NACCHO Aboriginal Male Health : How Redfern’s Sol Bellear prevented a massive life-threatening heart attack

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 ” I’ve been part of campaigns urging Aboriginal men to lead healthy lifestyles and get regular medical checks, but I didn’t follow my own advice.

If there’s one legacy I leave, I want it to be that Aboriginal men more regularly present for check-ups.”

“We need to take responsibility. We owe this to our families and our communities. We don’t need to keep dying too early from preventable heart disease.”

As the long-term Chair of the Aboriginal Medical Service and a Board member since 1975, Sol didn’t practice what he preached when it came to his own health.

Originally published by Our Mob 22 Dec 2017

Watch recent NACCHO TV Interview with Sol Bellear

All images in this story: Courtesy of the Bellear family

Land Rights legend Sol Bellear considers himself one of the lucky ones.

A decision Sol made some nine months ago to lead a healthier lifestyle not only saved his life but made him more determined to lead the campaign for men’s health.

A few months before he was to die from a massive heart attack, Sol decided to change his life.

While driving back together from a New South Wales Aboriginal Land Council (NSWALC) meeting in West Wyalong, Sol’s colleague, Acting CEO, Cal Davis told him about a diet he had started to control his diabetes.

“Sol was pretty interested in the diet and said he wanted to try it out,” Cal says.

“So I got him some books and he started to get his calories down and eat more low-carbohydrate, Mediterranean-style meals.”

The diet immediately brought results. Within eight weeks, Sol had lost seven kilos. But then his weight plateaued. When he started to do some light exercise he found he was short of breath after only a few steps.

Sol’s doctor referred him to cardiologist, Dr Raj Puranik who for seven years has conducted monthly clinics at the Redfern Aboriginal Medical Service.

“We took an ultrasound and I was concerned that an area of Sol‘s heart muscle wasn’t working,“ Dr Puranik said.

“After we did an angiogram (or x-ray of the heart), we found that two of his coronary arteries were 100 percent blocked and the other was 90 percent blocked.  So he was surviving on just ten percent blood flow.”

Sol could have suffered a life-threatening heart attack at any time.

How Sol Bellear prevented a massive life-threatening heart attack

A member of the surgical team that operated on Sol later told him that he was just three to four weeks away from a massive heart attack that would most likely have killed him.

Sol was rushed to the Royal Prince Alfred Hospital where surgeons performed an emergency coronary bypass operation.

Surgeons split his chest open and grafts were used to bypass the blockages in his arteries.

After four hours the operation was a success and Sol woke to see his concerned family huddled around his bed.

“You wake up in the Intensive Care Unit and all your family are there.  And you look at their faces and see all their grief.  You think, so this is what I’ve put them through,” he said.

As the long-term Chair of the Aboriginal Medical Service and a Board member since 1975, Sol didn’t practice what he preached when it came to his own health.

“I’ve been part of campaigns urging Aboriginal men to lead healthy lifestyles and get regular medical checks, but I didn’t follow my own advice.”

Sol was a keen sportsman who played rugby league for the South Sydney Rabbitohs and Redfern All Blacks, but after he retired from football he didn’t maintain regular exercise or watch his diet.

“I was working long hours, drinking too much and eating too many rubbish foods.”

Although he spent a large part of his life at the Aboriginal Medical Service, Sol, like many men, didn’t prioritise a visit to the doctor.

“It’s an ego thing. We think we’re bullet proof … it will never happen to me. But it did happen.”

Since his brush with death, Sol has been struck by how many of his friends and colleagues have had heart bi-passes.

“They say to me: ‘Brother, you’re now a member of the zipper club.’  But this isn’t a club where we want any new members.”

However, Sol knows that he is one of the lucky ones. After the operation he was at home recovering and feeling bored so he got out some old photos from his playing days.

There was one that was of the Redfern All Blacks team from 1978.

There are 20 young men in the photo including the ball boys.

Now all but six of them are dead, many from heart disease.

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“The greatest tragedy is that many of the deaths of these young men were preventable,” Sol says.

“The only thing separating me from them is luck.”

Dr Puranik says that Australia will never close the mortality gap between Aboriginal and non-Aboriginal people without action on heart disease.

“Heart disease is the number one driving factor behind the gap. It’s the number one killer but 90 percent of cardiac disease is preventable,” he says.

His years at the Redfern AMS have convinced Dr Puranik that getting the model of health care delivery right is crucial to overcoming the problem.

“We need to take our clinics to Aboriginal people in their community-controlled medical services and show through images rather than just tell them how their heart muscle is working.”

The secret, he says, is patience and building trust.

“When we first started out at Redfern in June 2009 we had a no show rate of around 90 percent.  Now we have seen more than 6,000 patients and the number of people who don’t turn up for appointments is down to 10 percent.”

Sol says that Aboriginal men can’t just leave it to the doctors to solve the problem.

“We now have some of the best doctors in the world at our Medical Services, but only we can change the way that we live by having regular check-ups and a healthier lifestyle,” he says.

Sol says that when you hit 40, you need to start getting regular check-ups – even if you play regular sport and feel fit and healthy.

“By the time you move through your 50s and 60s you should have a clear idea of your blood pressure, blood sugar and cholesterol levels.

You don’t want to leave it as long as I did – where you’re playing Russian roulette with your heart.”

Sol urges Aboriginal men to adopt a healthier lifestyle by not smoking, cutting down on alcohol and keeping weight down through healthy foods and regular exercise.

Dr Puranik says that there are some clear warning signs that indicate you should seek urgent medical attention.

These include pain to the left side of the central chest, neck or arm pain – particularly related to exercise, dizzy spells or blackouts, chest pain that wakes you up from sleep as well as breathlessness or palpitations.

Incredibly, given how close he came to death, just one month after surgery Sol’s normal heart function had been fully restored.

A veteran of the Aboriginal Land Rights movement and a pioneer of Aboriginal media, sports legal and health services, Sol says that nothing now matters as much to him as overcoming heart disease amongst Aboriginal men.

“If there’s one legacy I leave, I want it to be that Aboriginal men more regularly present for check-ups.”

“We need to take responsibility. We owe this to our families and our communities. We don’t need to keep dying too early from preventable heart disease.”

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For NACCHO Media Contact

Colin Cowell Editor 0401 331 251

Email mailto:nacchonews@naccho.org.au

NACCHO Aboriginal Health ” Tackling Indigenous Smoking ” : New Year #healthyfutures #quit message from Tom Calma

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 ” I want to say some more about New Year Eve resolutions or pledges.  Common among smokers around the world is the pledge they make to give up.  

This is great, but the common experience is that within a couple of months the pledge is put on the back burner and old habits re-emerge.  Now is a good time to mount a campaign to talk to your constituents about the “give up the smokes pledge” and encourage them to call Quitline or visit their doctor to talk about developing a strategy and getting support to quit and stay quit.

It would be great for colleagues to get on the Yarning Place and share successful strategies and to post success stories.  We might even want to host a pledge board and to monitor people’s pledges in three and six months’ time.

