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The Health Wrap: Booze battles, drug dilemmas, rethinking service delivery in Indigenous health

By Kellie Bisset

 

Battling the booze

As the fallout from Schoolies week hit many families across the nation, the debate turned once again to alcohol use by young people and how we might best be able to prevent harm. Professor John Toumbourou from Deakin University argued the case for price increases and discussed the impact of alcohol on the adolescent brain in a piece for The Conversation. A Sydney Morning Herald editorial called out Australia’s “punch drunk” culture and said it was time to act. And The Australian highlighted the latest alcohol action plan from the Australian National Council on Drugs, which recommends, among other things, for alcohol taxation to be addressed in line with the recommendations from the Henry tax review.

Australia’s peak alcohol and drug agency, the Alcohol and other Drugs Council of Australia then announced that Assistant Health Minister Fiona Nash had decided to end 50 years of support and defund the organisation. Writing on CroakeySondra Davoren, Senior Legal Policy Advisor at Cancer Council Victoria said the news was a huge loss for the alcohol and other drugs sector and the future of alcohol policy in Australia at a time when leadership in this area was sorely needed.

The importance to improving children’s lives of population-based strategies to tackle alcohol availability, marketing and pricing was a key theme to emerge from the Fetal Alcohol Spectrum Disorders Conference (FASD) in Brisbane, Croakey reported. The extensive Croakey coverage of the conference, including some tips for journalists and others reporting on FASD, can be found here.  A report on the ABC’s AM program addressed the issue of pregnant women getting mixed messages from their doctors about safe levels of drinking during pregnancy. And this ABC report explores how health workers in Tennant Creek are using puppets to get the FASD message across.

The problem of FASD is an international one. This report in the Calgary Herald looks at Canada’s efforts to combat the issue. And some sobering international research presented at the Australasian Professional Society on Alcohol and Other Drugs annual conference showed that hung­over driving impairs performance as much as driving under the influence of alcohol, the Daily Telegraph reports.

***

Too much of a good thing?

Antibiotic Awareness Week saw several groups speak out on the subject of antibiotic overuse. The American Academy of Pediatrics has also lent its weight to the growing push for action on overuse, with a report published in Pediatrics calling for antibiotics to be used more judiciously.

Meanwhile, writing on The Conversation, Matthew Cooper from the University of Queensland looks at what life might look like in a world without antibiotics. And the UK’s Chief Medical Officer Dame Sally Davies warned the public not to be alarmed about a strain of MRSA recently found in Christmas turkeys – though she did advise the birds should be cooked properly, the Mirror reports.

Ongoing debate over whether the cholesterol-lowering drugs statins should be used for primary prevention of cardiovascular disease took a new turn last week. The New York Times reported on concerns that a new online heart disease risk calculator developed by professional groups may significantly overestimate risk and drive more people on to statin treatment. It said the the American Heart Association (AHA) and the American College of Cardiology were considering how to respond to the concerns, which were raised in the early stages of the calculator’s development but not followed through. Medscape gives a good overview of how the issue played out at the AHA annual meeting, with many still arguing that there is enough evidence to support primary prevention (registration is free for this site).

Back in Australia, Medical Observer reported on the impact on patients of the recent Catalyst program on statins, which has been roundly criticised (including by the ABC’s own Media Watch and Dr Norman Swan) for its one-sided presentation of the evidence. According to a survey commissioned by pharma company MSD, Up to 40% of patients who told their doctor they were concerned about the program had already stopped taking their statins.

***

Rethinking service delivery in Indigenous health

How do we build a health system that is not racist? That’s the question posed by the first of Croakey’s reports from Marie McInerney covering the Closing the Credibility Gap conference held in Melbourne. The first step, Associate Professor Yin Paradies told the conference, is for health professionals working with Aboriginal and Torres Strait Islander people to test their own preconceived ideas using an implicit association test developed by US researchers.

The former co-chair of the National Congress of First Peoples Jody Broun, also told the conference she was concerned that shifting control of Aboriginal and Torres Strait Islander Affairs to Prime Minister Tony Abbott’s department may turn out to be “another failed experiment” in Australian Aboriginal policy. Ms Broun also raised fears that the Federal Government may drop the National Aboriginal and Torres Strait Islander Health Plan developed under the Labor Government and launched in July 2013. Croakey’s conference coverage is interesting and extensive and the full suite of stories can be found here.

Writing in the MJA, Dr Lesley Russell, says its clear that improving Indigenous health will require major changes to the way health services are delivered and funded.

“Governments and all stakeholders, including Indigenous people themselves, need to be bold enough to redesign current mainstream health policies, programs and systems to better fit Indigenous health concepts, community needs and culture,” she says. “This approach should not be seen as radical — it is where we are currently headed with Medicare Locals.”

Former head of the Department of PM and Cabinet Professor Peter Shergold, also spoke of the need for change. Professor Shergold, who has just joined Professor Ngiare Brown from the University of Wollongong on the Prime Minister’s Indigenous Council, told The Australian he would not support funding cuts in Indigenous Affairs but that there was a case for spending existing funds better. Professor Brown said she believed the secret to “closing the gap” of Indigenous disadvantage lay with reforming the system of service delivery.

New figures released by the ABS in the past fortnight show there have been small gains in life expectancy for Indigenous Australians but they are still lower than rates for non-Indigenous people. And ABS results on smoking rates among Indigenous people show a 1% decline annually from 2008 to 2012. The results were released as part of the first Aboriginal and Torres Strait Islander health survey, which also showed Indigenous people were three times as likely as non-Indigenous people to have diabetes.

