NACCHO Aboriginal Health and #Nutrition : Download @aihw Nutrition across the life stages report @CHFofAustralia Poor diet findings underline calls for action on #obesity now : More than one-third of Australians’ energy intake comes from junk foods.

 

” More than one-third of Australians’ energy intake comes from junk foods. Known as discretionary foods, these include biscuits, chips, ice-cream and alcohol. For those aged 51-70, alcoholic drinks account for more than one-fifth of discretionary food intake.

These are some of the findings from the Nutrition across the life stages report released by the Australian Institute of Health and Welfare ” 

From The Conversation see Part 3 below

Download copy aihw-nutrition report

 ” Overall, the diets of Indigenous and non-Indigenous Australians are similar. However, Indigenous adults in some age groups eat less fruit, vegetables and dairy products and alternatives.

They also have a lower intake of fibre and a higher intake of discretionary food and added sugars than non-Indigenous adults.”

For Indigenous Health see page 108 or Part 2 Below

Part 1 Poor diet findings underline calls for action on obesity now

Read our NACCHO Obesity submission plus 60 articles here

The poor diet of many Australians, beginning in childhood, as revealed in a new official report, underlines the need for concerted national action on obesity, the Consumers Health Forum has said

The report of the Australian Institute of Health and Welfare released today shows that Australians generally do not eat enough of the right food, like vegetables, and too much food rich in fat, salt and sugars.

“These findings again vindicate calls over the years by health and community groups for concerted action on obesity and at last, Australia’s health ministers have agreed to develop a national strategy to counter this huge public health challenge,” the CEO of the Consumers Health Forum, Leanne Wells, said.

“We welcome the decision by the COAG Health Ministers Council last week to develop a national plan on obesity.

“As this new AIHW report Nutrition across the life stages, shows, there is great scope for improving diets of most Australians of all ages.  This includes children whose formative diets do not include enough vegetables, teenagers who tend to eat too much junk food and even those in middle age whose alcohol intake is often too high.

“It has taken too long to reach a national agreement for action on obesity.  Now health ministers must move promptly to introduce effective measures.

“Governments have a ready-made blueprint for action, provided by the Obesity Policy Coalition’s report Tipping the Scales, which CHF strongly supported.

“After a comprehensive and expert investigation, that report proposed eight critical actions to tackle obesity.  These included tougher restrictions on TV junk food advertising, food reformulation targets, mandatory Health Star ratings on food, an active transport strategy, public health education campaigns and a 20 per cent health levy on sugary drinks.

The Health Ministers considered a number of aspects relating to obesity. They agreed that the national strategy should have a strong focus on prevention measures and social determinants of health, especially in relation to early childhood and rural and regional issues.

The Consumers Health Forum has called for more effective measures to counter obesity over several years.

In January 2015, with the support of the Obesity Policy Coalition, the Heart Foundation and the Public Health Association of Australia, CHF released the results of an Essential Research poll showing strong community backing for national action on obesity.

That poll revealed that 79 per cent of Australians polled believed that if we don’t do more to lower the intake of fatty sugary and salty foods/drinks, our children will live shorter lives than their parents. Half of those polled then approved of the idea of a tax on junk food/sugary drinks.

“We called then for the Federal Government to take decisive action to stop the never-ending promotion of unhealthy food and drink, particularly to young people.

“Australia has lagged behind other nations in taking effective action against obesity which is one of the greatest triggers of chronic health problems which afflict a growing number of Australians.

Unless we act now to arrest this trend, it will add up to even greater demands on our health system as it attempts to manage the growing levels of chronic disease in the community.

“The time for talk is well past.  We need action now,” Ms Wells said.

Part 2 Indigenous Australians

This report looked at whether food and nutrient intakes and health outcomes differ between
Indigenous and non-Indigenous Australians, and found that overall, there is little difference.
Intake of serves from the 5 food groups for Indigenous children is similar to the intake for
non-Indigenous children.

However, differences are seen in the adult populations, particularly for fruit, vegetables, dairy products and alternatives (for those aged 19–50 and 71 and over) and grain foods
(for those aged 19–50), where intake is lower for Indigenous Australians.

Comparing the contribution of discretionary food to energy intake for Indigenous and non-Indigenous Australians, the main differences are seen in women aged 19–30 and men and
women aged 31–50, with the contribution being higher in Indigenous Australians

While the intake of added sugars appears higher among Indigenous Australians than non-Indigenous Australians, this is only significant in those aged 19–30 and 31–50. Intake of saturated and trans fats and sodium are similar for Indigenous and non-Indigenous Australians.

Fibre intake for Indigenous Australians aged 19–30 and 31–50 is lower than for non-Indigenous Australians.

The small survey sample for Indigenous Australians makes comparisons difficult when looking at  levels of physical activity as there is a high margin of error, so results should be interpreted with caution.

Levels of sufficient physical activity appear higher in Indigenous Australians; however, in most cases, the differences are not statistically significant.

The only exceptions are children aged 4–8 and boys aged 9–13, where the levels are higher in Indigenous Australians. For adults aged 19–30 and 31–50, non-Indigenous Australians have higher levels of physical activity.

For males, the prevalence of overweight and obesity does not differ by Indigenous status.

However, for women, from the age of 19, the prevalence is higher among Indigenous women than non-Indigenous women.

Among Indigenous Australians, there is no difference in the prevalence of overweight and obesity between males and females, unlike non-Indigenous Australians, where from the age of 19, the prevalence is higher in men than women.

Diet quality among Indigenous Australians may be affected by the remoteness of the area in which they live, as a higher proportion of Indigenous Australians live outside of Major cities than non-Indigenous Australians (AIHW 2018a).

Hudson (2010) suggests that many Indigenous Australians know what foods they need to maintain health; however, supply and affordability of fresh produce appear to be limiting factors in dietary quality.

Limited stock of fruit and vegetables have been found in remote shops near Indigenous communities, with some areas going without a delivery of fresh produce for weeks. And what is available is expensive.

When deliveries are received, stock can be up to 2 weeks old, so of poor quality. Additionally, lack of competition in these areas appears to be a factor with price.

Fibre-modified and fortified white bread appears to provide a large proportion of energy and required key nutrients for Indigenous Australians living in remote areas (in particular protein, folate, iron and calcium) (Brimblecombe et al. 2013a; Brimblecombe et al. 2013b; Gwynn et al. 2012).

The diet of Indigenous Australians have for some time, been shifting from traditional Indigenous diets that were previously high protein, fibre, polyunsaturated fat and complex carbohydrates to a more highly refined carbohydrate diet, with added sugars, saturated fat, sodium and low levels of fibre (Ferguson et al. 2017).

This may be due to lack of access to traditional food and general food affordability (Brimblecombe et al. 2014).

Lack of facilities to prepare and store food such as refrigerators and stovetops, have also caused an increased reliance of ready-made meals or takeaway foods for Indigenous Australians living in remote areas (Hudson 2010).

Part 3 from The Conversation

From HERE 

The report also shows physical activity levels are low in most age groups. Only 15% of 9-to-13-year-old girls achieve the 60-minute target. The prevalence of overweight and obesity remains high, reaching 81% for males aged 51–70.

The food intake patterns outlined in this report, together with low physical activity levels, highlight why as a country we are struggling to turn the tide on obesity rates.

Not much change in our diets

The report shows little has changed in Australians’ overall food intake patterns between 1995 and 2011-12. There have been slight decreases in discretionary food intake, with some trends for increased intakes of grain foods and meat and alternatives.

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The message to eat more vegetables is not hitting the mark. There has been no change in vegetable intake in children and adolescents and a decrease in vegetable intake in adults since past surveys. The new data show all Australians fall well short of the recommended five serves daily. We are are closer to meeting the recommended one to two serves of fruit each day.

Australians are consuming around four serves of grains, including breads and cereals, compared to the recommended three to seven serves.

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One serve of vegetables is equivalent to ½ cup of cooked vegetables. For fruit, this is a medium apple; grains is around ½ cup of pasta. A glass of milk and 65-120g of cooked meat are the equivalent serves for dairy and its alternatives, and meat and its alternatives respectively.

