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

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

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

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

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

Rethink Sugary Drink campaign Download position statement

health-levy-on-sugar-position-statement

Read NACCHO previous articles Obesity / Sugartax

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

See NACCHO Story

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

There will be a special Facebook live event before the screenings

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

To view the position statement click here.

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

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

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

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

Sugar tax adds to the healthy living toolbox 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

  • Caroline Wells, is Diabetes Tasmania CEO

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Eliza Newton, Senior Account Director

NACCHO #IWD2017 Aboriginal Women’s #justjustice :Indigenous, disabled, imprisoned – the forgotten women of #IWD2017

 

” Merri’s story is not uncommon. Studies show that women with physical, sensory, intellectual, or psychosocial disabilities (mental health conditions) experience higher rates of domestic and sexual violence and abuse than other women.

More than 70 per cent of women with disabilities in Australia have experienced sexual violence, and they are 40 per cent more likely to face domestic violence than other women.

Indigenous women are 35 times more likely to be hospitalised as a result of domestic violence than non-Indigenous women. Indigenous women who have a disability face intersecting forms of discrimination because of their gender, disability, and ethnicity that leave them at even greater risk of experiencing violence — and of being involved in violence and imprisoned

Kriti Sharma is a disability rights researcher for Human Rights Watch

This is our last NACCHO post supporting  International Women’s Day

Further NACCHO reading

Women’s Health ( 275 articles )  or Just Justice  See campaign details below

” In-prison programs fail to address the disadvantage that many Aboriginal and Torres Strait Islander prisoners face, such as addiction, intergenerational and historical traumas, grief and loss. Programs have long waiting lists, and exclude those who spend many months on remand or serve short sentences – as Aboriginal and Torres Strait Islander people often do.

Instead, evidence shows that prison worsens mental health and wellbeing, damages relationships and families, and generates stigma which reduces employment and housing opportunities .

To prevent post-release deaths, diversion from prison to alcohol and drug rehabilitation is recommended, which has proven more cost-effective and beneficial than prison , International evidence also recommends preparing families for the post-prison release phase. ‘

Dying to be free: Where is the focus on the deaths occurring post-prison release? Article 1 Below

Article from Page 17 NACCHO Aboriginal Health Newspaper out Wednesday 16 November , 24 Page lift out Koori Mail : or download

naccho-newspaper-nov-2016 PDF file size 9 MB

As the world celebrates International Women’s Day, this week  I think of ‘Merri’, one of the most formidable and resilient women I have ever met.

A 50-year-old Aboriginal woman with a mental health condition, Merri grew up in a remote community in the Kimberley region of Western Australia. When I met her, Merri was in pre-trial detention in an Australian prison.

It was the first time she had been to prison and it was clear she was still reeling from trauma. But she was also defiant.

“Six months ago, I got sick of being bashed so I killed him,” she said. “I spent five years with him [my partner], being bashed. He gave me a freaking [sexually transmitted] disease. Now I have to suffer [in prison].”

I recently traveled through Western Australia, visiting prisons, and I heard story after story of Indigenous women with disabilities whose lives had been cycles of abuse and imprisonment, without effective help.

For many women who need help, support services are simply not available. They may be too far away, hard to find, or not culturally sensitive or accessible to women.

The result is that Australia’s prisons are disproportionately full of Indigenous women with disabilities, who are also more likely to be incarcerated for minor offenses.

For numerous women like Merri in many parts of the country, prisons have become a default accommodation and support option due to a dearth of appropriate community-based services. As with countless women with disabilities, Merri’s disability was not identified until she reached prison. She had not received any support services in the community.

Merri has single-handedly raised her children as well as her grandchildren, but without any support or access to mental health services, life in the community has been a struggle for her.

Strangely — and tragically — prison represented a respite for Merri. With eyes glistening with tears, she told me: “[Prison] is very stressful. But I’m finding it a break from a lot of stress outside.”

Today, on International Women’s Day, the Australian government should commit to making it a priority to meet the needs of women with disabilities who are at risk of violence and abuse.

In 2015, a Senate inquiry into the abuse people with disabilities face in institutional and residential settings revealed the extensive and diverse forms of abuse they face both in institutions and the community. The inquiry recommended that the government set up a Royal Commission to conduct a more comprehensive investigation into the neglect, violence, and abuse faced by people with disabilities across Australia.

The government has been unwilling to do so, citing the new National Disability Insurance Scheme (NDIS) Quality and Safeguard Framework as adequate.

While the framework is an important step forward, it would only reach people who are enrolled under the NDIS. Its complaints mechanism would not provide a comprehensive look at the diversity and scale of the violence people with disabilities experience, let alone at the ways in which various intersecting forms of discrimination affect people with disabilities.

The creation of a Royal Commission, on the other hand, could give voice to survivors of violence inside and outside the NDIS. It could direct a commission’s resources at a thorough investigation into the violence people with disabilities face in institutional and residential settings, as well as in the community.

The government urgently needs to hear directly from women like Merri about the challenges they face, and how the government can do better at helping them. Whether or not there is a Royal Commission, the government should consult women with disabilities, including Indigenous women, and their representative organizations to learn how to strengthen support services.

Government services that are gender and culturally appropriate, and accessible to women across the country, can curtail abuse and allow women with disabilities to live safe, independent lives in the community.

Kriti Sharma is a disability rights researcher for Human Rights Watch

 

croakey-new

How you can support #JustJustice

• Download, read and share the 2nd edition – HERE.

Buy a hard copy from Gleebooks in Sydney (ask them to order more copies if they run out of stock).

• Send copies of the book to politicians, policy makers and other opinion leaders.

• Encourage journals and other relevant publications to review #JustJustice.

• Encourage your local library to order a copy, whether the free e-version or a hard copy from Gleebooks.

• Follow Guardian Australia’s project, Breaking the Cycle.

Readers may also be interested in these articles:

NACCHO Aboriginal Health #KHW17 #Kidneysfirst :Ten bad food habits that will kill you

 ‘ Almost half of heart-related deaths are caused by 10 bad ­eating habits.

Diets high in salt or sugary drinks are responsible for ­thousands of deaths from heart disease, stroke and type 2 ­diabetes, according to a study. Scientists also blamed a lack of fruit and vegetables and high ­levels of ­processed meats.

Researchers looked at all 702,308 deaths from heart ­disease, stroke and type 2 diabetes in the US in 2012 and found that 45 per cent were linked with “suboptimal consumption” of 10 types of nutrients. They mapped data on dietary habits from population surveys, along with estimates from previous research of links between foods and disease, on to data about the deaths to come up with the figures.”

Originally published in The Australian

This is our last NACCHO post supporting Kidney Health Week / Day

Further NACCHO reading

Sugar Tax     Obesity     Diabetes    Nutrition/Healthy Foods

The highest proportion of deaths, at 9.5 per cent, was linked with eating too much salt, while a low intake of nuts and seeds was linked with 8.5 per cent.

Eating processed meats was linked with 8.2 per cent of deaths and a low amount of seafood omega-3 fats with 7.8 per cent. Low intake of vegetables ­accounted for 7.6 per cent and low intake of fruit 7.5 per cent.

Sugary drinks were linked with 7.4 per cent, a low intake of whole grains with 5.9 per cent, low polyunsaturated fats with 2.3 per cent and high unprocessed red meats with 0.4 per cent.

The research, published in the journal JAMA, also found men’s deaths were more likely to have links to poor diet than women’s.

Key Points

Question  What is the estimated mortality due to heart disease, stroke, or type 2 diabetes (cardiometabolic deaths) associated with suboptimal intakes of 10 dietary factors in the United States?

Findings  In 2012, suboptimal intake of dietary factors was associated with an estimated 318 656 cardiometabolic deaths, representing 45.4% of cardiometabolic deaths. The highest proportions of cardiometabolic deaths were estimated to be related to excess sodium intake, insufficient intake of nuts/seeds, high intake of processed meats, and low intake of seafood omega-3 fats.

Meaning  Suboptimal intake of specific foods and nutrients was associated with a substantial proportion of deaths due to heart disease, stroke, or type 2 diabetes.

Abstract

Importance  In the United States, national associations of individual dietary factors with specific cardiometabolic diseases are not well established.

