“This is a really significant day. We absolutely need more Aboriginal and Torres Strait Islander people becoming dental and other health professionals.
It makes a big difference in how people interact with and access care if Aboriginal and Torres Strait Islander people are involved in delivering it.
In September 2018 there were 48 Indigenous dentists across the whole of Australia: about 0.3 per cent of dentists, whereas Aboriginal and Torres Strait Islander people made up about 3 per cent of the population.
Having three Aboriginal women graduate as dentists on one day from one university is something we’d like to see a lot more of.”
Gari Watson, President of IDAA. See Interviews with graduates Part 2 Below
“They are such great role models for Indigenous people and will be working to improve oral health, particularly in regional and remote areas of our state,”
Pro Vice Chancellor Indigenous Education Professor Jill Milroy said it was wonderful to see three Indigenous women graduate from a highly demanding course.
” Hira Rind, Patricia Elder and Ashlee Bence were awarded a Doctor of Dental Medicine, boosting the number of Australia’s Indigenous dentists.
We are delighted for the graduates themselves and their achievement. We’re also excited about what it means in terms of increasing our Aboriginal and Torres Strait Islander health workforce.
There is a huge need for accessible, affordable, culturally safe and holistic health care services, particularly for Aboriginal and Torres Strait Islander people who often face major challenges getting the comprehensive care they need.”
IAHA CEO, Donna Murray :
Part 1 Three Aboriginal women recently graduated as dentists from the University of Western Australia.
Indigenous Dentists’ Association of Australia (IDAA) and Indigenous Allied Health Australia (IAHA) join in congratulating them on their achievement and welcome them in joining a growing number of Aboriginal and Torres Strait Islander people who are succeeding to become and practice as highly skilled practitioners.
Dr Tony Bartone, President of the AMA described the situation on the AMAs 2019 Report Card on Indigenous Health “Aboriginal and Torres Strait Islander children and adults have much higher rates of dental disease than their non-Indigenous counterparts across Australia, which can be largely attributed to the social determinants of health. Aboriginal and Torres Strait Islander people are also less likely to receive the dental care that they need”.
We expect this is also good news for the Western Australian Government, as improving the oral health of Aboriginal and Torres Strait people is a priority in the Western Australian Government’s State Oral Health Plan 2016-2020. The Plan notes and seeks to address the situation where Aboriginal people are less likely to receive treatment they need.
The WA Health Aboriginal Workforce Strategy 2014-24 also recognises the importance of addressing service capacity and workforce, stating “More Aboriginal staff are needed to help
address the significant health issues faced by Aboriginal people”.
As with the dental graduates today, we hope to be congratulating many more Aboriginal and Torres Strait Islander health practitioners in the future. Aboriginal and Torres strait islander
communities need better access to comprehensive healthcare. Good oral health is an essential element of health and well being.
Hira Rind, Patricia Elder and Ashlee Bence were awarded a Doctor of Dental Medicine, boosting the number of Australia’s Indigenous dentists by more than six per cent. Indigenous Allied Health Australia data shows there are currently 48 Indigenous dentists practising around Australia.
Dr Rind, a 29-year-old Yamatji woman originally from Mt Magnet but raised in Perth, began her studies at UWA in the Aboriginal Orientation course in 2008 and graduated with a Bachelor of Health Science in 2013. She went on to work in health and study oral health before enrolling in Dental Medicine.
“I’m planning to work in the North West of WA as part of the rural and remote program,” Dr Rind said.
Originally from Northampton, Dr Elder (29) is a Yindjbardni/Yamatji woman who obtained a Bachelor of Nursing from ECU in 2011 and worked as a registered nurse before commencing dentistry at UWA.
“I’m going to work for the State Government’s Dental Health Service as part of the rural and remote program in Kununurra,” she said.
Dr Bence (30) also worked as an Intensive Care Unit (ICU) nurse in Melbourne before moving to Perth to study dentistry at UWA.
She’s working for Derbarl Yerrigan Aboriginal Service in Perth as well as in private practice.
“Many Stolen Generations survivors experienced childhood trauma as a result of their forced removal from family, community, culture and language, and sometimes also as a result of abuse and racism experienced after their removal.
Every day events can trigger the original trauma, particularly if a situation brings back the lack of control Stolen Generations survivors experienced when they were taken from their families.”
Interacting with aged care staff, GPs, dentists and other services is often difficult for Stolen Generations survivors said The Healing Foundation’s Chair Professor Steve Larkin
‘General practice is often the first and only point of contact with the healthcare system for many patients. The RACGP has a strong interest in ensuring that general practice services and healthcare in general are safe and responsive to people who experienced the devastating impacts of forced removal,’ he said.
‘This new resource provides essential context and useful tools to assist GPs to identify and understand the impacts of trauma for their patients.
These are principles of good clinical practice, which is beneficial for all patients.’
Associate Professor Peter O’Mara, Chair of RACGP Aboriginal and Torres Strait Islander Health, said the factsheet is a vital resource for GPs.
The resources, launched by the Minister for Indigenous Australians The Hon Ken Wyatt AM MP, were developed by The Healing Foundation in collaboration with Stolen Generations survivors and peak bodies including the Royal Australian College of General Practitioners, the Australian Dental Association, Aged & Community Services Australia and the Aged Care Industry Association.
Stolen Generations survivor and member of The Healing Foundation’s Stolen Generations Reference Group Geoff Cooper said he hoped the fact sheets would create greater awareness about the best ways to provide services to the Stolen Generations without triggering trauma.
“Little changes can make a big difference to how we feel when we walk in to a service. Things like not making us talk about bad stuff that’s happened to us if we don’t want to, and explaining what you’re going to do before you do it so we aren’t caught off guard.”
The resources are part of The Healing Foundation’s Action Plan for Healing project, funded by the Department of Prime Minister and Cabinet in 2017 following the 20th anniversary of the 1997 Bringing them Home report, which highlighted the contemporary needs of the Stolen Generations and their descendants.
An Australian Institute of Health and Welfare analysis conducted as part of the Action Plan for Healing project found there are over 17,000 Stolen Generations survivors in Australia today, and by 2023 will all be aged over 50 and eligible for aged care.
“The development of the fact sheets has been guided by Stolen Generations survivors: they identified the key issues encountered when dealing with GPs, dentists and aged care providers, what is helpful and what should be avoided,” Professor Larkin said.
“We’ve been delighted with the level of interest the resources are already receiving from the target sectors, and are excited to see the materials taken up at the practice and provider level nationally.”
Australian Dental Association CEO Damian Mitsch said the organisation was proud to have supported the creation of the dental resource.
“This resource will go a long way in providing education and helpful tips to guide dental practitioners in providing effective dental care to Stolen Generations survivors,” Mr Mitsch said.
The CEO of Aged & Community Services Australia (ACSA), Patricia Sparrow, said the organisation and its members were pleased to have contributed to the aged care resource.
“We believe the work of The Healing Foundation in providing information about how aged care services acknowledge the needs, and care for Stolen Generations survivors is critical.
“Through these resources, providers of aged care are able to better understand some of the trauma and triggers as well as the diversity of needs for Stolen Generations survivors, which must be considered in delivering the best quality care for all people,” Ms Sparrow said.
Resources will now be developed for hospitals, allied health professionals and disability services.
The fact sheets provide practical tips, tailored for each profession, on how staff and management can improve services to Stolen Generations survivors. The suite of fact sheets can be downloaded here.
The Healing Foundation is a national Aboriginal and Torres Strait Islander organisation that partners with communities to address the ongoing trauma caused by actions like the forced removal of children from their families.
” Good oral health is fundamental to our overall health and wellbeing. It allows us to eat and speak without pain, discomfort or embarrassment.
Aboriginal and Torres Strait Islander children and adults have much higher rates of dental disease that their non-Indigenous counterparts across Australia, which can largely be attributed to the social determinants of health.
Indigenous Australians are also less likely to receive the dental care that they need.”
The 2019 Report Card on Indigenous Health focusses on the oral health status of Aboriginal and Torres Strait Islander people in Australia was launched in Darwin last week
Good oral health is fundamental to our overall health and wellbeing. It allows us to eat and speak without pain, discomfort or embarrassment.