NACCHO meanwhile, has just launched its first Aboriginal health newspaper, NACCHO Health News, which will be distributed three times a year with the Koori Mail.

“This is a tremendous leap for the dissemination of health information across our Aboriginal  population,” NACCHO chair Justin Mohamed said.

In other positive news, Melissa Sweet reports for Croakey that the social impact crowdfunding platform StartSomeGood has partnered with social media hub IndigenousX to empower Indigenous Australian change- makers to raise funds and rally community support for diverse Indigenous-founded initiatives. You can read her report here.

***

Sugar rush

Just as price signals may have an impact on alcohol sales, Harvard University research presented at the Obesity Society meeting in Atlanta shows that increasing the price of sugary drinks decreases consumption. But drinks manufacturer Coca Cola has its own way of being “part of the solution”. It is investing in awareness programs and sporting initiatives, including partnering with Bicycle Network to promote healthy lifestyle messages. The move has attracted criticism, including from Cancer Council Victoria CEO Tod Harper, who wrote recently on Croakey that the move was an attempt by Coca Cola to address its sugar-soaked image.

Bicycle Network CEO Craig Richards defended the Coke partnership, saying other non-profits should let his group get on with its job, and that the partnership was making it possible to address the massive problem of physical inactivity.

Coke is clearly not the only Big Food manufacturer to go down this path. This glowing story in the Washington Post about the local McDonalds mobile medical clinic is a case in point.

Parents Jury has put the spotlight on Big Food this fortnight with its Fame and Shame awards, targeting Hungry Jacks and Chupa Chups for marketing apps to kids designed to push junk food.

***

The poor, marginalised and vulnerable: behind the health eight ball

Health professionals must continue to speak out about the health impact of Australia’s asylum seeker policies, writes Michelle Hughes in this passionate and compelling blog for Croakey which despairs at the recent decision to restrict a mother’s access to her sick newborn.

Equity and social justice are also the themes of the Gavin Mooney Memorial Essay Competition, a joint project of the Sydney School of Public Health at the University of Sydney, Croakey, and Inside Story, an online current affairs publication from the Swinburne Institute for Social Research. Entries are still open and this Croakey post gives some background.

On the issue of access to care, this piece by the University of Sydney’s Glenn Jones, says that equity is an issue in NSW, with poorer patients having more difficulty getting into public hospitals.

And for an interesting perspective on how acting on the social determinants of health can change society, this interview between Professor Rob Moodie and Dr Kiran Martin is worth viewing. Dr Martin is the founder of Asha, a community organisation than works with more than 500,000 people in the slums of New Delhi.

Australia’s very own Ophelia project is gaining international attention for its innovative approach to health literacy. Writing on Croakey, Deakin University’s Professor Richard Osborne  says the project has the capacity to “change the world we live in for some of the most disadvantaged and disempowered peoples in all our communities”.

More views and developments on health literacy are available in this Croakey coverage of the International Health Literacy Network Conference held this week in Sydney.

***

Plain packing u-turn

Plain packaging of cigarettes could be in force before the 2015 UK general election after the UK Government opened the door for policy change. The Guardian reports that a government move earlier this year to hold off on plain packaging laws had caused widespread criticism, and the change of heart could be an effort to send a message that big business is not driving the policy agenda in the UK. Writing for The Independent, Stephen McGrath says that in the current climate, UK local authorities, who now have responsibility for tobacco control, must divest themselves of their huge investments in the tobacco industry. ” Hypocritical doesn’t begin to cover it,” he says.

Ireland is also looking to move on plain packaging, with the national parliamentary health committee about to hold hearings on legislation that will bring in standard packaging and larger health warnings on tobacco products.

Philip Morris joined the plain packaging conversation this week. It funded a study claiming to show that plain packaging was ineffective. Medical experts rejected the study as flawed and you can read Cancer Council Victoria’s critique of the data here.

Consistent and sensible counter arguments to Big Tobacco’s tactics have been critical in reducing smoking rates in Australia. And one of the most prominent voices in this area, Professor Simon Chapman, has now been honoured for his efforts with the Australian Skeptics’ Skeptic of the Year Award. The award also recognised Professor Chapman’s work in getting the evidence out on other issues such as alcohol, ‘wind-turbine syndrome’ and immunisation.

Public health giant New York Mayor Michael Bloomberg, is about to introduce more landmark legislation – this time banning the sale of tobacco products to anyone under the age of 21. Politico reports that this will make New York the first large city or state in the US to prohibit sales to young adults.

A new study in the Journal of Adolescent Health suggests that far from being a quit smoking aid, e-cigarettes represent a new route to nicotine addiction for young people. Protecting the young from tobacco will no longer be the province of Action on Smoking and Health though, which will close its doors after losing its funding. Medical Observer reports AMA president Dr Steve Hambleton saying ASH could “look back with pride on 20 years of outstanding promotion and advocacy to drive down smoking rates”.

***

Other Croakey reading you may have missed this fortnight:

You can find previous editions of The Health Wrap here.

  • Kellie Bisset is The Sax Institute’s Communications Director. She has worked in mainstream and medical journalism and communications for more than 20 years. During that time she edited both of Australia’s weekly medical publications for doctors, Australian Doctor and Medical Observer and developed a strong interest in health policy and evidence. The Sax Institute is a not-for-profit organisation that drives the use of research evidence in health policy and planning. 

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