In sport, you can tell how you or in a team sport, your team is traveling by the scoreboard. It’s not to say that winning is everything, and you can certainly enjoy playing sport for the enjoyment of playing sport. That’s a good thing. But if you want to know whether you’re winning or losing against another person or another team, the scorecard or scoreboard will tell you that.
In more solo pursuits, for example, running, you can measure your time. Are you going faster? Are you traveling more distance? And in a sport like golf, you can measure how many shots you have to take to get around the course. And ultimately, if the numbers are going in the right direction, it’s telling you you’re getting better.
If a sports team is consistently losing and the scoreboard shows that they’re losing by an increasing amount, then typically that team would examine what it’s doing and look to change its game plan. And in the same way, if your golf score is getting worse, the likelihood is that you might approach a coach and say, “Look, is there something that you can do to help me to improve my score?”
All right, where are we going with this?
Great quote from Milton Friedman, the economist. One of the great mistakes is to judge policies and programs by their intentions rather than their results.
Now in sports we understand that you can intend to really go well today, but if you lost by 10 goals, or your score on the golf course was 10 over what you did last week, your intent can be there, but if the result or outcome isn’t there, you can go back and question it—because it is the result or the outcome that matters.
A survey of 13,780 participants in Western Australia throughout 2024 found that less than half of adults self‑reported their general health as being excellent or very good compared to 50.2% in 2023. The figure is 10% below the 2014 figures.
And it actually does get worse. I’m going to quote a little bit of data here.
Smoking rates—and I will just for a moment digress—yes, this is data out of Western Australia and other jurisdictions may not be identical, but I’d be a little bit surprised if there are massive differences across Australia.
We’ve got a lot of policies and programs run by the health department, particularly advertising on mainstream media, urging people to quit smoking, change their diet, and exercise. All good. Absolutely well‑intended.
What are the outcomes? Smoking is 13.5%, up from 12.5% in 2023. So smoking rates have gone up. Illicit drug use is 12.4%, up from 11.4% in 2023.
Yes, these are statistics, and we spoke in a previous podcast about the limitations of statistics, but this is sheer numbers of people. The comparison to the previous year is what makes this useful, because the same limitations apply year to year.
Fast‑food consumption shows mixed results, depending on how it’s defined. Consumption overall appears to have gone up over the decade, even if some year‑to‑year changes are small.
Harm‑inducing alcohol consumption is 36.4%, up from 35.5% in 2023. Again, definitions matter.
On the plus side, exercise rates remain relatively steady, with 61% of adults saying they exercise regularly. The number of people consuming the so‑called correct amount of vegetables was 4.7%, though these guidelines themselves are open to question.
If health programs looked at these numbers the way a sports team looks at a scoreboard, they would be disturbed. While intentions are good, the outcomes are not only failing to improve—they’re moving in the opposite direction.
The one exception often highlighted is that vaping rates are down. But when vaping decreases and smoking increases, we know what’s happening. People are going back to smoking.
So what can we expect to happen next? Ideally, this data would prompt questioning and investigation into current policy settings. Is what we are doing having the intended effect? The answer is clearly no.
But history suggests that instead of changing course, public health authorities will blame the public for not listening and call for more funding to double down on what isn’t working.
Doing more of the same when something is failing is not a strategy that works in sport, in life, or in public health.
There are simple things that could help: making it easier to vape than to smoke, revisiting tobacco excise, moving away from low‑fat dietary guidelines, and encouraging people to eat real food—the kind people ate before the 1970s.
Not ultra‑processed food with stars, ticks, or stamps, but food that was grown, raised, or moved not long ago.
So what should individuals do? Take matters into your own hands. Eat real food. Exercise regularly. Manage stress. Get enough sleep. If you smoke, aim to stop. There are many ways to do that, all less harmful than smoking cigarettes.
If you drink too much, drink a little less. Most people are not addicted; they simply have one or two too many.
Keep it simple. Don’t rely on the government. When you have good intentions about your health, measure the outcomes. If they’re going the way you want, keep going. If they’re not, make changes.
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Dr Joe Kosterich – Doctor, Health Industry Consultant and Author
Doctor, speaker, author, and health industry consultant, Joe is WA State Medical Director for IPN, Clinical editor of Medical Forum Magazine, Medical Advisor to Medicinal Cannabis company Little Green Pharma and Course Chair, and writer for Health Cert. He is often called to give opinions in medico-legal cases, has taught students at UWA and Curtin Medical schools and been involved in post graduate education for over 20 years.
A regular on radio and TV, Joe has a podcast – Dr Joe Unplugged, has self- published two books and maintains a website with health information. He has extensive experience in helping businesses maintain a healthy workforce.
Past Chairman of Australian Tobacco Harm Reduction Association, current Vice President of Arthritis and Osteoporosis WA, Joe previously held senior positions in the Australian Medical Association and has sat on numerous boards.
