NACCHO #HealthElection16 Aboriginal – Māori: how Indigenous health suffers on both sides of the ditch

ANZ

“Indigenous people in Australia and New Zealand, despite the distance separating them and varying histories, have one disturbing issue in common: poor health. A landmark comprehensive report published today in medical journal The Lancet has highlighted that this commonality is shared among 23 countries and 154 million Indigenous and tribal people around the world.

Researchers assessed data on measures including life expectancy at birth, infant mortality, birthweight, maternal mortality, nutritional status and educational attainment for the countries involved. On all measures, Indigenous people were found to suffer more than their non-Indigenous counterparts.”

Graeme Maguire Professor and Head Clinical Research Domain, Baker IDI Heart & Diabetes Institute and

 Bridget Robson Associate Dean Māori, Department of Public Health, University of Otago

As published in the Conversation

This isn’t new knowledge, but the report reminds us of the breadth of the problem. We’ve compiled similar statistics in our region. No matter the type of measure used, the results show unacceptable levels of health disparity.

Indigenous children are less likely to receive a proper education and more likely to suffer mental illness as teenagers and be exposed to dangerous levels of alcohol. Marianna Massey/AAP

Greater numbers of Indigenous babies are born weighing less than a healthy 2,500 grams in both countries. This speaks to the amplifying nature of intergenerational poverty and disadvantage. Without a good start in the womb, an Indigenous baby will struggle to live a long, healthy life even before taking its first breath.

Small babies have less reserve in the bodies they are born into. Smaller kidneys and lungs and fragile hearts have less ability to deal with future challenges.

Indigenous children are less likely to receive a proper education, and more likely to suffer mental illness as teenagers and be exposed to dangerous levels of alcohol. They will grow up more prone to chronic diseases and be more likely to contract an infectious disease, such as syphilis.

All this translates to a shorter life. Below, we compare how both countries fare in key health indicators: life expectancy at birth, low birth weight, diabetes and youth suicide.

Indigenous Australians

Marianna Massey/AAP

https://datawrapper.dwcdn.net/z35cd/6/

Indigenous Australians must contend with the triple challenge of acute infectious disease (such as trachoma), chronic non-communicable disease (such as diabetes) and mental illness. There are few health conditions where they don’t have poorer health outcomes, extending from cancer to traumatic-related injuries, such as those that stem from car accidents and domestic violence.

There is nothing to suggest Aboriginal Australian and Torres Strait Islander people are intrinsically susceptible to disease. For instance, acute rheumatic fever – a preventable cause of heart disease in young Indigenous Australians that is now extremely rare in non-Indigenous children – was just as common in non-Indigenous Australians 100 years ago.

A large number of Indigenous Australians live in remote regions while about half of Australia’s Indigenous populations resides in regional towns and cities. Poorer medical access in these areas naturally leads to poor health outcomes.

A large number of Indigenous Australians live in remote regions. Neda Vanovac/AAP

Medical conditions are also exacerbated by poverty – not just the sort of poverty that means you don’t have enough money, but the extreme poverty that translates to educational and environmental disadvantage. This is associated with overcrowded housing and an inability to participate in the mainstream economy and benefit from living in a wealthy nation such as Australia.

But even this often fails to explain why young people are driven to the finality of suicide, at a rate nearly five times higher among Indigenous youth between 15 to 19 than other Australians of the same age. In this can be seen the existential nihilism of a lack of hope associated with compounding factors of family and community stress and attendant drug and alcohol use.

While health disadvantage persists, some areas have improved. Childhood mortality, for instance, has been substantially reduced over the last 20 years. This is in large part a testament to vaccination, slowly improving environmental conditions (including housing, water and sanitation facilities) and better access and quality of community and hospital health care.

New Zealand Māori

Seth Mazow/Flickr, CC BY

https://datawrapper.dwcdn.net/eRyO9/3/

In Aotearoa (New Zealand), low birth weight is associated with smoking during pregnancy. Although New Zealand has been lauded for its success in tobacco control, the smoking rate of around 40% among Māori – compared to 15% among the total population – shows the strategies haven’t succeeded for all.

Until recently, there have been only modest declines among Māori. Smoking rates remain relatively high among young adults in their 20s (the main age of childbirth among Māori). Pregnancy is a critical time to quit smoking, not just for the health of the baby, but also because children are more likely to become smokers if their parents smoke.

This requires an approach that works for the whole family, as women are more likely to resume smoking after pregnancy if they live with a smoker.

Increasing assertions of Māori self-determination are evident throughout Aotearoa. MARTY MELVILLE/Flickr, CC BY

Māori have championed the goal of a Smokefree Aotearoa by 2025. This will require a steep change in tobacco control – reducing supply as well as demand, and stopping future generations from starting.

