NACCHO Aboriginal Youth and Mental Health : Download Report from @MissionAust and @blackdoginst

 ” It is critical that responses to support a young person’s mental health be culturally sensitive and gender sensitive and that they address the structural issues that contribute to higher levels of psychological distress for young females and for Aboriginal and Torres Strait Islander young people.

For example, we know that Aboriginal and Torres Strait Islander people continue to be adversely affected by racism, disconnection from culture, and the long history of dispossession. All of these factors contribute to poor mental health, substance misuse and higher suicide rates.

As a matter of priority, suicide prevention programs that are tailored to the needs of the whole community and focussed on prevention should be available to Aboriginal and Torres Strait Islander people. All programs should be offered in close proximity to community and should be age appropriate as well as culturally sensitive.”

Download a copy of the Five-Year Youth Mental Health Report

 youth-mental-health-report

NACCHO Background References (1-4)

Ref 1:  Read / research the 250 NACCHO Articles

about Aboriginal Mental Health published in past 5 years

about suicide prevention in the past 5 years

Ref 2 :Download the Draft Fifth National Mental Health Plan at the link below:

 “The release of the Draft Fifth National Mental Health Plan is another important opportunity to support reform, and it’s now up to the mental health sector including consumers and carers, to help develop a plan that will benefit all.”

A successful plan should help overcome the lack of coordination and the fragmentation between layers of government that have held back our efforts to date.”

NACCHO and Mental Health Australia CEO Frank Quinlan have welcomed the release of the Draft Fifth National Mental Health Plan and is encouraging all ACCHO stakeholders to engage with the plan during the upcoming consultation period.

Download the Draft Fifth National Mental Health Plan at the link below:

PDF Copy fifth-national-mental-health-plan

You can download a copy of the draft plan;or see extracts below

Fifth National Mental Health Plan – PDF 646 KB
Fifth National Mental Health Plan – Word 537 KB

Ref 3: NACCHO Chairperson, Matthew Cooke see previous press Release

“Clearly Australia’s mental health system is failing Aboriginal people, with Aboriginal communities devastated by high rates of suicide and poorer mental health outcomes. 

Poor mental health in Aboriginal communities often stems from historic dispossession, racism and a poor sense of connection to self and community. It is compounded by people’s lack of access to meaningful and ongoing education and employment. Drug and alcohol related conditions are also commonly identified in persons with poor mental health.

While there was no quick fix for the crisis, an integrated strategy led by Aboriginal community controlled health services is a good starting point.

The National Mental Health Commission Review recommended the establishment of mental health and social and emotional wellbeing teams in Aboriginal Community Controlled Health Services, linked to Aboriginal and Torres Strait Islander specialist mental health services.

None of these can be fixed overnight but we can’t ignore the problems. We are on the brink of losing another generation of Aboriginal people to suicide, poor health and substance abuse.”

What we do know is the solution must be driven by Aboriginal leaders and communities – a model that is reaping great rewards in the Aboriginal Community Controlled health sector.

It must be a community based approach, backed up by governments of all levels.”

NACCHO Chairperson, Matthew Cooke

Ref 4 : Extra info provided by Tom Calma

Prof Pat Dudgeon and Tom Calma chair the ATSI Mental Health and Suicide Prevention Advisory Group to the Commonwealth and Pat Chairs NATSIMHL, the group who created the Gayaa Dhuwi.

Bottom line is that the community should feel confident that all the major initiatives in mental health and suicide prevention are being lead by our people and more can be found at http://natsilmh.org.au

and http://www.psychology.org.au/reconciliation/whats_new/

and http://www.atsispep.sis.uwa.edu.au

Action urgently needed to stem rising youth mental illness

Last week Mission Australia released its joint Five-Year Youth Mental Health Report with Black Dog Institute, sharing the insights gathered about the mental health of Australia’s young people during the years 2012 to 2016.

Learning what young people think is so important to the work we do at Mission Australia. By checking in with them we discover their thoughts about their lives and their futures, and what concerns them most.

The Five Year Mental Health Youth Report presents the findings of the past five years on the rates of psychological distress experienced by young Australians, aged 15-19.

  • Almost one in four young people met the criteria for having a probable serious mental illness – a significant increase over the past five years (rising from 18.7% in 2012 to 22.8% in 2016).
  • Across the five years, females were twice as likely as males to meet the criteria for having a probable serious mental illness. The increase has been much more marked among females (from 22.5% in 2012 to 28.6% in 2016, compared to a rise from 12.7% to 14.1% for males).
  • Young people with a probable serious mental illness reported they would go to friends, parents and the internet as their top three sources of help. This is compared to friends, parents and relatives/family friends for those without a probable serious mental illness.
  • In 2016, over three in ten (31.6%) of Aboriginal and Torres Strait Islander respondents met the criteria for probable serious mental illness, compared to 22.2% for non-Indigenous youth.

In light of these findings, Catherine Yeomans, Mission Australia’s CEO said: “Adolescence comes with its own set of challenges for young people. But we are talking about an alarming number of young people facing serious mental illness; often in silence and without accessing the help they need.

The effects of mental illness at such a young age can be debilitating and incredibly harmful to an individual’s quality of life, academic achievement, and social participation both in the short term and long term.

Ms Yeomans said she was concerned that the mental health of the younger generation may continue to deteriorate without extra support and resources, including investment in more universal, evidence-based mental health programs in schools and greater community acceptance.

Given these concerning findings, I urge governments to consider how they can make a major investment in supporting youth mental health to reduce these alarming figures, Ms Yeomans said.

“We need to ensure young people have the resources they need to manage mental health difficulties, whether it is for themselves or for their peers. Parents, schools and community all play a vital role and we must fully equip them with the knowledge and skills to provide effective support to young people.”

The top issues of concern for those with a probable serious mental illness were: coping with stress; school and study problems; and depression. There was also a notably high level of concern about other issues including family conflict, suicide and bullying/emotional abuse.

The report’s finding that young people with mental illness are turning to the internet as a source of help with important issues also points to prevailing stigma, according to Black Dog Institute Director, Professor Helen Christensen.

“This report shows that young people who need help are seeking it reluctantly, with a fear of being judged continuing to inhibit help-seeking,” said Professor Christensen.

“Yet evidence-based prevention and early intervention programs are vital in reducing the risk of an adolescent developing a serious and debilitating mental illness in their lifetime. We need to take urgent action to turn this rising tide of mental illness.

“We know that young people are turning to the internet for answers and our research at Black Dog Institute clearly indicates that self-guided, online psychological therapy can be effective in reducing symptoms of depression and anxiety.

“While technology can be a lifeline, e-mental health interventions must be evidence-based and tailored to support young people’s individual needs. More investment is needed to drive a proactive and united approach to delivering new mental health programs which resonate with young people, and to better integrate these initiatives across schools and the health system to help young people on a path to a mentally healthier future.”

Armed with this information we are able to advocate on their behalf for the support services they need, and for the broader policy changes.

Download the NACCHO Mental Health Help APP to find your nearest ACCHO

 The Five-Year Youth Mental Health Report shows some alarming results with almost one in four young people meeting the criteria for a probable serious mental illness (PSMI). That figure has gone up from 18.7 per cent in 2012 to 22.8 per cent in 2016.

Girls were twice as likely as boys to meet the criteria for having a PSMI, and this figure rose from 22.5% in 2012 to 28.6% in 2016, compared to a rise from 12.7% to 14.1% for boys.

An even higher number of Aboriginal and Torres Strait Islander respondents met the criteria for having a probable serious mental illness (PSMI ) at 31%.

These results make it clear that mental illness is one of the most pressing issues in our communities, especially for young people, and one that has to be tackled by the governments, health services, schools and families.

Three quarters of all lifetime mental health disorders emerge by the age of 24, but access to mental health services for this age group is among the poorest, with the biggest barriers being community awareness, access and acceptability of services.

What we need is greater investment in mental health services that are tailored to the concerns and help seeking strategies of young people and are part of a holistic wrap around approach to their diverse needs.

For young women, we know that a large proportion (64%) were extremely or very concerned about body image compared to a far smaller number of males (34.8%).

Such a finding suggests that social pressures such as discrimination based on ideals of appearance may need to be addressed to tackle this gender disparity in the levels of probable serious mental illness among girls.

And although girls are more likely to be affected negatively by body image issues, they are more likely to seek help when they need it than boys.

Clearly then, and for a variety of reasons, an awareness of gendered differences is a crucial component in the management of mental health issues.

We need to ensure that all young people, whether they live in urban areas or regional, have the resources they need to manage mental health difficulties, whether it is for themselves or for their peers. Parents, schools and community all play a vital role and we must fully equip them with the evidence-based knowledge and skills to provide effective support to young people.

 

 

 

NACCHO Aboriginal Health : NT Government invests in safer and healthier families / communities: cuts grog to problem drinkers

Budget 2017 is delivering on the Territory Labor Government’s election commitments, investing $33 million in our communities and tackling the causes of domestic, family and sexual violence to ensure that Territorians feel safe

“The Northern Territory has the highest rates of domestic and family violence in Australia, and that comes at an enormous social and economic cost.

Minister for Territory Families Dale Wakefield (see article 1 below )

 ” The BDR supported police in stopping alcohol related crime and antisocial behaviour and its return will make a difference. Police previously described it as one of the best tools for combating antisocial behaviour.

“We know that 60% of domestic violence incidents are alcohol related – this is simply unacceptable and cutting grog to problem drinkers will help address this blight.”

Chief Minister Michael Gunner today said returning the Banned Drinker Register (BDR) on September 1 is the number one thing the Territory Labor Government can do to tackle antisocial behaviour and crime – including the devastating rates of domestic violence.         (see article 2 below )

 ” The Territory Labor Government says the new Banned Drinkers Register will help ease pressures on frontline health workers by reducing the supply of alcohol to those who cause so much harm.

We’ve listened to concerns from medical professionals and community that critical resources are being diverted to deal with alcohol related harm and violence.

While every Territorian is entitled to have a drink and enjoy that responsibly, we know too many people are drinking at dangerous levels, harming themselves, their families and their communities.”

The Minister for Health Natasha Fyles ( See Article 3 below )

Article 1

More than $33 million will be invested in frontline services, infrastructure and strategies to support the prevention of domestic and family violence that will help keep Territorians safe.

Minister for Territory Families Dale Wakefield said Budget 2017 acknowledges the cost and serious impact that domestic and family violence has on our society, and today’s announcement will improve services and facilities for Territorians.

