“People who are obese in childhood are at increased risk of being obese in adulthood, which can increase the risk of cardiovascular disease, some types of cancer, diabetes, and arthritis,”
Research found reducing consumption of sugary drinks and junk food from an early age could benefit the health of Indigenous children, but that this is just one part of the solution to improving weight status.
“We know that Indigenous families across Australia – in remote, regional, and urban settings – face barriers to accessing healthy foods. Therefore, efforts to reduce junk food consumption need to occur alongside efforts to increase the affordability, availability, and acceptability of healthy foods,”
Ms Thurber, PhD Scholar, from the National Centre for Epidemiology and Population Health at ANU.
A major study into the health of Aboriginal and Torres Strait Islander children has found programs and policies to promote healthy weight should target children as young as three.
Lead researcher Katie Thurber from The Australian National University (ANU) said the majority of Indigenous children in the national study had a health body Mass Index (BMI), but around 40 per cent were classified as overweight or obese by the time they reached nine years of age.
Latest national figures show obesity rates are 60 per cent higher for Aboriginal and Torres Strait Islander peoples compared to non-Indigenous Australians.
In 2013, around 30 per cent of Indigenous children were classified as overweight or obese, and two thirds of Indigenous people over 15 years old were classified as overweight or obese.
• The majority of Aboriginal and Torres Strait Islander children nationally have a healthy Body Mass Index
• However, more than one in ten Aboriginal and Torres Strait Islander children in Footprints in Time were already overweight or obese at 3 years of age, and there was a rapid onset of overweight/obesity between age 3 and 9 years
• We need programs and policies to reduce the prevalence of overweight/obesity in the first 3 years of life, and to slow the onset of overweight/obesity from age 3-9 years
• Reducing children’s consumption of sugar-sweetened beverages and high-fat foods is one part of the solution to improving weight status at the population level
• To enable healthy diets, we need to (1) create healthier environments and (2) improve the social determinants of health (such as financial security, housing, and community wellbeing). Creating healthy environments is complex, and will require both increasing the affordability, availability, and acceptability of healthy foods and decreasing the affordability, availability, and acceptability of unhealthy foods
• Programs and policy to promote healthy weight need to be developed in partnership with Aboriginal and Torres Strait Islander communities
• Despite higher levels of disadvantage, most Aboriginal and Torres Strait Islander children maintain a healthy weight; we need programs and policies that cultivate environments and circumstances that will enable all Aboriginal and Torres Strait Islander children to have a healthy start to life
Ms Thurber said improving weight status would have a major benefit in closing the gap in health between Indigenous and non-Indigenous Australians.
“Obesity is a leading contributor to the gap in health,” Ms Thurber said.
“We want to work with Aboriginal and Torres Strait Islander families and communities, as well as policy makers and service providers, to think about what will work best to promote healthy weight in those early childhood years.
“We want to start early, and identify the best ways for families and communities to support healthy diets, so that all Aboriginal and Torres Strait Islander children can have a healthy start to life.”
The research used data from Footprints in Time, a national longitudinal study that has followed more than 1,000 Indigenous children since 2008. It is funded and managed by the Department of Social Services.
Professor Mick Dodson, Chair of the Steering Committee for the Footprints in Time Study and Director of the ANU National Centre for Indigenous Studies, said Aboriginal and Torres Strait Islander children deserve the best possible start in life.
“This study shows just how important it is to support them, their families and their communities to provide a healthy diet and opportunities for physical activity,” Professor Dodson said.
Ms Thurber said using the Footprints in Time study, researchers for the first time were able to look at how weight status changes over time for Aboriginal and Torres Strait Islander children, enabling them to identify pathways that help children maintain a healthy weight.
The Australian Government will provide $35.2 million next financial year to continue anti-smoking programs targeted to Aboriginal and Torres Strait Islander people in regional and remote areas.
Minister for Indigenous Health, Ken Wyatt, said the Government had approved the continuation of funding to 36 Aboriginal Community ControlledHealth Services and one private health service.
“These health services are all delivering frontline services to prevent young Indigenous people taking up smoking and to encourage existing smokers to quit,” .
“Reducing smoking rates is central to the Government’s efforts to close the gap in life expectancy, but requires a consistent, long-term commitment.
“Smoking causes the greatest burden of disease, disability, injury and earlydeath among Indigenous people and accounts for 23 per cent of the health gap between Indigenous and non-Indigenous Australians.”
Under the Council of Australian Governments (COAG) National Healthcare Agreement, all governments have committed to halving the 2008 adult daily smoking rate among Indigenous Australians, of 44.8 per cent, by 2018.
“The rate of smoking among Aboriginal and Torres Strait Islander people is still far higher than among other Australians and is damaging their health in many ways,” Minister Wyatt said.
“It’s unlikely now that we will meet the COAG target, but we are making progress.
“It’s important that anti-smoking programs are meaningful for Indigenous people and changes made in recent years have ensured that only programs which are evidence based and effective are receiving grants.”
Continued funding for the 37 health services follows a preliminary evaluation of the Tackling Indigenous Smoking program which found that it was operating effectively and using proven approaches to changing smoking behaviour.
“Young Australians, people in Aboriginal and Torres Strait Islander communities and socially disadvantaged groups are the highest consumers of sugary drinks.
These groups are also most responsive to price changes, and are likely to gain the largest health benefit from a levy on sugary drinks due to reduced consumption ,
A health levy on sugary drinks is not a silver bullet – it is a vital part of a comprehensive approach to tackling obesity, which includes restrictions on children’s exposure to marketing of these products, restrictions on their sale in schools, other children’s settings and public institutions, and effective public education campaigns.
We must take swift action to address the growing burden that overweight and obesity are having on our society, and a levy on sugary drinks is a vital step in this process.”
Rethink Sugary Drink campaign Download position statement
SBS will be showing That Sugar Film this Sunday night 2 April at 8.30pm.
There will be a special Facebook live event before the screenings
” The UK’s levy on sugar sweetened beverages will start in 2018, with revenue raised to go toward funding programs to reduce obesity and encourage physical activity and healthy eating for school children.
We know unhealthy food is cheaper and that despite best efforts by many Australians to make healthier choices price does affect our decisions as to what we buy.”
” Alarmingly, with overweight becoming the perceived norm in Australia, the number of people actively trying to lose weight is declining. A recent report by the Australian Institute of Health and Welfare found that nearly 64 per cent of Australians are overweight or obese. This closely mirrors research that indicates around 66 per cent of Americans fall into the same category.
With this apparent apathy towards personal health and wellbeing, is it now up to food and beverage companies to combat rising obesity rates?
Ten of Australia’s leading health and community organisations have today joined forces to call on the Federal Government to introduce a health levy on sugary drinks as part of a comprehensive approach to tackling the nation’s serious obesity problem.