Youth suicide is a relatively new phenomenon among Māori. In the 1980s and 90s, rates soared, alongside the introduction of policies specifically impacting youth (youth wages, increased costs for tertiary education, reduction of apprenticeships, lowered alcohol drinking age).

Although the suicide epidemic affected both Māori and non-Māori, Māori rates rose higher and have stayed relatively high since. Māori between the ages of 16 and 24 are more than twice as likely to take their own life as non-Māori of the same age. Great concern among Māori communities has led to recent efforts to curb youth suicide through community support programs that aim to replace despair with a culture of hope.

Diabetes is twice as prevalent among Māori (5.6%) as among non-Māori (2.8%). The government’s new childhood obesity plan will need to be twice as effective for Māori to bring the rates down.

Communal gardening projects have gone a way to help diabetes. from shutterstock.com

It is critical we reject “discourses of deficit” that maintain Māori youth exposure to everyday racism and to more overt discriminatory practices, such as targeting by police, and promote “discourses of potential” for a positive future.

Healthy lifestyle programs such as IronMāori and Mara Kai (communal gardening projects) are some of the ways Māori communities are working to overcome obesity. But extreme disparities in rates of avoidable complications of diabetes (with rates more than five times higher among Māori), including renal disease and lower limb amputations, indicate health-care system failure.

Increasing assertions of Māori self-determination are evident throughout Aotearoa – in Māori radio, television, Māori medium education, political parties and Māori provision of health and social services. This movement makes a difference. To mitigate, resist and undo ongoing racism and coloniality, it is vital to have a robust alternative vision for our communities and society. The health of our nation depends on it.

NACCHO Aboriginal Health Newspaper April 2016 edition : Advertising and Editorial opportunites

NACCHO NEWS 2016

“Celebrating the 10th Anniversary of the Close the Gap Campaign for the governments of Australia to commit to achieving equality  for Indigenous people in the areas of health and  life expectancy within 25 years.”

Next publication date 6 April 2016

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We are now looking to all our members, programs and sector stakeholders for advertising, compelling articles, eye-catching images and commentary for inclusion in our next edition.

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NACCHO Childrens Health :Worldwide childhood obesity is a major health challenge

 CO

 

“According to the report, many children are growing up today in environments encouraging weight gain and obesity. Driven by globalization and urbanization, exposure to unhealthy (obesogneic) environments is increasing in high-, middle- and low-income countries and across all socioeconomic groups. The marketing of unhealthy foods and non-alcoholic beverages was identified as a major factor in the increase in numbers of children being overweight and obese, particularly in the developing world.”

Dr Sania Nishtar, Commission co-chair

Download the REPORT HERE

The Commission on Ending Childhood Obesity (ECHO) presented its final report to the WHO Director-General today, culminating a two-year process to address the alarming levels of childhood obesity and overweight globally.

The ECHO report proposes a range of recommendations for governments aimed at reversing the rising trend of children aged under 5 years becoming overweight and obese. At least 41 million children in this age group are obese or overweight, with the greatest rise in the number of children being obese or overweight coming from low- and middle-income countries.

“Increased political commitment is needed to tackle the global challenge of childhood overweight and obesity.”

Sir Peter Gluckman, Commission co-chair

“Increased political commitment is needed to tackle the global challenge of childhood overweight and obesity,” says Sir Peter Gluckman, Commission co-chair. “WHO needs to work with governments to implement a wide range of measures that address the environmental causes of obesity and overweight, and help give children the healthy start to life they deserve.”

Fellow Commission co-chair, Dr Sania Nishtar, adds: “Overweight and obesity impact on a child’s quality of life, as they face a wide range of barriers, including physical, psychological and health consequences. We know that obesity can impact on educational attainment too and this, combined with the likelihood that they will remain obese into adulthood, poses major health and economic consequences for them, their families and society as a whole.”

“Overweight and obesity impact on a child’s quality of life, and poses major health and economic consequences for them, their families and society as a whole.”

Dr Sania Nishtar, Commission co-chair

According to the report, many children are growing up today in environments encouraging weight gain and obesity. Driven by globalization and urbanization, exposure to unhealthy (obesogneic) environments is increasing in high-, middle- and low-income countries and across all socioeconomic groups. The marketing of unhealthy foods and non-alcoholic beverages was identified as a major factor in the increase in numbers of children being overweight and obese, particularly in the developing world.

Overweight prevalence among children aged under 5 years has risen between 1990 and 2014, from 4.8% to 6.1%, with numbers of affected children rising from 31 million to 41 million during that time. The number of overweight children in lower middle-income countries has more than doubled over that period, from 7.5 million to 15.5 million.

