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The Health Wrap: Mental health, Food marketing confusion, Trump’s healthcare headache and more

This fortnight’s Health Wrap is compiled by Helen Signy, Senior Communications Officer at The Australian Prevention Partnership Centre led by the Sax Institute. Enjoy the wrap and don’t forget to tweet us @TAPPCentre and @SaxInstitute if you have any ideas you’d like to share.


Focus shifts to PHNs to address mental health

This week has seen a renewed focus on mental health, with an announcement that the Turnbull government will establish a new Primary Health Network Advisory Panel on Mental Health to help in the delivery of more frontline mental health services.

Co-chaired by Mental Health Australia CEO Frank Quinlan and National Mental Health Commission CEO Dr Peggy Brown, the panel will advise on mental health support, care and funding at a regional level through the Primary Health Networks (PHNs).

Health Minister Greg Hunt has reiterated his commitment to addressing mental health as one of four key pillars of the health system, along with Medicare, hospitals and medical research. He told ABC radio that he was particularly looking at boosting telehealth and online support, and that there would be an announcement soon on new trial sites around Australia aiming to address suicide prevention, especially for veterans.

The announcement came as a report by Mind Australia and the University of Queensland, reported in The Conversation, unveiled the true costs of caring for people with mental illness in Australia. The authors found it would cost an estimated $13.2 billion to provide the same level of support in the mental health service sector as is currently provided, unpaid, by 240,000 informal mental health carers, many of them children.

That number could grow, with fears of a looming services gap under the NDIS for up to three-quarters of people with mental illness. Advocates who met with MPs and Ministers this week have raised concerns that there are potentially around 200,000 Australians who could miss out on support currently provided by State and Commonwealth Government programs, ABC news reports. The Department of Human Services said each state and territory government had pledged continuity of support for clients not eligible for the NDIS, but how this will work is still unclear.

In the days, weeks and months ahead, as communities across Queensland and northern NSW grapple with the aftermath of Tropical Cyclone Debbie and related flooding, the experience of previous extreme weather events suggests that there will be significant implications for the mental health of populations and for health services.

Meanwhile, former Prime Minister Julia Gilliard was announced as the new chair of Beyondblue, saying that mental health and preventing suicide have always held a deep personal significance for her, as her father worked as a psychiatric nurse.

“In Beyondblue I have found an organisation that I respect and that champions this cause, which is so close to my heart. I also found a way to honour my father, who devoted so much of his life to those struggling with mental illness. It is a natural fit.”


The gap is closing – but not fast enough

A new publication released on March 20 by NACCHO Aboriginal health has confirmed slow but steady improvements in the health of Aboriginal and Torres Strait Islander people.

The Overview of Aboriginal and Torres Strait Islander health status 2016 shows a decline in Aboriginal mortality, especially in infant mortality. There have also been improvements in other key areas contributing to Aboriginal health, such as a decrease in the number of Aboriginal and Torres Strait Islander women smoking during pregnancy, fewer low birth weight babies, and a 26% decline in age-standardised death rates for respiratory disease in NSW, Queensland, WA, SA and NT between 1998 and 2012.

These positive developments are echoed in a Guardian story quoting leading ophthalmologist Professor Hugh Taylor as saying the gap in blindness between Aboriginal and non-Aboriginal people has halved since 2008, largely due to relatively cheap interventions such as providing clean water and better hygiene.

The key to success is sustained funding as well as leadership by Aboriginal community-controlled health organisations, say those at the frontline. The Hearing, Ear Health and Language Services (HEALS) project, which was developed in response to findings from the SEARCH partnership study into the health and wellbeing of urban Aboriginal children, has shown the considerable benefits in the life trajectory of young people who receive services for hearing and speech problems. But funding for this program is still not embedded. As HEALS program manager and paediatrician at The Children’s Hospital at Westmead, Dr Hasantha Gunasekera, told The Guardian:

“What we need is recurrent funding so we can plan services across the year and expand so that screening and treatment is not just available to those areas where we have research partnerships. I would argue that this type of program should be available to everyone with an Aboriginal background in Australia.”

Two other Aboriginal health success stories emerged this week: a dramatic turnaround in outcomes for Aboriginal patients at Katherine Hospital, and the establishment of a new hub for Aboriginal mothers and babies in Queensland.

Meanwhile, writing on Croakey, Colleen Lavelle outlines 10 ways everyone can help to close the gap, including employing more Indigenous hospital liaison officers and employing more Indigenous people across the entire health sector, while the issue of obesity in Australia’s remote Indigenous communities and the struggle to eat well against the odds, is explored in this JournalWatch article.

Following the recent Close the Gap progress report, The Australian reported that the Department of Health will evaluate the effectiveness of primary health care for Aboriginal and Torres Strait Islander people, including the Indigenous Australians’ Health Program, in order to speed up Australia’s move towards COAG targets.

