This column identifies many policy and funding gaps – for tackling violence against women and children, for oral healthcare, for the much-anticipated Australian Centre for Disease Control, and for tackling the spread of H5N1 avian influenza.
“Are we prepared for the fact it [H5N1] will inevitably reach Australia?” asks columnist Dr Lesley Russell.
She also reports on the characteristics of ‘super-agers’, and shares a link to a freely available, new book telling “the well-known, sad story about shortsightedness and missed opportunities to deliver affordable dental care to all Australians”.
The quotable?
Violence should be seen as a health equity issue; preventing violence is an important component of achieving equity in health and in communities. It is a key factor in undermining efforts to achieve gender equality.”
Lesley Russell writes:
The Health Wrap has had a short hiatus while I spent 13 marvellous days in the Kimberley.
We drove over 3,000 kilometres and hiked and swam. The geology was amazing, the landscape was strikingly beautiful, and the sunrises and sunsets were glorious.
There was lots of rock hopping, birdlife, boab trees and red dust and a few (freshwater) crocodiles, snakes and spiders.
As you can imagine, I took lots of photos. I chose this one, of Galvan’s Gorge in the Wunaamin Miliwundi Ranges Conservation Park, just off the Gibb Highway, because the place was so wonderfully spiritual.
We swam in the clear waters, let the waterfall pummel us, and lay on the rocks soaking up the sun and admiring that boab tree growing proudly at the top of the falls.
This is clearly an important area for the local First Nations communities. Nearby we found some well-preserved rock art – a beautiful wandjina and some mimi spirits.
The Budget and beyond
Now I’m back in Sydney and we are all busy analysing the 2024-2025 Budget outcomes.
This edition of The Health Wrap doesn’t undertake a Budget analysis but considers a number of topical issues in the light of Budget funding (or lack thereof).
Despite gender-based violence being front and centre in the Women’s Budget Statement, which outlines how the Albanese Government is working to deliver gender equality, the overall opinion is that there is little new support to address the crisis of domestic and family violence.
The media release from Katy Gallagher, the Minister for Women, on the 2024-2025 Budget funding for women’s issues is here.
See:
- Women’s Agenda. Limited support for ‘Crisis’ of domestic and family violence
- The Guardian. Australia’s budget has ‘gaping hole’ in funds for DV victims, environment and housing, advocates say
A report by ABC News has domestic, family and sexual violence organisations saying they will have to start winding back services because the Federal Government hasn’t invested enough in the sector in this Budget.
It isn’t just services for women victims that are underfunded; intervention and counselling services for men who are known to be abusive have huge waiting lists. The problem of violence against women will not be addressed without addressing male behaviour.
Violence should be seen as a health equity issue; preventing violence is an important component of achieving equity in health and in communities. It is a key factor in undermining efforts to achieve gender equality.
In October 2022, the Government launched the National Plan to End Violence against Women and Children 2022-2032 to ensure that communities are safe for all women and children.
The First Action Plan 2023-2027 is here.
Aboriginal and Torres Strait Islander Action Plan 2023-2025 is here.
In early 2023, the Department of Prime Minister and Cabinet released a discussion paper to inform the National Strategy to Achieve Gender Equality. This sees gender inequality as a driver of violence against women (and violence against women contributes to gender inequality).
Working for Women: A Strategy for Gender Equality was launched by the Minister for Women, Katy Gallagher, on 7 March 2024.
I think it is clear that – even though the need is great and there is so much more that must be done – the Albanese Government has a real commitment to addressing gendered violence and the associated inequalities and physical and mental harms.
Related to this issue of gender equity is the issue of economic inclusion. The most recent report of the Economic Inclusion Advisory Committee is here.
As an addendum: Regrettably (predictably?) there was nothing new in the Budget to address oral and dental health needs.
