Current government actions on the prevention of chronic disease through the control of risk factorsAustralian Health Survey: this new survey program will incorporate the existing National Health Survey and National Aboriginal and Torres Strait Islander Health Survey in addition to two new surveys—a National Nutrition and Physical Activity Survey and a National Health Measures Survey (a biomedical survey). The Australian Health Survey will improve our understanding of chronic diseases and their lifestyle risk factors in Australia. It will collect biomedical data as well as data on food and nutrient intake, physical activity and body measurements from participants aged 2 years and over. It will provide information for policy and program development for children, adults and Indigenous Australians.
The Jean Hailes Foundation has been funded since 1997 as an integrated model to improve women’s health in Australia. The foundation translates knowledge gained from research into strategies that assist to prevent illness, improve treatment and enhance wellbeing for women. The foundation links community and professional education with clinical practice and research. It undertakes education and research in the areas of menopause, hormone replacement therapy, cardiovascular disease in women, pre-menstrual syndrome and osteoporosis.
Taking Preventative Action—A Response to ‘Australia: The Healthiest Country by 2020’ outlines the government’s response to Australia: The Healthiest Country by 2020, the final report of the National Preventative Health Taskforce, which put forward a range of strategies to address the growing economic and health burden associated with obesity, tobacco and alcohol. The Australian Government supports or is already taking action in 28 of the 35 recommended key action areas. This is the first step in responding to the taskforce’s final report, and further action will be taken into the future, monitoring trends, assessing outcomes, evaluating the evidence and building on recent investments.
DiabetesThe Prevention of Type 2 Diabetes program. As its contribution to the 2007 COAG measure, Reducing the Risk of Type 2 Diabetes, the Australian Government introduced a lifestyle modification initiative focused on people aged 40–49 years with the objective of reducing or delaying their progression to Type 2 diabetes. This includes a Medicare item for general practitioners to undertake a diabetes risk evaluation and provide lifestyle advice, and referral for people at high risk of developing diabetes to a subsidised lifestyle modification program. Aboriginal and Torres Strait Islanders aged 15 to 54 years are also eligible to participate in the program.
CancerThe government supports two evidence-based population screening programs, whichn contribute significantly to improved women’s health—BreastScreen Australia and the National Cervical Screening Program. Participation rates for target age ranges are 56.9 per cent 342, and 61.2 per cent 343 respectively and mortality rates have decreased since the introduction of the programs.
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BreastScreen Australia provides breast cancer screening for women in the target age group, including women from rural and remote areas, culturally and linguistically diverse backgrounds and Aboriginal and Torres Strait Islander women. BreastScreen Australia is introducing digital mammography delivered by health professionals using specially equipped vans to increase the number of rural and remote women, including Aboriginal and Torres Strait Islanders, screened.
The Breast Cancer Nurses initiative supports the McGrath Foundation to recruit, train and place specialist breast care nurses across Australia for a four-year period. It will help improve the health outcomes for women with breast cancer, especially in rural and remote areas, by providing vital information, care, and practical and emotional support to women, their families and carers.
Building Cancer Support networks—this initiative will fund several projects focused on: key survivorship issues that are important to women with breast cancer; providing telephone support for women with ovarian cancer in rural and regional areas; and assessing the needs of lesbian and same sex attracted women affected by cancer.
The Collaborative Cancer Research Scheme is an initiative which targets research in women’s cancer to improve outcomes for all women with gynaecological and breast cancers.
The National Breast Cancer Foundation/BreastScreen Australia Cohort study will focus on over 100,000 women who attend BreastScreen and supports a range of breast cancer studies to improve prevention and treatment of breast cancer.
The National Breast and Ovarian Cancer Centre provides improved knowledge about breast and ovarian cancer control, including through the translation and dissemination of research into evidence-based information, clinical best practice, policy and health service delivery.
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National Centre for Gynaecological Cancers improves outcomes for women affected by gynaecological cancers, and their families and carers, by improving their access to information and supportive care.
The Practice Incentives Program (PIP) Cervical Screening incentive was introduced in 2001–02 to increase women’s participation in the National Cervical Screening Program. It aims to increase both the overall cervical cancer screening rates and also targets women who have not had a Pap smear in the past four years. From May 2011, the screening target for the PIP Cervical Screening Incentive outcomes payment will increase from the current 50 per cent to 65 per cent of a practice’s eligible female patients. Increasing the cervical screening target aims to encourage practices to screen a higher proportion of their female patients and improve the rate of early detection of cervical cancer in Australia.
Supporting Women in Rural Areas Diagnosed with Breast Cancer. This initiative develops programs to improve supportive care for women in rural areas diagnosed with breast cancer where geographic isolation and limited contact with specialist health care workers may impede access to the full range of treatment options and support services.
