| ” JUNK food would be banned from schools and sports venues, and a sugar drink tax introduced, under a new blueprint to trim the nation’s waistline.
The 47-point blueprint also includes a crackdown on using junk food vouchers as rewards for sporting performance and for fundraising.
State governments would be compelled to improve the healthiness of foods in settings controlled by them like hospitals, workplaces and government events.
And they would have to change urban planning rules to restrict unhealthy food venues and make more space for healthy food outlets. “
Download the 47-point blueprint Report here :
|NACCHO Aboriginal Health and #Obesity #junkfood : 47 point plan to control weight problem that costs $56 billion per year|
” In 2014-15, 63.4% of Australian adults were found by the National Health Survey to be overweight or obese. In response to Australia climbing up the ladder of the most obese countries in the world, professor Stephen Colagiuri, a diabetes expert at the University of Sydney, has urged the government to introduce a sugar tax to dissuade people from consuming sugary foods.”
Sophie Heizer Crikey intern
But what if you live in a place where you don’t have easy access to fresh food? What if the Macca’s down the road is within walking distance, but you have to jump in the car and drive for miles to get to the nearest supermarket? That’s called a food desert, and the sugar tax could have a bigger impact on people who live in those areas.
What is the sugar tax?
At this point, it is a recommendation from some health experts, which would place a levy on sugary drinks in order to mitigate obesity rates.
A report from the World Health Organization (WHO) says that a tax of 20% or more results in the drop of soft drink sales, which they say would also cut healthcare costs if it succeeded in improving health outcomes.
The Grattan Institute has suggested a tax of 40 cents per 100 grams of sugar, and calculated that obesity costs Australians $5.3 billion a year. The savings they have projected would mean an extra $500 million for the budget.
Is there support for the sugar tax?
The WHO called for a tax on sugary drinks across the world in October 2016 to curb the effects of sugary drinks on health.
Many health researchers also advocate for the tax as well. Dr Belinda Reeve from the University of Sydney writes that there needs to be more things done at the same time to reduce obesity rates and the risk of diabetes, but the tax could be effective in Australia, as the tobacco tax has been.
The Greens have released a statement saying that if the government doesn’t act on the issue, they will draft a private senator’s bill and introduce it to the Senate by the end of 2017.
Who is against it?
The Turnbull government, Labor, and senators Pauline Hanson and Derryn Hinch have all rejected the idea of imposing a sugar tax.
Minister for Health Greg Hunt has said the government was taking action in other ways: “We’re committed to tackling obesity, but increasing the family’s weekly shop at the supermarket isn’t the answer.”
Pauline Hanson said she would not support the tax because she believes it’s high time people take responsibility for what they put in their mouths, and Derryn Hinch said the tax would be unfair and unworkable.
Labor leader Bill Shorten said the opposition had no plans for a sugar tax, but said it was probably time to “toughen up advertising restrictions around junk food at peak periods when the little eyeballs are on the TV and getting all the wrong messages about food and healthy eating”.
What is a food desert?
A food desert is an area where there are no fresh fruit or vegetable outlets within a 500-metre radius. They are also defined by limited access to shops that sell healthy foods, coupled with an abundance of fast-food takeaway options within easy walking distance. These areas leave people disenfranchised by lack of access to affordable, healthy food and at a greater risk of obesity and the development of diabetes.
There have been a number of food deserts identified in Australia: Braybrook, Maidstone and West Footscray/Kingsville have been identified in Victoria, areas of western Sydney including Blacktown (where residents are three times more likely to develop diabetes) and Mount Druitt and even in wealthy areas of Canberra. Research commissioned by Anglicare and Red Cross showed that there was insufficient access to affordable and nutritionally adequate food in inner suburbs such as Kingston, Red Hill and Fyshwick, as well as Narrabundah Longstay Caravan Park, Belconnen, Weston Creek and newer suburbs in the Gungahlin region.
How would the sugar tax affect people living in food deserts?
The same kind of sugar tax was proposed in the UK. It was met with heavy resistance from the seemingly conservative lobby group, the TaxPayers’ Alliance, which cited the ineffectiveness of the tax in Mexico, the chief executive stating:
“It is astonishing that the government is pressing ahead with this pernicious tax when the evidence clearly suggests that it will simply not affect consumption in any meaningful way. As with any regressive tax, this will only raise living costs for hard-pressed families, already struggling with big tax bills. Politicians must look at the evidence and ignore the High Priests of the Nanny State in the public health lobby, and abolish the Sugar Tax before it is too late.”
Food deserts are, in particular, an issue for people of low socio-economic status (SES) and where there are people with mobility issues in the community. The tax will undeniably hit the poor and those living in food deserts harder because more of their income goes towards poor quality food, but there is evidence from studying the effectiveness of the tax in Mexico that it does decrease spending on unhealthy food products for everyone.
A research paper by PLOS One, which also supports the 20% hike in tax on sugar, states:
“We note that Australians of low SES are disproportionately affected by high rates of diet-related illnesses and are therefore likely to experience greater dietary improvements as a result of a tax on SSBs. Inequitable aspects are likely to be further ameliorated if revenue was used to support healthy eating initiatives and subsidies on healthy foods for low-SES households.”
This means the sugar tax could actually be beneficial to low-SES households in food deserts, as a result of both a shift in eating habits, and a freeing up of space in the health budget to rectify access issues in relation to cost and geography.
” Lung Foundation Australia in collaboration with the Queensland Government’s Indigenous Respiratory Outreach Care Program (IROC) have developed the Checklist specifically for the Indigenous community.
It only takes a few minutes to answer 8 questions that could save your or a loved one’s life.
It can be completed on a mobile phone, tablet or computer.
The Indigenous Lung Health Checklist is narrated by the Lung Foundation’s Ambassador and Olympic Legend Cathy Freeman.
Read or Download the PDF Brochure
Please go to the site as Indigenous peoples are almost twice as likely to die from a lung-related condition than non-Indigenous Australians.
# Indigenous Lung Health Checklist at
” Death by racism should be a category on death certificates, because the racism in hospitals is hindering the recovery of many Aboriginal and Torres Strait Islander people.
Spend some time as a patient in a hospital and you soon find out that the medical profession is full of bigots and people who might not consider themselves racist, but have preconceived ideas on race and hold outdated beliefs in racial stereotypes.”
We need cultural awareness programs on all levels of the system, writes Colleen Lavelle for IndigenousX : Our stories, our way” – each week, a new guest hosts the @IndigenousX Twitter account to discuss topics of interest to them as Aboriginal and/or Torres Strait Islander people. Produced with assistance of Guardian Australia staff.
NACCHO background info
” The National Cultural Respect Framework for Aboriginal and Torres Strait Islander Health 2016–2026 (the Framework) was recently launched by the Australian Health Ministers’ Advisory Council .
This ten year framework seeks to guide delivery of culturally safe, responsive, and quality health care to Aboriginal and Torres Strait Islander people and communities. ”
Download the COAG Cultural Respect Framework here :
I have been in and out of hospital for years with a brain tumour and have experienced the bigotry within the system first hand. I have also collected stories from Indigenous people around the country and a common thread is either: “Is it me or do they treat all of us like this?” or “Am I being overly sensitive?”
Indigenous cancer patients have even had pain relief denied to them. This might happen for a couple of reasons. First, because apparently some people think we Indigenous people can cope with more pain than our European counterparts. Let me state now that that ethnocentric view is not true. Another common view is that we are “faking it” to get drugs. Now, I don’t know about you, but if someone has cancer and is crying in pain, it’s pretty obvious they are not trying to get some cheap thrills.
A similar misconception is that we are drunk. I have even heard of cancer patients having their blood alcohol level tested before a doctor will see them. This assumption that we all take drugs or drink is outdated and just insulting.
Traditional people from remote communities have had to deal with their cultural mores being completely overlooked. Men have been shamed by having a young female nurse attend to them, when a male nurse is required. The same happens to our women too: a male attendant will try to do something that should only be done with or by a female. And when women ask to have another female in with them, they are quite often overlooked. I can’t understand why our cultural needs are overlooked when other peoples have their cultural rules respected.
The medical system seems so against us in so many ways, particularly if we are sent to a hospital away from home and English is not our first language. Good luck trying to find a translator to help! Governments, both at state and federal level can’t say they are doing all they can when our needs are not even considered important. All we hear are excuses like, “The cost is prohibitive for translators, patient transport, mobile medical units …”
We are the first people of this country and as such we shouldn’t be constantly overlooked. Perhaps fewer trips to the Gold Coast and a little bit more money into Indigenous health could help.
There are ways to make the road to good health better. For starters, no doctor or nurse should be allowed to work with Aboriginal people unless they have had cultural awareness training. It should be a requirement that all medical professionals do a cultural awareness course, with a refresher course after every year. Make it part of the accreditation process. It should be a part of the Close The Gap scheme that every general practice has to sign on to do cultural awareness. Even if it’s just one person in the practice doing it online. There could also be an incentive, such as the practice receives money for each Indigenous patient they see.
If every doctor and nurse across the country had this training and if hospitals and health executives spent quality time with Aboriginal and Torres Strait Islander patients, they might learn we are not so different. We might have some different needs, but they shouldn’t compromise the levels of compassion, caring and proper medial attention that we need.
