Health reform, if you judge it by the content of much public debate, is a matter for politicians and health professionals and is mostly about financing and health services.
The role of the community — not as passive recipients of services but as the drivers of innovation and leaders of health programs — generally receives far less attention. That’s a pity because it means we are often not making the most of the creative resources that we do have. We need to talk the talk with the people we’re talking about.
How often, for example, do you hear of shopping centres talked about as potential health promotion venues? And yet that’s exactly what is happening in shopping centres all over the place, thanks to the emergence of mall walking groups.
When you think about it, malls are ideal venues for just the types of people who may have most to gain from being more active — those becoming frail, the elderly or those with chronic diseases. Malls offer smooth surfaces, hand-rails, wheelchair access, and shelter from the weather. Larger ones are public transport hubs and can offer a two-kilometre walking route.
Mall walking groups have the added benefit of promoting social wellbeing, typically including a café stop and the chance for building the social connections and networks that are so important for good health. Older people may even come across their teenage grandchildren.
Naturally enough, mall walking first took off in North America, but there are more and more such groups around Australia, and the Injury Control Council of Western Australia has even developed an information kit to help them get started.
We are facing a massive tide of chronic diseases, thanks to the ageing of the population and the growing incidence of diabetes. The demographics and the epidemiology mean that we cannot rely on health services or health professionals being able to meet the full range of people’s needs. They simply won’t have the capacity.
Communities will have to increase their voluntary efforts to look after each other’s health. Supported, well-paced physical activity for older people — especially those with chronic disease — is one of the highest gain population health strategies around.
To work out how to do this, the people leading the health debates should get down to the malls and start walking the walk with some of the most creative people in health care. Who knows what their next idea will be?