The data show a trend of lower serves of the five food groups in outer metro, regional and remote areas of Australia. Access to quality, fresh foods such as vegetables at affordable prices is a key barrier in many remote communities and can be a challenge in outer suburban and country areas of Australia.

There was also a 7-10 percentage point difference in meeting physical activity targets between major cities and regional or remote areas of Australia. Overweight and obesity levels were 53% in major cities, 57% in inner regional areas and 61% in outer regional/remote areas.

The CSIRO Healthy Diet Score compares food intake to Australian Dietary Guidelines. You can use these to see how your diet stacks up and how to improve.

Discretionary food servings

Discretionary foods are defined in guidelines as foods and drinks that are

not needed to meet nutrient requirements and do not fit into the Five Food Groups … but when consumed sometimes or in small amounts, these foods and drinks contribute to the overall enjoyment of eating.

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A serve of discretionary food is 600kJ, equivalent to six hot chips, two plain biscuits, or a small glass of wine. The guidelines advise no more than three serves of these daily – 0.5 serves for under 8-year-olds.

Since 1995, the contribution of added sugars and saturated fat to Australians’ energy intake has generally decreased. This may be a reflection of the small decrease in discretionary food intake seen for most age groups.

But across all life stages, discretionary food intakes remain well in excess of the 0-3 serves recommended. Children at 2-3 years are eating more than three servers per day, peaking at seven daily serves in 14-to-18-year-olds. The patterns remains high throughout adulthood, still more four serves per day in the 70+ group.


Read more: Junk food packaging hijacks the same brain processes as drug and alcohol addiction


The excess intake of discretionary foods is the most concerning trend in this report. This is due to the doubleheader of their poor nutrient profile and being eaten in place of important, nutrient-rich groups such as vegetables, whole grains and dairy foods.

Our simulation modelling compared strategies to reduce discretionary food intake in the Australian population. We found cutting discretionary choice intake by half or replacing half of discretionary choices with the five food groups would have significant benefits for reducing intake of energy and so-called “risk” nutrients (sodium and added sugar), while maintaining or improving overall diet quality.

Main contributors to discretionary foods

Alcohol is often the forgotten discretionary choice. The NHMRC 2009 guidelines state:

For healthy men and women, drinking no more than two standard drinks on any day (and no more than four standard drinks on a single occasion) reduces the lifetime risk of harm from alcohol-related disease or injury.

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For adults aged 51–70, alcoholic drinks account for more than one-fifth (22%) of discretionary food intake. Alcohol intake in adults aged 51-70+ has increased since 1995. This age group includes people at the peak of their careers, retirees and older people. Stress, increased leisure time, mental health challenges and factors such as loneliness and isolation would all play a part in this complex picture.

 

Young children have small appetites and every bite matters. The guidelines suggest 2-to-3-year-olds should have very limited exposure to discretionary foods. In, studies the greatest levels of excess weight are seen in preschool years.

Biscuits, cakes and muffins are the key source of added sugars for young children. These are also the top source of energy and saturated fat and a key source of salt in young children. This is the time when lasting food habits and preferences are formed.

NACCHO Aboriginal Health and #rethinksugarydrink : A new campaign asking people to reduce their sugar intake highlights the link between obesity and 13 different types of cancer

 ” Obesity is now a leading preventable cause of cancer , but less than half of all Australians are aware of the link . A new campaign launched today by Cancer Council Victoria is aiming to change this.

In a ground-breaking new public awareness campaign, Cancer Council Victoria will expose the link between obesity and 13 types of cancer by depicting the toxic fat around internal organs.

As many as 98% of Australians are aware that obesity is a risk factor for type 2 diabetes and heart disease, but as little as 40% of Australians know about its link with cancer . ”

Being above a healthy weight is now a leading preventable cause of cancer. Our new campaign urges people to avoid to reduce their risk

You wouldn’t put this much sugar in a tea or coffee? But if you’re drinking one soft drink a day, over 20 years – that’s 73,000 teaspoons.”

Dr Gihan Jayaweera

A third of Victorians admit to drinking more than a litre of sugary drink each week 7, that’s more than 5.5kgs of sugar a year. We want people to realise that they could be drinking their way towards weight gain, obesity and toxic fat, increasing their risk of 13 types of cancer,”

Dr Ahmad Aly

 ” 69% of Aboriginal and Torres Strait Islander people are considered overweight (29%) or obese (40%); among children this is 30% (20% overweight, 10% obese) “

Read over 60 NACCHO Aboriginal Health and Obesity articles

Or see Statistics part 2 Below 

SEE NEWS COVERAGE

https://www.9news.com.au/7f9400a3-9f9d-4e39-9eb2-eef88a7291ce

Cancer Council Victoria CEO, Todd Harper, acknowledged that the campaign’s portrayal of toxic fat could be confronting but said so was the fact that nearly two-thirds of Australians were overweight or obese 4.

“While talking about weight is a sensitive issue, we can’t shy away from the risk being above a healthy weight poses to our health.” Mr Harper said.

“With around 3,900 cancers in Australia each year linked to being above a healthy weight, it’s vital that we work hard to help people understand the link and encourage them to take steps to reduce their risk 5.”

Sugary drinks contribute the most added sugar to Australians’ diets 6, so Cancer Council Victoria is focusing on how these beverages can lead to unhealthy weight gain, which can increase the risk of certain cancers. The campaign will communicate that one way of reducing the risk is to cut sugary drinks from your diet.

The ad features Melbourne surgeon Dr Ahmad Aly exposing in graphic detail what sugary drinks could be doing to your health, as his laparoscopic camera delves inside a patient’s body to expose the dangerous toxic fat around internal organs.

Watch Video 

Dr Aly has seen first-hand the impact toxic fat has on people’s health and hopes the campaign will make people think again before reaching for sugary drinks.

Jane Martin, Executive Manager of the Obesity Policy Coalition, said that while the campaign aims to get people thinking about their own habits, Cancer Council Victoria and partner organisations are also working to encourage governments, the food industry, and communities to make changes.

“It’s virtually impossible to escape the enormous amount of marketing for sugary drinks surrounding us on TV, social media and public transport. It’s also easier to get a sugary drink than it is to find a water fountain in many public places, and that’s got to change. We need to take sugary drinks out of schools, recreation and healthcare settings to make it easier for Victorians to make healthy choices.”

“The need for a healthy weight strategy in Victoria, as well as nationally, is overdue. In the same way tobacco reforms have saved lives, we now need to apply the same approach to improving diets”, Ms Martin said.

Case study: Fiona Humphreys

Since giving up the sweet stuff, Fiona Humphreys has more energy and has managed to shed the kilos and keep them off.

“I used to drink at least two sugary drinks every day as a pick me up, one in the morning and one in the afternoon. I was addicted to the sugar rush and thought I needed them to get through my busy day.”

“After giving up sugary drinks I saw an immediate change in both my mood and my waistline. I lost 7 kilos just by making that one simple change and I haven’t looked back.”

“I decided to go cold turkey and switched to soda or mineral water with a slice of lime or lemon. I tricked my mind to enjoy the bubbles and put it into a beautiful glass. I feel healthier and my mind is clearer as a result.”

The campaign will run for five weeks and be shown on TV and radio and will feature across social media channels as well as outdoors across the state.

A dedicated campaign website cancervic.org.au/healthyweight will provide factsheets for health professionals and consumers and digital elements about how to make small lifestyle changes to improve people’s health.

Top tips to avoid sugary drinks 

  • Avoid going down the soft drink aisle at the supermarket and beware of the specials at the checkout and service stations.
  • If you’re eating out, don’t go with the default soft drink – see what other options there are, or just ask for water.
  • Carry a water bottle, so you don’t have to buy a drink if you’re thirsty.
  • Herbal teas, sparkling water, home-made smoothies or fruit infused water are simple alternatives that still taste great.
  • For inspiration and recipe ideas visit cancervic.org.au/healthyweight

How is sugar linked to weight gain

Sugar is a type of carbohydrate which provides energy to the body. However, eating too much sugar over time can lead to weight gain. Strong evidence shows that being above a healthy weight increases the risk of developing 13 different types of cancer and chronic diseases including cardiovascular disease and type 2 diabetes.

