices implemented (or not) in their workplace and whether they are experiencing any symptoms. It also includes an option to download a report to take to their doctor to initiate conversations about their workplace exposure and risks. The Quiz went live during LFA’s National Silicosis Prevention and Awareness Campaign, launched in October 2023 and has run in subsequent years 2024 and 2025. To reach culturally and linguistically diverse workers, of which there are a large proportion working in these industries, the Quiz was translated into six languages – Vietnamese, Simplified Chinese and Arabic, Punjabi, Nepali and Spanish.
Findings: This presentation will share the key findings from the 2025 Quiz results, including the most reported industries where exposure is occurring, the most common type of exposures, workers’ awareness of control measures, and common symptoms experienced. The presentation will also provide a comparison of previous years’ outcomes.
Conclusion: The results of this Quiz will continue to build on evidence regarding the OLD climate in Australia, with a focus on risk factors. The findings will help inform key stakeholders, including government and industry, with where best to take action.

Problem
Sunshine, long hot summers and limited shade are synonymous with the Australian landscape. Despite its critical role in UV protection, 45% of Australians report difficulty finding adequate shade in parks and playgrounds, and half of NSW residents are dissatisfied with shade provision at their local playgrounds. Although Cancer Council had developed comprehensive shade guidelines, their adoption within the built environment sector has been inconsistent.
What We Did
To tackle this issue, Cancer Council NSW (CCNSW), the Australian Institute of Landscape Architects (AILA), and Cancer Institute NSW (CINSW) launched the ShadeSmart partnership in 2020. This initiative promotes high-quality shade design and UV protection through:
• Continuing professional development (CPD) training for landscape architects,
• Annual ShadeSmart awards,
• Strategic advocacy efforts, and
• Collaborative, policy-relevant research.
A dedicated ShadeSmart website was also created to support awareness and engagement. Initially piloted in NSW, the program expanded nationally in 2023.
Key Findings
Key survey findings from AILA members revealed that while 40% strongly agreed that there is a duty of care to plan and design shade, only 14% actively incorporate shade design for skin cancer prevention into their work.
Since its inception, ShadeSmart has delivered seven CPD modules featuring 20 expert presenters, announced 25 ShadeSmart awards over four years, and participated in multiple collaborative research projects.
Lessons
Quality shade isn’t just a design feature; it's critical infrastructure for healthy, resilient communities. Strategic partnerships with peak bodies enable systems alignment and program sustainability. Framing the co-benefits of shade for UV protection and heat mitigation has proven to be a powerful lever for engagement and impact.

Background:
Extreme heat events cause significant morbidity and mortality, and heat adaptation strategies can assist people maintain health in extreme heat events. This project aimed to understand the heat health risk profile of North East (NE) Melbourne and to assess local preparedness and response activities to extreme heat events.

Methods:
The Heat Health Risk Index (HHRI; Australian Bureau of Statistics), which measures heat exposure, social vulnerability and adaptive capacity, was used to identify local government areas (LGAs) with the highest heat health risk. Best practice strategies for preparing and responding to extreme heat events were identified from national and international literature. Assessment of the use of best practice strategies was performed by examining heat health plans, social media and surveying the three LGAs with the highest HHRI. This information was then analysed and synthesised into recommendations to consider.

Results:
Three of 12 LGAs within the NEPHU catchment contained the highest concentration of high and medium-high HHRI areas. Low adaptive capacity contributed to a high HHRI for all three LGAs. Social vulnerability also contributed to the higher HHRI in one LGA. Identified best practice strategies included planning early, completing a heat health check, strengthening home cooling, communicating heat health warnings, providing advice on how to survive the heat, knowing the signs of heat Illness, using community cool spaces, checking neighbours and family, rescheduling events and avoiding the heat. The gap analysis identified that many best practice strategies were already implemented by the LGAs assessed however, some areas that could be strengthened were identified.

Conclusions:
The following recommendations were made to strengthen the heat health preparedness and response further: sharing of extreme heat sub-plans, improving community preparedness activities, and improving communication and information provision during an extreme heat event.