” Ministerial champion ” for Indigenous Health Ken Wyatt toured the Derby Aboriginal Health Service with NACCHO CEO Pat Turner : See background story 2 below
” Ministerial Champion for Wujal Wujal ” Leeanne Enoch MP, Minister for Innovation, Science and Digital Economy and Minister for Small Business recently visited the Apunipima Cape York Health Council.
Image (L-R) Director-General Jamie Merrick, Minister Enoch, Apunipima CEO Cleveland Fagan
The Minister, accompanied by the Government Champion for Wujal Wujal, Jamie Merrick, Director-General, Department of Science, Information Technology and Innovation met with Apunipima’s senior managers to discuss the services and activities Apunipima provides to Wujal Wujal – a remote Aboriginal community which lies 70 km south of Cooktown.
The Champions program is based around supporting Mayors and communities to achieve the social and economic outcomes which they identify as important.
Apunipima CEO Cleveland Fagan said he welcomed the visit with the Minister and Director-General.
‘We were pleased to meet with Minister Enoch and Mr. Merrick to discuss our role in supporting the community and leadership in Wujal Wujal to achieve the goals that matter to the community.’
‘Apunipima provides culturally appropriate primary health care to the people of Wujal Wujal including a GP, Maternal and Child Health Nurse and Midwife, Podiatrist, Dietitian and Diabetes Educator.’
‘There are some real success stories when it comes to the health of the people of Wujal Wujal – 100 percent of children aged 12, 24 and 60 months are fully immunised, 75 percent of newborn bubs are within the normal weight range and nearly 90 percent of clients with type 2 diabetes have a GP Management Plan in place.’
‘There are some challenges, particularly around smoking rates and obesity and we will be working with community to address these health issues.’
‘We look forward to continuing to work closely with Minister Enoch and the Queensland Government to continue to improve the health of Aboriginal and Torres Strait Islander people living in Cape York.’
Story 2 Derby Aboriginal Health Service
To deliver holistic primary health care services which;
- Are based on the social justice principles of equity and access
- Address the needs of Aboriginal people, and
- Respect and reflect the cultural values of the communities we serve.
The Derby Aboriginal Health Service has been established by Aboriginal people for Aboriginal people, with the purpose of;
- Empowering Aboriginal people in the prevention and management of ill-health, and in the promotion of well-being for individuals, families and communities, as well as;
- Empowering Aboriginal people in the processes of decision-making, planning and service delivery
In early 1995 Winun Ngari Aboriginal Corporation received funding from the Aboriginal and Torres Strait Islander Commission (ATSIC) to carry out a comprehensive health planning exercise for Aboriginal people and communities in the Jayida Buru Ward of the Malarabah ATSIC Regional Council of the West Kimberley.
This region includes Aboriginal Communities in and around Derby town, south of Derby along the Fitzroy Valley, north east of Derby and along the Gibb River Road and Outstations north along the coast and up into the Mitchell Plateau. The Jayida Buru Health Strategy was the result of this process, and was the first health strategy for Aboriginal people in the Derby region which was developed from the Aboriginal perspective.
Amongst its findings was recognition that:
“…there appears to be little acknowledgement of the diverse needs of these population groups in the structure and operation of most mainstream services in the Derby region. These services often operate under constraints imposed by a Perth based policy and practise…and an organisational culture that excludes Aboriginal people from information and decision making”.
The Strategy outlined five key objectives;
- Aboriginal community and self-management of health related issues
- Service and program planning based on identical local health need
- A comprehensive, integrated and coordinated range of programs and services
- Equitable access to services
- Appropriate levels of resource allocation
and determined that;
“There are compelling reasons for the establishment of an Aboriginal Health Service in the Jayida Buru region; the health needs of the Aboriginal people in the region greatly exceed the capacity of the mainstream provider; the scope and models of mainstream service provision are not currently culturally appropriate or readily accessible; and there is no choice of health provider available to us.”
In April 1997 the Winun Ngari Aboriginal Corporation Committee established a Derby Aboriginal Medical Service (DAMS) Committee. This committee, with the support of the Winun Ngari Committee and Administration, began its struggle to establish a culturally appropriate health service to address the concerns raised through the Jayida Buru Health Strategy.
Funding from the Office of Aboriginal and Torres Strait Islander Health (OATSIH) was received in early 1997. On September 17, the first committee of the Derby Aboriginal Health Service Council was elected.
NACCHO has announced the publishing date for the 9 th edition of Australia’s first national health Aboriginal newspaper, the NACCHO Health News .
Publish date 6 April 2017
Working with Aboriginal community controlled and award-winning national newspaper the Koori Mail, NACCHO aims to bring relevant advertising and information on health services, policy and programs to key industry staff, decision makers and stakeholders at the grassroots level.
While NACCHO’s websites ,social media and annual report have been valued sources of information for national and local Aboriginal health care issues for many years, the launch of NACCHO Health News creates a fresh, vitalised platform that will inevitably reach your targeted audiences beyond the boardrooms.
NACCHO will leverage the brand, coverage and award-winning production skills of the Koori Mail to produce a 24 page three times a year, to be distributed as a ‘lift-out’ in the 14,000 Koori Mail circulation, as well as an extra 1,500 copies to be sent directly to NACCHO member organisations across Australia.
Our audited readership (Audit Bureau of Circulations) is 100,000 readers
Contact : Colin Cowell Editor
Mobile : 0401 331 251
Email : email@example.com
” While we ourselves did not work there, the societal beliefs interwoven with the professional theories practised at that time are a legacy we have inherited. Those attitudes and practices remain present within our professional space.
Have we done sufficient work to decolonise ourselves?
Decolonising is a conscious practice for Aboriginal and Torres Strait Islander nurses. It involves recognising the impact of the beliefs and practices of the coloniser on ourselves at a personal and professional level, then disavowing ourselves from them.
Is it time for the nursing and midwifery professions to reflect on our historical involvement in the subjugation of Aboriginal and Torres Strait Islanders and consider whether we owe a statement of regret for our failures as part of the wider healthcare system to respond to the needs of Aboriginal Australians?
Do formal apologies mean anything?
We welcome your input on this fundamental issue for Australians – and especially input from Aboriginal and Torres Strait Islander nurses and midwives.
In September 2016, the Australian Psychological Society issued a formal apology to Indigenous Australians for their past failure as a profession to respond to the needs of Aboriginal patients.
In the past, the NSW Nurses and Midwives’ Association and the ANMF more broadly have issued statements of apology for our professions’ involvement in the practices associated with the forced adoption of babies from the 1950s to 1980s.
In doing so we recognised that while those nurses and midwives were working under direction, it was often they who took the babies away from mothers who had been forced, pressured and coerced into relinquishing their children and we apologised for and acknowledged the pain these mothers, fathers and children had experienced in their lives as a result.
Following the recent commendable move by the Australian Psychological Society, is it now time for the nursing and midwifery professions to reflect on our historical involvement as healthcare providers in the subjugation of Aboriginal and Torres Strait Islanders and consider whether we owe a similar statement of regret for our failures as part of the wider healthcare system to respond to the needs of Aboriginal Australians?
But firstly, do such apologies mean anything?
Professor Alan Rosen AO (a non-indigenous psychiatrist) makes a cogent argument for an apology by the Australian mental health professions to Aboriginal and Torres Strait Islander peoples:
The recent apology by the Australian Psychological Society to Aboriginal and Torres Strait Islander people is of profound national and international significance.
The APS is believed to be the first mental health professional representative body in the world to endorse and adopt such a specific apology to indigenous peoples for what was done to them by the profession as part of, or in the name of, mental health/psychological assessment, treatment and care.
The APS Board also substantially adopted the recommendation of its Indigenous Psychologists’ Advisory Group (IPAG), whose Indigenous and non-Indigenous members crafted this apology together. This sets a fine precedent.
As some other Australian mental health professional bodies are still considering whether to make such an apology, it is to be hoped that the APS has set a new trend. The APS has provided a robust example of how to do it well and in a way that it is more likely to be considered to be sincere and acceptable by Aboriginal and Torres Strait Islander peoples.
Historically, Aboriginal and Torres Strait Islander peoples have suffered much more incarceration, inappropriate diagnoses and treatments and more control than care in the hands of mental health professionals, facilities and institutions.
This is also true for all First Nations peoples, globally.
Professor Rosen argues that such apologies demonstrate concern for possible historical wrongs, either deliberate or unwitting, by professionals and institutions and the enduring mental health effects of colonialism. The Croakey.org article goes on to describe the purposes and goals of an apology, why they are worth doing and proposes a template.
So, just as we have recognised and apologised for the role our professions played in forced adoptions, is it now time to examine and take responsibility for our professions’ historical contribution to undermining Indigenous Australians’ social and emotional health and wellbeing?
Janine Mohamed (right), CEO of the Congress of Aboriginal and Torres Strait Islander Nurses and Midwives (CATSINaM), argues we should.
Between 1908 and 1919, hundreds of Aboriginal patients were incarcerated in the Lock Hospitals off the coast of Carnarvon, with more than 150 people dying there. The West Australian government established the hospitals for the treatment of Aboriginal people with sexually transmitted infections, but there remains considerable doubt as to the accuracy of such diagnoses – many of which were made by police officers.