Let’s unpack what happens when our body receives more energy than it needs, how this can lead to weight gain and what you can do to decrease your risk of cancer.

Where do we find sugar?

In terms of health risks, we need to be concerned about ‘added sugar’. That is, sugar that has been added to food or drink.

Natural sugars in foods

  • Fruit and milk products
  • High in nutrients – vitamins, minerals, fibre or calcium.
  • We should eat these foods every day.

Sugar added to food

  • Processed foods
  • These foods are unhealthy and high in energy (kJ).
  • They don’t have other nutrients we need such as fibre, vitamins and minerals.
  • We should limit these foods.

Aboriginal and Torres Strait Islander Communities

Aboriginal and Torres Strait Islander communities tend to have higher rates of obesity and sugary drink consumption and experience poorer health outcomes as a result.

We know that more than half of the Aboriginal and Torres Strait Islander community drink sugary drinks almost every day.

The Overview also examined factors contributing to health, including nutrition and body weight. Some statistics of note include:

  • dietary risks contribute 9.7% to the total burden of disease for Aboriginal people
  • 69% of Aboriginal and Torres Strait Islander people are considered overweight (29%) or obese (40%); among children this is 30% (20% overweight, 10% obese)
  • 54% of Indigenous Australians meet the daily recommended serves of fruit; only 8% meet the daily recommended serves of vegetables
  • both measures are lower in remote communities compared with urban areas and intake is far more likely to be inadequate among the unemployed and those who did not finish school
  • on average, Aboriginal and Torres Strait Islander people consume 41% of their daily energy in the form of discretionary foods — 8.8% as cereal-based products (cakes, biscuits & pastries) and 6.9% as non-alcoholic beverages (soft drinks)
  • average daily sugar consumption is 111g — two-thirds (or the equivalent of 18tsp of white sugar) of which are free sugars from discretionary foods and beverages
  • 22% of Aboriginal people reported running out of food and being unable to afford more in the past 12 months; 7% said they had run out and gone hungry — both were more prevalent in remote areas

In the latest issue of JournalWatch, Dr Melissa Stoneham takes a look at obesity in Australia’s remote Indigenous communities and the struggle to eat well against the odds

Read in full at Croakey

Yorta Yorta woman Michelle Crilly gave up her sugary drink habit and hasn’t looked back. Watch her story.

Video: Rethink Sugary Drink - Michelle Crilly

Read more about the ‘Our Stories’ campaign and hear from more inspiring Victorian Aboriginal community members who have cut back on sugary drinks on our partner site Rethink Sugary Drink.

NACCHO Aboriginal Health and #Nutrition : Download @HealthInfoNet review that confirms community involvement is the most important factor determining the success of Aboriginal food and nutrition programs

It is important to note that from all the available evidence reviewed, that the most important factor determining the success of Aboriginal and Torres Strait Islander food and nutrition programs is community involvement in the program initiation, development and implementation, with community members working in partnership across all stages of development’.

HealthInfoNet Director, Professor Neil Drew

The Australian Indigenous HealthInfoNet (HealthInfoNet) at Edith Cowan University has published a new Review of programs and services to improve Aboriginal and Torres Strait Islander nutrition and food security.

Download

Review+of+programs+and+services+to+improve+Aboriginal+and+Torres+Strait+Islander+nutrition+and+food+security

This review is a companion document to the recent Review of nutrition among Aboriginal and Torres Strait Islander people published in February 2018. It builds on the broad discussion in that review by capturing a wider sample of evaluated programs and services and providing more detail about successful programs.

Written by Amanda Lee from the Australian Prevention Partnership Centre, The Sax Institute and Kathy Ride from the HealthInfoNet, the review highlights that improving diets, food supply and food security to better prevent and manage poor nutrition and diet-related disease is vital to the current and future health of Aboriginal and Torres Strait Islander people.

This review identifies that many Aboriginal and Torres Strait Islander communities are motivated to tackle diet-related health issues and they recognise the importance of improving nutrition to prevent and manage growth faltering and chronic disease. However, community effort needs to be supported through the building of an Aboriginal and Torres Strait Islander nutrition workforce, and adequate government investment of funds and policy commitment to sustain improvement of nutrition and diet-related health.

Improving diets, food supply and food security to better prevent and manage poor nutrition and diet-related disease is vital to the current and future health of Aboriginal and Torres Strait Islander
people.

Effective action requires a whole-of-life approach, across the whole health continuum, including: preventive community interventions; public health nutrition policy actions; nutrition promotion; and quality clinical nutrition and dietetic services .

Previous reviews of Aboriginal and Torres Strait Islander food and nutrition programs have consistently noted the lack of availability of rigorously-evaluated interventions, especially with respect to long term evaluations .

Quality evaluations with practical recommendations are critical to helping the workforce build on what has been learnt. Evaluation reports and recommendations need to be publically available for policy makers and practitioners to learn from, apply and build on .

Other reviews have found that most nutrition interventions have focused on remote settings despite most Aboriginal and Torres Strait islander people living in urban and regional areas.

Most of these employed a comprehensive, whole-of-population approach – combining provision and promotion of healthier options in community food stores with nutrition education – which was found to be effective .

As with all health programs, nutrition programs should be developed with the target communities, be delivered according to cultural protocols, be tailored to community needs, and not be forced, or perceived to be forced, upon communities (see Box 1)

A major success factor is community involvement in (and, ideally, control of) decisions relating to all stages of program initiation, development, implementation and evaluation [9; 10; 14]. Program implementation methods that build confidence among collaborating Aboriginal and Torres Strait Islander and non-Indigenous health agencies are fundamental to building capacity to enhance Aboriginal and Torres Strait Islander nutrition and health .

The typical short-term funding cycles experienced in this area are at odds with the time required for community stakeholders to develop capacity to mobilise and build momentum for specific interventions.

An effective ecological approach to chronic disease prevention also requires inter-organisational collaboration in planning and implementation . While many programs targeting nutritional issues are implemented as healthy lifestyle programs to address obesity, it must be remembered
that diet is more than a ‘lifestyle’ choice – it is determined by the availability of and access to healthy food, and by having the infrastructure, knowledge and skills to prepare healthy food.

To improve diet-related health sustainably it will be necessary to take a food systems approach .

The underlying factors influencing nutrition and food security in Aboriginal and Torres Strait Islander communities include socioeconomic factors such as income and employment opportunities, housing, over-crowding, transport, food costs, cultural food values, education, food and nutrition literacy, knowledge, skills and community strengths.

Key points

• Nutrition, public health and Indigenous health experts are calling for a nationwide, comprehensive, sustained effort to address Aboriginal and Torres Strait Islander nutrition.

Primary prevention of diet-related disease and conditions

• The most effective community-based programs tend to adopt a multi-strategy approach, addressing both food supply (availability, affordability, accessibility and acceptability of foods), and demand for healthy foods.
• Supply of micronutrient supplements rather than food does not address the underlying issues of food insecurity, poor dietary patterns or high rates of obesity.
• The population health intervention of folate fortification of bread flour has had the desired effect of increasing folate status in the Australian Aboriginal population.
• Analysis of remote store sales data during the Northern Territory Emergency Response found that income management provided no beneficial impact in relation to purchasing of tobacco, soft drink or fruit and vegetables.
• Nutrition programs implemented at the community level mainly focus on improving food supply and/or increasing demand for healthy food.
• As with all health programs, all nutrition programs should be developed with communities, be delivered according to cultural protocols, be tailored to community needs, and be directed by the communities.

Primary health care and clinical nutrition and dietetic services

• Primary health care services for Aboriginal and Torres Strait Islander people need to deliver both competent and culturally appropriate dietetic and chronic disease care.
• Health services run by Aboriginal and Torres Strait Islander communities provide holistic care that is relevant to the local community and addresses the physical, social, spiritual and emotional health of the clients.
• The involvement of Aboriginal and Torres Strait Islander Health Workers has been identified by health professionals and patients as an important factor in the delivery of effective clinical care to Aboriginal and Torres Strait Islander people, including in dietetics and
nutrition education.

