On 1 September 2009 the Minister for Health and Ageing, the Hon. Nicola Roxon, released the report of the Preventative Health Taskforce, the National Preventative Health Strategy entitled, Australia: the healthiest country by 2020.
The National Preventative Health Strategy – road map for action is available at http://www.preventativehealth.org.au/internet/preventativehealth/publishing.nsf/Content/nphs-roadmap.
The Strategy provides a blueprint for tackling the burden of chronic disease currently caused by obesity, tobacco, and excessive consumption of alcohol. It is directed at primary prevention and addresses policy in both the health and non-health sectors.
National Preventative Health Taskforce
The National Preventative Health Taskforce was established in April 2008 for a 3 year period. It has compiled research on national health issues, focussing primarily on obesity, smoking (tobacco) and alcohol, which together cause approximately 32 per cent of Australia’s illness. This in turn translates into approximately $6 billion per year of health costs, and an estimated $13 billion in lost productivity.
The Taskforce’s report on these issues follows the discussion paper released on 10 October 2008 and related technical papers (available at http://www.preventativehealth.org.au/internet/preventativehealth/publishing.nsf/Content/discussion-healthiest).
National Preventative Health Strategy
The Report provides targets, a roadmap for action, and some specific recommendations regarding obesity, tobacco and alcohol.
The National Preventative Health Strategy sets 4 targets to achieve by 2020:
The diagram below shoes these targets in the context of the overall ‘roadmap for action’.
The strategy goes on to detail the actions recommended for phased implementation.
- Being overweight or obese affects over 60% of Australian adults and 25% of Australian children. Nearly one in three Indigenous Australian adults is obese.
- Cardiovascular disease, type 2 diabetes, osteoarthritis and some cancers are some of the effects of obesity that contribute to higher mortality and/or morbidity.
- The total financial cost in Australia of obesity alone, not including overweight people is estimated at $8.3 billion in 2008.
- The most recent projections indicated that there will be 6.9 million obese Australians by 2025, demonstrating an urgent need for action.
The technical paper Obesity in Australia: a need for urgent action is available at http://www.preventativehealth.org.au/internet/preventativehealth/publishing.nsf/Content/tech-obesity.
First Phase Actions (2010-2013)
- Establishing a Prime Minister’s Council for Active Living and developing and implementing a national Framework for Active Living.
- Developing a business case for a new COAG National Partnership Agreement on Active Living.
- Developing and implementing a National Food and Nutrition Framework.
- Commissioning a review of economic policy with a view to using taxation, grants, pricing, incentives and/or subsidies as a way of promoting healthier foods.
- Establishing a Healthy Food Compact between governments, industry and non-government to drive change within food supply. Develop voluntary targets.
- Working to introduce food labelling on front of pack and menus to support healthier food choices.
- Fund, implement and promote programs for workplaces that supoprt healthy eating, physical activity and reduce sedentry behaviour.
- Develop a national accord to establish bets practice work programs.
- Establish a voluntary scorecard, benchmarking and award scheme for workplace health.
- Commission a review of potential legislative changes to promote take-up of workplace health programs.
- Examine the feasibility of rewarding employers through grants or tax incentives to achieve benchmarks
- Fund, implement and promote school programs to increase physical activity and healthy eating.
- Incorporate Health and Physical Education into the National Curriculum.
- Establish a system to monitor the policy requirement of at least two hours of physical activity per week for all students (K-10).
- Establish a national series of five-year intervention trials in 10 to 12 communities (includign low socio-economic status and indigenous communities).
- Develop a sustained social marketing strategy to increase healthy eating, physical activity and reduce sedentry behaviour.
- Reduce the exposure of children and others to marketing, advertising, promotion and sponsorship of energy-dense nutrient-poor foods and beverages thorugh voluntary self-regulation in advertising. If that fails, considering the introduction of a co-regulatory agreement or introducing legislation within four years if these measures are not effective.
- Expanding the relevant health workforce so that primary healthcare and the public workforce support people in making healthy choices.
- Improve access to services that provide physical activity, weight loss and healthy nutritional advice and support.
- Support low-income communities to improve their levels of physical activity and healthy eating through funding, implementing and promoting multi-component commmunity-based programs.
The second and third phase actions mostly deal with learning from the actions outlined above, monitoring their effect and implementing further strategies.
- Over three million people (around 18% of Australians aged 14 years and over) smoke, with almost 2.9 million people smoking on a daily basis.
- Tobacco use is currently the single-biggest preventable cause of death and disease in Australia, despite the use of tobacco products being at an historic low after a significant decline from the 1950s. Lung disease, lung cancer, heart attack and stroke are some of the health effects of smoking.
- Smoking rates are rapidly declining among the affluent, but continue to be substantially higher among those with lower levels of education and those living in more disadvantaged areas and among Indigenous people.
- Tobacco use is responsible for 12% of the total burden of disease and 20% of deaths in Indigenous Australians. Smoking resulted in an estimated 15,511 deaths in 2003 and cost the Australian community approximately $12 billion is tangible net costs in 2004-05.