The Fantome Island Lock Hospital operated in Queensland from 1928-45 under similar arrangements, detaining Aboriginal people with suspected sexually transmitted infections. There was also a lazaret on Fantome Island (1939-73) for segregated treatment of Aboriginal people with Hansen’s disease.
Aboriginal people taken to the hospitals were often forcibly removed from their families and communities and transported in traumatic conditions, in chains and under police guard. There is also evidence of medical experimentation and abuse.
The NSW Nurses and Midwives’ Association has embarked on the process of developing a Reconciliation Action Plan. As a first step, over coming months we will be working on developing a more thorough understanding of how historical practices have affected Aboriginal and Torres Strait Islander people in our care.
We welcome feedback, especially from our Aboriginal and Torres Strait Islander colleagues.
” The Australian Chronic Disease Prevention Alliance recommends that the Australian Government introduce a health levy on sugar-sweetened beverages, as part of a comprehensive approach to decreasing overweight and obesity, and with revenue supporting public education campaigns and initiatives to prevent chronic disease and address childhood obesity.
A health levy on sugar-sweetened beverages should not be viewed as the single solution to the obesity epidemic in Australia.
Rather, it should be one component of a comprehensive approach, including 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.
Health levy on sugar-sweetened beverages
ACDPA Position Statement
- The Australian Chronic Disease Prevention Alliance (ACDPA) recommends that the Australian Government introduce a health levy on sugar-sweetened beverages (sugary drinks)i, as part of a comprehensive approach to decreasing overweight and obesity.
- Sugar-sweetened beverage consumption is associated with increased energy intake and in turn, weight gain and obesity. Obesity is an established risk factor for type 2 diabetes, heart disease, stroke, kidney disease and certain cancers.
- Beverages are the largest source of free sugars in the Australian diet. One in two Australians usually exceed the World Health Organization recommendation to limit free sugars to 10% of daily intake (equivalent to 12 teaspoons of sugar).
- Young Australians are the highest consumers of sugar-sweetened beverages, along with Aboriginal and Torres Strait Islander people and socially disadvantaged groups.
- Young people, low-income consumers and those most at risk of obesity are most responsive to food and beverage 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 sugar-sweetened beverages in Australia is estimated to reduce consumption and potentially prevent thousands of cases of type 2 diabetes, heart disease and stroke over 25 years. The levy could generate revenue of $400-$500 million each year, which could support public education campaigns and initiatives to prevent chronic disease and address childhood obesity.
- A health levy on sugar-sweetened beverages should not be viewed as the single solution to the obesity epidemic in Australia. Rather, it should be one component of a comprehensive approach, including 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.
i ‘Sugar-sweetened beverages’ and sugary drinks are used interchangeably in this paper. This refers to all non-alcoholic water based beverages with added sugar, including sugar-sweetened soft drinks and flavoured mineral waters, fortified waters, energy and electrolyte drinks, fruit and vegetable drinks, and cordials. This term does not include milk-based products, 100% fruit juice or non-sugar sweetened beverages (i.e. artificial, non-nutritive or intensely sweetened). 2
The Australian Chronic Disease Prevention Alliance (ACDPA) brings together five leading non-government health organisations with a commitment to reducing the growing incidence of chronic disease in Australia attributable to overweight and obesity, poor nutrition and physical inactivity. ACDPA members are: Cancer Council Australia; Diabetes Australia; Kidney Health Australia; National Heart Foundation of Australia; and the Stroke Foundation.
This position statement is one of a suite of ACDPA statements, which provide evidence-based information and recommendations to address modifiable risk factors for chronic disease. ACDPA position statements are designed to inform policy and are intended for government, non-government organisations, health professionals and the community.
Chronic diseases are the leading cause of illness, disability, and death in Australia, accounting for around 90% of all deaths in 2011. One in two Australians (i.e. more than 11 million) had a chronic disease in 2014-15 and almost one quarter of the population had at least two conditions.
However, much chronic disease is actually preventable. Around one third of total disease burden could be prevented by reducing modifiable risk factors, including overweight and obesity, physical inactivity and poor diet.
Overweight and obesity
Overweight and obesity is the second greatest contributor to disease burden and increases risk of type 2 diabetes, heart disease, stroke, kidney disease and some cancers.
The rates of overweight and obesity are continuing to increase. Almost two-thirds of Australians are overweight or obese and one in four Australian children are already overweight or obese. Children who are overweight are also more likely to grow up to become overweight or obese adults, with an increased risk of chronic disease and premature mortality.
The cost of obesity in Australia was estimated to be $8.6 billion in 2011-12, comprising $3.8 billion in direct costs and $4.8 billion in indirect costs. If no further action is taken to slow obesity rates in Australia, the cost of obesity over the next 10 years to 2025 is estimated to total $87.7 billion.
Free sugars and weight gain
There is increasing evidence that high intake of free sugarsii is associated with weight gain due to excess energy intake and dental caries. The World Health Organization (WHO) strongly recommends reducing free sugar intake to less than 10% of total energy intake (equivalent to around 12 teaspoons of sugar), or to 5% for the greatest health benefits.
ii ‘Free sugars’ refer to sugars added to foods and beverages by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates.
In 2011-12, more than half of Australians usually exceeded the recommendation to limit free sugar intake to 10%. There was wide variation in the amounts of free sugars consumed, with older children and teenagers most likely to exceed the recommendation and adults aged 51-70 least likely to exceed the recommendation. On average, Australians consumed around 60 grams of free sugars each day (around 14 teaspoons). Children and young people were the highest consumers, with adolescent males and females consuming the equivalent of 22 and 17 teaspoons of sugar each day respectively .
Beverages contribute more than half of free sugar intake in the Australian diet. In 2011-12, soft drinks, sports and energy drinks accounted for 19% of free sugar intake, fruit juices and fruit drinks contributed 13%, and cordial accounted for 4.9%. 3
Sugar-sweetened beverage consumption
In particular, sugar-sweetened beverages are mostly energy-dense but nutrient-poor. Sugary drinks appear to increase total energy intake due to reduced satiety, as people do not compensate for the additional energy consumed by reducing their intake of other foods or drinks[3, 7]. Sugar-sweetened beverages may also negatively affect taste preferences, especially amongst children, as less sweet foods may become less palatable.
Sugar-sweetened beverages are consumed by large numbers of Australian adults and children, and Australia ranks 15th in the world for sales of caloric beverages per person per day.
One third of Australians consumed sugar-sweetened beverages on the day before the Australian Health Survey interview in 2011-12. Of those consuming sweetened beverages, the equivalent of a can of soft drink was consumed (375 mL). Children and adolescents were more likely to have consumed sugary drinks than adults (47% compared with 31%), and consumption peaked at 55% amongst adolescents. Males were more likely than females to have consumed sugary drinks (39% compared with 29%).
Australians living in areas with the highest levels of socioeconomic disadvantage were more likely to have consumed sugary drinks than those in areas of least disadvantage (38% compared with 31%). Half of Aboriginal and Torres Strait Islander people consumed sugary drinks compared to 34% of non-Indigenous people. Amongst those consuming sweetened beverages, a greater amount was consumed by Aboriginal and Torres Strait Islanders than for non-Indigenous people (455 mL compared with 375 mL). 4
The health impacts of sugar-sweetened beverage consumption
WHO and the World Cancer Research Fund (WCRF) recommend restricting or avoiding intake of sugar-sweetened beverages, based on evidence that high intake of sugar-sweetened beverages may increase risk of weight gain and obesity[7, 11]. As outlined earlier, obesity is an established risk factor for a range of chronic diseases.
The Australian Dietary Guidelines recommend limiting intake of foods and drinks containing added sugars, particularly sugar-sweetened beverages, based on evidence of a probable association between sugary drink consumption and increased risk of weight gain in adults and children, and a suggestive association between soft drink consumption and an increased risk of reduced bone strength, and dental caries in children.
Type 2 diabetes
Sugar-sweetened drinks may increase the risk of developing type 2 diabetes. Evidence indicates a significant relationship between the amount and frequency of sugar-sweetened beverages consumed and increased risk of type 2 diabetes[12, 13]. The risk of type 2 diabetes is estimated to be 26% greater amongst the highest consumers (1 to 2 servings/day) compared to lowest consumers (<1 serving/month).
Cardiovascular disease and stroke
The consumption of added sugar by adolescents, especially sugar-sweetened soft drinks, has been associated with multiple factors that can increase risk of cardiovascular disease regardless of body size, and increased insulin resistance among overweight or obese adolescents.
A high sugar diet has been linked to increased risk of heart disease mortality[15, 16]. Consuming high levels of added sugar is associated with risk factors for heart disease such as weight gain and raised blood pressure. Excessive dietary glucose and fructose have been shown to increase the production and accumulation of fatty cells in the liver and bloodstream, which is linked to cardiovascular disease, and kidney and liver disease. Non-alcoholic fatty liver disease is one of the major causes of chronic liver disease and is associated with the development of type 2 diabetes and coronary heart disease.
There is also emerging evidence that sugar-sweetened beverage consumption may be independently associated with increased risk of stoke.
Chronic kidney disease
There is evidence of an independent association between sugar-sweetened soft drink consumption and the development of chronic kidney disease and kidney stone formation. The risk of developing chronic kidney disease is 58% greater amongst people who regularly consume at least one sugar-sweetened soft drink per day, compared with non-consumers.