The 10 groups – all partners of the Rethink Sugary Drink campaign – have signed a joint position statement calling for a health levy on sugary drinks, with the revenue to be used to support public education campaigns and initiatives to prevent chronic disease and address childhood obesity.
This latest push further strengthens the chorus of calls in recent months from other leading organisations, including the Australian Medical Association, the Grattan Institute, the Australian Council of Social Services and the Royal Australian College of General Practitioners.
Craig Sinclair, Chair of the Public Health Committee at Cancer Council Australia, a signatory of the new position statement, said a health levy on sugary drinks in Australia has the potential to reduce the growing burden of chronic disease that is weighing on individuals, the healthcare system and the economy.
“The 10 leading health and community organisations behind today’s renewed push have joined forces to highlight the urgent and serious need for a health levy on sugary drinks in Australia,” Mr Sinclair said.
“Beverages are the largest source of free sugars in the Australian diet, and we know that sugary drink consumption is associated with increased energy intake and in turn, weight gain and obesity. Sugary drink consumption also leads to tooth decay.
“Evidence shows that a 20 per cent health levy on sugar-sweetened beverages in Australia could reduce consumption and prevent thousands of cases of type 2 diabetes, heart disease and stroke over 25 years, while generating $400-$500m in revenue each year to support public education campaigns and initiatives to prevent chronic disease and address childhood obesity.
“The Australian Government must urgently take steps to tackle our serious weight problem. It is simply not going to fix itself.”
Ari Kurzeme, Advocacy Manager for the YMCA, also a signatory of the new position statement, said young Australians, people in Aboriginal and Torres Strait Islander communities and socially disadvantaged groups have the most to gain from a sugary drinks levy.
The Rethink Sugary Drink alliance recommends the following actions to tackle sugary drink consumption:
• A public education campaign supported by Australian governments to highlight the health impacts of regular sugary drink consumption
• Restrictions by Australian governments to reduce children’s exposure to marketing of sugar-sweetened beverages, including through schools and children’s sports, events and activities
• Comprehensive mandatory restrictions by state governments on the sale of sugar-sweetened beverages (and increased availability of free water) in schools, government institutions, children’s sports and places frequented by children
• Development of policies by state and local governments to reduce the availability of sugar-sweetened beverages in workplaces, government institutions, health care settings, sport and recreation facilities and other public places.
Rethink Sugary Drink is a partnership between major health organisations to raise awareness of the amount of sugar in sugar-sweetened beverages and encourage Australians to reduce their consumption. Visit www.rethinksugarydrink.org.au for more information.
The 10 organisations calling for a health levy on sugary drinks are:
Stroke Foundation, Heart Foundation, Kidney Health Australia, Obesity Policy Coalition, Diabetes Australia
the Australian Dental Association, Cancer Council Australia, Dental Hygienists Association of Australia, Parents’ Voice, and the YMCA.
Every day we read or hear more about the so-called ‘sugar tax’ or, as it should be more appropriately termed, a ‘health levy on sugar sweetened beverages’.
We have heard arguments from government and health experts both in favour of, and opposed to this ‘tax’. As CEO of one the state’s leading health charities I support the state government’s goal to make Tasmania the healthiest population by 2025 and the Healthy Tasmania Five Year Strategic Plan, with its focus on reducing obesity and smoking.
However, it is only one tool in the tool box to help us achieve the vision.
Our approach should include strategies such as restricting the marketing of unhealthy food and limiting the sale of unhealthy food and drink products at schools and other public institutions together with public education campaigns.
Some of these strategies are already in progress to include in our toolbox. We all have to take some individual responsibility for the choices we make, but as health leaders and decision makers, we also have a responsibility to create an environment where healthy choices are made easier.
This, in my opinion, is not nannyism but just sensible policy and demonstrated leadership which will positively affect the health of our population.
Manufacturers tell us that there are many foods in the marketplace that will contribute to weight gain and we should focus more on the broader debate about diet and exercise, but we know this is not working.
A recent Cancer Council study found that 17 per cent of male teens drank at least one litre of soft drink a week – this equates to at least 5.2 kilograms of extra sugar in their diet a year.
Evidence indicates a significant relationship between the amount and frequency of sugar sweetened beverages consumed and an increased risk of developing type 2 diabetes. We already have 45,000 people at high risk of type 2 diabetes in Tasmania.
Do we really want to say we contributed to a rise in this figure by not implementing strategies available to us that would make a difference?
I recall being quite moved last year when the then UK Chancellor of the Exchequer George Osborne said that he wouldn’t be doing his job if he didn’t act on reducing the impact of sugary drinks.
“I am not prepared to look back at my time here in this Parliament, doing this job and say to my children’s generation… I’m sorry. We knew there was a problem with sugary drinks…..But we ducked the difficult decisions and we did nothing.”
The UK’s levy on sugar sweetened beverages will start in 2018, with revenue raised to go toward funding programs to reduce obesity and encourage physical activity and healthy eating for school children. We know unhealthy food is cheaper and that despite best efforts by many Australians to make healthier choices price does affect our decisions as to what we buy.
In Mexico a tax of just one peso a litre (less than seven cents) on sugary drinks cut annual consumption by 9.7 per cent and raised about $1.4 billion in revenue.
Similarly, the 2011 French levy has decreased consumption of sugary drinks, particularly among younger people and low income groups.
The addition of a health levy on sugar sweetened beverages is not going to solve all problems but as part of a coordinated and multi-faceted approach, I believe we can effect change.
Caroline Wells, is Diabetes Tasmania CEO
3. Who is responsible for Australia’s waistlines? from here
Alarmingly, with overweight becoming the perceived norm in Australia, the number of people actively trying to lose weight is declining. A recent report by the Australian Institute of Health and Welfare found that nearly 64 per cent of Australians are overweight or obese. This closely mirrors research that indicates around 66 per cent of Americans fall into the same category.
With this apparent apathy towards personal health and wellbeing, is it now up to food and beverage companies to combat rising obesity rates?
Unfortunately it is not clear cut. While Big Food and Big Beverage are investing in healthier product options, they also have a duty to shareholders to be commercially successful, and to expand their market share. The reality is that unhealthy products are very profitable. However companies must balance this against the perception that they are complicit in making people fatter and therefore unhealthier with concomitant disease risks.
At the same time, the spectre of government regulation continues to hover, forcing companies to invest in their own healthy product ranges and plans to improve nutrition standards.
The International Food and Beverage Alliance (a trade group of ten of the largest food and beverage companies), has given global promises to make healthier products, advertise food responsibly and promote exercise. More specific pledges are being made in developed nations, where obesity rates are higher and scrutiny is more thorough.
However companies must still find a balance between maintaining a profitable business model and addressing the problem caused by their unhealthy products.
