The Critical Decade: Climate Change and Health

The Climate Commission has released its second major report, The Critical Decade: Climate change and health. The report is a comprehensive and up to date synthesis of the expected impacts of climate change on the health of Australians.

Climate change is harming our health in Australia, and poses a significant threat for the future. Our health, and the health of our families and communities is the foundation for our way of life, our society and our economy. Health is one of the top priorities for Australians. Every year we collectively invest more and more in our health, and in 2008-09 this reached $112.8 billion.

Our health depends on the natural environment for our basic requirements: safe water, clean air, sufficient food, tolerable temperatures and protection from the elements. A changing climate is already putting pressure on the natural, economic and social systems that sustain good health. Climate change will lead to more injuries, disease and deaths in decades to come. Sustained action by Australia and other nations to reduce greenhouse gas emissions can help prevent the worst impacts.

NRHA reaction

Deaths from heatwaves to rise 'without emission cuts' (Sydney Morning Herald)

Commentary : Australians can’t ignore the health impacts of climate change

Australian hospital statistics 2010-2011: emergency department care and elective surgery waiting times; and staphylococcus aureus bacteraemia in Australian public hospitals (AIHW)

Australian hospital statistics 2010-2011: emergency department care and elective surgery waiting times

This report presents information relating to emergency department care in major public hospitals and public hospital elective surgery waiting times for the period 1 July 2010 to 30 June 2011. In 2010-11: over 6.2 million emergency department presentations were provided by major public hospitals, with 70% of patients receiving treatment within an appropriate time for their urgency (triage category); about 621,000 patients were admitted to Australian public hospitals from waiting lists for elective surgery, with 50% of patients admitted within 36 days.

Hospital statistics 2010-2011: staphylococcus aureus bacteraemia in Australian public hospitals

In 2010-11: all states and territories had rates of hospital-associated SAB below the national benchmark with rates ranging from 0.9 to 1.4 cases per 10, 000 patient days; there were 1,873 cases of hospital-associated SAB reported for Australia. The reported SAB cases occurred during approximately 17 million days of patient care.

Media release

The Draft Basin Plan for consultation (Murray-Darling Basin Authority)

The Murray-Darling Basin Authority has released The Draft Basin Plan for consultation. The Plan is now open for 20 weeks for submissions and public comment.

Submissions may be made online using the Basin Plan Submissions form, emailed to , faxed to (02) 6279 0558 or mailed to :

Proposed Basin Plan
Murray-Darling Basin Authority
GPO Box 3001
Canberra City ACT 2601

Press release and 10 key points.

Expert reactions to the Draft Plan

Australia's welfare 2011 (AIHW)

Australia's welfare 2011

Australia's welfare 2011 is the 10th biennial welfare report of the Australian Institute of Health and Welfare. It is the most comprehensive and authoritative source of national information on welfare services in Australia. Topics include: children and young people; disability and disability services; ageing and aged care; informal carers; homelessness; housing assistance; community services workforce; welfare expenditure; indicators of Australia's welfare.

Australia's welfare 2011 in brief presents selected highlights from the Australian Institute of Health and Welfare's 10th biennial report on welfare services in Australia.

Media release

General practice activity in Australia 2010-11 and A decade of Australian general practice activity 2001-02 to 2010-11.

General practice activity in Australia 2010-11. General practice series no.29

This report provides a summary of results from the 13th year of the BEACH program, a continuing national study of general practice activity in Australia.

From April 2010 to March 2011, 958 general practitioners recorded details about 95,800 GP-patient encounters, at which patients presented 149,005 reasons for encounter and 146,141 problems were managed. For an 'average' 100 problems managed, GPs recorded: 69 medications (including 56 prescribed, seven supplied to the patient and six advised for over-the-counter purchase); 11 procedures; 23 clinical treatments (advice and counselling); six referrals to specialists and three to allied health services; orders for 30 pathology tests and six imaging tests.

A subsample study of more than 31,000 patients suggests prevalence of measured risk factors in the attending adult (18 years and over) patient population were: obese - 27%; overweight - 35%; daily smoking - 15%; at-risk alcohol consumption - 25%. One in five people in the attending population had at least two of these risk factors.

