The global lessons of healthy country, healthy people

Dr David Campbell1

1Charles Darwin University


Noncommunicable disease has become a global pandemic, with the burden of this condition bearing most heavily on socioeconomically disadvantaged. While Aboriginal people have greater risk of being socioeconomically disadvantaged they suffer an ongoing history of colonisation and socioeconomic disenfranchisement. Those living in remote to very remote Australia suffer the additional burden of isolation from services and costly transport and the expense of limited food sources Yet, under certain conditions, Aboriginal people can have better health outcomes.

What is happening
A strong relationship exists between risky behavioural choices of lack of exercise, poor food selection, excess alcohol consumption and smoking. Risky behavioural choices might be attributed to a preference for short term satisfaction rather than, for instance, undertaking long-term self-investment in education with better employment and health possibilities. Failure to make such choices has been identified with overwhelming chronic stress, including loss of control and disenfranchisement. This is important given the higher stress levels suffered by Aboriginal people. Biomedical studies, however, show instances of better health outcomes for Aboriginal people in remote to very remote Australia. These studies demonstrate an inverse relationship between disease condition and traditional cultural connection with country, as through participation in traditional land management.
Using an economic framework, data from these and other studies showed substantial cost savings in chronic disease, plus additional private and public good benefits including meeting food and shelter needs, meeting cultural responsibilities, biodiversity, mitigation of dust storms, and biosequestration of greenhouse gases.

These results exemplify the possibility of nonmedical primary preventative health interventions as a cost-effective complement to curative health interventions. Or, lessons on how we might address the global noncommunicable disease pandemic.


Most of David’s professional life has been in regarding bio-economics, with a particular focus in fisheries. During this time, he wrote one of the earliest works in optimal harvest of a density independent species and the application of individual transferable quota; when these works required a micro and public economics view point. The last ten years were with the Centre for Remote Health, Alice Springs, where he supervised the remote post graduate course in Remote Health Economics. During this time his research and publication focus was on the social benefits of healthy country, healthy people, through Aboriginal involvement in traditional land management or caring for country. This and following work allowed him to recently finish up with a PhD by publication.