An example of this tension was evident when one leading company attempted to boost the sale of its healthier product lines and set targets to reduce salt, saturated fat and added sugar. The Company also modified its marketing spend to focus on social causes. Despite the good intentions, shareholders were disgruntled, and pressured the company to reinstate its aggressive advertising.
What role should governments play in shaping our consumption habits and helping us to maintain healthier weights? And should public policy be designed to alter what is essentially personal behaviour?
So far, the food and beverage industry has attempted to avoid the burden of excessive regulation by offering relatively healthier product lines, promoting active lifestyles, funding research, and complying with advertising restrictions.
Statistics indicate that these measures are not having a significant impact. Subsequently, if companies fail to address the growing public health burden, governments will have greater incentive to step in. In Australia, this is evident in the increased political support for a sugar tax. The tax has been debated in varying forms for years, and despite industry resistance, the strong support of public health authorities may see a version of the tax introduced.
Already, Australia’s food labelling guidelines have been amended and tightened, and a clunky star rating system introduced to assist consumers to make healthier choices. Companies that have worked to address and invest in healthy product ranges must still market them in a responsible way. Given the sales pressure, it is tempting for companies to heavily invest in marketing healthier product ranges. However they have an obligation under Australian consumer law to ensure products’ health claims do not mislead.
We know that an emboldened Australian Competition and Consumer Commission (ACCC) is taking action against companies that deliberately mislead consumers. The food industry is firmly in the its sights, with a case currently underway against a leading food company over high sugar levels in its products. This shows that the Regulator will hold large companies to account, and push for penalties that ‘make them sit up and take notice.’
At a recent Consumer Congress, ACCC Chair Rod Sims berated companies that don’t treat consumers with respect. He maintains that marketing departments with short-term thinking, and a short-sighted executive can lead to product promotion that is exaggerated and misleading. All of which puts the industry on notice.
With this in mind, it is up to Big Food and Big Beverage to be good corporate citizens. They must uphold their social, cultural and environmental responsibilities to the community in which they seek a licence to operate, while maintaining a strong financial position for their shareholders. It is a difficult task, but there has never been a better time for companies to accept the challenge.
‘ Almost half of heart-related deaths are caused by 10 bad eating habits.
Diets high in salt or sugary drinks are responsible for thousands of deaths from heart disease, stroke and type 2 diabetes, according to a study. Scientists also blamed a lack of fruit and vegetables and high levels of processed meats.
Researchers looked at all 702,308 deaths from heart disease, stroke and type 2 diabetes in the US in 2012 and found that 45 per cent were linked with “suboptimal consumption” of 10 types of nutrients. They mapped data on dietary habits from population surveys, along with estimates from previous research of links between foods and disease, on to data about the deaths to come up with the figures.”
The highest proportion of deaths, at 9.5 per cent, was linked with eating too much salt, while a low intake of nuts and seeds was linked with 8.5 per cent.
Eating processed meats was linked with 8.2 per cent of deaths and a low amount of seafood omega-3 fats with 7.8 per cent. Low intake of vegetables accounted for 7.6 per cent and low intake of fruit 7.5 per cent.
Sugary drinks were linked with 7.4 per cent, a low intake of whole grains with 5.9 per cent, low polyunsaturated fats with 2.3 per cent and high unprocessed red meats with 0.4 per cent.
The research, published in the journal JAMA, also found men’s deaths were more likely to have links to poor diet than women’s.
Question What is the estimated mortality due to heart disease, stroke, or type 2 diabetes (cardiometabolic deaths) associated with suboptimal intakes of 10 dietary factors in the United States?
Findings In 2012, suboptimal intake of dietary factors was associated with an estimated 318 656 cardiometabolic deaths, representing 45.4% of cardiometabolic deaths. The highest proportions of cardiometabolic deaths were estimated to be related to excess sodium intake, insufficient intake of nuts/seeds, high intake of processed meats, and low intake of seafood omega-3 fats.
Meaning Suboptimal intake of specific foods and nutrients was associated with a substantial proportion of deaths due to heart disease, stroke, or type 2 diabetes.
Importance In the United States, national associations of individual dietary factors with specific cardiometabolic diseases are not well established.
Objective To estimate associations of intake of 10 specific dietary factors with mortality due to heart disease, stroke, and type 2 diabetes (cardiometabolic mortality) among US adults.
Design, Setting, and Participants A comparative risk assessment model incorporated data and corresponding uncertainty on population demographics and dietary habits from National Health and Nutrition Examination Surveys (1999-2002: n = 8104; 2009-2012: n = 8516); estimated associations of diet and disease from meta-analyses of prospective studies and clinical trials with validity analyses to assess potential bias; and estimated disease-specific national mortality from the National Center for Health Statistics.
Exposures Consumption of 10 foods/nutrients associated with cardiometabolic diseases: fruits, vegetables, nuts/seeds, whole grains, unprocessed red meats, processed meats, sugar-sweetened beverages (SSBs), polyunsaturated fats, seafood omega-3 fats, and sodium.
Main Outcomes and Measures Estimated absolute and percentage mortality due to heart disease, stroke, and type 2 diabetes in 2012. Disease-specific and demographic-specific (age, sex, race, and education) mortality and trends between 2002 and 2012 were also evaluated.
Results In 2012, 702 308 cardiometabolic deaths occurred in US adults, including 506 100 from heart disease (371 266 coronary heart disease, 35 019 hypertensive heart disease, and 99 815 other cardiovascular disease), 128 294 from stroke (16 125 ischemic, 32 591 hemorrhagic, and 79 578 other), and 67 914 from type 2 diabetes.
The authors, from Cambridge University and two US institutions, said that their results should help to “identify priorities, guide public health planning and inform strategies to alter dietary habits and improve health”.
In an editorial, Noel Mueller and Lawrence Appel, of the Johns Hopkins Bloomberg School of Public Health, said: “Policies that affect diet quality, not just quantity, are needed … There is some precedence, such as from trials of the Mediterranean diet plus supplemental foods, that modification of diet can reduce cardiovascular disease risk by 30 per cent to 70 per cent.”
It is important to maintain a healthy weight for your height. The food you eat, and how active you are, help to control your weight.
Healthy eating tips include:
Eat lots of fruit, vegetables, legumes and wholegrain bread and rice.
At least once a week eat some lean meat such as chicken and fish.
Look at the food label and try to choose foods that have a low percentage of sugar and salt and saturated fats.
Limit take-away and fast food meals.
It’s recommended that you do at least 30 minutes of physical activity most days of the week – exercise leads to increased strength, stamina and energy.
The key is to start slowly and gradually increase the time and intensity of the exercise. You can break down any physical activity into three ten-minute bursts, which can be increased as your fitness improves
Drink plenty of fluids and listen to your thirst.
If you are thirsty, make water your first choice. Water has a huge list of health benefits and contains no kilojoules, is inexpensive and readily available.
Sugary soft drinks are packed full of ‘empty kilojoules’, which means they contain a lot of sugar but have no nutritional value.
