2 VicHealth Letter/40 MESSAGE FROM THE CHAIR CEO’S FOREWORD 3

In the late 1980s, a small cohort Welcome to the 40th edition of dedicated policy makers, of the VicHealth Letter legislators and health professionals planned a health promotion “ organisation. Knowledge is power, and in the hands and minds of consumers it becomes empowerment. These principles are the foundation of health Australia is promotion – taking evidence-based knowledge and programs to policy leading the makers, practitioners and the community. That is why the VicHealth Letter plays such an important role world in Professor Emeritus John Catford in generating health outcomes: particularly in the context of rapid Chair of the Board change and intensifying information density. The health sector many areas and consumers want to know the status of research and practice, of health and be confident of reliable and current information. CONTENTS VicHealth was established with all-Party support by Today Australia is leading the world in many areas of health research research and the State Parliament of Victoria, and mandated by the and promotion. To stay ahead and get the best outcomes for Victorians, Act 1987 to fund health promotion activity. VicHealth works closely with key partners to constantly innovate and promotion.” 04 NEWS The latest from VicHealth Additional taxes on tobacco were destined to fund better apply ideas, often from non-traditional sources. health for Victorians. Our story ‘Innovative ideas to lead health promotion in a new Jerril Rechter 05 Q+A: DR SHIN YOUNG-SOO It was a world-first initiative, and the VicHealth model direction’ (page 6) explores this continuous evolution and welcomes Chief Executive Officer Regional Director, Western Pacific was the first of its kind. The sense of purpose and energy leading government advisor, author, academic and Director of the World Health Organization around this new foundation was palpable, and the model United Kingdom’s Behavioural Insights Team, Dr David Halpern, has since been adopted by a number of countries around VicHealth’s first ‘Leading Thinker’. The Leading Thinker Initiative will 06 INNOVATIVE IDEAS TO LEAD HEALTH the world. connect international thought leaders with senior policy makers and PROMOTION IN A NEW DIRECTION Reading through this 40th edition of the VicHealth key experts to focus on complex health promotion issues including VicHealth shaping the future Letter, I am extremely proud to see that same sense of obesity, the focus of Dr Halpern’s residency. of health promotion purpose and energy has prevailed and grown stronger with Also in this edition of the VicHealth Letter, learn from the alarming time. As a state that has always aspired for good health, findings of a national survey on violence against women that reveal 10 BUILDING RESILIENCE FOR Victoria still needs it to keep accelerating forwards. some Australian men and women still believe that rape and physical YOUNG PEOPLE TO FLOURISH A new focus on resilience and Although diminished, remains a serious threat violence are justifiable. Importantly, the report concludes that, above young people in Australia to our health. We also face a major rise in the incidence all else, the main influence on people’s attitudes to violence against and impact of obesity and chronic diseases. And although women was their understanding of the issue and how supportive 12 HIGHLIGHTS we are living longer, it is the health-related decisions we they were of gender equality. Therefore, the they subscribe From 40 editions of the make early in our lives that determine the quality of our to conservative stereotypes about men and women, the more likely VicHealth Letter life in later years. they were to excuse, trivialise or justify violent behaviour. Read these VicHealth’s collaborations and groundbreaking findings and more on page 18 from the2013 National Community 18 AUSTRALIANS’ ATTITUDES research contribute to an expanding global knowledge Attitudes towards Violence Against Women Survey (NCAS) report. TO VIOLENCE AGAINST WOMEN and experience base, while informing strategies for the Positive mental health, psychological wellbeing and our plans to Findings from the 2013 National Australian context. The recent designation of VicHealth as build resilience in young people are explored in the article ‘Building Community Attitudes towards the new World Health Organization (WHO) Collaborating resilience for young people to flourish’ (page 10). Violence Against Women Survey Centre for Leadership in Health Promotion cements our Find out more about the work we’ve been undertaking with young status as a global leader in preventing chronic disease. people about drinking culture in Victoria. Read ‘The conversation 22 THE CONVERSATION WE HAD VicHealth shares knowledge and fosters discussion and we had to have on alcohol’ (page 22) for insights the NameThatPoint TO HAVE ON ALCOHOL Working towards a less harmful debate about how we can ensure the ongoing health of all campaign provided to develop our new campaign: No Excuse Needed. drinking culture in Victoria Victorians. This has been the role of the VicHealth Letter We are also delighted to feature a Q&A with