Aboriginal and Torres Strait Islander nutrition workforce

• A trained, well-supported and resourced Aboriginal and Torres Strait Islander nutrition workforce is essential to deliver effective interventions.
• It is estimated that less than 20 Aboriginal and Torres Strait Islander people have ever trained as nutritionists and/or dietitians in Australian universities.

NACCHO Example from Nhulundu Health Service

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A $100 GROCERY VOUCHER & TUCKA-TIME GIFT PACK

To enter simply like our page, comment a photo showing us your healthy meal and share! 🍉🍊🍓🥦🥑

Giveaway closes 5pm Friday 16/10/18. Winners will be announced on 18/10/18. You can enter as many times as you wish, good luck to everyone!

Get healthy, get cooking and get snapping

 

NACCHO Aboriginal Health and Alcohol : Creating safer communities with roll out of the floor price legislation designed to tackle alcohol related violence and crime by targeting problem drinkers. Comments from @FAREAustralia @DoctorBoffa and @DonnaAhChee1

Over 30 years of working as a GP in Central Australia it is clear that grog, priced cheaper than water, is more like a form of poison in terms of the harm that it generates. The harm is a factor of price, not product type

There have been various attempts over the years to remove this really cheap alcohol from the market, all with some success, but the holy grail has always been the achievement of a floor price, so this is a great development for public health in the Northern Territory.”

 Dr John Boffa, spokesperson for the Peoples Alcohol Action Coalition ( PAAC ) says his organisation has been advocating for many of these alcohol policy reforms since 1995 with a continued focus on the harm being caused by really cheap alcohol. See Full PAAC Press Release Part 2 below

Listen to Congress ACCHO Alice Springs : CEO Donna Ah Chee Radio National Interview  

http://mpegmedia.abc.net.au/rn/podcast/2018/09/bst_20180927_0651.mp3

Part 1 Territory Labor Government press release

The Territory Labor Government is creating safer communities with the commencement of the floor price legislation from Monday 1st  October, designed to tackle alcohol related violence and crime by targeting problem drinkers.

The case for tackling alcohol abuse is clear:

  • Territorians drink more than anyone else in Australia per capita, and are even amongst the highest in the world.
  • Data from 2009 shows that alcohol related violence and crime is costing Territorians upwards of $640 million a year. That’s about $4,197 per adult, compared to $943 nationally.
  • The Territory has the highest rates of hospitalisations related to alcohol abuse in Australia
  • 40% of all Territory road fatalities involve an illegal blood alcohol concentration.

The floor price is just one of the 219 recommendations from the Riley Review, designed to tackle alcohol related violence and crime stemming from alcohol abuse.

Comments attributable to Minister for Health and Attorney General, Natasha Fyles:

The Territory Labor Government is creating safer communities by introducing some of the most signification alcohol reforms in the Territory’s history

There is simply too much alcohol fuelled crime, anti-social behaviour and social dysfunction in the Northern Territory.

Floor price legislation targets cheap bulk alcohol favoured by at-risk drinkers, without punishing those of us who enjoy a drink responsibly.

This means that a standard drink cannot be cheaper than $1.30. Products that will see a price increase will be cheap, high alcohol content cask, bottled, and fortified wine.

In order to ensure bottle shops don’t increase the vast majority products that already meet the floor price, we have informed consumer affairs to keep a close watch on price changes as this initiative rolls out.

The majority of Territorians enjoy a drink responsibly, but there are many in the Territory whose abuse of alcohol is hurting our community, it’s hurting our businesses and it’s destroying individuals and families.

Part 2 Fare / PAAC Press release 

With the introduction of Minimum Unit Price (MUP) in the Northern Territory, the People’s Alcohol Action Coalition (paac) and the Foundation for Alcohol Research and Education (FARE) say the Gunner Government is to be congratulated for putting the evidence first, and in turn prioritising the health, welfare and safety of the people of the NT.

The successful introduction of a floor price on alcohol in the NT now opens the door to its introduction across Australia, and should positively impact the development of the Commonwealth Government’s draft National Alcohol Strategy.

FARE Chief Executive Michael Thorn stresses the legislation will provide universal benefits to all Territorians, and is another important step towards tackling the NT’s severe alcohol problems.

“A floor price is a win for the people of the NT. World-high rates of drinking are finally being addressed with a world-leading alcohol policy intervention; an evidence-based solution that will have no impact on light and moderate drinkers, but will lead to decreased alcohol consumption among the Top End’s heaviest drinkers,” Mr Thorn said.

Mr Thorn said it was important to remember that the MUP was just one part of a comprehensive package of evidence-based reforms that would prioritise health and welfare throughout the Territory, and commended the Gunner Government on its resolve to tackle the Territory’s long-standing problems with heavy drinking.

“There is no doubt that the introduction of the floor price in the NT is a landmark achievement, but we must remember that is just one part of a comprehensive plan that also includes measures such as the Banned Drinkers Register and efforts to curb aggressive alcohol marketing, that once implemented will result in less alcohol violence, crime, hospitalisations and death in the Territory, Mr Thorn said

Dr Boffa says that in 2006, the Alice Springs Liquor supply plan effectively doubled the minimum unit price by forcing products from the market, achieving a near 20 per cent reduction in alcohol consumption in the town and a significant cut in harm, including about 120 fewer hospital admissions per year for Aboriginal women for assault.

“We know that increasing the price works and it is very likely that the MUP combined with the other measures being implemented by the NT government will see drinking levels in the NT drop below the national average, which will be a great outcome for the people of the Northern Territory,” he concluded.

The WHO Global status report on alcohol and health 2018 released last week, highlighted the gap between drinking rates in the Territory and the rest of the world, with the NT’s average per capita alcohol consumption almost double the world average of 6.4 litres of pure alcohol.

“Our aspiration should be to halve the Territory’s alcohol consumption levels and to knock the Territory off the world leader board for most dangerous drinking jurisdiction. In doing so, we will reduce the alcohol burden that weighs so heavily on communities throughout the Top End,” Mr Thorn said.

Mr Thorn stresses that there are also significant national implications.

“In the absence of a willingness at the Commonwealth level to address the availability of cheap alcohol through meaningful taxation reform, it is up to the States and Territories to follow the lead of the NT,” Mr Thorn said.

“Indeed the Western Australian Government is currently doing just that. And on the national stage, there is the opportunity to influence the National Alcohol Strategy so that it is informed by the range of evidence-based, life-saving measures being introduced into the NT, and not by an alcohol industry resistant to any measures that would impact its bottom line.”

.

NACCHO Aboriginal Health and #Sugarydrinks : @BakerResearchAu Study reveals the damaging effects for inactive, young, obese people who consume soft drink regularly : What’s going on inside your veins ?

“ With lifestyle-related diseases such as obesity rising rapidly and sugar sweetened beverages the largest source of added sugars in Western diets, understanding the ‘real world’ health impact is critical in determining ‘real world’ prevention and intervention strategies,”

Professor Bronwyn Kingwell, the study’s senior author : See Baker Institute Press Release Part 1

If you did this day in, day out, your pancreas would be under considerable stress – and this is how diabetes can develop.

Having a little can of soft drink in the morning is going to have lasting effects throughout the day.”

If your diet has too much sugar in it, forcing your body to keep your insulin high all the time, eventually your cells will grow insulin-resistant. That forces the pancreas to make even more insulin, adding to its workload. Eventually, it will burn out

Professor Bronwyn Kingwell. See SMH Article Part 2 What’s going on inside your veins after you drink a soft drink

See NACCHO Nutrition ,Obesity , Sugar Tax,, Health Promotion 200 + articles published over 6 years and see our policy below

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

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

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

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

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

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

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

Download the full 15 Page submission HERE

Obesity Epidemic in Australia – Network Submission – 6.7.18

Press Release : Study reveals the damaging metabolic effects for inactive, young, obese people who consume soft drink regularly

We know drinking soft drink is bad for the waistline, now a study by Baker Heart and Diabetes Institute researchers provides evidence of the damaging metabolic effects on overweight and obese people who regularly consume soft drink and sit for long periods.

Researchers have quantified the detrimental effects on glucose and lipid metabolism by studying young, obese adults in a ‘real-world’ setting where up to 750ml of soft drink is consumed between meals daily and where prolonged sitting with no activity is the norm.