Some fruit juices are high in sugar and do not contain the fibre that the whole fruit has.
The role of the kidneys is often underrated when we think about our health.
In fact, the kidneys play a vital role in the daily workings of your body. They are so important that nature gave us two kidneys, to cover the possibility that one might be lost to an injury.
We can live quite well with only one kidney and some people live a healthy life even though born with one missing. However, with no kidney function death occurs within a few days!
The kidneys play a major role in maintaining your general health and wellbeing. Think of them as a very complex, environmentally friendly, waste disposal system. They sort non-recyclable waste from recyclable waste, 24 hours a day, seven days a week, while also cleaning your blood.
Most people are born with two kidneys, each one about the size of an adult fist, bean-shaped and weighing around 150 grams each. The kidneys are located at both sides of your backbone, just under the rib cage or above the small of your back. They are protected from injury by a large padding of fat, your lower ribs and several muscles.
Your blood supply circulates through the kidneys about 12 times every hour. Each day your kidneys process around 200 litres of blood. The kidneys make urine (wee) from excess fluid and unwanted chemicals or waste in your blood.
Urine flows down through narrow tubes called ureters to the bladder where it is stored. When you feel the need to wee, the urine passes out of your body through a tube called the urethra. Around one to two litres of waste leave your body each day as urine.
Aboriginal and Torres Strait Islander people are more likely to have end stage kidney disease and be hospitalised or die with chronic kidney disease than non-Indigenous people.4
The greater prevalence of chronic kidney disease in some Aboriginal and Torres Strait Islander communities is due to the high incidence of traditional risk factors, including diabetes, high blood pressure and smoking, in addition to higher levels of inadequate nutrition, alcohol abuse, streptococcal throat and skin infection, poor living conditions and low birth weight, which is linked to reduced nephron development.4
Aboriginal and Torres Strait Islander people experience a higher burden of disease; two and a half times that of non-Indigenous people.
A large part of the burden of disease is due to chronic diseases such as cardiovascular disease, diabetes, cancer, chronic respiratory disease and chronic kidney disease.
This higher burden can be reduced by identifying chronic disease earlier and through the management of risk factors and the disease itself. See more about the management of risk factors here.
A new systematic review and meta-analysis finds that lowering the cost of healthy foods significantly increases their consumption, while raising the cost of unhealthy items significantly reduces their intake.
Food subsidies and taxes significantly improve dietary choices
Interventions that alter food prices can improve people’s diets, leading to more healthy choices and fewer unhealthy choices
While everyone has a sense that food prices matter, the magnitude of impact of food taxes and subsidies on dietary intakes, and whether this varies by the food target, has not been clear. For the review, a team of researchers identified and pooled findings from a total of 30 interventional and longitudinal studies, including 11 that assessed the effect of higher prices (taxation) of unhealthy foods and 19 that assessed the effect of lower prices (subsidies) of healthy foods.
The findings were published in PLOS ONE on March 1.
“To date, evidence on effectiveness of fiscal policies on diet has mostly come from cross-sectional studies, which cannot infer causality. This is why we evaluated studies that examined the relationship between food price and diet over time,” said co-first author Ashkan Afshin, M.D., former postdoctoral fellow at the Friedman School of Nutrition Science & Policy at Tufts University and now at the University of Washington. “Our results show how 10 to 50 percent changes in price of foods and beverages at checkout could influence consumers’ purchasing behaviors over a relatively short period of time.”
In the pooled analysis, each 10 percent decrease in price of fruits and vegetables increased their consumption by 14 percent, and each 10 percent decrease in price of other healthy foods increased their consumption by 16 percent. A change in price of fruits and vegetables was also associated with body mass index (BMI): for every 10 percent price decrease, BMI declined by 0.04 kg/m2.
Conversely, each 10 percent price increase of sugar-sweetened beverages and unhealthy fast foods decreased their consumption by 7 percent and 3 percent, respectively. Every 10 percent price increase in unhealthy foods and drinks was associated with a trend toward lower BMI (per 10 percent price increase: -0.06 kg/m2), but this did not achieve statistical significance.
By merging findings from 23 interventional and 7 prospective cohort studies, the researchers evaluated relationships between the change in the price of specific foods or beverages and the change in their intake. Studies evaluated people’s reported intake or data on sales of foods and beverages. The study populations included children, adults, or both; and countries included the United States, the Netherlands, France, New Zealand, and South Africa. Price change interventions were conducted in various settings such as cafeterias, vending machines and supermarkets. The findings were centrally pooled in a meta-analysis.
Co-first author is Jose Penalvo, Ph.D., M.Sc., Friedman School of Nutrition Science & Policy at Tufts University. Additional authors on this study are Liana Del Gobbo, Ph.D., Stanford University School of Medicine; Jose Silva, M.D., Boston Medical Center; Melody Michaelson, M.Sc., Tufts University School of Medicine; Martin O’Flaherty, M.D., Ph.D., University of Liverpool; Simon Capewell, M.D., D.Sc., University of Liverpool; Donna Spiegelman, D.Sc., Harvard T.H. Chan School of Public Health; and Goodarz Danaei, M.D., D.Sc., Harvard T.H. Chan School of Public Health.
This work was supported by awards from the National Heart, Lung, and Blood Institute of the National Institutes of Health (HL098048, HL115189) and from The New York Academy of Sciences’ Sackler Institute for Nutrition Science. For conflicts of interest disclosure, please see the study.
Afshin, A., Penalvo, J., Del Gobbo, L., Silva, J., Michaelson, M., O’Flaherty, M., Capewell, S., Spiegelman, D., Danaei, G., Mozaffarian, D. (2017, March 1). The prospective impact of food pricing on improving dietary consumption: A systematic review and meta-analysis. PLOS ONE. doi: 10.1371/journal.pone.0172277
About the Friedman School of Nutrition Science and Policy at Tufts University
The Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University is the only independent school of nutrition in the United States. The school’s eight degree programs – which focus on questions relating to nutrition and chronic diseases, molecular nutrition, agriculture and sustainability, food security, humanitarian assistance, public health nutrition, and food policy and economics – are renowned for the application of scientific research to national and international policy.
” Recently the Federal Government has spoken in favour of investment in preventive health.
In an address to the National Press Club in February this year, Prime Minister Malcolm Turnbull said, “in 2017, a new focus on preventive health will give people the right tools and information to live active and healthy lives”.
Health Minister Greg Hunt echoed that sentiment on 20 February announcing the Government was committed to tackling obesity.
Prevention 1st, however, argues the need for a more comprehensive, long-term approach to the problem. Press Release
NACCHO was represented at the #ALPHealthSummit by Chair Matthew Cooke pictured above with Stephen Jones MP
Leading health organisations are calling on the Commonwealth to address Australia’s significant under-investment in preventive health and set the national agenda to tackle chronic disease ahead of Labor’s National Health Policy Summit today.
