NACCHO Aboriginal Health and Food security #IndigenousNCDs : Welfare reform is targeting many remote-living Aboriginal people impoverishing them and resulting in the consumption of unhealthy foods that are killing them prematurely from non-communicable diseases

What national and average Closing the Gap figures do not tell us is just how badly the estimated 170,000 Indigenous people in remote and very remote Australia are faring. This region where I focus my work covers 86 per cent of the Australian continent.

In the last decade new race-based instruments have been devised to regulate Indigenous people including their forms of expenditure (via income management), forms of working via the Community Development Programme (CDP) and their places of habitation, where they might access basic citizenship services.

All these measures have implications for consumption of market commodities, including food from shops, and of customary non-market goods, including food from the bush.

Owing to deep poverty, many people can only purchase relatively cheap and unhealthy takeaway foods that are killing them prematurely from non-communicable diseases, like acute heart and kidney disorders, followed by lung cancer from smoking.

With income management Aboriginal people are being coerced to shop at stores according to the government’s rhetoric for their ‘food security’. Before the introduction of this regime many more people were exercising their ‘food sovereignty’ right to harvest far healthier foods from the bush.

Extracts from Jon Altman a research professor in anthropology at the Alfred Deakin Institute for Citizenship and Globalisation at Deakin University, Melbourne.

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A version of this article was first published in the Land Rights News

READ over 5 Articles NACCHO Aboriginal Health and Nutrition 

READ Articles NACCHO Aboriginal Health and Welfare Card 

” NACCHO is strongly opposed to the current cashless debit card trials as well as any proposal to expand. We also note that Aboriginal people are disproportionately affected by the trials and that they are in and proposed for locations where the majority participants are Aboriginal. Whilst it is not the stated intent of the trials, its impact is discriminatory.

NACCHO knows that some Aboriginal people and communities need additional support to better manage their lives and ensure that income support funds are used more effectively.

However, NACCHO is firmly of the view that there are significantly better, more cost efficient, alternative approaches that support improvements in Aboriginal wellbeing and positive decision making.

Aboriginal Community Controlled Health Services would be well placed to develop and implement alternative programs. We firmly believe that addressing the ill health of Aboriginal people, including the impacts of alcohol, drug and gambling related harm, can only be achieved by local Aboriginal people controlling health care delivery.

We know that when Aboriginal and Torres Strait Islander people have a genuine say over our lives, the issues that impact on us and can develop our own responses, there is a corresponding improvement in wellbeing. This point is particularly relevant given that the majority of trial participants are Aboriginal. “

Selected extracts from Submission to the Senate Community Affairs Legislation Committee Inquiry into the Social Services Legislation Amendment (Cashless Debit Card Trial Expansion) Bill 2018 

Download HERE 

NACCHO submission on cashless debit card final

As is the case in many countries, Indigenous people in Australia, New Zealand, United States of America and Canada are disproportionately affected by NCDs.

Diabetes, cardiovascular disease, cancer,  smoking related lung disease and mental health conditions are the five main NCDs identified by the World Health Organisation (WHO), and these are almost uniformly experienced by Indigenous peoples at higher rates than other people.

Indigenous people globally are disproportionately affected by diabetes. In Australia, Aboriginal and Torres Strait Islander peoples are 6 times more likely than the non-Indigenous population to die from diabetes. In Canada, Indigenous peoples are 3-5 times more likely to have diabetes than other citizens.

Indigenous people are also more likely to have Cardiovascular disease. Cardiovascular disease accounts for almost a quarter of the mortality gap between Aboriginal and Torres Strait Islander peoples and other Australians. Maori people are 3-4.2 times more likely to die from cardiovascular disease than other people in New Zealand.

These numbers are not improving, despite national rates of smoking decreasing, and increased social marketing aimed at reducing sugar consumption and increasing physical activity.

Mainstream solutions do little to reduce the burden of NCDs for Indigenous populations. The broader social determinants of health have a huge role to play, and until these are addressed in a meaningful way, Indigenous peoples will continue to experience an inequitable burden.

With colonisation having had a devastating impact on Indigenous peoples, and mainstream solutions unable to significantly reduce the rates of NCDs experienced by Indigenous peoples, a new paradigm is urgently required.

What is required is not more state based solutions but Indigenous led solutions.

Summer May Finlay Croakey 

Welfare reform is targeting many remote-living Aboriginal people impoverishing them and resulting in the consumption of unhealthy foods that are killing them prematurely from non-communicable diseases

Rome (Canberra) continues to fiddle while Black Australia burns. Professor Jon Altman weighs in on the ongoing disasters of government policy that have a tight grip on remote living Indigenous people.

In the last month I participated in two workshops. I used what I observed on my latest visit to Arnhem Land and what people were telling me to inform what I presented at the workshops.

The first workshop explored issues around excessive consumption by industrialised societies globally and how this is harming human health and destroying the planet. Workshop participants asked how such ‘consumptogenic’ systems might be regulated for the global good? My job was to provide a case study from my research on consumption by Indigenous people in remote Australia.

The second workshop looked at welfare reform in the last decade in remote Indigenous Australia. In this workshop I looked at how welfare reform by the Australian state after the NT Intervention was creatively destroying the economy and lifeways of groups in Arnhem Land who are looking to live on their lands and off its natural resources.

Here I want to share some of what I said.

BROADLY speaking Indigenous policy in remote Australia is looking to do two things.

The first is to Close the Gaps so that Indigenous Australians can one future day have the same socio-economic status as other Australians. In remote Australia this goal is linked to the project to ‘Develop the North’ via a combination of opening Aboriginal communities and lands to more market capitalism and extraction, purportedly for the improvement of disadvantaged Indigenous peoples and land owners.

While remote-living Indigenous people have economic and social justice rights to vastly improved wellbeing, in such scenarios of future economic equality based on market capitalism, the downsides of what I think of as ‘consumptomania’ are never mentioned.

The second aim of policy is the extreme regulation of Indigenous people and their behaviour, when deemed unacceptable. In a punitive manifestation of neoliberal governmentality, the Australian state, and its nominated agents, are looking to morally restructure Indigenous people to transform them into model citizens: hard-working, individualistic, highly educated, nationally mobile at least in pursuit of work (not alcohol), and materially acquisitive.

This paternalistic project of improvement makes no concessions whatsoever to cultural difference, colonial history of neglect, connection to country, discrimination, and so on.

In the last decade new race-based instruments have been devised to regulate Indigenous people including their forms of expenditure (via income management), forms of working via the Community Development Programme (CDP) and their places of habitation, where they might access basic citizenship services.

All these measures have implications for consumption of market commodities, including food from shops, and of customary non-market goods, including food from the bush.

We have all heard the bad news, year after year, report after report, that the government-imposed project of improvement, called ‘Closing the Gap’ and introduced by Kevin Rudd in 2008, is failing.

Using the government’s own statistics, after 10 years only one target, year 12 attainment, might be on track. I say ‘might’ because ‘attainment’ is open to multiple interpretations: is attainment just about attendance or about gaining useful life skills?

What national and average Closing the Gap figures do not tell us is just how badly the estimated 170,000 Indigenous people in remote and very remote Australia are faring. This region where I focus my work covers 86 per cent of the Australian continent.

What we are seeing in this massive part of Australia according to the latest census are the very lowest employment/population ratios of about 30 per cent for Indigenous adults (against 80% for non-Indigenous adults) and the deepest poverty, more than 50 per cent of people in Indigenous households currently live below the poverty line.

This is also paradoxically where Indigenous people have most land and native title rights, a recent estimate suggests that 43 per cent of the continent has some form of indigenous title; and is dotted with maybe 1000 small Indigenous communities with a total population of 100,000 at most.

Native title rights and interests give people an unusual and generally unregulated right to use natural resources for domestic consumption.

This form of consumption might include hunting kangaroos or feral animals like the estimated 100,000 wild buffalo in Arnhem Land.

Such hunting is good for health because the meat is lean and fresh; it is also good for the environment because buffalo eat about 30kg of vegetation a day and are environmentally destructive; and it is good for global cooling because each buffalo emits methane with a carbon equivalent value of about two tonnes per annum.

The legal challenge of gaining native title rights and interests is that claimants must demonstrate continuity of customs and traditions and connection to their claimed country. But in remote Australia, culture and tradition have been identified as a key element of the problem that is exacerbating social dysfunction. (That is unless tradition appears as fine art ‘high culture’ which is imagined to be unrelated to the everyday culture and is a favourite item for consumption by metropolitan elites.)

Hence the project of behavioural modification to eradicate Indigenous cultures that exhibit problematic characteristics, like sharing and a focus on kinship and reciprocity, to be replaced by western culture with its high consumption, individualistic and materially acquisitive characteristics.

Connection to country, at least if it involves living on it, is also deemed highly problematic by the Australian state if one wants to produce western educated, home-owning, properly disciplined neoliberal subjects — terra nulliusis now to be replaced by terra vacua, empty land.

Such empty land would be ripe for resource extraction and capitalist accumulation by dispossession Despite all the talk of mining on Aboriginal land, there are currently very few operating mines on the Indigenous estate. This is imagined as one means to Develop the North, but recent history suggests that the long-term benefits to Aboriginal land owners from such development will be limited.

MUCH of what I describe above in general terms resonates with what I have observed in Arnhem Land where I have visited regularly since the Intervention; and what I hear from Aboriginal people and colleagues working elsewhere in remote Indigenous Australia.

From 2007 to 2012 all communities in Arnhem Land were prescribed under NT Intervention laws. Since 2012, under Stronger Futures laws legislated in force until 2022, the Aboriginal population has continued to be subject to a new hyper-regulatory regime: income management, government-licenced stores, modern slavery-like compulsory work for welfare, enhanced policing, unimaginable levels of electronic and police surveillance, school attendance programs and so on.

