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The Health Wrap: Health and welfare challenges; rethinking cancer screening; unpicking research papers and more

**WARNING: Aboriginal and Torres Strait Islander readers are warned that this article contains the names and images of deceased persons **

This fortnight’s Health Wrap has been complied by Ellice Mol, the Sax Institute’s Digital Communications Manager. Enjoy the Wrap and tweet us via @SaxInstitute if you have any ideas for future issues.

Health and welfare challenges

A report from the National Drug and Alcohol Research Centre (NDARC), released last week, has revealed that more Australians die from prescription pain killers than from heroin, SBS News reported. In response, Dr Bridin Murnion wrote for Croakey on the public health challenges associated with the ongoing opioid crisis and reflected on lessons for Australia from the opioid epidemic in the United States, in which the number of deaths related to prescription opioids has outstripped those from motor vehicle accidents.

A  study into Australian ice-related deaths was also highlighted in this Conversation piece, which revealed the large proportion of deaths associated with serious social, mental and physical health problems from using the drug, including heart disease, stroke and suicide.

Inequality was in the spotlight with the release of the latest report from the Household, Income and Labour Dynamics in Australia (HILDA) surveyThe Guardian reported that the survey showed the real income of households was now lower than it was in 2009 and, while the measure of income inequality appeared stable, there were signs that generational inequality was growing. Guardian columnist Greg Jericho wrote:

“It also highlights that while income inequality may have stabilised, the ability to use that income to build wealth has drastically changed. The report provides damning evidence that inequality across generations has increased – with those under 40 now much less able to buy a home than were young people in previous years.”

Meanwhile, there was further media coverage of a study that ranked Australia second best in the world for healthcare, while the US has placed last. The ABC reported that the United Kingdom took the top spot, the Netherlands third, with Norway and New Zealand sharing fourth place. The authors of the study wrote:

“The US performs relatively poorly on population health outcomes, such as infant mortality and life expectancy at age 60.”

As reported in the previous Health Wrap, the same study ranked Australia poorly on equity, as Dr Lesley Russell from the University of Sydney’s Menzies Centre for Health Policy pointed out for Croakey.

Debate over healthcare in the United States continues after US President Donald Trump suffered a major blow by failing to pass a “skinny” repeal of Obamacare in the Senate, The Guardian reported. Trump lashed out on Twitter threatening to end government payouts to health insurers if the “HealthCare bill is not approved quickly” by Congress. But as the debate rolls on “hundreds of U.S. counties are at risk of losing access to private health coverage in 2018 as insurers consider pulling out of those markets,” Reuters reported


Rethinking tests and screening

The Royal Australasian College of Physicians (RACP) has advised doctors to stop ordering “unreliable, potentially harmful” tests for women and children, reported The Sydney Morning Herald. The Society of Obstetric Medicine of Australia and New Zealand (SOMANZ) has released a list of 17 such tests which have been published by RACP as part of its Evolve initiative, which aims to eliminate unnecessary tests and treatments. SOMANZ’s Dr Helen Robinson said:

“The cost of all these unnecessary tests are covered by the taxpayer or private health insurance, so it’s important we identify and we reduce low-value practices.”

A cancer screening-themed issue of Public Health Research & Practice (PHRP) journal was also released this fortnight, in which researchers urged balance in cancer screening, saying that a  ‘one size fits all’ approach, particularly with prostate cancer, was inappropriate, leading in many cases to patient anxiety and worse health outcomes.

Amy Coopes wrote a detailed summary of the papers for Croakey, covering the issues of cancer overdiagnosis, cancer screening risks, and support for informed choice.

Meanwhile another paper in the journal suggested public health experts learn from the success of Pokémon Go in their own attempts to use technology to improve health, medical website 6minutes (subscription only) reported.