Chronic disease is Australia’s greatest health challenge, yet many chronic diseases are preventable, with one third of cases traced to four modifiable risk factors: poor diet, tobacco use, physical inactivity and risky alcohol consumption.
Adopting preventive health measures would address significant areas flagged as critical by the both major parties, including ensuring universal access to world-class healthcare, preventing and managing chronic disease, reducing emergency department and elective surgery waiting times, and tackling health inequalities faced by Indigenous Australians.
Prevention 1st – a campaign led by the Foundation for Alcohol Research and Education (FARE), the Public Health Association of Australia (PHAA), Consumers Health Forum of Australia (CHF Australia), and Alzheimer’s Australia – is urging the ALP to adopt the group’s Pre-Budget submission recommendations as part of the party’s key health policy framework.
FARE Chief Executive Michael Thorn says it is up to federal policymakers to address Australia’s healthcare shortfalls and that Labor has the perfect opportunity to reignite its strong track record and lead the way in fixing the country’s deteriorating investment in preventive healthcare.
“Australia’s investment in preventive health is declining, despite chronic disease being the leading cause of illness in Australia. Chronic disease costs Australian taxpayers $27 billion a year and accounts for more than a third of our national health budget. The ALP has both the opportunity and a responsibility as the alternate government to set the national agenda in the preventive healthcare space. Ultimately, however, it falls to the Government of the day to show leadership on this issue,” said Mr Thorn.
Its Pre-Budget submission 2017-18, Prevention 1st identifies a four-point action plan targeting key chronic disease risk factors.
Prevention 1st has called for Australia to phase out the promotion of unhealthy food and beverages, and for long overdue national public education campaigns to raise awareness of the risks associated with alcohol, tobacco, physical inactivity, and poor nutrition. Under the proposal, these measures would be supported by coordinated action across governments and increased expenditure on preventive health.
The costed plan also puts forward budget savings measures, recommending the use of corrective taxes to maximise the health and economic benefits to the community. Taxing products appropriate to their risk of harm will not only encourage healthier food and beverage choices but would generate much needed revenue – around $3.3 billion annually.
With return on investment studies showing that small investments in prevention are cost-effective in both the short and longer terms, and the opportunity to contribute to happier and healthier communities, Consumers Health Forum of Australia Chief Executive Officer Leanne Wells urged both the Australian Government and Opposition to take advantage of the opportunity to stem the tide of chronic disease.
“There is an obvious benefit in adopting forward-thinking on preventive healthcare to reduce pressure on the health budget and the impact of preventable illness and injury on society,” Ms Wells said.
The ALP National Health Policy Summit will be held at Parliament House in Canberra on Friday 3 March.
“The high costs of transporting food and groceries to remote communities mean that Aboriginal and Torres Strait Islander people in these areas are already paying inflated prices for these types of products, and all other grocery items.
“These communities are also less able to pay higher costs and have limited access to alternatives, particularly fresh fruit and vegetables – which, because of the long distances they need to be transported, are often past their prime and overpriced when they arrive,”
“Reducing sugar consumption is critical to reducing chronic health conditions, including diabetes; however, there needs to be more work done on how these issues would be overcome before NACCHO could support any tax-based approach such as a sugar tax.”
Chair Matthew Cooke from peak Indigenous health body, National Aboriginal Community Controlled Health Organisation (NACCHO) has expressed reservations about the tax to MJA InSight.
Senator Scullion said he has been working with remote stores to restrict the sale of larger bottles of soft drink.
“I’ve been trying to negotiate the two litre and 1.5 litres off the shelves completely,”
“It’s a difficult thing but the evidence shows that whatever portion you buy, a child will drink one–and-a-half litres.”
More recently he went to a community store where water was free, but despite trying to “hide the full-strength coke” it was the popular choice.
He gave one example where a remote community store was drawing half of its total profits from soft drink sales.
“It was the most expensive liquid in that store and everyone went straight there,”
Indigenous affairs minister, Nigel Scullion,
” TAXES on unhealthy foods, not subsidies on fruit and vegetables, are effective at reducing the burden of obesity, new research suggests, amid renewed clamour for a sugary drinks tax.
Researchers at the University of Melbourne have found that a subsidy on fresh fruit and vegetables would not on its own produce health gains, because it would lead to an undesirable increase in sodium and energy intake.”
However, adding a subsidy to a package of taxes on sugar, fat, salt and sugar-sweetened beverages could be effective, they wrote. The combination of taxes plus the subsidy could avert 470 000 disability-adjusted life years and save $3.4 billion from the health budget, the modelling study found.
The study drew on detailed New Zealand price–elasticity data – which track variations in product uptake with changes in product prices – to quantify disease risk reductions associated with each change in risk factor exposure.
A sugar tax would be most cost-effective, the study found, followed by a salt tax, a saturated fat tax and a sugar-sweetened beverages tax.
Writing in the journal PLOS Medicine, Dr Linda Cobiac and colleagues said that their findings added to the “growing evidence of large health benefits and cost-effectiveness of using taxes and regulatory measures to influence the consumption of healthy foods”.
The findings about the subsidy might at first appear counterintuitive, they said.
“However, using price subsidies or discounts as an incentive to purchase more fruits and vegetables may have the effect of increasing real income available to buy food, including unhealthy products, and could therefore lead to an overall increase in dietary measures such as saturated fat, sodium, or total energy intake,” they wrote.
In his MJA article, Professor Colagiuri cited the introduction of Mexico’s sugary drinks tax in 2014, which was followed by a 12% decline in the consumption of taxed beverages and a spike in bottled water consumption.
“The ongoing impact of [Mexico’s] tax has been challenged with new data suggesting a small increase in sales of SSBs [sugar-sweetened beverages] in 2015, but still lower than the increase in pre-tax sales,” he wrote.
“Arguments that an SSB tax is an ineffective means to reduce consumption are inconsistent with food industry claims of potential damage and job losses, which instead may point to the industry believing that a tax would substantially impact consumption.”
Professor Colagiuri noted that Australia was among the largest global markets for sugar-sweetened beverages, with males aged 4–30 years drinking an average 750 mL (two cans) per day.
“Government pays for health services and consequently has a right and duty to address externalities to promote and protect public health,” he wrote.
However, the federal government last week continued its resistance to any form of sugar tax, with health minister Greg Hunt commenting: “We’re committed to tackling obesity, but increasing the family’s weekly shop at the supermarket isn’t the answer.”
David Butt, CEO of the National Rural Health Alliance told MJA InSight that his organisation supported “the possibility of taxing sugar-sweetened beverages and using the revenue to subsidise access to healthier food options”.
Professor Andrew Wilson, director of the Menzies Centre for Health Policy at the University of Sydney, said that compared with taxing sugar per se or salt, the proposed tax on sugary drinks had “the virtue of being fairly easy to define”.