While sugar-sweetened beverages may contribute to cancer risk through their effect on overweight and obesity, there is no evidence to suggest that these drinks are an independent risk factor for cancer. 5
A health levy on sugar-sweetened beverages
WHO recommends that governments consider taxes and subsidies to discourage consumption of less healthy foods and promote healthier options. WHO concludes that there is “reasonable and increasing evidence that appropriately designed taxes on sugar-sweetened beverages would result in proportional reductions in consumption, especially if aimed at raising the retail price by 20% or more”.
Price influences consumption of sugar-sweetened beverages[24, 25]. Young people, low-income consumers and those most at risk of obesity are most responsive to food and beverage price changes, and are likely to gain the largest health benefit from a levy on sugary drinks due to reduced consumption. While a health levy would result in lower income households paying a greater proportion of their income in additional tax, the financial burden across all households is small, with minimal differences between higher- and lower-income households (less than $5 USD per year).
A 2016 study modelled the impact of a 20% ad valorem excise tax on sugar-sweetened beverages in Australia over 25 years. The levy could reduce sugary drink consumption by 12.6% and reduce obesity by 2.7% in men and 1.2% in women. Over 25 years, there could be 16,000 fewer cases of type 2 diabetes, 4,400 fewer cases of ischaemic heart disease and 1,100 fewer strokes. In total, 1,600 deaths could potentially be prevented.
The 20% levy was modelled to generate more than $400 million in revenue each year, even with a decline in consumption, and save $609 million in overall health care expenditure over 25 years. The implementation cost was estimated to be $27.6 million.
A separate Australian report is supportive of an excise tax on the sugar content of sugar-sweetened beverages, to reduce consumption and encourage manufacturers to reformulate to reduce the sugar content in beverages. An excise tax at a rate of 40 cents per 100 grams was modelled to reduce consumption by 15% and generate around $500 million annually in revenue. While a sugary drinks levy is not the single solution to obesity, the introduction of a levy could promote healthier eating, reduce obesity and raise revenue to combat costs that obesity imposes on the broader community.
There is public support for a levy on sugar-sweetened beverages. Sixty nine percent of Australian grocery buyers supported a levy if the revenue was used to reduce the cost of healthy foods. A separate survey of 1,200 people found that 85% supported levy revenue being used to fund programs reducing childhood obesity, and 84% supported funding for initiatives encouraging children’s sport.
An Australian levy on sugar-sweetened beverages is supported by many public health groups and professional organisations.
” NACCHO does not believe the operation of Part IIA of the Racial Discrimination Act 1975 (Cth) (the “RDA”) imposes unreasonable restrictions upon freedom of speech [taking into account the meaning given to that phrase in the Terms of Reference], or that sections 18C and 18D should be reformed. NACCHO’s submission instead argues that:
- Racism and racial vilification causes harm to individuals, to groups and society as a whole. The submission will summarise evidence of the important links between racism and health and wellbeing and the specific impacts of racism on the health and wellbeing of Aboriginal and Torres Strait Islander people.
- Racism and racial vilification experienced by Indigenous Australians is a widespread, serious and ongoing problem. The submission summarises recent evidence of the prevalence and nature of racist behaviours, including speech, directed at Aboriginal and Torres Strait Islander people.
- Any weakening of current restrictions on freedom of speech will directly undermine and work in opposition to existing Government strategies and programs for improving Aboriginal and Torres Strait Islander people’s health.
- Combating racial discrimination is a key strategy for closing the gap in health outcomes between Indigenous and non-Indigenous Australians and achieving the Australian Government’s vision for an Australian health system that is free of racism and inequality and where all Aboriginal and Torres Strait Islander people have access to health services that are effective, high quality, appropriate and affordable. The submission discusses some evidence-based approaches to addressing racial discrimination and helping to achieve this vision. “
Matthew Cooke Chair of NACCHO
Download our full submission here
FROM : NACCHO PO Box 5120 Braddon ACT 2612 8 December 2016
TO : Committee Secretary Parliamentary Joint Committee on Human Rights
PO Box 6100 Parliament House Canberra ACT 2600
Dear Committee Secretary
INQUIRY INTO FREEDOM OF SPEECH IN AUSTRALIA
The National Aboriginal Community Controlled Health Organisation (NACCHO) is a living embodiment of the aspirations of Aboriginal communities and their struggle for self-determination. NACCHO is the national peak body representing over 140 Aboriginal Community Controlled Health Services across the country on Aboriginal health and wellbeing issues. It has a history stretching back to a meeting in Albury in 1974.
NACCHO represents local Aboriginal community control at a national level to ensure that Aboriginal people have greater access to effective health care across Australia, and advocates for culturally respectful and needs-based approaches to improving health and wellbeing outcomes through Aboriginal Community Controlled Health Services. Our members continue to demonstrate that they are the leading provider of culturally appropriate, comprehensive, primary health care to Aboriginal people across the nation, exceeding Government or private providers.
The definition of “health” adopted by NACCHO and its members is in accordance with that described in the 1989 National Aboriginal Health Strategy:
“Aboriginal health means not just the physical wellbeing of an individual, but refers to the social, emotional and cultural wellbeing of the whole community in which each individual is able to achieve their full potential as a human being, thereby bringing about the total wellbeing of their community. It is a whole of life view and includes the cyclical concept of life-death-life.”
Aboriginal people enjoy quality of life through whole-of-community self-determination and individual spiritual, cultural, physical, social and emotional wellbeing.
NACCHO does not believe the operation of Part IIA of the Racial Discrimination Act 1975 (Cth) (the “RDA”) imposes unreasonable restrictions upon freedom of speech [taking into account the meaning given to that phrase in the Terms of Reference], or that sections 18C and 18D should be reformed. NACCHO’s submission instead argues that:
- Racism and racial vilification causes harm to individuals, to groups and society as a whole. The submission will summarise evidence of the important links between racism and health and wellbeing and the specific impacts of racism on the health and wellbeing of Aboriginal and Torres Strait Islander people.
- Racism and racial vilification experienced by Indigenous Australians is a widespread, serious and ongoing problem. The submission summarises recent evidence of the prevalence and nature of racist behaviours, including speech, directed at Aboriginal and Torres Strait Islander people.
- Any weakening of current restrictions on freedom of speech will directly undermine and work in opposition to existing Government strategies and programs for improving Aboriginal and Torres Strait Islander people’s health. Combating racial discrimination is a key strategy for closing the gap in health outcomes between Indigenous and non-Indigenous Australians and achieving the Australian Government’s vision for an Australian health system that is free of racism and inequality and where all Aboriginal and Torres Strait Islander people have access to health services that are effective, high quality, appropriate and affordable. The submission discusses some evidence-based approaches to addressing racial discrimination and helping to achieve this vision.
It is NACCHO’s strongly held view that there is no current or historical evidence, nor any policy or legal imperatives to support the notion that the handling of complaints made to the Australian Human Rights Commission under the Australian Human Rights Commission Act 1986 (Cth) should be reformed. NACCHO believes the process provides important access to remedies for victims of racial vilification with most complaints resolved through an accessible mediation process.
NACCHO can find no objective analysis of Part IIA of the RDA shows that the laws are not being interpreted sensibly by the courts. The laws appear to generally strike an appropriate balance between the right to freedom of expression and the right to freedom from racial discrimination and vilification.
NACCHO is not alone in its view that the current inquiry as unnecessary, misconceived and mischievous, noting that:
- Australians made their support for legislation against racial vilification very clear two years ago in response to the proposed Freedom of Speech (Repeal of s. 18C) Bill 2014 which proposed major changes to section 18C of the RDA.
- The terms of reference appear to be inconsistent with the proper enforcement of the RDA and thereby appear to seek to undermine the rule of law and the statutory role of the Australian Human Rights Commission.
- Position Statement
The link between racism and health and wellbeing
The link between self-reported perceptions or experiences of racism and poorer physical and mental health is established and the pathways from racism to ill-health are now well understood by health researchers.
Racism contributes to reduced access to societal resources and services such as education, employment, housing and medical care which impact on health and wellbeing. Evidence suggests that racism experienced in the delivery of health services contributes to low levels of access to health services by Aboriginal and Torres Strait Islander people. Aboriginal and Torres Strait Islander people may be reluctant to seek much-needed health, housing, welfare or other services from providers they perceive to be unwelcoming or who they feel may hold negative stereotypes about them. Racism has flow on effects for individuals’ social cohesion and for workforce participation, productivity and educational achievement.
Experiences of racism lead to inequitable exposure to risk factors including stress and cortisol dysregulation affecting mental health (anxiety and depression) as well as injury from racially motivated assault. Prolonged experience of stress can also have physical health effects, such as on the immune, endocrine and cardiovascular systems.
Longitudinal and cross-sectional studies both nationally and internationally have found a strong association between experiences of racism and ill-health and psychological distress, mental health conditions such as depression and anxiety, and risk behaviours such as substance use, all of which contribute significantly to the overall ill-health experienced by Aboriginal and Torres Strait Islander people.
More subtle experiences of racism strongly linked to poor mental health outcomes include feelings of being left out and avoided; a form of social exclusion that results from both direct and indirect racism. Ongoing harmful effects of racism including anxiety and depression continue long after exposure to racist incidents and that individuals also experience anxiety on behalf of relatives and loved ones.