A decade of Australian general practice activity 2001-02 to 2010-11. General practice series no. 30

This report highlights changes in general practice activity in Australia over the most recent decade (April 2001 to March 2011) of the BEACH program, a national cross-sectional study of general practice activity. Over this time 9801 participating GPs provided details of 981,000 GP-patient encounters. The report highlights changes that have occurred in the characteristics of general practitioners and the patients they see, the problems managed, and the treatments provided. Changes in prevalence of overweight and obesity, smoking status and alcohol use, are also described for subsamples of more than 30,000 adults and 3,000 children each year.

Previous years' reports are available from the AIHW website.

Mental health policy to be run by those who have fought the battle

A new Mental Health Commission is set to become one of the most powerful bodies in the state – and it will be run by someone who has had, or has, a mental illness. Every government agency will be compelled to co-operate with the Commission's implementation of a plan to fix mental healthcare in NSW, under landmark legislation to be introduced to parliament today by the Minister for Mental Health, Kevin Humphries.

Either the commissioner or a deputy commissioner must have personal, lived experience of mental illness, and a common clause dictating appointees can be removed if they become incapacitated by mental illness will not be in the bill.

Read more:

More needed for Australians with psychotic illness: report

About 64,000 Australians have a psychotic illness and a survey being released today shows most are unable to work full time, they suffer physical health problems and are prone to loneliness.

This is the second national survey of psychotic illness. The first was done 12 years ago. Nearly 2000 people with an illness like schizophrenia were surveyed, making it one of the biggest studies of its kind in the world. Barbara Hocking, the executive director of the mental health charity SANE Australia was an advisor to the study.

People living with psychotic illness 2010 [Full report]

People Living with Psychosis: A SANE Response [SANE Australia]

More needed for Australians with psychotic illness[ABC interview with Barbara Hocking]

Substance use + mental health comorbidity consumer resources

NDARC has launched a series of new resources for those living with both substance use and mental health issues. The resources are targeted at consumers of mental health and alcohol and other drug services Australia-wide and include an explanation of mental health conditions, how these are linked to substance use, the interplay between the two disorders, how to recognise and manage symptoms, and where to go for help. The 5 booklets are :

Anxiety + Substance use.
Mood + Substance use
Personality + Substance use
Psychosis + Substance use
Trauma + Substance use

The booklets may also be ordered in hard copy.

The NDARC site also has several other resources available.

Online Remote Primary Health Care Manuals

Online Remote Primary Health Care Manuals brings together 5 highly respected manuals used in Indigenous and remote primary health care in Australia.

CARPA Standard Treatment Manual, 5th Edition

Minymaku Kutju Tjukurpa Women's Business Manual, 4th edition

Clinical Procedures Manual for remote and rural practice, 2nd edition

Medicines Book for Aboriginal Health Workers, 2nd edition

Reference Book for the 5th edition of the CARPA Standard Treatment Manual

The organisations which collaborated to make this combined content available online are: Central Australian Rural Practitioner's Association Inc (CARPA), CRANAplus Inc, Central Australian Aboriginal Congress Alukura Branch, and the Centre for Remote Health.

These manuals are produced for primary health care workers including doctors, Aboriginal health workers, nurses, midwives and allied health professionals and should not be used as a substitute for professional qualified advice.

Access to the Remote Primary Health Care Manuals content is free of charge but does require registration and login.

The E-Health Revolution - easier said than done

The Parliamentary Library has released a Research Paper providing an introductory overview of some of e-health's critical aspects. The paper concentrates on the evolution of e-health policy in Australia, but also looks briefly at the overseas experience of e-health policy development and considers some practical application case studies.

NPS launches a new online information hub on World Diabetes Day

Why learn about
type 2 diabetes?

On World Diabetes Day (14 November 2011), National Prescribing Service launched an online information hub to help people with type 2 diabetes be medicine-wise about their condition.

The online hub is a comprehensive source of information about type 2 diabetes, including its causes, diagnosis and treatment. The theme for World Diabetes Day is education and prevention, and in line with this, the new NPS diabetes hub offers information on the vital role of healthy eating and physical activity, as well as in-depth information on the diabetes medicines available in Australia, how they work and their possible side effects and interactions.

The type 2 diabetes online hub is the first in a series of information hubs to be launched on a range of conditions and health topics, including depression, vaccines and respiratory tract infections.

National Evidence-Based Clinical Care Guidelines for Type 1 Diabetes for Children, Adolescents and Adults

The National Evidence-Based Clinical Care Guidelines for Type 1 Diabetes for Children, Adolescents and Adults has been developed by the Australasian Paediatric Endocrine Group and the Australian Diabetes Society.

This guideline is an update of the NHMRC approved Clinical practice guidelines: Type 1 diabetes in children and adolescents (2005). The scope of the guideline has been extended to address the needs of adults and the transition period from adolescence to adulthood, including pregnancy. This is the first Australian evidence-based guideline for type 1 diabetes that addresses clinical care across the whole lifespan.

Allergic rhinitis ('hay fever') in Australia (AIHW)

Hay fever is a term commonly used to refer to allergic rhinitis caused by seasonal exposure to pollen. Allergic rhinitis can cause significant irritation and interference in a sufferer's daily activities, considerably reducing their quality of life. It is one of the most common chronic respiratory conditions in Australia, affecting around 15% of Australians or 3.1 million people. The amount of money paid by community pharmacies to wholesalers for medications commonly used to treat allergic rhinitis doubled between 2001 ($107.8 million) and 2010 ($226.8 million).

Media release

Dancing your falls away

Ballroom dancing robots being used
as a partner for the elderly in Japan.
By Third Uncle on Flickr.

Foxtrot, salsa, rumba! Twice weekly ballroom dancing classes for senior citizens could bring back the balance and strength needed to prevent falls in elderly Australians, according to University of Sydney researchers. Dr Dafna Merom says it is widely acknowledged that falls are one of the most common health problems among older people, and a NHMRC funded study has the potential to reduce the incidence of falls for elderly Australians by as much 37%. "We know that formal exercise programs, particularly those that include balance challenging training, can help prevent falls, but formal training exercises may not be the best way to optimise results. There are promising alternatives," she says. Dr Merom is aiming to introduce classic ballroom dance routines as twice-weekly recreational activities at 13 aged care centres and retirement villages across Sydney. Often described as "old time dancing", Merom says these classic dances have the right moves and more.

The multi-centre study will include researchers from the University of Sydney, University of Western Sydney, Australian National University, and the University of Hong Kong. The researchers are aiming to recruit 450 older adults who will be engaged in the dance program, which will run for a year.

Dementia: Osborne Park Hospital Guide for Occupational Therapists in Clinical Practice

The Occupational Therapy Department of Osborne Park Hospital (WA) has published a resource called Dementia: Osborne Park Hospital Guide for Occupational Therapists in Clinical Practice which is available freely online (there is no print version).

Contents include : definitions and natural course of dementia, occupational therapy guidelines and standards for dementia care, occupational therapy strategies for aspects of dementia care (Driving, ADL, wandering etc), and a section on the caring role of families.

Women's Health Study reveals resilient rural women are still short-changed in health

A special report, Rural, remote and regional differences in women's health from the Australian Longitudinal Study on Women's Health (ALSWH), based at the Universities of Newcastle and Queensland, highlights the resilience of rural women during drought. Rural women have poorer health in general and worse access to health services than those in cities - and the health care they get is inadequate.

The risk and prevalence of diabetes and hypertension are much higher for women (of all ages) with increasing distance from major cities. Rural women were more likely to die from chronic obstructive pulmonary disease, lung cancer and ischaemic heart disease than women in urban areas. The report shows that women in rural areas have higher levels of risk factors for heart disease. Obesity, which is strongly associated with increased risk of diabetes and hypertension, is much higher for country women of all ages.

