What’s new in public health?
Following a drop in public health expenditure by OECD nations during the global financial crisis, spending is beginning to gather pace again, according to an article on Public Finance International website.
In Australia, there is some good news emerging from an Australian Institute of Health and Welfare report, Ross Gittins wrote in the SMH. Australians have one of the highest life expectancies in the world, and as our most basic desire is to delay death, on this score we’re doing particularly well, he wrote.
But a visiting economist, Nobel Prize winning Joseph Stiglitz, has criticised the Australian Government’s moves toward US-style universities and healthcare, saying these steps “would take it down the American path of widening inequality and economic stagnation”.
In the US, The Lancet dedicated an issue to an examination of the health of Americans, in a joint project with the US Centres for Disease Control. The issue found that Americans mostly die from chronic diseases, which are largely amenable to lifestyle changes like healthy eating and quitting smoking.
This news comes as the American Public Health Association has announced a lobbying program aiming to empower people to approach their local congress members to educate them about public health.
Controversy has emerged in the US, where many news outlets, including the Washington Post, reported a key part of President Barack Obama’s healthcare law was struck down by the US Supreme Court, with the ruling that family-owned businesses do not have to offer their employees contraceptive coverage if it conflicts with the owners’ religious beliefs.
Forbes reported on the wider implications of the decision, saying it raised the question of whether corporate leadership elsewhere might refuse coverage of other drugs, or vaccinations, due to religious beliefs. But Kaiser Health News said the court’s decision did not override state ‘contraceptive equity’ laws that require most employers whose health insurance covers prescription drugs to also cover contraceptives as part of that package.
Over in the UK, Prime Minister David Cameron has announced a review into why so few anti-microbial drugs have been introduced to the market in recent years, the BBC reported.
This comes amid news that health professionals in England have joined in a united push against overuse of antibiotics. And multi-drug resistant foodborne infections are also a growing public health threat, this article from the Global Dispatch said.
And a piece by London Loves Business editor Sophie Hobson has critiqued Public Health England’s new emphasis on commercial partnerships, saying it may give corporations too much influence over public health campaigns.
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Indigenous health, racism and healing
NAIDOC week began on 7 July, and to mark the event Diabetes Australia-Victoria wrote about the importance of Aboriginal health and their work in the area.
Croakey reported on the submissions to the Senate inquiry into out-of-pocket healthcare costs, and posted excerpts of the submission from the Victorian Aboriginal Community Controlled Health Organisation, which warned that introducing co-payments would be harmful for Aboriginal and Torres Strait Islander peoples’ health.
Dr Lesley Russell expanded on this in her detailed blog post about how the Federal Budget would impact upon Indigenous programs and services. The Australian Medical Association also published a media release warning that the Budget cuts could end up widening the Indigenous health gap.
Kelly Briggs, who blogs as The Koori Woman, wrote the first of a series of guest posts for Croakey on navigating health services from her personal experience as an Aboriginal woman living rurally in Australia – and judging from this article, the series will be a must-read.
Croakey also highlighted a public forum focused on the effects of trauma, and how Aboriginal and Torres Strait Islander people can apply cultural solutions to promote healing in communities. Summer May Finlay, a Yorta Yorta woman and public health researcher, wrote about the forum and shared some Canadian research showing the protective effects of cultural continuity.
Pat Anderson, the chairperson of the Lowitja Institute, used her personal story to paint a powerful picture of how racism can affect the health and wellbeing of children.
She was giving the opening address at a recent symposium which examined the impact of racism of child and adolescent health. Marie McInerney reported on the symposium in more detail on Croakey with some poignant examples of how children “understand what it means to be black” from a very young age, and shared research that showed tackling racism in schools may improve school attendance and education outcomes.
The impacts of racism and discrimination on health and wellbeing was further highlighted in a Croakey article by Professor Farida Fozdar, who said Muslims in Australia were experiencing more discrimination and exclusion than ever, and these types of discrimination can cause low levels of well-being, self-esteem and life satisfaction, as well as stress and anxiety.
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Retractions, research milestones and robots
In the research world, controversial stem cell studies have been retracted from the prestigious journal Nature, in which Japanese and US scientists claimed to have reprogrammed stem cells by exposing them to acid.
The MJA has published its centenary edition, with an article from the editor Professor Stephen Leeder examining the journal’s history and future.
An article in the edition highlighted important milestones in the history of health and medical research in Australia, covering the establishment of the National Health and Medical Research Council, the broadening of Australian research to include biomedical science, clinical medicine, public health and health services, and the adoption of Indigenous health research as a strategic priority for our country.
Croakey also covered the journal’s centenary edition.
Meanwhile an innovative study at Griffith University will use robotic seals to help treat and ease symptoms of dementia, the Age reported.
And in this post on the KevinMD blog a prominent medical researcher defended translational research, saying although it is sometimes messy and methodologically problematic, trying to answer the most challenging ‘real world’ questions is important.