“Budget 2017 is delivering on the Territory Labor Government’s election commitments, investing in our communities and tackling the causes of domestic, family and sexual violence to ensure that Territorians feel safe,” Ms Wakefield said.

“The Northern Territory has the highest rates of domestic and family violence in Australia, and that comes at an enormous social and economic cost.

“This budget will address both infrastructure and policy issues to ensure we have the necessary foundations to firstly reduce the rates of domestic and family violence, but also to provide victims essential support.”

This includes:

  • $6.2 million to continue current domestic violence services in the Territory, left unfunded by the CLP government
  • $3 million to refurbish Alice Springs Domestic Violence Court to improve the safety, experience and outcomes for people affected by domestic and family violence
  • $6 million for the replacement of the Alice Springs Women’s Shelter, so that women can establish independence and recover from trauma
  • $1 million to establish a remote women’s safe house in Galiwinku.

The Territory Labor Government is restoring trust in Government, creating jobs, investing in children and building safer, fairer and stronger communities – right across the Territory.

The Minister also reaffirmed additional investments being made right now into domestic and family violence programs that allow for community led solutions, including:

  • $700,000 over two years to expand the “NO MORE” violence prevention campaign
  • $350,000 to Charles Darwin University and Menzies School of Research to review key domestic and family violence reduction programs in the NT, particularly their impact and effectiveness in remote communities
  • $150,000 to NTCOSS to build the capacity of the domestic and family violence sector
  • $80,000 to improving services provided by the Gove Crisis Accommodation service
  • $30,000 to NPY Women’s Council towards a sexual violence research project.

Minister Wakefield said Budget 2017 is investing in the Territory’s future through jobs, children and community.

“We are going through a challenging economic period – everyone knows this and we have been very upfront about it,” Ms Wakefield said.

“This budget will create and support jobs, deliver on our election commitments and be a fair plan for our future

Article 2 : A BETTER BDR TACKLING SECONDARY SUPPLY AND CUTTING RED TAPE

Chief Minister Michael Gunner today said returning the Banned Drinker Register (BDR) on September 1 is the number one thing the Territory Labor Government can do to tackle antisocial behaviour and crime – including the devastating rates of domestic violence.

Mr Gunner today announced that the new BDR would address weaknesses in the old version by better addressing the problem of secondary supply and cutting red tape.

“We have listened to Police, the community and local businesses and taken action – we will introduce tougher punishment for secondary suppliers to banned drinkers,” Mr Gunner said.

“It will now be a criminal offence to intentionally supply alcohol to a person known to be on the BDR. Once charged with this offence police have the power to place the secondary supplier on the BDR. The offence can also carry significant fines.

“Another improvement cutting red tape is that once given a Banned Drinker Order, a person will go straight onto the BDR and will not require a tribunal hearing or appearance.

“Importantly, Banned Drinker Orders issued by Police will be automatically processed through the Integrated Justice Information System to immediately place problem drinkers on the BDR. This will happen within 48 hours which will help both Police and victims in urgent domestic and family violence situations.”

Mr Gunner said the Territory Labor Government introduced the BDR in July 2011 and the chaotic CLP Government scrapped it in 2012 for political reasons.

“Territorians hated that the chaotic CLP Government scrapped the BDR and they want it returned because it worked – we have listened and taken action,” he said.

“The BDR supported police in stopping alcohol related crime and antisocial behaviour and its return will make a difference. Police previously described it as one of the best tools for combating antisocial behaviour.

“We know that 60% of domestic violence incidents are alcohol related – this is simply unacceptable and cutting grog to problem drinkers will help address this blight.”

Mr Gunner said alcohol related crime and antisocial behaviour in our city centres is an issue facing many businesses and is hindering efforts to revitalise these areas.

“We want to make our city centres a vibrant place and the BDR will combat antisocial behaviour, in turn encouraging tourists and locals back into these areas,” he said.

“Undoing the CLP’s failed replacement scheme and bringing back the BDR is a significant piece of work and new legislation will be introduced into Parliament in May we are working as fast as we can because we know this will make a difference.”

Mr Gunner said Government is taking action on the causes of crime because every Territorian has the right for them and their homes and business to be safe.

He said measures including the recent $18.2 million overhaul of the broken youth justice system (which includes 52 Youth Diversion Workers, more funding for boot camps, supporting the enforcement of bail conditions and victims conferencing), greater powers for police (including electronic monitoring bracelets), more police officers and better training for staff in youth justice facilities showed his Government was taking crime very seriously.

Article 3 FRONTLINE HEALTH WORKERS TO BENEFIT FROM BDR (NT)

The Territory Labor Government says the new Banned Drinkers Register will help ease pressures on frontline health workers by reducing the supply of alcohol to those who cause so much harm.

The Minister for Health Natasha Fyles said Territorians have the right to access the high quality services our hospitals offer.

“We’ve listened to concerns from medical professionals and community that critical resources are being diverted to deal with alcohol related harm and violence,” Ms Fyles said.

“We’re empowering Territorians by creating more pathways to the BDR.

“The new BDR unveiled this week will have new provisions allowing medical officers, families and carers to refer problem drinkers to the BDR and to the rehabilitation they need.

“While every Territorian is entitled to have a drink and enjoy that responsibly, we know too many people are drinking at dangerous levels, harming themselves, their families and their communities.

“Our paramedics and hospital staff are dealing with the highest rates of alcohol related harm and injury at rates not seen in any other jurisdiction across the country

“The Territory continues to have the highest rates of alcohol related injury and disease in the nation – the number of deaths related to alcohol in the NT is three times the national average.

“Alcohol related harm costs the Territory more than $642 million a year and that is continuing to grow.

“The BDR was scrapped by the chaotic former CLP government in 2012 – delivering a sharp spike in alcohol related harm over the two most violent years on record.

“Department records show alcohol related Emergency Department presentations peaked at over 3000 across the Territory in 2013.

“We made an election promise to Territorians that we would bring back the BDR and we are delivering on that promise

“Seventy per cent of alcohol sold in the Territory is takeaway, so we know cutting supply to problem drinkers is a key way to curb alcohol fuelled violence and crime.

From September 1 the BDR will be reinstated, with Territorians and tourists having to show ID to purchase takeaway alcohol.

Those identified as being on the BDR won’t be able to buy takeaway alcohol.

More than a thousand people will be automatically included on the BDR from day one.

That figure is expected to grow to around 2500 by Christmas.

The legislation will be introduced to parliament next month.

 

 

NACCHO Aboriginal Health : From #WCPH2017 an international spotlight on #Indigenous public health equity

” The Indigenous Working Group will provide an opportunity to bring to the global public health and civil society arena a visible and prominent Indigenous voice that privileges an Indigenous world view and narrative.

We intend to creates a platform for change with the aim to address the health inequities experience by Indigenous peoples worldwide.”

From the 15th World Congress of Public Health Melbourne 

Full 4 Page WCPH2017 Demand for Action Download

WCPH2017-Melbourne-Demand-for-Action

See full report article 2 below

WCPH2017 Indigenous Press Release Working Group

 “I want to see Indigenous people not just at the table but at the head of the table, leading. I don’t want to continue to see the token black. I want our mob designing, implementing and evaluating our business.

No one should be speaking on our behalf. I expect to see Indigenous people’s voices preferenced and prioritised.

We shouldn’t just be consulted on issues affecting us. We should be making the decisions ourselves

And I am proud to announce, on the 50th anniversary of the World Federation of Public Health Associations, that the World Federation of Public Health Associations has endorsed the Indigenous Working Group

Nothing about us without being led by us

Video Former NACCHO Policy officer Summer May Finlay announcing the Indigenous Working group on the last day of #WCPHH2017 , Summer is Yorta Yorta. Social Justice. Public Health. Croakey Contributor. Writer. PhD Candidate

Read her full speech here on Croakey OR

Watch Video Here or Live Below

 

 ” I’ve written here and here  that mainstream health promotion has largely failed Indigenous people and communities.

My aim is not to blame health promotion for poor Indigenous health outcomes, or to blame the many dedicated health promoters working to improve Indigenous health. I acknowledge there are cases where health promotion has positively impacted the health of Indigenous people.

However, the majority of mainstream health promotion has shown little impact upon the burden of disease in Indigenous communities, and generally not enabled Indigenous Australians to take control of their lives.

In Australia, colonisation began with British imperialism to establish British control over land, involving many inhumane strategies that continue to profoundly impact Indigenous health  and cause disadvantage.

Australia’s health system, including health promotion practice and policy, is heavily implicated in these damaging colonising practices, as many have written about .

Consider that while Indigenous Australians were experiencing their first access to appropriate health care through the Aboriginal community controlled health service (ACCHS) movement, the first International Conference on Health Promotion was held in Ottawa in 1986.

At the conference, there were only two people present as ‘Indigenous representation’: an Indigenous consultant from the First Nations Confederacy in Manitoba, Canada; and a participant from Research and Development in Health and Welfare Canada who referenced Indigeneity in their professional background.

This representation, and the conference focus on wealthy countries, is a substantial shift away from the globally inclusive agenda promoted by the Ottawa Charter for Health Promotion, yet remains largely unacknowledged within the health promotion literature.

Dr Karen McPhail-Bell is a non-Indigenous early career academic and public health professional at the University Centre for Rural Health.

Her interest lies in the operation of power in relation to people’s health, and in strengths-based and reciprocal processes to support of community-controlled and Indigenous-led agendas.

Read her Croakey article in Full HERE

 ” While the Indigenous cultures in the four countries are different in some obvious and critical ways, they also share key commonalities in their colonial heritages and challenges in addressing development needs. 

 Through collaboration and sharing of new thinking and innovative processes Indigenous peoples can address their contemporary needs and aspirations. ”

Michelle Deshong is a global leader in governance. She’s completeing a PhD at James Cook University in Townsville and draws her connection to the Kuku Yulanji Nation.

The World Federation of Public Health Associations has formed its first Indigenous Working Group on its 50th Anniversary.

At the 15th World Congress of Public Health Melbourne conference, 40 Indigenous and non- Indigenous conference delegates of the yarning circle unanimously supported in principle the establishment of the World Federation of Public Health Associations Indigenous Working Group.

The Public Health Association of Australia, on Tuesday 4th April 2017, hosted a yarning circle to talk about establishing an Indigenous Working Group.

The yarning circle was led by Adrian Te Patu, the inaugural Indigenous representative on the World Federation of Public Health Association (WFPHA) Governing Council.