Aboriginal and Torres Strait Islander children and adults have much higher rates of dental disease that their non-Indigenous counterparts across Australia, which can largely be attributed to the social determinants of health. Indigenous Australians are also less likely to receive the dental care that they need.
Opportunities exist for political leaders at all levels of government to implement solutions to improve the oral health of Aboriginal and Torres Strait Islander people in Australia. This includes increasing fluoridation of Australia’s water supplies, enhancing oral health promotion, growing the Indigenous dental workforce and strengthening data collection to monitor and evaluate the oral health status and the performance of oral health care services.
Fundamentally, governments must ensure that Aboriginal and Torres Strait Islander people have access to affordable, culturally appropriate oral health care programs.
Many Aboriginal and Torres Strait Islander people rely on public oral health services, where they exist.
However, the availability of these services depends on government funding, which is often short-term. Consequently, a significant proportion of the Indigenous population live without regular dental care, which has adverse health outcomes.
Oral health is fundamental to overall health and wellbeing. Good oral health allows people to eat, speak and socialise without pain, discomfort or embarrassment.
Five action areas present opportunities for governments to improve the oral health of Aboriginal and Torres Strait Islander people in Australia. They are:
Fluoridated water supplies, especially in
Oral health promotion that works with fluoride varnish programs and a tax on sugar-sweetened
An effective dental workforce with greater participation of Aboriginal and Torres Strait Islander
Better coordination and reduced institutional racism in oral health care for Aboriginal and Torres Strait Islander
Data to know that the work being done is making a
Government action is needed because Aboriginal and Torres Strait Islander children and adults have dental disease at two to three times the rates of their non-Indigenous counterparts in urban, rural, and remote communities across Australia. They are also much less likely to get needed dental care.
The social determinants of health, such as poverty, racism, and colonialism contribute to a large proportion of the oral health gap between Aboriginal and Torres Strait Islander people and their non-Indigenous peers.
As a result, Aboriginal and Torres Strait Islander pre-school and primary-school-aged children are much more likely to be hospitalised for dental problems.
Community water fluoridation is a safe, effective, and equitable way to reduce dental decay. In Australia, access to fluoridated water varies due to the lack of a national approach.
This disadvantages Aboriginal and Torres Strait Islander people compared with non-Indigenous Australians because a greater proportion livein rural and regional areas, where water fluoridation is less common.
The situation is particularly concerning in Queensland where nearly half of the Aboriginal and Torres Strait Islander population does not have water fluoridation. Australian Government funding for State and Territory dental services is a lever to push for more water fluoridation.
Fluoride varnish programs also help in preventing dental decay, with proven effect in Aboriginal and Torres Strait Islander communities. The application is simple and requires minimal training. Australian Government leadership is needed to identify and remove the regulatory, administrative and program barriers to effective fluoride varnish programs for Aboriginal and Torres Strait Islander children and adults.
Sugary drinks are a major source of sugar that fuels tooth decay. A tax on sugar-sweetened beverages will reduce consumption and tooth decay, as well as the incidence of obesity, diabetes, heart disease, and stroke. Nearly 70 per cent of Australians are in favour of taxes on soft drinks.
Aboriginal and Torres Strait Islander people are nearly twice as likely to suffer from dental pain as non- Indigenous Australians, and five times as likely to have missing teeth. Pain from dental disease, and damage to teeth, can be effectively managed by dental practitioners.
Governments need to provide Aboriginal and Torres Strait Islander people with culturally safe dental care programs that are planned and implemented through collaborative and equal partnerships between communities and providers.
It is also well understood that health outcomes for Aboriginal and Torres Strait Islander patients are improved when they are treated by Aboriginal and Torres Strait Islander health professionals.
However, Aboriginal and Torres Strait Islander people are grossly under-represented in the oral health workforce. The goal of 780 Aboriginal and Torres Strait Islander dental practitioners by 2040 should be set as a target to promote employment parity in the dental workforce.
Finally, more comprehensive, consistent and coordinated oral health data are needed to better monitor and evaluate oral health status, as well as the performance of oral health care services across Australia. This in turn will lead to improvements in the oral health of Aboriginal and Torres Strait Islander people.
The two major dental diseases are tooth decay (caries) and gum disease (periodontal disease). Both diseases can cause pain, loss of function, and disfigurement.
Tooth decay is a chronic disease caused by dietary sugar. Oral bacteria ferment sugar to produce acids that demineralise, and ultimately destroy, the teeth. Tooth decay progresses with age, creating a lifelong burden.1 Gum disease damages the bone and gum supporting the teeth, and its progress is insidious, with symptoms of pain and loose teeth in the advanced stages
Gum disease susceptibilit varies between individuals, with a genetic component, and is exacerbated by smoking and diabetes.2,
“A proportion of Aboriginal and Torres Strait Islander people have good oral health. On average, however, Aboriginal and Torres Strait Islander people experience poor oral health earlier in their lifespan and in greater severity and prevalence than the rest of the population. Aboriginal and Torres Strait Islander people are also less likely to receive treatment to prevent or address poor oral health, resulting in oral health care in the form of emergency treatment.”
Photo above : Gari Watson is a Goreng Goreng, Gangulu and Biri Gubba man who grew up in Brisbane, Queensland Gari was the third Indigenous dentist to graduate from James Cook University (JCU) in 2014. Gari was working at the Institute for Urban Indigenous health in his hometown of Brisbane. “Working in Indigenous health, with my people, is my passion in life,” said Gari. “Working on the frontline to improve oral health and contributing to closing the gap in Indigenous health equality is exactly where I want to be. I’m living the dream.”
I have spent three decades working in and around dental health/public health and innovation in Australia and other places.
We are a team of many, many people from all over earth – there is more than 100 people working on things with us; from Jeddah to Utah and everywhere in-between.
We have graduate students focused on addressing inequality and building systems to reform health care in Australia and across the world.
Poor dental health has become a condition of poverty and marginalisation over the last five decades.
Today the “average” (actually does NOT exist) Aussie kid has less than one decayed tooth. In fact, over half of kids have NO decay.
But, a small minority of kids have LOTS of decay and suffer a lot. These are more often than not those for poor areas or are at the edge of society.
Why has decay dropped to such a low prevalence in society? Not actually a simple, clean one-line answer. Brushing, eating better, fluoride, toothpaste…. the list goes on.
Amazing turnaround!!! In 1960’s, a 12-year-old had 12 holes in their teeth – today less than ONE! AMAZING.
This started in the late 1960’s so many adults today have low decay levels too. BUT, there are pockets of trouble too!
This trend is now in adults too – the poor suffer far more than the rich with dental disease.
Why? The risk factors are higher for the marginalised, it’s harder to access good preventive care and more risk-taking activity.
Australia has two dental systems – private dental care, that are small independent businesses on the whole and are free to charge as they like. This is more than 85 percent of dental care.
AND, a small public system for those on health care cards or similar. Also, here we have Aboriginal Medical Service based dental services too.
PS We also have dental care in some tertiary hospitals for tough problems, cleft lip and palate, oral cancer, jaw fractures and more.
The public dental system is small, often under-resourced, especially as dental disease is now a condition of poverty. It’s the wrong way round now (private: public ratio)
Remember, the public dental systems are run by STATE governments – the federal government does not really have a role in dental (although there are some growing bits of funding now).
Where do we need to go in dental health in Australia?
Everyone says dental should be part of Medicare. If I said the bill for that could be as large as the NDIS as a cost, you can see the problem.
And remember that most dental care is provided by small businesses where the government cannot control prices – there would be payment gaps!
There are alternatives… We have seen some – targeted care for those in need subsidised by the government.
There are some efforts around to be targeted and maximising bang for buck. The most efficient models of providing good dental care are actually part of State government care systems.
State government dental care systems across Australia are run down, and the real opportunity now is to re-enforce them and grow them. Get some balance back into the nation
We now have dental workforce to do it!
In 2000, we were at a workforce crisis with a lack of dentists. Today, 20 years later, we have sufficient workforce coming though… In some places there are too many (Sydney and Melbourne) but as a nation we are now safe.
We need to get more dental workforce out of Nedlands, Double Bay and Toorak and into the rest of Australia – that’s the big effort for the next decade.
We need our dental focus to start with those in most need, the poor and marginalised (economically and geographically). This is where dental troubles are. They are not in Toorak or Double Bay.