“However, these drinks are so cheap to make that the tax will need to be substantial,” he added.
A recent report by the Grattan Institute recommended that sugar-sweetened beverages be taxed at a rate of 40 cents per 100 grams of sugar, increasing the price of a 2-litre bottle of soft drink by 80 cents. This would raise about $500 million a year, according to the Grattan Institute, which predicted a resultant 15% drop in consumption of sugary drinks and a small decrease in obesity rates.
Professor Wilson stressed that any taxation approach should be “part of a package that includes education and support for good nutrition, promotion and facilitation of physical activity, with particular focus on school-aged and older teens, planning considerations and, possibly for some areas and groups, subsidies for fruit and vegetables”.
Dr Cobiac agreed, commenting: “Our modelling shows that the potential health benefits of using taxes and subsidies to improve dietary choices and the nutritional quality of our foods in Australia are huge, but ultimately, they are just one of a number of measures that are needed to tackle obesity.”
Dr Cobiac noted that 13 other countries had announced taxes on unhealthy foods or sugar drinks in the past 5 years.
“It was true that Denmark had revoked its policies,” she said; however, she added that it was likely that as early initiators “they did not fully foresee or plan for dealing with the resulting backlash from the food industry”.
“We will never know what effect the taxes would have had in Denmark; they were repealed before there was a chance to properly evaluate them,” Dr Cobiac said.
“While many people want to eat better and lose weight, it is not easy to sustain the changes in behaviour when we live in an environment where unhealthy foods are widely available, heavily marketed and cheap.
“That environment is unlikely to change without a really comprehensive strategy to tackle the obesity problem.”
” In 2014-15, 63.4% of Australian adults were found by the National Health Survey to be overweight or obese. In response to Australia climbing up the ladder of the most obese countries in the world, professor Stephen Colagiuri, a diabetes expert at the University of Sydney, has urged the government to introduce a sugar tax to dissuade people from consuming sugary foods.”
But what if you live in a place where you don’t have easy access to fresh food? What if the Macca’s down the road is within walking distance, but you have to jump in the car and drive for miles to get to the nearest supermarket? That’s called a food desert, and the sugar tax could have a bigger impact on people who live in those areas.
What is the sugar tax?
At this point, it is a recommendation from some health experts, which would place a levy on sugary drinks in order to mitigate obesity rates.
A report from the World Health Organization (WHO) says that a tax of 20% or more results in the drop of soft drink sales, which they say would also cut healthcare costs if it succeeded in improving health outcomes.
The Grattan Institute has suggested a tax of 40 cents per 100 grams of sugar, and calculated that obesity costs Australians $5.3 billion a year. The savings they have projected would mean an extra $500 million for the budget.
Is there support for the sugar tax?
The WHO called for a tax on sugary drinks across the world in October 2016 to curb the effects of sugary drinks on health.
The Greens have released a statement saying that if the government doesn’t act on the issue, they will draft a private senator’s bill and introduce it to the Senate by the end of 2017.
Who is against it?
The Turnbull government, Labor, and senators Pauline Hanson and Derryn Hinch have all rejected the idea of imposing a sugar tax.
Minister for Health Greg Hunt has said the government was taking action in other ways: “We’re committed to tackling obesity, but increasing the family’s weekly shop at the supermarket isn’t the answer.”
Labor leader Bill Shorten said the opposition had no plans for a sugar tax, but said it was probably time to “toughen up advertising restrictions around junk food at peak periods when the little eyeballs are on the TV and getting all the wrong messages about food and healthy eating”.
What is a food desert?
A food desert is an area where there are no fresh fruit or vegetable outlets within a 500-metre radius. They are also defined by limited access to shops that sell healthy foods, coupled with an abundance of fast-food takeaway options within easy walking distance. These areas leave people disenfranchised by lack of access to affordable, healthy food and at a greater risk of obesity and the development of diabetes.
“It is astonishing that the government is pressing ahead with this pernicious tax when the evidence clearly suggests that it will simply not affect consumption in any meaningful way. As with any regressive tax, this will only raise living costs for hard-pressed families, already struggling with big tax bills. Politicians must look at the evidence and ignore the High Priests of the Nanny State in the public health lobby, and abolish the Sugar Tax before it is too late.”
Food deserts are, in particular, an issue for people of low socio-economic status (SES) and where there are people with mobility issues in the community. The tax will undeniably hit the poor and those living in food deserts harder because more of their income goes towards poor quality food, but there is evidence from studying the effectiveness of the tax in Mexico that it does decrease spending on unhealthy food products for everyone.
“We note that Australians of low SES are disproportionately affected by high rates of diet-related illnesses and are therefore likely to experience greater dietary improvements as a result of a tax on SSBs. Inequitable aspects are likely to be further ameliorated if revenue was used to support healthy eating initiatives and subsidies on healthy foods for low-SES households.”
This means the sugar tax could actually be beneficial to low-SES households in food deserts, as a result of both a shift in eating habits, and a freeing up of space in the health budget to rectify access issues in relation to cost and geography.
Updated Feb 21 with press release from Health Minister Greg Hunt See below
The Australian Government is taking action to tackle the challenge of obesity and encourage all Australians to live healthy lives
“In my view, we should be starting to tax sugary drinks as a first step. Nearly every week there’s a new study citing the benefits of a sugary drinks tax and and nearly every month another country adopts it as a policy. It’s quickly being seen as an appropriate thing to do to address the obesity epidemic.”
A health economist at the Grattan Institute, Stephen Duckett, said the researchers had put together a careful and strong study and set of tax and subsidy suggestions.see article 2 below
One hundred nutrition experts from 53 organisations working with state and federal bureaucrats have drawn up the obesity action plan to control the nation’s weight problem that is costing the nation $56 billion a year.
The review of state and federal food labelling, advertising and health policies found huge variation across the country and experts want it corrected by a National Nutrition Policy.
The nation is in the grip of an obesity crisis with almost two out of three (63 per cent) Australian adults, and one in four (25 per cent) Australian children overweight or obese.
Obesity is also one of the lead causes of disease and death including cancer.
More than 1.4 million Australians have Type 2 diabetes and new cases are being diagnosed at the rate of 280 per day.
Stomach, bowel, kidney, liver, pancreas, gallbladder, oesophagus, endometrium, ovary, prostate cancer and breast cancer in postmenopausal women have all been linked to obesity.
Half of all Australians are exceeding World Health Organisation’s recommendations they consume less than 13 teaspoons or sugar a day with most of the white stuff hidden in drinks and processed food, the Australian Bureau of Statistics Health Survey shows.
Teenage boys are the worst offenders consuming 38 teaspoons of sugar a day which makes up a quarter of their entire calorie intake.