The limited availability of mainstream work in this region as elsewhere means that most adults of working age receive their income from the new Community Development Program introduced in 2015. Weekly income is limited to Newstart ($260) for which one must meet a work requirement of five hours a day, five days a week if aged 18-49 years and able-bodied.

Of this paltry income, 50 per cent is quarantined for spending at stores where prices are invariably high, owing to remoteness.

The main aim of such paternalism is to reduce expenditure on tobacco and alcohol which cannot be purchased with the BasicsCard.

Shop managers that I have interviewed tell me that despite steep tax-related price rises (a pack of Winfield blue costs nearly $30) tobacco demand is inelastic and sales have not declined.

Since the year 2000, Noel Pearson has popularised his metaphor ‘welfare poison’. Pearson is referring figuratively to what he sees as the negative impacts of long-term welfare dependence. In Arnhem Land welfare is literally a form of poison because in the name of ‘food security’ people are forced to purchase foods they can afford with low nutritional value from ‘licenced’ stores.

However, paternalistic licencing to allow stores to operate the government-imposed BasicsCard is not undertaken equitably by officials from the Department of Prime Minister and Cabinet.

So one sees large, long-standing, community-owned and operated and mainly Indigenous staffed stores being rigorously regulated, managers argue over-regulated. Such stores are highly visible, as are their accounts.

But small private-sector operators (staffed mainly by temporary visa holders and backpackers) that have been established as the regional economy has been prised open to the free market appear under-regulated, even though they are also ‘licenced’ to operate the BasicsCard.

These private sector operators compete very effectively with community-owned enterprises because they only have a focus on commerce: all the profits they make and most of the wages they pay non-local staff leave the region.

Owing to deep poverty, many people can only purchase relatively cheap and unhealthy takeaway foods that are killing them prematurely from non-communicable diseases, like acute heart and kidney disorders, followed by lung cancer from smoking.

With income management Aboriginal people are being coerced to shop at stores according to the government’s rhetoric for their ‘food security’. Before the introduction of this regime many more people were exercising their ‘food sovereignty’ right to harvest far healthier foods from the bush.

This dramatic transformation has occurred as an unusual form of regional economy that involved a high level of customary activity has been effectively destroyed by the dominant government view that only prioritises engagement in market capitalism — that is largely absent in this region.

On one hand, we now see the most able-bodied hunters required to work for the dole every week day with their energies directed from what they do best.

On the other hand, the greatly enhanced police presence is resulting simultaneously in people being deprived of their basic equipment for hunting — guns and trucks — regularly impounded because they are unregistered or their users unlicenced.

People are being increasingly isolated from their ancestral lands and their hunting grounds.

Excessive policing, growing poverty, dependency and anomie are seeing criminality escalate with expensive fines for minor misdemeanours further impoverishing people and reducing their ability to purchase either more expensive healthy foods or the means to acquire bush foods.

A virtuous production cycle that until the Intervention saw much ‘bush food consumption’ has been disastrously reversed. Today, we see a vicious cycle where people regularly report hunger while living in rich Australia; people’s health status is declining.

Welfare reform and Indigeneity is indeed a toxic mix, poison, in remote regions like Arnhem Land.

I WANT to end with some more general conclusions.

On the regulation of Indigenous expenditure, we see a perverse policy intervention: the Australian government is committing what are sometimes referred to as Type 1 and Type 2 errors.

The former sees the government looking to regulate Indigenous consumption using the expensive instrument of income management that has cost over $1.2 billion to date, despite no evidence that it makes a difference.

The latter sees an absence of the proper regulation of supply in licences stores evident when stores with names like ‘The Good Food Kitchen’ sell cheap unhealthy take-aways.

In my view the racially-targeted and crude attempts to regulate Indigenous expenditure are unacceptable on social justice grounds.

Two principles as articulated by Guy Standing stand out.

‘The security difference principle’ suggests that a policy is only socially just if it improves the [food]security of the most insecure in society. Income management and work for the dole do not do this.

And ‘the paternalism test’ suggests that a policy like income management would only be socially just if it does not impose controls on some groups that are not imposed on the most-free groups in society.

Paternalistic governmentality in remote Australia is imposing tight regulatory frameworks on some people, even though the justifying ideology suggests that markets should be free and unregulated.

Sociologist Loic Wacquant in  Punishing the Poor shows how the carceral state in the USA punishes the poor with criminalisation and imprisonment; the poor there happen to be mainly black.

In Australia, punitive neoliberalism punishes those remote living Aboriginal people who happen to be poor and dependent on the state.

Once again there is a perversity in policy implementation.

Hence in Arnhem Land, people maintain strong vestiges of a hunter-gatherer subjectivity that when combined with deep poverty makes them avid consumers of western commodities that are bad for health (like tobacco that is expensive and fatty, sugary takeaway food that is relatively cheap).

At the same time commodities that might be useful to improve health, like access to guns and trucks essential for modern hunting, are rendered unavailable by a combination of poverty and excessive policing.

Australian democracy that is founded on notions of liberalism needs to be held to account for such travesties.

Long ago in 1859, John Stuart Mill, the doyen of liberals, wrote in  On Liberty: “…despotism is a legitimate form of government in dealing with barbarians, providing the end be their improvement and the means justified by actually effecting that end”.

In illiberal Australia today, authoritarian controls over remote living Indigenous people and their behaviour are again viewed as legitimate by the powerful now neoliberal state, even though there is growing evidence from remote Australia that things are getting worse.

I want to end with some suggested antidotes to the toxic mix that has resulted from welfare reform that is targeting many remote-living Aboriginal people and impoverishing them.

First, in my view despotism for some is never legitimate, so people should be treated equally irrespective of their ethnicity or structural circumstances.

Second, the Community Development Programme is a coercive disaster that is far more effective at breaching and penalising the jobless for not complying with excessive requirements than in creating jobs. CDP is further impoverishing people and should be replaced, especially in places where there are no jobs, with unconditional basic income support.

Third, people need to be empowered to find their own solutions to the complex challenges of appropriate development that accord with their aspirations, norms, values, and lifeways. Devolutionary principles of self-government and community control, not big government and centralised control, are needed.

Fourth, the native title of remote living people should be protected to ensure that they benefit from all their rights and interests. There is no point in legally allocating property rights in natural resources valuable for self-provisioning if people are effectively excluded from access to their ancestral lands and the enjoyment of these resources.

Finally, governments should support what has worked in the past to improve people’s diverse culturally-informed views about wellbeing and sense of worth.

While such an approach might not close some imposed ‘closing the gap’ targets, like employment as measured by standard western metrics, it will likely improve other important goals like reducing child mortality and enhancing life expectancy and overall quality of life.



NACCHO Aboriginal Health : Download @CSIROnews #FutureofHealth Report that provides a new path for national healthcare delivery, setting a way forward to shift the system from illness treatment, to #prevention.

Australians rank amongst the healthiest in the world with our health system one of the most efficient and equitable. However, the nation’s strong health outcomes hide a few alarming facts: 

  • There is a 10-year life expectancy gap between the health of non-Indigenous Australians and Aboriginal and Torres Strait Islander people
  • Australians spend on average 11 years in ill health – the highest among OECD countries
  • 63% (over 11 million) of adult Australians are considered overweight or obese
  • 60% of the adult population have low levels of literacy 
  • The majority of Australians do not consume the recommended number of serves from any of the five food groups.

From CSIRO Future of Health report

Download HERE full 60 Page Report NACCHO INFO FutureofHealthReport_WEB_180910

The CSIRO Future of Health report provides a list of recommendations for improving the health of Australians over the next 15 years, focussed around five central themes: empowering people, addressing health inequity, unlocking the value of digitised data, supporting integrated and precision health solutions, and integrating with the global sector.

CSIRO Chief Executive Dr Larry Marshall said collaboration and coordination were key to securing the health of current and future generations in Australia, and across the globe.

“It’s hard to find an Australian who hasn’t personally benefitted from something we created, including some world’s first health innovations like atomic absorption spectroscopy for diagnostics; greyscale imaging for ultrasound, the flu vaccine (Relenza); the Hendra vaccine protecting both people and animals; even the world’s first extended-wear contact lenses,” Dr Marshall said.

“As the world is changing faster than ever before, we’re looking to get ahead of these changes by bringing together Team Australia’s world-class expertise, from all sectors, and the life experiences of all Australians to set a bold direction towards a brighter future.”

The report highlighted that despite ranking among the healthiest people in the world, Australians spent on average of 11 years in ill health – the highest among OECD countries.

Clinical care was reported to influence only 20 per cent of a person’s life expectancy and quality of life, with the remaining 80 per cent relying on external factors such as behaviour, social and economic support, and the physical environment.

“As pressure on our healthcare system increases, costs escalate, and healthy choices compete with busier lives, a new approach is needed to ensure the health and wellbeing of Australians,” CSIRO Director of Health & Biosecurity Dr Rob Grenfell said.

The report stated that the cost of managing mental health related illness to be $60 billion annually, with a further $5 billion being spent on managing costs associated with obesity.

Health inequities across a range of social, economic, and cultural measures were found to cost Australia almost $230 billion a year.

“Unless we shift our approach to healthcare, a rising population and increases in chronic illnesses such as obesity and mental illness, will add further strain to the system,” Dr Grenfell said.

“By shifting to a system focussed on proactive health management and prevention, we have an exciting opportunity to provide quality healthcare that leaves no-one behind.