And people in Toorak or Double Bay have access to care – some of the highest densities of dentists in the world are around those suburbs!!! True.
It is interesting that the Labor Party policy released last week has focused on the elderly. Demographic shift.
As I am explaining, dental disease is reducing in adults and those born from mid 1960’s forward are on the whole dental far better than their elders.
Focus on elder dental health is good! Australia is growing old and we still have dental troubles for people.
The maximisation of bang-for-buck from what I can see is for people to take their “voucher” (if Labor wins) and spend it in the public dental service. Help grow the safety net for others in need.
Obviously, where there is no public system, do use the local private practice but I just wish people would try their darndest to support their fellow Australians by helping grow the public system.
I should say, I am not employed either as a private or public dentist and take no money in sponsorship. I am an academic. (In addition, I do not have a share portfolio!)
And new things to think about. Telehealth is coming to dental. Yes, imagine screening teeth from images you take in your own bathroom.
Telehealth really going to be important in closing geographic gaps. Imagine screening kids to prioritise them for the dental team when they come to town.
There is a digital future in dentistry (I have seen experimental robots doing dental care! – it’s coming)’
An important initiative in dental will be big data and prediction. Well protected (privacy) coupled with good analysis is going to give us great tools to predict risk and predict where needs are.
We do need to see support going into the R&D of these big-data solutions in health. They will squeeze every bit of value from every dollar we spend on dental care. A digital future is coming to public health and dentistry.
” Indigenous Australians are more likely than other Australians to have multiple caries and untreated dental disease, and less likely to have received preventive dental care (AHMAC 2017). The oral health status of Indigenous Australians, like all Australians, is influenced by many factors (see What contributes to poor oral health?) and a tendency towards unfavourable dental visiting patterns, broadly associated with accessibility, cost and a lack of cultural awareness by some service providers (COAG 2015; NACDH 2012).”
” With new figures revealing almost half of Australian children aged 5-10 experience tooth decay in their baby teeth , the Rethink Sugary Drink alliance is urging Aussies to give their teeth a break from sugary drinks and make the switch to water in a bid to protect their oral health.
The Australian Institute of Health and Welfare figures released today also reveal this trend continues into adulthood with Australians aged 15 and over having an average of nearly 13 decayed, missing or filled teeth.
Sugary drinks, such as soft drinks, sports drinks and energy drinks, are a major contributor of added sugar in Australian children’s diets and the leading cause of tooth decay.’ ,
Part 1 AIHW Report Oral health and dental care in Australia
Good oral health is fundamental to overall health and wellbeing (COAG 2015). Without it, a person’s general quality of life and the ability to eat, speak and socialise is compromised, resulting in pain, discomfort and embarrassment.
Oral health refers to the condition of a person’s teeth and gums, as well as the health of the muscles and bones in their mouth (AHMAC 2017). Poor oral health—mainly tooth decay, gum disease and tooth loss—affects many Australian children and adults, and contributed 4.4% of all the burden that non-fatal burden diseases placed on the community in 2011. Oral health generally deteriorates over a person’s lifetime
What contributes to poor oral health?
Many factors contribute to poor oral health (NACDH 2012), including:
consumption of sugar, tobacco and alcohol
a lack of good oral hygiene and regular dental check-ups
a lack of fluoridation in some water supplies
access and availability of services, including:
affordability of private dental care
long waiting periods for public dental care.
What is the impact of poor oral health?
The most common oral diseases affect the teeth (tooth decay, called ‘caries’) and gums (periodontal disease). Oral disease can destroy the tissues in the mouth, leading to lasting physical and psychological disability (NACDH 2012). Tooth loss can reduce the functionality of the mouth, making chewing and swallowing more challenging, which in turn can compromise nutrition. Poor nutrition can impair general health and exacerbate existing health conditions (NACDH 2012). Poor oral health is also associated with a number of chronic diseases, including stroke and cardiovascular disease (DHSV 2011) (Figure 1).
Poor oral health can also affect a person’s wellbeing. Dental disease can impair a person’s appearance and speech, eroding their self-esteem, which in turn can lead to restricted participation at school, the workplace, home and other social settings (NACDH 2012).
Some groups are at greater risk of poor oral health
The National Oral Health Plan identifies four priority population groups that have poorer oral health than the general population and also experience barriers to accessing oral health care—either in the private or public sector. State and territory governments are the current providers of most public dental services, and access is largely targeted towards people on low incomes or holders of concession cards. Eligibility requirements can vary between states and territories (AIHW 2018).
The four priority population groups identified in the plan are:
People who are socially disadvantaged or on low incomes:This group has historically been identified as those on a low income and/or receiving some form of government income assistance, but now extends to include people experiencing other forms of disadvantage including refugees, homeless people, some people from culturally and linguistically diverse backgrounds, and people in institutions or correctional facilities (COAG 2015). Poorer oral health results from infrequent dental care. Barriers include cost, appropriateness of service delivery and lower levels of health literacy, including oral health (COAG 2015).
Aboriginal and Torres Strait Islander Australians: Indigenous Australians are more likely than other Australians to have multiple caries and untreated dental disease, and less likely to have received preventive dental care (AHMAC 2017). The oral health status of Indigenous Australians, like all Australians, is influenced by many factors (see What contributes to poor oral health?) and a tendency towards unfavourable dental visiting patterns, broadly associated with accessibility, cost and a lack of cultural awareness by some service providers (COAG 2015; NACDH 2012).
People living in regional and remote areas: Overall, this group has poorer oral health than those in Major cities (COAG 2015), and oral health status generally declines as remoteness increases. Rural Australians have access to fewer dental practitioners than their city counterparts, which, coupled with longer travel times and limited transport options to services, affects the oral health care that they can receive (COAG 2015; Bishop & Laverty 2015). People living in Remote and Very remote areas are also more likely to smoke and drink at risky levels. They have reduced access to fluoridated drinking water and face increased costs of healthy food choices and oral hygiene products. These risk factors contribute to this population’s overall poorer oral health (COAG 2015).
People with additional and/or specialised health care needs: This group includes people living with mental illness, people with physical, intellectual and developmental disabilities, people with complex medical needs and frail older people. These people can be vulnerable to oral disease; for example, some medications for chronic diseases can cause a dry mouth, which increases the risk of tooth decay (Queensland Health 2008). A number of factors make accessing dental care more difficult for this group, including:
a shortage of dental health professionals with skills in special-needs dentistry
difficulties in physically accessing appropriate dental treatment facilities
the cost of treatment. People with additional and/or specialised health care needs often have their earning capacity eroded by ill health (COAG 2015).
Why does oral health vary across Australia?
People in some states and territories have generally poorer oral health than others. For example, the National Child Oral Health Study found that the prevalence of caries in the deciduous teeth of children was significantly higher in Northern Territory and Queensland than in all other states and territories (Do & Spencer 2016). Oral health status is influenced by a complex interaction of factors, as outlined above. These factors should be considered when looking at results by state and territory. For example:
all people living in the Northern Territory were located in Outer regional, Remote or Very remote areas, whereas the majority of the Victorian population were located in Major cities in 2016 (ABS 2018a)
the Northern Territory has Australia’s highest proportion of Aboriginal and Torres Strait Islander people (26% of its population) which is much higher than the next highest state, Tasmania (4.6% of its population) (ABS 2017)
Tasmania has the highest proportion of people living in the lowest socioeconomic areas (37%) (refer to Technical notes for explanation of SEIFA) (ABS 2018b).
The variations observed in oral health status between state and territory populations may also be partly explained by differences in individual state and territory oral health care funding, service models and eligibility requirements, which can result in varied patterns of dental visiting among residents (AIHW 2018). Oral health campaigns and policies can also make an impact. For example, water fluoridation coverage in Queensland has reduced since the Queensland Government transferred the decision whether to fluoridate water supplies from state to local governments in 2008, despite evidence that access to fluoridated drinking water has been shown to reduce tooth decay (Queensland Health 2015; NHMRC 2017).
Part 2 Australians’ love affair with sugary drinks rots the smiles of children as young as five
Leading health bodies call for people to rethink sugary drink this World Oral Health Day.
With new figures revealing almost half of Australian children aged 5-10 experience tooth decay in their baby teeth , the Rethink Sugary Drink alliance is urging Aussies to give their teeth a break from sugary drinks and make the switch to water in a bid to protect their oral health.
