Written by Karen Spehr & Rob Curnow, Community Change, 2011

The health arena is well advanced in sustaining successful attempts to change behaviour at a community-wide level in areas such as road safety (for example, wearing seat belts and drink driving), health screening (pap smears, breast cancer screening) and protective behaviours (safe sex, workplace safety). In stark contrast to environmental problems, many health issues have the benefit of fairly immediate personal consequences to motivate people to change. The dread factor in acquiring AIDS for example is a powerful driver for change, as is the idea that someone you love might be killed in a car accident.

For most people though, environmental problems like climate change are not here and not now. By the time we are able to perceive the personal consequences with our own eyes, behaviour change will be about how to adapt to a radically different environment rather than how to stabilise the current one. Arguably we have already reached this point, but in the meantime we have to meet the challenge of how to bring the problem close to home and in the here and now. What’s more, while all in our community agree that everyone should be healthy, many in our community are not sure that problems like climate change are even problems in the first place.

The other reason behaviour change is more difficult to achieve in the environment arena is the sheer complexity of most environmental problems which consist of many individual behaviours to change in areas as diverse as climate change, land use, water shortage, biodiversity loss and pollution. In contrast to a cancer screening program whose aim might be a couple of actions such as booking and undergoing a medical test, reducing household energy use might involve numerous behaviours, some of which may involve changing lifelong habits. Also, a cancer screening program may have a clear focus on a particular group at risk of contracting the disease whereas the majority of the community may need to use less energy, making it more difficult to target them effectively.

Health issues are not always more straightforward than those in the environmental area, some less successful programs more closely resembling those in the environment because of the large scale structural barriers to change they have to contend with. Health problems like obesity related diseases for instance are increasingly affecting the whole community. We drive more and walk less, our neighbourhoods are often not conducive to exercise, fast food is cheap, well advertised and almost everywhere and habits tend to be family centred rather than individually based. Like environmental programs, to be more successful they need to occur alongside structural changes, changes to the advertising of fast foods to children being a case in point. Despite their differences to environment programs, behaviour change efforts in community health have a wealthy store of lessons and success stories to use.