Chronic exposure to racism leads to excessive stress, which is an established determinant of obesity, inflammation and chronic disease. Analysis of the 2012-13 Australian Aboriginal and Torres Strait Islander Health Survey found that Indigenous Australians with high/very high levels of psychological distress were 1.3 times as likely to report having circulatory disease and 1.8 times as likely to report having kidney disease. The Productivity Commission’s Overcoming Indigenous Disadvantage: Key Indicators 2016 report showed that the situation is worsening, with the proportion of adults reporting high levels of psychological distress increasing from 27 per cent in 2004-05 to 33 per cent in 2014-15, and hospitalisations for self-harm increased by 56 per cent over this period.
Children and young people’s health and wellbeing
Children and young people’s perspectives and experiences of racism, and the ways in which such experiences impact their health and wellbeing should be a key consideration for the Committee.
Neuroscience and molecular biology tell us that early life experiences and exposures ‘get under the skin’ and become biologically embedded. A survey of research on the health effects of racism on children by UNICEF concluded that toxic stress in childhood is especially harmful, with ever increasing evidence that exposure to high levels of stress and adversity in childhood influences later physical and mental health and cardiovascular, metabolic and immune function right through to mid-life and older adulthood. Young people who experience high levels of racial discrimination were also found to have increased sleep difficulties, cellular aging, inflammation, and physiological wear and tear. UNICEF has stated that children and young people who are targets of racial discrimination are at higher risk of increased anxiety and depression, behavior difficulties, suicide and self-harm. Racial discrimination quite literally can get under the skin and make our children and young people sick.
UNICEF’s survey noted that racism experienced by a carer, family member or peer, that may or may not be witnessed by the child, has also been shown to place children and young people at risk. Studies show increased risk of common childhood illnesses, social emotional difficulties, and risk of overweight and obesity among children with carers and families who experience racism. Witnessing or hearing about racism in the media and online, including stereotyped, negative portrayals, is one harmful form of vicarious racism that also places children at risk.
The impact of racism on the health of Aboriginal and Torres Strait Islander people
Racism is a key social determinant of health for Aboriginal and Torres Strait Islander people, and can deter people from achieving their full capabilities. The impact of racism on the health of Aboriginal and Torres Strait Islander people can be seen in:
- inequitable and reduced access to the resources required for health (employment, education, housing, medical care, etc);
- inequitable exposure to risk factors associated with ill-health (junk food, toxic substances, dangerous goods);
- stress and negative emotional/cognitive reactions which have negative impacts on mental health as well as affecting the immune, endocrine, cardiovascular and other physiological systems;
- engagement in unhealthy activities (smoking, alcohol and drug use);
- disengagement from healthy activities (sleep, exercise, taking medications); and
- physical injury via racially motivated assault.
Research and survey results indicate a common response to experiencing racism is to subsequently avoid similar situations: 35% of those who reported in the 2012–13 Australian Aboriginal and Torres Strait Islander Health Survey that they had been treated badly, said they usually responded to discrimination by avoiding the person or situation. This holds implications across health, education and employment sectors.
Henry et al argue that healthcare in Australia is institutionally racist, but, more importantly, that such racism represents one of the greatest barriers to improving the health of Aboriginal and Torres Strait Islander people. There is a growing body of evidence that the health system itself does not provide the same level of care to indigenous people as to other Australians. This systemic racism is not necessarily the result of individual ill-will by health practitioners, but a reflection of inappropriate assumptions made about the health or behaviour of people belonging to a particular group.
Institutionalised racism occurs in many contexts in the Australian health system:
- Barriers to hospitals and health care institutions: Institutional racism manifests itself in (1) the adoption, administration, and implementation of policies that restrict admission; (2) the closure, relocation, or privatisation of hospitals that primarily serve Aboriginal and Torres Strait Islander communities; and (3) the continued transfer of unwanted patients (known as patient dumping) by hospitals and institutions. Such practices have a disproportionate impact on Aboriginal and Torres Strait Islander people.
- Discriminatory policies and practices can take the form of medical redlining, excessive wait times, unequal access to emergency care, and lack of continuity of care, which all have a negative effect on the type of care received.
- Lack of Language and Culturally Competent Care – cultural competency involves ensuring that all health care providers can function effectively in a culturally diverse setting; it involves understanding and respecting cultural differences including diverse groups with diverse histories, languages, cultures, religions, beliefs, and traditions. Without understanding and incorporating these differences, health care cannot be provided in a culturally competent manner.
How commonly is racism directed at Indigenous Australians?
The common perception seems to be that racism directed towards Aboriginal and Torres Strait Islander people is regrettable, but that such incidents are isolated, trivial and essentially harmless. Such views were commonly expressed, for example, following the racial abuse of Sydney Swans footballer and former Australian of the Year, Adam Goodes, earlier in 2015. Recent evidence suggests that racism and racial vilification experienced by Indigenous Australians is a widespread, serious and ongoing problem.
A key study in Victoria in 2010-11, funded by the Lowitja Institute, documented very high levels of racism experienced by Aboriginal Victorians. It found that of the 755 Aboriginal Victorians surveyed, almost all (97 per cent) reported experiencing racism in the previous year. This included a range of behaviours from being called racist names, teased or hearing jokes or comments that stereotyped Aboriginal people (92 per cent); being sworn at, verbally abused or subjected to offensive gestures because of their race (84 per cent); being spat at, hit or threatened because of their race (67 per cent); to having their property vandalised because of race (54 per cent). Significantly, more than 70 per cent of those surveyed experienced eight or more such incidents in the previous 12 months. Racism occurred across a broad range of settings and was commonly experienced in shops (67%), public spaces (59%), employment (42%), housing (35%), while nearly a third (29%) of respondents experienced racism in health settings. There were no differences in experiences of racism due to gender, age or geographical location. Other studies have found high levels of exposure to racist behaviours and language. For example, in the 2012-13 Australian Aboriginal and Torres Strait Islander Health Survey, 16% of respondents reported that they were treated badly in the previous 12 months because they identify as Indigenous Australians.
A recent survey to gain insight into discriminatory attitudes and beliefs of non-Indigenous Australians (aged 25–44 years) towards Indigenous Australians conducted by Beyond Blue in 2014 found a general lack of awareness of what behaviour is considered discriminatory, along with widespread belief that behaviours such as employment discrimination are considered an ‘unconscious act’ by the perpetrator. Key findings include:
- Discrimination is commonly witnessed, with 40% seeing others avoid Indigenous Australians on public transport and 38% witnessing verbal abuse.
- Almost a third (31%) witnessed employment discrimination against Indigenous Australians and 9% admit they themselves discriminate in this context.
- One in four (25%) do not agree that discrimination has a negative personal impact for Indigenous Australians.
- More than half (56%) believe that being Indigenous makes it harder to succeed.
- Many believe it is acceptable to discriminate, with 21% admitting they would move away from an Indigenous Australian if they sat nearby, and 21% would watch an Indigenous Australian’s actions when shopping.
Evidence-based approaches to reducing racism
The law has an important role to play in addressing the harm caused by racial discrimination and racial vilification. By setting standards of conduct, the laws constrain the spread of racism and racial hatred, and encourage people to speak out against racism, complementing broader education strategies. Protecting people from that harm is an appropriate object of government legislation, as recognised by the International Covenant on Civil and Political Rights and the International Convention on the Elimination of All Forms of Racial Discrimination. Freedom of expression is not an absolute right and preventing the harm caused by racist speech is of sufficient importance to warrant appropriate restrictions on freedom of speech as in sections 18C and 18D.
The Victorian Coalition for Aboriginal Health Equality argues for addressing discrimination against Aboriginal and Torres Strait Islander people through a human rights approach. The principles of human rights emphasise empowerment for all Indigenous peoples and provide a clear, positively oriented set of principles to guide individuals and organisations in addressing discriminatory behaviours, practices and policies. The Coalition has identified the following evidence-based approaches to addressing racial discrimination:
- Taking Preventive Action – Preventive action is a more effective and efficient public health intervention than responding to individual incidents of prejudice; a range of preventive actions can be undertaken at the interpersonal and organisation level.
- Communication, Training and Behavioural Change – International evidence shows that it is more effective to seek to change behaviours than to address underlying beliefs; strategies that curb racist behaviours will have a positive impact on reducing Aboriginal people’s experiences of racism. Underpinning this behavioural change, it is vital to provide accurate information and offer sound alternative explanations to racist views, to build a consensus that supports culturally safe behaviours.
- Strategic Approaches – Individuals, organisations, advocates and governments should incorporate longitudinal strategies and develop long-term plans for addressing discrimination rather than proposing rather one-shot interventions; effecting behavioural change and addressing institutionalised forms of inequality take time and cannot be effectively implemented without a commitment to continual improvement.
Any weakening of current restrictions on freedom of speech will directly undermine and work in opposition to existing Government strategies and programs for improving Aboriginal and Torres Strait Islander people’s health. Combating racial discrimination is a key strategy for closing the gap in health outcomes between Indigenous and non-Indigenous Australians and achieving the Australian Government’s vision outlined the National Aboriginal and Torres Strait islander Health Plan 2013-2023. The Health Plan vision is:
“The Australian health system is free of racism and inequality and all Aboriginal and Torres Strait Islander people have access to health services that are effective, high quality, appropriate and affordable. Together with strategies to address social inequalities and determinants of health, this provides the necessary platform to realise health equality by 2031.”