The Australian Institute of Health and Welfare figures released today also reveal this trend continues into adulthood with Australians aged 15 and over having an average of nearly 13 decayed, missing or filled teeth.
Sugary drinks, such as soft drinks, sports drinks and energy drinks, are a major contributor of added sugar in Australian children’s diets and the leading cause of tooth decay.
On World Oral Health Day today, Craig Sinclair, Head of Prevention at Cancer Council Victoria, a partner of Rethink Sugary Drink, is urging Australians to see this information as motivation to cut back on sugary drinks.
While regular sugary drink consumption leaves a lasting effect on Australians’ oral health, Mr Sinclair said the risks extend beyond just teeth.
“These super sugary drinks don’t stop at ruining Aussie smiles. In the long run they can lead to unhealthy weight gain, increasing the risk of serious health problems such as type 2 diabetes, heart and kidney disease, stroke and 13 types of cancer.”
“It’s sadly no surprise that tooth decay is hitting Australian kids hard, given the overwhelming availability of sugary drinks. Not only are there significantly more sugary drink choices available today, they are everywhere our kids look. Ironically they’re even in venues designed to help our kids be healthy, such as sports centres, sporting clubs, as well as places they visit regularly like train stations, festivals and events,” Mr Sinclair said.
“Big beverage brands don’t just stop there – they also sweet talk our kids into guzzling high-sugar drinks through social media, and outdoor and online advertising. We need government to invest in public education campaigns to cut through the marketing spin and expose the health impacts of sugary drinks.”
A/Prof Matthew Hopcraft, Chief Executive Officer of the Australian Dental Association Victorian Branch, a Rethink Sugary Drink partner, has seen the devastating impact sugary drinks has on children’s teeth and wants Australians to consider the consequences of drinking too many.
“I’ve seen firsthand the devastating impact tooth decay has on the health, nutrition, social and emotional wellbeing of these kids and their families. There are extreme cases where dentists are extracting all 20 baby teeth from kids as young as 3 – it’s not pretty.” A/Prof Hopcraft said.
“Some people may not realise every time they take a sip from a sugary drink they expose their teeth to an acid attack, dissolving the outer surface of our tooth enamel. This regular loss of enamel can lead to cavities and exposure of the inner layers of the tooth that may leave them feeling very sensitive and painful.
“Healthy teeth are an integral part of good oral health, enabling us to eat, speak and socialise without pain, discomfort or embarrassment. It’s disheartening to know 27% of Aussie kids feel uncomfortable about the appearance of their teeth. No kid should look back on their childhood and remember the distress and pain that came as a result of drinking too many sugary drinks.”
A/Prof Hopcraft said World Oral Health Day serves the perfect chance for Australians to rethink their choice of drink.
“We know less than 10 per cent of Australian adults have managed to avoid tooth decay. There is no reason why we can’t turn these numbers around. If Australians can simply cut back on sugary drinks or remove them entirely from their diet, their teeth will be much stronger and healthier for it,” A/Prof Hopcraft said
“We recommend taking a look at how much sugar is in these drinks – people may be shocked to know some have as many as 16 teaspoons of sugar. Water is always the best choice and your teeth will thank you in the long run.”
In support of World Oral Health Day the Rethink Sugary Drink alliance are calling for the following actions in addition to the restriction of unhealthy drink marketing to address the issue of sugary drink overconsumption:
A public education campaign supported by Australian governments to highlight the health impacts of regular sugary
 AIHW (Australian Institute of Health and Welfare) 2019. Oral health and dental care in Australia, 2014-15 and 2016-17
About Rethink Sugary Drink: Rethink Sugary Drink is a partnership between the Apunipima Cape York Health Council, Australian Dental Association, Australian Dental and Oral Health Therapists’ Association, Cancer Council Australia, Dental Health Services Victoria, Dental Hygienists Association of Australia, Diabetes Australia, Healthier Workplace WA, Kidney Health Australia, LiveLighter, The Mai Wiru Sugar Challenge Foundation, Nutrition Australia, Obesity Policy Coalition, Royal Australasian College of Dental Surgeons, Stroke Foundation, Parents’ Voice, the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) and the YMCA to raise awareness of the amount of sugar in sugar-sweetened beverages and encourage Australians to reduce their consumption.
“Aboriginal and Non- Aboriginal kids are being inundated with the advertising of alcohol, junk food and gambling through AFL sponsorship deals according to a new study.
With obesity and excessive drinking remaining a significant problem in our communities, it’s time for the AFL ladder of unhealthy sponsorship (see below) to end,
Children under the age of eight are particularly vulnerable to advertising because they lack the maturity and mental skills to evaluate the messages. Therefore, in the case of the AFL, they begin to associate unhealthy products with their favourite sport and players
We need to ask ourselves why Australia’s most popular winter sport is serving as a major advertising platform for soft drink, beer, wine, burgers and meat pies. It’s sending the wrong message to Australians that somehow these unhealthy foods and drinks are linked to the healthy activity of sport,”
Says the Public Health Association of Australia (PHAA).
In the study published this week in the Australian and New Zealand Journal of Public Health, Australian researchers looked at the prevalence of sponsorship by alcohol, junk food and gambling companies on AFL club websites and on AFL player uniforms.
The findings were used to make an ‘AFL Sponsorship Ladder’, a ranking of AFL clubs in terms of their level of unhealthy sponsorships, with those at the top of the ladder having the highest level of unhealthy sponsors.
The study clearly demonstrated that Australia’s most popular spectator sport is saturated with unhealthy advertising.
Ainslie Sartori, one of the authors involved in the research confirmed, “After reviewing the sponsorship deals of AFL clubs, we found that 88% of clubs are sponsored by unhealthy food and beverage companies. A third of AFL clubs are also involved in business partnerships with gambling companies.”
Sponsorship offers companies an avenue to expose children and young people to their brand, encouraging a connection with that brand.
The AFL could reinforce healthy lifestyle choices by shifting the focus away from the visual presence of unhealthy sponsorship, while taking steps to ensure that clubs remain commercially viable.
Policy makers are encouraged to consider innovative health promotion strategies and work with sporting clubs and codes to ensure healthy messages are prominent
The study noted that children are often the targets of AFL advertising. This is despite World Health Organization recommendations that children’s settings should be free of unhealthy food promotions and branding (including through sport) due to the known risk it poses to their diet and chances of developing obesity.
PHAA CEO Terry Slevin commented, “When Australian kids see their sports heroes wearing a uniform plastered with certain brands, they inevitably start to associate these brands with the player they look up to and with the positive and healthy experience of the sport.”
He added, “The AFL is in a unique position to positively influence the health of Australian kids through banning sponsorship by alcohol, junk food and gambling companies. It could instead reinforce the importance of a healthy lifestyle for them.”
“Australian health policy makers need to consider innovative health promotion strategies and work together with sport clubs and codes to ensure that unhealthy advertising is not a feature. We successfully removed tobacco advertising from sport and we can do it with junk food and gambling too,” Mr Slevin said.
The recently released Sport 2030 plan rightly identifies sport as a positive vehicle to promote good health. But elite “corporate sport” plays a role of bypassing restrictions aimed at reducing exposure of children to unhealthy product marketing.
“The evidence is clear – it’s time for Australia to phase out all unhealthy sponsorship of sport,” Mr Slevin conclude
9 August : Beyond Survival March for Aboriginal Rights – Better Solutions for a Better Future
NSW Aboriginal Land Council and the Coalition of Aboriginal Peak Organisations (CAPO) says it is time governments and policy-makers commit to actively engaging the expertise of Aboriginal community controlled organisations.
“That is why we are marching on the International Day of the World’s Indigenous Peoples,” said Councillor Roy Ah-See, Chair of NSWALC and Co-Chair of CAPO.
“CAPO’s expertise across health, education, cultural and family connections, community care, the legal system and Land Rights spans more than 200 years.
And the Land Rights network continues to support our people and communities to access quality health care, decent housing, education, sustainable employment and economic participation.”
Cr Ah-See said that current policy is built on shifting sands, while the knowledge and expertise of Aboriginal community controlled organisations provide the solid foundation for a better future for our people.
“That is why it is vital we all take this opportunity to walk together in solidarity and march for Aboriginal Rights and community control on a highly significant day,” Cr Ah-See said.