The Yarning Circle was hosted by the Victorian Aboriginal Community Controlled Health Organisation ( VACCHO )

Once supported by the delegates, the formation of the Indigenous Working Group was accepted by acclimation by the world assembly of Public Health Associations.

Under Mr. Te Patu’s leadership, the next steps are to formalise the Indigenous Working Group and develop its vision.

The WFPHA’s function and mandate includes its link into the global health governance mechanisms such as the World Health Organisation.

Contacts

New Zealand :  Adrian Te Patu Email: adriantepatu@gmail.com

Australia  : Summer May Finlay Email: summermayfinlay@gmail.com

Article 2 Health in all policies

At the recently concluded 15th World Congress on Public Health in Melbourne, the partner organisations, together with delegates from over 83 countries articulated their concerns for the public’s health and demanded that world leaders make the public’s health a priority.

They outlined a future vision for a healthier world based on Protection, Prevention and Health Promotion as set out in the World Federation of Public Health Associations’ paper ‘A Global Charter for the Public’s Health’ http://bit.ly/2odN1MO and the UN Sustainable Development Goals http://bit.ly/2d4dcA4 .

The Congress called on governments to enable public health professionals and their organisations to carry out their work to develop further public health functions and quality health systems as global public resources.

They also called on governments to hold all sectors accountable for the health impacts of their policies and actions, consistent with the intent of the social determinants of health and their responsibilities to strive to achieve the Sustainable Development Goals.

You can access the WFPHA Call for action here:

https://t.co/MunOH2KT3N or

read the Congress statement as an online book: http://online.fliphtml5.com/eeyoy/adza/

Aboriginal Health #WCPH2017 #WorldActivityDay : Snapshot report physical activity programs for Aboriginal people in Australia

 

” This is important as sharing information about program practice is an important part of effective health promotion and can serve to guide future initiatives.

The Ottawa Charter outlines a settings based approach to effective health promotion. We found most programs were delivered in community, followed by school, settings. Both have proven efficacy in achieving health outcomes.

They are likely be particularly effective settings for reaching Aboriginal and Torres Strait Islander people given the importance of holistic health promotion and whole-of-community approaches

Capturing current practice can inform future efforts to increase the impact of physical activity programs to improve health and social indicators.

Targeted, culturally relevant programs are essential to reduce levels of disadvantage experienced by Aboriginal and Torres Strait Islanders

Rona Macniven, Michelle Elwell, Kathy Ride, Adrian Bauman and Justin Richards Prevention Research Collaboration, Charles Perkins Centre, University of Sydney, & Australian Indigenous HealthInfoNet

Picture above : Redfern All Blacks recently won the Women’s Division Ella Sevens Rugby Union tournament in Coffs Harbour beating the Highlanders 36-7

Download

 A snapshot of physical activity programs targeting Aboriginal and Torres Strait Islander people in Australia

 

Picture above :The Knight Riders beat the Shindogs 28-21 in the Men’s Final Ella Sevens Rugby Union tournament in Coffs Harbour

Issue addressed

Participation in physical activity programs can be an effective strategy to reduce chronic disease risk factors and improve broader social outcomes. Health and social outcomes are worse among Aboriginal and Torres Strait Islanders than non-Indigenous Australians, who represent an important group for culturally specific programs.

The extent of current practice in physical activity programs is largely unknown. This study identifies such programs targeting this population group and describes their characteristics.

Aboriginal Health

Almost a third of programs aimed to promote physical activity to achieve broader social benefits such as educational and employment outcomes and reduced rates of crime. Health and sport programs are worthy crime prevention approaches.

There are also recognised relationships between physical activity and fitness level and academic achievement as well as social and mental health benefits specific to Aboriginal and Torres Strait Islander populations.

However, a cautious approach to alluding to wider social benefits directly arising from individual programs should be taken in the absence of empirical evidence, as well as the direct effects of standalone programs on health.

Yet the documentation of existing program evaluation measures in this snapshot represents a vital first step in reviewing programs collectively and some have demonstrated encouraging evidence of positive educational and employment outcomes.

There is also some evidence of social benefits, such as community cohesion and cultural identity; derived from sport programs in this snapshot, which are important for Aboriginal and Torres Strait Islander health.

Such programs might therefore contribute to corresponding ‘Closing the Gap’ policy indicators and should be resourced accordingly.

Methods

Bibliographic and Internet searches and snowball sampling identified eligible programs operating between 2012 and 2015 in Australia (phase 1). Program coordinators were contacted to verify sourced information (phase 2). Descriptive characteristics were documented for each program.

Results

A total of 110 programs were identified across urban, rural and remote locations within all states and territories. Only 11 programs were located through bibliographic sources; the remainder through Internet searches.

The programs aimed to influence physical activity for health or broader social outcomes. Sixty five took place in community settings and most involved multiple sectors such as sport, health and education.

Almost all were free for participants and involved Indigenous stakeholders. The majority received Government funding and had commenced within the last decade. More than 20 programs reached over 1000 people each; 14 reached 0–100 participants. Most included process or impact evaluation indicators, typically reflecting their aims.

Conclusion

This snapshot provides a comprehensive description of current physical activity program provision for Aboriginal and Torres Strait Islander people across Australia. The majority of programs were only identified through the grey literature. Many programs collect evaluation data, yet this is underrepresented in academic literature.

 The Famous AFL “Fitzroy All Stars from Melbourne

 

NACCHO Aboriginal Health and #Nutrition : FYI delegates #WCPH2017 Aboriginal traditional foods key role in protecting against #chronicdisease

“We have long understood that native animal and plant foods are highly nutritious.

There is no evidence that Aboriginal and Torres Strait Islander people had diabetes or cardiovascular disease whilst maintaining a diet of traditional foods, and it has been shown that reverting to a traditional diet can improve health.

In addition to demonstrating significant health benefits, traditional foods remained an integral part of identity, culture and country for Aboriginal and Torres Strait Islander people, while also alleviating food insecurity in remote communities.”

Menzies researcher and lead author Megan Ferguson see research paper in full below

Photo above :  Frank told us how the ‘old people’, which literally means his ancestors, lived under the trees, gathered food and fished in the swamp. He said that during the dry, they used to build a sort of rock stepping-stone bridge to access the island in the swamp where they would gather magpie goose eggs.

Photo above  : With a focus to improve community nutrition, over 2000 bush tucker trees and conventional fruits were planted at the Barunga Community, south of Katherine.

Aboriginal people have been using bush tucker for over 50,000 years, but it was hoped the plantation would lure more children onto a free feed of fruit, instead of a portion of chips. Some of the bush tucker fruits being planted include the Black Plum, Bush Apple, Cocky Apple, Red Bush Apple, and White Currant

 ” The bush tucker diet was high in nutritional density, offering good levels of protein, fibre, and micronutrients. It was low in sugar and glucose, and lower in insulin than similar western foods, and the hunter-gatherer lifestyle meant plenty of physical activity. Some animal foods such as witchetty grubs and green ants were high in fat, but most native land animals were lean, especially when compared with the domesticated animals eaten today.

It was this knowledge of the land that sustained the Aboriginal people of the Northern Territory for tens of thousands of years “

Your Complete Guide to Bush Tucker in the Northern Territory

Traditional food trends in remote Northern Territory communities

The majority of Aboriginal people living in remote Northern Territory communities are regularly using traditional foods in their diets according to research from Menzies School of Health Research published in the Australian and New Zealand Journal of Public Health see below

The paper, Traditional food availability and consumption in remote Aboriginal communities in the Northern Territory reports that a nutritious diet including the consumption of traditional foods plays a key role in protecting against chronic disease for Aboriginal and Torres Strait Islander people living in remote communities.

‘Surveys conducted in remote Northern Territory (NT) communities revealed almost 90% of people consumed a variety of traditional foods each fortnight.

‘In relation to food insecurity we also found that 40% of people obtained traditional food when they would otherwise go without food due to financial hardship or limited access to stores,’ Ms Ferguson said.

The list of traditional food reported during the research is extensive and includes a range of native animal foods including echidna, goanna, mud mussel, long-neck turtle and witchetty grubs and native plant foods including green plum, yam and bush onion.

The 20 remote NT communities surveyed reported that traditional foods were available year round.

‘There is still much to be learnt about the important contribution traditional foods makes to nutrition and health outcomes. We need to work with Aboriginal and Torres Strait Islander leaders to understand more about contemporary traditional food consumption. This is crucial to informing broader policy that affects where people live, how they are educated, employment and other livelihood opportunities,’ Ms Ferguson said.

The article will be available at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1753-6405

Traditional food availability and consumption in remote Aboriginal communities in the Northern Territory, Australia

Objective: To explore availability, variety and frequency consumption of traditional foods and their role in alleviating food insecurity in remote Aboriginal Australia.

Methods: Availability was assessed through repeated semi-structured interviews and consumption via a survey. Quantitative data were described and qualitative data classified.

Results: Aboriginal and non-Indigenous key informants (n=30 in 2013; n=19 in 2014) from 20 Northern Territory (NT) communities participated in interviews. Aboriginal primary household shoppers (n=73 in 2014) in five of these communities participated in a survey. Traditional foods were reported to be available year-round in all 20 communities. Most participants (89%) reported consuming a variety of traditional foods at least fortnightly and 71% at least weekly. Seventy-six per cent reported being food insecure, with 40% obtaining traditional food during these times.

Conclusions: Traditional food is consumed frequently by Aboriginal people living in remote NT.

Implications for public health: Quantifying dietary contribution of traditional food would complement estimated population dietary intake. It would contribute evidence of nutrition transition and differences in intakes across age groups and inform dietary, environmental and social interventions and policy. Designing and conducting assessment of traditional food intake in conjunction with Aboriginal leaders warrants consideration.