Dr Shin Young-soo, across 20 years and 40 editions. Regional Director for the Western Pacific with the World Health 24 RESEARCH UPDATE On behalf of the Board, I wish to acknowledge the Organization (page 5); a centrespread of highlights from 40 editions A selection of the most recent many partners we featured and the many people who of the VicHealth Letter (page 12) and a summary of our published research projects have contributed to the writing, editing and production research (page 24). of this respected publication. Your energy and efforts are This bumper edition reflects the great range of activity VicHealth 26 ACKNOWLEDGEMENTS, manifest in this anniversary edition of the VicHealth Letter, leads in 2014. On behalf of our organisation, I wish to congratulate IMAGES AND REFERENCES which is rich in insight and information, and lives up to our partners, contributors and those whose work has led to the the expectations VicHealth’s founders had in 1987. development of the VicHealth Letter over time, and thank our readers I would also like to extend our gratitude to outgoing for their ongoing interest and support. Board Chair Mark Birrell for his huge contribution to Finally, I would like to take this opportunity to acknowledge VicHealth’s success, from its initial inception in the 1980s outgoing Chair of the VicHealth Board Mark Birrell for his stewardship through to his visionary and transformational leadership and invaluable commitment to the organisation since its inception, on the Board in this decade. An outstanding achievement and welcome Professor John Catford in the role as Chair and Ms Nicole for better health in Victoria. Thank you, Mark. Livingstone as Deputy Chair. 4 VicHealth Letter/40 NEWS Q+A 5

Dr Shin Young-soo The ageing of Australia’s population is expected to result in increasing numbers of VICHEALTH GOES Regional Director for the people with disability from diseases such as Western Pacific World dementia, Parkinson’s disease, hearing and GLOBAL AS A WHO Health Organization (WHO) vision loss, and osteoarthritis. I would like to once again thank Australia COLLABORATING for its pioneering work in introducing plain We are excited to feature an interview packaging for in a bid to reduce with Dr Shin Young-soo following the recent smoking rates. This was a bold and courageous CENTRE designation of VicHealth as a World Health move, and one that is now being considered Pictured: (left to right) Chair of the VicHealth Organization (WHO) Collaborating Centre for by several other countries. Board Professor John Catford, DR SHIN Leadership in Health Promotion. Below he Deaths from NCDs like heart disease, diabetes, Outgoing Chair of the VicHealth Board Mark Birrell, Victorian Health Minister The Hon. David Davis, expresses the future health priorities for the and chronic lung disease are increasing in VicHealth CEO Jerril Rechter. Western Pacific Region and his enthusiasm the WPR. What are the WHO’s key strategies In September VicHealth was honoured to be designated as the new YOUNG- of a fruitful and sustainable partnership to address this in the region? World Health Organization (WHO) Collaborating Centre for Leadership with VicHealth. Ultimately, our vision is that countries sustain in Health Promotion. Dr Shin Young-soo was appointed as WHO’s their political and financial commitments to The Collaborating Centre based at VicHealth will focus on strengthening Regional Director for the Western Pacific in prevent and control NCDs so they are no longer health promotion leadership in the Western Pacific Region. SOO 2009 and successful in securing a second five- a barrier to socioeconomic development. VicHealth will lead the activities of the Collaborating Centre which year term in 2014. Specifically, WHO recommends the following include hosting international delegations, forging new partnerships What do you hope to achieve in your cost-effective interventions to address NCDs: in health, sharing information and resources and on-the-ground second term with the WHO? The Western – increasing taxes on tobacco products, technical support. Pacific Region (WPR) is very dynamic and smoke-free zones in all public spaces, graphic will continue to evolve. Key issues include health warnings on packaging and a total ageing populations, climate change and the ban on marketing transition to the post-2015 development – limiting commercial/public availability agenda. All this is within the context of of alcoholic products and restrictions on economic change, and for some countries marketing unprecedented private sector growth. The – reducing salt intake and public awareness significance of the private sector will continue programs to encourage healthy eating to increase in coming years. – addressing physical inactivity with public Going forward, we must do everything awareness program on the benefits of an possible to ensure health is a core development active lifestyle. issue. Only in this way will we be able to It is great to see Australia taking a lead role offer real hope of health and wellbeing – and in implementing many of these interventions, the promise for sustainable development – for and inspiring other countries in