It has been a big year of learning and successes; please stay safe and healthy over the festive period and enjoy quality family time, drink alcohol responsibly and be smoke free of course “

Professor Tom Calma, National Coordinator for Tackling Indigenous Smoking, in his final Monthly Message of the year : Included in the National Best Practice Unit for Tackling Indigenous Smoking Update of the 12 December 2016 see below , is urging all Aboriginal organisations to take control and resolve in 2017 to implement smoke free workplaces.

  ‘Our mob have the right to work in a smoke free environment just like everyone else in this country.’
 
Visit the Tackling Indigenous Smoking portal on Australian Indigenous HealthInfoNet to access resources to help you achieve smoke free workplaces,homes, cars and events:
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For those individuals who are thinking of making a ‘give up smokes pledge’ this New Year, there are several supports available, including:
·         Quitline – 13 78 48
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·         The QuitNow website: http://www.quitnow.gov.au/internet/quitnow/publishing.nsf/Content/home for other resources
·         Your Aboriginal Community Controlled Health Organisation and /or Tackling Indigenous Smoking regional team can provide you with smoking cessation support.
naccho-app

 Download the NACCHO APP

Hi colleagues,

 

Tackling smoking in the workplace is often put in the ‘too hard basket’.  In 2016 this is no longer excusable.

 
If we want to make significant inroads into tackling our smoking rates, we must have the courage and will to take control of our workplaces and have Board members, CEOs and Managers and staff step up and set an example to their communities.  Our mob have the right to work in a smoke free environment just like everyone else in this country.

On the 30 November this year, the Commonwealth Department of Health celebrated 30 years of being smoke free.    Think of the benefits to all those working in this Department over these three decades.   Health lead the way in the Commonwealth, with all other Departments becoming smoke free by 1988.  Public and private sector offices implemented their own smoke free policies in the mid-1990s.  Why is it that Aboriginal and Torres Strait Islander organisations, corporations and workplaces are either not smoke free, or do not enforce smoke free policies?
 
The Smoke Free Workplace Policy currently operating in the Department bans smoking and use of e-cigarettes/personal vaporisers within 15 metres of all health buildings at all time.  There may be elements of this Policy that you can draw on, including ideas on the assistance available to staff to quit.   So when you work with or interact with an Aboriginal and Torres Strait Islander organisation or group encourage them to develop a smoke free policy and give them some guidance on how to do it.

The TIS Portal includes resources on smoke free spaces: 
http://www.aodknowledgecentre.net.au/aodkc/aodkc-tobacco/tackling-indigenous-smoking/resources-that-work/tools-and-resources-to-support-activities-that-work.    I encourage you to engage with colleagues on the Yarning Place to share strategies and ideas for smoke free workplace success.

The 30 November was also the fourth anniversary of commencement of Australia’s world-leading tobacco plain packaging measures.  If we can be world leading on tobacco control for all Australians, we can become leaders in Indigenous tobacco control to save our people, our culture and our languages.

As this is my last message for 2016 I would urge you to place at the top of your New Year resolutions list adopting and enforcing smoke free workplace policies in your organisation and encouraging and helping our Aboriginal and Torres Strait Islander organisations to also realise these goals.
 
I want to say some more about New Year Eve resolutions or pledges.  Common among smokers around the world is the pledge they make to give up.  This is great, but the common experience is that within a couple of months the pledge is put on the back burner and old habits re-emerge.  Now is a good time to mount a campaign to talk to your constituents about the “give up the smokes pledge” and encourage them to call Quitline or visit their doctor to talk about developing a strategy and getting support to quit and stay quit.   It would be great for colleagues to get on the Yarning Place and share successful strategies and to post success stories.  We might even want to host a pledge board and to monitor people’s pledges in three and six months’ time.
 
It has been a big year of learning and successes; please stay safe and healthy over the festive period and enjoy quality family time, drink alcohol responsibly and be smoke free of course. J  
 
Regards TOM
 
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NACCHO Aboriginal Health Alert #GetonTrack Report : The ten things we need to do to improve our health

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” Australia’s Health Tracker reports that 25.6% of children and 29.5% of young people are overweight or obese, with even higher prevalence reported in Aboriginal and Torres Strait Islander communities.

Over-consumption of discretionary or junk foods contributes to Australia’s inability to halt the rise of diabetes and obesity. Australia’s Health Tracker also reports that junk foods contribute, on average, to approximately 40% of children and young people’s daily energy needs.

These foods and drinks tend to have low levels of essential nutrients and can take the place of other, more nutritious foods. They are associated with increased risk of obesity and chronic disease such as heart disease, stroke, type 2 diabetes, and some forms of cancer.

Obesity during adolescence is a risk factor for chronic disease later in life and can seriously hinder children’s and young people’s physical and mental development. ”

From the Getting Australia’s Health on Track

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Download the report here getting-australias-health-on-track-ahpc-nov2016

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NACCHO Aboriginal Health #Newspaper What Works Part 3 : Healthy Futures for our Aboriginal Community Controlled Health Services the 2016 Report Card will say

Report from the Conversation

In Australia, one in every two people has a chronic disease. These diseases, such as cancer, mental illness and heart disease, reduce quality of life and can lead to premature death. Younger generations are increasingly at risk.

Crucially, one-third of the disease burden could be prevented and chronic diseases often share the same risk factors.

A collaboration of Australia’s leading scientists, clinicians and health organisations has produced health targets for Australia’s population to reach by the year 2025.

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These are in line with the World Health Organisation’s agenda for a 25% global reduction in premature deaths from chronic diseases, endorsed by all member states including Australia.

Today the collaboration is announcing its top ten priority policy actions in response to a recent health report card that identifies challenges to meeting the targets.

The actions will drive down risk factors and help create a healthier Australia.

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1. Drink fewer sugary drinks

One in two adults and three out of four children and young people consume too much sugar. Sugary drinks are the main source of sugar in the Australian diet and while many other factors influence health, these drinks are directly linked to weight gain and the risk of developing diabetes.

Putting a 20% tax on sugary drinks could save lives and prevent heart attacks, strokes and diabetes. The tax would also generate A$400 million each year that could be spent on much needed health programs.

2. Stop unhealthy food marketing aimed at kids

Almost 40% of children and young people’s energy comes from junk food. Children are very responsive to marketing and it is no coincidence almost two-thirds of food marketing during popular viewing times are unhealthy products.

Restricting food marketing aimed at children is an effective way to significantly reduce junk food consumption and Australians want action in this area. Government-led regulation is needed to drive this change.

3. Keep up the smoking-reduction campaigns

Smoking remains the leading cause of preventable death and disease in Australia, although the trends are positive.

Campaigns that highlight the dangers of smoking reduce the number of young people who start smoking, increase the number of people who attempt to quit and support former smokers to remain tobacco free.

4. Help everyone quit

About 40% of Aboriginal people and 24% of people with a mental illness smoke.

To support attempts to quit, compliance with smoke-free legislation across all work and public places is vital. Media campaigns need to continue to reach broad audiences. GPs and other local health services that serve disadvantaged communities should include smoking cessation in routine care.

5. Get active in the streets

More than 90% of Australian young people are not meeting guidelines for sufficient physical activity – the 2025 target is to reduce this by at least 10%.