In 2014, almost half (48%) of all overweight and obese children aged under 5 lived in Asia and one-quarter (25%) in Africa. The number of overweight children aged under 5 in Africa has nearly doubled since 1990 (5.4 million to 10.3 million).

The ECHO Report has 6 main recommendations for governments

Promote intake of healthy foods

Implement comprehensive programmes that promote the intake of healthy foods and reduce the intake of unhealthy foods and sugar-sweetened beverages by children and adolescents (through, for example, effective taxation on sugar-sweetened beverages and curbing the marketing of unhealthy foods).

Promote physical activity

Implement comprehensive programmes that promote physical activity and reduce sedentary behaviors in children and adolescents.

Preconception and pregnancy care

Integrate and strengthen guidance for the prevention of noncommunicable diseases (NCDs) with current guidance on preconception and antenatal care (to reduce risk of childhood obesity by preventing low or high birth weight, prematurity and other complications in pregnancy).

Early childhood diet and physical activity

Provide guidance on, and support for, healthy diet, sleep and physical activity in early childhood and promote healthy habits and ensure children grow appropriately and develop healthy habits(by promoting breastfeeding; limiting consumption of foods high in fat, sugar and salt; ensuring availability of healthy foods and physical activity in the early child care settings).

Health, nutrition and physical activity for school-age children

Implement comprehensive programmes that promote healthy school environments, health and nutrition literacy and physical activity among school-age children and adolescents (by establishing standards for school meals; eliminating the sale of unhealthy foods and drinks and; including health and nutrition and quality physical education in the core curriculum);

Weight management

Provide family-based, multi component, lifestyle weight management services for children and young people who are obese.

The ECHO findings urge WHO to institutionalize, throughout the Organization, a cross-cutting and life-course approach to ending childhood obesity. The report also identifies a range of actions to be undertaken by other players, calling for nongovernmental organizations to raise the profile of childhood obesity and advocate for improvements in the environment, and for the private sector to support the production and improved access to foods and beverages that contribute to a healthy diet.

 

NACCHO Aboriginal Health News : United Nations urges better healthcare for world’s indigenous peoples

UN

“Only by acknowledging the interrelationship between health and the social determinants of health, such as poverty, illiteracy, marginalization, the impact of extractive industries, environmental degradation, and the lack of self-determination, will any new human development goals be truly achievable amongst indigenous peoples,

The current Millennium Development Goals (MDGs)  have  failed to identify the relationship (or access) to customary land as an indicator of well-being. Similarly, mental health issues such as depression, substance abuse and suicide will not be completely addressed so long as the harms of colonization and the status of indigenous peoples are not acknowledged.”

Australia’s  Professor Megan Davis

Chair of the UN Permanent Forum on Indigenous Issues.

Photo above NACCHO library

Indigenous peoples must not be left out of the global community’s unfolding sustainable development agenda, United Nations Secretary-General Ban Ki-moon affirmed as he marked the 2015 edition of the International Day of the World’s Indigenous Peoples with a focus on their lagging access to health care services around the world.

“They count among the world’s most vulnerable and marginalized people. Yet their history, traditions, languages and knowledge are part of the very bedrock of human heritage,” the Secretary-General declared in remarks delivered at an event held at a special UN Headquarters in New York. The event was also expected to hear remarks from Wu Hongbo, Under-Secretary-General for Economic and Social Affairs, and Megan Davis, Chair of the UN Permanent Forum on Indigenous Issues.

“Indigenous peoples can teach the world about sustainable lifestyles and living in harmony with nature,” he added.

The International Day of the World’s Indigenous Peoples is commemorated annually on 9 August in recognition of the first meeting of the UN Working Group on Indigenous Populations, held in Geneva in 1982.

This year, the Day’s theme focuses the spotlight on promoting the health and well-being of the world’s indigenous peoples through the 2030 Sustainable Development Agenda, which will be launched in September. The new agenda expands on the success of the Millennium Development Goals (MDGs), which had a target date of 2015, and contains 17 sustainable development goals.

Today’s event also saw the launch of the UN’s latest State of the World’s Indigenous Peoples State of the World’s Indigenous Peoples report which examines the major challenges indigenous peoples face in terms of adequate access to and utilization of quality health care services.

According to the UN, there are an estimated 370 million indigenous people in some 90 countries around the world who constitute 15 per cent of the world’s poor and about one third of the world’s 900 million extremely poor rural people. Practicing unique traditions, they retain social, cultural, economic and political characteristics that are distinct from those of the dominant societies in which they live.

At the same time, the unique placement of indigenous peoples in society puts them at a disadvantage when seeking access to healthcare while also rendering them more susceptible to specific forms of illness.

