A sobering article in The Lancet, details the refined methods used by the Global Burden of Disease 2019 Tobacco Collaborators to estimate the increasing toll of tobacco-attributable morbidity and mortality. Their analysis improves on previous calculations of prevalence of smoking in adults and tobacco-related disease.

The authors found that global age-standardised prevalence of smoking tobacco use decreased by 27·5% in males and 37·7% in females aged 15 years and older between 1990 and 2019. However, inexorable population growth has increased the number of smokers from 0·99 billion in 1990 to 1·14 billion in 2019, who consumed 7·41 trillion cigarette-equivalents of tobacco in 2019. The authors estimated that 5·96 million (77·5%) of 7·69 million smoking-attributable deaths in 2019 occurred in low-income and middle-income countries and that 66 (93%) of 71 countries that had significant increases in such deaths were low-income and middle-income countries.

How to tackle the global smoking pandemic has become a perpetual dilemma. Tobacco control—a term adopted by 1990s academia to keep radical grassroots antismoking activism at arm’s length—remains mired in descriptive research that generates data to support policies aimed at reducing smoking. However, unlike, for instance, mosquito control, the vector—the tobacco industry—survives and thrives. And, like a mutating virus, it adapts to legislative and regulatory attempts to hinder the sale, promotion, and use of its products.

To view The Lancet article in full click here.

Image source: Sydney Criminal Lawyers website.

NACCHO Chair joins new advisory group

A new advisory group that will inform the development of the government’s national plan to end family, domestic and sexual violence. Co-chairs the Department of the Prime Minister and Cabinet’s Office for Women, and the Department of Social Services, have been joined by representatives from culturally and linguistically diverse communities, Indigenous communities, and LGBTQIA+ communities. People with disability, children and young people have also been represented. NACCHO’s Chair Donnella Mills, is one of the 17 members making up the advisory group.

The appointments were announced last Friday 18 June 2021 with the group attending a virtual meeting of the Women’s Safety Taskforce that day. During the meeting, commonwealth, state and territory governments discussed their progress toward ending violence against women and children, while advisory group members voiced support for evidence, data and clear monitoring for all items in the upcoming national plan. “This will ensure we can thoroughly assess and track our long term target to ending violence against women and their children,” Women’s Safety Minister Anne Ruston said.

The advisory group’s contributions will be detailed in a consultation report, to inform the national plan. The group will work with the Aboriginal and Torres Strait Islander Advisory Council to ensure relevant Closing the Gap targets are embedded in the plan.

The public can give feedback on the plan here until Saturday 31 July 2021.

To view the full article in The Mandarin click here.

Image source CBA website.

June 2021 RPHCM Project Update

The June 2021 Project Update for the Remote Primary Health Care Manuals (RPHCMs) has been released.

Secondary reviewers are being sought – if are you a nurse or Aboriginal and Torres Strait Islander Health Practitioner working in a remote clinic your feedback is being sought on whether the protocols are easy to read and understand, and apply to your daily practice.

Protocol groups coming up for endorsement include (1) dental protocols and procedures (2) cervical screening, and (3) child respiratory.

To view the June 2021 RPHCM project update click here.

Image source: Centre for Remote Health website.

AWHs’ vital role in paediatric burn care

Burns affect Australia’s First Nations children more than other Australian children, they also experience longer lengths of stay in tertiary burns units and face barriers in accessing burn aftercare treatment. Data sets from two studies were combined whereby 19 families, 11 First Nations Health Worker (FNHW) and 56 multidisciplinary burn team members from across Australia described the actual or perceived role of FNHW in multidisciplinary burn care.

Data highlighted similarities between the actual role of FNHW as described by families and as described by FNHW such as enabling cultural safety and advocacy. In contrast, a disconnect between the actual experience of First Nations families and health workers and that as perceived by multidisciplinary burn team members was evident. More work is needed to understand the impact of this disconnect and how to address it.

To view the research paper in full click here.

Image source: The George Institute for Global Health.

Cervical cancer elimination targets unmet

Achieving the World Health Organisation (WHO) cervical cancer elimination target of fewer than four new cases per 100,000 woman-years requires scaling up HPV vaccination of girls, cervical screening, and pre-cancer and cancer treatment. Data has been reviewed from four high-income colonised countries (Australia, Canada, Aotearoa NZ, and the US) to identify how each is currently performing compared to the cervical cancer incidence elimination and triple-intervention targets, nationally and in Indigenous women.

To achieve elimination, cervical cancer incidence must be reduced by 74% in Indigenous women in Australia, and 63% in Maori women in NZ. Only Australia meets the vaccination coverage target. Screening coverage is lower for Indigenous women in all four countries though the differential varies by country. Currently, only Australia universally offers HPV-based screening. Data on pre-cancer and cancer treatment were limited in all countries.

Large inequities in cervical cancer currently exist for Indigenous peoples in Australia, Canada, New Zealand and the US, and elimination is not on track for all women in these countries. Current data gaps hinder improvements. These countries must urgently address their systemic failure to care and provide health care for Indigenous women.

To view the research article in full click here.

Art by Madison Connors, a Yorta Yorta, Dja Dja Wurrung, Kamilaroi woman from NE Victoria. Image source: Cancer Council Victoria.

Digital inequities in supporting mental health

An article Connection to… Addressing Digital Inequities in Supporting the Well-Being of Young Indigenous Australian in the Wake of COVID-19 examines whether connection to digital technologies helps connect young Indigenous people in Australia to culture, community and country to support good mental health and well-being and protect against indirect and potentially long-term effects of COVID-19.

A literature review revealed there are inequities in affordable access to digital technologies. Only 63% of Indigenous people have access to internet at home. Digital technologies and social media contribute to strong cultural identity, enhance connections to community and country and improve mental health and social and emotional well-being outcomes.

Access to digital technologies can facilitate healing and cultural continuity, self-determination and empowerment for young people to thrive, not just survive, in the future. More targeted policies and funding is urgently needed to promote digital technologies to enhance Indigenous young people’s access to mental health and well-being services, maintain cultural connections and evaluate the effectiveness of these initiatives using Indigenous well-being indicators.

To view the full article click here.

#thismymob app. Image source: SBS NITV website.