The National Preventative Health Taskforce was established in April 2008 for a 3 year period, and will be responsible for producing the National Preventative Health Strategy in June 2009. The Government is particularly focused on the prevention of chronic disease and promotion of health because of the significant benefits it will have not only for individual health, but also for the sustainability of the national health care system challenged by an ageing population. Taking measures to prevent illness will reduce the overload on hospitals, health and welfare services, mitigate rising costs within the health system, and diminish losses in workplace productivity due to illness.
Further information on the National Preventative Health Taskforce can be found here.
Today (10th October 2008) the Health Minister, Nicola Roxon, released the Taskforce’s first discussion paper, Australia: the healthiest country by 2020 and related technical papers.
The Taskforce has compiled research on national health issues, in particular, obesity, smoking and alcohol, which together cause approximately 32% of Australia’s illness. Other important areas of preventative health such as mental health, injury, immunisation, sexual and reproductive health and illicit substance use will be considered in the next phase of the Taskforce’s work in 2009.
The Taskforce has proposed targets for the healthiest country to be achieved by 2020:
- Halt and reverse the rise in overweight and obesity.
- Reduce the prevalence of daily smoking to 9% or less.
- Reduce the prevalence of harmful drinking of alcohol for all Australians by 30%.
- Contribute to the ‘Close the Gap’ target for indigenous people, reducing the 17 year life expectancy gap between Indigenous and non-Indigenous people.
The Taskforce also proposes the establishment of a National Prevention Agency to coordinate policy.
The discussion paper highlights the role not only for individuals in making better health choices, but also for communities, employers, community leaders, workplaces, businesses, industries and all levels of government.
Obesity
- Overweight and obesity now 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 was 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.
Some of the key actions recommended in the report are to:
- Review the taxation system to enable access to healthier foods and recreation (eg. Increase tax breaks for fitness related products and for workplaces/schools to provide healthy foods) and provide disincentives for unhealthy foods (eg. Consider increasing taxes for energy dense foods.)
- Regulate the amount of fats, salt and sugar in foods.
- Provide subsidies for rural and remote area transport of fresh foods.
- Curb inappropriate advertising and promotion, including banning advertising of energy dense, nutrient poor foods during children’s viewing hours.
- Develop effective national media advertising and public education campaigns to improve eating habits and levels of physical activity.
- Enhance food labelling to support healthier food choices.
- Introduce school, workplace and community programs.
- Facilitate adoption of consistent town planning and general building design that encourage greater levels of physical activity.
The technical paper Obesity in Australia: a need for urgent action is available here.
Smoking
- 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.
Some of the key actions recommended in the report are to:
- Increase duty and prevent evasion of duty in order to increase the cost of tobacco products.
- Eliminate all remaining forms of promotion of tobacco including by banning displays at point of sale and ensuring plain packaging.
- Tighten and enforce State and Territory legislation to eliminate sales to minors and protect against exposure to second-hand smoking (particularly in workplaces, youth events, cars, and outdoor areas where movement is restricted).
- Change licensing laws so that state and territories licence to retailers, with no licence available for sales through vending machines, internet, at hospitality and other social venues.
- Make tobacco use a ‘classifiable element’ in movies and video games.
- Legislate to ensure full reporting and governmental controls over all tobacco product constituents, additives, emissions, and other aspects of manufacture and design.
The technical paper Tobacco Control in Australia: making smoking history is available here.
Alcohol
- 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.
Some of the key actions recommended in the report are to:
- Develop a staged approach to restrict alcohol advertising and fund effective social marketing and public education campaigns to prevent misuse and reduce alcohol-related harm, including targeted approaches and local complementary initiatives for different population groups.
- Review the taxation system to stimulate the production and consumption of low-alcohol products and remove tax deductibility for advertising.
- Enforce legislation on responsible serving of alcohol, through intelligence-led policing programs that focus on the drinking establishment.
- Commission research on effective strategies to address social determinants of alcohol consumption in Indigenous and low-income communities.
- Changes to regulation of alcohol outlet density.
The technical paper Preventing Alcohol-related Harm in Australia: a window of opportunity is available here.
Performance Indicators
The discussion paper notes that a new Health Care Agreement will be signed by the Council of Australian Governments (COAG) in 2009. The new agreement will incorporate a system of National Partnership Payments (NPPs) aimed at proving incentive payments to states and territories for reforms, or for specific and agreed joint projects. To receive funding, states and territories must deliver ‘nationally significant economic and social reforms’ measured against performance benchmarks. The Taskforce has proposed a list of such indicators and recommends that for the NPPs, the indicators be selected from the ‘health and related systems performance’ tier (view the performance indicators table here).
Conclusions
The discussion paper and technical papers outline options for reform, rather than making final recommendations. The purpose of the paper is to foster public debate and research to better inform government decisions.
Upcoming issues for obesity, alcohol and tobacco policy:
- Taxation Review
- Access and Affordability
- Product Marketing
- Public Education
- Community Engagement
- Universal and Targeted Action
- Long-term Strategy
The Taskforce is accepting submissions from the public on the discussion paper until 2 January 2009.