Aboriginal and Torres Strait Islander Australians have experienced a rapid nutrition transition since colonisation by Europeans 200 years ago, similar to that experienced by other Indigenous populations globally.1 The traditional food system provided a framework for society and was interwoven with culture, a framework that is now eroded by a food system with no distinct cultural ties or values.2 Early reports of Aboriginal people prior to European contact indicate that they were lean and healthy, attributable to an active lifestyle and a nutrient-dense diet characterised by high protein, polyunsaturated fat, fibre and slowly digested carbohydrates.3 The diet was sourced from a wide range of uncultivated plant foods and wild animals and was influenced by the seasons and geographical location; although there were differences in the food sources by location, there were similarities in the overall nutrient profile.3,4 Since colonisation, this nutritious diet has been systematically replaced by high intakes of refined cereals, added sugars, fatty (domesticated) meats, salt and low intakes of fibre and several micronutrients.5–7

There is no evidence that Aboriginal people maintaining traditional diets had diabetes or cardiovascular disease.4 However, the integration of non-traditional foods into the contemporary diet of Aboriginal Australians has led to an excessive burden of lifestyle-related chronic diseases.3 A nutritious diet, such as that afforded by the consumption of traditional foods, plays a key role in protecting against these conditions. Short-term reversion to a traditional diet has demonstrated significant weight loss, improvement in risk factors of diabetes and cardiovascular disease and improvements in glucose tolerance and other abnormalities related to type 2 diabetes mellitus among a small group of Aboriginal Australians.8,9

High levels and a wide variety of polyunsaturated fatty acids, in the context of overall lower fat content, found in native animal foods are one of the benefits of a traditional diet; reported to reduce the risk of developing obesity, type 2 diabetes mellitus and cardiovascular diseases.3,4Traditional foods remain an integral part of the contemporary Aboriginal and Torres Strait Islander diet strongly linked to identity, culture and country. An analysis of national data collected in 2008 reported that 72% of participants aged over 15 years living in remote communities reported having harvested wild foods in the past 12 months;10 and yet there is a dearth of information on the contribution of traditional foods to the contemporary diet of Aboriginal and Torres Strait Islander people.7,11 Most available information is also limited to describing harvesting behaviours and preferences.11 A recent environmental study, for example, in two Australian tropical river catchments reported more than one harvesting trip per fortnight for households in which 42 different animal and plant species were collected over a two-year period. This study also described the food-sharing networks that are likely to play a crucial role in alleviating food insecurity;12 of which 31% of Aboriginal and Torres Strait Islander people living in remote communities report to experience.13Some researchers estimate that more than 90% of foods are purchased and traditional foods contribute less than 5% to dietary energy intake,5 others argue that in some contexts the proportion of purchased foods is much lower.14

This variation likely relates to the diverse study contexts, including where people live, with higher intakes of traditional foods suggested to be consumed in small outstations rather than communities and townships.14 Until recently, most estimates of population level dietary intake have been limited to store-purchased food and drinks,5–7 an extremely valuable source of data, though one the authors acknowledge is limited by a lack of information on traditional food intake. The 2011–13 National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey (NATSINPAS), which included a 24-hour dietary recall, provided the first set of dietary intake data of Aboriginal and Torres Strait Islander people nationally, though it did not aim to provide an estimate of traditional food intake.13This paper explores informant interview and self-report data relating to the: i) availability, ii) frequency and iii) variety of traditional food consumption. It also reports on the role of traditional food in alleviating food insecurity. For this study, traditional food included all native and introduced animal and plant foods procured for consumption. It was conducted as part of the SHOP@RIC study.15

Methods

Sample

A survey of contextual factors, defined as factors that may influence food purchases from the community store, was conducted in each of the 20 communities participating in the SHOP@RIC study, in the Northern Territory (NT), Australia.15 This included a rapid appraisal of traditional food availability through an interview with two key informants who had resided in the community for the previous 12 months. The study was not designed to collect comprehensive data on seasonal availability of traditional foods.

The cohort participating in the customer survey of the SHOP@RIC study15 was drawn from five very remote Aboriginal communities in the NT randomly selected from 20 study communities. All five communities had one food store, most had community-based food programs such as school nutrition and aged care meal programs and all were considered to have access to a traditional food supply from their surrounding lands. Households in each of the five communities were randomly selected and an eligible adult (i.e. community resident, plans to reside in the community for 12 months, >18 years, purchases food from the community store, and is the primary shopper) was invited to participate in a series of three surveys; pre-, post- and six-months post intervention. On completion of each survey, a $20 gift of fruit, vegetables and water was provided. The study aimed to include 150 customers in the cohort.

Data collection

The survey of contextual factors was conducted in English by a research team member, either in person or by telephone, at a time convenient to the key informant. Data were collected at two time points. As early as possible in 2014 and 2015, participants were interviewed about events in the previous year, including traditional food hunted or gathered. Initially, contact was made with the Shire/Council Services Manager of each community, who was invited to participate and recommend another suitable local person to complete the interview. The manager was selected due to their overall knowledge of a broad range of factors affecting store purchases, including population movement, community income and provision of essential services. If this manager could not be contacted, contact was made with someone in the community who was already associated with the main project to determine the most suitable people in the community to respond to these questions.

The customer survey was conducted by a research team, which included an Aboriginal community-based researcher trained in the conduct of the study. Interviews were conducted in English, with translation provided by the local researcher where necessary. The third survey (six months post intervention) was conducted from May 2014 to December 2014, in one community every two months in line with the main study design.15 This survey included a measure of frequency and variety consumption of traditional food in the preceding two weeks and questions to elicit information on the role of these foods in alleviation of food insecurity, the results of which are presented in this paper. A short script introduced the set of questions, noting that these included all hunted and gathered foods, which might be referred to by participants as traditional foods or bush foods, and included introduced species. The questions and response options were: How often do you eat traditional foods? (never, 1 day a fortnight, 1 day a week, 2–3 days a week, on most days, everyday). What type of traditional foods have you eaten? In the last 12 months, were there any times that you ran out of food, and couldn’t afford to buy more? (yes, no). If yes, how often did this happen? (once per week, once every 2 weeks, once per month, don’t know). Are there days when you don’t have enough food and feel hungry? (yes, no). What things can you do to get food on these days? Pictorial resources, with examples of foods known to be consumed across Central Australia and the Top End of the NT, grouped into similar food types, served as prompts. This study did not aim to collect data at the species level as nutrient analysis was not planned. These measures were based on a systematic review of the literature and expert consensus, and were pilot tested in line with the development of the overall customer survey.

Data analysis

The data from the contextual factor survey was entered into an Access database and exported to Excel for analysis. One author (CG) collated the data and verified with MF. Traditional food sources recalled being available over the calendar year and/or at different seasonal periods were described. The quantitative data from the customer survey were described, using Stata Version 14.0 (Stata, College Station, Texas, USA). The qualitative data from the customer survey were managed in an Access database and exported to Excel. One author (CB) allocated each individual food to one of eight categories,16 clarifying any difficult classification of foods with JB and MF.

Ethics

The study was approved by the Human Research Ethics Committee of the NT Department of Health and Menzies School of Health Research, the Central Australian Human Research Ethics Committee and Deakin University Human Research Ethics Committee. Written informed consent was obtained from all participants.

Results

Participants

At least one interview was conducted in each of the 20 study communities for the years 2013 or 2014. In 2013, 30 participants across 19 of the 20 study communities contributed to the contextual data; the participants held roles in the local council, government welfare agency, store, health centre, aged care facility, school and training and employment program. In 2014, 19 participants across 15 of the 20 study communities contributed to the repeat survey, holding roles in the local council, government welfare agency, store, health centre, community men’s program, research institute and training and employment program or were a community resident not in paid employment. In some cases, mobility from employed roles and from the community prevented repeat interview with the same informants each year.

Seventy-three participants aged 18 years or over, most of whom were female (97%), over the age of 35 years (69%) and not in paid employment (56%) contributed to the third customer survey. The participants differed marginally from the original cohort (92% female, 64% >35 years of age, 62% not in paid employment).

Annual availability of traditional food

Traditional foods were consistently reported for all 20 communities to be available year round. Informants reported hunting activity, with someone from all communities recalling a variety of animal foods that were available over the year or that hunting and fishing occurred. Informants from 15 communities across the Top End and Central Australia reported a variety of plant foods available in the previous 12 months. In four of the five communities where no plant foods were reported, it should be noted that data were only able to be collected for one of the two time points.

The survey did not intend to collect data on environmental or other impacts on the availability of the traditional food supply. It is worth noting that informants from three Top End communities and one customer survey participant from a fourth Top End community reported that goanna were in limited numbers or no longer available due to the impact of cane toads. In two Top End communities it was said that turkey were scarce or no longer available and in one of these communities, that the availability of yams had reduced due to environmental damage caused by introduced animals.

Frequency of traditional food consumption

Most (89%) participants reported consuming traditional foods on at least a fortnightly basis, in the two weeks preceding the survey. Seventy-one per cent of participants reported consuming traditional foods at least weekly.

Variety of traditional foods consumed

The variety of traditional foods reported to be available across 20 communities and consumed by participants in the five communities is reported in Table 1. There were a range of different native animal and plant foods and a smaller number of introduced animal foods recalled.

Table 1. List of the varietya of traditional foods reported to be available in communities and to be consumed in the preceding two weeks by a customer cohort.
Community data set (n=20) Participant data set (n=73)
  1. a: Foods listed as per participant response to an open-ended question which did not specify how to identify foods (e.g. as food category [e.g. seafood], food [e.g. fish] or species [e.g. barramundi]). The adjective ‘bush’ and ‘wild’ was provided at times with some foods (e.g. bush turkey and turkey). Occasionally participants used both local and English language; only the English language name is reported here.
  2. b: Echidna was often referred to as porcupine; buffalo as bullocky; cow as beef, cattle or killer.        c: The term shellfish was not used by participants in the customer cohort.
Animals
Native land animals Bandicoot, carpet snake, duck (diving duck), echidna,b emu, goanna (perentie), goose (magpie goose), honey, honey ant, kangaroo, lizard, possum, turkey, wallaby Black-headed snake, duck, echidna,b emu, goanna, goose, kangaroo, turkey
Introduced land animals Buffalo,b cow,b pig Buffalo,b cow,b pig
Fish or seafood Crab (mud crab), crocodile, crocodile egg, dugong, fish (barramundi, black bream, bream, catfish, fresh- and saltwater fish), shellfish (large creek mussel, long bum, mud mussel, mussel, oyster), prawn, stingray, turtle (long-neck turtle, sea turtle, short-neck turtle), turtle egg, water goanna Crab (mud crab), fish (barramundi, black bream, catfish, red snapper), mangrove worm, shellfishc (cone shell, long bum, mud mussel, oyster, periwinkle), stingray, turtle (long-neck turtle, sea turtle, short-neck turtle), turtle egg, water goanna
Witchetty grub Witchetty grubs Witchetty grub
Sugar bag Sugar bag
Plants
Fruit or berry Apple, banana, berry (blackcurrant, conga berry), cashew tree fruit, fruit (not specified), plum (black plum, green plum and sugar plum), sultana Apple, banana, berry, plum (black plum, green plum), raisin, sultana, tomato
Yam or root vegetables Potato, yam Potato, yam (budgu)
Other plants Bean, onion, tomato Bulb (sandy beach bulb), onion
Seed or nut Cashew tree nut Kora (seed)

The role of traditional food consumption in alleviating food insecurity

Most participants (76%) reported experiencing food insecurity. Of the coping strategies identified, 40% related to obtaining traditional food during times they went without food and 53% were borrowing food or money during these times.