Objective  To estimate associations of intake of 10 specific dietary factors with mortality due to heart disease, stroke, and type 2 diabetes (cardiometabolic mortality) among US adults.

Design, Setting, and Participants  A comparative risk assessment model incorporated data and corresponding uncertainty on population demographics and dietary habits from National Health and Nutrition Examination Surveys (1999-2002: n = 8104; 2009-2012: n = 8516); estimated associations of diet and disease from meta-analyses of prospective studies and clinical trials with validity analyses to assess potential bias; and estimated disease-specific national mortality from the National Center for Health Statistics.

Exposures  Consumption of 10 foods/nutrients associated with cardiometabolic diseases: fruits, vegetables, nuts/seeds, whole grains, unprocessed red meats, processed meats, sugar-sweetened beverages (SSBs), polyunsaturated fats, seafood omega-3 fats, and sodium.

Main Outcomes and Measures  Estimated absolute and percentage mortality due to heart disease, stroke, and type 2 diabetes in 2012. Disease-specific and demographic-specific (age, sex, race, and education) mortality and trends between 2002 and 2012 were also evaluated.

Results  In 2012, 702 308 cardiometabolic deaths occurred in US adults, including 506 100 from heart disease (371 266 coronary heart disease, 35 019 hypertensive heart disease, and 99 815 other cardiovascular disease), 128 294 from stroke (16 125 ischemic, 32 591 hemorrhagic, and 79 578 other), and 67 914 from type 2 diabetes.

See for full text

The authors, from Cambridge University and two US institutions, said that their results should help to “identify priorities, guide public health planning and inform strategies to alter dietary habits and improve health”.

In an editorial, Noel Mueller and Lawrence Appel, of the Johns Hopkins Bloomberg School of Public Health, said: “Policies that affect diet quality, not just quantity, are needed … There is some precedence, such as from trials of the Mediterranean diet plus supplemental foods, that modification of diet can reduce cardiovascular disease risk by 30 per cent to 70 per cent.”

Keeping your kidneys healthy

It is important to maintain a healthy weight for your height. The food you eat, and how active you are, help to control your weight.

Healthy eating tips include:

  • Eat lots of fruit, vegetables, legumes and wholegrain bread and rice.
  • At least once a week eat some lean meat such as chicken and fish.
  • Look at the food label and try to choose foods that have a low percentage of sugar and salt and saturated fats.
  • Limit take-away and fast food meals.

Exercise regularly

It’s recommended that you do at least 30 minutes of physical activity most days of the week  – exercise leads to increased strength, stamina and energy.

The key is to start slowly and gradually increase the time and intensity of the exercise. You can break down any physical activity into three ten-minute bursts, which can be increased as your fitness improves

Drink plenty of fluids and listen to your thirst.

If you are thirsty, make water your first choice. Water has a huge list of health benefits and contains no kilojoules, is inexpensive and readily available.

Sugary soft drinks are packed full of ‘empty kilojoules’, which means they contain a lot of sugar but have no nutritional value.

Some fruit juices are high in sugar and do not contain the fibre that the whole fruit has.

The role of the kidneys is often underrated when we think about our health.

In fact, the kidneys play a vital role in the daily workings of your body. They are so important that nature gave us two kidneys, to cover the possibility that one might be lost to an injury.

We can live quite well with only one kidney and some people live a healthy life even though born with one missing. However, with no kidney function death occurs within a few days!

The kidneys play a major role in maintaining your general health and wellbeing. Think of them as a very complex, environmentally friendly, waste disposal system. They sort non-recyclable waste from recyclable waste, 24 hours a day, seven days a week, while also cleaning your blood.

Most people are born with two kidneys, each one about the size of an adult fist, bean-shaped and weighing around 150 grams each. The kidneys are located at both sides of your backbone, just under the rib cage or above the small of your back. They are protected from injury by a large padding of fat, your lower ribs and several muscles.

Your blood supply circulates through the kidneys about 12 times every hour. Each day your kidneys process around 200 litres of blood. The kidneys make urine (wee) from excess fluid and unwanted chemicals or waste in your blood.

Urine flows down through narrow tubes called ureters to the bladder where it is stored. When you feel the need to wee, the urine passes out of your body through a tube called the urethra. Around one to two litres of waste leave your body each day as urine.

Resource Library

Kidneys are the unsung heroes of our bodies and perform a number of very important jobs:

  • Blood pressure control – kidneys keep your blood pressure regular.
  • Water balance – kidneys add excess water to other wastes, which makes your urine.
  • Cleaning blood – kidneys filter your blood to remove wastes and toxins.
  • Vitamin D activation – kidneys manage your body’s production of this essential vitamin, which is vital for strong bones, muscles and overall health.

All this makes the kidneys a very important player in the way your body works and your overall health.

NACCHO Aboriginal Health and #Immunisation Requirements : Pauline Hanson’s vaccination advice is ‘ignorant, dangerous and wrong, experts say

ama

 ” The ‘IF’ doesn’t belong in this sentence.

The AMA and doctors everywhere are happy to report that vaccines save lives, control and eradicate disease. Always trust a doctor before a politician.

Parents who wish to discuss health issues regarding their children, including routine immunisation, are very welcome to ask their GP.

Alternatively, ‘The Science of Immunisation:

Questions and Answers’ booklet is held in very high regard by doctors. Check it out: https://www.science.org.au/learning/general-audience/science-booklets/science-immunisation “

Australian Medical Association’s AMA Media alert 5 March

 ” DOCTORS, health experts and politicians have lashed One ­Nation senator Pauline Hanson for peddling ignorant and dangerous advice to parents about vaccinating their children, after she urged them to “go out and do their own research”.

As reported in Daily Telegraph see full report below

 “Indigenous immunisation web pages. 

These pages provide some references and information about immunisation for Aboriginal and Torres Strait Islander peoples. ”

More information Here

The No Jab, No Play policy was introduced to counter an alarming drop-off in the rate of vaccination, which was exposing children to a range of deadly diseases.

Only parents of children (less than 20 years of age) who are fully immunised or are on a recognised catch-up schedule can receive the Child Care Benenifit, the Child Care Rebate and the Family Tax Benenefit Part A end of year supplement.

The relevant vaccinations are those under the National Immunisation Program (NIP), which covers the vaccines usually administered before age five.

These vaccinations must be recorded on the Australian Childhood Immunisation Register (ACIR).
• Children with medical contraindications or natural immunity for certain diseases will continue to be exempt from the requirements.
• Conscientious objection and vaccination objection on non-medical grounds will no longer be a valid exemption from immunisation requirements.
• Families eligible to receive family assistance payments and have children less than 20 years of age, who may not meet the new immunisation requirements, will be noti ed by Centrelink.
• To support these changes, the ACIR is being expanded. From 1 January 2016, you will be able to submit the details of vaccinations given to persons less than 20 years of age to the ACIR.

Download Fact File Here no-jab-no-pay

greg-hunt

Pauline Hanson’s vaccination advice is ‘ignorant, dangerous and wrong, experts say

Ms Hanson’s outspoken comments — in which she also appeared to liken the government’s No Jab, No Pay policy to blackmail and the actions of a “dictatorship” — were also linked to previous remarks she has made that seem to connect vaccinations with autism.

“What I’ve heard from parents and their concerns about it … and what I have said is I advise parents to go out and do their own research with regards to this,” Ms Hanson said.

The right-wing senator went on to argue that parents needed to “make an informed decision”.

“What I don’t like about it is the blackmailing that’s happening with the government,” she told ABC TV. “Don’t do that to people. That’s a dictatorship. And I think people have a right to investigate themselves.”

NSW Health Minister Brad Hazzard slammed the One ­Nation leader’s comments, saying: “Those who claim the right to represent and safeguard the community shouldn’t apply hocus pocus pixieland critiques of otherwise extremely well-founded, evidence-based scientific immunisation programs.”

Opposition health spokesman Walt Secord said he shook his head “in total disbelief” at Ms Hanson appearing “on ­national television linking arms with the anti-vaxxers”.

The Australian Medical Association’s NSW president, Brad Frankum, labelled Ms Hanson’s remarks “very disappointing and really quite ignorant”.