The UN chief noted, in fact, that indigenous peoples regularly encounter inadequate sanitation and housing, lack of prenatal care and widespread violence against women as well as enduring high rates of diabetes, drug and alcohol abuse, youth suicide and infant mortality.

In Australia, he warned, many Aboriginal communities have a diabetes rate six times higher than the general population. Meanwhile, in Rwanda, Twa households remain seven times more likely to have poor sanitation and twice as likely to lack safe drinking water. Similarly, in Viet Nam, more than 60 per cent of childbirths among ethnic minorities take place without prenatal care while for the majority population, the figure hovers closer to 30 per cent.

“These statistics are unacceptable,” concluded Mr. Ban. “They must be urgently addressed as part of the 2030 Agenda for Sustainable Development. As we launch the 2030 Agenda with its 17 sustainable development goals, in September, we must ensure that the targets are met for all.”

In her remarks, Ms. Davis said the active and ongoing involvement of indigenous peoples in the development, implementation, and management and monitoring of policies, services and programs affecting the well-being of their communities is essential.

“Only by acknowledging the interrelationship between health and the social determinants of health, such as poverty, illiteracy, marginalization, the impact of extractive industries, environmental degradation, and the lack of self-determination, will any new human development goals be truly achievable amongst indigenous peoples,” she said.

The current MDGs have, Ms. Davis continued, failed to identify the relationship (or access) to customary land as an indicator of well-being. Similarly, mental health issues such as depression, substance abuse and suicide will not be completely addressed so long as the harms of colonization and the status of indigenous peoples are not acknowledged.

“Thus, on the eve of the adoption of a new development agenda, new indicators of indigenous peoples’ health and well-being must be defined in consultation with indigenous peoples. Similarly, States should seriously engage in the disaggregation of data in order to better inform the effectiveness of their health policies and plans for indigenous peoples,” she said.

 

NACCHO International Day of the World’s Indigenous Peoples: Ensuring Indigenous peoples’ health and wellbeing”.

IDWID

This International Day of the World’s Indigenous Peoples, I want us all to reflect on health and its links to reconciliation. Better outcomes for Aboriginal and Torres Strait Islander Australians will inevitably come through better health. Better health for our people has the effect of building stronger education and employment outcomes, financial security, social participation and respect. Better health is about the social, cultural, emotional and spiritual wellbeing of the individual, the family and the community. Better health is very clearly linked to the positive outcomes of reconciliation.”

Dr Tom Calma AO from #IDWIP Message

The International Day of the World’s Indigenous Peoples, a United Nations event commemorated worldwide, is celebrated on 9 August each year. The theme for 2015 is “Post 2015 agenda: Ensuring Indigenous peoples’ health and wellbeing”.

Since 2002, Australia’s National Health and Medical Research Council (NHMRC), the Canadian Institutes of Health Research (CIHR), and the Health Research Council of New Zealand (HRC) have been working together on initiatives to improve Indigenous people’s health. To commemorate this year’s event, contributors from these organizations and Cochrane have prepared a series of Special Collections focusing on health issues relevant to Indigenous people.

Internationally, the health of Indigenous peoples continues to be inequitable. The International Working Group on Indigenous Affairs reported that: “Indigenous peoples remain on the margins of society: they are poorer, less educated, die at a younger age, are much more likely to commit suicide, and are generally in worse health than the rest of the population.”[1]

Since 2002, Australia’s National Health and Medical Research Council (NHMRC), the Canadian Institutes of Health Research (CIHR), and the Health Research Council of New Zealand (HRC) have been signatories to an agreement on trilateral cooperation to improve Indigenous people’s health.[2] Regularly updated, the agreement commits the three agencies to working collaboratively to improve the health of Indigenous peoples through sharing of best practice, information, and expertise.

Priorities for research identified in the current agreement include fetal alcohol spectrum disorder (FASD) and suicide prevention, both the focus of Cochrane Library Special Collections. A third Special Collection on diabetes reflects the burden of disease attributable to this chronic condition on Indigenous peoples worldwide and its status within the Global Alliance for Chronic Disease as a research priority.[3]

There are 713,600 Aboriginal and Torres Strait Islander people, comprising about 3% of the Australian population.[4] Over one-third are less than 15 years of age. In Aotearoa New Zealand, with a total population of around 4.25 million at the 2013 census, nearly 600,000 (15%) identified Māori as one or only ethnicity, with a comparatively youthful median age of 24 years.[5] Canada’s First Peoples comprise approximately 1.4 million First Nations, Inuit, and Métis, representing 4.3% of the total Canadian population.[6] These three groups, like their counterparts in Australia and New Zealand, are young and growing compared with non-Indigenous populations. The median age for First Nations people is 26 years of age and for Métis, age 31, while Inuit are the youngest of the three groups, with a median age of 23 years.[6]