Active travel to and from school programs will reach 3.7 million of Australia’s children and young people. This can only occur in conjunction with safe paths and urban environments that are designed in line with the latest evidence to get everyone moving.

6. Tax alcohol responsibly

The Henry Review concluded that health and social harms have not been adequately considered in current alcohol taxation. A 10% increase on the current excise, and the consistent application of volume-based taxation, are the 2017 priority actions.

Fortunately, the trends suggest most people are drinking more responsibly. However approximately 5,500 deaths and 157,000 hospital admissions occur as a consequence of alcohol each year.

7. Use work as medicine

People with a mental illness are over-represented in national unemployment statistics. The 2025 target is to halve the employment gap.

Unemployment and the associated financial duress exerts a significant toll on the health of people with a mental illness, and costs an estimated A$2.5 billion in lost productivity each year.

Supported vocational programs have 20 years of evidence showing their effectiveness. Scaling up and better integrating these programs is an urgent priority, along with suicide prevention and broader efforts.

8. Cut down on salt

Most Australian adults consume in excess of the recommended maximum salt intake of 5 grams daily. This contributes to a high prevalence of elevated blood pressure among adults (23%), which is a major risk factor for heart diseases.

Around 75% of Australian’s salt intake comes from processed foods. Reducing salt intake by 30% by 2025, via food reformulation, could save 3,500 lives a year through reductions in heart disease, stroke and kidney disease.

9. Promote heart health

Heart disease is Australia’s single largest cause of death, and yet an estimated 970,000 adults at high risk of a cardiovascular event (heart attack or stroke) are not receiving appropriate treatment to reduce risk factors such as combined blood pressure and cholesterol-lowering medications. Under-treatment can be exacerbated by people’s lack of awareness about their own risk factors.

National heart risk assessment programs, along with care planning for high-risk individuals, offer a cost-effective solution.

10. Measure what matters

A comprehensive Australian Health Survey must be a permanent and routine survey every five years, so Australia knows how we are tracking on chronic disease.

All of these policies are effective, affordable and feasible opportunities to prevent, rather than treat, Australia’s biggest killer diseases

 

NACCHO Aboriginal Health Debate : # A sugary drinks tax could recoup some of the costs of #obesity while preventing it

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Personal responsibility, not the Australian Tax Office, should determine how much sugar Australians consume, says Barnaby Joyce. Often as not, Barnaby’s recovery program involves half a packet of Marlboros, which he calls bungers.

Barnaby was much agitated on Wednesday about the suggestion by the Grattan Institute that a tax on high-sugar fizzy drinks might go some way towards alleviating Australia’s obesity problem.

“This is one of the suggestions where right at the start we always thought was just bonkers mad,” he declared, adding his party would not be supporting a sugar tax.

This shouldn’t knock you cold with surprise. Barnaby is the leader of the Nationals. Name a sugar-growing area and you’ll find a Nationals or a Liberal National Party member at the local school fete knocking back a mug of raw sugar-cane juice and proclaiming it God’s food.

But Barnaby wasn’t simply stopping at political solidarity with his northern MPs.

He had some Barnaby-advice on how you might lose weight without taxing sugar.

“People are sitting on their backside too much, and eating too much food and not just soft drinks, eating too many chips and other food,” he lectured.

“Well, so the issue is take the responsibility upon yourself. The Australian Taxation Office is not going to save your health, right. Do not go to the ATO as opposed to go to your doctor or put on a pair of sandshoes and walk around the block and…go for a run.

The ATO is not a better solution than jumping in the pool and going for a swim.

The ATO is not a better solution than reducing your portion size.

“So get yourself a robust chair and a heavy table and halfway through the meal, put both hands on the table and just push back. That will help you lose weight.”

Barnaby Joyce, living miracle, offers a health plan : Pictured above David Gillespie Assistant Minister for Rural Health and Member for Lyne

Note 1: The Federal electorates of Lyne which takes in Taree and Port Macquarie has been identified at the Number One stroke ‘hotspot’ in Australia.Refer

Note 2 : The Minister is not to be confused with David Gillespie Author of How Much Sugar and Sweet Poison : Why Sugar makes us fat .

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In the wake of the progress report on Closing the Gap, the Indigenous Affairs Minister Nigel Scullion has declared sugary soft drinks are “killing the population” in remote Indigenous communities.

Key points:

  • Closing the Gap report found worst health outcomes found in remote communities
  • One remote community store drawing half of total profits from soft drink sales, Senator Scullion says
  • Senator Scullion says he thinks attitudes to soft drink are changing

According to evidence provided to Senate estimates today, at least 1.1 million litres of so-called “full sugar” soft drink was sold in remote community stores last financial year.

NACCHO Health News Alert : Scullion says sugary soft drinks ‘killing the population’ in remote Aboriginal communities

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Grattan Institute report

 ” Obesity is a major public health problem  In Australia more than one in four adults are now classified as obese, up from one in ten in the early 1980s.

And about 7% of children are obese, up from less than 2% in the 1980s.

The sugary drinks tax  revenue could be spent on obesity programs that benefit the disadvantaged, reducing the regressivity of the tax.

While the beverage and sugar industries are strongly opposed to any tax on sugar, their concerns are overblown.

A sugar-sweetened beverages tax will reduce domestic demand for Australian sugar by around 50,000 tonnes, which is only about 1% of all the sugar produced in Australia. And while there may be some transition costs, this sugar could instead be sold overseas (as 80% of Australia’s sugar production already is).

A tax on sugary drinks is a public health reform whose time has come.

The Conversation

A sugary drinks tax could recoup some of the costs of obesity while preventing it

In our new Grattan Institute report, A sugary drinks tax: recovering the community costs of obesity, we estimate community or “third party” costs of obesity were about A$5.3 billion in 2014/15.

Obesity not only affects an individual’s health and wellbeing, it imposes enormous costs on the community, through higher taxes to fund extra government spending on health and welfare and from forgone tax revenue because obese people are more likely to be unemployed.

In our new , A sugary drinks tax: recovering the community costs of obesity, we estimate community or “third party” costs of obesity were about A$5.3 billion in 2014/15.

We propose the government put a tax on sugar-sweetened beverages to recoup some of the third-party costs of obesity and reduce obesity rates. Such a tax would ensure the producers and consumers of those drinks start paying closer to the full costs of this consumption – including costs that to date have been passed on to other taxpayers. There is the added benefit of raising revenue that could be spent on obesity-prevention programs.

The scope of our proposed tax is on non-alcoholic, water-based beverages with added sugar. This includes soft drinks, flavoured mineral waters, fruit drinks, energy drinks, flavoured waters and iced teas.

While a sugary drinks tax is not a “silver bullet” solution to the obesity epidemic (that requires numerous policies and behaviour changes at an individual and population-wide level), it would help.

Why focus on sugary drinks?

Sugar-sweetened beverages are high in sugar and most contain no valuable nutrients, unlike some other processed foods such as chocolate. Most Australians, especially younger people, consume too much sugar already.

People often drink excessive amounts of sugary drinks because the body does not send appropriate “full” signals from calories consumed in liquid form. Sugar-sweetened beverages can induce hunger, and soft drink consumption at a young age can create a life-long preference for sweet foods and drinks.