“The way she has framed it is that somehow a non-medical parent is going to make a more informed decision about the value of vaccination than the entire medical profession,” Professor Frankum said.

“That’s very dangerous, really. It is going to give people the idea that they can avoid vaccination (for their kids).”

Prof Frankum also took aim at Ms Hanson’s apparent attack on the government’s No Jab, No Play policy, which prevents parents from receiving childcare rebates and certain other welfare payments if they have not properly vaccinated their children.

“It is not forcing parents to vaccinate their children but it’s sending the message that the government is trying to look after children,” he said.

Some groups continue to link vaccinations to autism and claim they pose serious health risks, but the study that popularised the supposed link has since been discredited and debunked.

The No Jab, No Play policy was introduced to counter an alarming drop-off in the rate of vaccination, which was exposing children to a range of deadly diseases.

“If parents choose not to vaccinate their children, they are putting their children’s health at risk and every other person’s children’s health at risk too,” Prime Minister Malcolm Turnbull said yesterday.

NACCHO Aboriginal #prevention Health : #ALPHealthSummit : With $3.3 billion budget savings on the table, Parliament urged to put #preventivehealth on national agenda

prevention-copy

 ” Recently the Federal Government has spoken in favour of investment in preventive health.

 In an address to the National Press Club in February this year, Prime Minister Malcolm Turnbull said, “in 2017, a new focus on preventive health will give people the right tools and information to live active and healthy lives”.

Health Minister Greg Hunt echoed that sentiment on 20 February announcing the Government was committed to tackling obesity.

Prevention 1st, however, argues the need for a more comprehensive, long-term approach to the problem. Press Release

mathew-cooke

NACCHO was represented at the #ALPHealthSummit by Chair Matthew Cooke pictured above with Stephen Jones MP

Leading health organisations are calling on the Commonwealth to address Australia’s significant under-investment in preventive health and set the national agenda to tackle chronic disease ahead of Labor’s National Health Policy Summit today.

Chronic disease is Australia’s greatest health challenge, yet many chronic diseases are preventable, with one third of cases traced to four modifiable risk factors: poor diet, tobacco use, physical inactivity and risky alcohol consumption.

Adopting preventive health measures would address significant areas flagged as critical by the both major parties, including ensuring universal access to world-class healthcare, preventing and managing chronic disease, reducing emergency department and elective surgery waiting times, and tackling health inequalities faced by Indigenous Australians.

prevention-copy-2

Prevention 1st – a campaign led by the Foundation for Alcohol Research and Education (FARE), the Public Health Association of Australia (PHAA), Consumers Health Forum of Australia (CHF Australia), and Alzheimer’s Australia – is urging the ALP to adopt the group’s Pre-Budget submission recommendations as part of the party’s key health policy framework.

FARE Chief Executive Michael Thorn says it is up to federal policymakers to address Australia’s healthcare shortfalls and that Labor has the perfect opportunity to reignite its strong track record and lead the way in fixing the country’s deteriorating investment in preventive healthcare.

“Australia’s investment in preventive health is declining, despite chronic disease being the leading cause of illness in Australia. Chronic disease costs Australian taxpayers $27 billion a year and accounts for more than a third of our national health budget. The ALP has both the opportunity and a responsibility as the alternate government to set the national agenda in the preventive healthcare space. Ultimately, however, it falls to the Government of the day to show leadership on this issue,” said Mr Thorn.

Its Pre-Budget submission 2017-18, Prevention 1st identifies a four-point action plan targeting key chronic disease risk factors.

Prevention 1st has called for Australia to phase out the promotion of unhealthy food and beverages, and for long overdue national public education campaigns to raise awareness of the risks associated with alcohol, tobacco, physical inactivity, and poor nutrition. Under the proposal, these measures would be supported by coordinated action across governments and increased expenditure on preventive health.

The costed plan also puts forward budget savings measures, recommending the use of corrective taxes to maximise the health and economic benefits to the community. Taxing products appropriate to their risk of harm will not only encourage healthier food and beverage choices but would generate much needed revenue – around $3.3 billion annually.

With return on investment studies showing that small investments in prevention are cost-effective in both the short and longer terms, and the opportunity to contribute to happier and healthier communities, Consumers Health Forum of Australia Chief Executive Officer Leanne Wells urged both the Australian Government and Opposition to take advantage of the opportunity to stem the tide of chronic disease.

“There is an obvious benefit in adopting forward-thinking on preventive healthcare to reduce pressure on the health budget and the impact of preventable illness and injury on society,” Ms Wells said.

The ALP National Health Policy Summit will be held at Parliament House in Canberra on Friday 3 March.


View the submission

View media release in PDF

NACCHO Aboriginal #SUDI Children’s Health : Queensland leads the way with #Pepi-Pods safe co-sleeping spaces

 pepi-pod-baby

” The Pēpi-Pod® Program, comprising a safe sleep enabler, safe sleeping parent education and safety briefing; and family commitment to share safe sleeping messages in social networks, was delivered to Aboriginal and Torres Strait Islander families with identified SUDI risks, recruited through Queensland maternal and child health services (n=10 services, 25 communities) across metropolitan, regional and rural/remote areas.”

From the Pepi-Pod Program Website

 ” Hundreds of Aboriginal and Torres Strait Islander newborns will be tucked safely into bed with funding for more safe co-sleeping spaces. 

Mothers in Aboriginal and Torres Strait Islander communities will be provided with a Pēpi-Pod for their babies to sleep safely in, as well as access to a safe sleeping education program in a bid to cut infant deaths.

The safe sleeping program is a partnership between the Department of Communities, Child Safety and Disability Services, Queensland Health, University of the Sunshine Coast, the Queensland Aboriginal and Islander Health Council, Rural Doctors Association for Queensland Foundation and Red Nose.”

Premier Annastacia Palaszczuk said the Queensland Government would provide $100,000 to continue the roll-out of a safe sleeping program in Indigenous communities, including 600 Pēpi-Pods for young mothers aged 15-25 years.

“Safe sleeping arrangements are absolutely vital and provide a starting point to keep babies and young children safe at home,” she said.

“Sudden Unexpected Death in Infancy (SUDI) is one of the leading causes of death amongst infants and in some cases may be preventable with the right education and support.

“Pēpi-Pods have made a real difference in helping reduce infant mortality in New Zealand by up to 30 per cent over the last four years, so I’m pleased that hundreds of young Indigenous mothers right here in Queensland will be able to use them, in conjunction with education and health support.”

Minister for Child Safety Shannon Fentiman said The Queensland Family and Child Commission 2015-16 report into Queensland child deaths found half of infants who died from sudden unexpected death were sleeping with one or more people at the time of death.

“We know co-sleeping can increase the risk of sudden unexpected death and fatal sleep accidents, especially for babies less than 12 weeks of age,” she said.

“The rates of sudden unexpected death are around four times higher among Indigenous infants than non-Indigenous infants,” she said.

“We know that co-sleeping can be a risk factor associated with sudden unexpected deaths in some circumstances, which is why we’re focusing this trial on the delivery of education and support for high-risk young women.”

Pēpi-Pod’s are a safe sleep enabler, which provides physical protection around a baby when they are asleep in places where the risk of suffocation is heightened, for example, on adult beds, couches or in makeshift beds.

The Pēpi-Pod Program is made up of a portable sleeping space designed for babies up to five months, which includes appropriate bedding, and is embedded in safe sleep education and a family commitment to spreading safe sleep messages within their own social network.

The program was first introduced in Queensland as a research trial led by Professor Jeanine Young from the University of the Sunshine Coast in collaboration with New Zealand’s Change of our Children social innovation organisation and Queensland Health in 2012.

Professor Young said babies thrive when they are kept close to their mothers.

“We have had strong support from health services participating in the study,” she said.

“This program is all about valuing and maintaining the cultural values of keeping babies close, but also ensuring baby has a safe place to sleep, particularly when there are other risk factors present.

“Safe sleeping advice needs to be evidence-based but also transferable in a way that is practical, acceptable and valuable for families caring for their babies.

“The Pēpi-Pod Program helps families move safe sleep advice to safe sleep action.”

Ms Fentiman said an education and awareness program, including antenatal workshops, will be rolled out in conjunction with the Pēpi-Pod Program through local community-controlled health networks.