 Death of an icon highlights inequality

Earlier this fortnight, Federal Minister for Indigenous Health Ken Wyatt proposed that a new Indigenous advisory body be better to be established by Parliament, after the release of the Referendum Council’s report had suggested the decision to enshrine a representative body in the constitution should be made by referendum, the ABC reported. Mr Wyatt said:

“If it is enshrined in a way that both major parties agree to it, and agree that there’s not going to be an abolition, and build and restore the faith of Aboriginal and Torres Strait Islander people, then I think it is better enshrined in legislation.”

Meanwhile in the latest edition of Croakey’s JournalWatch Dr Melissa Stoneham explored the barriers to driver licensing for Aboriginal people, amid findings that there are many structural barriers, including the closure of many licensing support and driver education courses due to lack of funding.

And tributes have poured in for musical icon Dr G Yunupingu, who died in Royal Darwin Hospital last week after suffering years of ill health, having contracted hepatitis B as a child, Sky News reported. He was Australia’s most prominent Indigenous musician and his death has once again highlighted the disparity in life expectancy between Indigenous and non-Indigenous Australians, an issue which featured in this episode of ABC’s Life Matters.

Opposition Leader Bill Shorten told ABC Radio:

‘We use words about death like ‘taken too soon’ but they are very true words in this case. The gap between health outcomes for our first Australians and other Australians is shocking.’

The loss of Dr Yunupingu came as a Western Australian court acquitted a man of manslaughter over the heavily publicised death of Elijah Doughty. The decision has angered many Aboriginal and Torres Strait Islander people. Croakey provided links to valuable reading on this issue and tributes to Dr G and other recent losses in the Aboriginal and Torres Strait Islander community here.


Research papers unpicked

A global group of researchers have called for the threshold on the p-value – an expression of how likely it is that research results are due to chance – to be dropped from 0.05 to 0.005. In response, Shlomo Argamon, Professor of Computer Science and Director of the Master of Data Science at the Illinois Institute of Technology, argued that doing so could entrench woes within the current system. He called for a rethink on how research is published, in a series of blog posts that have been republished for Croakey readers.

This blog explores another relevant issue for researchers, looking at how to ensure Cochrane Reviews remain trusted, and trustworthy evidence to inform health decisions in an era of fake news.

In other news, a timely report published by the Australian Commission on Safety and Quality in Healthcare has evaluated the economic impact of investigator-led clinical trials conducted by networks, which revealed approximately $2 billion (2014 dollars) in benefits, measured through better health outcomes and reduced health service costs.

Also in the higher education sector, the long-awaited publication of a report into sexual assault at Australian universities revealed more than half of all university students were sexually harassed last year, the ABC reported. The report, based on a landmark survey of 39,000 students across the country by the Australian Human Rights Commission, prompted this article on The Conversation on how to address the problem, which includes tackling factors known to drive violence as well as a range of holistic measures. The findings also attracted widespread international media attention, including reports from the BBC in the UK and CNN in the United States.


Engaging people in health

Last week was DonateLife week, with the Federal Government announcing it is committed to increasing Australia’s organ donation rates by making it easier to register as an organ donor online, the ABC reported.

Head and neck cancer survivor, journalist Julie McCrossin wrote for Croakey on the rising epidemic of head and neck cancers caused by the human papillomavirus (HPV). She has co-edited a new book of patient’s stories of diagnosis, treatment and survival that was launched to mark World Head and Neck Cancer Day.

And in this piece for Croakey, Dr Melissa Stoneham from the Public Health Advocacy Institute of Western Australia (PHAIWA) has challenged academics and public health researchers to use Twitter to increase their professional profile. A recent article by the Sax Institute also urged researchers to embrace Twitter with these nine convincing reasons.

In related news, Croakey provided an insightful analysis of the impact of its @WePublicHealth Twitter account, curated by a different public health professional or organisation each week, in this article: How @WePublicHealth packed a punch in 2016.


Other Croakey news you may have missed this fortnight:

And a #CroakeyGO series: