Sustainability in health promotion: a critical imperative
Health promotion and prevention programs often begin with great energy and promise—but far too often, they struggle to last. Through my doctoral research at QUT, I explored the question that many in our field wrestle with: What makes a program sustainable beyond its initial phase? And how can we better design for that sustainability from the very beginning?
The Core Challenge
In many cases, we do strong work in planning and implementation. But sustainability is left as an afterthought. What I found is that when sustainable implementation isn’t deliberately built into the process, even well-evidenced and well-intentioned programs can fade out. And when that happens, communities are left without the continuity they need for long-term wellbeing.
Barriers and Enablers
Across my research, several common barriers to sustainability emerged:
Fragmented governance
Short-term, rigid funding structures
Limited community involvement
Lack of sustainability planning at the design stage
But there were also clear enablers:
Cross-sector partnerships grounded in trust
Community ownership and leadership
Embedding sustainability principles from the outset
Clear governance arrangements that support long-term adaptation
What became evident is that sustainability isn’t just about keeping a program going—it’s about embedding it within a broader ecosystem of people, processes, and values.
Why It Matters
When programs endure, so do their benefits: fewer chronic illnesses, stronger social cohesion, and more resilient communities. Sustainable programs create space for long-term change—something quick wins can’t offer on their own. In my reflections, I came to believe that sustaining health promotion efforts is one of the most important contributions we can make toward systemic, equitable change.
What We Can Do
Here are a few lessons I’ve carried forward that may support others working in this space:
Think about sustainability early. It’s never too soon to ask who will carry the work forward.
Prioritise relationships. Sustainable programs are rarely held up by one organisation alone—they thrive on shared leadership.
Establish strong governance. Accountability and structure matter, especially when original champions move on.
Invest in community capacity. Building skills, confidence and ownership within communities is key.
Use evaluation to guide adaptation. Measure what matters—not just outcomes, but what keeps a program alive and relevant.
A Collective Commitment
This work is never done alone. If we want health promotion programs to truly make a lasting impact, we need to think and act collectively. I offer these insights not as fixed answers, but as part of an ongoing conversation. My hope is that we can continue learning together—so the work we start today still matters tomorrow.
Let’s build health promotion that endures—thoughtfully, humbly, and together.