This fortnight’s Health Wrap is compiled by Helen Signy, Senior Communications Officer at The Australian Prevention Partnership Centre, based at the Sax Institute. Enjoy the wrap and don’t forget to tweet us @TAPPCentre and @SaxInstitute if you have any ideas you’d like to share.
Focus on physical activity
In what NSW Treasurer Dominic Perrottet announced as the ‘soul’ of his first budget – a landmark move for public health – all children in the state who play sport will receive a voucher for $100 to reimburse some of the cost of registration and swimming lessons. He said:
“Tearing around the sports ground is the best thing about being a kid, but sports registration and lesson fees can add up for families. Our Budget will lower that cost for every school child in NSW, making sport more accessible, helping families out and reducing barriers to healthy activity.”
While some commentaries, including this piece from The Sydney Morning Herald, saw the move as a bid to win votes from families and communities, public health experts lauded the announcement as a long overdue step towards supporting physical activity and tackling childhood obesity.
The move came shortly after a visit to Australia by the architects of England’s highly successful sport and physical activity strategy, which includes a cross-government commitment to boosting daily physical activity for even the most inactive.
As Public Health England’s Dr Justin Varney explained, the key to the UK success in improving participation rates is a co-ordinated approach between government agencies in the health, sport, education and welfare sectors, as well as sport and the workplace. You can read more of Dr Varney’s recommendations in this Croakey article.
Meanwhile, the ABC reported that every child who comes into contact with a health clinic or hospital in New South Wales will be weighed. These mandatory health assessments will be followed by referral to weight loss clinics if necessary, with NSW Health Minister Brad Hazzard reportedly considering whether to open more dedicated obesity clinics needed across the state.
The pressure on governments to take action on obesity continues unabated. Writing in the Conversation, Dr Lennert Veerman, senior health economist with the Cancer Council NSW, unveiled a new study predicting that higher taxes on sugar-sweetened drinks would lead to increased economic productivity, and the Global Obesity Centre at Deakin University published a study showing a sugar tax would provide the most health benefits to low income groups without excessively punishing their hip pockets, as the lead author Anita Lal detailed at Croakey.
The Obesity Policy Coalition called for cartoon characters to be banned on junk foods after its national survey found that more than half of supermarket products marketed at children are unhealthy. And the George Institute for Global Health released a major new report stating that Health Star Ratings should be extended to cover fast food restaurants, following analysis of more than 1500 products from 13 leading chains. Co-authors Dr Elizabeth Dunford and Professor Bruce Neal said that, despite problems with the ratings, dietary guidelines aren’t working and Australians are continuing to put on weight. Neal said:
“The fast food industry has one of the best-funded and least regulated advertising programs in the world. We now have a way to combat the junk end of the fast food market, and we need to leap on the opportunity. I doubt there is much that would dismay the junk food industry more than to be required to put health star ratings on all its products.’’
Sydney Morning Herald commentator Peter Fitzsimons has been waging his own war on the Health Star Ratings, with his recent column ‘It’s freaking hopeless’ achieving widespread coverage. This week he went further, calling for governments to free the public health infrastructure from the influence of industry:
“When it comes to the politics of food, we need a government that insists the public health infrastructure be freed from the influence of Big Sugar and be devoted to one thing and one thing only – something like, you know, public health?”
A national strategy for climate change and health
This week saw the launch of the National Strategy for Climate, Health and Well-Being, developed by the Climate and Health Alliance (CAHA), a coalition of more than 30 health and medical organisations. The Strategy called for the establishment of a Ministerial Health and Climate Change Forum to oversee coordinated national action on climate change and health. Read Croakey’s full wrap of the launch here.
The document included a recommendation for a new national standard to ensure health services plan for and address the impacts of climate change on healthcare. You can read a summary here by Alison Verhoeven, chief executive of the Australian Healthcare and Hospitals Association (AHHA), who said climate change was leading to unprecedented events in health, such as the devastating thunderstorm asthma event in Melbourne last November.
If implemented, the framework outlined in the report would make Australia a world leader in tackling the health effects of climate change, as Nick Watts, executive director at Lancet Countdown, told The Guardian:
“The implementation of a national strategy on climate change and health could put Australia in a leadership position globally and go a long way to ensuring the protection of community health and well-being while reducing carbon emissions.”
The launch came after new evidence was released detailing the extent of likely future heat-related mortality in the tropics. The Guardian also published a compelling read outlining some of the world’s top climate change hot spots.
The push for medical marijuana
The launch of a new industry body, the Medical Cannabis Council, and a three-day United in Compassion Medical Cannabis Symposium have thrown the issue of medical cannabis back into the spotlight.
Even though the Royal Australasian College of Physicians (RACP), the Australian Medical Association (AMA) and the Therapeutic Goods Administration (TGA) have called for caution, the Senate voted earlier this month to remove some tight Federal Government controls on patient access to medicinal cannabis produced overseas.
For a patient perspective, listen to this interview on ABC Radio with multi-millionaire businessman Barry Lambert, grandfather of a little girl with Dravet Syndrome and of a son, Michael, who was convicted recently of cultivating cannabis for her. The family is pushing for law reform around medicinal hemp supply, and have donated $33.7 million to the University of Sydney to establish the Lambert Initiative for Cannabinoid Therapeutics.