We estimate, based on US evidence, about 10% of Australia’s obesity problem is due to these sugar-filled drinks.

Many countries have implemented or announced the introduction of a sugar-sweetened beverages tax including the United Kingdom, France, South Africa and parts of the United States. The overseas experience is tax reduces consumption of sugary drinks, with people mainly switching to water or diet/low-sugar alternatives.

There is strong public support in Australia for a sugar-sweetened beverages tax if the funds raised are put towards obesity prevention programs, such as making healthier food cheaper. Public health authorities, including the World Health Organisation and the Australian Medical Association, as well as advocates such as the Obesity Policy Coalition, support the introduction of a sugar-sweetened beverages tax.

What the tax would look like

We advocate taxing the sugar contained within sugar-sweetened beverages, rather than levying a tax based on the price of these drinks, because: a sugar content tax encourages manufacturers to reduce the sugar content of their drinks, it encourages consumers to buy drinks with less sugar, each gram of sugar is taxed consistently, and it deters bulk buying.

The tax should be levied on manufacturers or importers of sugar-sweetened beverages, and overseas evidence suggests it will be passed on in full to consumers.

We estimate a tax of A$0.40 per 100 grams of sugar in sugary drinks, about A$0.80 for a two-litre bottle of soft drink, will raise about A$400-$500 million per year. This will reduce consumption of sugar-sweetened beverages by about 15%, or about 10 litres per person on average. Recent Australian modelling suggests a tax could reduce obesity prevalence by about 2%.


Author provided/The Conversation, CC BY-ND

Low-income earners consume more sugar-sweetened beverages than the rest of the population, so they will on average pay slightly more tax. But the tax burden per person is small – and consumers can also easily avoid the tax by switching to drinks such as water or artificially sweetened beverages.

People on low incomes are generally more responsive to price rises and are therefore more likely to switch to non-taxed (and healthier) beverages, so the tax may be less regressive than predicted. Although a sugar-sweetened beverages tax may be regressive in monetary terms, the greatest health benefits will flow through to low-income people due to their greater reduction in consumption and higher current rates of obesity.

The revenue could also be spent on obesity programs that benefit the disadvantaged, reducing the regressivity of the tax.

While the beverage and sugar industries are strongly opposed to any tax on sugar, their concerns are overblown. Most of the artificially sweetened drinks and waters, which will not be subject to the tax, are owned by the major beverage companies.

A sugar-sweetened beverages tax will reduce domestic demand for Australian sugar by around 50,000 tonnes, which is only about 1% of all the sugar produced in Australia. And while there may be some transition costs, this sugar could instead be sold overseas (as 80% of Australia’s sugar production already is).

A tax on sugary drinks is a public health reform whose time has come.

NACCHO Aboriginal Health : OBESITY – Australia’s biggest public health challenge

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“Obesity is markedly more prevalent amongst people of Aboriginal and Torres Strait Islander descent compared to all Australians, with 25 per cent of men and 29 per cent of women being obese.

Aboriginal and Torres Strait Islander communities need information that is culturally appropriate, evidence-based, easily understood, action-oriented and motivating. There is also the need to promote healthy eating to facilitate community ownership and does not undermining the cultural importance of family social events, the role of elders and traditional preferences for some foods. Food supply in Indigenous communities needs to ensure healthy, good quality food options are available at competitive prices.

Primary health care services have a central role in promoting and improving Aboriginal and Torres Strait Islander health and the sector needs specialised training and resources to implement new initiatives and provide culturally appropriate advice.”

Department of Health Website

OBESITY – AUSTRALIA’S BIGGEST PUBLIC HEALTH CHALLENGE

Download AMA Position Statement on Obesity 2016

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AMA President, Dr Michael Gannon, said today that obesity is the biggest public health challenge facing the Australian population, and called on the Federal Government to take national leadership in implementing a multi-faceted strategy to address the serious health threat that obesity poses to individuals, families, and communities across the nation.

Releasing the AMA’s revised and updated Position Statement on Obesity 2016, Dr Gannon said that combating obesity demands a whole-of-society approach.

“The AMA strongly recommends that the national strategy include a sugar tax; stronger controls on junk food advertising, especially to children; improved nutritional literacy; healthy work environments; and more and better walking paths and cycling paths as part of smarter urban planning,” Dr Gannon said.

“A national obesity strategy requires the participation of all governments, non-government organisations, the health and food industries, the media, employers, schools, and community organisations.

“The whole-of-society strategy must be coordinated at a national level by the Federal Government and must be based on specific national goals and targets for reducing obesity and its numerous health effects.

“More than half of all adult Australians have a body weight that puts their health at risk. More than 60 per cent of adults are either overweight or obese, and almost 10 per cent are severely obese.

“At least a quarter of Australian children and adolescents are overweight or obese.

“Obesity is a risk factor for type 2 diabetes, heart disease, hypertension, stroke, musculoskeletal diseases, and impaired social functioning.

“Around 70 per cent of people who are obese have at least one established health condition, illness, or disease, which can increase the cost of their health care by at least 30 per cent.

“Obesity was conservatively estimated in 2011-12 to cost Australian society $8.6 billion a year in health costs and lost productivity. More recent studies have put the cost much higher.

“The AMA recommends that the initial focus of a national obesity strategy should be on children and adolescents, with prevention and early intervention starting with the pregnant mother and the fetus, and continuing through infancy and childhood.

“We are urging the Federal Government to lead a national strategy that encompasses physical activity; nutritional measures; targeted interventions, community-based programs, research, and monitoring; and treatment and management.

“Governments at all levels must employ their full range of policy, regulatory, and financial instruments to modify the behaviours and social practices that promote and sustain obesity.

“Every initiative – diet, exercise, urban planning, walking paths, cycle paths, transport, work environments, sport and recreation facilities, health literacy – must be supported by comprehensive and effective social marketing and education campaigns,” Dr Gannon said.

The AMA recommends that the Federal Government’s national obesity strategy incorporates these key elements:

  • greater and more sustained investment in research, monitoring, and evidence collection to determine which and individual and population measures are working;
  • town planning that creates healthy communities, including safe access to walking and cycle paths, parks, and other recreational spaces;
  • a renewed focus on obesity prevention measures;
  • ban the targeted marketing of junk food to children;
  •  a ‘sugar tax’ – higher taxes and higher prices for products that are known to significantly contribute to obesity, especially in children;
  • subsidies for healthy foods, such as fruit and vegetables, to keep prices low, especially in remotes areas;
  • action from the food industry and retail food outlets to reduce the production, sale, and consumption of energy-dense and nutrient-poor products;
  • easy to understand nutrition labelling for packaged foods;
  • expansion of the Health Star Rating scheme;
  • greater support for doctors and other health professionals to help patients lose weight; and
  • local community-based education and information programs and services.