“The Queensland Government and Family Matters are also working together to develop an action plan that lays the platform for our efforts to improve the lives of Indigenous people and ensure that their children are safe, healthy and have the same opportunities as other Queensland children,” she said.

Background

Co-sleeping is a culturally valued practice by many Indigenous families, however is associated with sudden unexpected death in infancy (SUDI) in hazardous circumstances. This study aimed to evaluate a safe sleep strategy in collaboration with Aboriginal and Torres Strait Islander families with high risk for SUDI.

A project team from USC have collaborated with Change for our Children Limited in New Zealand for the first trial of a safe sleep enabler in Australia. The Pēpi-Pod Safe Sleep Program was initiated in New Zealand by Change for our Children in 2011 as a public health response for babies at a higher risk of SUDI.

Methods

The Pēpi-Pod® Program, comprising a safe sleep enabler, safe sleeping parent education and safety briefing; and family commitment to share safe sleeping messages in social networks, was delivered to Aboriginal and Torres Strait Islander families with identified SUDI risks, recruited through Queensland maternal and child health services (n=10 services, 25 communities) across metropolitan, regional and rural/remote areas.

Results

Program acceptability and feasibility was established and raised awareness of safe sleeping in communities. Families reported benefits including safety, convenience and portability. Partnering health services reported that the program was feasible, flexible, sustainable, and built local workforce capacity with integration into current service models.

Awards

This project was recognised with two national awards in 2014:

  • Winner, HESTA Australian Nursing Awards – Team Innovation
  • National Winner, National Lead Clinicians Group Award for Excellence in Innovative Implementation of Clinical Practice (Indigenous Health Category).

Conclusion

This is the first evaluation of a safe sleep enabler in Australia. Evaluating innovative and culturally respectful strategies to reduce SUDI risk through enabling safe sleep environments, which support community ownership, develop multidisciplinary team skills, and reorient services from safe sleep advice to safe sleep action, will better inform the evidence-base used by educators, clinicians, researchers and policy makers in supporting parents and reducing infant deaths.

More information

Please contact Professor Jeanine Young, Chief Investigator, Australian Pepi-Pod® Program.

Recruitment information for partnering sites in the Pēpi-Pod® Program:

For more information about the New Zealand and Australian Pepi-Pod® Safe Sleep Program please see Introducing the Pepi-Pod Safe Sleep Program and Change for our Children website.

Aboriginal Health #Sugartax debate : Sugar consumption is critical to reducing chronic health conditions, including diabetes says NACCHO

sugar-tax

“The high costs of transporting food and groceries to remote communities mean that Aboriginal and Torres Strait Islander people in these areas are already paying inflated prices for these types of products, and all other grocery items.

“These communities are also less able to pay higher costs and have limited access to alternatives, particularly fresh fruit and vegetables – which, because of the long distances they need to be transported, are often past their prime and overpriced when they arrive,”

“Reducing sugar consumption is critical to reducing chronic health conditions, including diabetes; however, there needs to be more work done on how these issues would be overcome before NACCHO could support any tax-based approach such as a sugar tax.”

Chair Matthew Cooke from peak Indigenous health body, National Aboriginal Community Controlled Health Organisation (NACCHO) has expressed reservations about the tax to MJA InSight.

See NACCHO Previous obesity articles HERE

 “sugary drinks were “killing the population” in remote communities, after the senate heard evidence of an “astounding” level of soft drink sales at remote community stores.

Senator Scullion said he has been working with remote stores to restrict the sale of larger bottles of soft drink.

“I’ve been trying to negotiate the two litre and 1.5 litres off the shelves completely,”

“It’s a difficult thing but the evidence shows that whatever portion you buy, a child will drink oneand-a-half litres.”

More recently he went to a community store where water was free, but despite trying to “hide the full-strength coke” it was the popular choice.

He gave one example where a remote community store was drawing half of its total profits from soft drink sales.

“It was the most expensive liquid in that store and everyone went straight there,”

Indigenous affairs minister, Nigel Scullion,

 ” TAXES on unhealthy foods, not subsidies on fruit and vegetables, are effective at reducing the burden of obesity, new research suggests, amid renewed clamour for a sugary drinks tax.

Researchers at the University of Melbourne have found that a subsidy on fresh fruit and vegetables would not on its own produce health gains, because it would lead to an undesirable increase in sodium and energy intake.”

Authored by Sarah Colyer from MJA Insight

However, adding a subsidy to a package of taxes on sugar, fat, salt and sugar-sweetened beverages could be effective, they wrote. The combination of taxes plus the subsidy could avert 470 000 disability-adjusted life years and save $3.4 billion from the health budget, the modelling study found.

The study drew on detailed New Zealand price–elasticity data – which track variations in product uptake with changes in product prices – to quantify disease risk reductions associated with each change in risk factor exposure.

A sugar tax would be most cost-effective, the study found, followed by a salt tax, a saturated fat tax and a sugar-sweetened beverages tax.

Writing in the journal PLOS Medicine, Dr Linda Cobiac and colleagues said that their findings added to the “growing evidence of large health benefits and cost-effectiveness of using taxes and regulatory measures to influence the consumption of healthy foods”.

The findings about the subsidy might at first appear counterintuitive, they said.

“However, using price subsidies or discounts as an incentive to purchase more fruits and vegetables may have the effect of increasing real income available to buy food, including unhealthy products, and could therefore lead to an overall increase in dietary measures such as saturated fat, sodium, or total energy intake,” they wrote.

The federal government is facing growing pressure from public health advocates to tax sugary drinks, with the Australian Greens pledging to introduce a bill on the measure later in 2017.

Writing in the MJA, the University of Sydney’s Professor Stephen Colagiuri urged the government to make the tax a priority as part of a multicomponent strategy against obesity.

That call was echoed in a separate report released last week by the Obesity Policy Coalition, whose member organisations include Cancer Council Victoria, Diabetes Australia (Victoria) and Deakin University.

In his MJA article, Professor Colagiuri cited the introduction of Mexico’s sugary drinks tax in 2014, which was followed by a 12% decline in the consumption of taxed beverages and a spike in bottled water consumption.

“The ongoing impact of [Mexico’s] tax has been challenged with new data suggesting a small increase in sales of SSBs [sugar-sweetened beverages] in 2015, but still lower than the increase in pre-tax sales,” he wrote.

“Arguments that an SSB tax is an ineffective means to reduce consumption are inconsistent with food industry claims of potential damage and job losses, which instead may point to the industry believing that a tax would substantially impact consumption.”

Professor Colagiuri noted that Australia was among the largest global markets for sugar-sweetened beverages, with males aged 4–30 years drinking an average 750 mL (two cans) per day.

“Government pays for health services and consequently has a right and duty to address externalities to promote and protect public health,” he wrote.

However, the federal government last week continued its resistance to any form of sugar tax, with health minister Greg Hunt commenting: “We’re committed to tackling obesity, but increasing the family’s weekly shop at the supermarket isn’t the answer.”

Decrying the proposed tax as a “nanny state” response, assistant minister for health, Dr David Gillespie, noted that Denmark had repealed its sugar tax and dropped plans for a tax on saturated fats.

Indigenous affairs minister, Nigel Scullion, said in 2016 that sugary drinks were “killing the population” in remote communities, after the senate heard evidence of an “astounding” level of soft drink sales at remote community stores.

David Butt, CEO of the National Rural Health Alliance told MJA InSight that his organisation supported “the possibility of taxing sugar-sweetened beverages and using the revenue to subsidise access to healthier food options”.

Professor Andrew Wilson, director of the Menzies Centre for Health Policy at the University of Sydney, said that compared with taxing sugar per se or salt, the proposed tax on sugary drinks had “the virtue of being fairly easy to define”.

“However, these drinks are so cheap to make that the tax will need to be substantial,” he added.

A recent report by the Grattan Institute recommended that sugar-sweetened beverages be taxed at a rate of 40 cents per 100 grams of sugar, increasing the price of a 2-litre bottle of soft drink by 80 cents. This would raise about $500 million a year, according to the Grattan Institute, which predicted a resultant 15% drop in consumption of sugary drinks and a small decrease in obesity rates.