“Aboriginal organisations have the solutions and we are the ones who should have control of what our children’s future will look like.”
The Beyond Survival March for Aboriginal Rights is on Thursday August 9 at 11am, leaving from Hyde Park North to NSW Parliament House.
This year during Dental Health Week (6 – 12 August), the ADA is reminding everyone to #WatchYourMouth, in the light of the latest national survey conducted by the Association that showed Australians are not prioritising their oral health.
It follows the launch earlier this year by the ADA of Australia’s Oral Health Tracker which was developed in response to data showing that just over 52% of Australians are only brushing once a day instead of the recommended twice daily and nearly two in five (38%) never floss or clean in between their teeth. Australians also need more regular dental check-ups, with 69% only going to the dentist when they have a problem.
This is especially concerning given the fact that tooth decay is Australia’s most common disease, with one in five adults having untreated tooth decay and one in five also have gum disease, with oral cancer rates also on the rise.
To help combat these figures, Dental Health Week 2018 is stressing these four key tips for good oral health:
• Brush twice a day with fluoridated toothpaste
• Clean in between your teeth with floss or interdental brushes
• Eat a healthy diet, limit sugary foods and drinks
• Visit your dentist regularly
Dr Hugo Sachs, ADA President said Dental Health Week is an opportunity for people to take a look and learn more about why a healthy mouth is so important.
“Good oral health is vital to good overall health, so watching your mouth will help maintain your general wellbeing. Watching your mouth means: brushing and flossing, eating a healthy diet, lowering our sugar and alcohol intake, stopping smoking and seeing your dentist for regular check-ups. These good habits will greatly reduce the risk of oral disease.”
This year’s Ambassador for Dental Health Week 2018, MasterChef 2016 runner-up and restaurateur Matt Sinclair, added:
“Quality oral hygiene has always been paramount in my life; it was something we were raised to be very conscious of. Mum would never allow us to go to school or bed without brushing our teeth and our regular dentist check-ups were compulsory. As the Dental Health Week Ambassador, I’m encouraging Australians to watch their mouth and take their oral health seriously.
“Working as a chef, I’m constantly tasting food throughout the day, so I’m more aware of the importance of looking after my mouth. Simple regular oral hygiene habits, seeing a dentist for checkups and eating good quality fresh food will ensure our mouths and teeth can continue to perform for us.”
To follow the extensive range of Dental Health Week events, search #DentalHealthWeek and #WatchYourMouth on Facebook, Twitter and Instagram
We have two clinics to keep your whole mouth healthy & your smile deadly.
For more info call: Gabba – 3240 8922 or Logan – 3029 6518 WEBSITE
Am I eligible?
To be eligible for appointments at our dental clinics you must:
reside in South East Queensland and identify as Aboriginal or Torres Strait Islander
be a regular ongoing patient with one of our ATSICHS Brisbane medical clinics and be up to date with your annual health check. If you are a new patient to ATSICHS Brisbane, our GPs will need to have had a chance to review your medical records.
We encourage kids to get their health check prior to their dental appointment. We have a dental van at the Murri School that specialises in children’s dental care. We can also see kids at our two other clinics.
If you are a non Indigenous patient with an Indigenous spouse you may be eligible for care. Please contact our dental team for further information.
If you do not currently attend one of our ATSICHS Brisbane medical clinics, you are invited to transfer your medical records and become a regular ongoing medical patient. You will then become eligible for dental care once your health check is completed.
If you prefer not to attend one of our medical clinics, you are unable to access the dental clinics at Woolloongabba or Logan.
What are my alternatives?
Other choices for dental care are:
Queensland Health Oral Health – if you are a holder of a Centrelink concession card call them on 1300 300 850 OR
a private dentist of your choice.
Access and fees
There are no fees for the general dental care provided the eligibility criteria is met.
Fees do apply for laboratory work, e.g., mouth guards, denture and crown work.
Treatment is provided to the majority of children via the Child Dental Benefits Scheme.
Aged pensioners are eligible for free acrylic dentures.
Our dental team consists of dentists, oral health therapists, dental assistants, dental technicians and a dental prosthetist.
We support the training of dental students, by providing clinical placements for final year dental students throughout the year.
Our services include:
emergency treatment for toothache, trauma and wisdom teeth
routine dental checkups and screening
root canal on anterior teeth
wisdom teeth extractions
dentures and crowns
mouth guards and splints
simple orthodontic procedures
scaling and cleaning with oral health promotion
regular recalls and follow up.
Dental services are available at our Woolloongabba and Logan clinics.
All services are provided in the clinics and staff are supportive of visiting and participating in community days and other special events to provide information on dental care and disease prevention.
Registrations are currently open for the inaugural Institute for Urban Indigenous Health (IUIH) System of Care Conference, to be held on Monday 27 and Tuesday 28 August 2018 in Brisbane.
This conference will focus on IUIH’s successful approach to Closing the Gap in Indigenous health and would be of interest to people working in
• Aboriginal and Torres Strait Islander Community Controlled Health Services
• Primary Health Networks (PHNs)
• Health and Hospital Boards and management
• Government Departments
• the University Sector
• the NGO sectorCome along and gain fresh insights into the ways in which a cross-sector and integrated system can make real impacts on the health of Aboriginal and Torres Strait Islander peoples as we share the research behind the development and implementation of this system.
Featuring presentations by speakers across a range of specialisations including clinic set up, clinical governance, systems integration, wrap around services such as allied and social health, workforce development and research evidence.
The NACCHO Members’ Conference and AGM provides a forum for the Aboriginal community controlled health services workforce, bureaucrats, educators, suppliers and consumers to:
Present on innovative local economic development solutions to issues that can be applied to address similar issues nationally and across disciplines
Have input and influence from the ‘grassroots’ into national and state health policy and service delivery
Demonstrate leadership in workforce and service delivery innovation
Promote continuing education and professional development activities essential to the Aboriginal community controlled health services in urban, rural and remote Australia
Promote Aboriginal health research by professionals who practice in these areas and the presentation of research findings
Develop supportive networks
Promote good health and well-being through the delivery of health services to and by Indigenous and non-Indigenous people throughout Australia.
Expressions of Interest to present
NACCHO is now calling for EOI’s from Affiliates , Member Services and stakeholders for Case Studies and Presentations for the 2018 NACCHO Members’ Conference. This is an opportunity to show case grass roots best practice at the Aboriginal Community Controlled service delivery level.
The recent week-long #MensHealthWeek focus offered a “timely reminder” to all men to consider their health and wellbeing and the impact that their ill health or even the early loss of their lives could have on the people who love them. The statistics speak for themselves – we need to look after ourselves better .
That is why I am encouraging all men to take their health seriously, this week and every week of the year, and I have made men’s health a particular priority for Indigenous health.”
Federal Minister for Indigenous Health and Aged Care Ken Wyatt who will be a keynote speaker at NACCHO Ochre Day in August
To celebrate #MensHealthWeek NACCHO has launches its National #OchreDay2018 Mens Health Summit program and registrations
The NACCHO Ochre Day Health Summit in August provides a national forum for all Aboriginal and Torres Strait Islander male delegates, organisations and communities to learn from Aboriginal male health leaders, discuss their health concerns, exchange share ideas and examine ways of improving their own men’s health and that of their communities
All too often Aboriginal male health is approached negatively, with programmes only aimed at males as perpetrators. Examples include alcohol, tobacco and other drug services, domestic violence, prison release, and child sexual abuse programs. These programmes are vital, but are essentially aimed at the effects of males behaving badly to others, not for promoting the value of males themselves as an essential and positive part of family and community life.
To address the real social and emotional needs of males in our communities, NACCHO proposes a positive approach to male health and wellbeing that celebrates Aboriginal masculinities, and uphold our traditional values of respect for our laws, respect for Elders, culture and traditions, responsibility as leaders and men, teachers of young males, holders of lore, providers, warriors and protectors of our families, women, old people, and children.
NACCHO’s approach is to support Aboriginal males to live longer, healthier lives as males for themselves. The flow-on effects will hopefully address the key effects of poor male behaviour by expecting and encouraging Aboriginal males to be what they are meant to be.