The results, outlined by PhD candidate Pia Varsamis in the Clinical Nutrition journal, show how habitual soft drink consumption and large periods of sedentary behaviour may set these young adults on the path to serious cardiometabolic diseases such as fatty liver disease, type 2 diabetes and heart disease.

Whilst most studies to date have focused on the relationship between soft drink consumption and obesity, the large amount of added sugars contained in these drinks has additional implications beyond weight control.

Watch TV Interview

Senior author, Professor Bronwyn Kingwell, who heads up the Institute’s Metabolic and Vascular Physiology laboratory, says the acute metabolic effects of soft drink consumption and prolonged sitting identified in this latest study are cause for concern.

“With lifestyle-related diseases such as obesity rising rapidly and sugar sweetened beverages the largest source of added sugars in Western diets, understanding the ‘real world’ health impact is critical in determining ‘real world’ prevention and intervention strategies,” Professor Kingwell says.

She says this study quantified the effects of soft drink consumption compared to water on glucose and lipid metabolism in a context that was reflective of typical daily consumption levels, meal patterns and activity behaviours such as sitting for long periods.

The study, involved 28 overweight or obese adults aged 19–30 years who were habitual soft drink consumers. They participated in two separate experiments on different days drinking soft drink on one and water on the other both mid-morning and mid-afternoon during a 7-hour day of uninterrupted sitting.

Professor Kingwell says the combination of soft drink and prolonged sitting significantly elevated plasma glucose and plasma insulin, while reducing circulating triglycerides and fatty acids which indicates significant suppression of lipid metabolism, particularly in males.

She says the metabolic effects of a regular diet of soft drink combined with extended periods of sitting may contribute to the development of metabolic disease in young people who are overweight or obese, including predisposing men to an elevated risk of fatty liver disease.

“The acute metabolic effects outlined in this study are very worrying and suggest that young, overweight people who engage in this type of lifestyle are setting themselves on a path toward chronic cardiometabolic disease,” Professor Kingwell says. “This highlights significant health implications both for individuals and our healthcare system.”

Part 2 : Here’s what’s going on inside your veins after you drink a soft drink

Orginally published Here

Half an hour after finishing a can of soft drink, your blood sugar has spiked.

So you’re probably feeling pretty good. Your cells have plenty of energy, more than they need.

Maybe that soft drink had some caffeine as well, giving your central nervous system a kick, making you feel excitable, suppressing any tiredness you might have.

But a clever new study, published this week, nicely illustrates that while you’re feeling good, strange things are going on inside your blood vessels – and in the long run they are not good for you.

For this study, 28 obese or overweight young adults agreed to sit in a lab for a whole day while having their blood continuously sampled.

The volunteers ate a normal breakfast, lunch and dinner. At morning tea and afternoon tea, researchers from Melbourne’s Baker Heart and Diabetes Institute gave them a can of soft drink.

Their blood samples revealed exactly what happened next.

Sugar from, say, a chocolate bar is released slowly, as your digestive system breaks it down.

With a can of soft drink, almost no break-down time is needed. The drink’s sugar starts to hit your bloodstream within about 30 minutes. That’s why you get such a big spike.

Your body responds to high levels of blood sugar by producing a hormone called insulin.

Insulin pumps through the bloodstream and tells your cells to suck in as much sugar as they can. The cells then start burning it, and storing what they can’t burn.

That quickly reduces the amount of sugar in the blood, and gives you a burst of energy. So far so good.

But the sugar keeps coming. High levels of blood sugar will quickly damage your blood vessels, so the body keeps making insulin.

In fact, just having two cans of soft drink meant the volunteers’ insulin stayed significantly higher than usual – all day.

After lunch, and another soft drink for afternoon tea, their sugar and insulin levels spiked again.

And, once again, over the next few hours blood sugar dropped but insulin levels stayed stubbornly high – right through to late afternoon, when the study finished.

The study demonstrates that two cans of soft drink is all it takes to give your pancreas – the crucial organ that produces insulin – a serious workout, says Professor Bronwyn Kingwell, the study’s senior author.

Watch Video 

We get more sugar each year from beverages than all the sweet treats you can think of combined.

“If you did this day in, day out, your pancreas would be under considerable stress – and this is how diabetes can develop,” says Professor Kingwell. “Having a little can of soft drink in the morning is going to have lasting effects throughout the day.”

If your diet has too much sugar in it, forcing your body to keep your insulin high all the time, eventually your cells will grow insulin-resistant. That forces the pancreas to make even more insulin, adding to its workload. Eventually, it will burn out.

But something else interesting is happening inside your body as well.

Insulin tells your body to burn sugar. But it also tells it to stop burning fat.

Normally, the body burns a little bit of both at once. But after a soft drink, your insulin stays high all day – so you won’t burn much fat, whether you’re on a diet or not.

One of the study’s participants, Michelle Kneipp, is now trying as hard as she can to kick her soft-drink habit.

She’s switched soft drinks for flavoured sparkling water. “It still tastes like soft drink, and it’s still got the fizz,” she says.

“But it’s hard, because sugar’s a very addictive substance.”

 

NACCHO Aboriginal Health and #Cancer Policies , Strategies and Future directions : Latest @HealthInfoNet review shows many cancers are preventable among Aboriginal and Torres Strait Islander people

‘The review shows that cultural safety in service provision, increased participation in breast, bowel and cervical screening and reduction in risk factors will improve outcomes for cancer among Aboriginal and Torres Strait Islander people.

The good news is that many cancers are considered to be preventable. Lung cancer is the most commonly diagnosed cancer among Aboriginal and Torres Strait Islander people, followed by breast cancer, bowel cancer and prostate cancer.

Tobacco smoking is still seen as the greatest risk factor for cancer’.

HealthInfoNet Director, Professor Neil Drew

Read over 75 Aboriginal Health and Cancer articles published by NACCHO last 6 years

“Aboriginal and Torres Strait Islander Community Controlled Health Services

Aboriginal and Torres Strait Islander Community Controlled Health Services are located in all jurisdictions and are funded by the federal,state and territory governments and other sources [91].

They are planned and governed by local Aboriginal and Torres Strait and Torres
Strait Islander communities and aim to deliver holistic and culturally appropriate health and health-related services.

Services vary in the primary health care activities they offer. Possible activities include: diagnosis and treatment of illness or disease; management of chronic illness; transportation to medical appointments; outreach clinic services; immunisations; dental services; and dialysis services.

Aboriginal and Torres Strait Islander cancer support groups have been identified as important for improving cancer awareness and increasing participation in cancer screening services [92].

Aboriginal women attending these support groups have reported an increased
understanding of screening and reported less fear and concern over cultural appropriateness, with increases in screening rates [19].

Support groups have also been found to help in follow up and ongoing care for cancer survivors [19, 93], particularly where they are shaped to meet the needs of Aboriginal and Torres Strait Islander people [73, 94].”

See Page 12 of Review

Download Review+of+cancer+among+Aboriginal+and+Torres+Strait+Islander+people

The Australian Indigenous HealthInfoNet (HealthInfoNet) at Edith Cowan University has published a new Review of cancer among Aboriginal and Torres Strait Islander people.

The review, written by University of Western Australia staff (Margaret Haigh, Sandra Thompson and Emma Taylor), in conjunction with HealthInfoNet staff (Jane Burns, Christine Potter, Michelle Elwell, Mikayla Hollows, Juliette Mundy), provides general information on factors that contribute to cancer among Aboriginal and Torres Strait Islander people.

It provides detailed information on the extent of cancer including incidence, prevalence and survival, mortality, burden of disease and health service utilisation.

This review discusses the issues of prevention and management of cancer, and provides information on relevant programs, services, policies and strategies that address cancer among Aboriginal and Torres Strait Islander people.