The Health Plan’s accompanying Implementation Plan, released by the then Minister for Rural Health, Senator the Hon. Fiona Nash, in 2015, takes forward the overarching vision by progressing strategies and actions that prevent and address systemic racism and discrimination in the health system. The Implementation Plan focuses on the Australian Government’s role in ensuring that the health system is free of racism. It includes strategies to reduce racism and discrimination and improving the cultural safety of the mainstream health system, including primary health care. Strategies and actions such as empowering youth and adolescents to be proud of their identity and culture and recognising the centrality of culture in the health and wellbeing of Aboriginal and Torres Strait Islander peoples are also supported. Any moves to water down the existing restrictions upon freedom of speech through reform of sections 18C and 18D of the RDA will jeopardise this strategic investment and presents major risks for the effective implementation of the Health Plan.
The link between self-reported perceptions or experiences of racism and poorer physical and mental health is established and the pathways from racism to ill-health are now well understood by health researchers. Racism and racial vilification experienced by Indigenous Australians is a widespread, serious and ongoing problem.
Any weakening of current restrictions on freedom of speech will directly undermine and work in opposition to existing Government strategies for improving Aboriginal and Torres Strait Islander people’s health. Combating racial discrimination is a key strategy for closing the gap in health outcomes between Indigenous and non-Indigenous Australians and achieving the Australian Government’s vision for an Australian health system that is free of racism and inequality.
In conclusion we wish to express our very profound concerns that the terms of reference for this inquiry appear to suggest that the right to freedom of speech is superior to the right to freedom from discrimination, in particular in the form of racist vilification. Freedom of expression is not an absolute right and preventing the serious harm caused by racist speech is of sufficient importance to warrant appropriate restrictions on freedom of speech as currently contained in sections 18C and 18D of the RDA.
Please contact Dawn Casey on (02) 62** **** or by email at firstname.lastname@example.org if there is any area of this submission for which we can provide further assistance or information.
- Anderson, P (2013) “Racism a driver of ill health”, The Australian; July 27, 2013 http://www.theaustralian.com.au/national-affairs/opinion/racism-a-driver-of-ill-health/news-story/caed7cfeca6b5a9051ee1fd18042923d
- Australian Health Ministers’ Advisory Council, 2015, Aboriginal and Torres Strait Islander Health Performance Framework 2014 Report, AHMAC, Canberra.
- Department of Health, Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013–2023, Australian Government, Canberra, 2015
- Australian Government, National Aboriginal and Torres Strait Islander Health Plan 2013–2023, Australian Government, Canberra, 2013 http://www.health.gov.au/NATSIHP
- Ferdinand, A., Paradies, Y. & Kelaher, M. 2012, Mental Health Impacts of Racial Discrimination in Victorian Aboriginal Communities: The Localities Embracing and Accepting Diversity (LEAD) Experiences of Racism Survey, The Lowitja Institute, Melbourne.
- Paradies, Yin (2006) “A systematic review of empirical research on self-reported racism and health”, International Journal of Epidemiology, (35) pp. 888-901.
- Coalition for Aboriginal Health Equality Victoria, 2014, Racial Discrimination and Health Outcomes for Aboriginal and Torres Strait Islander People http://www.vaccho.org.au/assets/01-RESOURCES/TOPIC-AREA/POLICY/Position-Statement-on-Racial-Discrimination-and-Health-Outcomes-for-Aboriginal-and-Torres-Strait-Islander-People.pdf
- SCRGSP (Steering Committee for the Review of Government Service Provision) 2016, Overcoming Indigenous Disadvantage: Key Indicators 2016, Productivity Commission, Canberra.
- Priest N, 2016, Research reveals what racism can do to a child’s body http://www.unicef.org.au/blog/november-2016/research-reveals-what-racism-can-do-to-a-childs-body?utm_source=facebook&utm_campaign=racism&utm_medium=page-post&utm_content=research-reveals-blog-post-1
- Henry BR, Houston S, Mooney GH. (2004) “Institutional racism in Australian healthcare: a plea for decency”, The Medical Journal of Australia 2004 May 17; 180(10): 517-20.
- Beyond Blue 2014, Discrimination against Indigenous Australians: A snapshot of the views of non-Indigenous people aged 25-44. https://www.beyondblue.org.au/docs/default-source/research-project-files/bl1337-report—tns-discrimination-against-indigenous-australians.pdf?sfvrsn=2
- Australian Bureau of Statistics, Australian Aboriginal and Torres Strait Islander Health Survey: First Results, Australia, 2012-13 (Cat no. 4727.0.55.001)
- Mooney G. “Inequity in Australian health care: how do we progress from here?” Aust N Z J Public Health 2003; 27: 267-270. See also Y Paradies, ‘A systematic review of empirical research on self-reported racism and health’ (2006) 35(4) International Journal of Epidemiology 888; D Williams & R Williams-Morris, ‘Racism and mental health: The African American experience’ (2000) 5(3–4) Ethnicity and Health 243; J Soto, N Dawson-Andoh & R BeLue, ‘The relationship between perceived discrimination and generalized anxiety disorder among African Americans, Afro Caribbeans, and non-Hispanic whites’ (2011) 25(2) Journal of Anxiety Disorders 258; E Pascoe & L Richman L, ‘Perceived discrimination and health: A meta-analytic review’, (2009) 135(4) Psychological Bulletin 531.
- National Best Practice Framework for Indigenous Cultural Competency in Australian Universities (Universities Australia, 2011).
” Australia has the highest incidence of melanoma and other skin cancers in the world, and while skin cancer is more common in people with light skin, it’s a dangerous misconception that darker skinned people aren’t at risk.
In a 2014 study, one third of Aboriginal and Torres Strait Islander participants from Northern and Central Australia had vitamin D deficiency, which carries some very negative health implications: low vitamin D levels are linked to an increased risk of diseases like diabetes and heart disease.
Given the burden of these chronic diseases in Aboriginal and Torres Strait Islander people, and their contribution to a much reduced life expectancy, more research is needed on the role of sun exposure and vitamin D.
Across all aspects of the healthcare system, overcoming the disadvantage within Indigenous heath is, and needs to be, a priority – dermatology is no exception.”
Fair or freckled skin, red or blond hair and blue or green eyes: these are the common calling cards of skin cancer susceptibility. But while the risks in darker skinned people is generally reduced, it’s certainly not absent.
In Aboriginal and Torres Strait Islander people – a group with diverse, but commonly darker skin tones – melanoma and other skin cancers are less prevalent than in the non-Indigenous population, but still cause deaths every year.
Public health campaigns – think ‘slip, slop, slap’ – are often targeted to light skinned people, however the inequalities in the availability and appropriateness of health care can impact how different groups access diagnosis and treatment.
Some studies out of the US and UK suggest that, when people of colour (POC) do get skin cancers, they’re often diagnosed at a later stage and carry a higher mortality risk.
Combine this with the dearth of research on skin cancer in darkly pigmented people (studies on skin cancer in Aboriginal and Torres Strait Islanders are particularly sparse), and the picture for darker skinned people is pretty unclear.
In light of this, this article can’t offer any health advice on sun protection beyond that put forward by the Cancer Council.
What it can do is look at what skin cancers are, how different types of pigmentation can change a person’s risk of skin cancer, and go over some other health considerations for sun protection in dark skin that you can bring up with your doctor.
The skin you’re in, and where it could become cancerous:
Some quick human biology: your skin is your largest organ, and is made up of the epidermis (upper layer) and the dermis (lower layer). When skin is exposed to the sun, ultraviolet (UV) rays can damage its DNA, causing the uncontrolled growth of abnormal cells.
The most common types of skin cancer all begin in the epidermis (the upper skin layer), and are handily named after the types of cells they start in:
Basal cell carcinoma (BCC): the basal cells are column-shaped and form the bottom layer of the epidermis. BCC can look like a lump or scaly patch, pale, pink or dark in colour. It’s usually slow growing, rarely spreading to other parts of the body. The earlier it’s found, the easier it is to treat.
Squamous cell carcinoma (SCC): the squamous cells are in the upper layer of the epidermis. SCC can look like a thickened scaly spot or rapidly growing lump, and tends to grow quickly. If left untreated, it can spread to other parts of the body, but this isn’t very common.
Melanoma: melanocytes are located in the basal cell layer and produce melanin pigment. Melanoma are aggressive tumors, and while this cancer is less common than BCC and SCC, it’s much more likely to spread to other parts of the body (like your brain, bones and lungs) through your lymphatic system and bloodstream.
Pigmentation – what’s it got to do with skin cancer risk?
The colour of a person’s skin is strongly influenced by their skin pigments, which are determined by their genetics and lifestyles factors, like sun exposure.
Remember those melanocytes (where melanomas form)? These cells produce melanin and package it in organelles called melanosomes. The melanin in skin comes in two main types: eumelanin is black or brown protective pigment, while pheomelanin is a yellow-red colour.
The type and amount of melanin each person produces will affect their pigmentation (skin colour). Eumelanin is abundant in darker skinned people, who produce more melanin than people with light skin.