In a recent article for Croakey Health Media, Dr Shalinie King highlights that many women who are the victims of physical domestic violence need access to dental services when their teeth and facial bones are broken,
Continuing viral threats
In the April 23 edition of The Health Wrap I wrote about more threats from more viruses – and there is now considerably more news on that front.
The threat from H5N1 bird flu continues, especially in the United States. The virus has been found in dairy cows and in raw milk and there is at least one case of cow to human transmission. Scientists are worried that it is spreading in mammals with which humans have close contact.
The US Centers for Disease Control and Prevention wants to study the outbreak but many farmers, especially in Republican states like Texas (where the outbreak started), don’t want the federal government on their property.
This H5N1 bird flu strain is spreading rapidly – it’s already reached South America and Antarctica [you can also read more in recent ICYMI columns here and here].
Are we prepared for the fact it will inevitably reach Australia?
Monitoring the spread of this virus is a task for the new Australian Centre for Disease Control – which, as far as I can determine – got not one mention in the 2024-2025 Budget.
Of course COVID-19 is a continuing threat, and mosquito-borne viral diseases are becoming more common due to climate change.
So it was good to see two provisions in the Budget to address these issues:
- $126.5 million over two years (why such a short time frame?) for the continuation and expansion of national strategies for blood-borne viruses and sexually transmitted infections (Page 118, Budget Paper 2).
- Funding for the continuation of programs to prevent and control communicable diseases in the Torres Strait Islands and Far North Queensland (Page 114, Budget Paper 2).
Meanwhile, as winter approaches, influenza and COVID-19 are spreading rapidly, triggering an early spike in people visiting emergency departments.
The latest NSW Health data showed a 40 percent jump in COVID-19 cases and a 30 percent increase in influenza cases in the week to May 11.
In NSW about 400 cases were reported each day in the week to May 11 (who knows how many cases were unreported?), with most cases in elderly people aged 90 and older (ie people in residential aged care).
Ageing well
Maybe it’s the accumulation of birthdays, but I am constantly fascinated by what we are learning about ageing and how to do it well.
Most research on aging and memory and cognition focuses on dementia. Now a paper from Spanish researchers, just published in the Journal of Neuroscience, sheds light on the brains of super-agers (the term applied to individuals aged 80 and up with the memory ability of a person 20 to 30 years younger).
It provides evidence that age-related cognitive decline is not inevitable. The biggest takeaway, in combination with a companion study on the same group of individuals, is that their brains have less atrophy than those of their peers.
Experts don’t know how someone becomes a super-ager although it seems that health and lifestyle behaviours are important. The Spanish super-agers had slightly better physical health, both in terms of blood pressure and glucose metabolism, they performed better on mobility tests, and reported better mental health.
As you can imagine, I really liked this commentary on how overcoming negative attitudes to ageing can help you live longer and better.
“Ageism is arguably the last acceptable prejudice. While other forms of discrimination are considered reprehensible, it is normalised…Unfounded stereotypes about old age directly affect the lives of those in their later years – their financial opportunities and medical treatment, for example. Ageism is one of the biggest barriers faced by people everywhere, affecting all facets of life…It’s so pervasive, it’s so accepted, it’s so invisible.”
And finally, this intriguing finding, published in Nature: a rare mutation (Laron syndrome) that causes dwarfism may also slow ageing. Studies have associated the condition with a number of positive health effects, including protection against diabetes, hear disease, cancer and cognitive decline.
Digital health issues
A research paper released this month by the Productivity Commission Research looks at the role digital technology can play in improving patient outcomes and enhancing productivity in healthcare.
The paper finds that better integration of digital technology into everyday healthcare practice could save more than $5 billion a year and ease pressures on the healthcare system.
The Mandarin has an interesting analysis of the paper’s findings and reminds us how much money (and time) has been wasted on health IT over the years.
The National Digital Health Strategy 2023-2028 and the Delivery Map for the Strategy are available here.
A recent health policy brief from the US based journal Health Affairs outlines the connections between digital inclusion and health equity.