The review provides:

  • general information on factors (historical/protective/risk) that contribute to cancer among Aboriginal and Torres Strait Islander people
  • detailed information on the extent of cancer among Aboriginal and Torres Strait Islander people, including: incidence, prevalence and survival data; mortality and burden of disease and health service utilisation
  • a discussion of the issues of prevention and management of cancer
  • information on relevant programs, services, policies and strategies that address cancer among Aboriginal and Torres Strait Islander people
  • a conclusion on the possible future directions for combating cancer in Australia

Selected Extracts

Policies and strategies

There are very few national policies and strategies that focus specifically on cancer in the Aboriginal and Torres Strait Islander population. The National Aboriginal and Torres Strait Islander Cancer Framework is therefore significant as the first national approach to addressing the gap in cancer outcomes that currently exists between Aboriginal and Torres Strait Islander people and the non-Indigenous population [132]. However, over the past 30 years, there have been a number of relevant strategies and frameworks developed addressing cancer in the general population, and broader aspects of Aboriginal and Torres Strait Islander health. A selection of national policy developments relevant to addressing cancer among Aboriginal and Torres Strait Islander people are described briefly below.

Selected national policy developments relevant to addressing cancer among Aboriginal and Torres Strait Islander people

2018 Lung Cancer Framework: Principles for Best Practice Lung Cancer Care in Australia is released
2016 National Framework for Gynaecological Cancer Control is released
2015 First National Aboriginal and Torres Strait Islander Cancer Framework is released
2015 Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan is released
2014 Second Cancer Australia Strategic Plan 2014–2019 is published
2013 First National Aboriginal and Torres Strait Islander Health Plan 2013–2023 is published
2011 First Cancer Australia Strategic Plan 2011–2014 is published
2008 National Cancer Data Strategy for Australia is released
2003 Report Optimising Cancer Care in Australia is published
1998 First National health priority areas cancer control report is published
1996 Cancer becomes one of four National health priority areas (NHPA)
1988 Health for all Australians report is released
1987 First National Cancer Prevention Policy for Australia is published

 

It was not until the late 1980s that national cancer control strategies and policies began to be developed [133]. In 1987, the first National Cancer Prevention Policy for Australia, was published by the Australian Cancer Society (ACS) (now the Cancer Council Australia) based on a series of expert workshops [134].

It outlined what prevention activities were currently being undertaken, what should be undertaken and suggested a number of goals, targets and strategies in the areas of cancer prevention and early detection and screening. This policy has been updated many times over the years [133] and is still in publication as the National cancer control policy [135].

The following year, in 1988, the Health for all Australians report, commissioned by the Australian Health Ministers’ Advisory council (AHMAC), recognised that cancers could be influenced by primary or secondary prevention strategies [136]. The report recommended nine goals and 15 targets related to cancers, based on those put forward by the National Cancer Prevention Policy for Australia. Cancer prevention and strategies relating to breast, cervical and skin cancer and tobacco smoking were recommended as initial priorities under the National Program for Better Health. These were then endorsed at the Australian Health Ministers Conference and funding was provided.

In 1996, cancer control was identified as one of four National health priority areas (NHPA). This led, the following year, to the publication of the First report on national health priority areas 1996, which outlined 26 indicators spanning the continuum of cancer care, and included outcome indicators, indicators relating to patient satisfaction and the creation of hospital based cancer registries [137].

In 1998, the first NHPA cancer control report was produced [138]. It identified a number of opportunities for improvements in cancer control, including within ‘special populations such as Indigenous people’ [138].

In 2003, the report Optimising cancer care in Australia was jointly developed by The Cancer Council Australia, the Clinical Oncological Society of Australia (COSA) and the National Cancer Control Initiative (NCCI), with strong consumer input [139]. This report made 12 key recommendations, including that the needs of Aboriginal and Torres Strait Islander people be the focus of efforts to bridge gaps in access to and utilisation of culturally sensitive cancer services.

In 2008, the National Cancer Data Strategy for Australia aimed to provide direction for collaborative efforts to increase data availability, consistency and quality [140]. It reported that although Indigenous status is recorded by cancer registries, data quality is poor, and recommended that the quality of Indigenous markers in hospital and death statistics collections needs to improve if cancer registries are to have better data.

In 2011, Cancer Australia published the first Cancer Australia strategic plan 2011–2014, which aimed to identify future trends in national cancer control and to outline strategies for the organisation to improve outcomes for all Australians diagnosed with cancer [141]. It was followed in 2014, by the Cancer Australia Strategic Plan 2014–2019, which had an increased focus on improving quality of cancer care and outcomes for Aboriginal and Torres Strait Islander people [142].

In 2013, the National Aboriginal and Torres Strait Islander Health Plan 2013–2023 (the Health plan) was developed to provide a long-term, evidence-based policy framework approach to closing the gap in disadvantage experienced by Aboriginal and Torres Strait Islander people [143].

The Health plan emphasises the importance of culture in the health of Aboriginal and Torres Strait Islander people and the rights of individuals to a safe, healthy and empowered life. Its vision is for the Australian health system to be free of racism and inequity and all Aboriginal and Torres Strait Islander people to have access to health services that are effective, high quality, appropriate and affordable. This led to the publication of the Implementation plan for the National Aboriginal and Torres Strait Islander Health Plan 2013–2023 in 2015 [90], which outlines the strategies, actions and deliverables required for the Australian Government and other key stakeholders to implement the Health plan.

The first National Aboriginal and Torres Strait Islander Cancer Framework (the Framework­) was released in 2015, to address disparities and improve cancer outcomes for Aboriginal and Torres Strait Islander people [56]. It provides strategic direction by setting out seven priority areas for action and suggests enablers that may help in planning or reviewing strategies to address each of the priority areas. The Framework aims to improve cancer outcomes for Aboriginal and Torres Strait Islander people by ensuring timely access to good quality and appropriate cancer related services across the cancer continuum.

In 2016, Cancer Australia released the National Framework for Gynaecological Cancer Control to guide future directions in national gynaecological cancer control to improve outcomes for women affected, as well as their families and carers [144]. It aims to ensure the provision of best practice and culturally appropriate care to women across Australia by offering strategies across six priority areas, of which one pertains specifically to improving outcomes for Aboriginal and Torres Strait Islander women.

In 2018, Cancer Australia released the Lung Cancer Framework: Principles for Best Practice Lung Cancer Care in Australia [145]. It aims to improve the outcomes and experiences of people affected by lung cancer by supporting the uptake of five principles: patient-centred care; multidisciplinary care; timely access to evidence-based care; coordination, communication and continuity of care and data-driven improvements.

Future directions

The National Aboriginal and Torres Strait Islander Cancer Framework (the Framework­) provides guidance for individuals, communities, organisations and governments [56]. The Framework was developed in partnership with Menzies School of Health Research, and was informed by a systematic review of the evidence and extensive national consultations. The parties involved in these consultations included Aboriginal and Torres Strait Islander people affected by cancer, health professionals working with Aboriginal and Torres Strait Islander people and experts in Indigenous cancer control. The Framework outlined seven evidence-based priority areas for action as follows:

  • improving knowledge and attitudes about cancer
  • focusing prevention activities
  • increasing participation in screening and immunisation
  • ensuring early diagnosis
  • delivering optimal and culturally appropriate treatment and care
  • involving, informing and supporting families and carers
  • strengthening the capacity of cancer-related services to meet the needs of Aboriginal and Torres Strait Islander people.

Each of these priorities was accompanied by a number of enablers to assist in planning or reviewing strategies to address that priority. The enablers provide flexible approaches to meeting the priorities that allow for local context and needs.

The development of the Framework has been responsible for gathering national support and agreement on the priorities and for creating a high level of expectation around the ability to address the growing cancer disparity [146]. Cancer Australia has since commenced a number of projects and initiatives that focus on one or more of the priorities identified by the Framework. One project aims to identify critical success factors and effective approaches to increasing mammographic screening participation for Aboriginal and Torres Strait Islander women [147]. A leadership group on Aboriginal and Torres Strait Islander cancer control tasked with driving a shared agenda to improve cancer outcomes has also been established [148]. In addition, the development of a monitoring and reporting plan for the Framework is underway.

Quality data are critical to understanding the variations in cancer care and outcomes of Aboriginal and Torres Strait Islander people, and to inform policy, service provision and clinical practice initiatives to improve those outcomes. However, it has been repeatedly reported in the literature and by the Framework, that current data are inadequate or incomplete, and there is a significant need for improved local, jurisdictional and national data on Aboriginal and Torres Strait Islander people with cancer [56149-151]. In particular, the need for primary healthcare services to address the under identification of Aboriginal and Torres Strait Islander status in data registries. A project currently underway in SA, which is likely to have relevance to other regions, aims to develop an integrated comprehensive, cancer monitoring and surveillance system for Aboriginal people, while also incorporating their experiences with cancer services [149].