Professor Wilson stressed that any taxation approach should be “part of a package that includes education and support for good nutrition, promotion and facilitation of physical activity, with particular focus on school-aged and older teens, planning considerations and, possibly for some areas and groups, subsidies for fruit and vegetables”.

Dr Cobiac agreed, commenting: “Our modelling shows that the potential health benefits of using taxes and subsidies to improve dietary choices and the nutritional quality of our foods in Australia are huge, but ultimately, they are just one of a number of measures that are needed to tackle obesity.”

Dr Cobiac noted that 13 other countries had announced taxes on unhealthy foods or sugar drinks in the past 5 years.

“It was true that Denmark had revoked its policies,” she said; however, she added that it was likely that as early initiators “they did not fully foresee or plan for dealing with the resulting backlash from the food industry”.

“We will never know what effect the taxes would have had in Denmark; they were repealed before there was a chance to properly evaluate them,” Dr Cobiac said.

“While many people want to eat better and lose weight, it is not easy to sustain the changes in behaviour when we live in an environment where unhealthy foods are widely available, heavily marketed and cheap.

“That environment is unlikely to change without a really comprehensive strategy to tackle the obesity problem.”

Please leave your comment below

7 thoughts on “Sugar tax: what you need to know”

    1. Anonymous says:

      This debate has been going around and around for far too long. In the meantime, overweight and obesity rates are increasing. Public health advocates need to change tack and get on with their ‘real’ jobs to make a positive difference. Scrap the idea of additional taxes on processed foods. And as for ‘modelling studies’ to underpin an evidence base to guide action. We know what to do: listen to people demonstrating ‘Lived Experience’.

    1. Andrew says:

      I second the previous comment. “Modelling” is not evidence. Let’s see real world evidence first — does a tax on sugar actually reduce obesity rates? That is the only evidence that counts.

      As a side point, imposing a “sugar tax” will cause food manufacturers to substitute sugar with other sweeteners, e.g. stevia. The long term health implications of stevia (and other additives) are unknown. Of course public health “experts” love to pretend that they are omniscient and infallible, but some caution is warranted. Let’s not repeat the massive public health failures of the past, such as the notorious food pyramid which was based on the flimsiest of evidence.

    1. Dr Rosemary Stanton says:

      We do know what to do, but the political power of the processed food industry means we get obstruction to anything that might decrease sales of its products. Junk food and drinks contribute 35% of adults’ and over 40% of children’s energy intake. That is the elephant in the room and we need multiple actions to tackle it. A sugar tax is one that is simple to implement, especially applied to drinks.

      Even more importantly, we need to stop promoting junk food and drinks. That means stopping advertising these products during TV programs that children watch. It means sporting teams and sports heros not acting as walking billboards. It needs bans on advergames for children where product placement of junk foods and drinks are visible for the time spent playing the game – which may be 30 minutes. It needs schools to stop selling children junk food and drinks from the school canteen (which negates anything they might learn in the classroom).

      We also need to talk about foods rather than nutrients. The Dietary Guidelines talk about foods. Sadly, almost no one follows them – as shown by the fact that less than 7% eat even the minimal amount of vegetables and fruit recommended, and junk food consumption is so high.

    1. Roger McMaster-Fay MRCOG FRANZCOG says:

      Oh great, another tax and it worked so well on cigarettes!. We are one of the most highly taxed countries in the world! We need a new paradigm to tackle this problem and we doctors should be able to come up with one. What about tax deductions for people who loose weight?

    1. Dr. ARC says:

      Lot’s of salient comments from Rosemary and Roger. I do not believe that drinks alone are the major cause of obesity. As always if you put more calories in than you need or use in exercise the extra calories are stored as fat, period! We need to return to the era of good home cooking and stop eating out at expensive restaurants and quick take away options which are loaded with fat and sugar. Then and only then can we begin to tackle the problem of obesity.

    1. Virginia Fazio says:

      What will the food industry use to replace ingredients that are taxed? Instead of sugar in foods will they use starches and intense sweeteners? Metabolically very little difference between starch and sugar. Will saturated fat be replaced with unsaturated fats that may be less heat stable and produce byproducts may have other health risks? Will consumers go back to adding more salt during cooking and at the table to processed foods with lower salt levels? Research needs to be on the whole diet outcomes if some processed foods carry an additional tax. We know that how the food industry meet consumer demand for low cholesterol and low saturated fat foods did not always result in a “healthy” food. Perhaps as a community we need improved cooking and gardening skills so we rely less on highly processed foods.

  1. Andrew Jamieson says:

    Education, education, education!! Where is ‘health’ on the syllabus at our schools? What public education is there on nutrition despite the valiant efforts of the likes of Rosemary Stanton. We might as well tax cars even more more as we kill lots of people with them! And it has been well pointed out that sugar alone is not responsible for our health woes. Logically we need more put GST on food, however no government would seriously consider this

 

NACCHO Aboriginal #Healthmatters : @AustralianLabor National #HealthPolicy Summit Agenda this week and getting evidence into health policy

smoking-nr

Question to the Honourable Nicola Roxon, former Australian Labor Minister for Health and Ageing (2007–2011) : Can you give an example of this more courageous leadership during your time as minister?

A: One example is a cause close to my heart: Australia’s introduction of plain packaging for tobacco products. We are proud to be world leaders in introducing our shocking and ugly plain packs, and even more proud of the lively discussion and action it is generating elsewhere around the world on the future of tobacco control.

Picture above : Lessons learnt : Plain packaging for tobacco products is a great example of implementing good health policy where trusted health organisations worked across political groups, provided expert research and supported the government to take action

What’s planned for this weeks Labor National Health Policy Summit 

According to the Federal Opposition, Labour will build on a legacy as the party of health care reform by hosting a National Health Policy Summit next Friday 3 March in Canberra , led by Leader of the opposition Bill Shorten and Shadow Minister for Health Catherine King :

See interim Full day Agenda below

 “One of the most challenging aspects of the current Government is the complete lack of any vision for health in Australia. Instead of building our health system up and preparing for the future, the tenure of the Abbott/Turnbull Governments has been characterised by cuts and chaos.

Not only does our health system deserve more – it needs more. The government simply isn’t filling this space, so Labor will.”

The National Health Policy Summit will put the people who know best at the centre of health discussions – giving patients, providers, stakeholders and experts a much-needed voice in health reform.

It will give representatives the chance to not only contribute to our health debate, but to challenge the direction of our health system.

Labor has a long history of reforming Australia’s healthcare system for the benefit of all.”

 NACCHO Note : Both NACCHO and Croakey will be covering

croakey-new

See Croakey Coverage

We welcome articles and press releases from all political parties

Interview with the Hon. Nicola Roxon:

Getting evidence into health policy

Editor-in-Chief of Public Health Research & Practice, Don Nutbeam spoke to the Honourable Nicola Roxon, former Australian Labor Minister for Health and Ageing (2007–2011), to gain some insight into the process, and advice on how to engage most productively with government.

Q: Often ministers and policy makers must try to make good policy decisions in areas where evidence is incomplete or contested. What strategies or processes did you employ when trying to make good public health decisions at a federal level when the evidence was insufficient? What were the main challenges involved and how did you overcome them?

A: I think it is very rare for ministers or governments to want to make decisions where evidence is incomplete or contested (provided the contest is real, not fabricated by vested interests). There are so many competing, worthy, evidence based causes – especially in health – that these will usually be given priority. However, in a crowded political agenda, having a worthy cause isn’t always enough to capture the imagination of government. The biggest single mistake I saw when I was Health Minister was repeated over and over again, by decent, hard-working researchers, medicos and advocates – and it was the naive assumption that, because they were working on something good, or had developed a worthy project, the government would therefore act on it.

As a minister, I was able to act on some fabulous ideas, and I’m proud of that. But many good ideas were not acted upon – often because of financial constraints, but also many other reasons played a role.

Just because your idea is good, even worthy, isn’t enough.

Q: So, how does evidence inform policy decisions in the real world?

A: To get real decisions and actions in your area, you must think closely and carefully about who you are putting your evidence to, their needs and priorities, and why your proposal will help them. In a world where most interventions cost money – and, in health, usually a lot of money – simply appealing to their good nature is too simplistic. You need to make it easy for decision makers to see how acting on your idea is worth taking up time, money and political energy.