For those among us who tan in the sun, exposure to UV rays increases the production of melanin by the melanocytes; when the melanin accumulates in the epidermal layers, a tan builds up and the skin darkens.
Melanin helps protect skin against the sun’s rays by absorbing UV radiation in the surface layers, reducing the risk of cellular DNA damage that can lead to skin cancer.
This protective melanin helps reduce skin cancer risk in dark skinned people.
The flip side – dark skin and vitamin D deficiency
While this melanin barrier can protect against UV damage, it can also make it more difficult for darker skinned people to get the Vitamin D they need.
Vitamin D, known as the ‘sunshine vitamin’, is produced when our skin is exposed to ultraviolet B (UVB) light. Melanin filters this light, reducing the penetration of UVB and putting darker skinned people at a higher risk of vitamin D deficiency.
A local perspective: sun exposure and health risks for Aboriginal and Torres Strait Islander people
While the research on skin cancer in Aboriginal and Torres Strait Islanders is pretty thin on the ground, some stats published in the Australian Institute of Health and Welfare give a general picture of melanoma incidence:
Between 2005-2009, the rate for melanoma in Indigenous Australians was 9.3 cases in 100,000 people, compared to 33 cases per 100,000 in non-Indigenous Australians.
For BCC and SCC cancers, the data is extremely limited, as, unlike melanoma, these cancers aren’t mandatory to report in state and territory registries.
To gain a better understanding of what skin cancer risks are at play for the diverse Aboriginal and Torres Strait Islander population, more research is needed.
For more information on how to stay safe in the sun this Summer, contact Cancer Council Australia
“With Aboriginal and Torres Strait Islander Australians still 20 times more likely to die from RHD, the AMA’s call for firm targets and a comprehensive and consultative strategy is welcome. We encourage governments to adopt these recommendations immediately.
“As noted by the AMA, it is absolutely critical that governments work in close partnership with Aboriginal health bodies. Without strong community controlled health services, achieving these targets for reducing RHD will be impossible.
While this is a long term challenge, the human impacts on Aboriginal and Torres Strait Islander communities are being felt deeply right now. Action is required urgently.
NACCHO is standing ready to work with the AMA and governments to develop and implement these measures. We have to work together and we have to do it now.”
National Aboriginal Community Controlled Health Organisation (NACCHO) Chairperson Matthew Cooke pictured above at Danila Dilba Health Service NT with AMA President Dr Michael Gannon (right ) and the Hon Warren Snowdon MP Shadow Assistant Minister for Indigenous Health (left )
” RHD, which starts out with seemingly innocuous symptoms such as a sore throat or a skin infection, but leads to heart damage, stroke, disability, and premature death, could be eradicated in Australia within 15 years if all governments adopted the recommendations of the latest AMA Indigenous Health Report Card.
AMA President, Dr Michael Gannon see full AMA Press Release below
” We have many of the answers, we just need commitment from Govt to help implement necessary changes ”
Ms Olga Havnen is the CEO of Danila Dilba Biluru Binnilutlum Health Service in Darwin
NACCHO Press Release
The peak Aboriginal health organisation today welcomed the release of the Australian Medical Association’s Report Card on Indigenous Health as a timely reminder of the importance of community controlled services.
The 2016 Report Card on Indigenous Health focuses on the enormous impact that Rheumatic Heart Disease (RHD) is having on Aboriginal and Torres Strait Islander people in Australia with a ‘Call to Action to Prevent New Cases of RHD in in Indigenous Australia by 2031’.
DOWNLOAD the Report Card here :
AMA RELEASES PLAN TO ERADICATE RHEUMATIC HEART DISEASE (RHD) BY 2031
AMA Indigenous Health Report Card 2016: A call to action to prevent new cases of Rheumatic Heart Disease in Indigenous Australia by 2031
The AMA today called on all Australian governments and other stakeholders to work together to eradicate Rheumatic Heart Disease (RHD) – an entirely preventable but devastating disease that kills and disables hundreds of Indigenous Australians every year – by 2031.
AMA President, Dr Michael Gannon, said today that RHD, which starts out with seemingly innocuous symptoms such as a sore throat or a skin infection, but leads to heart damage, stroke, disability, and premature death, could be eradicated in Australia within 15 years if all governments adopted the recommendations of the latest AMA Indigenous Health Report Card.
The 2016 Report Card – A call to action to prevent new cases of Rheumatic Heart Disease in Indigenous Australia by 2031 – was launched at Danila Dilba Darwin Friday 25 November
Dr Gannon said the lack of effective action on RHD to date was a national failure, and an urgent coordinated approach was needed.
“RHD once thrived in inner-city slums, but had been consigned to history for most Australians,” Dr Gannon said.
“RHD is a disease of poverty, and it is preventable, yet it is still devastating lives and killing many people here in Australia – one of the world’s wealthiest countries.
“In fact, Australia has one of the highest rates of RHD in the world, almost exclusively localised to Indigenous communities.
“Indigenous Australians are 20 times more likely to die from RHD than their non-Indigenous peers – and, in some areas, such as in the Northern Territory, this rate rises to 55 times higher.
“These high rates speak volumes about the fundamental underlying causes of RHD, particularly in remote areas – poverty, housing, education, and inadequate primary health care.
“The necessary knowledge to address RHD has been around for many decades, but action to date has been totally inadequate.
“The lack of action on an appropriate scale is symptomatic of a national failure. With this Report Card, the AMA calls on all Australian governments to stop new cases of RHD from occurring.”
RHD begins with infection by Group A Streptococcal (Strep A) bacteria, which is often associated with overcrowded and unhygienic housing.
It often shows up as a sore throat or impetigo (school sores). But as the immune system responds to the Strep A infection, people develop Acute Rheumatic Fever (ARF), which can result in damage to the heart valves – RHD – particularly when a person is reinfected multiple times.
RHD causes strokes in teenagers, and leads to children needing open heart surgery, and lifelong medication.
In 2015, almost 6,000 Australians – the vast majority Indigenous – were known to have experienced ARF or have RHD.
From 2010-2013, there were 743 new or recurrent cases of RHD nationwide, of which 94 per cent were in Indigenous Australians. More than half (52 per cent) were in Indigenous children aged 5-14 years, and 27 per cent were among those aged 15-24 years.
“We know the conditions that give rise to RHD, and we know how to address it,” Dr Gannon said.
“What we need now is the political will to prevent it – to improve the overcrowded and unhygienic conditions in which Strep A thrives and spreads; to educate Indigenous communities about these bacterial infections; to train doctors to rapidly and accurately detect Strep A, ARF, and RHD; and to provide culturally safe primary health care to communities.”
The AMA Report Card on Indigenous Health 2016 calls on Australian governments to:
Commit to a target to prevent new cases of RHD among Indigenous Australians by 2031, with a sub-target that, by 2025, no child in Australia dies of ARF or its complications; and
Work in partnership with Indigenous health bodies, experts, and key stakeholders to develop, fully fund, and implement a strategy to end RHD as a public health problem in Australia by 2031.
“The End Rheumatic Heart Disease Centre of Research Excellence (END RHD CRC) is due to report in 2020 with the basis for a comprehensive strategy to end RHD as a public health problem in Australia,” Dr Gannon said.
“We need an interim strategy in place from now until 2021, followed by a comprehensive 10-year strategy to implement the END RHD CRC’s plan from 2021 to 2031.
“We urge our political leaders at all levels of government to take note of this Report Card, and to be motivated to act to solve this problem.”
The AMA Indigenous Health Report Card 2016 is available at https://ama.com.au/article/2016-ama-report-card-indigenous-health-call-action-prevent-new-cases-rheumatic-heart-disease
TIME TO TAKE HEART
Labor calls on the Turnbull government to take heart and address Rheumatic Heart Disease, an entirely preventable public health problem which is almost exclusively affecting First Nation Peoples.
Labor welcomes the release of the Australian Medical Association’s 2016 Aboriginal and Torres Strait Islander Health Report Card, A Call To Action To Prevent New Cases Of Rheumatic Heart Disease In Indigenous Australian By 2031.
Poor environmental health conditions, like overcrowded housing remain rampant in Aboriginal and Torres Strait Islander communities, devastating families and the lives of young people.
“As the AMA’s report card suggests, we must build on the success of the 2009 Commonwealth Government Rheumatic Fever strategy, established to improve the detection and monitoring of Acute Rheumatic Fever and Rheumatic Heart Disease.
Funding under the Rheumatic Fever strategy is uncertain after this financial year,” Ms King said.
The Productivity Commission’s report Overcoming Indigenous Disadvantage [OID] released last week found 49.4% of Aboriginal and Torres Strait Islander peoples in remote communities live in overcrowded housing. Additionally, the report details no significant improvement in Aboriginal and Torres Strait Islander Peoples access to clean water, functional sewerage and electricity.
“We know Rheumatic Heart Disease is a disease of poverty and social disadvantage, which is absolutely preventable. Aboriginal and Torres Strait Islander communities, especially in the Top End of the Northern Territory, suffer the highest rates of definite Rheumatic Heart Disease,” Mr Snowdon said.
Labor applauds the work of the Take Heart Australia awareness campaign, and their work to educate and advocate putting Rheumatic Heart Diseases on the public health agenda.