Dr Gary Sacks from Deakin University whose research underpins the obesity control plan says it’s time for politicians to put the interests of ordinary people and their health above the food industry lobbyists
“It’s a good start to have policies for restricting junk foods in school canteens, but if kids are then inundated with unhealthy foods at sports venues, and they see relentless junk food ads on prime-time TV, it doesn’t make it easy for them to eat well,” he said.
That’s why the experts want a co-ordinated national strategy that increases the price of unhealthy food using taxes and regulations to reduce children’s exposure to unhealthy food advertising.
The comprehensive examination of state and federal food policies found Australia is meeting best practice in some areas including the Health Star Rating food labelling scheme, no GST on basic foods and surveys of population body weight.
While all States and Territories have policies for healthy school food provision they are not all monitored and supported, the experts say.
“When nearly two-thirds of Australians are overweight or obese, we
know that it’s not just about individuals choosing too many of the wrong foods, there are strong environmental factors at play – such as the all pervasive marketing of junk food particularly to children,” she said.
The new policy comes as a leading obesity experts says a tax on sugary drinks in Australia would be just as logical as existing mandatory controls on alcohol and tobacco
The UK will introduce a sugar tax next year and in Mexico a sugar tax introduced in 2014 has already reduced consumption of sugary drinks by 12 per cent and increased the consumption of water.
Australian politicians have repeatedly dismissed a sugar tax on the grounds it interferes with individual rights.
However, Professor Colagiuri says “individual rights can be equally violated if governments fail to take effective and proportionate measures to remove health threats from the environment in the cause of improving population health.”
Australian researchers say subsidising fresh fruit and vegetables would ensure the impact of food taxes on the household budget would be negligible. Photograph: Dave and Les Jacobs/Getty Images/Blend Images
Health experts have developed a package of food taxes and subsidies that would save Australia $3.4bn in healthcare costs without affecting household food budgets.
Linda Cobiac, a senior research fellow at the University of Melbourne’s school of public health, led the research published on Wednesday in the journal Plos Medicine.
Cobiac and her team used international data from countries that already have food and beverage taxes such as Denmark, but tweaked the rate of taxation and also included a subsidy for fresh fruit and vegetables so the total change to the household budget would be negligible.
They then modelled the potential impact on the Australian population of introducing taxes on saturated fat, salt, sugar and sugar-sweetened beverages, and a subsidy on fruits and vegetables. Their simulations found the combination of the taxes and subsidy could result in 1.2 additional years of healthy life per 100 people alive in 2010, at a net cost-saving of $3.4bn to the health sector.
“Few other public health interventions could deliver such health gains on average across the whole population,” Cobiac said.
The sugar tax produced the biggest gains in health, followed by the salt tax, the saturated fat tax and the sugar-sweetened beverage tax.
The fruit and vegetable subsidy, while cost-effective when added to the package of taxes, did not lead to a net health benefit on its own, the researchers found.
AdvertisementA co-author of the paper, Prof Tony Blakely, said this was because although a fruit and vegetable subsidy alone would encourage people to eat more fresh foods, previous studies of consumer behaviour had found they would spend the money saved on sugary foods.
The researchers suggest introducing a tax of $1.37 for every 100 grams of saturated fat in those foods with a saturated fat content of more than 2.3%, excluding milk; a salt tax of 30 cents for one gram of sodium above Australian maximum recommended levels; a sugar-sweetened beverage tax of 47 cents a litre; a fruit and vegetable subsidy of 14 cents for every 100 grams; and a sugar tax of 94 cents for every 100ml in ice-cream with more than 10 grams of sugar per 100 grams; and 85 cents for every 100 grams in all other products.
The taxes exclude fresh fruits, vegetables, meats and many dairy products.
“You need to include both carrots and sticks to change consumer behaviour and to encourage new taxes,” Blakely said. “That’s where this paper is cutting edge internationally.
“We have worked out the whole package of taxes with minimal impact on the budget of the household, so you can see an overall gain for the government. The government would be less interested in the package if it was purely punitive, but this provides subsidies and savings to health spending that could be reinvested back into communities and services.”
He said taxing junk foods also prompted food manufacturers to change their products and make them healthier to avoid the taxes.
“For those who might say this is an example of nanny state measures, let’s consider that we don’t mind asbestos being taken out of buildings to prevent respiratory disease, and we’re happy for lead to be taken from petrol. We need to change the food system if we are going to tackle obesity and prevent disease.”
A health economist at the Grattan Institute, Stephen Duckett, said the researchers had put together a careful and strong study and set of tax and subsidy suggestions. “This is a very good paper,” he said.
“In my view, we should be starting to tax sugary drinks as a first step. Nearly every week there’s a new study citing the benefits of a sugary drinks tax and and nearly every month another country adopts it as a policy. It’s quickly being seen as an appropriate thing to do to address the obesity epidemic.”
A Grattan Institute report published in November found introducing an excise tax of 40 cents for every 100 grams of sugar in beverages as part of the fight against obesity would trigger a 15% drop in the consumption of sugary drinks. Australians and New Zealanders consume an average of 76 litres of sugary drinks per person every year.
In a piece for the Medical Journal of Australia published on Monday, the chair of the Council of Presidents of Medical Colleges, Prof Nicholas Talley, wrote that “the current lack of a coordinated national approach is not acceptable”.
More than one in four Australian children are now overweight or obese, as are more than two-thirds of all adults.
Talley proposed a six-point action plan, which included recognising obesity as a chronic disease with multiple causes. He also called for stronger legislation to reduce unhealthy food marketing to children and to reduce the consumption of high-sugar beverages, saying a sugar-sweetened beverage tax should be introduced.
“There is evidence that the food industry has been a major contributor to obesity globally,” he wrote. “The health of future generations should not be abandoned for short-term and short-sighted commercial interests.”
Press Release 21 February Greg Hunt Health Minister
The Australian Government is taking action to tackle the challenge of obesity and encourage all Australians to live healthy lives.
The Turnbull Government is taking action to tackle the challenge of obesity and encourage all Australians to live healthy lives.
But unlike the Labor Party, we don’t believe increasing the family grocery bill at the supermarket is the answer to this challenge.
We already have programmes in place to educate, support and encourage Australians to adopt and maintain a healthy diet and to lead an active life – and there’s more to be done.
Earlier this month, the Prime Minister flagged that the Government will soon be announcing a new focus on preventive health that will give people the right tools and information to live active and healthy lives. This will build on the significant work already underway.
Yesterday, we launched the second phase of the $7 million Girls Make Your Move campaign to increase physical activity for girls and young women. This is now being rolled out across Australia.
Our $160 million Sporting Schools program is getting kids involved in physical activity. Already around 6,000 schools across the country have been involved – with many more to come. This is a great programme that Labor wants to axe.
Our Health Star Rating system helps people to make healthier choices when choosing packaged foods at the supermarket and encourages the food industry to reformulate their products to be healthier.