Both the Framework and the literature have identified a need for a more supportive and culturally appropriate approach across the cancer care continuum for Aboriginal and Torres Strait Islander people [5677151152]. The Wellbeing Framework for Aboriginal and Torres Strait Islander Peoples Living with Chronic Disease, (Wellbeing framework), aims to assist healthcare services to improve the quality of life and quality of care, as well as health outcomes, for Aboriginal and Torres Strait Islander people living with chronic disease [153]. This addresses the identified need for more supportive and culturally appropriate care as it attempts to incorporate the social, emotional, cultural and spiritual aspects of health and wellbeing, as well as the physical aspects.

The Wellbeing framework is underpinned by two core values, which are considered fundamental to the care of Aboriginal and Torres Strait Islander people [153154]. These core values highlight that wellbeing is supported by:

  • upholding people’s identities in connection to culture, spirituality, families, communities and country and
  • having culturally safe primary healthcare services in place.

The Wellbeing framework consists of four essential elements for supporting the wellbeing of Aboriginal and Torres Strait Islander people living with chronic disease [153154]. These show the importance of having:

  • locally defined, culturally safe primary health care services
  • appropriately skilled and culturally competent health care teams
  • holistic care throughout the lifespan
  • best practice care that addresses the particular needs of a community.

The Wellbeing framework suggests a number of practical and measurable applications for applying or achieving the underlying principles of each element. It has the capacity to be adapted by primary healthcare services, in consultation with the communities they serve, to more effectively meet the chronic and cancer care needs of their communities [153154].

 

The Leadership Group on Aboriginal and Torres Strait Islander Cancer Control was established in 2016-17 to:

  • provide strategic advice and specialist expertise in Indigenous cancer control
  • encourage cross-sector collaboration in addressing the priorities in the National Aboriginal and Torres Strait Islander Cancer Framework
  • share knowledge across the sector to leverage opportunities.

Concluding comments

Despite considerable improvements in cancer detection and treatment over recent decades, Aboriginal and Torres Strait Islander people diagnosed with cancer generally experience poorer outcomes than non-Indigenous people for an equivalent stage of disease [2797]. This is highlighted by statistics which showed that, despite lower rates of prevalence and hospitalisation for all cancers combined for Aboriginal and Torres Strait Islander people compared with non-Indigenous people, between 1998 and 2015, the age-standardised mortality rate ranged from 195 to 246 per 100,000 while the rate for non-Indigenous people decreased from 194 to 164 per 100,000 [2].

Furthermore for 2007–2014, while 65% of non-Indigenous people had a chance of surviving five years after receiving a cancer diagnosis, only 50% of Aboriginal and Torres Strait Islander people did [2].

The disparities are particularly pronounced for some specific cancers – for lung cancer the age-standardised incidence rate for Aboriginal and Torres Strait Islander people was twice that for non-Indigenous people, while for cervical cancer the rate was 2.5 times the rate for non-Indigenous people for 2009–2013 [2].

The factors contributing to these poorer outcomes among Aboriginal and Torres Strait Islander people are complex. They reflect a broad range of historical, social and cultural determinants and the contribution of lifestyle and other health risk factors [6], combined with lower participation in screening programs, later diagnosis, lower uptake and completion of cancer treatment, and the presence of other chronic diseases [2798155]. Addressing the various factors that contribute to the development of cancer among Aboriginal and Torres Strait Islander people is important, but improvements in some of these areas, particularly in reducing lifestyle and behavioural risk factors, are likely to take some time to be reflected in better outcomes.

Current deficiencies in the prevention and management of cancer suggest there is considerable scope for better services that should lead to improvements in the short to medium term. Effective cancer prevention and management programs that are tailored to community needs and are culturally appropriate are vital for the current and future health of Aboriginal and Torres Strait Islander people [5657]. Providing effective cancer prevention and management also requires improved access to both high quality primary health care services and tertiary specialist services. Effective and innovative programs for the prevention and management of cancer among Aboriginal and Torres Strait Islander people do exist on an individual basis and, in some cases, the efforts made to engage Aboriginal and Torres Strait Islander people in screening programs, in particular, are impressive. However, a more coordinated, cohesive national approach is also required.

Reducing the impact of cancer among Aboriginal and Torres Strait Islander people is a crucial aspect in ‘closing the gap’ in health outcomes. The National Aboriginal and Torres Strait Islander cancer framework [56] may be an important first step in addressing the current disparity in cancer outcomes and raises the probability of real progress being made. Cancer Australia has recently released the Optimal Care pathway for Aboriginal and Torres Strait Islander people which recommends new approaches to cancer care and with the aim of reducing disparities and improving outcomes and experiences for Aboriginal and Torres Strait Islander people with cancer [156]. As encouraging as these developments are, substantial improvements will also depend upon the effective implementation of comprehensive strategies and policies that address the complexity of the factors underlying the disadvantages experienced by Aboriginal and Torres Strait Islander people.

Action beyond the health service sector that addresses the broader historical, social and cultural determinants of health are also required if real progress is to be made [6].

NACCHO Aboriginal #Mentalhealth #SuicidePrevention and #RUOKday : If you ask #RUOK ? What do you do if someone says ‘no’? Plus Sponsorships for 10 #Indigenous young people to take participate #chatsafe campaign

R U OK Day today encouraging all of us to check in with others to see if they’re OK.

But what if someone says “no”? What should you say or do? Should you tell someone else?

What resources can you point to, and what help is available?

Read NACCHO Aboriginal Health articles over the past 6 Years

Mental Health 189 posts 

Suicide Prevention 124 Posts

Here is a guide 

Stop and listen, with curiosity and compassion

We underestimate the power of simply listening to someone else when they’re going through a rough time. You don’t need to be an expert with ten years of study in psychology to be a good listener. Here are some tips:

Listen actively. Pay attention, be present and allow the person time to speak.

Be curious. Ask about the person’s experience using open questions such as

what’s been going on lately?

you don’t seem your usual self, how are you doing/feeling?

Validate their concerns. See the situation from the person’s perspective and try not to dismiss their problems or feelings as unimportant or stupid. You can say things like

I can see you’re going through a tough time

it’s understandable to feel that way given everything you’ve been going through.

There are more examples of good phrases to use here.

Don’t try to fix the problem right now

Often our first instinct is wanting to fix the person’s problems. It hurts to see others in pain, and we can feel awkward or helpless not knowing how to help. But you don’t have to have all of the answers.

Instead of jumping into “fix it” mode right away, accept the conversation may be uncomfortable and allow the person to speak about their difficulties and experiences.

Sometimes it’s not the actual suggestion or practical help that’s most useful but giving the person a chance to talk openly about their struggles. Also, the more we understand the person’s experience, the more likely we are to be able to offer the right type of help.

Encourage them to seek help.

Ask:

how can I help?

is there something I can do for you right now?

Sometimes it’s about keeping them company (making plans to do a pleasant activity together), providing practical support (help minding their kids to give them time out), or linking them in with other health professionals.

Check whether they need urgent help

It’s possible this person is suffering more than you realise: they may be contemplating suicide or self-harm. Asking about suicidal thoughts does not worsen those thoughts, but instead can help ease distress.

It’s OK to ask them if they’re thinking about suicide, but try not to be judgemental (“you’re not thinking of doing anything stupid, are you?”). Listen to their responses without judgement, and let them know you care and you’d like to help.

Read more: How to ask someone you’re worried about if they’re thinking of suicide

There are resources and programs to help you learn how to support suicidal loved ones, and crisis support lines to call:

  • Contact the Social and Emotional team at your nearest ACCHO
  • Lifeline (24-hour crisis telephone counselling) 13 11 14
  • Suicide Callback Service 1300 659 467
  • Mental health crisis lines

If it is an emergency, or the person is at immediate risk of harm to themselves or others, call 000.