Australians' life expectancy among the highest in the world

Australian life expectancy for both males and females continues to be amongst the highest in the world, according to Deaths, Australia, 2010 from the Australian Bureau of Statistics (ABS). A boy born today can expect to live an average of 79.5 years, while a girl can expect to live to 84.0 years. Having survived to age 60, men could expect to live another 23 years and women another 26 years. Since 1990, life expectancy has increased by 6 years for men and just under 4 years for women, reflecting the decrease in death rates over time.

The increase in life expectancy is one of the factors contributing to the ageing of Australia's population. Death rates have continued to decline over the past 20 years. In 2010, the standardised death rate was the lowest on record at 5.7 deaths per 1000 people. In 1990, the standardised death rate was 8.6 deaths per 1000 people. The infant mortality rate decreased slightly, from 4.3 deaths per 1,000 births in 2009 to 4.1 in 2010.

While there are serious issues with the quality of data, a special chapter on Indigenous mortality indicates that the mortality level of Aboriginal and Torres Strait Islander Australians remains substantially higher than that of the total Australian population.

Australian's life expectancy among the highest in the world - Media release.

Navigating the maze of private health insurance (new website)

The growing number of Australians covered by private health insurance will find it easier to make informed choices about their level of cover with handy new tools available on from this week. "The new online tutorials will make it easier for consumers to navigate their way through the 20,000 private health insurance products available in Australia and make a choice that best suits their needs. Being able to compare policies quickly and easily will be even simpler with the new online tutorials," Minister Nicola Roxon said.

The website enables ready comparison of health insurance policies, and features include videos, brochures, and an inquiry service.

Drugs in Australia 2010: tobacco, alcohol and other drugs (AIHW)

Drugs in Australia 2010: tobacco, alcohol and other drugs provides a comprehensive summary of Australians' consumption of alcohol, tobacco and other drugs and use of treatment services, drawing on the latest statistics from major national collections. It also includes information about drug-related health issues, and drugs in the context of crime and law enforcement.

Alcohol and other drug treatment services in Australia 2009-10: report on the National Minimum Data Set (AIHW)

Alcohol and other drug treatment services in Australia 2009-10: report on the National Minimum Data Set reports on the approximately 170,000 treatment episodes for alcohol and other drug use which were provided in Australia in 2009-10. Almost half were for treatment related to alcohol use-the highest proportion observed since the collection began in 2001. As with previous years, counselling was the most common type of treatment offered. 1 in 10 episodes involved more than one type of treatment.

Media release

Rural and Regional Health Australia

Rural and Regional Health Australia (RRHA) has now released its new website. The website provides details of existing and forthcoming Government programs and initiatives aimed at improving health services in regional, rural and remote Australia. Its interactive map shows health services in specific locations in all states and territories, and it will be upgraded over time to hold more place-based health information. In the same way more resources will be added to the website as it develops, making it a valuable tool both for the rural population and for health professionals.

Rural and Regional Health Australia (RRHA) started operation on 1 July 2011 in the Department of Health and Ageing. It provides a single entry point for information about health and aged care programs with a regional, rural and/or remote focus.

RRHA has 3 contact points for regional health consumers and providers:

The website

The Call Centre 1800 899 538 (Toll free) An email service

Press release

NRHA reaction

Assisted reproductive technology in Australia and New Zealand 2009 (AIHW)

Assisted reproductive technology in Australia and New Zealand 2009 reveals that in 2009, there were 70,541 assisted reproductive technology (ART) treatment cycles undertaken in Australian and New Zealand. Of these cycles, 17.2% resulted in a live delivery (the birth of at least one liveborn baby). In total, 13,114 liveborn babies were born following ART treatment in 2009. The most important trend in ART treatment has been the increase of single embryo transfer, from 48.3% in 2005 to 69.7% in 2009. This trend has resulted in significant reduction of multiple delivery rate from 14.1% in 2005 to 8.2% in 2009.

Media release

Lung cancer in Australia in 2011: an overview (AIHW)

The rate of new cases of lung cancer among women has risen while the rates for men have fallen, according to a new report by the Australian Institute of Health and Welfare (AIHW) and Cancer Australia. Lung cancer in Australia in 2011 : an overview is the first comprehensive summary of national statistics on lung cancer in Australia.

"The report shows the number of new lung cancers increased markedly in both sexes between 1982 and 2007," said AIHW spokesperson Chris Sturrock. "But when the age structure and size of the population are taken into account, lung cancer incidence fell by 32%in men but rose by 72% in women."

The differing directions in lung cancer incidence rates in men and women may be attributed to historical differences in smoking behaviour, with smoking rates in men decreasing since the 1960s but rates not decreasing until the 1970s for women.

Data in this report provide a comprehensive picture of lung cancer in Australia including how lung cancer rates differ by geographical area, socioeconomic status, Indigenous status and country of birth.

Media release

Managing two worlds together - city hospital care for country Aboriginal people

Aiming to improve the experience of health care system for Indigenous people, Managing two worlds together by Health Care Management, Flinders School of Medicine considered Aboriginal patients from rural and remote areas of South Australia and parts of the Northern Territory. The project is based on 4 separate studies:

* Study 1-Report on Admissions and Costs analyses the patterns of admission and length of stay of country Aboriginal patients in city public hospitals
* Study 2- Staff Perspectives on Care for Country Aboriginal Patients reports the views of staff who provide care for country Aboriginal patients in city and country hospitals and health services
* Study 3-The Experiences of Patients and Their Carers is a first-hand report of rural Aboriginal patients and their carers
* Study 4-Complex Country Aboriginal Patient Journeys maps 4 journey case studies, and analyses gaps and breakpoints in those care journeys.

Obesity and injury in Australia: a review of the literature (AIHW)

Obesity and injury are major health burdens on society. Possible relationships between obesity and injury have recently been reported, but their nature and extent has been unclear.

Obesity and injury in Australia: a review of the literature presents summary information from an overview of the existing literature to investigate obesity injury relationships.

It shows that while findings are mixed, most evidence suggests that obesity increases the risk of injury. "The probability of falls, trips, or stumbles rises with obesity," said Professor James Harrison of the AIHW's National Injury Surveillance Unit. "Sleep apnoea is also strongly associated with obesity, and this condition greatly increases the risk of road injury, due to the fatigue experienced by sufferers."

The outcomes of injury are also affected by obesity. "The average length of stay in hospital is significantly longer for obese injured patients than for patients who are not obese," Professor Harrison said. "They may also have greater requirements for respiratory support, and are more likely to suffer certain complications of care, such as pneumonia, renal failure and sepsis, during their time in hospital."

Media release

Thinking about mental health (Uni of Sydney Research)

Youth depression and mental illness are growing problems but educators are beginning to find new ways to combat the problem. University of Sydney research shows more than a quarter of young Australians between the ages of 16 and 24 suffer from mental or behavioural disorders with 6500 children currently using anti-depressants. Scotch College is one school tackling the issue using a new positive education program.

Climate change and rural health: a GP’s call for action, plus an update on recent studies

The Australian Journal of Rural Health has an editorial from the ANU’s Professor Tony McMichael, who writes that rural and remote communities can expect to feel the increasing brunt of human-induced climate change: “… as global climate change progresses over coming decades, dust, smoke, flames, water and wind will impinge more damagingly on many of Australia’s rural and remote communities. Property, harvests, incomes, jobs and community vitality are at risk. More troubling, there are great risks to physical and, in particular, mental health.”

Professor McMichael outlines 4 studies including "The Rural Adversity Mental Health Program."

Policy Issue Review : new health policy series from PHC RIS

PHC RIS has released a series of Policy Issue Reviews about policy-relevant topics in primary health care. Each issue, which has been reviewed by a content expert, focuses on a particular topic that is relevant to Australian health reform. The available Policy Issue Reviews are:

Disparities in primary health care utilisation: Who are the disadvantaged groups? How are they disadvantaged? What interventions work?
Describes several sub-populations in Australia that experience poor accessibility to primary health care services; highlights the barriers to using services; and identifies the interventions that have been implemented to improve accessibility and reduce the disparities in primary health care utilisation.

Initiatives to integrate primary and acute care, including ambulatory care services
Focuses on the patient's experience of integrated care; and the strategies that have been implemented to enhance patients' experience and health outcomes.