Discussion

This exploratory study demonstrates that traditional food makes an important contribution to the contemporary diet of Aboriginal people living in remote NT communities. In 20 remote communities, traditional foods were reported to be available year round. A high frequency and wide variety of traditional foods were reported to be consumed by participants across five remote communities. In this exploratory study, more animal foods than plant foods were recalled to have been consumed and commonly a few animal foods predominated. Accessing traditional foods was reported to be a means of alleviating food insecurity for almost half the people who experienced food insecurity.

There are limited records of the traditional diet of Aboriginal and Torres Strait Islander people prior to European colonisation. Available reports describe gender roles, with women providing daily sustenance through collecting plant foods and small animals and men hunting large animals on a less regular basis, with the balance of plant and animal foods determined by factors including location and season.3 Studies of Canadian Aboriginal people suggest a high intake of traditional animal foods as part of the contemporary diet.17,18 This study suggests that an understanding of the contribution that animal (native and introduced) and plant foods make to the contemporary diet among Aboriginal and Torres Strait Islander people of Australia is warranted.

The frequent self-reported consumption of animal sources of traditional foods, suggests that contemporary population-level dietary assessment using store purchasing data has the potential to over-estimate nutrient deficiencies, particularly of protein, a concern we have previously raised.7,19 In Aboriginal populations elsewhere, it is estimated that traditional foods might contribute anywhere from 10% to 36% of energy and disproportionately to protein and other micronutrients,17,20–23 representing an important dietary contribution. Even weekly or fortnightly consumption of a nutrient-dense food, such as that reported to be consumed in this study, is likely to make an important contribution to the diet.11 Introduced land animal foods, such as buffalos, cattle and pigs, were reported to be hunted and consumed by participants. The contribution of introduced land animals may be influenced by availability and in some areas may be well integrated into the traditional food system.5 In the absence of volume consumption data, it is not possible to draw conclusions on the dietary contribution of introduced land animals. Although these foods contribute to dietary protein intake, the higher quantity of fat and poorer fatty acid profile, compared with native animal foods, is worth noting.3

We have demonstrated that it is possible to measure frequency consumption and to some extent variety of traditional foods consumed – in fact, our impression was that people enjoyed talking about these foods. We acknowledge the limitations of traditional dietary assessment methods, including additional challenges in remote contexts such as the practice of sharing community meals,12,24–27 though also consider that attributes such as the high regard given to traditional food, may aid assessment.24,27,28 Studies have demonstrated how standard tools can be modified to assess individual dietary intake with Aboriginal populations29 and lessons can be learnt from previous dietary survey work in remote Australian Aboriginal communities.15,26

Comprehensive assessment of traditional food consumption would serve a number of purposes. These data would provide an understanding of the different types of traditional foods consumed and the contribution they make to the contemporary diet of Aboriginal people across Australia. This information would assist in developing targeted strategies to ensure sustainable access and increased consumption of traditional foods. This study was not designed to examine differences in consumption of traditional foods across age, gender and other population groups. International studies in Aboriginal populations have found higher intakes of nutrient-poor store foods in young people and higher intakes of traditional foods in older people.17,22,23,30,31 In addition to contributing to improved health through dietary intake, the socio-cultural contribution and opportunity for physical activity that traditional foods provide is important to recognise.21,32,33 The impact that climate change, changes in the natural environment and development policies regarding land and sea use may have on traditional food use and thus health and wellbeing is critical to understand.12,32,34 Although not designed to collect information on environmental and other impacts on traditional food, this study suggests that introduced animals are affecting the availability of small animal and plant foods, at least in the Top End of the NT.

In addition to being nutritionally superior, traditional foods are considered to be a low-monetary form of sustenance, important in a context where people generally have low incomes and where the cost of food is high.12,18,20,35 Similar to our findings, 40% of coastal urban-dwelling Aboriginal people reported increased access of wild resources at times of financial hardship.32 In a small Western Australian outstation, hunting for various types of wild foods has been shown to respond differently to market and economic scarcity.33 The harvest of traditional foods and food sharing networks reduce the reliance on the market economy,10,12 important in a context where high numbers of people report to be food insecure. Others share our opinion that further understanding the role of traditional foods in the diet and in alleviating food insecurity36 is crucial in an environment where few, if any, significant changes are occurring in terms of the high cost of food and prevailing low-income levels.

Data regarding the contribution of traditional foods in the diet and role in livelihoods of Aboriginal people living in remote communities will be important in relation to broader environmental and social policy making. Evidence of the contribution of traditional foods to the contemporary diet of remote Aboriginal people is crucial to informing broader government policy that affects where people live, how they are educated, employment and other livelihood opportunities.10 It has been suggested that the use of traditional foods may be gaining interest nationally and internationally, and in addition to being good for human and environmental health, could provide economic and employment opportunities for Aboriginal and Torres Strait Islander Australians.37 There is a developing interest in sustainability of traditional foods in environmental protection efforts,12 such as working with Aboriginal people to develop adaption strategies to mitigate the impact of climate change on the environment and traditional food supply.32,34 Similarly, traditional food data are used internationally to maintain and improve availability and access to traditional foods as a result of global warming and environmental insults, such as contamination.17,18,21

There are three limitations related to our survey methodology. First, this study relies on self-report data, which is considered to be biased by recall and reporting. To address this, the data were collected through a facilitated recall methodology,38 which improves recall through the use of locally relevant prompts and questions.39 While respondents were asked to recall intake in the preceding two weeks only, it is possible that foods consumed beyond this timeframe were recalled. Second, the individual dietary data was collected from participants in only five remote NT communities; however, these were randomly selected from a larger sample of 20 communities and were spread across the NT. Third, the data were collected based on recall of a two-week period from participants in each community. Normally, frequency consumption data would be collected over a longer period to account for factors such as seasonality, although it has been collected in some studies for shorter periods.17 It was not within the scope of this study to collect longer-term data. The data were, however, collected over a 10-month period from the five communities, two months apart and have been supported by annual availability of traditional foods data from key informants across 20 communities. The key limitation in relation to the semi-structured interviews was that the key informants did not always include an Aboriginal person from each community and so reports of annual availability of traditional foods are likely to be conservative.

Implications

Although focused on availability, frequency and variety, this study provides an important step in improving non-Aboriginal knowledge of the contribution of traditional food in the contemporary diet of Aboriginal Australians living in remote Australia. This study suggests that it is possible to collect data regarding the contribution of traditional foods to diet. These data would complement population-level data collected through community store sales. Data of the nutrient profiles of many traditional foods exists and continues to be built on in Australia. Through a strong collaboration with Aboriginal people, methods for conducting individual dietary assessment of traditional food intake could be developed, which could include methodologies such as repeated 24-hour recall, visual recall40 and food frequency questionnaires, resulting in validated tools for ongoing use in this context. Our limited data, combined with national and international evidence suggest that priorities should include understanding differences across ages, gender, education and employment status and across remote, regional and urban areas in Australia. It is crucial that these processes align with developments in the broader environmental and societal work in this area.

Acknowledgements

The authors are grateful to community residents who provided data and acknowledge that the ownership of Aboriginal knowledge and cultural heritage is retained by the informant. The authors thank Prof Kylie Ball, Anthony Gunther, Elaine Maypilama and Carrie Turner who contributed to the development of the customer survey, those who assisted with pilot testing the customer survey and Federica Barzi who assisted with analyses. The Stores Healthy Options Project in Remote Indigenous Communities was funded by the National Health and Medical Research Council (1024285). The contents of the published material are solely the responsibility of the individual authors and do not reflect the views of the NHMRC. Julie Brimblecombe is supported through a National Heart Foundation Fellowship (100085

 

Aboriginal Health #racism and #cancer #WCPH2017 : The inoperable, unstoppable @Proudblacksista Colleen Lavelle and other strong stories

“People will forget what you said, people will forget what you did,

but people will never forget how you made them feel. – Maya Angelou

These strong words are so true. I look at how my behaviour has changed with the brain tumour. I shudder when I think of the things I have said to my children.

I think it was about eight or nine years ago I was diagnosed with a brain tumour,

The reason I’m vague on it is I actually don’t think it’s a day to remember. It’s not a celebratory day.

Thinking about my four children motivates me to keep going

I’ll be buggered if I am going to have the [child safety] department or someone like that come in and take care of my kids.”

Cancer is a leading cause of death among Indigenous Australians, but fear, stigma and shame mean it is rarely spoken about.

Ms Colleen Lavelle’s a Wakka Wakka woman, from Queenslandknown as @Proudbacksista  tumour has been deemed inoperable, which means it’s considered terminal.

Hear or Download hear her Radio National Interview 

Or

Watch ABC TV report

Photo above from previous NACCHO News Alert

NACCHO Aboriginal Health : Death by #racism: Is bigotry in the health system harming Indigenous patients ?

NACCHO and Cancer over 60 articles

NACCHO Cultural Safety

Federal Government Website

Cancer in Aboriginal and Torres Strait Islander people of Australia

Colleen lives in Brisbane and through her blog she has become a support person for other Aboriginal people facing cancer, helping them with practical matters and being a friendly voice on the other end of a phone line.

She also accompanies some patients to hospital appointments and would like to see it made easier for Aboriginal volunteers to do such work.

“If you come from the Torres Strait and you’ve come down here and someone’s speaking to you really fast, rattling off all these medical things you’ll kind of be going, ‘what?’,” she said.

“If you’ve got someone, one of your own mob there it makes it easier.”

 Recently Colleen wrote for Croakey /We Public Health

Close the Gap should be so much more than a photo opportunity or a morning tea. There are ways that everyone can help. I am going to share ten simple ones that I have been trying to get happening for years.