“Like always, Aboriginal and Torres Strait Islander communities need to be front and centre in taking action. The most positive outcomes will come through communities working with Aboriginal and Community Control Health Organisations to design and deliver programs tailored to their needs,” Senator Dodson said.
The National Aboriginal and Torres Strait Islander Health Plan 2013-2023 noted more than three years ago the association of RHD with ‘extremes of poverty and marginalisation’, these conditions remain and are almost exclusively diseases of Indigenous Australia.
If we are serious about closing the gap, we must take heart, and address this burden of Rheumatic Heart Disease facing First Nation Peoples.
ACTION TO END RHEUMATIC HEART DISEASE (RHD) IN 15YRS
The Heart Foundation has today supported the Australian Medical Association (AMA) call for governments to work together to eliminate Rheumatic Heart Disease (RHD) in 15 years, by 2031.
Heart Foundation National CEO, Adjunct Professor John Kelly (AM) said RHD was an avoidable but widespread disease that kills and harms hundreds of Indigenous Australians every year.
“Considering how preventable RHD is, it is a national shame that our Indigenous population are left languishing.
“The Heart Foundation has strongly advocated from the RHD strategy. We continue to call on the government to fund the National Partnership Agreement on Rheumatic fever strategy and Rheumatic Heart Disease Australia (RHD Australia) with a $10 million over 3 years’ commitment, “Adj Prof Kelly said.
With the AMA predicting that RHD could be eradicated in Australia within 15 years if all governments adopted its recommendations, the time to act is now.
“We need to boost funding for the national rheumatic fever strategy. New Zealand is allocating $65 million over 10 years. A robust approach can put an end to RHD as a public health issue within 15 years,” Adj Prof Kelly said.
This call to action was part of the release of the AMA’s 2016 Indigenous Report Card – A call to action to prevent new cases of Rheumatic Heart Disease in Indigenous Australia by 2031.
“We want a strong and robust strategy to tackle this challenge. We will be working with the AMA to support and advocate for these recommendations which include:
- A commitment to a target to prevent new cases of RHD among Indigenous Australians by 2031, with a sub-target that, by 2025, no child in Australia dies of ARF or its complications; and
- Working in partnership with Indigenous health bodies, experts, and key stakeholders
- to develop, fully fund, and implement a strategy to end RHD as a public health problem in Australia by 2031.
The road to justice is a long one fraught with difficulties and obstacles that only the most determined and committed can overcome to achieve the justice, human rights and respect deserved.
But he needs the support and help of Australians, in particular, Indigenous Australians, to reinforce this message to the federal government and invite positive action to help, not hurt, our nation’s First Peoples.
Deep within Clinton Pryor’s heart lies an overwhelming commitment to justice, hope and peace in his country for the First Nation Peoples.”
Wajuk man Clinton Pryor has embarked on a Walk For Justice across Australia to discuss the impacts government decisions are having on local indigenous communities in Western Australia.
NACCHO calls on all its members to assist Clinton on his journey to Canberra
Article page 20 NACCHO Aboriginal Health Newspaper out Wednesday 16 November , 24 Page lift out Koori Mail : or download
naccho-newspaper-nov-2016 PDF file size 9 MB
Written by Emma Meconi
But he needs the support and help of Australians, in particular, Indigenous Australians, to reinforce this message to the federal government and invite positive action to help, not hurt, our nation’s First Peoples.
“The government is going to close communities and I need your help to make a stand against the government,” he said on his website.
“As a young indigenous man and my people, it is our duty to look after the planet.
“Our elders fought so hard to get this community built. That community is very important to us.”
Mr Pryor does not want to see his community shut down because of funding cuts to vital services.
He is embarking on this walk so he can raise awareness nationwide and let the Prime Minister know closing communities is not right.
He wants to save his people from losing their home and country.
He began his journey in Perth in September this year and will complete it in Canberra in May next year.
He will travel thousands of kilometres on foot to deliver his very important message directly to the Prime Minister.
His message is one of hope and justice for Aboriginal Australia and it all began with a life changing moment in Mr Pryor’s life when he was a teenager.
“The hardest part of my life [was] when my father passed away when I was 16 years old. It was the day my life changed forever.
“I put my hand on his head and promised him three things and that was to help my people, look after my family and keep our people’s culture alive,” he explained.
Pryor is from the Mulan community in the east Kimberley region in far North-Eastern Western Australia.
His family moved to Perth when he was seven and this is where he grew up and he now still lives in Perth, in the suburb of Rivervale.
Up until his father’s passing, Mr Pryor had enjoyed a fairly fulfilling high school journey.
He said that the best part of his life was when he was in high school and played footy, had a girlfriend and a job and spent his weekends surfing at the beach.
Like most young men, he dreams of a life where he will be a Dad and have his own family and fulfil his childhood dream of making a change in the world.
But the rhythm of life with its constant changes brings moments of light and darkness, happiness and sadness, hope and despair, harmony and challenges.
Pryor experienced a period of homelessness not long after his father passed away.
“I lost my job, my girlfriend left me and I left home to live on the street for two years before I got myself together and back on track again because I knew if I didn’t move on with my life and not believe in myself I was not going nowhere with life,” he said on his website.
Pryor said the disconnection from others and not having a home was the hardest part of being homeless.
“The hardest thing when I was homeless was not having no money, no home and no-one caring for me or asking me how I being. It was like no-one cared about me and it feels like I was alone.”
Connection to country and growing up in a remote community reinforces why this walk is so vital.
“Community life is very important because it keeps my people out of town or out of the city because in town and in the city there is drugs, alcohol and violence.”
He said that community life is controlled by the elders who lead in a traditional way in accordance with their own law and this law which they have followed for 60,000 years keeps them calm and harmonised.
He strongly believes in his people’s spirituality and feels very connected to living life around him and the Great Spirit in the air, everywhere.
“I can tell what is right and what is not right. It is a sense in my heart that I can tell something is good or something is bad and tell by the animal around me if it is going to be a great day or not.”
He gains his strength from this force in the land around him and in return he loves and cares for the land, looks after her and protects her.
He stated that one threat to this harmony with country and land was mining companies because of the damage caused to the land wounds the culture and heart of indigenous people and damages their spiritual home.
“My people, we believe that when we die we come back and be a part of the tree, animal, rock, river, the air and the land itself. That is why I am very connected to the land because I know that those who pass on before me are always with me and around me. The great energy of life.”
He does not want to see what he cares most about in this world, his family, friends and culture, destroyed by corporate greed.
Similarly, he does not want to see the forced closure of remote communities and the resulting homelessness because of government spending cuts.
He said he had been involved in protests and rallies and was not prepared to give up on the belief that together he will win the fight for First Nation people of the land we all stand on.
“The most things I worry about is seeing a lot of my people living homeless, watching the land being destroyed and my culture dying out.”
This was a critical aspect of this walk because closing a community is not just taking people away from their home and leading to homelessness and feeling lost, it is also disconnecting them from their spiritual home and their identity.
“If community are closing down the sacred site, cave art and the song lines are under threat and can be lost forever without the young generation knowing their culture and about their people and how we live on the land,” Pryor said.
He wants to give his people hope and make sure they do not give up and that they keep fighting no matter what happens.
His message to the Prime Minister will be to ask the government to give the elders full control of their communities without interference by government.
More broadly, Pryor wants to emphasise the importance of a treaty in moving forward in an independent, harmonious and accepting way so Indigenous Australians can live the way they always have.
By undertaking this walk, Pryor will also be honouring the past, which is an important element in the Indigenous ritual where young men go walkabout to learn survival skills and spiritual awakening.
Pryor will have a lot of time for reflection and contemplation about the significance this walk will hold for indigenous Australians and also our nation as a whole and how things should change for the better.
“This walk is about bringing people from different cultures back together and showing that if there is any hope for this country we must work together.”
Songlines form the essence of spirituality and connection to land in indigenous culture and as Mr Pryor travels across Australia he will take some roads that follow songlines and some that don’t.
But all the while he wants to learn about his people and culture and what is happening to them now.
His aim is to “know the truth about how my people are living and understand the different law and dreamtime story.”
He said that something needs to be done and he hopes to meet and speak with many people along the way and create a force for good across the nation that he hopes the Prime Minster will be interested in hearing about.
He has a large social network of family, friends, his people and elders who are all supporting him and have encouraged him to do what he believes in.
He is not sure what he will say to the Prime Minister specifically but local elders have told him he will know what to say after he has done his walk.
The experience of walking over this vast land should serve to empower, embolden and strengthen Mr Pryor as he gets closer to achieving his goal.
Deep within Clinton Pryor’s heart lies an overwhelming commitment to justice, hope and peace in his country for the First Nation Peoples.
This commitment is ignited by a spiritual connection to country and culture that commands the nation’s respect, acceptance, appreciation, understanding and encouragement.
Time will tell if the Prime Minister shares an interest and affinity with the peaceful continuation of one of our nation and planet’s oldest and enriching cultures and civilisation.
The Prime Minister, increasingly seen as representing the big end of town and disconnected from the realities confronted by Indigenous Australians, did not respond to requests for comment on Mr Pryor’s Walk for Justice.
Anyone interested in supporting Clinton Pryor’s Walk for Justice can visit his Facebook page and Twitter profile.