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The Health Wrap: Health and environment for Aboriginal people, rethinking sugar, mental health and marriage equality, last drinks?

This fortnight’s Health Wrap is compiled by my new Sax Institute colleague Barry Dunning, who is our new Communications and Media Manager. Enjoy the wrap and don’t forget to tweet us @SaxInstitute if you have any ideas you’d like to share.

Health and environment for Aboriginal people

The media spotlight was firmly in Darwin this past fortnight, as the Royal Commission into the Child Protection and Youth Detention Systems of the Northern Territory began its hearings. It didn’t take long for shocking testimony to be heard.  National Children’s Commissioner Megan Mitchell painted a grim picture of the Don Dale Youth Detention Centre, telling the inquiry that children were frequently and routinely isolated for very long periods in the hot, ageing facility.

The former NT Ombudsman Carolyn Richards told the Commission that the Northern Territory Department of Children and Families was “impenetrable” and “secretive” and that she had powers to investigate the child protection system taken away from her by a former Labor minister.

The mother of Dylan Voller, the teenager shown hooded and bound on the ABC’s Four Corners program that sparked the Royal Commission, told a public forum at the University of Sydney on Monday that she feared her son would experience severe repercussions after giving evidence at the Royal Commission.

“When the story first went to air, he was really relieved that the story was out and to see the people all over Australia do the rallies and everything, it gave him hope,” Joanne Voller was reported as saying. “But right now, the last few conversations I’ve had with him, to be honest – he’s really scared … when he gives the royal commission evidence, he still has to go back to jail. I’m really fearful that I’m going to lose my son, to be honest. Is he going to be the next person who passes away in custody?”

The ongoing suicide crisis in remote Aboriginal communities also remained in the news, with a major new report from the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project (ATSISPEP) expected to call for a radical rethink in Indigenous mental health policy to place Aboriginal and Torres Strait Islander people at the centre of care. For the past two and half years ATSISPEP researchers have been mapping Indigenous suicide rates nationally and tracking evidence on effective prevention.

The report was not officially released as expected by Health Minister Sussan Ley, Assistant Minister for Health and Aged Care Ken Wyatt, and the Indigenous Affairs Minister Nigel Scullion at a round table with Indigenous representatives in Broome on Friday, although a number of media outlets have reported getting copies. Ahead of the meeting, Croakey’s Marie McInerney interviewed Professor Tom Calma, one of the report’s authors, who said it was important the report it did not “end up in a Northern Territory Intervention style response”. Rather, he said it should prompt an implementation “partnership” with guidance from its authors and coordination across and within government.

The human tragedy of this crisis was highlighted once again last week when a 37-year-old woman took her life at the site of teenager Elijah Doughty’s death in Kalgoorlie.  Fourteen-year-old Elijah  died when he was allegedly run down by a motorist in late August on the outskirts of Kalgoorlie.

Meanwhile, the first Aboriginal woman to be elected to the house of representatives and a former domestic violence victim Linda Burney lashed out at the head of the Prime Minister’s Indigenous Advisory Council Warren Mundine for claiming in an Opinion Piece for The Australian (paywalled) that the Indigenous community ignores domestic violence.

Burney told BuzzFeed news that she was “angered and flabbergasted at the lack of understanding Warren demonstrated in that article [about] what is actually going on at the community level”.  She also said Mundine has been the chief advisor to the government “when the government withdrew services and said nothing.” Writing in The GuardianAmy McQuire also addressed the issue:”If you think Aboriginal women are silent about domestic violence, you’re not listening”.

McQuire also wrote about the ongoing indignities inflicted on the family of Ms Dhu, who died in custody in Western Australia after being denied medical care. Her article was published at Croakey as part of its #JustJustice series into the overincarceration of Aboriginal and Torres Strait Islander people.

In Alice Springs, young mother Shirleen Campbell urged her fellow residents to speak out against family violence and report incidents to police before another woman was killed by their partner.  Campbell has established a successful women’s committee at the Indigenous settlement in Alice Springs that has overseen a drop in violent incidents in the short time it has been operating.