“How Australia navigates this shift over the next 15 years will significantly impact the health of the population and the success of Australian healthcare organisations both domestically and abroad.”

CSIRO has been continuing to grow its expertise within the health domain and is focussed on research that will help Australians live healthier, longer lives.

The Future of Health report was developed by CSIRO Futures, the strategic advisory arm of CSIRO.

More than 30 organisations across the health sector were engaged in its development, including government, health insurers, educators, researchers, and professional bodies.

Australia’s health challenges:

  • Australians spend on average 11 years in ill health – the highest among OECD countries.
  • 63 per cent (over 11 million) of adult Australians are considered overweight or obese.
  • There is a 10-year life expectancy gap between the health of non-Indigenous Australians and Aboriginal and Torres Strait Islander peoples.
  • 60 per cent of the adult population have low levels of health literacy.
  • The majority of Australians do not consume the recommended number of serves from any of the five food groups.

The benefits of shifting the system from treatment to prevention:

  • Improved health outcomes and equity for all Australians.
  • Greater system efficiencies that flatten the cost curve of health financing.
  • More impactful and profitable business models.
  • Creation of new industries based on precision and preventative health.
  • More sustainable and environmentally friendly healthcare practices.
  • More productive workers leading to increased job satisfaction and improved work-life balance.

More info :

NACCHO Aboriginal Children’s Health : Dr @SandroDemaio presents a five-point policy plan using a lifeSPANS approach to address child obesity in Australia: #NCDs #EnoughNCDs @FAREAustralia @AHPA_AU @SaxInstitute


” The answer to obesity will never be in telling people what to do, guilting them for making unhealthier choices in a confusing consumption landscape, or by simply banning things. We also know that education and knowledge will get us only so far.

The real answers lie not even in inspiring populations to make hundreds of healthier decisions each and every day in the face of a seductively obesogenic, social milieu.

If we are to drive long‐term, sustained and scalable change, we must tweak the system to ensure those healthier choices become the path of least resistance—and eventually preferred. And I believe we must focus, initially, on our kids.

It is time for a lifeSPANS approach to addressing obesity in Australia.”

Dr Alessandro Demaio ” A $100 Million question ” see Bio in full Part 2

Download this Paper HERE : Demaio-2018-Health_Promotion_Journal_of_Australia

Listen to Dr Sandro’s childhood obesity Podcast HERE 

  ” The 2012-13 Health Survey identified that Indigenous adults were 1.6 times as likely to be obese as non-Indigenous Australians, with the prevalence increasing more rapidly in Aboriginal school-aged children.

Overweight and obesity in childhood are important predictors of adult adiposity, increasing the risk of developing a range of medical conditions, each of which is a major cause of morbidity, mortality and health expenditure.

While it is surprisingly clear what needs to be done to improve the health of Indigenous children, recent cuts to Indigenous preventative workforce and nutrition programs throughout Australia have severely reduced the capacity to respond.

Comprehensive primary health care is a key strategy for improving the health of Indigenous Australians and is an important platform from which to address complex health and social issues associated with obesity.

Closing the Gap, including the gap attributable to obesity, requires ensuring the ACCHS sector is resourced to deliver the full range of core services required under a comprehensive and culturally safe model of primary health care.

The effectiveness of ACCHSs has long been recognised, with many able to document better health outcomes than mainstream services for the communities they serve. “

Extract from NACCHO Network Submission to the Select Committee’s Obesity Epidemic in Australia Inquiry. 

Download the full 15 Page submission HERE

Obesity Epidemic in Australia – Network Submission – 6.7.18

Compelling populations, individuals or even ourselves to act pre‐emptively on the urgent and massive challenges of tomorrow is notoriously difficult.

The concept is called temporal or future discounting, and it is well documented.1 It is the idea that we prioritise our current comfort and happiness over our future and seemingly distant safety or wellbeing.

This psychological shortcoming plays out in many ways. At the micro level, we may defer until next week what we should do today—that run, drinking more water or the dentist check‐up—as it may not reap benefits for months, or ever. Eventually, we may act on some of these but whether delayed, deferred or denied, it can reap serious health consequences.

At the macro level, it becomes even more problematic. When we combine this “delay what’s beyond tomorrow” phenomenon with short‐term political cycles in the context of systems‐based, slowly evolving and largely invisible future threats, important but not yet imminent issues are not just postponed, but ignored.

Few challenges are a greater threat to the health of Australians, nor better define future discounting, than obesity. At the individual level and in our modern, obesogenic societies, weight gain has become the norm—the biological and social path of least resistance.

Food systems have shifted from a focus on seasonal, fresh and relatively calorie‐poor staples with minimal processing or meat, to an environment where junk foods and processed foods are ubiquitous, heavily advertised, hugely profitable and, for many communities, the only feasible “choice”.

Poor nutrition is now the leading risk factor for disease in our country.2City living has come with benefits, but along with an increasingly automated and digitalised lifestyle, has seen physical activity become something we must seek out, rather than an unavoidable component of our daily lives. Factors such as these have made individual action difficult for most of us and combined with our biology, have contributed to obesity rates more than doubling in Australia since 1980 alone.3

At the policy level, a dangerous, pernicious and unhealthy status quo has evolved over decades. One which sees a population increasingly affected by preventable, chronic disease. One which can only be solved through difficult decisions from politicians and the public to make the short‐term, passive but unhealthy comfort harder; and the long‐term promise of wellbeing more attractive.

One which must see sustained public demand and political commitment for a distant goal and best scenario of nil‐effect, in the face of constant, coordinated and powerful pushback, threats and careful intimidation from largely unprecedented policy counter‐currents.

But opportunities do exist; levers throughout this gridlocked policy landscape that can be utilised to move the obesity agenda forward.

One of those is our kids.

We know that if we cannot prevent obesity in our children, those young Australians will likely never achieve wellbeing.

We know that one in four of our children is overweight or obese and that while 5% of healthy weight kids become obese adults, up to 79% obese children will never realise a healthy weight.45 We know that the school years are a time when major weight gain occurs in our lifecourse and almost no one loses weight as they age.6

Recent evidence suggests early, simple interventions not only reduce weight and improve the health for our youngest kids, but also reduce weight in their parents.78 An important network of effective implementation platforms and primed partners already exist in our schools and teachers around the nation.

Finally, a large (but likely overstated) proportion of Australians may call “nanny state” at even the whiff of effective policies against obesity, but less so if those policies are aimed at our children.

With this in mind, I was recently invited to Canberra to present on how I would spend an extra $100 million each year on preventive health for the nation.

This is the five‐point policy plan I proposed; a lifeSPANS approach to addressing child obesity—and with it, equipping a new generation of Australians to act on tomorrow’s risks, today. This is an evidence‐based package to reduce the major sources of premature deaths, starting early.


  • $3 million to support the revision and implementation of clear, mandatory guidelines on healthy food in school canteens
  • $3 million to coordinate and support the removal of sales of sugary drinks
  • $13 million to expand food and nutrition programs to remaining primary schools
  • $40 million as $5000‐10 000 means‐tested grants for infrastructure that supports healthy eating and drinking in primary schools
  • $130 million to cover 1.7 million daily school breakfasts for every child at the 6300 primary schools nationally910
  • $140 million left from sugary drink tax revenue for school staffing and programs for nutrition and physical activity

Schools alone cannot solve the child obesity epidemic; however, it is unlikely that child obesity rates can be reversed without strong school‐based policies to support healthy eating and physical activity. Children and adolescents consume 19%‐50% of daily calories at school and spend more time there than in any other environment away from home.11 Evidence suggests that “incentives” are unlikely to result in behaviour change but peer pressure might.12 Therefore, learning among friends offers a unique opportunity to positively influence healthy habits.

Trials have demonstrated both the educational and health benefits of providing free school meals, including increased fruit and vegetable consumption, knowledge of a healthy diet, healthier eating at home and improved school performance. Providing meals to all children supports low‐income families and works to address health inequalities and stigma.10

School vending machines or canteens selling sugary drinks and junk foods further fuel an obesogenic, modern food environment. Sugary drinks are the leading source of added sugar in our diet in Australia and are considered a major individual risk factor for non‐communicable diseases, such as type 2 diabetes.13 Removing unhealthy foods and drinks from schools would support children, teachers and parents and send a powerful message to communities about the health harms of these products.

Finally, it is not only about taking things away but also supporting locally driven programs and the school infrastructure to support healthier habits. Drinking fountains, play equipment and canteen hardware could all be supported through small grants aimed at further empowering schools as decisions makers and agents for healthier kids.