In Australia and Aotearoa New Zealand average life expectancy of Indigenous people continues to lag behind non-Indigenous counterparts by 10 and 7 years, respectively.[7,8] In Canada, the life expectancy for First Nations and Métis is on average 5 to 6 years less; and for Inuit, the lag is 10 to 15 years, whereby Inuit have the lowest projected life expectancy of all groups in Canada.[9] These numbers underplay the human and economic costs, loss of potential, and cultural impact of this life expectancy gap. Eliminating ethnic inequities is documented as a priority in almost every jurisdiction but remains a challenge.

Research has a mixed reputation among Indigenous communities, who have considered research harmful, damaging, insensitive, and exploitative.[10] A large number of research projects have been implemented to serve the professional, political, and academic needs of non-Indigenous researchers, with little or no translation into improving health outcomes.

Keeping community interests and priorities central in research is paramount to addressing the factors that impact health in Indigenous communities. These factors are unique to and vary between each group and cannot be compared to the same factors affecting the health of non-Indigenous citizens.

In our developed and wealthy nations such health inequities justify inquiry and action. In the past, research often resulted in harm as well as lost opportunity for mutual learning and development. Furthermore this ‘done to’ approach inevitably fosters ‘victim-blame’ analyses and discourses that are unable to encompass the broader determinants and root causes of inequity. These include structural and societal features, including the historic and contemporary effects of colonisation and racism.

Systematic reviews of good-quality studies have provided the foundation for evidence-based guidelines for clinical practice and improved health outcomes for specific conditions, and therefore may be useful in eliminating Indigenous health disparities. But alternative research approaches are also needed. To be relevant to decision-making in countries with disparities in health outcomes among Indigenous peoples it is particularly important that the authors of Cochrane Reviews interpret their results through the lens of the broader determinants of inequity. This will more readily facilitate the introduction of healthcare practices, policies, and systems that will ultimately enable Indigenous health developm

The Special Collections, available on the Cochrane Library, focus on available Cochrane evidence in three topic areas, each of which has significant health implications for Indigenous populations:  diabetes, fetal alcohol spectrum disorders, and suicide prevention:

Diabetes

Fetal alcohol spectrum disorders

Suicide prevention

Two accompanying editorials reflect on the health and societal contexts in which evidence can contribute to informed research and treatment decision-making:

Improving health outcomes for Indigenous peoples: what are the challenges?

Can Cochrane Reviews inform decisions to improve Indigenous people’s health?

Acknowledgements
These Special Collections were prepared with the collaboration and support of the following individuals and organizations:

  • Canadian Institutes of Health Research – Institute of Aboriginal Peoples’ Health: Malcolm King, Cynthia Stirbys
  • Health Research Council (New Zealand) – Māori Health Research: Rachel Brown, Jaylene Wehipeihana
  • National Health and Medical Research Council (Australia) – Research Policy and Translation: Samantha Faulkner, Davina Ghersi
  • Cochrane Centres: Sue Brennan, Sally Green, Steve McDonald, Jordi Pardo Pardo
  • The Cochrane Editorial Unit
  • Professor Jonathan Craig, Cochrane Kidney and Transplant Group

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NACCHO Aboriginal Health Newspaper: OPPORTUNITY to promote your services and employment

 

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NACCHO has announced the publishing date (1 July) for 5th edition of Australia’s first national Aboriginal health newspaper, the NACCHO Health News, creating a fresh, positive, vitalised platform that for advertisers will reach your targeted audience decision makers.

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Working with Aboriginal community controlled and award-winning national newspaper the Koori Mail, NACCHO aims to bring relevant information on health services, policy and programs to key industry staff and stakeholders at the grassroots.

NACCHO will leverage the brand, coverage and award-winning production skills of the Koori Mail is produced  three times a year, with 20-28 pages to be distributed as a ‘lift-out’ in the 14,000 Koori Mail circulation, as well as an extra 1500 copies sent directly to NACCHO member organisations and stakeholders across Australia.

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New in 2015

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NACCHO preventative health news : Unhealthy big business spreading great harm worldwide-Prof Rob Moodie

Comic

“Surely we must find a balance between unrestrained commercialism and  maximising health and wellbeing. We need business  for our individual and  collective wellbeing.”

However, the benefits unhealthy businesses bring are  outweighed by the costs – in terms of premature death, chronic illness, limited  healthcare finances, overcrowding of hospitals and loss of productivity from  unhealthy employees.”

RM

Rob Moodie is professor of public health at the University of  Melbourne THE AGE 

Illustration: Jim Pavlidis.