the WPR and the 1.8 billion people in our region. beyond to do the same. How different are the WPR’s health priorities What do you hope to achieve through the to other regions? The WPR is home designation of VicHealth as a WHO Collaborating to about one quarter of the world’s population, Centre for Leadership in Health Promotion? TAKE THE 30-DAY A BOOST FOR ARTS CREATING A HEALTHIER SUPPORTING VICTORIANS yet we experience a much larger share of VicHealth is one of the pioneering health the world’s most pressing health issues and promotion foundations in the world. It has CHALLENGE: H30 WATER AND HEALTH FUTURE ONE STEP AT A TIME TO GET ACTIVE “ natural disasters. accumulated a wealth of experience and Evidence indicates sugar-sweetened VicHealth and Arts Victoria have VicHealth’s annual Walk to School This year, for the first time in 26 Non-communicable diseases (NCDs) – mainly expertise that can be shared with other beverages are contributing to rising partnered up to develop arts projects event is on again for the month of years, VicHealth’s Active Club Grants We see VicHealth levels of obesity in the population. that act as a gateway to regular October. Walk to School encourages will offer two rounds of funding playing a key role cardiovascular disease, cancer, diabetes and countries that may be embarking on their VicHealth’s H30 Challenge exercise through VicHealth’s Active children to walk to and from school opportunities to hundreds of Victorian chronic respiratory diseases – are responsible own journey to set up health promotion encourages participants to replace Arts Strategy 2014–2017. every day, highlighting the ways sports clubs. in inspiring other for four out of five deaths in the Region. foundations. VicHealth certainly has much to sugary drinks and ‘switch to water’ A major focus for VicHealth has walking improves children’s health The Active Club Grants, of up Of WHO’s six regions, the WPR has the most offer as evidenced by its culture of innovation for 30 days to reap a whole range always been the role the arts play in and wellbeing – and there are to $3000 each, aim to make it easier smokers, the largest number of male smokers and cutting edge research. of health benefits. Signing up to promoting good mental health and fantastic prizes available for schools for clubs to encourage people to join, countries to the challenge is free and participants enhancing social connection, but this and students. Last year more than by funding items or equipment, and and the fastest increase in tobacco uptake We also see VicHealth playing a key role can choose their own start date. new strategy goes further and looks 32,000 students from 303 primary helping to improve the safety of those champion health by women and young people. in inspiring other countries to champion Sign up today and encourage others at the additional physical benefits of schools took part, and together taking part. promotion.” What do you see as the particular health health promotion. In addition, we hope that to get involved. active and participatory arts. they walked more than 400,000 The first round has now closed. challenges facing the Australian population VicHealth will continue welcoming delegates A key part of the strategy combines kilometres. This year more than 550 The second round will open on www.h30challenge.com.au regarding risk factors for burden of disease? and study tours to witness the workings of digital technology with the latest schools have registered their interest Monday 12 January 2015 and run until trends in design innovation from around in participating. Friday 13 February 2015. Australians enjoy very good health outcomes VicHealth firsthand. We see our collaboration the globe. www.walktoschool.com.au www.vichealth.vic.gov.au/acg and many of the health conditions are with VicHealth as one based on a shared www.vichealth.vic.gov.au/Active- www.facebook.com/WalkToSchool associated with modifiable risk factors, such vision, mutual exchange, and synergistic Arts-Strategy as improper nutrition and lack of physical knowledge transfer. activity. NCDs account for 91 per cent of total deaths in Australia. 6 VicHealth Letter/40 7

“ The VicHealth Letter has chronicled the changing face of health.” INNOVATIVE IDEAS TO LEAD HEALTH PROMOTION IN A NEW DIRECTION

Two decades ago, esteemed Taking aim at the , he led VicHealth’s early agenda to dislodge tobacco sponsorship from sport scientist and VicHealth Chair, and the arts. Professor Emeritus Sir Gustav ‘Tobacco companies knew that both sports and the Nossal AC CBE, called for arts could provide convincing advocates and powerful role models – “cultural ambassadors” capable of carrying a new approach and broader ideas across the community,’ said Professor Nossal in vision for health promotion. the inaugural edition of the VicHealth Letter, then called the VicHealth Action Report. His frank and impassioned message was that successful cross-sector collaboration was building momentum, reducing the reliance sports and the arts had on tobacco industry sponsorship and delivering healthy messages to the community. VicHealth went on to forge strong alliances between sport, the arts and health. Today, the image of a smoking athlete or cigarette advertising at an arts event is starkly anachronistic. Such is the power of strategic health promotion, the founding purpose of the Victorian Health Promotion Foundation. From Quit and SunSmart to Active for Life, the VicHealth Letter has chronicled the changing face of health promotion across 40 editions, regularly delivered to private and public sector readers. The VicHealth Letter is playing a key role in sharing the pioneering work of the foundation and its collaborators as well as acting as a trustworthy source of health promotion information. The diversity and breadth of articles in this anniversary edition is compelling evidence of the growth in impact of health promotion activity in Victoria and beyond. 