Knowing what is going on in the decision maker’s portfolio, what is troubling them, what is taking up their time and giving them sleepless nights helps you find a way to fit your issue into their thinking space. Start by putting yourself in the position of the minister you want to take action. Do you know what they are trying to achieve? Have you read any of their speeches or policies or recent interviews? Demonstrating your understanding of their issues and pressures is good manners, but also helps you shape your pitch to their current interests or pressures.

For example, when the Australian Government announced health reform negotiations with the states, a few groups came to us with proposals that could be part of those discussions. Not all were successful, but it showed they were tuned in to opportunities, and ready to make the most of them in a way that might suit government.

Even a scandal or problem can sometimes be a chance to offer a helpful solution. It might help solve the problem, or detract from it! Either way, this might be welcome.

The more in tune you are with the decision maker’s pressures, the more likely you are to be agile and think laterally, to find good opportunities to raise your cause at the right time.

Q: When these opportunities present themselves, what is the best way to communicate?

A: Are you clear on what you would say and how you would say it if you got a brief chance to pitch your idea? A lot of people talk about having an ‘elevator pitch’ – this is the idea of what you would say if you were, by good luck, in an elevator with the decision maker. Could you explain your idea simply? And quickly enough?

The aim is to first capture the imagination of the decision maker – get them to be interested in your idea, impressed with your focus and your offer to help them.

I had too many meetings to recall where people tried to download 20 years of in-depth research in a 10-minute meeting – the minister needs to know it is there, to appreciate your expertise or credibility, but they don’t need to be able to present a paper on it to the next technical meeting of the World Health Organization (WHO)!

Stick to the headline message or your core thesis to support a proposal – then you can leave the detailed summary for an adviser or official to mull over.

What you want from your meeting is to spark enough interest that the minister asks for more work to be done on your issue – not that they decide to write a book on it. Worse, your clear message will be diluted or lost if you try to do too much in a short meeting.

Q: What do you say to the researchers who feel that their work is ignored?

A: I am frustrated that governments are almost universally criticised for not taking action on public health. Sometimes that criticism of governments is fair and well based. We are right to expect courage and leadership from our governments. But, in truth, criticism of governments is also sometimes lazy. It can be easier to criticise a government for not acting on your issues than to ask whether you’ve done all you can to help them take that decision.

From the perspective of a former minister, I want to urge researchers, advocates and clinicians to assess whether they have done all they can to create a fertile environment to encourage government leadership. When they do, governments will provide leadership.

Q: Can you give an example of this more courageous leadership during your time as minister?

A: One example is a cause close to my heart: Australia’s introduction of plain packaging for tobacco products. We are proud to be world leaders in introducing our shocking and ugly plain packs, and even more proud of the lively discussion and action it is generating elsewhere around the world on the future of tobacco control.

I have been very flattered, and often overwhelmed, by the recognition I get from introducing this measure. But the truth that ought to be acknowledged is that there were many people and many factors that made this courageous public health decision a good one for government, and easier than people imagine.

What made us choose this courageous path, when there were so many other competing issues on the table? It offers a good case study about advocacy.

The work of so many researchers, advocates, doctors, past governments, journalists and ordinary Australians moved this seemingly courageous decision into a political ‘sweet spot’. Ultimately, it was a good policy decision that was good politics too.

It was an inexpensive policy with high impact; a policy with lots of supporters and a disliked opponent (the tobacco industry); a highly visible policy that complemented other measures important to the government, but perhaps less ‘sexy’.

On each of these issues, advocates and supporters of the initiative sought to make the necessary links to our broader health reforms, our fresh focus on prevention and our interest in Indigenous health.

And it helped that the public had responded well in the past to tobacco control interventions, showing the huge benefits of a comprehensive approach to tobacco control measures. The research was strong, and the international treaty on tobacco (the WHO Framework Convention on Tobacco Control) supportive.

Q: What role would you expect from civil society in this process?

A: The Cancer Council and Heart Foundation in Australia were the rolled-gold best examples of this on plain packaging – they worked across political groups, and had expert research as well as highly responsive media teams. They are trusted voices for consumers and were prepared to use that voice to not just criticise, but to help government act, as well. Their expertise and advice were vital.

Their advice on potential problems was also invaluable to the government. In tobacco control, you need a good working knowledge of international tobacco control developments and global industry tactics. Being carefully prepared for attacks is smart for governments, but just as vital is for other civil society participants to be ready to explain to the media or to parliamentary committees.

Q: What of more contested issues, such as alcohol regulation and tackling obesity in the population?

A: In Australia, it has been harder to garner support for strong interventions on alcohol and obesity. On obesity in particular, the mixed approaches from advocates and researchers about what is needed to be successful have made it more difficult for governments to act decisively. When multifactorial approaches are likely to be needed, this can make the ‘ask’ confusing – governments often want a clear plan, or a clear starting point. In some public health areas, it is often hotly contested where one should start.

With alcohol, at least in Australia, it is sometimes difficult to find the lever. Do we target individuals or the community? Consumers or business? And it can be even more perplexing with food, where mixed messages make the need to improve public awareness of the risks of obesity even more complicated.

The challenge to advocates on these issues and most other public health priorities is to find that lever – the right lever, at the right time for the decision maker you are trying to convince. Be careful, of course, not to weaken the argument by going in too many directions at once.

Developing alliances across consumers, clinicians, advocates and researchers will always be very powerful. The same proposal from multiple groups gives your argument weight and depth. Instead of all asking for something slightly different, if you can agree on one major initiative or a good starting point, it is a very much more convincing request. It automatically lifts it above the 20 other meetings and requests the minister has that day. You can be confident that everyone else asking the minister for something that day will probably not have done that work – so it is a way to make your cause better and more attractive, easier to sit up and take notice.

bill-a-ck

What’s planned for the Summit

Labor says the Summit will bring together more than 130 of Australia’s leading thinkers on health to be part of roundtable discussions via a packed program, with two blocks of four concurrent sessions, led by Shadow Ministers and leading health figures.

The event will begin with a welcome from Shadow Health Minister Catherine King and a keynote from Opposition Leader Bill Shorten and will end with a panel discussion between chairs to report back on the following policy roundtables (see also the co-chairs, some who are still to be announced).

1.Opportunities and challenges in our health sectors

Protection, prevention and promotion

Public Health Association of Australia CEO Michael Moore
Stephen Jones, Shadow Minister for Regional Services, Territories and Local Government Stephen Jones.

  • the preventable chronic disease crisis
  • risk factors
  • protective factors

Primary, secondary and community care

 Sharon Claydon, Chair, Medicare Caucus Committee

  • general practice
  • specialist primary health
  • allied health
  • pathology & imaging
  • pharmacy & medicines
  • dental

 Hospitals

Brian Owler, former President, Australian Medical Association

  • post-2020 public hospital funding
  • reducing emergency department and elective surgery waiting times
  • interaction between public and private hospitals
  • private health insurance
  • improving quality, safety and value in hospitals
  • outpatient clinics

Mental health and suicide prevention

Frank Quinlan, Mental Health Australia and Sue Murray, Suicide Prevention Australia
Julie Collins, Shadow Minister for Ageing and Mental Health

Mental health priorities

  • Mental health reform
  • Measuring outcomes
  • Stigma and awareness
  • Workforce

Suicide reduction priorities

  • Early intervention and prevention
  • Integrated services
  • Research and data collection

2.Where to for health reform?

Ensuring universal access for all Australians

Dr Stephen Duckett, Grattan Institute
Jenny Macklin, Shadow Minister for Families and Social Services

  • access, including out-of-pocket costs and waiting times
  • integration of primary care
  • coordination of primary, secondary and acute care
  • health financing

Designing our health workforce for the future

Professor Mary Chiarella, Sydney University
Tony Zappia, Shadow Assistant Minister for Medicare

  • future health service needs
  • health workforce reform
  • Commonwealth health workforce programs

Tackling health inequality and other whole-of-government challenges

 Professor Sharon Friel, Australian National University
Mark Butler, Shadow Minister for Climate Change and Energy

  • Regional, rural and remote health
  • Indigenous health
  • Other health inequalities
  • Interface with aged care
  • Interface with NDIS
  • Other social policy issues
  • Climate change and health

Innovation across our health system

Professor Christine Bennett AO, School of Medicine, Sydney, The University of Notre Dame Australia and past Chair of Research Australia
Murray Watt, Senate Community Affairs Committee

  • Health, medical and translational research
  • eHealth and digital technologies
  • Safety and quality
  • Precision medicine
  • New technologies
  • Partnerships and collaboration.