  1. More Indigenous hospital liaison officers – Whatever title you use, we need more people in the hospital working for us. Big hospitals often only employ two, that is not even close to being enough. They should be employed around the clock.
  2. Indigenous hospital volunteers – Hospitals need to have a separate army of volunteers, who deal exclusively with Indigenous patients, to spend time with the person from a remote area in a city hospital. To sit with someone having a long treatment. Just a friendly face in an alien environment.
  3. Cultural Awareness Training (CAT) – Should be compulsory with all hospital staff, from the cleaner to the director. This training should address the issues and problems in health, but also needs to be localised to have the Traditional Owners from the area to share their knowledge. To truly let people understand, I am not talking a one of two-hour session a year, but a long, fully-formed training, with refresher courses each year. All medical and Allied Health professionals should do, and be assessed on, Cultural Awareness on a regular basis, and this needs to be registered. It is not good enough when a health professional does one course on Indigenous People and 20 years later still think that was enough. General Practice also need to have CAT, even if they are not signed on to CTG, because they are going to be seeing Indigenous patients.
  4. General Practice incentive payments – GPs must lose their incentive payments if they sign on for the incentive and, during that time they don’t see an Indigenous patient. Again, they should lose the bonus if they are signed up and do not annotate the prescriptions for patients.
  5. Indigenous people have the right of choice – We should be able to see a private GP or the local Indigenous Medical Service, or both if we want, but some funding seems to steer us towards the Indigenous Medical Service. This can be hard if it’s a long way from your home and you have to depend on public transport.
  6. Employ more Indigenous people in the health sector, not just  doctors – It can be as simple as a receptionist, who makes a difference.
  7. Indigenous patients must be heard – Not just in the surgery but on national committees. Our experiences must be more than just fodder for researchers or funding applications.
  8. Buck-passing – PHNs, Division of General Practices and other organisations, must stop handing over Indigenous units to others. You have patients that see so many doctors, you have to be responsible. Handing units over to Indigenous Medical Services etc, is passing the buck. It takes away our free choice. It is a way of saying you are not interested in our wellbeing.
  9. Respect – Invite Elders to your hospital, clinic, whatever, on a regular basis, consider having an Elder in residence at your local hospital.
  10. Recognise and celebrate our important dates – It smacks of racism if a hospital is decked out in green and shamrocks everywhere for St Patrick’s day and come NAIDOC, there is a morning tea, hidden away, with only a few people involved. Share it. Don’t even get me started on Australia Day. (Okay, just a little bit) Understand that we don’t think it’s great to wave the flag or want to be in your premises when you have complete overkill of decorations and start talking about how wonderful it is.

The unspoken illness: Cancer in Aboriginal communities

Cancer is a leading cause of death among Indigenous Australians, but fear, stigma and shame mean it is rarely spoken about.

Aboriginal Australians are less likely to be diagnosed with cancer, but significantly more likely to die of the disease.

Often, symptoms and diagnoses are ignored because of the fear surrounding cancer.

Cancer in Aboriginal communities:

  • Indigenous Australians have a slightly lower rate of cancer diagnosis than non-Indigenous Australians
  • The Aboriginal cancer mortality rate is 30 per cent higher
  • Indigenous Australians are more likely to be diagnosed when cancer is advanced
  • They are less likely to participate in cancer screening programs
  • Lung cancer is the most common cancer among Indigenous Australians

Lateline spoke to some Aboriginal people about how they dealt being diagnosed and how they’re trying to break down taboos in their communities.

Rodney Graham: Bowel cancer

Rodney

Rodney Graham literally ran away from his diagnosis in 2015.

For seven months he didn’t go back to his doctor after he was told he had bowel cancer.

Eventually though, he mustered the courage to deal with the diagnosis and get treatment.

He had to travel 700 kilometres from his community of Woorabinda, in central Queensland, to Brisbane to be operated on.

“A big city like that, I don’t even like going to [Rockhampton] really. I can’t stand Rocky. But Brisbane that was a step up you know,” he said.

Now Mr Graham is happy to talk about his illness and wants to help others in his community face up to cancer.

“It might happen to someone else and they say, ‘Well we’ll go see Rodney, he knows all about it’,” he said.

“I’ll give them some advice and see how it goes from there.”

Mr Graham gave up drinking years ago and he said it probably saved his life.

“I think if I was still drinking I wouldn’t be here, you know what I mean,” he said.

Aunty Tina Rankin: Cervical cancer

Aunty Tina has survived cancer, but seen several close relatives succumb to the disease.

“One minute you’re sitting down there with that person, that person is so healthy, and then the next time you see them they’re that sick, they’re that small you can hardly recognise them,” she said.

“People think of it as the killer disease.

“They see people in cancer wards and to look at those people it puts them into a depressed state, and they go home thinking that they’re going to end up like that.”

Aunty Tina said people need to know there is help available for cancer sufferers.

She is part of the Woorabinda Women’s Group who are working to raise awareness in the community about cancer so sufferers don’t feel isolated.

“When you’re well and up and running, you’ve got that many friends,” she said.

“All of a sudden you get sick, you find out you’ve got cancer, you’ve got nobody, it feels as if you’re on your own.

“There were times when I just wanted to go and commit suicide through the depression.

“But I sit down and think about things, I pull myself out of that deep hole.”

Sevese Isaro: Lost his father to cancer

Sevese Isaro, or Tatay as he’s known locally, is Woorabinda’s radio host.

He knows first-hand how hard it can be to talk about cancer, having lost his father to the disease just a few years ago.

“Everyone just tried to stop talking about it,” he said.

“I fell back into drinking, everybody just went their own way.”

He said many people don’t go to the doctor when they suspect they could have cancer.

“They know that there’s something wrong with them, but they don’t want to go because they’re frightened of the answer,” he said.

“I guess people once they hear the word cancer they start getting frightened and they automatically give up hope.”

If you or anyone you know needs help contact your local ACCHO or call

Aboriginal #Earlychildhood #Obesity Study : We need to reduce the prevalence of overweight/obesity in the first 3 years of life

“People who are obese in childhood are at increased risk of being obese in adulthood, which can increase the risk of cardiovascular disease, some types of cancer, diabetes, and arthritis,”

Research found reducing consumption of sugary drinks and junk food from an early age could benefit the health of Indigenous children, but that this is just one part of the solution to improving weight status.

“We know that Indigenous families across Australia – in remote, regional, and urban settings – face barriers to accessing healthy foods. Therefore, efforts to reduce junk food consumption need to occur alongside efforts to increase the affordability, availability, and acceptability of healthy foods,”

 Ms Thurber, PhD Scholar, from the National Centre for Epidemiology and Population Health at ANU.

A major study into the health of Aboriginal and Torres Strait Islander children has found programs and policies to promote healthy weight should target children as young as three.

Lead researcher Katie Thurber from The Australian National University (ANU) said the majority of Indigenous children in the national study had a health body Mass Index (BMI), but around 40 per cent were classified as overweight or obese by the time they reached nine years of age.

Download the Report Here Thurber BMI Trajectories LSIC

Latest national figures show obesity rates are 60 per cent higher for Aboriginal and Torres Strait Islander peoples compared to non-Indigenous Australians.

In 2013, around 30 per cent of Indigenous children were classified as overweight or obese, and two thirds of Indigenous people over 15 years old were classified as overweight or obese.

Key messages

•  The majority of Aboriginal and Torres Strait Islander children nationally have a healthy Body Mass Index
•  However, more than one in ten Aboriginal and Torres Strait Islander children in Footprints in Time were already overweight or obese at 3 years of age, and there was a rapid onset of overweight/obesity between age 3 and 9 years
•  We need programs and policies to reduce the prevalence of overweight/obesity in the first 3 years of life, and to slow the onset of overweight/obesity from age 3-9 years
•  Reducing children’s consumption of sugar-sweetened beverages and high-fat foods is one part of the solution to improving weight status at the population level
•  To enable healthy diets, we need to (1) create healthier environments and (2) improve the social determinants of health (such as financial security, housing, and community wellbeing). Creating healthy environments is complex, and will require both increasing the affordability, availability, and acceptability of healthy foods and decreasing the affordability, availability, and acceptability of unhealthy foods
•  Programs and policy to promote healthy weight need to be developed in partnership with Aboriginal and Torres Strait Islander communities
•  Despite higher levels of disadvantage, most Aboriginal and Torres Strait Islander children maintain a healthy weight; we need programs and policies that cultivate environments and circumstances that will enable all Aboriginal and Torres Strait Islander children to have a healthy start to life
 

Ms Thurber said improving weight status would have a major benefit in closing the gap in health between Indigenous and non-Indigenous Australians.

“Obesity is a leading contributor to the gap in health,” Ms Thurber said.

“We want to work with Aboriginal and Torres Strait Islander families and communities, as well as policy makers and service providers, to think about what will work best to promote healthy weight in those early childhood years.

“We want to start early, and identify the best ways for families and communities to support healthy diets, so that all Aboriginal and Torres Strait Islander children can have a healthy start to life.”

The research used data from Footprints in Time, a national longitudinal study that has followed more than 1,000 Indigenous children since 2008. It is funded and managed by the Department of Social Services.

Professor Mick Dodson, Chair of the Steering Committee for the Footprints in Time Study and Director of the ANU National Centre for Indigenous Studies, said Aboriginal and Torres Strait Islander children deserve the best possible start in life.

“This study shows just how important it is to support them, their families and their communities to provide a healthy diet and opportunities for physical activity,” Professor Dodson said.

Ms Thurber said using the Footprints in Time study, researchers for the first time were able to look at how weight status changes over time for Aboriginal and Torres Strait Islander children, enabling them to identify pathways that help children maintain a healthy weight.

The research has been published in Obesity.

NACCHO Aboriginal Health and #Smoking : @KenWyattMP announces $35.2 million funding #ACCHO Anti-smoking programs

These health services are all delivering frontline services to prevent young Indigenous people taking up smoking and to encourage existing smokers to quit.

Reducing smoking rates is central to the Government’s efforts to close the gap in life expectancy, but requires a consistent, long-term commitment”

Minister for Indigenous Health, Ken Wyatt

Over 100 NACCHO Articles about smoking

REDUCING INDIGENOUS SMOKING TO CLOSE THE GAP

The Australian Government will provide $35.2 million next financial year to continue anti-smoking programs targeted to Aboriginal and Torres Strait Islander people in regional and remote areas.

Minister for Indigenous Health, Ken Wyatt, said the Government had approved the continuation of funding to 36 Aboriginal Community ControlledHealth Services and one private health service.

“These health services are all delivering frontline services to prevent young Indigenous people taking up smoking and to encourage existing smokers to quit,”  .

“Reducing smoking rates is central to the Government’s efforts to close the gap in life expectancy, but requires a consistent, long-term commitment.

“Smoking causes the greatest burden of disease, disability, injury and earlydeath among Indigenous people and accounts for 23 per cent of the health gap between Indigenous and non-Indigenous Australians.”