Two-thirds of Indonesian men smoke and more than half of Chinese men smoke.  Even more disturbing is that 40 per cent of 13-15-year-old Indonesian boys  smoke. How have these levels been reached while the world has known for more  than 50 years that tobacco is such a deadly habit?

In China, it is now estimated that 114 million people have diabetes.  South  Africa has one of the highest per capita alcohol consumption rates in the world,  with more than 30 per cent of the population struggling with an alcohol problem  or on the verge of having one.

Tobacco, alcohol, and diabetes related to overweight and obesity all have one  feature in common. They are each largely driven, and in the case of tobacco  completely caused, by powerful commercial interests in the form of transnational  corporations. It has been said that China’s booming economy has brought

Two-thirds of Indonesian men smoke and more than half of Chinese men smoke.  Even more disturbing is that 40 per cent of 13-15-year-old Indonesian boys  smoke. How have these levels been reached while the world has known for more  than 50 years that tobacco is such a deadly habit?

In China, it is now estimated that 114 million people have diabetes.  South  Africa has one of the highest per capita alcohol consumption rates in the world,  with more than 30 per cent of the population struggling with an alcohol problem  or on the verge of having one.

Tobacco, alcohol, and diabetes related to overweight and obesity all have one  feature in common. They are each largely driven, and in the case of tobacco  completely caused, by powerful commercial interests in the form of transnational  corporations. It has been said that China’s booming economy has brought with it  a medical problem that could bankrupt the health system.

We now face a major dilemma: unrestrained commercial development is pitted  against the health and wellbeing of populations. This dilemma is not new –  opponents of the abolition of slavery complained it would ruin the economy – but  it is manifesting in more obvious ways in the 21st century.

The tobacco, alcohol and ultra-processed (”junk”) food and drink industries  have been rapidly expanding in low and middle-income countries. In the past  decade, tobacco retail sales growth in these countries was 20 times that of the  developed world. For alcohol consumption it was three times; sugar-sweetened  beverages it was twice. But it isn’t only Indonesia, China and South Africa  where we find this dilemma; it is alive and well in Australia.

For years we have known that the tobacco industry promotes and funds biased  research findings, co-opts policy makers and health professionals, lobbies  politicians and officials to oppose public regulation, and influences voters to  oppose public health measures through expensive public relations campaigns. This  success has  been noticed and over the past decade alcohol and ultra-processed  food and drink companies have been emulating these very same tactics.

This is of little surprise given the flow of people, funds and activities  across the industries. For example Philip Morris owned both Kraft and Miller  Brewing; the board of SAB Miller (the second largest alcohol manufacturer)  includes at least five past or present tobacco company executives and board  members; and the Diageo executive director responsible for public affairs spent  17 years in a similar role at Philip Morris.

Economic development plays an important role in the health and wellbeing of  populations. Income, employment and education levels are all major determinants  of good health. Businesses create wealth, provide jobs and pay taxes (but as we  have seen, not all of them).  One of the best ways to protect and promote health  is to ensure people have safe, meaningful jobs. The more evenly wealth and  opportunity are distributed, the better the overall health and wellbeing of a  population.

But clearly not all businesses are good or healthy – yet we see some of them  expanding their markets and influence across the globe – seemingly with no  capacity to diminish or mitigate the harm they do. It is astonishing that an  industry such as tobacco, which is so harmful to human health, can wield so much  power.  In Indonesia, Philip Morris and its affiliate, Sampoerna, will invest  $US174 million to improve production capacities so, as Sampoerna’s president has  said, ”Indonesia would be the centre of the Marlboro brand production to cater  [for] demands in the Asia-Pacific region”.

Why do they need to expand their activities? Aren’t the existing 700 million  smokers in the  region enough? Especially when we know that more than half of  them will die prematurely, losing about 20 years of life   to  tobacco.

The major tobacco, food, and alcohol companies have assets that are greater  than many countries and can wield this power in  parliament, law courts and the  media, against the interests of the public’s health.

A new battlefront in this power play is the Trans Pacific Partnership   Agreement (TPP). This trade agreement among 12 countries (including Australia,  Japan and the US) represents about 40 per cent of the global economy.

The Australian government aims to ”pursue a TPP outcome that eliminates, or  at least substantially reduces, barriers to trade and investment” and that will  ”also deal with behind-the-border impediments to trade and investment”.

It is highly complex, has 29 chapters, is being negotiated in secret and is  provoking considerable criticism on the basis that it could greatly strengthen  the hand of some industries to sue national governments for their domestic  policies and also greatly weaken the capacity of governments to buy cheaper  generic drugs. The Nobel prize-winning humanitarian group Medicins sans  Frontieres says the TPP ”could restrict access to generic medicines, making  life-saving treatments unaffordable to millions”.