As part of Croakey’s ongoing Acknowledgement series, Janine Mohamed, CEO of the Congress of Aboriginal and Torres Strait Islander Nurses (CATSINaM), advocated for the nursing profession to follow the lead of psychologists in making an apology to Aboriginal and Torres Strait Islander people as part of moves towards wider embedding of cultural safety. Mohamed wrote about the lessons to be learnt from recent revelations about ‘lock hospitals’ for Aboriginal and Torres Strait Islander people that operated in Western Australia and Queensland during the first half of the 20th century, saying that,

“While we (today’s nurses) ourselves did not work there, the societal beliefs interwoven with the professional theories practiced 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?”

And the Sax Institute highlighted research on housing this fortnight from SEARCH – the active long-term research partnership between the Sax Institute, the Aboriginal Health and Medical Research Council, leading researchers and four Aboriginal Community Controlled Health Services. The research found that improving housing may be key to improving the health of urban Aboriginal Australians. It showed that housing problems were common, and perceived to have a significant impact on people’s health and wellbeing.


Rethinking sugar

Added sugar has been front and centre of this year’s World Obesity Day.  Last week saw the launch of the Sugar By Half campaign to encourage people to cut down on added sugar. Eating too much added sugar has been linked to a whole host of serious health problems, including obesity, heart disease, type 2 diabetes and tooth decay. The launch garnered widespread media coverage and debate, including this piece on Croakey. Also on World Obesity day, Federal Health Minister Sussan Ley and ALP Health spokesperson Catherine King had duelling opinion pieces on the epidemic of childhood obesity.

In international developments,  Ireland has announced plans to join the growing number of countries taxing the sugar in fizzy drinks.  One in three young Irish people are drinking sugar-sweetened drinks on a near daily basis sugar and the average consumption for the entire population equals 200 cans of sugar-sweetened drinks on a yearly basis. Implementation of the Irish tax will be delayed until 2018, to coincide with the introduction of a similar tax in the United Kingdom.

The Irish Government’s announcement coincides with a call from the World Health Organisation for all countries to consider introducing a tax on sugary drinks. Douglas Bettcher, director of the WHO’s department for the prevention of non-communicable diseases, didn’t pull any punches in his assessment of the impacts of sugar and the need for Government action:

“Consumption of free sugars, including products like sugary drinks, is a major factor in the global increase of people suffering from obesity and diabetes. If governments tax products like sugary drinks, they can reduce suffering and save lives. They can also cut healthcare costs and increase revenues to invest in health services.”

Of course it’s not too late to help solve our biggest food-related health and environmental challenges in the most delicious way possible – over a shared, locally-sourced, nourishing meal. NCDFREE Global Coordinator for Australasia Juliette Wittich told us all about the upcoming #FeastOfIdeas in this Croakey post.

Meanwhile “nudge theory“, which has been raised in the debate over obesity, was the subject of a piece by the Mandarin, with the founder of Australia’s first nudge unit, Rory Gallagher saying he was confident it wasn’t a passing fad, though he warned against complacency and overuse.

Nudge has become increasingly visible in the public sector over the past decade, with behavioural insights units in Canberra, Sydney and more celebrated outfits in the UK and USA working on the contested theory that subtle changes to the way decisions are framed and conveyed can have big impacts on behaviour.

“But with the growing popularity of nudges, governments must not get complacent about the need to base each nudge project on legitimate research and to continue monitoring over time to make sure they keep working,” Gallagher said.

Finally, if you’ve not gotten around to reading Ian Leslie’s article on the decades of successful lobbying by the sugar  industry to make fat – and not sugar – public health enemy number one, it is essential reading. Grab a cup of something sugar-free and take 20 minutes to enjoy this one!


Last drinks? Maybe not yet

Speaking of things that can taste great, but represent a potential health hazard, alcohol has remained in the public spotlight. While the evidence for restricting trading hours may be heading in one direction the public debate in New South Wales is a different story. According to The Daily Telegraph, Premier Mike Baird is planning to relax the lockout laws any day now.

Meanwhile, new research from the  Australian Institute of Health and Welfare’s 10-year survey of the nation’s drinking habits has found that Australians are drinking less alcohol as prices rise and club trading hours fall.

And another study published in Public Health Research and Practice found that only 3 per cent of people are taking up medical options to treat their alcohol dependency, despite these drugs being as effective a treatment option as anti-depressants are for treating depression and available on the PBS. The lead author of the study, Professor Paul Haber, spoke to ABC Radio’s the World Today on the issue.

And on Twitter @Wepublichealth teased out important issues around to alcohol misuse.