AsthmaThe Asthma Management Program provides funding to reduce the personal, social and economic impact in Australia of asthma and linked chronic respiratory conditions y facilitating best practice treatment of the conditions and encouraging proactive management. The program funds a range of initiatives aimed at reducing the cost of asthma and linked chronic respiratory conditions to the Australian community, including:
- raising awareness about asthma and linked chronic respiratory conditions;
- supporting action and self-management in the community;
- providing training for primary care professionals for best practice asthma care; and
- undertaking national data monitoring and surveillance of asthma and linked chronic respiratory conditions.
Risk factorsObesity, unhealthy eating and physical inactivity The National Partnership Agreement on Preventive Health (NPAPH) was announced by the Council of Australian Governments (COAG) on 29 November 2008.
Under the NPAPH, the Australian Government will provide $872.1 million over six years from 2009–10. This is the largest investment ever made by an Australian Government in health prevention. The NPAPH aims to address the rising prevalence of lifestyle-related chronic diseases by:
1. laying the foundations for healthy behaviours in the daily lives of Australians through social marketing efforts and national programs supporting healthy lifestyles;
2. supporting these programs and policy with infrastructure to enable evidencebased policy design and coordinated implementation.
The various initiatives funded through the National Partnership Agreement on Preventive Health are detailed below.
Healthy Communities ($72 million from 2009–10 to 2012–2013)
- This initiative will support a targeted, progressive roll out of community-based healthy lifestyle programs which will facilitate increased access to physical activity, healthy eating and healthy weight activities for disadvantaged groups and those not in the workforce. The Commonwealth will administer funding to local government organisations, provide a national quality assurance framework, the accreditation/registration of programs and service providers, and a web-based information portal.
- State and territory governments will implement a range of interventions for children 0 to 16 years of age to increase physical activity and improve nutrition through child care centres, pre-schools, schools and within families. Programs may include intensive programs to support at-risk children and their families in achieving healthy weight through healthy eating and exercise programs in children’s settings. Top of page
- This initiative provides funding to support implementation of healthy lifestyle programs in workplaces, targeting overweight and obesity, physical inactivity, poor diet, smoking and the excessive consumption of alcohol (including binge drinking). The states and territories will facilitate the implementation of programs in workplaces and the Commonwealth will support these programs with national-level soft infrastructure including developing a national charter, voluntary competitive benchmarking, nationally agreed standards for workplace prevention programs, and national awards for excellence in workplace health programs.
- This initiative will develop and support partnerships between governments and various relevant industry sectors to encourage changes in their policies and practices so they are consistent with the government’s healthy living agenda. The partnerships will initially focus on the food industry, and may extend to the fitness and weight loss sectors following the establishment of the quality assurance element of the Healthy Communities initiative. The Commonwealth will manage the implementation of this initiative in consultation with the states and territories.
Measure Up ($59 million)
- This initiative provides supplementary funding for Measure Up, in order to extend its duration by three years and expand its reach to high-risk groups. Activities under the campaign aim to raise awareness of healthy lifestyle choices, focusing on the importance of physical activity and nutrition, as well as the link between lifestyle behaviours and the risk of some chronic diseases. The Commonwealth will manage and coordinate a national integrated program of social marketing activity ($41 million), whilst the states and territories will deliver a program of activities at the local level that reinforce and extend the national campaign messages ($18 million).
National Health Risk Survey ($15 million)
- The National Health Risk Survey (HRS) will collect essential data on prevalence of chronic disease risk factors in the Australian population through a series of surveys covering all jurisdictions. Funding for an initial HRS has been provided through the National Nutrition and Physical Activity Survey Program—this survey is expected to be conducted in 2010–11 and will focus on adults. A second HRS will be conducted in 2012–13 and will focus on children.
- This initiative provides funding for the implementation of a complementary system of more frequent health, nutrition and physical activity monitoring surveys. The states and territories will collect and report on the agreed performance indicators and implement surveillance systems using the nationally agreed methodology.
- The Australian National Preventive Health Agency will be established to provide evidence-based policy advice to Ministers, manage national-level social marketing activities targeting obesity and tobacco, administer the preventive health research fund, and oversee the workforce audit and strategy. The Commonwealth has responsibility for these programs and will work closely with the states and territories to ensure effective implementation.
- This initiative will identify and quantify the workforce required to deliver the settings‑based initiatives funded through the prevention National Partnership (Healthy Workers, Healthy Children and Healthy Communities) and propose options to ensure there is sufficient capacity within the sector to support the roll out of activities and programs. The Commonwealth will administer the funds for this initiative.Top of page
- The National Eating Disorders Collaboration (the Collaboration) will facilitate the implementation of a nationally consistent and comprehensive approach to promotion and prevention, early intervention and management of eating disorders. The Collaboration will bring together experts in the field of research, education, health promotion, public health and mental health, as well as the media, to progress a coordinated national approach to eating disorders and provide information to adolescents, schools, health providers and the media. The Commonwealth will administer the funds for this initiative.