Under the Council of Australian Governments (COAG) National Healthcare Agreement, all governments have committed to halving the 2008 adult daily smoking rate among Indigenous Australians, of 44.8 per cent, by 2018.

“The rate of smoking among Aboriginal and Torres Strait Islander people is still far higher than among other Australians and is damaging their health in many ways,” Minister Wyatt said.

It’s unlikely now that we will meet the COAG target, but we are making progress.

“It’s important that anti-smoking programs are meaningful for Indigenous people and changes made in recent years have ensured that only programs which are evidence based and effective are receiving grants.”

Continued funding for the 37 health services follows a preliminary evaluation of the Tackling Indigenous Smoking program which found that it was operating effectively and using proven approaches to changing smoking behaviour.

Aboriginal Health ” managing two worlds ” : How Katherine Hospital, once Australia’s worst for Indigenous health, became one of the best

 

” Katherine Hospital in the Northern Territory has gone from one of the worst facilities in the country when it comes to Indigenous health care to one of the best.

Their secret: engaging with Indigenous patients and supporting doctors.”

Dr Quilty his high level of specialist training has meant that patients who would have had to be evacuated to Royal Darwin Hospital can now receive treatment in Katherine. Full Story below

Photo above : Gaye is a 50 year-old cancer patient from Mataranka in the NT. Supplied: Simon Quilty

NACCHO support INFO

Aboriginal Patient Journey Mapping Tools Project:

Communicating complexity

The Managing Two Worlds Together project aims to add to existing knowledge of what works well and what needs improvement in the system of care for Aboriginal patients from rural and remote areas of South Australia (and parts of the Northern Territory). It explores their complex patient journey.

The relationship between patients and health care providers is the foundation of care and requires communication across cultures, geography and life experiences. As a staff member in one rural Aboriginal Community Controlled Health Service put it: ‘It’s like managing two worlds together, it doesn’t always work’.

Download Stage 3 Study Managing Two World Study Report

NACCHO Aboriginal Health News Alert :

Do we need to close the gap on Aboriginal hospital experiences ?

How Katherine Hospital, once Australia’s worst for Indigenous health, became one of the best

As published ABC NEWS  By Hagar Cohen for Background Briefing

When physician Simon Quilty arrived at the hospital, it was going through a major crisis.

“What had happened in 2010 is that the hospital found itself in a situation where things were falling apart,” he says.

A number of doctors complained to the NT Medical Board about a lack of supervision and the impractical workload. The hospital was on the verge of shutting down.

More than one in four Indigenous patients left Katherine Hospital before completing treatment, often without informing staff, the worst rate in the nation. These “take own leave” cases are complex, but one factor is Indigenous patients’ perception of inadequate treatment.

It’s an issue plaguing the health system nationally: a 2014 Federal Health Department report found that racism contributes to the low rates of access to health services by Aboriginal people.

Similarly, the number of patients who “discharge against medical advice” is recorded and recognised by health departments as a key indicator for the quality of Aboriginal healthcare.

In the NT, 11 per cent of all Indigenous patients discharge themselves against medical advice.

“These people have very complex illnesses,” says Dr Quilty. “Many of them are highly likely, if not treated well, to resolve in significant injury or death. Hospitals in remote locations really need high expertise to deal with the very sick patients that turn up here.

“Thirteen and 15-year-olds are developing type 2 diabetes, they’ve got kidney impairment by the time they’re 22 and they’re on dialysis in their early 30s. It’s a bit terrifying really.”

Back from the brink

The NT Department of Health conducted an investigation into the staffing crisis at the Katherine Hospital. Its findings weren’t released publicly.

Background Briefing can reveal that the final report concluded that there were “significant deficiencies in nearly all the essential dimensions of safe clinical service provision”, adding that the “root cause is that the medical service model is unsustainable and becomes more unsustainable with each passing year”.

Six years ago, a new general manager and a group of new doctors arrived with an ambition to turn things around.

Katherine Hospital

They’ve brought highly trained specialist doctors who are invested in the community, interpreters are used regularly and families of Indigenous patients are consulted on complex treatment plans.

In the past, interpreters were available but rarely used. Families weren’t a part of the consultation process. Many of the doctors were junior, and staff turnover was high.

The new management has made huge inroads in the way the hospital cares for Aboriginal patients.

This year, only 4 per cent of the Indigenous patients “took own leave”, making Katherine one of the best performing hospitals in the nation when it comes to caring for Aboriginal patients.

Systematic use of interpreters

In 2006, when respected Indigenous lawman Peter Limbunya, from the remote community of Kalkarindji, stayed in the hospital for 10 days, he did not have access to an interpreter, despite not speaking English.

At the end of his treatment, Mr Limbunya, who was part of the legendary Wave Hill walk off in the 60s, was flown to a remote airstrip 5 kilometres away from his community.

His family wasn’t told he’d be back that day and nobody was there to meet him. He died of dehydration.

During the inquest into his death, the coroner found that interpreters were not in use at the hospital.

His cousin, lifetime activist and advocate for Aboriginal people Josie Crawshaw, remains outraged. She says her uncle would have known “absolutely nothing” about his treatment and what was going on.

But things have come along way since then. The hospital’s Aboriginal liaison officer, Theresa Haidle, says improving the way doctors communicate is the key to developing Indigenous patients’ trust in their treatment plans.

Regular use of interpreters has been an essential part of Ms Haidle’s work. She says they’ve been key in making sure patients understand their illnesses and treatment options.

“English isn’t their first language. It may not even be their second or third either. If there’s any doubt, we get interpreters in, or even on the phone.”

The systematic use of interpreters is a big change at Katherine Hospital.

Ms Haidle says the hospital has a lot further to go when it comes to providing a culturally safe environment, but overall, the relationship with the Aboriginal community is getting better all the time.

“It’s like a big learning process for everybody,” she says.

“We have to break it down as simple as we can,” she says. “There’s not an Aboriginal word that means cancer, so how do you explain those things?

“I remember one day a lady had this fungus, and there’s no words for those things on women’s bodies, or inside. So I heard the interpreter telling her: ‘You know, like mushrooms growing?’ They got her to stay and get it treated.”

Changing doctors’ attitudes

Pip Tallis, who is training to be a physician at Katherine Hospital, has worked in hospitals in Alice Springs and Darwin, where she says many of her Indigenous patients left before their treatment was complete.

“I found it really hard to understand why,” she says.

“It was frustrating as a doctor, and there was a lot of frustration among the staff and no-one really took the time to understand why people were taking their own leave, or really did anything to change it.

“I think, there was a bit of hands up in the air. ‘Whatever, what can we do about it? It’s their problem.'”

The NT town of Katherine, seen from the air

Dr Tallis says that her perspective has changed since coming to work at Katherine Hospital.

“I’ve spent six months working with the team here and observing how they engage with the patients, and I think that they do significant things to result in people not taking their own leave,” she says.

“Previously I was very inflexible. Now I spend a lot more time appreciating why people take their own leave.

“I’m also picking up the subtle signs on a patient who’s starting to not engage. I’ll sit down with them and explore their issues. And if they say they want to just go for a walk, you just say, ‘Would you like to take some medicine with you just in case you don’t come back?'”

Care plans to lower ‘take own leave’ rates

The introduction of weekly meetings to go over care plans for the Indigenous patients means everyone in the hospital can keep up with what’s happening with individual patients

These meetings are attended by social workers, doctors, nurses and admin staff.

At one such meeting, Dr Tallis mentions Jason, a 30-year-old patient from the remote community of Ngukurr, 330 kilometres south-east of Katherine.

Jason has tuberculosis, and has left the hospital during treatment once before. His family has convinced him to return. Dr Tallis explains at the meeting that Jason doesn’t like the hospital food, and that special food is being provided for him.

“We tried really hard to engage him,” she says. “We even got bacon and eggs for him in the mornings so he doesn’t complain about porridge, he’s got a DVD player, USB drive, he got pizza the other day. So we tried really hard to make it possible.”

But there’s still a cultural divide. At the end of the meeting, Jason explains to another doctor that he thinks “white fella” medicine is too slow.

“I want to go back to bush medicine,” he says. “It’s better and works fast because we learned it from old people.”

More support for staff

The hospital’s general manager, Angela Brannelly, says the 2010 investigation into the staffing crisis recommended major changes to the way the hospital operates, its level of staffing and supervision.

She says supporting the medical staff was one of her first priorities.

“We took it very seriously and made some really serious changes to the way that the medical team was supported here. It was around ensuring that someone’s got their back,” she says.

Dr Quilty, who joined the hospital in 2012, was the first physician to have ever been employed at the hospital. Last year he won the Royal Australian College of Physicians’ medal for clinical service in rural and remote areas.

A dark-skinned doll

His high level of specialist training has meant that patients who would have had to be evacuated to Royal Darwin Hospital can now receive treatment in Katherine. Since 2012, there has been a decrease of 43 per cent in the number of total aeromedical evacuations to Darwin.

Many Indigenous patients who live in remote communities don’t like going to Darwin to receive medical treatment because it’s far from family and the hospital is bigger and less personal.

Gaye, 50, a cancer patient who was transferred to Darwin for chemotherapy says she felt lonely in Darwin. “In Darwin I was always sad and crying a lot,” she says.

No-one in Darwin had realised that Gaye was deaf, which made communication with medical staff virtually impossible. In Katherine her deafness was recognised by the nurses and she was given a hearing aid, which she says made a huge difference to her mental health.

Katherine Hospital now employs two full-time physicians.

Still no Aboriginal doctors

Katherine Hospital employs 24 doctors but none of them are Indigenous.

Ms Brannelly admits the hospital hasn’t done enough to attract Aboriginal doctors.

“That’s good advice for us, and it’s probably where we need to go in that space around seeking out Aboriginal medical officers to come and work for us,” she says.

“I think we have some work to do there, absolutely.”

Aboriginal Health #obesity : 10 major health organisations support #sugartax to fund chronic disease and obesity #prevention

Young Australians, people in Aboriginal and Torres Strait Islander communities and socially disadvantaged groups are the highest consumers of sugary drinks.

These groups are also most responsive to price changes, and are likely to gain the largest health benefit from a levy on sugary drinks due to reduced consumption ,

A health levy on sugary drinks is not a silver bullet – it is a vital part of a comprehensive approach to tackling obesity, which includes restrictions on children’s exposure to marketing of these products, restrictions on their sale in schools, other children’s settings and public institutions, and effective public education campaigns.