Mental Health and marriage equality

The fortnight also marked World Mental Health Day, with the Federal Government using this date to “reaffirm its commitment to trialling innovative approaches in delivering mental health services, in an effort to curb rates of suicide around the country”.

While the Government focused on its investment, others contrasted this with the potential mental health impacts of a divisive Marriage Equality plebiscite. Former High Court judge, the Hon Michael Kirby, shared his insights into the personal impacts of the planned plebiscite on marriage equality at the 34th annual CRANAplus conference, reported by Croakey.

As the debate continued over the potential health impact of a plebiscite continued, Casey Kennedy from Queerspace in Victoria advised services dealing with LGBTIQ clients on how to support them during the debate over marriage equality. Croakey also published this article by Jason Rostant, detailing concerns from health professionals about the plebiscite and asking whether the Australian Medical Association was missing in action on the debate.

The mental health impacts on LGBTI Australians and their families  was one of the core reasons given by the Labor Party in ultimately opposing a plebiscite, a position lambasted by the Prime Minister.  A plebiscite now looks increasingly unlikely.

Meanwhile, Victorian mental health researcher and tertiary educator Cath Roper talked about how the horrific treatment and indignities she experienced as a mental health patient has driven her work since. She was speaking to Croakey after being presented with a lifetime achievement award at an awards night to mark the 20th anniversary of the mental health consumer workforce in Australia.


Joining the dots between health and climate change

The slow moving car crash that is climate change continues to be a topic of huge concern and controversy. Croakey covered a roundtable forum of public health leaders in Canberra hoping to put health at the forefront of Australia’s action on climate change. As the Climate and Health Alliance executive director Fiona Armstrong told the Huffington Post;

“There has been advocacy on climate change over several years, but we’re concerned that as the issue becomes more urgent, there has been a failure to reflect the concerns of the health sector in climate policy decisions.”

The Guardian also reported that health professionals overwhelmingly say they don’t know of any policies that deal with the health implications of climate change. Back at Croakey, the Chief Executive of cohealth Lyn Morgain, argued that The Australian Institute of Health and Welfare should address the health effects of climate change.

Climate change even managed to secure a brief moment of oxygen in the US Presidential Debate, with Al Gore joining Hillary Clinton at a Florida campaign rally. Clinton wasted no time in making the  difference between the two candidates clear emphasising:

“We cannot risk putting a climate denier in the White House…We need a president who believes in science”


Cancer and heart disease

Following on from the success of its long-running campaigns to get people to use suntan lotion and stop smoking, the Cancer Council has launched a new campaign to tackle some of the other key risk factors for cancer. Dubbed the one-in-three campaign, its focus is on some of the other risk factors such as poor diet, being overweight, not doing enough physical activity and drinking too much alcohol.

New research from the Australian Catholic University’s Mary McKillop Institute for Health has found that heart disease contributes to more deaths among women than most forms of cancer. The lead author of the study told the ABC that 60% of the causes of heart disease in women were preventable, but that many women falsely believed that heart disease was a condition that affected mainly men.


And there’s more

Reporting ahead of the 34th annual CRANAplus conference Croakey ran a fascinating piece on the safety of remote area health professionals, with the murder of remote area nurse Gayle Woodford having weighed heavily on the hearts and minds of many of the conference delegates . Christopher Cliffe, Chief Executive Officer of CRANAplus said that to improve the safety of remote area health professionals, the sector needed to look “outside of the box” to learn from other industries.

Croakey moderator Jennifer Doggett published an extensive report that is essential reading for anyone who doesn’t have time to read the Australian Institute of Health and Welfare’s Health expenditure Australia 2014–15. She concludes the health system is:

“An inefficient and inequitable  system which does not support the provision of high-quality care and leaves many consumers facing large and inequitable payments for essential services.”

Finally this month, the Nobel Prizes were handed out with Japanese cell biologist Yoshinori Ohsumi awarded the Prize in Physiology or Medicine for his discoveries of mechanisms for autophagy, which it is hoped could lead to breakthroughs in treatments for cancer, Parkinson’s disease and Alzheimer’s disease. More humorously, the IgNobel prizes were handed out at the end of September, with Rats in tiny trousers, rocks with personalities and other oddities sweeping the boards.

Other Croakey reading you may have missed this fortnight:

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