In many communities, males have established and are maintaining men’s groups, and attempting to be actively involved in developing their own solutions to the well documented men’s health and wellbeing problems, though almost all are unfunded and lack administrative and financial support.
To assist NACCHO to strategically develop this area as part of an overarching gender/culture based approach to service provision, NACCHO decided it needed to raise awareness, gain support for and communicate to the wider Australian public issues that have an impact on the social, emotional health and wellbeing of Aboriginal Males.
It was subsequently decided that NACCHO should stage a public event that would aim to achieve this and that this event be called “NACCHO Ochre Day”.
7. NATSIHWA National Professional Development Symposium 2018
We’re excited to release the dates for the 2018 National Professional Development Symposium to be held in Alice Springs on 2nd-4th October. More details are to be released in the coming weeks; a full sponsorship prospectus and registration logistics will be advertised asap via email and newsletter.
This years Symposium will be focussed on upskilling our Aboriginal and/or Torres Strait Islander Health Workers and Health Practitioners through a series of interactive workshops. Registrants will be able to participate in all workshops by rotating in groups over the 2 days. The aim of the symposium is to provide the registrants with new practical skills to take back to communities and open up a platform for Health Workers/Practitioners to network with other Individuals in the workforce from all over Australia.
Building on the foundations of our membership, history and diversity, AIDA is shaping a future where we continue to innovate, lead and stay strong in culture. It’s an exciting time of change and opportunity in Indigenous health.
The AIDA conference supports our members and the health sector by creating an inspiring networking space that engages sector experts, key decision makers, Indigenous medical students and doctors to join in an Indigenous health focused academic and scientific program.
AIDA recognises and respects that the pathway to achieving equitable and culturally-safe healthcare for Indigenous Australians is dynamic and complex. Through unity, leadership and collaboration, we create a future where our vision translates into measureable and significantly improved health outcomes for our communities. Now is the time to put that vision into action.
Nominate our members’ outstanding contributions towards improving the health and life outcomes of Aboriginal and Torres Strait Islander Peoples.
We invite you to be part of the CATSINaM Professional Development Conference held in Adelaide, Australia from the 17th to the 19th of September 2018.
The Conference purpose is to share information while working towards an integrated approach to improving the outcomes for Aboriginal and Torres Strait Islander Australians. The Conference also provides an opportunity to highlight the very real difference being made in Aboriginal and Torres Strait Islander health by our Members.
To this end, we are offering a mixed mode experience with plenary speaker sessions, panels, and presentations as well as professional development workshops.
A global movement, Healing Our Spirit Worldwidebegan in Canada in the 1980s to address the devastation of substance abuse and dependence among Indigenous people around the world. Since 1992 it has held a gathering approximately every four years, in a different part of the world, focusing on a diverse range of topics relevant to Indigenous lives including health, politics, social inclusion, stolen generations, education, governance and resilience.
The International Indigenous Council – the governing body of Healing Our Spirit Worldwide – has invited the University of Sydney and The Healing Foundation to co-host the Eighth Gathering with them in Sydney this year. The second gathering was also held in Sydney, in 1994.
Please also feel free to tag us in any relevant cross posting: @HOSW8 @hosw2018 #HOSW8 #HealingOurWay #TheUniversityofSydney
On Monday night Four Corners investigates the power of Big Sugar and its influence on public policy.
“How did the entire world get this fat, this fast? Did everyone just become a bunch of gluttons and sloths?” Doctor
The figures are startling. Today, 60% of Australian adults are classified as overweight or obese. By 2025 that figure is expected to rise to 80%.
“It’s the stuff of despair. Personally, when I see some of these young people, it’s almost hard to imagine that we’ve got to this point.” Surgeon
Many point the finger at sugar – which we’re consuming in enormous amounts – and the food and drink industry that makes and sells the products fuelled by it.
Tipping the scales, reported by Michael Brissenden and presented by Sarah Ferguson, goes to air on Monday 30th of April at 8.30pm. It is replayed on Tuesday 1st of May at 1.00pm and Wednesday 2nd at 11.20pm.
It can also be seen on ABC NEWS channel on Saturday at 8.10pm AEST, ABC iview and at abc.net.au/4corners.
” In 2012-13, Aboriginal and Torres Strait Islander people 2 years and over consumed an average of 75 grams of free sugars per day (equivalent to 18 teaspoons of white sugar)1. Added sugars made up the majority of free sugar intakes with an average of 68 grams (or 16 teaspoons) consumed and an additional 7 grams of free sugars came from honey and fruit juice. “
“Amata 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.
The thing that I say in community meetings all the time is that, the reason we’re doing this is so that the young children now do not end up going down the same track of diabetes, kidney failure, dialysis machines and early death, which is the track that many, many people out here are on now,”
NACCHO Post : Mai Wiru, meaning good health, and managed by long-time community consultant John Tregenza.
“This isn’t about, as the food industry put it, people making their own choices and therefore determining what their weight will be. It is not as simple as that, and the science is very clear.” Surgeon
Despite doctors’ calls for urgent action, there’s been fierce resistance by the industry to measures aimed at changing what we eat and drink, like the proposed introduction of a sugar tax.
“We know about the health impact, but there’s something that’s restricting us, and it’s industry.” Public health advocate
On Monday night Four Corners investigates the power of Big Sugar and its influence on public policy.
“The reality is that industry is, by and large, making most of the policy. Public health is brought in, so that we can have the least worse solution.” Public health advocate
From its role in shutting down debate about a possible sugar tax to its involvement in the controversial health star rating system, the industry has been remarkably successful in getting its way.
“We are encouraged by the government here in Australia, and indeed the opposition here in Australia, who continue to look to the evidence base and continue to reject this type of tax as some sort of silver bullet or whatnot tosolve what is a really complex problem, and that is our nation’s collective expanding waistline.” Industry spokesperson
We reveal the tactics employed by the industry and the access it enjoys at a time when health professionals say we are in a national obesity crisis.
“We cannot leave it up to the food industry to solve this. They have an imperative to make a profit for their shareholders. They don’t have an imperative to create a healthy, active Australia.” Health advocate
NACCHO post – Sixty-three per cent of Australian adults and 27 per cent of our children are overweight or obese.
“This is not surprising when you look at our environment – our kids are bombarded with advertising for junk food, high-sugar drinks are cheaper than water, and sugar and saturated fat are hiding in so-called ‘healthy’ foods. Making a healthy choice has never been more difficult.
The annual cost of overweight and obesity in Australia in 2011-12 was estimated to be $8.6 billion in direct and indirect costs such as GP services, hospital care, absenteeism and government subsidies.1 “
OPC Executive Manager Jane Martin
” This campaign is straightforward – sugary drinks are no good for our health. It’s calling on people to drink water instead of sugary drinks.’
Aboriginal and Torres Strait Islander people in Cape York experience a disproportionate burden of chronic disease compared to other Australians.’
‘Regular consumption of sugary drinks is associated with increased energy intake and in turn, weight gain and obesity. It is well established that obesity is a leading risk factor for diabetes, kidney disease, heart disease and some cancers. Consumption of sugary drinks is also associated with poor dental health.
Water is the best drink for everyone – it doesn’t have any sugar and keeps our bodies healthy.’
Apunipima Public Health Advisor Dr Mark Wenitong
Read over 48 NACCHO articles Health and Nutrition HERE
1. Aboriginal sexual health: The Australian : Was the syphilis epidemic preventable ? NACCHO responds
2.Royal Flying Doctors Service extra 4-year funding $84 million Mental Health and Dental Services
3.Nurses PAQ continues political membership campaign spreading false and misleading information about our cultural safety
4.AMSANT has called for re-doubled efforts to implement the recommendations of the Royal Commission into the care and protection of children in partnership with NT Aboriginal leaders
5.Dialysis facilities worth $17 million are sitting padlocked, empty and unused in WA’s north
6.ALRC Report into Incarceration of Aboriginal and Torres Strait Islander People.
7. Minister Ken Wyatt : Listening to Indigenous Needs: Healthy Ears Program Extended with $29.4 commitment
8.Tangentyere Alice Springs Women’s Family Safety Group visits Canberra
9.Minister Ken Wyatt launches our NACCHO RACGP National Guide to a preventative health assessment for Aboriginal and Torres Strait Islander people
10. Your guide to a healthy Easter : #Eggs-actly
1.Aboriginal sexual health: The Australian : Was the syphilis epidemic preventable ? NACCHO responds
“These (STIs) are preventable diseases and we need increased testing, treatment plans and a culturally appropriate health education campaign that focuses resources on promoting safe-sex messages delivered to at-risk communities by our trained Aboriginal workforce,”
Pat Turner, chief executive of peak body the National Aboriginal Community Controlled Health Organisation, is adamant about this.