Encourage them to seek professional help

We’re fortunate to be living in Australia, with access to high quality mental health care, resources and support services. But it can be overwhelming to know what and where to seek help. You can help by pointing the person in the right direction.

The first place to seek help is the general practitioner (GP). The GP can discuss treatment options (psychological support and/or medication), provide referrals to a mental health professional or arrange access to local support groups. You can help by encouraging your friend to make an appointment with their GP.

There are great evidence-based online courses and self-help programseducational resources and free self-help workbooks that can be accessed at any time.

There are also online tools to check emotional health. These tools help indicate if a person’s stress, anxiety and depression levels are healthy or elevated.

What if they don’t want help?

People with mental health difficulties sometimes take years between first noticing the problem and seeking professional help. Research shows approximately one in three people experiencing mental health problems accesses treatment.

So even if they don’t want help now, your conversation may have started them thinking about getting help. You can try understanding what’s stopping them from seeking help and see if there’s anything you can do to help connect them to a professional. You don’t need to push this, but simply inviting the person to keep the options in mind and offering your ongoing support can be useful in the long run.

Follow up. If appropriate, organise a time to check in with the person again to see how they’re doing after your conversation. You can also let the person know you’re around and they are always welcome to have a chat with you. Knowing someone is there for you can itself be a great source of emotional support.

Read more: Five types of food to increase your psychological well-being

The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences bursary

Orygen, The National Centre of Excellence is seeking expressions of interest (EOI) from all Aboriginal and Torres Strait Islander young people who would like to share their expertise, advice, and ideas and contribute to the development of a suicide prevention social media campaign!

About the #chatsafe campaign

We would like to partner with Aboriginal and Torres Strait Islander young people to co-design a suicide prevention social media campaign specifically for the Aboriginal community. The campaign will focus on educating and empowering young people to support themselves and other young people within their online social networks. Rather than speaking on behalf of Aboriginal communities, we wish to draw on the expertise, cultural identities, and strengths of the community to inform campaign materials.

The co-design workshop will involve a yarning circle, where young people will be given the opportunity to share their experiences and express their needs. The yarning circle will be facilitated by an Aboriginal and Torres Strait Islander person. The workshop will also involve working together, in groups, to generate ideas for a social media campaign (e.g., digital storytelling, drawing, etc.).

The workshop will be hosted in Perth, as a part of the The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences. The workshop will be conducted in the morning and breakfast will be provided. Young people will be reimbursed $30.00 per hour for their time.

Opportunity for financial support

Oyrgen would like to sponsor 10 Aboriginal and Torres Strait Islander young people to take part in our co-design workshop and The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences, hosted from 20 to 23 November, in Perth, by providing a bursary.

SEE CONFERENCE WEBSITE

Eligibility

To be eligible for Orygen’s bursary funding, the applicant must be an Aboriginal and Torres Islander young person, aged between 18 and 25 years. We encourage young people from all geographic regions, across Australia, to apply.

Submitting your application

If you would like to be a part of the co-design workshop, please email your application to Jo at

The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences bursary

Orygen, The National Centre of Excellence is seeking expressions of interest (EOI) from all Aboriginal and Torres Strait Islander young people who would like to share their expertise, advice, and ideas and contribute to the development of a suicide prevention social media campaign!

About the #chatsafe campaign

We would like to partner with Aboriginal and Torres Strait Islander young people to co-design a suicide prevention social media campaign specifically for the Aboriginal community. The campaign will focus on educating and empowering young people to support themselves and other young people within their online social networks. Rather than speaking on behalf of Aboriginal communities, we wish to draw on the expertise, cultural identities, and strengths of the community to inform campaign materials.

The co-design workshop will involve a yarning circle, where young people will be given the opportunity to share their experiences and express their needs. The yarning circle will be facilitated by an Aboriginal and Torres Strait Islander person. The workshop will also involve working together, in groups, to generate ideas for a social media campaign (e.g., digital storytelling, drawing, etc.). The workshop will be hosted in Perth, as a part of the The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences. The workshop will be conducted in the morning and breakfast will be provided. Young people will be reimbursed $30.00 per hour for their time.

Opportunity for financial support

Oyrgen would like to sponsor 10 Aboriginal and Torres Strait Islander young people to take part in our co-design workshop and The 2nd National Aboriginal and Torres Strait Islander Suicide Prevention and World Indigenous Suicide Prevention Conferences, hosted from 20 to 23 November, in Perth, by providing a bursary.

Eligibility

To be eligible for Orygen’s bursary funding, the applicant must be an Aboriginal and Torres Islander young person, aged between 18 and 25 years. We encourage young people from all geographic regions, across Australia, to apply.

Submitting your application

If you would like to be a part of the co-design workshop, please email your application to Jo at jo.robinson@orygen.org.au. Submissions can be made on, or before Sunday, 30 September, 2018.

Selection process

In the first week of October, a panel consisting of Oyrgen staff, a Culture is Life representative, Professor Pat Dudgeon from the conference organising committee, Summer May Finlay (a Yorta Yorta woman), and young people will review all written applications and select 10 successful applicants. The selection panel will endeavour to select a diverse range of young people. The 10 successful applicants will be notified by email by mid-October. The success applicants will have until 31 October, 2018 to accept the bursary offered.

Requirements

The successful recipients of the bursaries are required to attend a half-day co-design workshop. Recipients will also be asked to complete and submit a ‘Wellness Plan’, ‘Bank Details Form’, and ‘Consent Form’ prior to participation in the w

. Submissions can be made on, or before Sunday, 30 September, 2018.

Selection process

In the first week of October, a panel consisting of Oyrgen staff, a Culture is Life representative, Professor Pat Dudgeon from the conference organising committee, Summer May Finlay (a Yorta Yorta woman), and young people will review all written applications and select 10 successful applicants. The selection panel will endeavour to select a diverse range of young people. The 10 successful applicants will be notified by email by mid-October. The success applicants will have until 31 October, 2018 to accept the bursary offered.

Requirements

The successful recipients of the bursaries are required to attend a half-day co-design workshop. Recipients will also be asked to complete and submit a ‘Wellness Plan’, ‘Bank Details Form’, and ‘Consent Form’ prior to participation in the w

Anyone seeking support and information about mental health can contact beyondblue on 1300 22 46 36. For information about suicide and crisis support, contact Lifeline on 13 11 14 or the Suicide Callback Service on 1300 659 467

 

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

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

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

From CSIRO Future of Health report

Download HERE full 60 Page Report NACCHO INFO FutureofHealthReport_WEB_180910

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Australia’s health challenges:

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

The benefits of shifting the system from treatment to prevention:

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

More info : www.csiro.au/futureofhealth

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

 

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

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

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

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

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

Download this Paper HERE : Demaio-2018-Health_Promotion_Journal_of_Australia

Listen to Dr Sandro’s childhood obesity Podcast HERE 

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

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

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

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

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

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

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

Download the full 15 Page submission HERE

Obesity Epidemic in Australia – Network Submission – 6.7.18

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

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

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

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

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

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

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

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

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

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

One of those is our kids.

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

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

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

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

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

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

1 .SCHOOLS AS PLATFORMS FOR HEALTH

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

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

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

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

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

2.PRICING THAT’S FAIR TO FAMILIES

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

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

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

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

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

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

3. ADVERTISING THAT SUPPORTS OUR KIDS

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

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

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

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

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

4.NUTRITION LABELLING THAT MAKES SENSE TO EVERYONE

  • Further strengthen existing labelling approaches, including mandatory systems

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

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

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

5.SUPPLY CHAIN SYSTEMS AS SOLUTION‐CATALYSTS

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

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

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

Part 2

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

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

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

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

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

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

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

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

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

Watch here 

No 2 Watch here 

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

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

From The Saturday Paper see in full Part 2 Below

Aboriginal #Sexualhealth News : 

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

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

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

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

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

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

Have a look at the TV commercials and a couple of the new short videos by clicking the images below OR access them on the syphilis outbreak webpages at http://youngdeadlyfree.org.au/

Problems downloading the videos?

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

Phase 1 Rescreened

No 2 Watch Here 

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

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

By Michele Tydd

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

From The Saturday Paper 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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