In Australia, individuals who work outdoors are exposed to significantly higher levels of ultraviolet radiation (UVR)-up to ten times more than indoor workers-placing them at greater risk of skin cancer. SunSmart delivers a UV Safety Training Program that supports workplaces through education and training to help protect outdoor workers from the harms of UVR. However, the role of policy in shaping sun/UVR protection practices in workplaces that employ outdoor workers remains underexplored. This survey examined the presence and implementation of sun/UVR protection policies (“policy” herein) in Victorian workplaces, identifying key drivers and barriers to implementation.
A cross-sectional online survey was conducted in November 2024 with 515 Victorian workplaces employing outdoor workers. Respondents included those in Human Resources (HR), policy development and/or policy implementation roles. The survey assessed workplace characteristics, policy presence, communication, and drivers and barriers to the implementation of UVR protective measures.
Two-thirds (66%) of workplaces reported having a policy-22% as a stand-alone policy and 44% integrated within a broader Workplace Health and Safety (WHS) policy. Smaller workplaces (0-100 employees) were significantly more likely to have no policy (35% cf. 21% overall). Workplaces with fewer than 20% of employees working outdoors were significantly less likely to communicate about sun/UVR protection (20 days p/year cf. 50 days p/year in workplaces with over 40% of employees working outdoors). The most common policy driver was WHS legislation (61%). Most workplaces (70%) reported barriers to implementation, including keeping policies updated and building staff capability.
Policies play a critical role in enabling sun/UVR protection practices in the workplace. However, our survey indicates smaller workplaces or those employing fewer outdoor workers are less likely to have UVR policies and practices in place. These insights have informed SunSmart’s program approach to supporting workplaces with outdoor workers, particularly smaller ones, through targeted policy guidance, training, and resources.

Problem

Two in three Australians will be diagnosed with skin cancer by the age of 70. Melanoma is the most common cancer in Australians aged 15 – 29. Ultraviolet radiation (UV) is the main cause, making skin cancer one of the most preventable yet costly cancers. In Tasmania, melanoma is forecasted to become the second most commonly diagnosed cancer by 2032. Although childcare and primary schools engage in the SunSmart Schools and Early Childhood Program, little progress has been made in secondary schools. Tasmanian adolescent survey data shows over 40% of secondary students reported not receiving any sun protection-related lessons at school, and preference for tanning increased from 57% in 2017 to 65% in 2022/23.

What we did

In 2017, Cancer Council Tasmania extended the SunSmart program to offer a tailored UV program to secondary schools. The aim was to increase uptake in sun protection policies and adherence to sun protective behaviors by providing one-on-one support to schools for policy development; and delivering educational workshops to students and school health nurses to reinforce sun protective behaviours.

Results

To date, 52% of secondary schools have adopted a UV policy, covering more than 9,000 students. Participating schools have implemented practices (from all five sun protective measures) that create sun protective environments and guide behaviours.

Lessons

Key barriers to scaling in secondary schools include cost and planning complexity of shade infrastructure and policy gaps including where the department mandates a sun protection policy but not SunSmart program membership. At an individual level, adolescent hat wearing was identified as a persistent barrier. Student feedback indicates sun protection uptake would increase if uniformly enforced, reducing peer pressure. Next steps include advocating to make the SunSmart program membership mandatory, undertaking research to audit shade infrastructure and policies and regulations for shade in school and other youth-focused settings.

Introduction:
The increasing frequency, intensity, and duration of wildfires globally pose a growing threat to human health. These climate-driven events contribute to acute and chronic health outcomes through exposure to particulate matter, toxic gases, heat, displacement, and environmental degradation. Vulnerable populations, including children, older adults, pregnant individuals, Indigenous communities, people living in remote regions, and outdoor workers face disproportionate risks. This presentation outlines a clinical framework for addressing wildfire-related health impacts in primary care settings. It emphasizes risk identification, patient education, and long-term monitoring to mitigate the burden of wildfire exposure.