  • 20% increase in sugary drinks pricing with phased expansion to fast foods over three years, unlocking approximately $400 million in annual revenue to add to existing $100 million for prevention
  • More than $600 million in annual health savings expected from sugary drinks price increase of 20%
  • $10 million for social marketing campaigns to explain the new policy measures, and benefits to community
  • Compensation package for farmers and small retailers producing and selling sugary drinks (cost unknown but likely small)
  • Such legislation would also support industry to reformulate or reshape product portfolios for long‐term market planning

Today’s food environment sees increased availability of lower cost, processed foods high in salt, fats and added sugars.14 People have less time to prepare meals and are influenced by aggressive food marketing. This leads to food inequality with those from low socioeconomic backgrounds at greater risk from obesity. Obesity increases the risks of cardiovascular disease, type 2 diabetes, stroke, cancer, mental health issues and premature death.15 There are also wider societal and economic costs amounting to an estimated $8.6 billion spent in the health sector alone annually.16

Food prices should be adjusted in relation to nutritional content. Policy makers must shift their pricing focus to integrate the true societal cost of products associated with fiscally burdensome disease. In 2016, a WHO report highlighted that a 20% increase in retail price of sugary drinks lowers consumption as well as obesity, type 2 diabetes and tooth decay.17

The landmark peso per litre sugar tax from Mexico highlighted the behaviour change potential such policies possess. Sales of higher priced beverages decreased substantially in subsequent years. Importantly, the most significant decreases occurred among the poorest households.18 For Australia, a similar approach is estimated to lead to $609 million in annual health savings and raise $400 million in direct revenue.16

These legislative approaches should be framed as an expansion of our existing GST and would encourage industry to reformulate products, positively influencing the food environment.131517

This is not a sin tax or ban, it is an effective policy and pricing that is fair to families. It is also backed by evidence and supported by the public.19


  • End all junk food marketing to children, and between 6 am and 10 pm on television
  • End the use of cartoons on any food or drink packaging
  • $30 million to replace junk food sponsorship of sport and arts events with healthy messaging and explanation of lifeSPANS policy approach
  • Phased expansion of advertising ban over three years to all non‐essential foods (GST language)

The food industry knows that marketing works, otherwise they would not spend almost $400 million annually on advertisements in Australia alone.20

Three of four commercial food advertisements are for unhealthy products and evidence suggests that food advertising triggers cognitive processes that influence our food choices, similar to those seen in addiction. Studies also demonstrate that food commercials including the use of cartoons influence the amount of calories that children consume and the findings are particularly pronounced in overweight children.21

Fast food advertising at sporting and arts events further reinforces a dangerous and confusing notion that sees the direct association between societal heroes or elite athleticism and the unhealthiest of foods.

Ending junk food advertising to children, including any use of cartoons in the advertisement of food and drinks, is an important step to support our kids.


  • Further strengthen existing labelling approaches, including mandatory systems

Nutritional information can be confusing for parents, let alone children. Food packaging often lists nutritional information in relation to portion size meaning a product with a higher figure may simply be larger rather than less healthy. While the Health Star Rating system, implemented in 2014, has made substantive progress, it remains voluntary.22

Efforts should be made to strengthen the usability of existing efforts and make consistent, evidence‐based and effective labelling mandatory. Such developments would also provide stronger incentives for manufacturers to reformulate products, reducing sugar, fat and salt content.

Clearer and consistent information would help create a more enabling food environment for families to make informed choices about their food.


  • Utilise procurement and supply chains of schools and public institutions to drive demand for healthier foods
  • Leverage the purchasing power of large organisations to reduce the costs of healthy foods for partner organisations and communities

Coordinated strategies are needed to support the availability of lower cost, healthy foods for all communities. Cities and large organisations such as schools and hospitals could collaborate to purchase food as collectives, thus driving demand, building market size and improving economies of scale.23

By leveraging collective purchasing power, institutions can catalyse the availability of sustainable and healthy foods to also support wider, positive food environment change.

Part 2

Dr Alessandro Demaio, or Sandro, trained and worked as a medical doctor at The Alfred Hospital in Australia.

While practicing as a doctor he completed a Master in Public Health including fieldwork to prevent diabetes through Buddhist Wats in Cambodia. In 2010, he relocated to Denmark where he completed a PhD with the University of Copenhagen, focusing on non-communicable diseases. His doctoral research was based in Mongolia, working with the Ministry of Health.

He designed, led and reported a national epidemiological survey, sampling more than 3500 households. Sandro held a Postdoctoral Fellowship at Harvard Medical School from 2013 to 2015, and was assistant professor and course director in global health at the Copenhagen School of Global Health, in Denmark.

He established and led the PLOS blog Global Health, and served on the founding Advisory Board of the EAT Foundation: the global, multi-stakeholder platform for food, health and environmental sustainability.

To date, he has authored over 23 scientific publications and more than 85 articles and blogs. In his pro bono work, Dr Demaio co-founded NCDFREE, a global social movement against noncommunicable diseases using social media, short film and leadership events – crowdfunded, it reached more than 2.5 million people in its first 18 months.

Then, in 2015, he founded festival21, assembling and leading a team of knowledge leaders in staging a massive and unprecedented, free celebration of community, food, culture and future in his hometown Melbourne. In November 2015, Sandro joined the Department of Nutrition for Health and Development at the World Health Organization’s global headquarters, as Medical Officer for noncommunicable conditions and nutrition.

From 2017, he is also co-host of the ABC television show Ask the Doctor – an innovative and exploratory factual medical series broadcasting weekly across Australia. Sandro is currently fascinated by systems-innovation and leadership; impact in a post-democracy; and the commercial determinants of disease. He also loves to cook.

NACCHO Aboriginal #SexualHealth News Alert : @sahmriAU #NT #QLD #WA #SA Syphilis outbreak : New #YoungDeadlySyphilisFree TV and Radio campaign launched today 9 September @atsihaw : Plus @researchjames article

 ” SAHMRI launches Phase 2 of its Young Deadly Syphilis Free campaign today, with two new TV commercials screening in syphilis outbreak areas across Queensland the Northern Territory, Western Australia and South Australia. Radio snippets will also be broadcast, in English and local languages.”

Watch here 

No 2 Watch here 

Medical experts describe the top end’s syphilis epidemic as a “failure of public health at every level of government .

As an infectious syphilis epidemic continues to ravage northern Australia – now threatening the lives of newborn babies – Indigenous sexual health specialist James Ward is leading a campaign to help remote communities. By Michele Tydd.

From The Saturday Paper see in full Part 2 Below

Aboriginal #Sexualhealth News : 

NACCHO is co-leading a coordinated Aboriginal Community Controlled Health Services (ACCHS) $8.8 million response to address the #syphilis outbreak in Northern Australia. @Wuchopperen @DanilaDilba @TAIHS__

Read over 40 Aboriginal Sexual Health articles published over past 6 years

Part 1 : The TV and radio syphilis campaign will build on messaging developed for Phase 1 of the campaign, which ran until March this year.

Once again the campaign will be strongly supported by social media, with regular Facebook posts, Divas Chat advertising  and promotion on our website featuring all new video clips and infographics.

The campaign promotes whole communities’ involvement in tackling syphilis as a public health issue along with other STIs, and has involved young people, clinicians and people of influence such as parents and extended family members/carers.

New clinician resources for those practising in remote communities will also be developed over the next year, promoting appropriate testing to those most at risk, including testing of antenatal women during pregnancy.

Have a look at the TV commercials and a couple of the new short videos by clicking the images below OR access them on the syphilis outbreak webpages at

Problems downloading the videos?

Contact SAHMRI at for a USB containing Young Deadly Syphilis Free videos, as well as STI and BBV resources developed for the Remote STI and BBV Project – Young Deadly Free; and HIV resources developed for Aboriginal and Torres Strait Islander HIV Awareness Week – ATSIHAW.

Phase 1 Rescreened

No 2 Watch Here 

The Young Deadly Syphilis Free campaign is funded by the Australian Government Department of Health.

Part 2 As an infectious syphilis epidemic continues to ravage northern Australia – now threatening the lives of newborn babies – Indigenous sexual health specialist James Ward is leading a campaign to help remote communities.

By Michele Tydd

While the federal government committed $8.8 million this year to fight an ongoing syphilis epidemic sweeping Australia’s top end, many prominent sexual health physicians and academics claim the money is too little too late.

From The Saturday Paper 

“Every day there are more cases, so we are not seeing a downward trend yet,” says Dr Manoji Gunathilake, who heads up a government-run health service known as Clinic 34.

Gunathilake is the Northern Territory’s only specialist sexual health physician. She says local health workers are ramping up testing as part of a fight to contain the infection, which particularly affects young sexually active Aboriginal and Torres Strait Islanders in the territory. However, it seems those measures are struggling to contain the STI’s spread.

Nearly seven years ago, an increase in syphilis notifications showed up in north-west Queensland. The outbreak soon moved across to the NT, then to Western Australia and more recently into South Australia. So far, more than 2100 cases – evenly split between males and females – have been recorded across the affected zones.

However, the key concern for health-care professionals is the potential health consequences for babies born to women with the infection. Syphilis is primarily spread through sexual contact, but it can also be passed from mother to baby. Since 2011, six babies have died from congenital syphilis – the latest death came in January this year in northern Queensland. The STI also carries antenatal risks, increasing the chance of miscarriage and stillbirth.

Darren Russell, a Cairns-based associate professor of medicine at both James Cook University and the University of Melbourne, has been working in sexual health for 25 years. He describes the top end’s syphilis epidemic as a “failure of public health at every level of government”.

He says he’s not sure whether the outbreak could have been prevented entirely. However, he believes there was an opportunity for public health officials to stop it from escalating.

“The first case occurred in the Gulf country of north-west Queensland in January 2012 and the first Northern Territory cases weren’t found until July 2013,” says Russell. “There was a window of opportunity in 2012 to work with the affected local communities and to fly in extra nurses, doctors and Indigenous health workers to do some good culturally appropriate health promotion. But nothing at all happened, absolutely nothing as the epidemic spread.

“The first Queensland state funding to deal with the now widespread epidemic was rolled out in 2016, more than five years after the epidemic began, and the first Commonwealth money has only been allocated this year.”

Russell says he could not imagine the same happening if a deadly epidemic broke out in a major city.

“For years now a multijurisdictional syphilis outbreak committee has been coordinating the response largely without additional resourcing to reach people most at risk,” says Associate Professor James Ward, an Indigenous researcher and sexual health specialist who heads the Aboriginal infection and immunity program at SAHMRI (the South Australian Health and Medical Research Institute) in Adelaide. Ward has been working behind the scenes for years, trying to bring more attention and funding to this outbreak.