8 VicHealth Letter/40 9

VicHealth’s Action Agenda for Health Promotion provides Contemporary challenges in health call for smarter thinking “We need the entire system to support healthy choices, the organisation with a bold vision and strategic plan for In 2010, Britain’s Prime Minister David Cameron set up a ‘nudge unit’ to work on from urban planning that makes physical activity an easy the next 10 years. The new strategic approach will see how to use behavioural economics and market signals to influence the choices choice, to preserving farming land to secure nutritious VicHealth innovate by finding new ways to address health citizens make and guide them towards healthier and more socially integrated food, or changing labelling and marketing of food to priorities; inform by instigating action and broadening decisions.1 This unit, otherwise known as the Behavioural Insights Team, applies protect children, so consumers can see through the spin.” the organisation’s impact; and integrate by embedding insights from a range of disciplines to health and uncover a new approach to VicHealth is aiming to focus Dr Halpern’s residency interventions into the Victorian Prevention System. influencing people’s behaviour.2 What began as the world’s first government towards obesity prevention to help people make The Action Agenda also provides a means by which institution of its kind is now a world-leading social purpose company with three better choices about their health and engage in more “ to measure progress against VicHealth’s strategic owners: the Behavioural Insights Team, the UK government and Nesta (the UK’s physical activity. imperatives to promote good health and prevent illness leading innovation charity). Its chief executive, Dr David Halpern has led the UK- This work with Dr Halpern represents one of the new Behavioural insights brings – promote healthy eating, encourage regular physical based team since its inception. approaches VicHealth is taking to address the contemporary activity, prevent tobacco use, prevent harm from alcohol, Dr Halpern has since become VicHealth’s first ‘Leading Thinker’, which means challenges in health – looking for different ways to think together ideas from a range and improve mental wellbeing. he and his team will be building evidence-based research to assist with driving and shape the future. of inter-related academic the VicHealth Action Agenda, with a central focus on obesity prevention. From new funding models and exploratory research to He says he’s thrilled to become the inaugural Leading Thinker for VicHealth. influencing healthier choices, VicHealth is at the forefront disciplines.” ‘Having led the Behavioural Insights Team since it was set up, I am looking of health promotion worldwide with knowledge creation forward to introducing this work to the Victorian public. Ground work for the team playing a central role. started while I was the Founding Director of UK’s Institute for Government and “Dr Halpern’s arrival at VicHealth as our first ‘Leading continued while I held the role as Chief Analyst under the former Prime Minister Thinker’ is an example of the organisation’s commitment Dr David Halpern, ‘Leading Thinker’ at VicHealth of the United Kingdom, Tony Blair.’ to innovation and evidence-based research to improve ‘Working with VicHealth presents an opportunity for the Behavioural Insights the health of all Victorians. Team under my stewardship to work collaboratively with a consortium of Victorian “We need brave new thinking, as well as insights to partners, with input from key members based in our Australian office. Effectively continue our pioneering work and I welcome the Behavioural we will be building evidence- based research to assist in driving the Action Agenda Insights Team to VicHealth and the many exciting for VicHealth, with a central focus on obesity. possibilities they bring to Victoria’s prevention system,” ‘Behavioural Insights bring together ideas from a range of inter-related academic says Ms Rechter. disciplines – behavioural economics, psychology and social anthropology. The idea is simple: to understand how people make everyday decisions and what shapes An in-depth overview of the Leading Thinkers Initiative behaviour. We can use these insights to design policies or interventions that can can be found here: www.vichealth.vic.gov.au/About- encourage, support and enable people to make better choices for themselves VicHealth/Leading-Thinkers-initiative and society – and often at lower cost and with less use of traditional mandating To read more about the Behavioural Insights Team go to: and instruction.’ www.behaviouralinsights.co.uk ‘In Britain, people initially regarded our work as a novelty until they started to see some of the strong evidence which showed the effectiveness of behavioural insights. For example, in one our most well-known initiatives, we informed people who failed to pay their tax that most other people had already paid. This simple action, which took the form of an additional sentence in a letter, increased payment rates by over five percentage points. This, along with other similar interventions, has brought forward hundreds of millions of pounds.’ ‘Similarly, we showed that seemingly small changes have been able to reduce medical errors, reduce missed appointments and get people back to work faster. When people see results such as these, particularly those who are bound by constraints in their work, they move from being sceptical to embracing the approach.’ ‘Primarily, the goal of my residency will be to develop simple but effective and far-reaching programs to help all Victorians make healthy food choices and encourage regular physical activity. But I also hope that it will lead to many other insights too, both within public health and beyond. Ultimately, behaviour change is not just about what governments do, but about business, third sector and the public too.’ In recent years Australia has experienced a rapid rise in the prevalence of chronic diseases, especially those related to obesity. A VicHealth report on obesity in Australia by world-leading obesity expert Associate Professor Anna Peeters surmises that obesity levels will reach a crisis point in a decade unless a whole of community and government approach is adopted. VicHealth CEO Jerril Rechter says obesity is without a doubt one the most significant and complicated public health emergencies we now face as a society. “Tackling obesity is going to take more than asking individuals to change their diet and exercise more,” she said. 10 VicHealth Letter/40 11

To help shift the nation’s mental health profile and encourage young people to reach their full psychological potential, VicHealth will collaborate with leading BUILDING organisations active in the fields of resilience, work, school RESILIENCE and digital technology. Here’s what the experts are saying: Jan Owen AM Dr Jenny Proimos Associate Professor Jane Burns Winthrop Prof. Stephen Zubrick CEO, Foundation for Young Principal Medical Advisor, CEO, Young and Well Cooperative Senior Principal Research Fellow FOR YOUNG Australians Department of Education and Research Centre Deputy Director, ARC Centre Early Childhood Development of Excellence for Children and PEOPLE TO (Victoria) Families over the Life Course FLOURISH

What constitutes psychological wellbeing and positive mental health?

The subject of positive mental health – happiness, satisfaction and a sense of Working gives young people the Resilience is an attribute that For most young Australians, Mental illness and mental health purpose – and the factors that may contribute to it is being increasingly explored resources to participate actively is best developed early and technologies, social networks distress are set to become the by international thought leaders, practitioners and decision makers. in their community. If you don’t influenced by all the experiences and apps play a critical role single biggest burden to the Healthy individuals are able to realise their own abilities, cope with the normal feel like you have a sense of children and young people have. in curating both their offline and health and social welfare system stresses of life and be a productive member of their community. Corey Keyes connectedness and a sense of Education settings are crucial online relationships. Research in the coming two decades. There envisages mental wellbeing as a continuum, where the healthiest are ‘flourishing’ belonging and you don’t feel like to building resilience as children from the Young and Well is a huge scope for promoting — something he estimated only 17 per cent of the US population experienced.1 you are contributing, you can and young people spend so much Cooperative Research Centre ‘mentally healthy’ behaviours, Similar studies by Huppert and So in Europe found that flourishing varied widely get into behaviours that people time there and are strongly shows that when harnessed workplaces and communities. between nations, from as low as 9 per cent in some countries to 40 per cent in others.2 consider antisocial — you either influenced by the adults, the appropriately, technologies can Even when life gets very Central to this wellness model is the concept of resilience – the ability to withdraw or you act out. peers and the social environment help young people develop strong confronting and challenging, cope with, recover from and be strengthened by experiences of adversity – and I think that the number one around them. social networks, ensure they feel a resilient young person has discussions about how to build it. The UK Foresight Mental Capital and Wellbeing thing we’re missing in building Research shows that children connected and, particularly for the emotional and behavioural Project takes a life cycle view of resilience recognising that it develops across the resilience for young people and young people who feel cared our most vulnerable young people, flexibility to manage, stay well lifespan, with parenting in early childhood, school and work experiences and the across the board in our country for by people at their school enable them to actively participate and see things through. quality of our communities as key in its development.3 is risk-taking. That’s what builds and feel connected to learning in issues and communities that There is a general consensus Forty per cent of young Australians experience low social and emotional resilience. It’s not actually lots are more likely to be motivated they care about. of evidence that our future wellbeing and 13 per cent encounter mental health difficulties.4 Further, as of happiness, it’s not the joy pill, and show improved academic Digital resilience is the ability prospects are optimised when 75 per cent of mental health problems occur before the age of 25,4 understanding and it’s actually failure which you outcomes.5 to deal with negative experiences individuals are able to: ways to build resilience and cope with life’s setbacks could be a particularly recover from. For younger people Victorian research shows that both online or offline and the – regulate their emotions powerful way to prevent mental illness among young people. feeling like they’re in a vibrant children and young people with capacity to bounce back in the – engage in exploratory behaviour Since 1999, VicHealth has provided leadership in the mental wellbeing field, working environment where you a higher level of connectedness face of adversity. Technology – communicate effectively focusing its efforts on preventing factors that lower mental wellbeing and can experiment, you can fail, you to school are less likely to abuse provides us a unique opportunity – be self-directed contribute to mental ill health through race-based discrimination, gender inequity, can try again, is really important. substances, engage in violence, to overcome the barriers around – have intellectual flexibility violence against women and social exclusion. report mental health problems improving mental health and – possess some degree of Building on the knowledge created through these successes, VicHealth is starting or engage in sex at an early age.6 wellbeing for young people, introspection new work aiming to increase resilience among young people, with a particular Social and school connectedness including the isolation of distance, – possess self-efficacy in meeting focus on three areas — the workplace, school and digital technology. in early secondary school are the stigma of help-seeking and life’s challenges. VicHealth’s Principal Program Officer in the mental wellbeing team Dr Stephen predictors of late teenage the lack of knowledge about Carbone says it is essential that resilience-building activities are embedded in the substance abuse, mental health where to go to find help. We now environments in which children and young people live, play, learn and work. and academic outcomes.7 have the evidence to understand “A focus on resilience will allow VicHealth to contribute to the capacity of those where young people ‘are’ and who are at risk of mental illness to avoid it or survive it, while assisting those who how to best engage them – and are already well to flourish,” explains Dr Carbone. the answer is simple: online. 12 VicHealth Letter/40 13

Congratulations to VicHealth on the 40th How fortunate Victorians edition of its most are that community valuable and news- leaders had the foresight worthy VicHealth Letter. It is with pleasure to establish VicHealth. What I particularly value that I congratulate The VicHealth Letter has Through its leadership, about these publications VicHealth on the 40th become an important health promotion and is the lively presentation, edition of its newsletter. spotlight on health public health have been the topical nature of the This issue marks over promotion in Victoria encouraged (and in some subjects discussed and 20 years of raising since its launch in cases funded) to work the heavy emphasis on community awareness 1994. It has showcased and undertake research prevention. Each edition about pressing important issues for the in new and innovative makes me feel quite health issues such as health and wellbeing of areas, including creating sentimental about the smoking, domestic Victorians, ranging from supportive social and heady period when I was violence and obesity. violence, through sports physical environments the Founding Chairman This is a significant clubs to broader socio- where people live, of this outstanding social achievement which has economic inequalities. work, play and age. initiative. At the same promoted good health The strength of the Locally, nationally and time, each issue reminds to Victorians through its VicHealth Letter has internationally we me of how enormously schools, hospitals and been its focus on both heard about these and positively the service agencies. I thank the problems and the developments through programme has the staff who produce CELEBRATING solutions, highlighting the VicHealth Letter. developed since those VicHealth Letter and many innovative Congratulations on your early days. The VicHealth I look forward to their approaches along 40th edition: long may model really leads the ongoing efforts. 