The AMA Position Statement on Obesity 2016 is at https://ama.com.au/position-statement/obesity-2016

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1. Call to action to Present
at the 2016 Members Conference closing 8 November
See below or Download here

2.NACCHO Partnership Opportunities

3. NACCHO Interim 3 day Program has been released
4. The dates are fast approaching – so register today

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NACCHO #ABS Aboriginal Health Download Report : Consumption of Food Groups from the Australian Dietary Guidelines, 2012-13

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Aboriginal and Torres Strait Islanders consume too little of the five major food groups and too much sugar and other discretionary foods, according to figures released by the Australian Bureau of Statistics (ABS) today.

DOWNLOAD the Report

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Like the rest of the population, Aboriginal and Torres Strait Islander peoples’ diets fail to meet the 2013 Australian Dietary Guidelines, which recommend minimum serves for vegetables, fruit, dairy products, lean meats and alternatives, and grain-based foods.

ABS Director of Health, Louise Gates said the latest results showed Aboriginal and Torres Strait adults consumed an average of 2.1 serves of vegetables per day, which is less than half of the 5-6 serves recommended by the Guidelines.

“Aboriginal and Torres Strait Islander adults consumed almost one serve (or 30 per cent) less vegetables than non-Indigenous people,” said Ms Gates.

“They also consumed just one serve of fruit on average, half the recommended two serves per day.”

In remote Australia, Aboriginal and Torres Strait Islander people consumed less than one serve (0.9) of fruit (e.g. less than one medium sized apple) and less than one serve (0.9) of dairy products (e.g. less than one cup of milk) per day, which was lower than those living in urban areas (1.3 serves for both fruit and dairy products).

However, Aboriginal and Torres Strait Islander people living in remote areas consumed around half a serve more of grain foods and lean meats and alternatives than people living in urban areas.

“The data also shows that 41 per cent of the population’s total daily energy intake came from energy-dense, nutrient-poor ‘discretionary foods’, such as sweetened beverages, alcohol, cakes, confectionery and pastry products,” said Ms Gates.

On average, this equates to over six serves of discretionary foods per day, triple the number of vegetable serves consumed. The Australian Dietary Guidelines recommend limiting discretionary foods to occasional, small amounts.

KEY FINDINGS

The 2013 Australian Dietary Guidelines (ADG or the Guidelines) recommend that Australians “Enjoy a wide variety of nutritious foods from the Five Food Groups every day and drink plenty of water”.1

This publication provides analysis on the consumption of the Five Food groups from the Australian Dietary Guidelines using nutrition data collected in the 2012-13 National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey (NATSINPAS).

FIVE FOOD GROUPS

In 2012-13, Aboriginal and Torres Strait Islander people consumed an average total of 10 serves of foods from the Five Food Groups per day.

Vegetables and legumes/beans group

    • Aboriginal and Torres Strait Islander people aged two years and over consumed an average of 1.8 serves of vegetables and legumes/beans per day compared with 2.7 among non-Indigenous people.
    • The number of vegetable serves consumed increased with age, with children aged 2-18 years consuming 1.4 serves per day on average compared with 2.1 among adults aged 19 years and over.
    • The average daily consumption of vegetable and legumes/beans serves for each age-sex group of Aboriginal and Torres Strait Islander people was considerably less than the respective recommendations.

Fruit group

    • Around 1.2 serves of fruit (including fruit juice and dried fruit) were consumed per day on average by Aboriginal and Torres Strait Islander people aged two years and over, compared with 1.5 serves per day in the non-Indigenous population.
    • Fresh or canned fruit made up 62% and one-third (34%) came from fruit juice.
    • Children consumed more serves of fruit than adults, averaging 1.6 serves per day compared with 1.0 respectively.
    • Aboriginal and Torres Strait Islander people living in non-remote areas consumed more serves of fruit on average than those living in remote areas (1.3 serves compared with 0.9).
    • The average daily consumption of 1.0 serves of fruit by Aboriginal and Torres Strait Islander adults was half the recommended two serves.

Milk, yoghurt, cheese and alternatives group

    • Aboriginal and Torres Strait Islander people aged two years and over consumed an average of 1.2 serves of milk, yoghurt, cheese and alternatives per day, compared with 1.5 serves among non-Indigenous people.
    • Dairy milk made up almost two-thirds (65%) of this food group, followed by cheese (30%).
    • The average daily consumption of milk, yoghurt, cheese and alternatives for each age-sex group of Aboriginal and Torres Strait Islander people, with the exception of children aged 2-3 years and girls 4-8 years, was considerably lower than the respective recommend number of serves.

Lean meats and poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans group

    • The average consumption of lean meats and poultry, fish, eggs, tofu, nuts and seeds and legumes/beans was around 1.6 serves per day for Aboriginal and Torres Strait Islander people aged two years and over, slightly less than for non-Indigenous Australians (1.7 serves).
    • People living in remote areas consumed more serves of lean meats and poultry, fish, eggs, tofu, nuts and seeds and legumes/beans than those living in non-remote areas (2.0 serves compared with 1.4).
    • Lean red meats made up almost half (49%) of the serves of lean meats and poultry, fish, eggs, tofu, nuts and seeds and legumes/beans. The contribution of lean red meats was higher for people living in remote areas compared with non-remote (61% compared with 44%)
    • The average daily consumption of lean meats and poultry, fish, eggs, tofu, nuts and seeds and legumes/beans for each age-sex group of Aboriginal and Torres Strait Islander people, with the exception of girls 2-3 years, was considerably less than the respective recommendations.


Grain (Cereal) foods group

    • On average, Aboriginal and Torres Strait Islander people aged two years and over consumed around 4.1 serves of grain (cereal) foods per day, compared with 4.5 serves among non-Indigenous Australians.
    • Aboriginal and Torres Strait Islander people in remote areas consumed more serves of grain (cereal) foods on average than those in non-remote areas (4.6 serves compared with 4.0 serves)
    • One-quarter (25%) of grain (cereal) foods consumed were from wholegrain and/or high fibre varieties.
    • The average number of serves of grain (cereal) foods consumed by Aboriginal and Torres Strait Islander boys aged 4-13 years and girls aged 4-11 was equal to or greater than the recommendation.

WATER

The Guidelines also include the recommendation that Australians drink plenty of water. In 2012-13, the average amount of plain water, including both bottled and tap, consumed by Aboriginal and Torres Strait Islander people was around one litre per day (997 ml), 76 ml less than the average for non-Indigenous people (1,073 ml). An additional 262 ml of water was consumed from other non-discretionary beverages such as tea and coffee. Plain water contributed just under half (48%) of Aboriginal and Torres Strait Islander peoples’ total beverage consumption, slightly less than that of non-Indigenous Australians (50%).

UNSATURATED SPREADS AND OILS

The Guidelines also recommend a daily allowance for unsaturated fats, oils and spreads. In 2012-13, Aboriginal and Torres Strait Islander people aged 2 years and over consumed an average 1.4 serves of unsaturated spreads and oils from non-discretionary sources.

DISCRETIONARY FOODS

The Guidelines recommend that discretionary foods (i.e. those not necessary for nutrients but are often high in saturated fat, salt, sugar or alcohol) are only consumed sometimes and in small amounts. However, over two-fifths (41%) of total daily energy in 2012-13 came from foods and beverages classified as discretionary. 2

According to the Guidelines, a serve of discretionary food is around 500-600 kJ. Based on this, Aboriginal and Torres Strait Islander people consumed an average of 6.1 serves of discretionary foods per day, which was higher than the non-Indigenous population average of 5.5 serves. The leading contributors to serves of from discretionary foods were alcoholic beverages (10%), soft drinks (9.1%), potato products such as chips and fries (8.2%), pastries (7.1%), cakes and muffins (6.4%) and confectionary (6.3%).