“Workforce is certainly an issue because syphilis is an infection that not many clinicians have been exposed to in clinical practice and this is further exacerbated by a high turnover of staff in remote communities,” he says. “Community awareness and understanding of the infection has been very low, so we have been recently trying to get the message out on the internet and social media”.

The multi-strategy STI awareness-raising campaign urging people to be tested is targeted at the 30,000 young people aged between 15 and 34 in affected outbreak areas through the website as well as a dedicated Facebook page.

“We’ve also been tapping into online chat programs young people are using in remote areas such as Diva Chat,” says Ward.

Since the 1940s, penicillin has been used to successfully treat the syphilis infection, although people can become reinfected. While deaths in adults are now rare, the consequences can be dire for babies born to mothers who have been infected at some stage either before or during the pregnancy.

“There is a wide range of quite sinister pathology in babies born with syphilis,” says Professor Basil Donovan of the Kirby Institute at the University of New South Wales, who has been treating syphilis cases for nearly four decades.

Some babies are merely snuffly and miserable, sometimes with heavily blood-stained nasal discharge. Others can suffer neurological damage and bone deformities that can cause great pain when they move their limbs.

Donovan says that, for the past 60 years, every pregnant woman in Australia should have been routinely tested for syphilis. “The big difference between adults and babies is that all the damage is done before they are born,” he says. “If there is more syphilis about, then catastrophe becomes inevitable.”

Syphilis, caused by the bacteria Treponema pallidum, is an infection primarily spread through unprotected vaginal, anal or oral sex.

The first sign in adults is most likely a painless sore on the skin, normally where the bacteria has entered the body during sexual intercourse – in the genital area or in the mouth.

Secondary syphilis occurs about six weeks later with symptoms that include a general feeling of being unwell, a rash on the hands, feet or other parts of the body. Soft lumps might also develop on the warm, moist areas of the body such as the genitals and around the anus. Symptoms can often be dismissed as being due to flu or cold.

Outward symptoms of secondary syphilis, such as the initial sores, will disappear without treatment, but the person affected will still have latent syphilis.

The third stage, known as early and late latent syphilis, which may develop any time between one and 30 years later, can seriously affect the brain, spinal cord or heart and – rarely now – can lead to death.

“Before penicillin, syphilis was a terrible way to die,” says Donovan. “In about a third of those who contracted it, it would go on to cause serious neurological or brain disease, spinal disease or heart problems particularly with the aorta.

“That said, even now one in about 30 per cent who get syphilis will get some neurological disease. All of us clinicians have got patients who might have lost sight in one eye or gone deaf in one ear as a result.”

Donovan stresses the current outbreak in the top end has nothing to do with sexual behaviour. “[Residents in these regions] have the same number of partners [as the broader population] so very high levels of STIs including syphilis are more the result of failure in health-care delivery,” he says.

Gunathilake says the NT has seen more than 800 cases of infectious syphilis since the outbreak began. She wants to help build an educated and stable workforce, especially to support the remote clinicians.

“In these remote areas health-care workers don’t tend to say for long periods so it’s important to train and update new staff members quickly,” she says.

Work is also being done in community engagement by producing promotional material in several Indigenous languages to help people better understand the importance of testing and treatment as well as tracing and informing sexual partners.

“Going home and passing on the diagnosis to sexual partners is very difficult for anybody and much more challenging in any close-knit community,” says Gunathilake.

“Many people regardless of background feel ashamed about having STIs and they don’t want to tell anyone, so it is a psychological burden, but our staff are trained to help people in this situation.”

She says contact tracing can be more difficult for people who have casual or anonymous partners. Gay men are represented in the NT outbreak, but only in relatively small numbers.

A spokeswoman for the federal government says the first round of the federal money has gone to three urban Aboriginal health-care centres in Cairns, Darwin and Townsville, which will roll out a new “test and treat” model at the point of care.

The next phase of funding is expected to be directed at remote communities.

There is no indication when this outbreak will start to retract, says Basil Donovan, who was working as a doctor during the AIDS epidemic in the late 1980s. This is because once STIs outbreaks take off, they don’t just cycle through like a flu epidemic. “It takes at least five to 10 years to get a major outbreak under control, and part of that involves a permanent [health-care] workforce to develop trust,” he says. “People flying in and flying out won’t even touch the sides.”

This article was first published in the print edition of The Saturday Paper on Sep 8, 2018 as “Into the outbreak”. Subscribe here.

NACCHO Aboriginal Children’s Health #Nutrition #Obesity : @IndigenousPHAA The #AFL ladder of sponsorships such as soft drinks @CocaColaAU and junk food @McDonalds_AU endangers the health of our children

 “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).

Read all NACCHO Aboriginal Health Nutrition / Obestity articles over 6 years HERE 

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.

Download PDF Copy of report NACCHO Unhealthy sponsors of sport

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

NACCHO Aboriginal Health and #WorldHepatitisDay : @MenziesResearch Making hepatitis B information more widely available to Indigenous communities

 ” Hepatitis B is the most prevalent form of viral hepatitis worldwide. It’s also the leading cause of liver cancer. Interestingly, hepatitis B used to be known as the “Australia Antigen” as it was first discovered in Australian Aboriginal people in the 1960s.

Hepatitis B is around ten times more prevalent in Indigenous communities than in the rest of Australia. Of the nearly 240,000 Australians estimated to be living with chronic hepatitis B, over 20,000 are thought to be Indigenous people. New infections with hepatitis B remain three times as common in Indigenous people as in non-Indigenous Australians.”

Dr G. Yunupingu’s legacy: it’s time to get rid of chronic hepatitis B in Indigenous Australia

Read HERE 

By making information about HBV accessible and available in first languages, we can improve community health literacy.

This will help people better understand the disease, setting the groundwork for us to work towards eliminating chronic HBV in the NT, by 2023.

“There are just over 4,000 Territorians with HBV, but not all of them understand why they need blood tests or vaccinations.

Menzies researcher, Dr Jane Davies.

The app is currently available in English and Yolngu matha, but in the near future it will also include translations into Kriol, Arrernte, Murrinh-Patha, Pitjantjatjara, Warlpiri, Tiwi, Kunwinjku, Anindilyakwa, Burarra and Gurindji.

The Hep B story is a visual, interactive app in English and Yolŋu matha designed for patients living with chronic hepatitis B (hep B) and their families. It tells the story of the hep B virus, how you get it, what happens over time, how you know you have it as well as details about immunisation and treatment (including a game). There is also a separate women’s section dealing with mother to child transmission and ways to prevent it.

MORE INFO Download 

Menzies School of Health Research (Menzies) is doing its part to ensure more Indigenous people living in the Northern Territory have access to potentially life-saving information about hepatitis B (HBV) this World Hepatitis Day.

The Menzies HBV research team estimates more than 70 per cent of Indigenous Territorians will benefit from learning about HBV in their first language as the Hep B Story app will be translated into 10 additional Indigenous languages.

The theme for this year’s World Hepatitis Day is ‘Finding the Missing Millions’, which is in line with Menzies’ goal of providing people vulnerable to the virus culturally-appropriate information through the National Health and Medical Research Council (NHMRC) funded Hep B PAST research collaboration.

Together with partners, including the Northern Territory Government, Miwatj Aboriginal Corporation, Katherine West Health Board, Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine and the NT AIDS and Hepatitis Council, Menzies is developing a NT HBV clinical registry.

This collaboration will enable appropriate HBV care to be delivered to those who need it in a systematic and sustainable way.

The Hep B Story app was developed by Menzies in 2014. It provides information about how HBV is contracted, as well as symptoms, treatments and immunisation.

ACCHO Activity Other ways to reduce infections


An example of innovative care has been operating in Dr G. Yunupingu’s home community of Galiwin’ku for over five years. Under the management of Miwatj Health, an Aboriginal community-controlled health organisation, a hepatitis specialist visits regularly three to four times per year.

The specialist brings necessary diagnostic equipment and effectively provides a “one-stop shop” for individuals living with hepatitis B in Galiwin’ku. Just as importantly, a local healthcare practitioner champions the cause of hepatitis B treatment and elimination. Those infected are contacted and encouraged to see the specialist team.

Several other regions in the world with large Indigenous populations and high hepatitis B prevalence, such as Alaska and New Zealand, have developed programs to test most of the population and identify those with hepatitis B infections. Affected individuals are offered regular follow-up and care to prevent cirrhosis and liver cancer.

When delivering such care to Indigenous communities, it’s essential to develop trust and ensure culturally appropriate approaches. Also important is partnering with communities and their health workers to develop new ways of building awareness of hepatitis B as an important health issue.

With comprehensive public health initiatives, long-term commitment to funding and policy – including significant workforce development to ensure as many people as possible are tested and appropriately followed up – the impact of hepatitis B on Indigenous communities can be eliminated.


NACCHO Aboriginal Health and Obesity NEWS : 1.Network Submission to the Select Committee’s #Obesity Epidemic in Australia Inquiry and our 13 recommendations: 2.Healthy Food Partnership Survey


” The 2012-13 Health Survey identified that Indigenous adults were 1.6 times as likely to be obese as non-Indigenous Australians, with the prevalence increasing more rapidly in Aboriginal school-aged children.

Overweight and obesity in childhood are important predictors of adult adiposity, increasing the risk of developing a range of medical conditions, each of which is a major cause of morbidity, mortality and health expenditure.

While it is surprisingly clear what needs to be done to improve the health of Indigenous children, recent cuts to Indigenous preventative workforce and nutrition programs throughout Australia have severely reduced the capacity to respond.

Comprehensive primary health care is a key strategy for improving the health of Indigenous Australians and is an important platform from which to address complex health and social issues associated with obesity.