If our trade negotiators buckle under the pressure from other governments,  which are, in turn, highly influenced by transnational companies, then Australia  will have to confront some major problems. These include delayed availability of  cheaper generic drugs and increased cost of medicines; interference with our  Pharmaceutical Benefits Scheme; enshrining of rights to foreign corporations,  such as tobacco companies, to sue our government; interference with our capacity  to introduce health warnings on alcohol packaging, and the limiting of future  options for food labelling.

Surely we must find a balance between unrestrained commercialism and  maximising health and wellbeing. We need business  for our individual and  collective wellbeing. However, the benefits unhealthy businesses bring are  outweighed by the costs – in terms of premature death, chronic illness, limited  healthcare finances, overcrowding of hospitals and loss of productivity from  unhealthy employees.

This is why we have governments – to ensure a balance among the rights of  individuals, consumers, businesses and society as a whole. If, as Prime Minister  Abbott has said, Australia is open for business, then we need to make sure it’s  open for good business.  If we can’t control the vested interests of unhealthy  industries in trade agreements or in our domestic regulations, unhealthy  business will come back to bite us all.

Rob Moodie is professor of public health at the University of  Melbourne

Read more: http://www.theage.com.au/comment/unhealthy-big-business-spreading-great-harm-20140105-30bnk.html#ixzz2pkGpmrUG

NACCHO celebrates International Day of the World’s Indigenous Peoples

Un 2

NACCHO today celebrates our international involvement with International Day of the World’s Indigenous Peoples

Pictured above NACCHO’s Lisa Briggs,Matthew Cooke and Professor Ngiare Brown at the UN in New York (May 2013)

“We must ensure the participation of indigenous peoples – women and men – in decision-making at all levels.

This includes discussions on accelerating action towards achieving the Millennium Development Goals and defining the post-2015 development agenda

2013 Theme: “Indigenous peoples building alliances: Honouring treaties, agreements and other constructive arrangements”

The International Day of the World’s Indigenous People (9 August) was first proclaimed by the General Assembly in December 1994, to be celebrated every year during the first International Decade of the World’s Indigenous People (1995 – 2004).

In 2004, the Assembly proclaimed a Second International Decade, from 2005 – 2014, with the theme of “A Decade for Action and Dignity.” The focus of this year’s International Day is “Indigenous peoples building alliances: Honouring treaties, agreements and other constructive arrangements.”

The theme aims to highlight the importance of honouring arrangements between States, their citizens and indigenous peoples that were designed to recognize indigenous peoples’ rights to their lands and establish a framework for living in proximity and entering into economic relationships. Agreements also outline a political vision of different sovereign peoples living together on the same land, according to the principles of friendship, cooperation and peace.

A special event at UN Headquarters in New York will be held on Friday, 9 August, starting at 3pm, featuring the UN Secretary-General, the Chairperson of the UN Permanent Forum on Indigenous Issues, a delegate of Panama, a representative of the Office of the UN High Commissioner of Human Rights, and an indigenous representative. The event will be webcast live at webtv.un.org.

Also on 9 August, hundreds of indigenous and non-indigenous rowers are scheduled to arrive at Pier 96 at 57th Street in Manhattan at 10am, after having collectively travelled thousands of miles on rivers and horsebacks to honour the first treaty -– the Two Row Wampum -– concluded between Dutch immigrants and the Haudenosaunee (a confederacy of six nations, with capital in the Onondaga nation, in NY State) 400 years ago, in 1613. They will gather with members of the UN Permanent Forum on Indigenous Issues at Dag Hammarskjold Plaza at 1:30pm.

NACCHO International health news: ACCESS to JUSTICE for Aboriginal People

Shane Duffy

Shane Duffy, the Chairperson of the National Aboriginal & Torres Strait Islander Legal Services (NATSILS) delivered a joint statement on behalf NATSILS and the Indigenous Peoples Organisation Network of Australia (IPO) in response to a Study on access to justice in the promotion and protection of the rights of Indigenous Peoples at the Expert Mechanism on the Rights of Indigenous Peoples (EMRIP) at the Sixth Session meeting in Geneva from 8-12 July 2013.

Mr Duffy said studies such as these provide a critical point of reference and authoritative guidance for States (National Governments) in their efforts to provide for and implement their obligations concerning the rights of Indigenous Peoples.

However, while Mr Duffy agrees that the experience of Indigenous Peoples within the criminal justice system the world over requires urgent action, he said care needs to be taken not to confine States understanding their responsibilities by limiting the expression or scope of these rights to one element or area of concern.