This graph shows the mean serves consumed from the five Australian Dietary Guidelines food groups and unsaturated spreads and oils from non-discretionary sources plus serves of discretionary foods for Australians aged 2 years and over by Indigenous status

(a) Based on Day 1. See Glossary for definition.
(b) From non-discretionary sources unless otherwise specified.
(c) A discretionary serve is defined as 500-600 kJ. Discretionary serves were derived by summing energy from discretionary foods and dividing by 550 kJ. Does not include meats that do not meet the ADG criteria but are not flagged as discretionary.
Sources: National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey, 2012-13 and the National Nutrition and Physical Activity Survey, 2011-12.

ENDNOTES

1. National Health and Medical Research Council, 2013, Australian Dietary Guidelines. Canberra: Australian Government. <https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n55_australian_dietary_guidelines_130530.pdf >, Last accessed 27/10/2016

2. See discussion of Discretionary foods from 4364.0.55.007 – Australian Health Survey: Nutrition First Results – Foods and Nutrients, 2011-12, <http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4364.0.55.007~2011-12~Main%20Features~Discretionary%20foods~700 >

More details are available in Australian Aboriginal and Torres Strait Islander Health Survey: Consumption of food groups from Australian Dietary Guidelines (cat. no. 4727.0.55.008), available for free download from the ABS website, http://www.abs.gov.au.

partnerships-naccho

1. Call to action to Present
at the 2016 Members Conference closing 8 November
See below or Download here

2.NACCHO Partnership Opportunities

3. NACCHO Interim 3 day Program has been released

4. The dates are fast approaching – so register today

 

NACCHO #ABS Aboriginal Health Report : Indigenous Australians consuming too much added sugar

 sugary-drink
 

In 2012-13, Aboriginal and Torres Strait Islander people 2 years and over consumed an average of 75 grams of free sugars per day (equivalent to 18 teaspoons of white sugar)1. Added sugars made up the majority of free sugar intakes with an average of 68 grams (or 16 teaspoons) consumed and an additional 7 grams of free sugars came from honey and fruit juice.

ABS Report abs-indigenous-consumption-of-added-sugars

Aboriginal and Torres Strait Islander people consume around 14 per cent of their total energy intake as free sugars, according to data from the Australian Bureau of Statistics (ABS).

The World Health Organization (WHO) recommends that free sugars contribute less than 10 per cent of total energy intake.

Director of Health, Louise Gates, said the new ABS report showed Aboriginal and Torres Strait Islander people are consuming an average of 18 teaspoons (or 75 grams) of free sugars per day (almost two cans of soft drink), four teaspoons more than non-Indigenous people (14 teaspoons or 60 grams).

OTHER KEY FINDINGS

    • Aboriginal and Torres Strait Islander people derived an average of 14% of their daily energy from free sugars, exceeding the WHO recommendation that children and adults should limit their intake of free sugars to less than 10% of dietary energy.
    • Free sugars made the greatest contribution to energy intakes among older children and young adults. For example, teenage boys aged 14-18 years derived 18 per cent of their dietary energy from free sugars as they consumed the equivalent of 25 teaspoons (106 grams) of free sugars per day. This amount is equivalent to more than two and a half cans of soft drink. Women aged 19-30 years consumed 21 teaspoons (87 grams) of free sugars, which contributed 17 per cent to their total energy intake.
    • The majority (87%) of free sugars were consumed from energy dense, nutrient-poor ‘discretionary’ foods and beverages. Two thirds (67%) of all free sugars consumed by Aboriginal and Torres Strait Islander people came from beverages, led by soft drinks, sports and energy drinks (28%), followed by fruit and vegetable juices and drinks (12%), cordials (9.5%), and sugars added to beverages such as tea and coffee (9.4%), alcoholic beverages (4.9%) and milk beverages (3.4%).
    • Intakes were higher for Aboriginal and Torres Strait Islander people living in non-remote areas where the average consumption was 78 grams (18.5 teaspoons), around 3 teaspoons (12 grams) higher than people living in remote areas (65 grams or 15.5 teaspoons).
    • Aboriginal and Torres Strait Islander people consumed 15 grams (almost 4 teaspoons) more free sugars on average than non-Indigenous people. Beverages were the most common source of free sugars for both populations, however Aboriginal and Torres Strait Islander people derived a higher proportion of free sugars from beverages than non-Indigenous people (67% compared with 51%).

ENDNOTES

1 A level teaspoon of white sugar contains 4.2 grams of sugar.

sugary-drink-infographic

“Free sugars include the sugars added by consumers in preparing foods and beverages plus the added sugars in manufactured foods, as well as honey and the sugar naturally present in fruit juice,” said Ms Gates.

“The data shows that Aboriginal and Torres Strait Islander people living in urban areas derived more energy from free sugars than those living in remote areas (14 per cent compared with 13 per cent).”

Free sugars contributed 18 per cent to dietary energy intake for teenage boys aged 14-18 years, who consumed 25 teaspoons (106 grams) of free sugars per day. This amount is equivalent to more than two and a half cans of soft drink.

Women aged 19-30 years consumed 21 teaspoons (87 grams) of free sugars, which contributed 17 per cent to their total energy intake.

“Beverages were the source of two thirds of free sugars, with soft drinks, sports and energy drinks providing 28 per cent, followed by fruit and vegetable juices with 12 per cent, cordials (9.5 per cent), sugars added to beverages such as tea and coffee (9.4 per cent), alcoholic beverages (4.9 per cent) and milk drinks (3.4 per cent),” said Ms Gates.

More details are available in Australian Aboriginal and Torres Strait Islander Health Survey: Consumption of Added Sugars (cat. no. 4727.0.55.009), available for free download from the ABS website, http://www.abs.gov.au.

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This year’s theme: Strengthening Our Future through Self Determination

As you are aware, the  2016 NACCHO Members’ Meeting and Annual General Meeting will be in Melbourne this year 6-8 December

1. Call to action to Present
at the 2016 Members Conference closing 8 November
See below or Download here

2.NACCHO Partnership Opportunities

3. NACCHO Interim 3 day Program has been released

4. The dates are fast approaching – so register today

 

NACCHO #NNW2016 Aboriginal Health and Nutrition : What works to keep our mob healthy and strong?

 nut-1

” More effective action is urgently required in order to reduce the unacceptable health inequalities experienced by Aboriginal and Torres Strait Islander peoples.

During National Nutrition Week, 16-22 October 2016 NACCHO highlights food insecurity and nutrition-related chronic conditions are responsible for a large proportion of the ill-health experienced by Australia’s First Peoples who, before colonisation, enjoyed physical, social and cultural wellbeing for tens of thousands of years. Food and nutrition programs, therefore, play an important role in the holistic approach to improving health outcomes for Aboriginal and Torres Strait Islander peoples.

