Objective: The aim of this literature review was to establish the economic burden of preventable disease in Australia in terms of attributable health care costs, other costs to government and reduced productivity. Methods: A systematic review was conducted to establish the economic cost of preventable disease in Australia and ascertain the methods used to derive these estimates. Nine databases and the grey literature were searched, limited to the past 10 years, and the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analysis) guidelines were followed to identify, screen and report on eligible studies. Results: Eighteen studies were included. There were at least three studies examining the attributable costs and economic impact for each risk factor. The greatest costs were related to the productivity impacts of preventable risk factors. Estimates of the annual productivity loss that could be attributed to individual risk factors were between $840 million and $14.9 billion for obesity; up to $10.5 billion due to tobacco; between $1.1 billion and $6.8 billion for excess alcohol consumption; up to $15.6 billion due to physical inactivity and $561 million for individual dietary risk factors. Productivity impacts were included in 15 studies and the human capital approach was the method most often employed (14 studies) to calculate this. Conclusions: Substantial economic burden is caused by lifestyle‐related risk factors. Implications for public health: The significant economic burden associated with preventable disease provides an economic rationale for action to reduce the prevalence of lifestyle‐related risk factors. New analysis of the economic burden of multiple risk factors concurrently is needed.

Objective: A systematic review was conducted to determine the health burden of preventable disease in Australia. Methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta‐Analyses) statement guidelines were followed to identify, screen and describe the protocols used in the systematic review. Results: Eleven studies were included in the review. Data on the health burden associated with lifestyle‐related risk factors were extracted by disease with outcomes reported in attributable number and proportion of deaths, years of life lost, years lived with disability and disability‐adjusted life years (DALYs). Around one‐third of DALYs was attributed to all modifiable risk factors. The range of estimates of DALYs attributable to each prioritised risk factor was: combined dietary risk factors, 7.2% to 9.7%; tobacco, 7.9% to 9.0%; alcohol, 5.1% to 12.2%; high body mass, 5.5% to 8.3%; and physical inactivity, 1.2% to 5.5%. Conclusions: Although the methods used to estimate preventable health burden varied greatly between studies, all found that a substantial amount of death and disability was attributable to lifestyle‐related risk factors. Implications for public health: There is a large health burden in Australia caused by modifiable risk factors and further action is warranted to address this burden.

Objectives There is a growing crisis of hunger and food inequality among Indigenous people in Australia who are increasingly urbanized. They experience substantially higher rates of food insecurity than the general population which impacts on diet-sensitive chronic disease risk and life expectancy. This project aimed to apply systems tools to identify systemic challenges to achieving food security and possible local actions to address the problem in two large Aboriginal communities. Methods A qualitative system dynamics method used group model building (GMB) in two regional and outer urban communities involving participants from Aboriginal Community Controlled Health Services, food relief charities, council, educational groups and some food industry partners in the two local areas. The GMB enabled the participants to consider all the connections between contributing factors, feedback and reinforcing loops to produce a map of food insecurity linked to the local food system. This project was done in collaboration with the Study of Environment of Aboriginal Resilience and Child Health (SEARCH), Australia's largest cohort study into the health of urban Aboriginal children. Results The GMB workshops resulted in causal loop diagrams that mapped the complexities of the food insecurity challenge. The maps highlighted the impact of low incomes and unemployment that influenced the communities’ ability to budget and afford healthy food, thereby leading to a reliance on convenience food outlets. This, in turn, influenced communities’ healthy food preferences, which negatively impacted on food security. Additionally, community education around healthy food choices, meal planning and financial literacy were factors that also directly impacted food security. A distinct loop reflected that a lack of coordination between agencies was leading to duplication and confusion about available food relief services and the ability to access these services. Conclusions These analyses elicited local understanding of the potential levers within the system to address food insecurity in Indigenous people. They are being used to develop community-level workplans to shift the high prevalence of food insecurity and its longer-term impact on preventable chronic disease. Funding Sources This work was funded by the Australian Prevention Partnership Centre and the Sax Institute, Sydney.