Already the changing regulatory environment is leading to new commercial ventures, such as the importation of cannabis oil from overseas for children with epilepsy, with other possibilities including cosmetics for problem skin, according to a report in The Australian (paywalled) quoting the company Bod Australia.
Meanwhile, Canada has just launched public health guidelines for low-risk cannabis use, based on a scientific review by an international team of experts. The guidelines are published here.
NDIS in a hurry
There have been several media reports in recent weeks raising alarm over the fast pace of the rollout of the National Disability Insurance Scheme (NDIS).
The ABC reported concerns from the disability sector that the process of writing care plans had been cut back from weeks to hours in New South Wales, with a similar story in other states. And though a Productivity Commission position paper stated that the NDIS is on track in terms of cost, it also expressed concerns that its overall effectiveness could be undermined by the speed of the rollout.
UNSW’s Associate Professor Helen Dickinson’s piece in the Conversation outlined the areas where the scheme is achieving, where there should be improvements, and the need for political will.
The Mandarin has previously covered concerns that NDIS quality is being compromised by a focus on being on time and on budget, but quoted National Disability Insurance Agency (NDIA) CEO David Bowen’s unswerving obligation to deliver better outcomes for people with disability. The main positive to be derived from the experience so far, he said, was the extraordinary level of commitment from all stakeholders, including governments, participants, families and carers, providers, and the community.
10 years on: the health impacts of the Intervention
Ten years since the Northern Territory Intervention, a number of commentators queried whether it had had the intended effects.
Writing in the Conversation, Professor Graeme Maguire of the Baker Heart and Diabetes Institute examined the effects of the Intervention’s main healthcare initiative, community-based child health checks. He acknowledged that more than 10,000 Aboriginal and Torres Strait Islander children under the age of 15 were screened, two thirds of whom were referred for follow up and most of whom had seen by 2012 – with associated measurable improvements in oral health, hearing loss and ear disease.
But, he said, the process was associated with the disenfranchisement of local communities due to the initial compulsory, intrusive nature of the health checks, inexperienced staffing and lack of coordination with existing primary healthcare such as GP clinics. He said the overall message was that investment and resourcing of Indigenous health can bring about measurable improvements, but these must occur in partnership with stakeholders and communities.
The Northern Territory National Emergency Response has both demonstrated how increased resourcing of health care for Indigenous Australians can lead to positive measurable change while, at the same time, showing how not to do it.”
Other commentators wrote that the cumulative health effects of the Intervention have been negative and severe. Diana Perche of the Nura Gili Indigenous Programs Unit at UNSW pointed to the psychological damage caused by the punitive nature of measures such as welfare quarantining, stigmatisation, loss of autonomy, and imposition of culturally inappropriate policies. In addition, most of the policy measures were not evidence-based, and the Intervention breached international human rights obligations, racial discrimination policies, and failed to respect the rights of Indigenous peoples to self-determination, she wrote.
Elsewhere, anthropologist Melinda Hinkson of Deakin University wrote in Arena magazine that the Intervention resulted in a loss of knowledge and authority, and displaced the identity, value and optimism of Aboriginal communities. Former NT Labor chief minister Clare Martin said the Intervention was a “political stunt” rolled out without her consultation, and ABC Indigenous affairs editor Stan Grant wrote a powerful summary of the ‘torment of powerlessness’ that lives on.
The great autism furore
One Nation Senator Pauline Hanson’s comments – that children with autism should be removed from mainstream classrooms – continue to create a furore.
Despite criticism from politicians across the political spectrum, Senator Hanson stood by her comments while others entered the debate to call for more resources for the education of children with a disability or to back teachers’ calls for more support.
Guardian Australia’ Greg Jericho, the father of a child with a disability, argued that Hanson’s speech was not about the need for increased funding (she called for less money to be spent on education) or for better services for children with autism. Instead, he said, it is another example of her view that we are under threat from those who are ‘other’ than her picture of what Australians should be.
And don’t miss this heartfelt piece by Dr Brian Owler, former national president of the AMA, who said his ‘beautiful autistic daughter’ had taught him many lessons about the value of diversity.
Thinking about drinking
Australia’s first study of case law relating to appeals over the rejection of liquor license or outlet applications has found that the law favours the interests of the alcohol industry over community health. The research, resulting from a project supported by The Australian Prevention Partnership Centre, shows when development applications for new alcohol outlets are rejected, groups with vested interests take local governments to court and win – even when hundreds of community submissions have been received opposing the developments. This opinion piece from the George Institute’s Jan Muhunthun outlines the issue and you can read the ABC online story from Sophie Scott here.
This article on the TTPI blog gave an interesting comparative overview of the way alcohol and tobacco are taxed in Australia and, as we move into Dry July, this article on The Conversation from UTS researcher Julie Robert examined the evidence of effectiveness for these types of awareness campaigns.
In Canada’s Globe and Mail, Andre Picard wrote that it was time we stopped romanticising alcohol, while the Canadian Institute for Health Information issued this infographic showing that more Canadians died from alcohol than heart attacks.