 

NACCHO Aboriginal Health #obesity : What is the #sugartax and who reckons it’s a good idea?

obesity
 ” JUNK food would be banned from schools and sports venues, and a sugar drink tax introduced, under a new blueprint to trim the nation’s waistline.

The 47-point blueprint also includes a crackdown on using junk food vouchers as rewards for sporting performance and for fundraising.

State governments would be compelled to improve the healthiness of foods in settings controlled by them like hospitals, workplaces and government events.

And they would have to change urban planning rules to restrict unhealthy food venues and make more space for healthy food outlets. “

Download the 47-point blueprint Report here :

aust-summary-food-epi-report

 ama

 NACCHO Aboriginal Health and #Obesity #junkfood : 47 point plan to control weight problem that costs $56 billion per year

 

” In 2014-15, 63.4% of Australian adults were found by the National Health Survey to be overweight or obese. In response to Australia climbing up the ladder of the most obese countries in the world, professor Stephen Colagiuri, a diabetes expert at the University of Sydney, has urged the government to introduce a sugar tax to dissuade people from consuming sugary foods.”

Sophie Heizer Crikey intern

But what if you live in a place where you don’t have easy access to fresh food? What if the Macca’s down the road is within walking distance, but you have to jump in the car and drive for miles to get to the nearest supermarket? That’s called a food desert, and the sugar tax could have a bigger impact on people who live in those areas.

What is the sugar tax?

At this point, it is a recommendation from some health experts, which would place a levy on sugary drinks in order to mitigate obesity rates.

A report from the World Health Organization (WHO) says that a tax of 20% or more results in the drop of soft drink sales, which they say would also cut healthcare costs if it succeeded in improving health outcomes.

The Grattan Institute has suggested a tax of 40 cents per 100 grams of sugar, and calculated that obesity costs Australians $5.3 billion a year. The savings they have projected would mean an extra $500 million for the budget.

Is there support for the sugar tax?

The WHO called for a tax on sugary drinks across the world in October 2016 to curb the effects of sugary drinks on health.

Many health researchers also advocate for the tax as well. Dr Belinda Reeve from the University of Sydney writes that there needs to be more things done at the same time to reduce obesity rates and the risk of diabetes, but the tax could be effective in Australia, as the tobacco tax has been.

The Greens have released a statement saying that if the government doesn’t act on the issue, they will draft a private senator’s bill and introduce it to the Senate by the end of 2017.

Who is against it?

The Turnbull government, Labor, and senators Pauline Hanson and Derryn Hinch have all rejected the idea of imposing a sugar tax.

Minister for Health Greg Hunt has said the government was taking action in other ways: “We’re committed to tackling obesity, but increasing the family’s weekly shop at the supermarket isn’t the answer.”

Pauline Hanson said she would not support the tax because she believes it’s high time people take responsibility for what they put in their mouths, and Derryn Hinch said the tax would be unfair and unworkable.

Labor leader Bill Shorten said the opposition had no plans for a sugar tax, but said it was probably time to “toughen up advertising restrictions around junk food at peak periods when the little eyeballs are on the TV and getting all the wrong messages about food and healthy eating”.

What is a food desert?

A food desert is an area where there are no fresh fruit or vegetable outlets within a 500-metre radius. They are also defined by limited access to shops that sell healthy foods, coupled with an abundance of fast-food takeaway options within easy walking distance. These areas leave people disenfranchised by lack of access to affordable, healthy food and at a greater risk of obesity and the development of diabetes.

There have been a number of food deserts identified in Australia: Braybrook, Maidstone and West Footscray/Kingsville have been identified in Victoria, areas of western Sydney including Blacktown (where residents are three times more likely to develop diabetes) and Mount Druitt and even in wealthy areas of Canberra. Research commissioned by Anglicare and Red Cross showed that there was insufficient access to affordable and nutritionally adequate food in inner suburbs such as Kingston, Red Hill and Fyshwick, as well as Narrabundah Longstay Caravan Park, Belconnen, Weston Creek and newer suburbs in the Gungahlin region.

How would the sugar tax affect people living in food deserts?

The same kind of sugar tax was proposed in the UK. It was met with heavy resistance from the seemingly conservative lobby group, the TaxPayers’ Alliance, which cited the ineffectiveness of the tax in Mexico, the chief executive stating:

“It is astonishing that the government is pressing ahead with this pernicious tax when the evidence clearly suggests that it will simply not affect consumption in any meaningful way. As with any regressive tax, this will only raise living costs for hard-pressed families, already struggling with big tax bills. Politicians must look at the evidence and ignore the High Priests of the Nanny State in the public health lobby, and abolish the Sugar Tax before it is too late.”

Food deserts are, in particular, an issue for people of low socio-economic status (SES) and where there are people with mobility issues in the community. The tax will undeniably hit the poor and those living in food deserts harder because more of their income goes towards poor quality food, but there is evidence from studying the effectiveness of the tax in Mexico that it does decrease spending on unhealthy food products for everyone.

A research paper by PLOS One, which also supports the 20% hike in tax on sugar, states:

“We note that Australians of low SES are disproportionately affected by high rates of diet-related illnesses and are therefore likely to experience greater dietary improvements as a result of a tax on SSBs. Inequitable aspects are likely to be further ameliorated if revenue was used to support healthy eating initiatives and subsidies on healthy foods for low-SES households.”

This means the sugar tax could actually be beneficial to low-SES households in food deserts, as a result of both a shift in eating habits, and a freeing up of space in the health budget to rectify access issues in relation to cost and geography.

NACCHO Aboriginal Health and #Obesity #junkfood : 47 point plan to control weight problem that costs $56 billion per year

junk

 ” JUNK food would be banned from schools and sports venues, and a sugar drink tax introduced, under a new blueprint to trim the nation’s waistline.

The 47-point blueprint also includes a crackdown on using junk food vouchers as rewards for sporting performance and for fundraising.

State governments would be compelled to improve the healthiness of foods in settings controlled by them like hospitals, workplaces and government events.

And they would have to change urban planning rules to restrict unhealthy food venues and make more space for healthy food outlets. “

Originally published as Move to ban junk food in schools

Updated Feb 21 with press release from Health Minister Greg Hunt See below

The Australian Government is taking action to tackle the challenge of obesity and encourage all Australians to live healthy lives

“In my view, we should be starting to tax sugary drinks as a first step. Nearly every week there’s a new study citing the benefits of a sugary drinks tax and and nearly every month another country adopts it as a policy. It’s quickly being seen as an appropriate thing to do to address the obesity epidemic.”

A health economist at the Grattan Institute, Stephen Duckett, said the researchers had put together a careful and strong study and set of tax and subsidy suggestions.see article 2 below  

One hundred nutrition experts from 53 organisations working with state and federal bureaucrats have drawn up the obesity action plan to control the nation’s weight problem that is costing the nation $56 billion a year.

The review of state and federal food labelling, advertising and health policies found huge variation across the country and experts want it corrected by a National Nutrition Policy.

The nation is in the grip of an obesity crisis with almost two out of three (63 per cent) Australian adults, and one in four (25 per cent) Australian children overweight or obese.

Obesity is also one of the lead causes of disease and death including cancer.

More than 1.4 million Australians have Type 2 diabetes and new cases are being diagnosed at the rate of 280 per day.

Stomach, bowel, kidney, liver, pancreas, gallbladder, oesophagus, endometrium, ovary, prostate cancer and breast cancer in postmenopausal women have all been linked to obesity.

Half of all Australians are exceeding World Health Organisation’s recommendations they consume less than 13 teaspoons or sugar a day with most of the white stuff hidden in drinks and processed food, the Australian Bureau of Statistics Health Survey shows.

Teenage boys are the worst offenders consuming 38 teaspoons of sugar a day which makes up a quarter of their entire calorie intake.