40 EDITIONS the way. it continue. world in so many ways! Associate Professor Prof. Billie Giles-Corti Prof. Sir Gustav Nossal The Honourable Alex Anna Peeters Director of the McCaughey AC, CBE, FRS, FAA Chernov AC QC Head of Obesity VicHealth Centre for Professor Emeritus, Governor of Victoria OF VICHEALTH & Population Health, Community Wellbeing, Department of Pathology, (Patron-in-Chief) Baker IDI Heart and The University of Melbourne University of Melbourne LETTER Diabetes Institute

For two decades the VicHealth Letter has been a trusted vehicle for discussion in addressing the big issues in health and providing transformational insights from our world-class interventions. 1994—2014 Today it continues to showcase VicHealth’s Prof. Rob Moodie Prof. David Hill Professor of Public Health pioneering work and our invaluable at the Melbourne School Dr Nigel Gray AO Mr Paul Briggs OAM Cancer Council Victoria of Population Health, Former Cancer Council Executive Chairman partnerships to improve the health of all Honorary Associate The University of Melbourne Victoria Director of the Kaiela Institute Victorians. This special feature reflects on the highlights from the past 40 VicHealth Having been involved The VicHealth Letter is The VicHealth Letter Without doubt at the time VicHealth the “promoter of health reassures me that while prevention is the Letter editions. was conceived and promotion”. It has tackling the large risk principal philosophy in born in the Victorian been a great way of factors, we are not securing and sustaining Parliament, it has highlighting and sharing letting the smaller risk a high standard of always been a delight so many of the creative, factors slip away from health and wellbeing. for me to read about sustained and effective us. The big campaigns The VicHealth Letter VicHealth’s innovations health promotion are evident to all, but has made a highly To read past editions of the VicHealth Letter and achievements initiatives of VicHealth’s the myriad of other credible and valued visit: www.vichealth.vic.gov.au/vichealthletter in this publication. partners, and VicHealth health programs which contribution to the The VicHealth Letter itself, over the years. are needed in a diverse wellbeing of our broader reflects the spirit of These stories emanate society like ours don’t society for many years. the organisation, its from Victoria’s attract the attention Congratulations on your values, its challenges, wonderfully rich and that the majors such as 40th edition, may there and reports engagingly diverse local Quit and SunSmart do. be many more. on health promotion communities, as well programs enabled from major health NGOs, by this fine Victorian sporting and arts institution. Best wishes agencies, universities for the next 40 issues. and research institutes. 14 VicHealth Letter/40 17

Interview with Kyle Vander Professor Emeritus Kuyp, nine times Australian Sir Gustav champion, emphases the Nossal AC CBE “We must begin to value of sport in his life. understand that mental For several women TOBACCO BEYOND PUBLIC HEALTH EQUITY it was their first time health is fundamental Issue 14–2000 KOORI HEALTH Issue 37–2013 INAUGURAL EDITION in a swimming pool to good health and quality Issue 18–2002 HEALTH 2004 EDUCATION Issue 1–1994 YOUNG PEOPLE of life, and therefore VicHealth’s origins provided Issue 22–2004 HEALTHY PLANET, CAMPAIGNS Another VicHealth Letter Issue 4–1996 must be addressed as part us with a unique position In 2002 the health status HEALTHY PEOPLE Issue 33–2008 on the important issue Inaugural edition of the of improving Australia’s from which to examine the of Indigenous people A special edition on what Issue 26–2006 THE GOLD MEDAL of raising awareness on VicHealth Letter, originally This edition provided an overall health.” tobacco issue, publish our in Australia was still was to come when FOR PARTICIPATION The articles in this edition the need to help reduce called the VicHealth Action overview of VicHealth’s Professor Rob Moodie position on it and advocate worse than the rest of Melbourne hosted the 18th VicHealth Letter pushed Issue 29–2007 encouraged a closer look at health inequity. Report. Former VicHealth research and funding to MEN AND WOMEN for redoubled pressure the population. Koori World Conference on Health the debate forward about the methods of marketing Chair Professor Emeritus establish facts on health Issue 6–1997 on one of the single largest communities, with the Promotion and Health how sectors can work Former VicHealth Board as a potential toolbox for WORK AND HEALTH Sir Gustav Nossal’s opening promotion practice causes of preventable support of VicHealth and its Education. In this issue we better together to promote Member