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The Health Wrap: experimental medicine, everyday racism and equity

By Frances Gilham

Ebola, experimental medicine and evidence

The Ebola crisis is worsening.

ABC news reported on Liberia’s plea to the US for help, and Barack Obama’s response to send 3,000 troops to West Africa.

A fascinating article in the New York Times described the work of a doctor who has returned to his childhood slums to gain the trust of the locals in the hope he can help “defuse the Ebola time bomb”.

And the PLOS blog Public Health Perspectives explored the ethical dilemma of experimental medicine: do we give it to western aid workers or African locals; and if the latter, are we experimenting on a vulnerable population?

In other research news, rapid genome sequencing has shown promise for real-time tracking of multi-drug resistant antibiotics – and its use may help close down outbreaks faster and save lives, The Guardian reported.

To the dismay of many cancer survivors and research advocates, Australia’s Federal Court decided that private companies have the right to control human genes, according to an article in the SMH.

Patent lawyers said the laws were a fair reflection of the work done by the biotechnology industry, and the decision might draw business to Australia, the article said.

And this past fortnight, industry minister Ian Macfarlane upset many scientists when he called them “precious petals” for complaining about the Government’s approach to medical and scientific research in Australia.

Q & A ran a special science edition of its show, entitled Scientists: precious petals or passionate teachers, and it’s well worth a watch.

Croakey also published a response to the “precious petals” comments from Andrew Weatherall, who said the treatment of science in this way represents “the pervasive dismissal of evidence in all areas of policy”.

***

Medicinal marijuana, opioid prescribing, and alcohol

Also this past fortnight, the debate about medicinal marijuana continued, with NSW and Victoria preparing to conduct clinical trials for the drug, the Herald Sun reported.

Prime Minister Tony Abbott showed his support for the move, writing a letter to talkback radio host Alan Jones, saying: “I have no problem with the medical use of cannabis, just as I have no problem with the medical use of opiates.”

But opioid prescribing isn’t straightforward either, with Medical Observer reporting on findings presented at a recent symposium showing opioid prescribing for chronic non-cancer pain continues to rise despite poor knowledge about the long-term effectiveness of the drugs on pain.

And ABC reported on a new study that showed teenagers who were given alcohol by their parents were three times more likely to be heavier drinkers in their late teens than those from families that did not supply alcohol.

On illicit drug use, president of the Australian Drug Law Reform Foundation Alex Wodak examined the evidence, and said the flourishing of the illicit global drug trade showed current approaches to drug policy – mostly prohibition – have failed.

***

Aboriginal research initiatives, mental health and everyday racism

An interesting article in The Conversation by researchers from the Menzies School of Health Research outlined Australia’s Aboriginal Birth Cohort study, the largest and longest-running study of the lives of Indigenous babies in Australia, and explained how it has changed health policy and practice.

Also writing for The Conversation, Bronwyn Carlson from the University of Wollongong outlined her research looking at Aboriginal and Torres Strait Islander Peoples’ use of online social media, and how it relates to youth suicide.

Croakey also looked at the issue of mental health recently, with Kelly Briggs writing in her Koori Woman column about mental health and trauma in Indigenous communities.

Croakey covered a range of other issues affecting Aboriginal and Torres Strait Islander peoples.

Writing for Croakey, Karen McPhail-Bell, a PhD candidate at Queensland University of Technology, said mainstream health promotion had failed Aboriginal and Torres Strait Islander peoples, and she argued that those working in the field could learn from strengths-based programs like the Institute for Urban Indigenous Health’s Deadly Choices.

In another Croakey piece, Daniel Reeders and Suzanne Nguyen discussed how experiences of everyday racism correlated with health over time in Aboriginal Australian and culturally diverse people in Victoria.

And finally, Jennifer Doggett wrote that abolishing the Indigenous Tutorial Assistance Scheme (ITAS) would impact negatively on the Government’s education commitment.

***

Health innovation and technology news

With the Apple Watch launched, experts have put out a warning to consumers to be careful who has their private health data, and what they might be doing with it.

Writing for The Conversation, Deborah Lupton said when people use digital devices that connect to computing cloud storage facilities or developers’ data archives, the user no longer owned or controlled their own data.

Locally, an Australian-first health research centre was launched at UNSW, and will investigate how big data can reduce the costs of healthcare while simultaneously improving the prevention and management of many diseases, HealthCanal reported.

Another new centre, announced by the University of Queensland, will investigate telehealth and how it can improve delivery of health services to remote and regional areas.

And in another example of innovation, the George Institute for Global Health has launched a website that aims to fill the void left by the removal of the government’s food labelling website.

Their website rates food products based on government-backed formulae which measures salt, saturated fat, sugar and kilojoules plus any positive nutrients, this ABC article says.

***

Geography, equity and health

Rural health was in the spotlight recently, with the 4th Rural and Remote Health Scientific Symposium being held in Canberra.

There, participants committed to a National Strategy and Action Plan for maximising the value of rural and remote health research, according to a statement published at Croakey.

On his blog, Pearls and Irritations, John Menadue argued the Coalition should be fighting for better rural health outcomes, given its members represented some of the poorest electorates in the country – with the worst health services in the country.

But in happier news, Greg Mundy, CEO of Rural Health Workforce Australia, provided an update on the rural workforce for Croakey and he said that since 2009, the number of GPs working in rural areas had increased by 23 per cent.

We know where you live has a strong impact on your health, and now a new study published in the American Journal of Public Health has found that in the US, Hispanic neighbourhoods experience the most air pollution, while white neighbourhoods face the least.

Another event held recently focusing on health equity was the Australian Health Promotion and Chronic Diseases Network Conference, which took place in Alice Springs earlier this month. Cat Street provided an overview for Croakey, with a focus on the conversation in social media.

And still on equity, a promising program in Utah in the US called Housing First has demonstrated that providing housing to the chronically homeless can save the government money and successfully keep people off the streets long-term, according to an article in The New Yorker.

***

Healthcare system sustainability

Richard King wrote an interesting article for MJA Insight, well worth a read, exploring why, if we want our health system to remain sustainable, we need to focus on health procedure disinvestment.

In the same edition, Stephen Leeder argued for managed care to be introduced in Australia.

Croakey also published a range of articles with different perspectives on our health system, including an article in which Jennifer Doggett suggested other ways we could save health dollars, and one in which she outlined what she views as the ‘Seven wonders’ of health funding – including the myth of the funding crisis, the underuse of data, and the importance of primary health care as the foundation of the ‘pyramid’ of our health system.

In another Croakey piece, Richard Madden, the former director of AIHW reflected on what’s at risk if AIHW were to lose its welfare functions.

Margaret Faux discussed the most appropriate role for the private sector in supporting core government functions and the risks involved when private sector interests conflicted with the central role of government.

And this moving essay explored how doctors felt about the constant demand on their services, and how being unable to take proper time to care for patients was causing great amounts of stress in the workforce.

***

Stay in touch

If you see news that you are keen to have covered in this fortnightly column, contact me on Twitter via @francesgilham, my colleague Kellie Bisset via@medicalmedia, or use the hashtag #healthwrap.

You can find previous editions of the Health Wrap here.

Frances Gilham is the Digital Communications Manager at the Sax Institute, a non-profit organisation that drives the use of research evidence in health policy and planning. Frances has qualifications in health science and communications, and has previously worked in nutrition and the public sector. She enjoys playing online, and using digital media technologies for conversations about health, health policy, and the importance of evidence.

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