Closing the Gap, including the gap attributable to obesity, requires ensuring the ACCHS sector is resourced to deliver the full range of core services required under a comprehensive and culturally safe model of primary health care.

The effectiveness of ACCHSs has long been recognised, with many able to document better health outcomes than mainstream services for the communities they serve. “

Extract from NACCHO Network Submission to the Select Committee’s Obesity Epidemic in Australia Inquiry. 

Download the full 15 Page submission HERE

Obesity Epidemic in Australia – Network Submission – 6.7.18

 ” The Healthy Food Partnership is a mechanism for government, the public health sector and the food industry to cooperatively tackle obesity, encourage healthy eating and empower food manufacturers to make positive changes.

The Healthy Food Partnership’s Reformulation Working Group has developed draft reformulation targets for sodium, sugars and/or saturated fats, in 36 sub-categories of food.  These food categories are amongst the highest contributors of sodium, sugars and saturated fat to Australian population level intakes.”

See Healthy Food Partnership Survey Part 2 Below

Read over 50 NACCHO Aboriginal Health and Obesity articles published in past 6 years 


Introduction to NACCHO Network Sumission and selected extracts 

The National Aboriginal Community Controlled Health Organisation (NACCHO) is the peak body representing 143 Aboriginal Community Controlled Health Services (ACCHSs) across Australia.

ACCHSs provide comprehensive primary health care to Aboriginal and Torres Strait Islander people through over 300 Aboriginal medical clinics throughout Australia.

ACCHSs deliver three million episodes of care to around 350,000 people each year, servicing over 47% of the Aboriginal population, with about one million episodes of care delivered in remote areas.

The Aboriginal Community Controlled Health Service (ACCHS) sector is the largest single employer of Indigenous people in the country, employing 6,000 staff, the majority of whom are Aboriginal or Torres Strait Islander.

The evidence that the ACCHS model of comprehensive primary health care delivers better outcomes than mainstream services for Aboriginal people is well established.

Without exception, where Aboriginal people and communities lead, define, design, control and deliver services and programs to their communities, they achieve improved outcomes.

The ACCHS model of care has its genesis in Aboriginal people’s right to self-determination, and is predicated on principles that incorporate a holistic, person-centred, whole-of-life, culturally secure approach.

The ACCHS principles of self-determination and community control remain central to wellbeing and sovereignty of Aboriginal people. Equipped with inequitable levels of funding and resources ,

ACCHSs continue to meet the ongoing challenges of addressing the burden of disease in Aboriginal communities.

Executive summary

The National Aboriginal Community Controlled Health Organisation (NACCHO) welcomes the opportunity to provide input into the Inquiry into the Obesity epidemic in Australia.

Aboriginal and Torres Strait Islander people represent approximately 3% of the Australian population yet are disproportionately over-represented on almost every indicium of social, health and wellbeing determinant.

Social determinants and historical factors such as intergenerational trauma, racism, social exclusion, and loss of land and culture are commonly recognised as causative factors for these disparities.

In 2008 the Council of Australian Governments (COAG) committed to addressing the health disparity between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians by adopting the Closing the Gap initiative. Whilst gaining some success in achieving convergence for some health indicators, wide health and wellbeing disparity still remains for both children and adults.

The life expectancy gap between Indigenous and non-Indigenous Australians remains 10.6 years for males and 9.5 years for females.

As a major contributor to morbidity and mortality among Indigenous Australians, obesity is estimated to account for 16% of the health gap between Aboriginal and Torres Strait Islander peoples and the total Australian population.

Comprehensive primary health care is a key strategy for improving the health of Indigenous Australians and is an important platform from which to address complex health and social issues associated with obesity.

Closing the Gap, including the gap attributable to obesity, requires ensuring the ACCHS sector is resourced to deliver the full range of core services required under a comprehensive and culturally safe model of primary health care. The effectiveness of ACCHSs has long been recognised, with many able to document better health outcomes than mainstream services for the communities they serve.

Combating the burden of obesity and its health effects for Indigenous Australians demands a strategic and coordinated whole-of-society approach at a national level by the Federal Government.

Without coordinated, sustained national action, efforts to improve the health status of Aboriginal children are likely to fail. In recognising the need to seriously address this critical and increasing gap in Indigenous health, NACCHO welcomes this inquiry and proposes the following recommendations:

  1. Government to work in partnership with NACCHO and the ACCHS sector to develop policies and plans that are responsive to the needs of Aboriginal communities
  2. A commitment to increase the understanding of Aboriginal and Torres Strait Islander peoples of the health significance of overweight and obesity, and facilitating access for these communities to resources which support healthy eating and physical activity
  3. Additional investment to build organisational capacity within the ACCHS sector and to increase the capacity of Aboriginal Health Promotion Officers to maintain a focus on public health initiatives
  4. Government to encourage professional support systems for, and assist Aboriginal Health Worker’s and other primary care workers to provide advice to adults and children about weight management as part of existing health checks and screening programs – this may be achieved by encouraging the MBS Aboriginal Health Check item to communicate more effectively the importance of physical activity, nutrition and weight management
  5. Fund the development of Aboriginal and Torres Strait Islander cultural awareness training for health care professionals covering care, education and information relating to food, physical activity, lifestyle choices and health service arrangements
  6. In understanding that health promotion is more difficult in regional and rural Australia, targeted funding should be dedicated to these areas to overcome the pervasive problems associated with distance
  7. A commitment to ongoing consultation with Aboriginal communities on what can be achieved at a local level to effectively promote healthy eating and physical activity for children
  8. Facilitate access for Aboriginal and Torres Strait Islander communities to resources which support lifestyle changes, including access to information, physical activity opportunities, and healthy food choices
  9. The prevalence of childhood obesity and the absence of culturally specific programs for Aboriginal and Torres Strait Islander people warrants further work in the development of culturally appropriate programs and tailored communication strategies alongside mainstream campaigns and messages
  10. Given the paucity of studies on Indigenous children, there is a need for further research on effective obesity prevention interventions for Indigenous families. This requires commitment to more detailed monitoring of young Indigenous children’s diets and their physical activity
  11. Government to work with the food industry and community stores to implement retail intervention strategies to positively influence access to and consumption of healthy food choices for Aboriginal and Torres Strait Islander communities
  12. Consider mechanisms to sustain programs on physical activity, nutrition and weight management that have proven effective
  13. Ensure significant participation of Aboriginal and Torres Strait Islander people in national surveys and evaluations by enhancing the sampling frame and applying culturally appropriate recruitment strategies

Evidence-based measures and interventions to prevent and reverse childhood obesity, including experiences from overseas jurisdictions

Evidence-based profiling of obesity and overweight in Indigenous Australian children has been poor, with very little known about the effectiveness of culturally adapted children’s interventions. Given the impact on health, finances and community, the need for better strategies and interventions to manage obesity are now being recognised by the entire health system.

Historically, initiatives have focused on nutrition or physical activity as separate entities and have shown modest effects. In recent years, global interventions considering the wider ‘obesogenic environment’ have been recommended, with policymakers and public health practitioners increasingly turning to evidence-based strategies to discover effective interventions to childhood obesity.

It is important to note, however, that the rapidly growing body of literature has meant many recommendations for childhood obesity have often relied on research that has not been systematically reviewed and focused more on assessing the internal validity of study results than on evaluating the external validity, feasibility or sustainability of intervention effects.

Experience in several countries has shown that successful obesity prevention during childhood can be achieved through a combination of population-based There is strong evidence for the effectiveness of school-based strategies, acting as an ideal setting for interventions to support healthy behaviours, and can also potentially reach most school age 9 children of diverse ethnic and socioeconomic groups. The Centre for Disease Control and Prevention (CDC) recommends a curriculum that is culturally appropriate and a school environment that reflects the culture within the community by demonstrating cultural awareness in healthy eating and physical activity practices.l

Examples of school-based strategies include policies that limit student access to foods and beverages that are high in fats and sugar, contributing to decreased consumption during the school dayliii, and efforts to increase physical activity leading to a lowered body mass indexliv and improved cognitive abilities,lv especially in younger children. An evaluation of a school-based health education program for urban Indigenous youth found compromising results in physical activity, breakfast intake and fruit and vegetable consumption, all of which are core components of healthy weight management.lvi

Studies have examined the effectiveness of culturally specific versions of programs to tackle obesity, including a US study comparing a mainstream program with a culturally adapted version. Findings were that cultural adaptations improved recruitment and retention numbers, with the authors recommending that to improve program design, ethnic communities and organisations should be approached to collaborate with researchers in design, modifications, recruitment techniques, implementation, evaluation and interpretation of results.lvii

A 2013 Canadian pilot evaluation of a whole-school health promotion program, Healthy Buddies, involved researchers consulting Aboriginal community members about how the program could be more effective, sustainable and culturally appropriate, resulting in a new version called Healthy Buddies – First Nations. Prior to implementation, communities were able to review the program and tailor its cultural appropriateness. Lesson content and visual aids were amended to resemble Aboriginal children, as well as Aboriginal food and activities.lviii In promoting social responsibility through the buddy system, the program showed a significant lowering in BMI and waist circumference and was considered particularly important for remote communities.

Systematic and evidence-based reviews have suggested promise in tailoring programs to be more culturally appropriate for specific ethnic and culturally diverse groups. The 2014 Global Nutrition Report, which examined the limited access to supermarkets and a reliance on fast-food as contributing to the growing prevalence of obesity in American Indian communities, recommended that interventions need to be multi-faceted, culturally sensitive, grounded in cultural traditions, and developed with full participation of American Indian communities.lix

Similar recommendations were made in a review by Toronto Public Health, identifying that interventions targeting children from low socioeconomic or culturally diverse backgrounds can positively impact on physical activity levels and dietary intake. This highlights the need to consider focusing on specific cultural backgrounds, like Indigenous Australians, when planning obesity prevention interventions to achieve better outcomes.