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Nutrition news
GPs were up in arms about news that Woolworths wants to introduce basic health checks in their stores, according to Medical Observer. But while commentators suggested that their complaints may be as much about turf as patient care, other experts reminded us that supermarkets are businesses, and don’t necessarily have the public’s health at heart.
The World Cup has presented an interesting case study into the clever marketing tactics of companies like Coca-Cola, researchers wrote on The Conversation. Corporate philanthropic initiatives – such as providing World Cup tickets to Brazilian boys from the favelas of Rio de Janeiro – allows Coca-Cola to market their products to children and families in the favelas, even as obesity is becoming a major problem in Brazil, linked with high consumption of soft drinks.
And now Public Health England has announced an investigation into advertising promotions of soft drinks and other high sugar, fat and salt products, to help tackle Britain’s growing obesity problem.
In Australia, the health star rating system for front-of-pack labelling has been signed off; a culmination of years of negotiation between government, industry and consumers, this article on The Conversation said.
And in the US, an analysis on Politico compared soda to John Snow’s pump handle – which was removed from Broad St, London, to prevent the cholera epidemic in 1854 – and said the evidence linking sugary drinks to poorer health is in and it’s just a matter of time before policy initiatives advance across the US to reduce its consumption.
The ‘State of the Tropics’ report was covered in this article on The Conversation, which said the next generation in this region will grow up wealthier, but with higher levels of communicable disease.
SMH reported on research that showed the heavier you are in middle age, the more likely you were to have self-care disabilities as you get older.
And Chris Forbes-Ewan wrote a great article for The Conversation that explained how ‘nutritionism’ – eating based on individual nutrients – has confused the healthy eating message. He finished up his article with Michael Pollan’s famous instructions: ‘Eat food. Not too much. Mostly plants.’
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Prescribing problems
Australia has topped the world rankings for use of prescribed opioids and illicit drugs, Medical Observer reported.
In the US, the American Public Health Association wrote about new data released showing that the number of prescriptions for opioid painkillers in America has been increasing markedly – along with the rate of deaths due to opioid and narcotic painkiller overdoses.
And there were concerns raised in Australia that elderly Australians have been taking NSAIDs for too long, and without adequate precautions to prevent side effects, 6minutes reported.
Ben Goldacre wrote an analysis for The BMJ on the use of statins, saying the questions we have about their risks and benefits indicated a failure of evidence-based medicine. Their common use should have provided us with enough data to resolve all our research questions – but we need better data, better dissemination of data, and better communication of data, he said.
John Menadue wrote a really interesting blog post, in which he argued that the Australian Pharmacy Guild is preventing necessary reform of our pharmacy sector.
And in this blog for Croakey, the CEO of the Consumers Health Forum Adam Stankevicius wrote that privacy concerns of pharmaceutical companies, government agencies and doctors may be preventing the public from accessing data that could lead to health insights.
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Primary care and broader health questions
The $7 GP co-payment measure continued to come under fire, with Medical Observer reporting on a new study that found the co-payment would create a bigger price signal than anticipated, and Croakey blogger Margaret Faux writing that the plan would effectively deregulate the bulk-billing market.
British doctors face being named and shamed if they repeatedly fail to catch cancer signs in their patients, under a ‘red flag’ program run by Britain’s National Health Service, Medical Observer reported – and closer to home, MO published a story that said Queenslanders can now submit GP complaints directly to the new Office of the Health Ombudsman.
MJA Insight quoted Professor Michael Kidd from Flinders University calling on his GP colleagues to help developing countries develop their primary care systems, by sharing local experiences and solutions.
This article in The BMJ argued for a renaissance in evidence-based medicine. The authors said that the concept had been hijacked by commercial interests, and needed to return to relationship-based, individual-focused care based on judgement rather than inflexible rules, with a public health dimension.
And a Croakey blog post by Melissa Raven from the Primary Health Care Research and Information Service examined the evidence around the health needs of fly-in fly-out workers in Australia’s remote and rural areas, pointing to a need for more health systems research to understand the demand on health services.
Lesley Russell provided an analysis of the Budget and its potential impacts on mental health in Australia for Croakey, saying it would have many negative consequences for people with mental illness.
The McClure Review’s release of its interim report on welfare reform caused anxiety amongst many. An anonymous Croakey blogger wondered about the stance of the Mental Health Council of Australia on the reform suggestions, and queried whether its links to the Business Council of Australia presented a conflict – but the Council responded at the bottom of the article by agreeing that reform was needed and highlighting the work they’ve been doing in the area.
But Jeff Kennett, beyondblue chairman, defended the Government and its welfare proposals, writing in his column for the Sydney Morning Herald that mental illness shouldn’t mean a lifetime on disability support.
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Other Croakey reading you may have missed
- Entries sought for essay competition focusing on mental health
- Frontline health, legal services and what’s crucial behind them
- Action on the social determinants of health – views from inside the policy process
- Book review: “Commendable” reading on climate change and equity
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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.