Key Recommendations

  1. Consistent incorporation of nutrition and breastfeeding advice into holistic maternal and child health care services.
  2. Creation of dedicated positions for Aboriginal or Torres Strait Islander people to be trained and supported to work with their local communities to improve food security and nutrition.
  3. Development of strategies which increase access to nutritious food, such as meal provision or food subsidy programs, should be considered for families experiencing food insecurity.
  4. Adoption of settings-based interventions (e.g. in schools, early childhood services and sports clubs) which combine culturally-appropriate nutrition education with provision of a healthy food environment.

The evidence suggests that the most important factor determining the success of Aboriginal and Torres Strait Islander food and nutrition programs is community involvement in (and, ideally, control of) program development and implementation.

Working in partnership with Aboriginal or Torres Strait Islander health professionals and training respected community members to deliver nutrition messages are examples of how local strengths and capacities can be developed. Incorporation of Aboriginal and Torres Strait Islander knowledge and culture into program activities is another key feature of strength-based practice which can be applied to food and nutrition programs.”

Food and nutrition programs for Aboriginal and Torres Strait Islander Australians: what works to keep people healthy and strong?

Download full report food-and-nutrition-programs-aboriginal-what-works

The authors would also like to acknowledge the National Aboriginal Community Controlled Health Organisation (NACCHO) for their contribution to this work.

Deeble Institute for Health Policy Research, Australian Healthcare and Hospitals Association (AHHA), Canberra.

Nutrition Australia, the country’s leading non-profit nutrition organisation and creators of the Healthy Eating Pyramid, is challenging all Australians to take the pledge to eat more veg during National Nutrition Week, 16-22 October 2016.

With an alarming 96% of Australians failing to eat their recommend daily intake of vegetables, Nutrition Australia’s Try For 5 theme encourages all Australians to discover new ways to add veg to their day.

nut-2

The recommended daily intake for people over 4 years of age is around 5 serves of vegetables and legumes a day (75g per serve), yet data from the Australia Bureau of Statistics shows that the average Australian eats around half that amount.

“It’s the food group that we eat the least, yet it’s the one we should eat from the most!” said Lucinda Hancock, Accredited Nutritionist and CEO of Nutrition Australia Vic Division.

“Whether they’re fresh, frozen or canned, eating a rainbow of vegetables every day is one of the easiest things we can do to improve our health and wellbeing.”

“Vegetables are full of vitamins, minerals, fibre and antioxidants which all help keep our minds and bodies working day-to-day, and reduce our risk of chronic disease in the future.”

President of Nutrition Australia, Rob Rees said “Our Healthy Eating Pyramid has been advising Australians to eat a diet of mostly plant foods, including vegetables and legumes, for over 30 years. Sadly, we know that most Australians don’t eat the balanced diet that’s recommended by the Pyramid, and this is why we’re seeing such high rates of diet-related diseases.”

“In fact the average Australian gets over a one third of their daily kilojoules (energy) from ‘junk foods’, like biscuit and cakes, confectionery, take away foods, sugary drinks and alcohol,“ said Mr Rees .

Nutrition Australia is supporting the Try For 5 goal with 3 key strategies to boost vegetable intake:

 

eatarainbow  

Eat a rainbow

Eating a variety of vegetables each day exposes us to a wide range of nutrients for better health. We should eat different coloured vegetables every day because each colour carries its own set of unique health-promoting properties called ‘phytochemicals’ that give vegetables their colour, flavour, taste and even smell.

nnwiconnew  

Try something new

Trying new things is a great strategy to boost your vegetable intake. Whether that’s trying new vegetables, a new recipe, or trying vegetables in a way that you normally don’t consume them like at breakfast or in a snack. Experimenting with vegetables and preparing foods can give you the knowledge, skills and confidence to easily prepare vegetables to suit your tastes, which makes you more likely to buy, cook and consume them.

 nnwiconlegumes  

Love your legumes

2016 is International Year of the Pulse (another term for legumes) and they are a cheap and versatile source of fibre, protein plus many other important nutrients. We should have 2–3 serves of legumes a week for health benefits.

Sibylla Stephen is one half of children’s band, Teeny Tiny Stevies, who are ambassadors for National Nutrition Week 2016.

Mum-of-two Sibylla and her bandmate and sister, Beth, are releasing the animated video for their song “I Ate A Rainbow” during National Nutrition Week, which was written as a tool to help parents teach their children about why we should eat different coloured vegetables every day.

And it’s a perfect match with the storybook, I’m having a rainbow for dinner published by Nutrition Australia’s Queensland Division.

“I’m thrilled to be an ambassador for National Nutrition Week because I think we can all do with learning some new quick and easy ways to feed ourselves and our families with vegetables,” Sibylla said.

“My children are four and one, and their relationship with food changes as they get older. It can be incredibly frustrating to get them to eat their veggies, but I always encourage them to try different veggies cooked in different ways, and learn what they do and don’t like.

“As parents we try so hard to make sure our kids are well nourished, but the stats show that we’re not taking our own advice. I think ‘eating a rainbow’ is a great message for children and adults alike!”

Report continued

The National Aboriginal and Torres Strait Islander Health Plan takes a “whole-of-life” approach to improving health outcomes. Priority areas include maternal health and parenting; childhood health and development; adolescent and youth health; healthy adults and healthy ageing.

This Policy Issues Brief provides a synthesis of the evidence for food and nutrition programs at each of these life stages. It answers questions such as, what kind of food and nutrition programs are most effective for Aboriginal and Torres Strait Islander peoples? And, how should these food and nutrition programs be developed and implemented?

Nutrition research has been criticised for focusing too much on quantifying dietary risks and deficits, without offering clear solutions.

Increasingly, Aboriginal organisations are calling for strength-based approaches, which utilise community assets to promote health and wellbeing.

Evidence-based decision-making must consider not only what should be done, but also how food and nutrition policies and programs can be developed to support the existing strengths of Aboriginal and Torres Strait Islander communities.

National Nutrition Week runs from 16-22 October 2016. Click here for recipes, tips and resources to discover new ways to add veg to your day.

How you can share positive health messages and  stories about Aboriginal Community Controlled Health issues ? Closing this week for advertising and editorial

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NACCHO Aboriginal Health and Smoking : New #AIHW report Indigenous smoking rates gap is widening

smoking

 ” While improvements were seen across all population groups, some achieved greater progress than others.

For example, despite the fact that Indigenous smoking rates are improving, they are not improving at the same rate as non-Indigenous Australians, so the gap is widening across a number of indicators.

Factors influencing smoking behaviours among Aboriginal and Torres Strait Islander (Indigenous) people are complex and interrelated.

As with other populations, some Indigneous people experience multiple levels of disadvantage, for example, low socioeconomic position, unemployment, low educational attainment and a single-parent household type.

There were significant declines in the proportion of Indigenous people smoking tobacco daily and being exposed to tobacco smoke between baseline and midpoint.

However, they were generally more likely to be exposed to tobacco smoke, to have tried and transitioned to established smoking patterns and were less likely to succeed at quitting smoking than non-Indigenous people.