The role of the food industry in contributing to poor diets and childhood obesity in Australia

Improving the access to and availability of nutritious food is a vital step to combating the prevalence of obesity. Indigenous people living in rural and remote areas in particular face significant barriers in accessing nutritious and affordable food.

The level and composition of food intake is influenced by socio-economic status, high prices, poor quality fruit and vegetables in community stores, and unavailability of many nutritious foods.lxi This is indeed exacerbated by the exposure to high levels of unhealthy food marketing across a range of media. 10

The ubiquitous marketing of unhealthy food creates a negative food culture, undermining nutrition recommendations.

Substantial research documents the extensiveness and persuasive nature of food marketing in Australia; importantly, the vast majority of all food and drink marketing, regardless of medium or setting, is for food and drinks high in fat, sugar and/or salt.lxii Australian children are exposed to high levels of unhealthy food marketing through a range of mediums, including sponsorship arrangements with children’s sport. With research identifying a logical sequence of effects linking food promotion to individual-level weight outcomes,lxiii it is clear that food marketing influences children’s attitudes and subsequent food consumption.

Australia’s National Preventative Health Taskforce has highlighted the importance of restricting inappropriate marketing of unhealthy food and beverages to children as a cost-effective obesity prevention strategy.lxiv Clear affirmative action in Australia to such marketing has been lacking to date, compounding the need for Government to explore options for regulating the production, marketing and sale of energy-dense and nutrient-poor products to reduce consumption.

Research has shown that the prevalence of obesity increases and consumption of fruit and vegetables decreases with increasing distance to grocery stores and supermarketslxv and a higher density of convenience stores and take-away food outlets.lxvi Cost is also a major issue, with the price of basic healthy foods increased by 50% or more in rural and remote areas where there is a higher proportion of Indigenous residents compared to non-Indigenous residents than in urban areas.lxvii The purchasing behaviour of children is particularly sensitive to price, and can have significant effects over time.

Foods of better nutritional choice, including fresh fruits and vegetables, are often expensive due to transportation and overhead costs, or only minimally available.lxviii Comparatively, takeaway and convenience food, often energy-dense and high in fat or sugar, are less affected by cost and availability.

A study of intake of six remote Aboriginal communities, based on store turnover, found that intake of energy, fat and sugar was excessive, with fatty meats making the largest contribution to fat intake.lxx Compared with national data, intake of sweet and carbonated beverages and sugar was much higher in these communities, with the proportion of energy derived from refined sugars approximately four times the recommended intake.

Recent evidence from Mexico indicates that implementing health-related taxes on sugary drinks and on ‘junk’ food can decrease purchase of these foods and drinks.lxxi A recent Australian study predicted that increasing the price of sugary drinks by 20% could reduce consumption by 12.6%.lxxii Revenue raised by such a measure could be directed to an evaluation of effectiveness and in the longer term be used to subsidise and market healthy food choices as well as promotion of physical activity.

It is imperative that all of these interventions to promote healthy eating should have community-ownership and not undermine the cultural importance of family social events, the role of Elders, or traditional preferences for some food. Food supply in Indigenous communities needs to ensure healthy, good quality foods are available at affordable prices.

In Summary

It is widely understood that many Aboriginal and Torres Strait Islander people, predominantly children, are at high-risk of ill-health due to overweight and obesity. This is likely to lead to a widening gap in health outcomes for Indigenous Australians if prevention efforts are not improved. Despite the identified health and economic gains which can be achieved by using a social determinants and culturally appropriate approach, Australia is yet to embed such thinking in health policy.

Policy in isolation will not solve the epidemic of childhood obesity for Indigenous children. What is required, is urgent action to address poverty, education, unemployment and housing, all of which are factors that shape a child’s ability to engage with healthy behaviours. There also needs to be close ongoing national monitoring through the collection of comparable data; more detailed monitoring of the composition of young Indigenous children’s diets and physical activity is necessary to determine whether patterns are changing in response to interventions.

Undeniably, strategic investment is needed to implement population-based childhood obesity prevention programs which are effective and also culturally appropriate, evidence-based, easily understood, action-oriented and motivating. Interventions must be positioned within broad strategies addressing the continuing social and economic disadvantages that many Indigenous people experience and need to have an emphasis on training community-based health workers, particularly in the ACCHS sector who are best placed to respond to the increasing rates of obesity and associated health concerns for Aboriginal and Torres Strait Islander people.

The ACCH sector has a central role in promoting and improving health outcomes for Indigenous people yet requires additional targeted funding and resources to implement new initiatives, including intervention, education, and research to encourage physical activity and healthy nutrition. Indeed, multifaceted strategies involving the public, private and ACCHS sector, along with community participation and government support, are required to gradually reverse this trend.

NACCHO and its Affiliates in each State and Territory appreciate the opportunity to make this submission on behalf of our member services. With circumstances unimproved after years of policy approaches, the need remains to overturn the prevalence of overweight and obesity of Indigenous people. There needs to be a commitment at all levels of government in terms of funding, policy development, and support for the implementation of culturally appropriate programs and services. There must be a recognition that self-determination of Aboriginal and Torres Strait Islander people will be the foundation of true progress.

NACCHO strongly recommend that Government engage in meaningful dialogue with NACCHO, NACCHO’s Affiliates in each State and Territory and ACCHSs in relation to the proposals canvassed in this response; and work in partnership to address the significant prevalence of obesity in Aboriginal and Torres Strait Islander people, especially children


Part 2 Overview Healthy Food Partnership Survey 

The Healthy Food Partnership is a mechanism for government, the public health sector and the food industry to cooperatively tackle obesity, encourage healthy eating and empower food manufacturers to make positive changes.

The Healthy Food Partnership’s Reformulation Working Group has developed draft reformulation targets for sodium, sugars and/or saturated fats, in 36 sub-categories of food.  These food categories are amongst the highest contributors of sodium, sugars and saturated fat to Australian population level intakes.

Please note the different closing dates relating to feedback on the various nutrient targets.

Why We Are Consulting

The Healthy Food Partnership (Partnership) recognises that many companies are already reformulating their products to improve the nutritional quality and aims to build on (rather than replicate) these efforts.

It is not the intention of the Partnership to disadvantage companies that are already reformulating, but to recognise and support their efforts to date, and encourage those companies that are yet to engage in reformulation activities to move towards improving the nutritional profile of their products.  Targets will create certainty for industry of what they, and their competitors, should be aiming for.

Feedback is sought on the feasibility of the draft targets, the appropriateness of the draft category definitions (including products which are included or excluded), and the proposed implementation period (four years).  Consultation feedback will inform the final recommendations of the Reformulation Working Group, to the Partnership’s Executive Committee.

Deidentified information from submissions will be provided to the Reformulation Working Group and other committees involved with the Healthy Food Partnership.

Submissions will be published at the end of the consultation period, unless confidentiality has been requested.

Begin survey

NACCHO Aboriginal Health #NRW2018 News Alerts : 1. @RACGP The importance of culturally appropriate healthcare spaces 2. @AusHealthcare @Aus_Lighthouse Recognising the historic experience of #Indigenous patients is key to reconciliation

Patients have the right to respectful care that promotes their dignity, privacy and safety.

Equipped with greater cultural awareness and the ability to ensure cultural safety, GPs will provide better quality and more appropriate care to all of their patients.
It will also ensure they are well-rounded and more effective doctors.’

Associate Professor Peter O’Mara, Chair of RACGP Aboriginal and Torres Strait Islander Health, believes GPs can make important contributions towards creating a safe and culturally welcoming environment for Aboriginal and Torres Strait Islander peoples.

A/Prof Peter O’Mara, NACCHO Chair John Singer Minister Ken Wyatt & RACGP President Dr Bastian Seidel launch the National guide at Parliament house 28 March

He views National Reconciliation Week (27 May – 3 June) as an opportunity to improve the relationships between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians.

To mark National Reconciliation Week, Morgan Liotta from newsGP looks at the importance of cultural safety in general practice and highlights some useful resources for GPs and practice teams.

See Full RACGP Press Release Part 2 Below

The inequitable situation whereby Aboriginal and Torres Strait Islanders are 30% less likely to receive appropriate care after a heart attack demands action.

 Working in partnership with Aboriginal and Torres Strait Islander peoples and health organisations is the most effective tool for building cultural safety in our public hospitals, reducing discharge against medical advice and improving care pathways after discharge.

Understanding the true history of Australia allows non-Indigenous clinicians and health administrators to be aware of the background to our current situation, learn about their stereotypes, reflect on practices and build trust with Aboriginal and Torres Strait Islander people.’

Dr Chris Bourke, a Gamillaroi man and Director of Strategic Programs at the AHHA, said the five dimensions of reconciliation—race relations, equality and equity, institutional integrity, unity and historical acceptance—directly relate to the Lighthouse goal of achieving better outcomes for Aboriginal and Torres Strait Islander patients who go to hospital after a heart attack.

Hospitals are developing stronger links with ACCHO’s / Aboriginal Medical Services; this means discharges are better planned, so patients are more likely to access follow up appointments, take ongoing medication and use cardiac rehabilitation services.

See Full Press Release Part 2 Below

Part 1 The RACGP The importance of culturally appropriate healthcare spaces

Given GPs are considered the first point of contact for most Australians when accessing healthcare, a culturally responsive general practice environment can play a significant part in improving that access, and can be crucial to closing the gap in health outcomes.