The Healthy Weight Guide website provides useful advice including tips and tools to encourage physical activity and healthy eating to achieve and maintain a healthy weight.
The Healthy Food Partnership with the food industry and public health groups is increasing people’s health knowledge and is supporting them to make healthier food and drink choices in order to achieve better health outcomes.
We acknowledge today’s report, but it does not take into account a number of the Government programs now underway.
Obesity and poor diets are complex public health issue with multiple contributing factors, requiring a community-wide approach as well as behaviour change by individuals. We do not support a new tax on sugar to address this issue.
Fresh fruit and vegetables are already effectively discounted as they do not have a GST applied.
Whereas the GST is added to the cost of items such as chips, lollies, sugary drinks, confectionery, snacks, ice-cream and biscuits.
We’re committed to tackling obesity, but increasing the family’s weekly shop at the supermarket isn’t the answer
The Lighthouse hospital project is a joint initiative of the Heart Foundation and the Australian Healthcare and Hospitals Association (AHHA).
The aim: to improve care and health outcomes for Aboriginal and Torres Strait Islander peoples experiencing coronary heart disease, the leading cause of death among this population.
Australia is a privileged nation by world standards. Despite this, not everyone is equal when it comes to heart health and Aboriginal and Torres Strait Islander people are the most disadvantaged. The reasons are complex and not only medical in nature. Aboriginal and Torres Strait Islander people have a troubled history with institutions of all kinds, including hospitals.
The Lighthouse Hospital project aims to change this experience by providing both a medically and culturally safe hospital environment. A culturally safe approach to healthcare respects, enhances and empowers the cultural identity and wellbeing of an individual.
This project matters because the facts are sobering. Cardiovascular disease occurs earlier, progresses faster and is associated with greater co-morbidities in Aboriginal and Torres Strait Islander peoples. They are admitted to hospital and suffer premature death more frequently compared with non-Indigenous Australians.
Major coronary events, such as heart attacks, occur at a rate three times that of the non- Indigenous population. Fatalities because of these events are 1.5 times more likely to occur, making it a leading contributor to the life expectancy gap .
Current employment opportunities
1.The National Project Manager – Lighthouse Hospital Project
Will manage the development, delivery and evaluation of the Lighthouse Hospital Project (Phase 3) across 18 hospital sites nationally. The role will lead project partnerships and oversee a national team of four to drive sustainable change in acute settings to improve cardiac care and outcomes for Aboriginal and Torres Strait Islander peoples. Regular interstate travel will be required.
Will manage the day to day support for the development, implementation and evaluation of the Lighthouse Hospital Project (Phase 3) in approximately six hospital sites each. The Coordinators will support the development of local and state-based project partnerships and work as part of a national project team of five to drive sustainable change in acute settings to improve cardiac care and outcomes for Aboriginal and Torres Strait Islander peoples. Regular interstate travel will be required.
Aim – To improve the care of Aboriginal and Torres Strait Islander peoples experiencing acute coronary syndrome (ACS).
We developed this project was developed in response to a 2006 report from the Australian Institute of Health and Welfare (AIHW).
The project first focused on providing culturally safe and positive consumer experiences, which were reviewed by 10 organisations known for providing exemplary care in the treatment of Aboriginal and Torres Strait Islander patients with acute coronary syndromes (ACS).
The project identified key elements that make a difference to ACS care:
expanding roles for Aboriginal Liaison Officers, Health Workers, Patient Pathway Officers and equivalent roles
better identification of Aboriginal and Torres Strait Islander patients
building strong partnerships and communication channels with local Aboriginal and Torres Strait Islander communities and other relevant organisations
fostering and supporting clinical champions
building capacity for patient-focused care
use of technology
use of an industry-based quality matrix.
Phase 2 (2013–2016)
Aim – To drive systemic change in acute care hospital settings to improve care for and the experience of Aboriginal and Torres Strait Islander peoples experiencing ACS.
In Phase two, the scope was to improve activities in eight public hospitals across Australia to improve clinical and cultural care for Aboriginal and Torres Strait Islander patients with ACS.
We developed a quality improvement toolkit, ‘Improving health outcomes for Aboriginal and Torres Strait Islander peoples with acute coronary syndrome’, to provide a framework to address health disparities.
The toolkit aimed to:
ensure care providers met minimum standards of care, cultural safety
identify practices and actions that can and/or should be improved
improve healthcare services for Aboriginal and Torres Strait Islander peoples with ACS.
The toolkit outlined four areas that were critical in providing holistic care for Aboriginal and Torres Strait Islander peoples and their families as they journeyed through the hospital system and return to their communities.
The four domains were:
Eight pilot hospitals participated in testing the toolkit:
Bairnsdale Regional Health Service, Victoria
Coffs Harbour Health Campus, New South Wales
Flinders Medical Centre, South Australia
Liverpool Hospital, New South Wales
Princess Alexandra Hospital, Queensland
Royal Perth Hospital, Western Australia
St Vincent’s Hospital, Victoria
Tamworth Rural Referral Hospital, New South Wales.
Each hospital developed an action plan that outlined the areas they would address and the quality improvement activities they would undertake during the pilot. The project outcomes were dependent on community engagement, capacity to embed change, project support and the governance structures at each site.
Key Phase 2 achievements
Improved relationships with Aboriginal and Torres Strait Islander patients
Strengthening relationships with the Aboriginal and Torres Strait Islander community and medical services
Creating culturally safe environments for Aboriginal and Torres Strait Islander patients
Increased self-identification among Aboriginal and Torres Strait Islander patients
Streamlining processes related to culturally appropriate clinical care of Aboriginal and Torres Strait Islander patients
Enhanced staff capacity to respond to the needs of Aboriginal and Torres Strait Islander patients
We are awaiting funding for Phase three of the Lighthouse Project.
This will aim to increase the reach and the critical mass of Aboriginal and Torres Strait Islander peoples experiencing an acute coronary syndrome who receive evidence based care in a culturally safe manner.
Within this phase there will be a focus on integration of health services and care coordination by enhancing the relationships between local community groups, hospitals, local Aboriginal Community Controlled Organisations and Primary Health Networks.
The implementation of this phase would enable hospitals to address the actions in the revised Australian Commission on Safety and Quality in Healthcare National Safety and Quality Health Service.
The Lighthouse hospital project is a joint initiative of the Heart Foundation and the Australian Healthcare and Hospitals Association and is funded by the Australian Government Department of Health.
Australian Health Ministers Advisory Council (AHMAC). Aboriginal and Torres Strait Islander Health Performance Framework 2012 Report. Canberra: AHMAC, 2012.
Mathur S, Moon L, Leigh S. Aboriginal and Torres Strait Islander people with coronary heart disease: further perspectives on health status and treatment. Cardovascular disease series no. 25. Canberra: Australian Institute of Health and Welfare, 2006.