Review of the Dietary Guidelines. In partnership with the Department of Health and Ageing, the National Health and Medical Research Council (NHMRC) is undertaking a review of national nutrition recommendations including the Core Food Groups; Australian Dietary Guidelines for infants, children, adolescents, adults and older Australians; and the Australian Guide to Healthy Eating publications.
This review of Australia’s foundation nutrition recommendations provides an opportunity to ensure the resulting updated nutrition education tools are complementary, evidencebased, and provide practical recommendations. A Dietary Guidelines Working Committee (DGWC) consisting of leading Australian nutrition and population health experts has been established to oversee all aspects of the Australian Dietary Guidelines Review. The revised recommendations and new resources are anticipated to be available in mid-2011.
National Physical Activity Guidelines. Physical activity is an important factor in maintaining good health and preventing overweight and obesity. The Australian Government provides information and guidelines regarding the levels of physical activity required to obtain a health benefit for children, adolescents, adults and older Australians. The consumer resources include information on the benefits of participation in physical activity, the types and amounts of physical activity that are beneficial across the lifespan, and ways to incorporate physical activity into everyday life.
Tobacco useThe government is addressing high rates of smoking by Indigenous Australians, including pregnant women and new mothers, through the Indigenous Tobacco Control Initiative (ITCI) ($14.5 million) and the Tackling Smoking measure ($100.6 million) which comes under the COAG National Partnership Agreement on Closing the Gap in Indigenous Health Outcomes. Eighteen ITCI projects are developing and National Women’s Health Policy 2010 evaluating innovative approaches to smoking cessation. Five of the ITCI projects have a particular focus on pregnant women and new mothers. The Tackling Smoking measure is funding the rollout of Regional Tackling Smoking and Healthy Lifestyle Teams in 57 regions nationally over a three year period. The Tackling Smoking workers will work with communities to address smoking levels including through targeted social marketing activities. One important focus of their work is to support and educate girls, pregnant women and mothers about the effects of smoking and the importance of healthy living in a smoke-free environment.
The measures funded through the National Partnership include provisions for the particular needs of socioeconomically disadvantaged Australians.
The National Partnership Agreement on Preventive Health tobacco social marketing campaign includes $61 million over four years (2009–2013) to conduct a series of national-level social marketing activities aimed at increasing awareness of the risks associated with smoking to contribute to a reduction in smoking uptake and prevalence.
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In the 2010–2011 Budget, the Australian Government also provided funding of $27.8 million for a complementary campaign The National Tobacco Campaign— More Targeted Approach which will aim to reduce smoking prevalence among highneed and hard to reach groups. These include people who are at risk, have high smoking rates, and/or for whom it is a challenge for mainstream campaigns to effectively reach, such as pregnant women and their partners, prisoners, people with mental illness, people from culturally and linguistically diverse backgrounds, and people living in low socio-economic areas.
Excessive alcohol consumptionThe Australian Guidelines to Reduce Health Risks from Drinking Alcohol (released by the National Health and Medical Research Council in 2009) provide general advice for adults, as well as specific advice for pregnant and breastfeeding women on lowering the risk of harm. Communications materials are available that promote the message of the guidelines to pregnant and breastfeeding women that not drinking is the safest option for women who are pregnant, planning a pregnancy or breastfeeding. These materials include a ‘flyer’ and poster for breastfeeding women as well as a ‘flyer’ for pregnant women. The materials are now being distributed to target audiences across Australia. To promote the guidelines among culturally and linguistically diverse groups, the pregnancy and breastfeeding flyers have been translated into nine languages (Russian, Serbian, Italian, Traditional Chinese, Vietnamese, Arabic, Korean, Turkish, and Khmer). The material can be accessed at: www.alcohol.gov.au.
Future government action on the prevention of chronicdisease through the control of risk factors There is evidence that gender and equity issues can influence behavioural risk factors for a
range of diseases such as diabetes, lung cancer, arthritis and cardiovascular disease. There is a need to consider the impact of the biological and social context of women’s lives on prevention and health promotion activities.
Health messages should have a clearly identified, evidence-based target group—a group that should be involved in the development and testing of messages so that they engage the group. Different types and styles of communication, including appropriate language, should be used for different groups. And materials should be disseminated in settings and ways that are appropriate. Developing materials in a partnership approach with advocacy and specialist knowledge groups is encouraged.
1.1 Explore opportunities for programs focused on cardiovascular disease to be specifically targeted to women.
1.2 Consider action to address barriers that may inhibit women’s access to preventative health services; for example:
- Explore opportunities to consider the impact of the biological and social context of women’s lives on prevention activities.
- Health communication strategies to consider the whole population and subgroups.
- Education strategies for communities on availability of interpreters.
- Work with primary health workers to increase interpreter awareness and enhance cultural sensitivity.
- Increased awareness of discrimination experienced by women with disabilities, lesbian and bi-sexual women.
- Use of new technologies to target women who may not be reached by more traditional forms of media.
1.4 Identify and adapt prevention programs through multicultural services, disability advocacy groups, lesbian and bisexual advocacy groups and carer’s networks to target women from varied communities.