Between baseline and midpoint, the difference in rates (the gap) among these groups narrowed for some indicators but widened for others. The gap widens despite the fact that Indigenous smoking rates are declining because the non-Indigenous rate is declining faster than the Indigenous rate. The gap closes when the Indigenous rate is declining faster than the non-Indigenous rate.

Tobacco Indicators: measuring mid-point progress: reporting under the National Tobacco Strategy 2012-2018

Table 3.1: Smoking phases, per cent change (Indigenous)

Download report here

national-tobacco-strategy-mid-point-report

Read 85 NACCHO Smoking Stories HERE

Tobacco smoking remains a major cause of many health problems, but according to a new report from the Australian Institute of Health and Welfare (AIHW), Australians’ smoking behaviours are improving-with some groups improving more than others.

The report, Tobacco Indicators: measuring mid-point progress: reporting under the National Tobacco Strategy 2012-2018, measures smoking behaviours in Australia against a range of indicators, and shows that across most, Australia is progressing well.

The report’s indicators look at a range of smoking phases-including exposure to tobacco smoke, initial uptake of tobacco smoking, established smoking patterns and quitting-and measure progress since the baseline report, released in 2015.

‘Since the baseline report, we’ve seen improvements when it comes to people taking up smoking, with fewer secondary school students and adults trying cigarettes-and those who do, are taking up tobacco smoking at older ages than in the past,’ said AIHW spokesperson Tim Beard.

Falls were also recorded in the number of secondary students and adults who smoked regularly with a decline of almost a quarter for both groups.

‘Our report also shows a significant fall in the number of children and non-smokers who are exposed to tobacco smoke in the home,’ Mr Beard said.

While improvements were seen across all population groups, some achieved greater progress than others.

‘For example, despite the fact that Indigenous smoking rates are improving, they are not improving at the same rate as non-Indigenous Australians, so the gap is widening across a number of indicators.’

Similar findings were seen for people living in Remote and Very remote areas (compared to Major cities).

Daily smoking rates significantly improved among people living in the lowest and second-lowest socioeconomic areas, but not at the same rate as those living in the highest socioeconomic area.

The report showed unclear results when it came to quitting, but some positive results were recorded among people who had smoked more than 100 cigarettes in their lifetime (referred to in the report as ‘ever-smokers’).

Since the baseline report, the proportion of adult ever-smokers who have now quit smoking has risen from 47% to 52%.’

In 2013, more than half (52%) of adult ever-smokers had quit smoking (they had not smoked in the last 12 months). This was an increase from 47% in 2010.

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NACCHO Aboriginal Health News Alert : Five ways that the $160m same sex plebiscite could be spent in health

phaa

PHAA chief executive Michael Moore said the money should be funnelled into areas that would benefit the community such as health and education instead.

“Essentially this is a waste of money at a time when governments are cutting health budgets – and particularly slashing prevention,” Mr Moore said.

Reporting in todays The Age

Photo Above Some in the health industry name Indigenous health as the top area worthy of investment. Photo: Michael Amendolia

The growing cost of health – powered by an ageing population and more expensive technology – presents an ongoing challenge to the federal government, but there is no shortage of people willing to offer Health Minister Sussan Ley some unsolicited advice on how to better spend her portion of the budget.

If the $160 million was diverted to health, here is where some health advocates believe it could be better invested, in no particular order.

  1. Preventative health

The latest Australian Institute of Health and Welfare report showed the proportion of health expenditure devoted to prevention had decreased to 1.4 per cent in 2013-14, down from 2.2 per cent in 2007-2008.

Although much of the preventative health dollar in that peak year went towards introducing the HPV vaccine, other evidence suggests a disinvestment in preventative health, including the termination of funding to the Australian National Preventative Health Agency [ANPHA].

Michael Moore said the re-opening of that agency and all the programs that it ran would be one good use of the funds, or campaigns on the harms associated with tobacco, alcohol or obesity.

“You could easily spend all of the money on this as we cannot hope to compete with industry bombardment,” he said.

The Heart Foundation has called for $35 million to be spent annually on addressing physical inactivity, which is estimated to cause 14,000 deaths every year.

General manager advocacy Rohan Greenland said Australia was in the bottom third of OECD nations in terms of the amount it spent on preventative health.

“While we are doing well on tobacco control, we should be putting the same, sustained effort into preventing obesity, tackling physical inactivity and addressing poor nutrition,” Mr Greenland said.

A Department of Health spokeswoman said the activities of ANPHA had been taken over by the department.

Preventative programs included projects centred on chronic conditions, a National Asthma Strategy, a National Diabetes Strategy, activities addressing healthy eating, physical activity, obesity, tobacco, alcohol, research, immunisation,  mental health initiatives and cancer screening, she said.

  1. Aged care

Nurses nominate aged care as the sector in most dire requirement of funding.

Aged care providers have long been predicting a shortage of places and qualified nurses as baby boomers move into their dotage, with lack of staffing blamed on an increase in violent incidents.

The Australian Nursing and Midwifery Federation federal secretary Lee Thomas said $160 million could replace some of the money that has been taken out of the sector in recent years.

“Currently, there is a shortage of 20,000 nurses in aged care,” Ms Thomas said.

“This needs to be fixed as a matter of urgency, given Australia’s rapidly ageing population.

“The restoration of funding for the health sector would also go toward supporting public hospitals in the states and Territories and allowing more graduate nurses to be employed.”

  1. Indigenous health

Australian Healthcare and Hospitals Association chief executive Alison Verhoeven has a wishlist that lasts pages (“Oh there’s so much you could do”) but indigenous health tops her list.

As a start, the money could be invested in closing the gap in diseases such as rheumatic heart disease and trachoma or addressing the high rates of suicide, drug and alcohol abuse.

“We could be looking beyond that at things like how we incorporate investment in safe housing and safe food supplies and ensure that kids growing up in indigenous, particularly remote and rural, communities actually get a good start in life,” Ms Verhoeven said.

  1. Chronic disease

The Heart Foundation has argued that there is an economic and social argument to address chronic disease, which cause 90 per cent of all deaths and 85 per cent of the burden of disease.

“The health minister has rightly said that chronic disease is our greatest health challenge,” Mr Greenland said.

“We need to be better at early detection of those at risk of having heart attacks, strokes or developing diabetes and kidney disease.”

The federal government unveiled in March a trial of “Health Care Homes”, whereby people with chronic disease would have all their care managed from a single GP practice, but Ms Verhoeven says the $21 million package would only cover education and training.

“It’s not enough to make a real change across Australia in the way we deliver primary care.”

A Department of Health spokeswoman said the $21 million was in addition to $93 million that would be redirected from the Medicare Benefits Schedule in 2017-18 and 2018-19 to support the management of patients with chronic conditions.

  1. Mental health

Many in the health sector are concerned that the angst caused by the plebiscite could actually contribute to its overall cost.

Michael Moore said the mental health impact of the plebiscite was estimated to cost $20 million and already there was more demand for counselling services.

The Royal Australian and New Zealand College of Psychiatrists has called for employment support for people with mental illness and improved services for people with borderline personality disorder, aged care residents, children and adolescents and Aboriginal and Torres Strait Islanders.