7. Minister Ken Wyatt : Listening to Indigenous Needs: Healthy Ears Program Extended with $29.4 commitment
The Australian Government has committed $29.4 million to extend the Healthy Ears – Better Hearing, Better Listening Program, to help ensure tens of thousands more Indigenous children and young adults grow up with good hearing and the opportunities it brings.
8.Tangentyere Alice Springs Women’s Family Safety Group visits Canberra
This week the Tangentyere Women’s Family Safety Group from Alice Springs were in Canberra. They shared with politicians, their own solutions for their own communities, and they are making an enormous difference.
Big thanks to all the Tangentyere women who made it to Canberra.
And finally hope you had a Happy Easter all you mob ! After you have enjoyed your chocolate #Easter eggs and hot cross buns , this is how much exercise you will require to work of those Easter treats .
For medical and nutrition advice please check with your ACCHO Doctor , Health Promotion / Lifestyle teams or one of our ACCHO nutritionists
There is no reason it should have happened, especially not in a first-world country like Australia, but it has: indigenous communities in the country’s north are in the grip of wholly treatable sexually transmitted diseases.
In the case of syphilis, it is an epidemic — West Australian Labor senator Patrick Dodson described it as such, in a fury, when health department bureaucrats mumbled during Senate estimates about having held a few “meetings” on the matter.
There have been about 2000 syphilis notifications — with at least 13 congenital cases, six of them fatal — since the outbreak began in northern Queensland in 2011, before spreading to the Northern Territory, Western Australia and, finally, South Australia.
What’s worse, it could have been stopped. James Ward, of the South Australian Health and Medical Research Institute, wrote in mid-2011 that there had been a “downward trend” over several years and it was likely at that point that the “elimination of syphilis is achievable within indigenous remote communities”.
But governments were slow to react, and Ward is now assisting in the design of an $8.8 million emergency “surge” treatment approach on the cusp of being rolled out in Cairns and Darwin, with sites in the two remaining affected states yet to be identified.
It will be an aggressive strategy — under previous guidelines, you had to have been identified during a health check as an active carrier of syphilis to be treated. Now, anyone who registers antibodies for the pathogen during a blood prick test, whether actively carrying syphilis or not, will receive an immediate penicillin injection in an attempt to halt the infection’s geographical spread.
This is key: the high mobility of indigenous people in northern and central Australia means pathogens cross jurisdictions with impunity. Australian Medical Association president Michael Gannon calls syphilis a “clever bacterium that will never go away”, warning that “bugs don’t respect state borders”.
Olga Havnen, one of the Northern Territory’s most respected public health experts, points out that many people “will have connections and relations from the Torres Strait through to the Kimberley and on to Broome — and it’s only a matter of seven or eight kilometres between PNG and the northernmost islands there in the Torres Strait”.
“This is probably something that’s not really understood by the broader Australian community,” Havnen says. “I suspect once you get a major outbreak of something like encephalitis or Dengue fever, any of those mosquito-borne diseases, and that starts to encroach onto the mainland, then people will start to get a bit worried.”
But it is not just syphilis — indeed, not even just STIs — that have infectious disease authorities concerned and the network of Aboriginal Community Controlled Health Organisations stretched.
Chlamydia, the nation’s most frequently diagnosed STI in 2016 based on figures from the Kirby Institute at the University of NSW, is three times more likely to be contracted by an indigenous Australian than a non-indigenous one.
The rate was highest in the NT, at 1689.1 notifications per 100,000 indigenous people, compared with 607.9 per 100,000 non-indigenous Territorians. If you’re indigenous, you’re seven times more likely to contract gonorrhoea, spiking to 15 times more likely if only women are considered. Syphilis, five times more likely.
As the syphilis response gets under way, health services such as the one Havnen leads, the Darwin-based Danila Dilba, will be given extra resources to tackle it. “With proper resourcing, if you want to be doing outreach with those people who might be visitors to town living in the long grass, then we’re probably best placed to be able to do that,” she says.
But the extra focus comes with a warning. A spate of alleged sexual assaults on Aboriginal children, beginning with a two-year-old in Tennant Creek last month and followed by three more alleged attacks, has raised speculation of a link between high STI rates and evidence of child sexual assault.
After the first case, former NT children’s commissioner Howard Bath told this newspaper that STI rates were “a better indicator of background levels of abuse than reporting because so many of those cases don’t get reported to anyone, whereas kids with serious infections do tend to go to a doctor”. Others, including Alice Springs town councillor Jacinta Price and Aboriginal businessman Warren Mundine, raised the spectre of the need for removing more at-risk indigenous children from dangerous environments.
However, Sarah Giles, Danila Dilba’s clinical director and a medical practitioner of 20 years’ standing in northern Australia, warns this kind of response only exacerbates the problem. She is one of a range of public health authorities who, like Havnen, say connecting high STI figures to the very real scourge of child sex abuse simply makes no sense. They do not carry correlated data sets, the experts say.
“One of the things that’s really unhelpful about trying to manage STIs at a population level is to link it with child abuse and mandatory reporting, and for people to be fearful of STIs,” Giles says. “The problem is that when they’re conflated and when communities feel that they can’t get help because things might be misinterpreted or things might be reported, they’re less likely to present with symptoms. The majority of STIs are in adults and they’re sexually transmitted.”
Havnen says there is evidence of STIs being transmitted non-sexually, including to children, such as through poor hand hygiene, although Giles says that is “reasonably rare”. And while NT data shows five children under 12 contracted either chlamydia or gonorrhoea in 2016 (none had syphilis), and there were another five under 12 last year, Havnen points to the fact that over the past decade there has been no increasing trend in under 12s being affected. Where there has been a rise in the NT is in people aged between 13 and 19, with annual gonorrhoea notifications increasing from 64 cases in the 14-15-year-old female cohort in 2006 to 94 notifications in 2016.
In the 16-17-year-old female cohort the same figures were 96 and 141 and in the 12-13-year-old group it rose from 20 in 2006 to 33 in 2016. Overall, for both boys and girls under 16, annual gonorrhoea notifications rose from 109 in 2006 to 186 in 2016, according to figures provided to the royal commission into child detention by NT Health. Havnen describes the rise as “concerning but not, on its own, evidence of increasing levels of sexual abuse”.
Ward is more direct. Not all STIs are the result of sexual abuse, he warns, and not all sexual abuse results in an STI. If you’re a health professional trying to deal with an epidemiological wildfire, the distinction matters — the data and its correct interpretations can literally be a matter of life and death.
Indeed, in its own written caveats to the material it provided to the royal commission, the department warns that sexual health data is “very much subject to variations in testing” and warns against making “misleading assumptions about trends”. Ward says: “Most STIs notified in remote indigenous communities are assumed to be the result of sex between consenting adults — that is, 16 to 30-year-olds. Of the under 16s, the majority are 14 and 15-year-olds.” He says a historically high background prevalence of STIs in remote indigenous communities — along with a range of other infectious diseases long eradicated elsewhere — is to blame for their ongoing presence. Poor education, health services and hygiene contribute, and where drug and alcohol problems exist, sexually risky behaviour is more likely too. The lingering impact of colonisation and arrival of diseases then still common in broader society cannot be underestimated.
But Ward claims that an apparently high territory police figure of about 700 cases of “suspected child sexual offences” in the NT over the past five years may be misleading. He says a large number of these are likely to be the result of mandatory reporting, where someone under 16 is known to have a partner with an age gap of more than two years, or someone under 14 is known to be engaging in sexual activity. Ward points out that 15 is the nationwide median sexual debut age, an age he suggests is dropping. At any rate, he argues, child sex abuse is unlikely to be the main reason for that high rate of mandatory reporting in the NT.
Data matters, and so does how it is used. Chipping away at the perception of child sexual abuse in indigenous communities are the latest figures from the Australian Institute of Health and Welfare showing the rate of removals for that crime is actually higher in non-indigenous Australia.
