3 March 2017.

The Health Wrap is a regular feature on Croakey from the Sax Institute communications team, which covers some of the interesting and important health news from the previous fortnight, including items covered at Croakey and elsewhere. Enjoy the wrap and tweet us @SaxInstitute with any items you think should make it into the next issue.

By Frances Gilham, Digital Communications Manager

Prevention advocacy

This fortnight began with the release of a significant report supported by the Australian Prevention Partnership Centre, in which more than 100 nutrition and policy experts from 53 organisations came together to identify critical areas where Australian governments need to take action to tackle the rise of obesity through unhealthy diets. The full report on the study, with analysis covering each jurisdiction, can be downloaded at www.foodpolicyindex.org.au.

News.com.au reported on the problem of variation in implementation of nutrition policies across the country; the ABC identified four key strategies from the report – tax sugary drinks, restrict junk food advertising, change the health star rating scheme, and restrict junk food sponsorship of sport – and the Daily Telegraph provided a good overview of how Australia compared internationally with regard to obesity prevention measures.

Health Minister Greg Hunt responded by saying the Coalition is tackling obesity but that increasing the family’s weekly grocery bill by introducing a new tax on sugar isn’t the answer, according to this article on news.com.au.

MJA Insight reported on research published in PLOS Medicine that modelled what taxes and subsidies would be most effective for improving diet and population health in Australia, finding that a sugar tax would be most cost-effective, followed by a salt tax, a saturated fat tax and a sugar-sweetened beverages tax. The article summarises the current state of play on sugar taxation in Australia – who is pushing for it and who is against it – and it’s well worth a read to get a handle on this ever-changing area.

Also in obesity prevention news, Dr Ben Ewald, GP and senior lecturer from the University of Newcastle, wrote for The Conversation about his research which found a link between time spent walking and fewer days spent in hospital, for people aged 55 to 80. He said:

“With governments searching for ways to reduce spending, and 16% of the federal budget being spent on health, tackling physical inactivity of individual patients, as well as ensuring our urban centres are walking- and cycling-friendly would make a major difference.”

On another preventive health front, there has been a lot of confusion surrounding the cervical cancer screening program this fortnight, with the Federal Government announcing a delay in the roll-out of its new program which will see a switch to screening for human papillomavirus (HPV), and the launch of a petition opposing the new program.

The new HPV screening program was due to start in May but has been pushed back, raising fears women would face delays in receiving Pap smear results because pathology companies have already laid off many cytologists, according to Australian Doctor (registration required).

But Commonwealth Chief Medical Officer Professor Brendan Murphy announced that an agreement had been reached with pathologists to ensure women can continue to have the existing Pap test, with a stop-gap measure of a new Medicare item liquid-based cytology for Pap tests allowing more automated processing.

This Conversation article by University of Sydney researchers does a good job of explaining the changes to the program, why women have been protesting against the changes, and why, instead of labelling them “woefully misinformed” as the Australian Medical Association has done, we need to do a better job of communicating the changes.

New approaches on justice

A new series in The Guardian – “Indigenous incarceration: breaking the cycle” – has been exploring what can and is being done to change the statistics that shame Australia.

This article introduces the series and sets the scene, explaining how the problem of Indigenous over-incarceration is at its most severe among children, and exploring a range of possible solutions.

A second article, originally published at Croakey as part of its #JustJustice project, describes how Cowra, a country town in central west NSW, is exploring the concept of justice reinvestment, aiming to shift spending from punishment to prevention.

Priorities identified for reinvestment in Cowra have so far included service mapping, keeping young people engaged in education at all costs, employment and skills development, personal safety with an emphasis on housing (emergency, halfway houses, hostels), and community transport.

Aboriginal barrister and academic Professor Mick Dodson says in the article, “We’re not talking about keeping everyone out of prison because some people who commit offences that are horrendous are a danger to society and have to be locked up. But we’re talking about people who can’t pay their fines, doing low-level crime.”

Croakey has also published a suite of #JustJustice articles coinciding with The Guardian‘s project, including:

  • An article that calls for smarter approaches to violence against Aboriginal and Torres Strait Islander women and children.
  • An edited speech excerpt by Professor Pat Dudgeon, a Bardi woman and leading psychologist, who argues that there are similarities in the approaches needed for tackling both suicide prevention and youth over-incarceration, both of which are indicative of much larger suffering and problems.
  • A summary of the work that went into the recently released Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project.
  • An interview with Ken Wyatt, Minister for Indigenous Health, where he discusses the over-representation of Aboriginal and Torres Strait Islander people in custody and prisons.

Policy ideas and plans

Medicare funding has again been in the media spotlight over the past fortnight.

Health Minister Greg Hunt has signalled that the Coalition may be reconsidering the Medicare rebate freeze, The Guardian reported. In an interview with the ABC, he raised the prospect of removing the freeze , but indicated any change would be part of a wider package, the article says.

The SMH reported on a proposal from the Australian Council of Social Service (ACOSS) that all high-income earners in Australia should pay the Medicare levy surcharge, regardless of their private health insurance status, a change that would reportedly raise $4 billion per year.

And Croakey has been reporting on a range of policy issues, including a discussion of ideas raised at the recent WA Public Health Pre-Election Forum, an exploration of a change to the PBS that could save an estimated $500 million a year or more on subsidised medicines in Australia, a piece welcoming changes to the way GP trainees are chosen and why it’s important, and an article by Professor Tim Carey which explores how we can improve the evaluation of health services and programs for remote communities.

The Sax Institute also published a piece detailing how the work of one of its HARC scholarship recipients is helping shed light on the grey area of unwarranted clinical variation.

Amid the current debate around funding priorities for mental health, Community Mental Health Australia President Liz Crowther wrote an article for Croakey arguing that the community managed mental health sector is where frontline services happen, and where investment in mental health will be of most use. In it she lays out a pre-budget roadmap for mental health reform.

Following on from that article was one by Professor Colin Tatz who says ‘prevention or intervention?’ isn’t the question we should be asking on suicide; rather, is suicide necessarily related to mental health or is much of it an entirely rational response to socio-economic, geographic, historical or other factors?

For a frontline view, this fascinating article, written by an anonymous physician in a large city hospital, powerfully demonstrates how a false economy has resulted in patients spending too long in expensive hospital beds when they could be more cheaply and appropriately cared for within the community, if not for lack of coordination and integration.

Some research reading

Last week, ABC News reported on research that showed smartphone photos taken of X-ray images can help medical professionals diagnose common lung problems in babies just as effectively as the standard films do.

More recent research looked at whether moderately overweight people with type 2 diabetes would benefit from gastric band surgery, finding almost a quarter of participants who had surgery had their diabetes go into remission within five years, according to the Sydney Morning Herald.

And another diabetes study, based on data from the Sax Institute’s 45 and Up Study, found a diagnosis of type 2 diabetes is associated with a worsening quality of life and social isolation.

A big international study published in The Lancet showed that life expectancies in developed countries are set to continue increasing, with predictions women’s life expectancy could surpass 90 years in South Korea by 2030.

Australia is predicted to come in fifth internationally with women living to an average of 84 years in 2030, according to the study in which researchers developed and combined results from 21 models to predict life expectancy in 35 developed countries, the SMH reported.

Here are some excellent long reads on a variety of research-related themes that are well worth bookmarking and spending some time on:

And lastly, this short video from the World Economic Forum shows Professor Emily Banks, Scientific Director of the Sax Institute’s 45 and Up Study and Professor of Epidemiology and Public Health at ANU, discussing how big data can help us avoid some of the more horrible medical mistakes of the past.

View previous Health Wraps on our archive.