He further added; Access to justice for Indigenous Peoples must be about how we can use both Indigenous and Western systems of justice to ensure the greatest possible quality of life for all Indigenous Peoples’, which is highlighted at Article 5 of the Declaration on the Rights of Indigenous Peoples that affirms Indigenous Peoples right to maintain and strengthen our political, legal, economic, social and cultural institutions while retaining our right to also participate fully in the political, economic, social and cultural life of the State.

Mr Duffy’s statement called on the Human Rights Council (HRC) to encourage States to implement the United Nations Declaration on the Rights of Indigenous Peoples as the foundational document for the development of all policies concerning Indigenous Peoples, including issues related to access to justice, and that the HRC request the EMRIP extend the Study on access to justice in the promotion an protection of the rights of Indigenous Peoples to include a practical analysis of Articles 1 (4) and 2 (2) of the Convention on the Elimination of All Forms of Racial Discrimination and General Comment XXIII by the CERD as it relates to special measures and the requirement to obtain free, prior and informed consent.

Mr Duffy further added ‘it is important that States utilise informed standardised data collections that ensures a more strategic approach that provides appropriate needs based financial resources to Indigenous organisations to build their capacity to respond appropriately to Indigenous justice needs.

Mr Duffy said, ‘In Australia, the statistics provide a damning picture, with Aboriginal and Torres Strait Islander adults incarcerated at 15 times the rate of non-Indigenous adults; imprisonment rate for our women has grown by 58.6% between the years 2000 to 2010; Our children are 24 times more likely to be in youth detention than non-Indigenous young people. In 2011-12, our children were subjected to child protection substantiations at a rate of 41.9 per 1000, nearly eight times that of non-Indigenous children.  They are also ten times more likely to be in out-of-home care (comprising 31% of all children in care), despite making up only 4.2% of the population of all children and young people. In addition to the rising rates, our children are increasingly being placed with non-Indigenous foster carers.

We have therefore called on the Australian government to take into consideration the significant issues highlighted in the full intervention to work collaboratively with us to facilitate the restoration and strengthening of local governance and decision-making structures to improve Aboriginal and Torres Strait Islander people’s access to justice’.
Contact:

For a full copy of Mr Duffy’s Intervention and/or interview enquiries please contact Amala Groom
Phone: +61 425 820 658
Email

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NACCHO international: Aboriginal People’s delegation to the Sixth Session of the Expert Mechanism on the Rights of Indigenous Peoples 2013

Dea Thiele, David Lee, Geoff Scott and Tina Williams.

Pictured:  Dea Thiele, David Lee, Geoff Scott and Tina Williams

Indigenous organisations from Australia are in Geneva as part of the Human Rights Council’s 6th Session of the Expert Mechanism on the Rights of Indigenous Peoples (EMRIP).

The 6th Session of EMRIP is being held from 8-12 July 2013 where the focus is on studies regarding access to justice, the World Conference on Indigenous Peoples and progress on the implementation of the United Nations Declaration on the Rights of Indigenous Peoples.

The Indigenous People’s Organisation (IPO) Network of Australia is a broad affiliation of Aboriginal and Torres Strait Islander organisations and individuals, who engage with the Human Rights Council and other United Nations mechanisms and frameworks to advocate for the implementation of the Declaration.

Co-chairs at the Expert Mechanism, Brian Wyatt and Dea Thiele, assist in coordinating the activities with the Aboriginal and Torres Strait Islander community organisations that make up the IPO attending this year’s Expert Mechanism.

Discussion will take place on the status of recommendations around previous thematic studies which health, culture and education as well as this year’s agenda item on access to justice in the promotion and protection of the rights of Indigenous Peoples.

Indigenous organisation delegates that make up the IPO at this year’s Expert Mechanism include the National Native Title Council, Aboriginal Medical Service of Western Sydney, New South Wales Aboriginal Land Council, National Aboriginal and Torres Strait Islander Legal Services, National Aboriginal and Torres Strait Islander Women’s Alliance and the Aboriginal and Torres Strait Islander Social Justice Commissioner.

According to Mr Wyatt, ‘this year’s Expert Mechanism acknowledged significant input from the National Native Title Council, in their report on a survey questionnaire seeking views of States and Indigenous Peoples on best practices regarding possible appropriate measures and implementation strategies to attain the goals of the United Nations Declaration on the Rights of Indigenous Peoples’.

New South Wales Aboriginal Land Council was also acknowledged by the Expert Mechanism for their detailed report on the Study on Access to Justice for Indigenous Peoples including Truth and Reconciliation Processes.

Tina Williams, Craig Cromelin, Shane Duffy and Mick Gooda.

Pictured: Tina Williams, Craig Cromelin, Shane Duffy and Mick Gooda

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