The technical paper Tobacco Control in Australia: making smoking history is available at http://www.preventativehealth.org.au/internet/preventativehealth/publishing.nsf/Content/tech-tobacco.
First Phase Action (2010-2013)
- Make tobacco products significantly more expensive - $20 per 30 cigarette packet – within three years.
- Develop a national straetgy to combat illicit trade of tobacco.
- Increase the frequency, reach and intensity of national social marketing campaigns.
- Legislate to eliminate all remaining forms of tobacco promotion, including, as feasible, through new and emerging forms of media.
- Amend legislation to ensure that tobacco is out-of-sight in retail outlets.
- Eliminate the promtion of tobacco products through design of packaging by amending the Tobacco Advertising Prohibition Act 1992 so that cigarettes may only be sold using government prescribed packaging (shape, size, material and colour).
- Amend the Trade Practices CPIS (Tobacco) Regulations 2004 to specify exact requirmeents for plain packaging.
- Amend legislation to eliminate exposure to second-hand smoke in public places such as in any public place where there are children, travelling in cars, workplace, outdoor areas etc.
- Mandate standard plain packaging of all tobacco products so that the design features of the pack in no way reduce the prominance or impact of presecribed government warnings.
- Increase the size of required pack warnings.
- Prohibit misleading labelling, brand names and product characteristics.
- Tighten and enforce legisliation to eliminate sales to minors and ony form of promotion at a retail level.
- Require all tobacco retailers to be licensed.
- Preclude sales through vending machines, the internet, and at hospitality and other social venues.
- Investigate the feasisbility of legal action by governments and others against tobacco companies.
- Encourage all smokers in contact with health serivices are encouraged to quitthrough asking patients routinely about their smoking status, increasing the availability of Quitline services, and ensure that nicotine replacement therapy is affordable.
- Work with Indigenous groups to reduce smoking among Indigneous Australians, including placing specialist Tobacco Control Workers in community health organisations.
- Increase efforts to discourage smoking amoung people living with mental illness.
- Establish a National Tobacco Steering Committee
- Make smoking a classifiable element in movies and videos.
Second (2014-2017) and third (2018-2020) phase actions include further price increases, social marketing campaigns and more restrictive legislation if necessary.
- Alcohol in an intrinsic part of Australian culture – as a relaxant, an accompaniment to socialising and celebration, as a source of employment and exports, and as a generator of revenue.
- 83% of Australians are drinkers and 1.4 million people consume alcohol on a daily basis.
- Consumption of alcohol accounts for 3.2% of the total burden of disease and injury in Australia, at an estimated cost of $11 billion annually.
- 72.6% of Australians drink below levels that would incur long-term risk of harm.
- Effects of the harmful consumption of alcohol include diseases, accidents, injury and crime such as violent and disruptive behaviour, drink driving and abuse and neglect of children. This in turn impacts on workforce productivity, healthcare services such as hospitals and ambulances, law enforcement, property damage and insurance administration.
- The types of intervention considered the most effective are regulating the physical availability, taxation and pricing. Currently the alcohol taxation system is the responsibility of the Commonwealth and the liquor licensing systems are the responsibility of the states and territories (states), creating some complexity in coordinated action. Different taxes are applied to different products (beer, wine and spirits) affecting pricing.
The technical paper Preventing Alcohol-related Harm in Australia: a window of opportunity is available at http://www.preventativehealth.org.au/internet/preventativehealth/publishing.nsf/Content/tech-alcohol.
First Phase Action (2010-2013)
- Harmonise liquor control regulations between the states and territories, focussing on outlet opening times and outlet density, accreditation requirements for liquor licensing, late night and other high risk outlets, and training modules for the responsible service of alcohol.
- new COAG national partnership on policing and enforcement.
- Develop comprehensive and sustained social marketing and public education strategies.
- Phase out alcohol promotions from times and placements that have high exposure to people under 25 years including live sport broadcasts, adolescent/child viewing and sponsorship of sport and cultural events.
- Reforming alcohol taxation and pricing arrangements and commission modelling for a rationalised tax and excise regime for alcohol that discourages harmful consumption.
- Improve the health of Indigenous Australians through increasing access to health services and supporting local initiatives such as restricting the physical availablility of products, reducing the number of licensed premises.
- Establish and fund a multi-site trial of alcohol diversion programs.
- Enhance the role of primary healthcare organisations in preventing and resopnding to alcohol-related health problems and develop a more comprehensive network of referral servies and programs to support behavioural change in primary healthcare.
The Second (2014-2017) and Third (2018 -2020) phases include monitoring and evaluating the outcomes of the actions in the First Phase.
The Taskforce has proposed a list of indicators and benchmarks that will be used to measure progress towards achieving the targets
The Government is expected to respond to the Taskforce’s final report in December 2009.
For further information see www.preventativehealth.org.au.