In other significant news for the health and wellbeing of Aboriginal and Torres Strait Islander people, the Australian Senate last night voted down the Turnbull Government’s proposed changes to Section 18C of the Racial Discrimination Act. (The changes had been opposed by many health groups). Reconciliation Australia CEO Justin Mohamed said in a statement that the result “should be considered a success in the advancement of reconciliation” and “sends a strong message that racism has no place in Australia today”.


Trump’s healthcare headache

The battleground over Obamacare reached new heights this week with mounting fallout over US President Donald Trump’s failure to repeal the Affordable Health Care Act.

After weeks of negotiations around the repeal of Obamacare, the White House failed to build consensus within the Republican Party and was forced to pull the legislation from the House floor, in a move that doesn’t bode well for the President’s ability to reform the tax code or implement a major infrastructure package. Blaming a group of conservative Republican lawmakers known as the Freedom Caucus, the President has now turned to the Democrats for support as he faces future battles over health.

As this opinion piece in The New York Times explains, the war is far from over. Trump’s predictions that Obamacare will implode could prove correct, largely due to stealthy moves from the administration encouraging insurance companies to drop out of the market. As commentator Steven Rattner explains:

…the requirement that all Americans have insurance is at the heart of Obamacare. Without maximum participation of healthy, young Americans in the insurance exchanges, insurers cannot afford the cost of covering older, less healthy individuals. That’s the essence of why companies have been dropping out of the marketplace, creating the risk that counties in states like Tennessee and Arizona may have no insurers participating.

Looking for an immediate political win, meanwhile, Trump rapidly signed executive orders that will see a dramatic change in US federal climate change rules by targeting Obama’s Clean Power Plan and increasing support for coal and other fossil fuels. This came just days after the Trump administration appointed climate change denier Scott Pruitt as head of the US Environmental Protection Agency.

And the White House also proposed a US$1.2 billion cut to the budget of the National Institutes of Health’s budget, targeting research grants, STAT reported – a stark contrast to the Australian Government’s reassurance to the research community that there would be funding certainty under the new National Science Statement.

Closer to home, Croakey also reported that the Climate and Health Alliance had released a draft framework for a national strategy on climate, health and wellbeing, on which they are seeking feedback. A  tweet-up convened this week as part of the #JustClimate project identified many ways in which the draft framework could be enhanced by a focus on Indigenous knowledges, voices and practices.

Meanwhile, in this articleCroakey looked at how current events from President Trump’s climate climate change order to the triggering of Brexit are a reminder that politics, as currently practised, often represent a threat to population health, and asked “is it time for a healthier type of politician”?


Food marketing creates confusion over healthy choices

There has been more evidence recently that self-regulation by the food industry is not enough when it comes to helping people make healthy food choices.

To mark the 10th World Salt Awareness Week (March 20 – 26), The George Institute for Global Health released its study of the salt content of more than 1400 bread products. It found that although salt content in bread had reduced by about 10% since Government Australian Food and Health Dialogue targets were introduced in 2010, many of the loaves being marketed as ‘healthy’ contained more than a third of the daily recommended salt intake in just two slices.

Flat breads, bagels and muffins all contained considerably more salt than white bread, the study found, with rye bread containing 20% more salt than recommended under the target. A typical slice of bread has double the amount of salt than a serve of chips, said lead researcher Clare Farrand.

Clever food marketing is also threatening the credibility of the Health Star Rating system, according to the Obesity Policy Coalition’s Jane Martin, who accused food companies of using the ratings only on their healthiest products, as reported in The Sydney Morning Herald.

Although the Health Star Ratings have been in place since 2014, a Heart Foundation study last year found that the system was not widely seen as credible and reliable. A formal review of the system is expected in mid-2019.


Australians quitting health insurance as premiums rise

This is the busiest time of year for the health insurance industry, with premiums expected to rise an average 4.84% on April 1. And for some Australians, the cost is now outweighing the benefits.

The Sydney Morning Herald reported that fewer Australians than ever are joining health funds, with the industry’s growth rate dropping from 3.7% in 2011-12 to 1.34% in 2015-16. A Galaxy survey commissioned by comparison website iSelect found that 50% of policyholders planned to compare or switch health funds to make sure they’re getting the best deal, while 24% planned to downgrade or cancel their policy.

With the number of Australians owning hospital cover at its lowest level since 2012, the question has shifted from whether consumers are getting the best deal to why Australians have health insurance, a question asked in this explainer article on The Conversation.  Choice has launched an online tool, Do I need health insurance?, to help consumers make that decision, while HCF is pioneering a tool to help people avoid bill shock when they go to hospital.

The availability of data on out-of-pocket health costs was also in the spotlight in an article on Croakey , with researchers from the University of Melbourne’s Centre for Health Policy arguing for greater transparency in Medicare data to inform policy reform.


Other Croakey reading you may have missed this fortnight:

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