Local community reporting models for regional primary health care organisations
Examines information about different models which overseas primary health care organisations have used for reporting to local communities.

Models of patient enrolment
Describes 7 different International patient enrolment models and synthesises information about enrolment in terms of accountability and continuity of care.

Patient experience of health care performance
Examines the mechanisms for measuring patient experience of primary health care; and identified how patient experience has been used in Australia and overseas to inform policy and practice.

Policy Issue Reviews are available on the PHC RIS website.

Bulky billing: Missing out on fair and affordable health care

Australians are paying more than $1 billion each year in out-of-pocket expenses for GP visits, pharmaceuticals, pathology and diagnostic testing despite Medicare's pledge to provide "fair and affordable" health care, a new study by The Australia Institute reveals. Bulky Billing: Missing out on fair and affordable health care examines the shortfalls in Medicare and the Pharmaceutical Benefits Scheme (PBS) and the role GPs can play in determining out-of pocket expenses.

The study also confirmed that many Australians are forgoing treatment, with 23% of survey respondents admitting they had postponed or avoided having a prescription filled because they could not afford to pay for it.

Research Fellow David Baker said GPs have enormous discretion over how much patients pay, not just for their consultation, but for drugs and pathology and diagnostic tests." Only 6% of survey respondents reported first hearing about generic medications from their GP, while 43% said they would not use generic medication without first checking with their doctor. Just 17% realised that it was up to their doctor to tick the bulk billing box on referral forms for pathology tests," said Mr Baker.

Media release

Expenditure on health for Aboriginal and Torres Strait Islander people 2008-09: an analysis by remoteness and disease (AIHW)

In 2008-09, health expenditure for Aboriginal and Torres Strait Islander people varied across remoteness areas, service types and disease groupings. The greatest difference in expenditure between Indigenous and non-Indigenous Australians was in Remote and very remote areas where, for every dollar spent per non-Indigenous Australian, $2.41 was spent per Indigenous Australian. Expenditure on genitourinary diseases, and mental and behavioural disorders, accounted for the highest proportions of admitted patient expenditure for Indigenous Australians (11% and 10% respectively).

Additional analysis has been undertaken in the 2008-09 report to include expenditure on potentially preventable hospitalisations.

Media release

Case studies on the Mental Health Nurse Incentive Program

The Mental Health Nurse Incentive Program (MHNIP) is part of the Australian Government's component of the National Action Plan on Mental Health 2006-2011. Funding of $191.6 million was allocated over 5 years, commencing July 2007. The funding allows general practices, private psychiatrists and other appropriate community providers (including general practice networks and private hospitals) to engage or retain mental health nurses to assist in the provision of coordinated clinical care for people, in the community, with severe mental health disorders. The MHNIP is intended to help community based patients with a severe mental illness get the right services at the right time, assisting to prevent unnecessary hospital admissions/readmissions.

Mental Health Nurse Incentive Program: case studies project report details a project which investigated 7 sites where the MHNIP has been implemented, covering a variety of locations, service models and employment arrangements. The case studies were intended to highlight the development, implementation and some early outcomes of the MHNIP.

Mental Health Nurse Incentive Program: seven case studies gives detailed studies on the 7 services in Longford, Clare, Bathurst, Geelong, Ipswich, Mackay and Ballarat.

Consensus-Based Clinical Practice Guideline for the Management of Volatile Substance Use in Australia

The Minister for Mental Health and Ageing, Mark Butler, and Minister for Indigenous Health, Warren Snowdon, today welcomed Australia's first Consensus-Based Clinical Practice Guideline for the Management of Volatile Substance Use in Australia, and a quick - reference summary, to support heath workers treating clients in this challenging area.

Volatile substance use (VSU) - inhaling solvents, gases and aerosols for intoxication - is a significant problem in some Australian communities. Mr Butler said people who use volatile substances, such as petrol or glue, often have special needs not met by conventional drug and alcohol treatment strategies.

"Health professionals working in metropolitan, rural and remote communities now have a clinical practice guideline that provides a planned approach to identify, assess and treat people who use volatile substances," Mr Butler said.

Press release