We must take swift action to address the growing burden that overweight and obesity are having on our society, and a levy on sugary drinks is a vital step in this process.”

Rethink Sugary Drink campaign Download position statement

health-levy-on-sugar-position-statement

Read NACCHO previous articles Obesity / Sugartax

Amata SA was an alcohol-free community, but some years earlier its population of just under 400 people had been consuming 40,000 litres of soft drink annually.

See NACCHO Story

SBS will be showing That Sugar Film this Sunday night 2 April at 8.30pm.

There will be a special Facebook live event before the screenings

 ” The UK’s levy on sugar sweetened beverages will start in 2018, with revenue raised to go toward funding programs to reduce obesity and encourage physical activity and healthy eating for school children.

We know unhealthy food is cheaper and that despite best efforts by many Australians to make healthier choices price does affect our decisions as to what we buy.”

Sugar tax adds to the healthy living toolbox   see full article 2 below

 ” Alarmingly, with overweight becoming the perceived norm in Australia, the number of people actively trying to lose weight is declining.   A recent report by the Australian Institute of Health and Welfare found that nearly 64 per cent of Australians are overweight or obese.  This closely mirrors research that indicates around 66 per cent of Americans fall into the same category.

With this apparent apathy towards personal health and wellbeing, is it now up to food and beverage companies to combat rising obesity rates?

Who is responsible for Australia’s waistlines?  Article 3 Below

Ten of Australia’s leading health and community organisations have today joined forces to call on the Federal Government to introduce a health levy on sugary drinks as part of a comprehensive approach to tackling the nation’s serious obesity problem.

The 10 groups – all partners of the Rethink Sugary Drink campaign – have signed a joint position statement calling for a health levy on sugary drinks, with the revenue to be used to support public education campaigns and initiatives to prevent chronic disease and address childhood obesity.

This latest push further strengthens the chorus of calls in recent months from other leading organisations, including the Australian Medical Association, the Grattan Institute, the Australian Council of Social Services and the Royal Australian College of General Practitioners.

Craig Sinclair, Chair of the Public Health Committee at Cancer Council Australia, a signatory of the new position statement, said a health levy on sugary drinks in Australia has the potential to reduce the growing burden of chronic disease that is weighing on individuals, the healthcare system and the economy.

“The 10 leading health and community organisations behind today’s renewed push have joined forces to highlight the urgent and serious need for a health levy on sugary drinks in Australia,” Mr Sinclair said.

“Beverages are the largest source of free sugars in the Australian diet, and we know that sugary drink consumption is associated with increased energy intake and in turn, weight gain and obesity. Sugary drink consumption also leads to tooth decay.

“Evidence shows that a 20 per cent health levy on sugar-sweetened beverages in Australia could reduce consumption and prevent thousands of cases of type 2 diabetes, heart disease and stroke over 25 years, while generating $400-$500m in revenue each year to support public education campaigns and initiatives to prevent chronic disease and address childhood obesity.

“The Australian Government must urgently take steps to tackle our serious weight problem. It is simply not going to fix itself.”

Ari Kurzeme, Advocacy Manager for the YMCA, also a signatory of the new position statement, said young Australians, people in Aboriginal and Torres Strait Islander communities and socially disadvantaged groups have the most to gain from a sugary drinks levy.

The Rethink Sugary Drink alliance recommends the following actions to tackle sugary drink consumption:
• A public education campaign supported by Australian governments to highlight the health impacts of regular sugary drink consumption
• Restrictions by Australian governments to reduce children’s exposure to marketing of sugar-sweetened beverages, including through schools and children’s sports, events and activities
• Comprehensive mandatory restrictions by state governments on the sale of sugar-sweetened beverages (and increased availability of free water) in schools, government institutions, children’s sports and places frequented by children
• Development of policies by state and local governments to reduce the availability of sugar-sweetened beverages in workplaces, government institutions, health care settings, sport and recreation facilities and other public places.

To view the position statement click here.

Rethink Sugary Drink is a partnership between major health organisations to raise awareness of the amount of sugar in sugar-sweetened beverages and encourage Australians to reduce their consumption. Visit www.rethinksugarydrink.org.au for more information.

The 10 organisations calling for a health levy on sugary drinks are:

Stroke Foundation, Heart Foundation, Kidney Health Australia, Obesity Policy Coalition, Diabetes Australia

the Australian Dental Association, Cancer Council Australia, Dental Hygienists Association of Australia,  Parents’ Voice, and the YMCA.

Sugar tax adds to the healthy living toolbox 

Every day we read or hear more about the so-called ‘sugar tax’ or, as it should be more appropriately termed, a ‘health levy on sugar sweetened beverages’.

We have heard arguments from government and health experts both in favour of, and opposed to this ‘tax’. As CEO of one the state’s leading health charities I support the state government’s goal to make Tasmania the healthiest population by 2025 and the Healthy Tasmania Five Year Strategic Plan, with its focus on reducing obesity and smoking.

However, it is only one tool in the tool box to help us achieve the vision.

Our approach should include strategies such as restricting the marketing of unhealthy food and limiting the sale of unhealthy food and drink products at schools and other public institutions together with public education campaigns.

Some of these strategies are already in progress to include in our toolbox. We all have to take some individual responsibility for the choices we make, but as health leaders and decision makers, we also have a responsibility to create an environment where healthy choices are made easier.

This, in my opinion, is not nannyism but just sensible policy and demonstrated leadership which will positively affect the health of our population.

 Manufacturers tell us that there are many foods in the marketplace that will contribute to weight gain and we should focus more on the broader debate about diet and exercise, but we know this is not working.

A recent Cancer Council study found that 17 per cent of male teens drank at least one litre of soft drink a week – this equates to at least 5.2 kilograms of extra sugar in their diet a year.

Evidence indicates a significant relationship between the amount and frequency of sugar sweetened beverages consumed and an increased risk of developing type 2 diabetes.  We already have 45,000 people at high risk of type 2 diabetes in Tasmania.

Do we really want to say we contributed to a rise in this figure by not implementing strategies available to us that would make a difference?

I recall being quite moved last year when the then UK Chancellor of the Exchequer George Osborne said that he wouldn’t be doing his job if he didn’t act on reducing the impact of sugary drinks.

“I am not prepared to look back at my time here in this Parliament, doing this job and say to my children’s generation… I’m sorry. We knew there was a problem with sugary drinks…..But we ducked the difficult decisions and we did nothing.”

The UK’s levy on sugar sweetened beverages will start in 2018, with revenue raised to go toward funding programs to reduce obesity and encourage physical activity and healthy eating for school children. We know unhealthy food is cheaper and that despite best efforts by many Australians to make healthier choices price does affect our decisions as to what we buy.

In Mexico a tax of just one peso a litre (less than seven cents) on sugary drinks cut annual consumption by 9.7 per cent and raised about $1.4 billion in revenue.

Similarly, the 2011 French levy has decreased consumption of sugary drinks, particularly among younger people and low income groups.

The addition of a health levy on sugar sweetened beverages is not going to solve all problems but as part of a coordinated and multi-faceted approach, I believe we can effect change.

  • Caroline Wells, is Diabetes Tasmania CEO

3. Who is responsible for Australia’s waistlines? from here

Alarmingly, with overweight becoming the perceived norm in Australia, the number of people actively trying to lose weight is declining.   A recent report by the Australian Institute of Health and Welfare found that nearly 64 per cent of Australians are overweight or obese.  This closely mirrors research that indicates around 66 per cent of Americans fall into the same category.

With this apparent apathy towards personal health and wellbeing, is it now up to food and beverage companies to combat rising obesity rates?

Unfortunately it is not clear cut.  While Big Food and Big Beverage are investing in healthier product options, they also have a duty to shareholders to be commercially successful, and to expand their market share. The reality is that unhealthy products are very profitable.  However companies must balance this against the perception that they are complicit in making people fatter and therefore unhealthier with concomitant disease risks.

At the same time, the spectre of government regulation continues to hover, forcing companies to invest in their own healthy product ranges and plans to improve nutrition standards.

The International Food and Beverage Alliance (a trade group of ten of the largest food and beverage companies), has given global promises to make healthier products, advertise food responsibly and promote exercise. More specific pledges are being made in developed nations, where obesity rates are higher and scrutiny is more thorough.

However companies must still find a balance between maintaining a profitable business model and addressing the problem caused by their unhealthy products.

An example of this tension was evident when one leading company attempted to boost the sale of its healthier product lines and set targets to reduce salt, saturated fat and added sugar.  The Company also modified its marketing spend to focus on social causes.  Despite the good intentions, shareholders were disgruntled, and pressured the company to reinstate its aggressive advertising.

What role should governments play in shaping our consumption habits and helping us to maintain healthier weights? And should public policy be designed to alter what is essentially personal behaviour?

So far, the food and beverage industry has attempted to avoid the burden of excessive regulation by offering relatively healthier product lines, promoting active lifestyles, funding research, and complying with advertising restrictions.

Statistics indicate that these measures are not having a significant impact.  Subsequently, if companies fail to address the growing public health burden, governments will have greater incentive to step in.  In Australia, this is evident in the increased political support for a sugar tax.  The tax has been debated in varying forms for years, and despite industry resistance, the strong support of public health authorities may see a version of the tax introduced.

Already, Australia’s food labelling guidelines have been amended and tightened, and a clunky star rating system introduced to assist consumers to make healthier choices. Companies that have worked to address and invest in healthy product ranges must still market them in a responsible way. Given the sales pressure, it is tempting for companies to heavily invest in marketing healthier product ranges.  However they have an obligation under Australian consumer law to ensure products’ health claims do not mislead.

We know that an emboldened Australian Competition and Consumer Commission (ACCC) is taking action against companies that deliberately mislead consumers.  The food industry is firmly in the its sights, with a case currently underway against a leading food company over high sugar levels in its products. This shows that the Regulator will hold large companies to account, and push for penalties that ‘make them sit up and take notice.’

At a recent Consumer Congress, ACCC Chair Rod Sims berated companies that don’t treat consumers with respect.  He maintains that marketing departments with short-term thinking, and a short-sighted executive can lead to product promotion that is exaggerated and misleading.  All of which puts the industry on notice.

With this in mind, it is up to Big Food and Big Beverage to be good corporate citizens.  They must uphold their social, cultural and environmental responsibilities to the community in which they seek a licence to operate, while maintaining a strong financial position for their shareholders. It is a difficult task, but there has never been a better time for companies to accept the challenge.

Eliza Newton, Senior Account Director