According to a report this month from the AIHW, removals based on substantiated sex abuse cases in 2016-17 were starkly different for each cohort: 8.3 per cent for indigenous children, from a total of 13,749 removals, and 13.4 per cent for non-indigenous children, from 34,915 removals.
Havnen concedes there is a need for better reporting of child abuse and has called for a confidential helpline that would be free of charge and staffed around the clock by health professionals.
It’s based on a model already in use in Europe that she says deals with millions of calls a year — but it would require a comprehensive education and publicity campaign if it were to gain traction in remote Australia. And that means starting with the adults.
“If you’re going to do sex education in schools and you start to move into the area about sexual abuse and violence and so on, it’s really important that adults are educated first about what to do with that information,” she says. “Because too often if you just educate kids, and they come home and make a disclosure, they end up being told they’re liars.”
These challenges exist against the backdrop of a community already beset by a range of infectious diseases barely present elsewhere in the country, including the STIs that should be so easily treatable. It is, as Havnen is the first to admit, a complex matter.
Cheryl Jones, president of the Australasian Society for Infectious Diseases, says the answer is better primary treatment solutions and education, rather than trying to solve the problem after it has occurred. “For any of these public health infectious disease problems in remote and rural areas, we need to support basic infrastructure at the point of care and work alongside communities to come up with solutions,” she says.
Pat Turner, chief executive of peak body the National Aboriginal Community Controlled Health Organisation, is adamant about this. “These (STIs) are preventable diseases and we need increased testing, treatment plans and a culturally appropriate health education campaign that focuses resources on promoting safe-sex messages delivered to at-risk communities by our trained Aboriginal workforce,” Turner says.
The Australian Medical Association has called for the formation of a national Centre for Disease Control, focusing on global surveillance and most likely based in the north, as being “urgently needed to provide national leadership and to co-ordinate rapid and effective public health responses to manage communicable diseases and outbreaks”.
“The current approach to disease threats, and control of infectious diseases, relies on disjointed state and commonwealth formal structures, informal networks, collaborations, and the goodwill of public health and infectious disease physicians,” the association warned in a submission to the Turnbull government last year.
However, the federal health department has rebuffed the CDC argument, telling the association that “our current arrangements are effective” and warning the suggestion could introduce “considerable overlap and duplication with existing functions”.
“I think it (the CDC) might have some merit, if it helps to advocate with government about what needs to happen,” Havnen says, “but if these things are going to be targeted at Aboriginal bodies, it needs to be a genuine partnership. It’s got to be informed by the realities on the ground and what we know. That information has to be fed up into the planning process.”
” It is important for children to form good habits by choosing healthy drinks from a young age. It’s not only important for children but adults as well, and children are more likely to learn healthy habits if they see the adults around them making healthy choices.
“Water is the best choice, It doesn’t have any sugar in it and it’s free, straight from the tap.Plain milk is also a very good choice with important benefits such as building strong bones and teeth.
Too many sugary drinks can harm our health, by causing weight gain and obesity as well as poor dental health in both children and adults.”
Apunipima’s Community Nutritionist Kani Thompson
” The Sugary drinks proper no good – Drink more water Youfla campaign includes access to free water throughout the local community.
‘We’re really worried about the impact of sugar in our area, because of the high rates of overweight and obesity leading to chronic diseases such as diabetes and heart disease,’
Dr Mark Wenitong, senior medical officer at Apunipima Cape York Health Council in Far North Queensland, told newsGP @RACGP
‘What we say in a cultural way is water is not colonised, and it’s not coming from corporates who are trying to make money, Water has been here ever since we’ve been here. Keep drinking it.And see our water story ”
An apple a day might help keep the doctor away and could also mean better performance at school. One thing that we tend to think less about is the type of drinks that we are having.
As school has started for most Queensland children last week and many interstate today , Apunipima Cape York Health Council wants to remind families that healthy drinks are just as important as healthy food for good health.
Sugary drinks have become popular choices but they have little or no benefit to health. Sugary drinks refers to all drinks with added sugar such as soft drinks, fruit drinks, cordials, sports drinks, and flavoured waters. An alternative to having a ‘popper’ fruit drink or juice is to have a piece of fruit and water as a drink instead – these are much better choices!
Kani said packing healthy drinks with lunches was easy – keep it simple.
“Remember to pack water as the main drink with school lunches. Tetra packs of fruit drinks or juice can be a popular and are an easy drink to add to school lunches, but they have a lot of sugar that growing bodies just don’t need. It’s just as easy to swap them for a water bottle. And adults can take a reusable water bottle to work and keep refilling during the day as needed.”
Too many sugary drinks can harm our health, by causing weight gain and obesity as well as poor dental health in both children and adults.
Top tips for drinking more water at school or work:
Take a reusable water bottle that can be refilled
Freeze a water bottle the night before to put in school lunch boxes to help keep it cold the next day
If you are drinking a lot of sugary drinks start by swapping one for water
A series of videos have been developed with three Cape York communities to promote water as the drink of choice. The social marketing campaign is part of a larger project that involves a range of activities in the communities, that include adults and school aged children.
Apunipima is a partner with the Rethink Sugary Drink Alliance to increase awareness, and to tackle high consumption of sugary drinks which has led to overweight and obesity, an increased risk of chronic diseases and, poor dental health.
Excessive sugar consumption is a major health problem in many remote Aboriginal and Torres Strait Islander communities throughout Australia.
The Sugary drinks proper no good – Drink more water Youfla campaign includes access to free water throughout the local community.
‘We’re really worried about the impact of sugar in our area, because of the high rates of overweight and obesity leading to chronic diseases such as diabetes and heart disease,’ Dr Mark Wenitong, senior medical officer at Apunipima Cape York Health Council in Far North Queensland, told newsGP.
Aboriginal and Torres Strait Islander peoples today consume 15 g more free sugars on average than non-Indigenous Australians, with the majority of the excess coming in the form of sweetened beverages.
In response to this situation, the Apunipima Cape York Health Council launched its public health campaign, Sugary drinks proper no good – Drink more water Youfla, in November. The campaign uses a variety of channels to raise awareness, with language designed to resonate with the target demographic.
‘The language came from our Aboriginal health workers,’ Dr Wenitong said. ‘We are trying to get the message into the communities in a number of ways, from primary healthcare clinics, through GPs and health workers; through radio and TV ads; and also through social media.
‘[Social media] is the big one these days, because most people in remote communities have mobile devices and are pretty avid users of social media.’
In remote populations such as Cape York, some of the increased consumption of sweetened beverages can be attributed to the challenges presented by the logistics of a remote location.
‘Our area is tropical and remote, so there’s not a lot of infrastructure around with constant access to cool water, and we have lot of hot weather so people are always looking for a cold drink, particularly in summer,’ Dr Wenitong said.
‘If all that is around is soft drinks, that’s what people are going to go for.’
Dr Wenitong also believes there is a historical basis for sugar consumption among Aboriginal and Torres Strait Islander peoples.
‘Back in the day when [Aboriginal and Torres Strait Islander peoples] were consigned to missions, they were fed white sugar, white flour, white tea. That was their staple diet,’ he said. ‘That’s why, I think, we’ve got this long history of having a poor diet, leading to a lot of the chronic diseases we have today.’
‘[That involves] making sure there’s water coolers outside the store, free water in the schools, handing out free bottles that people can refill with water and keep with them,’ Dr Wenitong said.
While the message of the campaign is simple and straightforward – just drink water – Dr Wenitong believes GPs can also use it to highlight a range of other positive health messages.
‘When you’re using self-management techniques, you’re really asking patients what’s most important in their lives and then hanging on that some of the things you know are healthy for them,’ Dr Wenitong said.
‘If it’s, “I really want to lose weight” they can say “One of the ways we can help you with that is to drink more water and drink less sugary drinks”; if it’s “I want to improve my dentition” they can say “Well, swap the lollies and soft drinks for water and healthier things, like fruit”.’
Dr Wenitong hopes the campaign will have a positive effect on the health of his community and his people.
‘What we say in a cultural way is water is not colonised, and it’s not coming from corporates who are trying to make money,’ he said. ‘Water has been here ever since we’ve been here. Keep drinking it.’
Amanda Lyons Amanda is an experienced health journalist and a newsGP staff writer