It finds evidence suggesting two pathways through which digital inclusion (seen as a social determinant of health) and health equity are connected.
The direct pathway is through increasing access to healthcare services.
The indirect pathway is when people use the internet to address health-related social needs such as education, employment, and social services. This pathway is strongly influenced by neighbourhood and socio-economic characteristics and the availability of high-quality, affordable internet services.
In case you missed it
More diversity in the upper levels of the Australian Public Service
The Public Service Act 1999 requires the Public Service Commissioner “to foster an Australian Public Service (APS) workforce that reflects the diversity of the Australian population.”
About 25 percent of the APS come from culturally and linguistically diverse (CALD) backgrounds – a similar portion to the overall population.
But APS employment data show that CALD employees are over-represented in technical and specialist jobs, and under-represented in positions with decision-making authority.
The APS Culturally and Linguistically Diverse Employment Strategy and Action Plan (available here) were released in April. There is a 24 percent CALD target for the Senior Executive Service.
New initiative to support science in developing countries
The world’s three largest health philanthropies – the Novo Nordisk Foundation, the Gates Foundation, and the Wellcome Trust (which is chaired by former Prime Minister Julia Gillard) – have announced a new partnership, committing US $300 million over three years to stimulate innovative research in developing countries into climate change, infectious diseases and antimicrobial resistance (AMR).
These are seen as three of the world’s most critical global health challenges.
An additional funding stream will support research towards a greater understanding of the interplay between nutrition, immunity, infectious and non-communicable diseases, and developmental outcomes.
Dental care and healthcare are the same thing
Dr Jamie Robertson and Dr John Roger from the University of Melbourne summarise their new book, Looking Back Looking Forward – Oral health in Victoria 1970 to 2022 and beyond, here.
The book is available as a free pdf here.
It’s the well-known, sad story about shortsightedness and missed opportunities to deliver affordable dental care to all Australians.
Their article concludes: “We think the key actions that are required are: a greater focus on prevention; improved oral health information systems; and a phased introduction of basic dental care into Medicare.
“This is an ambitious reform agenda that will ultimately ‘put the mouth back into the body’ and requires urgent discussion and policy attention to determine priorities, timelines, funding and implementation responsibilities.”
Breast feeding as a carbon offset
A new World Health Organization Bulletin paper, led by Professor Julie Smith at ANU and Professor Phillip Baker at the University of Sydney, argues that breastfeeding should be recognised in food and well-being statistics and investments in breastfeeding should be considered a carbon offset in global financing arrangements for sustainable food, health and economic systems.
“Achieving global nutrition targets for breastfeeding would realise far greater reductions in greenhouse gas emissions than decarbonizing commercial milk formula manufacturing.”
[Read more on this in a recent ICYMI column].
Good news on Indigenous health
A recent article by Professor Juli Coffin in The Guardian outlines how the horses of the Yawardani Jan-ga equine stud are helping young Indigenous people through assisted learning and making them feel seen, wanted and loved.
The program, which taps into a First Nations worldview of relationships between people, animals and land, has been able to make an impact in remote areas where mainstream suicide services struggle to have an impact.
Professor Coffin’s work in this area has been recognised with a number of awards.
Best of Croakey
Croakey editors and contributors have done a brilliant job this past week with coverage of the 2024-2025 Federal Budget.
Kudos and thanks to all involved!
More good news
Some good news frivolity to end this edition of The Health Wrap.
If you’ve even taken this drive, accessible only by high suspension 4WD vehicles, then you will understand. It is a narrow, unsealed track with a number of creek crossings, some sharp corners, and ascents and descents. The 53 kilometre journey takes 2.5 to 3 hours.
The views along the way and on arrival at Purnululu are just spectacular. 
Croakey thanks and acknowledges Dr Lesley Russell for providing this column as a probono service to our readers. Follow her on Twitter at @LRussellWolpe.
Previous editions of The Health Wrap can be read here.