Methods:
A review of peer-reviewed and grey literature was conducted, supplemented by guidance from public health agencies. The findings informed the development of a practical, evidence-informed approach for primary care providers.

Results:
Wildfire smoke exposure is associated with respiratory and cardiovascular exacerbations, neurocognitive decline, adverse pregnancy outcomes, and mental health disorders. Environmental contamination from wildfires further threatens water and soil safety. The proposed framework equips primary care teams to: Identify and support high-risk individuals, deliver targeted education and preparedness strategies, optimize chronic disease management, monitor for delayed health effects, and advocate for climate-resilient health systems.

Conclusion:
Healthcare providers are uniquely positioned to implement preventive strategies that reduce health risks from wildfires. By integrating environmental health into clinical practice, they can effectively prevent, monitor and manage health impacts of wildfire smoke.

Introduction
The NSW SunSmart schools’ program is designed to protect children from harmful UV radiation. While 86% of NSW primary schools are current or former SunSmart members, research shows that membership status alone does not necessarily translate into improved sun safe behaviours. Genuine engagement and active involvement are needed to transform program reach into lasting change, underscoring the need for ongoing innovation and continuous improvement. To address this, a thorough program evaluation was required to better identify its strengths and limitations.

Methods
The impact evaluation was conducted to systematically assess the extent to which NSW primary schools were implementing the SunSmart program, and to evaluate its influence on sun safety knowledge, attitudes, and behaviours. Additionally, the study investigated the association between program membership and the adoption of sun safe practices within these settings. The study was comprised of a school survey, a parent survey, and qualitative interviews with school staff.

Results
Perceived membership status was a stronger predictor of sun safe attitudes and behaviours than actual membership among staff and parents. Only 69% of current member schools correctly identified their membership; 23% of lapsed-member schools and 19% of non-member schools believed they were current members. Sun protection measures were similar for member and non-member schools, except for sunscreen provision, which was higher in schools identifying as members regardless of their actual status.

Conclusion
The NSW SunSmart Program has improved sun safety knowledge and behaviour in primary schools; however gaps remain in awareness and practical application. Many schools assume sun protection is embedded, leading to complacency. Both schools and parents expressed concern that, without external enforcement or reminders, students’ sun-safe behaviours would likely decline. These findings highlight the need for continuous improvement and targeted strategies to sustain sun protection practices and reinvigorate sun safety as a priority in NSW schools.

Problem: Early Childhood Education and Care services (ECECs) are vital settings for promoting healthy eating and physical activity among children aged 0–5 years. In New South Wales, the Ministry of Health requires Local Health District (LHD) health promotion officers (HPOs) to engage >65% of ECECs annually and support them to implement up to 16 health-promoting policies and practices. Within the Hunter New England LHD, >500 ECECs span 131,785 km², making in-person contact challenging and phone-based implementation resource-intensive. Additionally, ECEC staff report being time-poor.

What we did: To address these challenges, an online self-assessment survey was developed using Research Electronic Data Capture (REDCap). The survey allowed services with data older than 24 months to provide updates on their current implementation of the recommended policies and practices. They could then receive tailored feedback with links to relevant resources to support implementation. HPOs emailed eligible services, inviting them to complete the survey and offering a small incentive for participation. A reminder email was sent after two weeks, followed by up to three reminder phone calls to non-responders.

Results: 143 services were emailed the self-assessment survey. Completion rate of the survey was 77% (111/143), and 65% of services subsequently accessed their tailored feedback statements. 45% (51/111) of services completed the survey as a result of the emails alone and did not require the additional phone calls. The process reduced costs by approximately 36% compared to traditional HPO-conducted phone calls or service visits.

Lessons: Online self-assessments and tailored feedback represent a practical, efficient alternative for monitoring ECEC implementation of health promoting policies and practices. Future research should look to evaluate the ECEC service acceptability of this approach and further refinements, such as improving access and clarity of feedback statements, may enhance usability and increase the overall effectiveness of this approach.