Ada Parry is a community representative on the RACGP Aboriginal and Torres Strait Islander Health Board. She agrees that cultural awareness benefits all aspects of a healthcare relationship – from a patient’s greeting as they enter a practice to fostering an ongoing connection throughout the care.

‘A really simple step is to have a friendly face at reception. Many Aboriginal and Torres Strait Islander people go to mainstream health services and want to be treated like everyone else,’ Ms Parry told newsGP.


‘It is important to understand that some Aboriginal and Torres Strait Islander patients may have a different culture or cultural practices to non-Indigenous Australians.

‘If [healthcare professionals] don’t show that they care about those differences, this can really affect their patients.’

Ms Parry strongly believes that taking the time to get to know patients, to hear their story and help them understand their illness and treatments can make a big difference.

‘People need to get past stereotypes and stop making assumptions,’ she said.

‘The approaches that work for most of your patients may not always work for Aboriginal and Torres Strait Islander patients.

‘Treat patients the way you would like to be treated.’

Associate Professor O’Mara agrees, emphasising that the strength of culturally responsive care is not only for patients.

‘The role healthcare professionals, organisations, medical colleges and governments have in providing safe and appropriate spaces for Aboriginal and Torres Strait Islander patients could not only benefit the patients, but also the healthcare providers themselves,’ he said.

NACCHO & will be running free half day workshops to support practice teams to maximise the opportunity for prevention of disease for Indigenous clients . For busy GPs, members , practice nurses or ACCHO practice managers

Details HERE

GP resources

The RACGP has a number of educational resources and standards that help to support the cultural needs of Aboriginal and Torres Strait Islander peoples:

Part 2 AHHA Recognising the historic experience of Indigenous patients is key to reconciliation

Understanding the history behind why Aboriginal and Torres Strait Islander patients are five times more likely to leave hospital against medical advice is key to achieving reconciliation in the hospital system, the Australian Healthcare and Hospitals Association (AHHA) and the Heart Foundation said this week.

National Reconciliation Week is this week, and the theme ‘Don’t Keep History a Mystery’ highlights the importance of all Australians exploring our past, learning more about Aboriginal and Torres Strait Islander histories and cultures, and developing a deeper understanding of our national story.

Reitai Minogue, national manager for the Lighthouse Hospital Project, said, ‘Closing the heart health gap between Indigenous and non-Indigenous Australians requires understanding why many Aboriginal and Torres Strait Islander patients have a distrust of hospitals.

‘Historic experiences such as racism, miscommunication and mistreatment have influenced the level of distrust, which is reflected in the fact that Aboriginal and Torres Strait Islander patients are five times more likely to leave hospital against medical advice.’

The Lighthouse Hospital Project, a federally funded joint program by the AHHA and the Heart Foundation, is working with 18 hospitals around the nation to transform the experience of healthcare for Indigenous patients by trying to make their environments more culturally safe.

Examples of positive changes include improving the hospital environment with local artwork, bush gardens and cultural spaces for family, and expanding and better supporting the Aboriginal workforce. Hospitals are developing stronger links with Aboriginal Medical Services; this means discharges are better planned, so patients are more likely to access follow up appointments, take ongoing medication and use cardiac rehabilitation services.

About the Lighthouse Hospitals Project

The Lighthouse Hospitals Project is a joint initiative of AHHA and the Heart Foundation. The $10 million third phase of the Lighthouse Hospitals Project is funded by the Commonwealth Department of Health through the Indigenous Australians’ Health Program.

NSW: Coffs Harbour Health Campus, John Hunter Hospital, Liverpool Hospital, Orange Health Service and Tamworth Rural Referral Hospital.

NT: Royal Darwin Hospital.

Qld: Cairns and Hinterland Hospital and Health Service, Mount Isa Base Hospital, Princess Alexandra Hospital, Prince Charles Hospital and Townsville Hospital and Health Service.

SA: Flinders Medical Centre. Vic: Bairnsdale Regional Health Service.

WA: Broome Regional Health Campus, Fiona Stanley Hospital, Kalgoorlie Health Campus, Royal Perth Hospital and Sir Charles Gairdner Hospital.


NACCHO Aboriginal Health and #WorldHypertensionDay @strokefdn High #bloodpressure – known to doctors as ‘hypertension’ – is a silent killer of our mob with 47% having high #stroke risk


 ” But high blood pressure – known to doctors as ‘hypertension’ – is a silent killer of our mob because there are no obvious signs or symptoms, and many people don’t realise they have it. “

A staggering 82 percent of those, found to have high blood pressure, were not aware prior to taking the health check and were referred to their doctor for a further assessment.

Aboriginal and Torres Strait Islander are between two and three times as likely to have a stroke than non-Indigenous Australians which is why increasing stroke awareness is crucial.

Too many Australians couldn’t spot a stroke if it was happening right in front of them.

We know that in Aboriginal and Torres Strait Islander communities this awareness is even lower.

We want all Australians, regardless of where they live or what community they’re from, to learn the signs of stroke.”

Stroke Foundation and Apunipima ACCHO Cape York Project

 ” Naomi and Rukmani’s stroke rap runs through vital stroke awareness messages, such as lifestyle advice, learning the signs of stroke, and crucially the need to seek medical advice when stroke strikes.

Music is a powerful tool for change and we hope that people will listen to the song and remember the FAST message – it could save their life,”

Stroke Foundation Queensland Executive Officer Libby Dunstan 

Naomi Wenitong  pictured with her father Dr Mark Wenitong Public Health Officer at  Apunipima Cape York Health Council  in Cairns:

Share the stroke rap with your family and friends on social media

Listen to the new rap song HERE

                                       or Hear

Research has shown the number of strokes would be practically cut in half (48 percent) if high blood pressure alone was eliminated

NACCHO has published over 90 articles Aboriginal health stroke prevention and recovery READ HERE

“It can happen to anyone — stroke doesn’t discriminate against colour, it doesn’t discriminate against age “

Photo above Seith Fourmile, Indigenous stroke survivor campaigns for culture to aid in stroke recovery

” Cardiovascular disease is the leading cause of death for Aboriginal and Torres Strait Islander people, who experience and die from cardiovascular disease at much higher rates than other Australians.

What you don’t know can hurt you. Heart disease and strokes are the biggest killers of Australians, and the biggest risk factor for both of them is high blood pressure.

But high blood pressure – known to doctors as ‘hypertension’ – is a silent killer because there are no obvious signs or symptoms, and many people don’t realise they have it. “

John Kelly CEO-National, Heart Foundation

Aboriginal and Torres Strait Islander people, when compared with other Australians, are:

  • 1.3 times as likely to have cardiovascular disease
  • three times more likely to have a major coronary event, such as a heart attack
  • more than twice as likely to die in hospital from coronary heart disease
  • 19 times as likely to die from acute rheumatic fever and chronic rheumatic heart Disease
  • more likely to smoke, have high blood pressure, be obese, have diabetes and have end-stage renal disease.

It was World Hypertension Day yesterday  and the Stroke Foundation is determined to slash stroke numbers in Australia – with your help.

Today kicks off Australia’s Biggest Blood Pressure Check for 2018 and communities are being urged to take five minutes out of their day for a potentially life-saving blood pressure check.

More than 4.1 Million Australians are living with hypertension or high blood pressure, putting themselves at serious and unnecessary risk of stroke.

Research has shown the number of strokes would be practically cut in half (48 percent) if high blood pressure alone was eliminated.

The major concern with high blood pressure is many people don’t realise they have it. It has no immediate symptoms, but over time, it damages blood vessels and increases the risk of stroke and heart disease.

How you can help?

  • Encourage your family and friends to take advantage of a free check.
  • Help spread the word via social media:  Research has shown the number of strokes would be practically cut in half if high blood pressure alone was eliminated.
  • Get your free health check today! #WorldHypertensionDay

  • I am urging you – no matter what age you are – to have a blood pressure check regularly with your ACCHO GP (General Practitioner), pharmacist or via a digital health check machine.
  • Stroke strikes in an instant, attacking the brain. It kills more women than breast cancer and more men than prostate cancer and leaves thousands with an ongoing disability, but stroke is largely preventable by managing blood pressure and living a healthy lifestyle.
  • Stroke Foundation and SiSU Wellness conducted more than 520,000 digital health checks throughout 2017, finding 16 percent of participants had high blood pressure putting them at risk of stroke

Given there will be 56,000 strokes in Australia this year alone, if we can reduce high blood pressure we will have a direct and lasting impact on the rate of stroke in this country.Yours sincerely,

Sharon McGowan
Chief Executive Officer
Stroke Foundation

NACCHO Aboriginal Health and #Sugartax : @4Corners #Tippingthescales: #4corners Sugar, politics and what’s making us fat #rethinksugarydrinks @janemartinopc @OPCAustralia

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

See Preview Video here

 ” 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. “

NACCHO post – ABS Report abs-indigenous-consumption-of-added-sugars 

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.

See Previous NACCHO Post Aboriginal Health and Sugar TV Doco: APY community and the Mai Wiru Sugar Challenge Foundation

4 Corners Press Release

“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 to solve 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

Read over 24 NACCHO articles Sugar Tax HERE

NACCHO Aboriginal Health @VACCHO_org @Apunipima join major 2018 health groups campaign @Live Lighter #RethinkSugaryDrink launching ad showing heavy health cost of cheap $1 frozen drinks

NACCHO Aboriginal Health #Junkfood #Sugarydrinks #Sugartax @AMAPresident says Advertising and marketing of #junkfood and #sugarydrinks to children should be banned