Dr Gary Sacks from Deakin University whose research underpins the obesity control plan says it’s time for politicians to put the interests of ordinary people and their health above the food industry lobbyists

“It’s a good start to have policies for restricting junk foods in school canteens, but if kids are then inundated with unhealthy foods at sports venues, and they see relentless junk food ads on prime-time TV, it doesn’t make it easy for them to eat well,” he said.

That’s why the experts want a co-ordinated national strategy that increases the price of unhealthy food using taxes and regulations to reduce children’s exposure to unhealthy food advertising.

The comprehensive examination of state and federal food policies found Australia is meeting best practice in some areas including the Health Star Rating food labelling scheme, no GST on basic foods and surveys of population body weight.

While all States and Territories have policies for healthy school food provision they are not all monitored and supported, the experts say.

Jane Martin, Executive Manager of the Obesity Policy Coalition and a partner in the research, said a piecemeal approach would not work to turn the tide of obesity in Australia.

“When nearly two-thirds of Australians are overweight or obese, we

know that it’s not just about individuals choosing too many of the wrong foods, there are strong environmental factors at play – such as the all pervasive marketing of junk food particularly to children,” she said.

The new policy comes as a leading obesity experts says a tax on sugary drinks in Australia would be just as logical as existing mandatory controls on alcohol and tobacco

Professor Stephen Colagiuri from the University of Sydney’s Charles Perkins Centre claims a ‘sugar tax’ help individuals moderate their sugary beverage intake, in much the same way as current alcohol, tobacco, and road safety measures like seat belts and speed restrictions preventing harmful behaviours.

The UK will introduce a sugar tax next year and in Mexico a sugar tax introduced in 2014 has already reduced consumption of sugary drinks by 12 per cent and increased the consumption of water.

Australian politicians have repeatedly dismissed a sugar tax on the grounds it interferes with individual rights.

However, Professor Colagiuri says “individual rights can be equally violated if governments fail to take effective and proportionate measures to remove health threats from the environment in the cause of improving population health.”

Originally published as Move to ban junk food in schools

ARTICLE 2 Australia would save $3.4bn if junk food taxed and fresh food subsidised, says study 

fruit-and-veg

O as published in the Guardian

Australian researchers say subsidising fresh fruit and vegetables would ensure the impact of food taxes on the household budget would be negligible. Photograph: Dave and Les Jacobs/Getty Images/Blend Images

Health experts have developed a package of food taxes and subsidies that would save Australia $3.4bn in healthcare costs without affecting household food budgets.

Linda Cobiac, a senior research fellow at the University of Melbourne’s school of public health, led the research published on Wednesday in the journal Plos Medicine.

Cobiac and her team used international data from countries that already have food and beverage taxes such as Denmark, but tweaked the rate of taxation and also included a subsidy for fresh fruit and vegetables so the total change to the household budget would be negligible.

They then modelled the potential impact on the Australian population of introducing taxes on saturated fat, salt, sugar and sugar-sweetened beverages, and a subsidy on fruits and vegetables. Their simulations found the combination of the taxes and subsidy could result in 1.2 additional years of healthy life per 100 people alive in 2010, at a net cost-saving of $3.4bn to the health sector.

“Few other public health interventions could deliver such health gains on average across the whole population,” Cobiac said.

The sugar tax produced the biggest gains in health, followed by the salt tax, the saturated fat tax and the sugar-sweetened beverage tax.

The fruit and vegetable subsidy, while cost-effective when added to the package of taxes, did not lead to a net health benefit on its own, the researchers found.

The researchers suggest introducing a tax of $1.37 for every 100 grams of saturated fat in those foods with a saturated fat content of more than 2.3%, excluding milk; a salt tax of 30 cents for one gram of sodium above Australian maximum recommended levels; a sugar-sweetened beverage tax of 47 cents a litre; a fruit and vegetable subsidy of 14 cents for every 100 grams; and a sugar tax of 94 cents for every 100ml in ice-cream with more than 10 grams of sugar per 100 grams; and 85 cents for every 100 grams in all other products.

The taxes exclude fresh fruits, vegetables, meats and many dairy products.

“You need to include both carrots and sticks to change consumer behaviour and to encourage new taxes,” Blakely said. “That’s where this paper is cutting edge internationally.

“We have worked out the whole package of taxes with minimal impact on the budget of the household, so you can see an overall gain for the government. The government would be less interested in the package if it was purely punitive, but this provides subsidies and savings to health spending that could be reinvested back into communities and services.”

He said taxing junk foods also prompted food manufacturers to change their products and make them healthier to avoid the taxes.

“For those who might say this is an example of nanny state measures, let’s consider that we don’t mind asbestos being taken out of buildings to prevent respiratory disease, and we’re happy for lead to be taken from petrol. We need to change the food system if we are going to tackle obesity and prevent disease.”

A health economist at the Grattan Institute, Stephen Duckett, said the researchers had put together a careful and strong study and set of tax and subsidy suggestions. “This is a very good paper,” he said.

“In my view, we should be starting to tax sugary drinks as a first step. Nearly every week there’s a new study citing the benefits of a sugary drinks tax and and nearly every month another country adopts it as a policy. It’s quickly being seen as an appropriate thing to do to address the obesity epidemic.”

A Grattan Institute report published in November found introducing an excise tax of 40 cents for every 100 grams of sugar in beverages as part of the fight against obesity would trigger a 15% drop in the consumption of sugary drinks. Australians and New Zealanders consume an average of 76 litres of sugary drinks per person every year.

In a piece for the Medical Journal of Australia published on Monday, the chair of the Council of Presidents of Medical Colleges, Prof Nicholas Talley, wrote that “the current lack of a coordinated national approach is not acceptable”.

More than one in four Australian children are now overweight or obese, as are more than two-thirds of all adults.

Talley proposed a six-point action plan, which included recognising obesity as a chronic disease with multiple causes. He also called for stronger legislation to reduce unhealthy food marketing to children and to reduce the consumption of high-sugar beverages, saying a sugar-sweetened beverage tax should be introduced.

“There is evidence that the food industry has been a major contributor to obesity globally,” he wrote. “The health of future generations should not be abandoned for short-term and short-sighted commercial interests.”

Press Release 21 February Greg Hunt Health Minister

The Australian Government is taking action to tackle the challenge of obesity and encourage all Australians to live healthy lives.

PDF printable version of Turnbull Government committed to tackling obesity – PDF 269 KB

The Turnbull Government is taking action to tackle the challenge of obesity and encourage all Australians to live healthy lives.

But unlike the Labor Party, we don’t believe increasing the family grocery bill at the supermarket is the answer to this challenge.

We already have programmes in place to educate, support and encourage Australians to adopt and maintain a healthy diet and to lead an active life – and there’s more to be done.

Earlier this month, the Prime Minister flagged that the Government will soon be announcing a new focus on preventive health that will give people the right tools and information to live active and healthy lives. This will build on the significant work already underway.

Yesterday, we launched the second phase of the $7 million Girls Make Your Move campaign to increase physical activity for girls and young women. This is now being rolled out across Australia.

Our $160 million Sporting Schools program is getting kids involved in physical activity. Already around 6,000 schools across the country have been involved – with many more to come. This is a great programme that Labor wants to axe.

Our Health Star Rating system helps people to make healthier choices when choosing packaged foods at the supermarket and encourages the food industry to reformulate their products to be healthier.

The Healthy Weight Guide website provides useful advice including tips and tools to encourage physical activity and healthy eating to achieve and maintain a healthy weight.

The Healthy Food Partnership with the food industry and public health groups is increasing people’s health knowledge and is supporting them to make healthier food and drink choices in order to achieve better health outcomes.

We acknowledge today’s report, but it does not take into account a number of the Government programs now underway.

Obesity and poor diets are complex public health issue with multiple contributing factors, requiring a community-wide approach as well as behaviour change by individuals. We do not support a new tax on sugar to address this issue.

Fresh fruit and vegetables are already effectively discounted as they do not have a GST applied.

Whereas the GST is added to the cost of items such as chips, lollies, sugary drinks, confectionery, snacks, ice-cream and biscuits.

We’re committed to tackling obesity, but increasing the family’s weekly shop at the supermarket isn’t the answer