Lindsay Gaze health promotion. Feature Issue 35–2010 message celebrates directed at changing young In the 1997 ‘Men & death in Australia today. partners, have embarked spoke with indigenous health healthy environments and provided an editorial in this insights from Professor successful cross-sector people’s risk behaviour. Women’ edition we Since VicHealth was on an innovative series experts from Canada and featured some influential edition that explored some Rob Donovan, Professor This VicHealth Letter provided DIGITAL collaboration to reduce the It featured an interview featured our prevention established we have seen of programs designed to New Zealand; we found out commentators to contribute of the challenges of a public of Social Marketing in the a broad picture of healthy INNOVATIONS reliance sports and the arts with Tammy Curtis on programs focused on MENTAL HEALTH some enormous changes improve the health status what rapid globalisation to this edition, including health/sport partnership School of Marketing at workplaces and hoped to Issue 38–2013 had on tobacco industry the value of VicHealth’s the different gender needs, Issue 10–1998 and certainly have much of Indigenous Victorians. means for health; we looked Professor Ian Lowe, and highlighted examples Curtin University WA, and promote further discussion sponsorship, and the role sponsorship of Volleyball as well as those within to be proud of. But we These initiatives and at a successful bullying Richard Eckersley, Dr Iain of how sport is attracting Professor Mike Ewing, Head of what makes for positive An edition on finding VicHealth plays in delivering Victoria and the National the communities of Kooris, Professor Rob Moodie’s continue to be vigilant and our contribution on this prevention program; and Butterworth, Professor more participants of Marketing in the Faculty changes and what some new ways to use digital health messages to the Heart Foundation’s Heart migrants and people first editorial as CEO for this maintain the pressure to important health issue were at the UN’s global report on Evelyn de Leeuw and Doctor and promoting healthy of Business & Economics organisations do to imple- technology to facilitate community. Health message. with disabilities. edition on mental health. drive down smoking rates. explored in this edition. the challenge of the slums. Mardie Townsend. environments. at Monash University. ment positive programs. innovative collaboration. 1994 1996 1997 1998 2000 2002 2004 2006 2007 2008 2010

40 EDITIONS1999 2001 OF2003 VICHEALTH2005 2009LETTER2013 2014 MENTAL HEALTH OLDER PEOPLE FAMILIES & HEALTH MOTHERS’ AND PHYSICAL ACTIVITY RESEARCH A GROWING CONCERN RESPECT, MAKING THE LINK FROM MARGINS HEALTHY VICHEALTH TAKES PROMOTION EDITION Issue 5–1996 PROMOTION CHILDREN’S HEALTH Issue 16–2001 Issue 20–2003 Issue 24–2005 RESPONSIBILITY BETWEEN CULTURAL TO MAINSTREAM ENVIRONMENTS CENTRE STAGE IN Issue 2–1994 As the number and Issue 7–1997 Issue 11–1999 The trend of decreasing VicHealth has a core focus A VicHealth Letter devoted AND EQUALITY DISCRIMINATION AND Issue 34–2009 Issue 36–2013 THE ARTS Issue 28–2006 Issue 39–2014 Mental health promotion proportion of older One of the key goals VicHealth believes rates of physical activity on building evidence to to the issue of physical HEALTH Special edition: From How do the places we Australians increase, cuts across all ages and support health promotion activity and children. has been a high priority of health promotion improved outcomes in This VicHealth Letter Issue 30–2007 Margins to Mainstream live, learn, work and play An exciting edition featuring health promotion social groups. Increasing and public health activity. for VicHealth from its early must be to support the child and maternal health featured an editorial by reported on a conference influence our health? In our arts investments needs to recognise the the rates of physical Since 1999 we have Todd Harper as CEO co-wrote years. This edition, with a development of healthy will influence the health AN OUNCE OF VicHealth CEO Rob Moodie hosted by VicHealth and this edition we explored with Melbourne Now and importance of supportive activity requires a multi- commissioned research an editorial with Professor foreword by inaugural CEO families with all the status of the population as PREVENTION IS and Chief Commissioner co-organised with the why creating healthy White Night Melbourne and healthy environments faceted approach at both when necessary to answer Ian Anderson in this issue of Rhonda Galbally, is one different manifestations we grow older. Perhaps in Victoria Police Christine World Federation for environments is critical our research into obesity for older people, as this the policy and community broad questions related WORTH A POUND the VicHealth Letter on raising of many dedicated to the of diversity in family no other stage of life is the Nixon on the work of Mental Health, the Mental to our wellbeing and is trends and lack of physical edition highlighted. level. In this issue we to policy and programs. OF CURE awareness of the problem of outstanding research we structures. This edition health and wellbeing of two VicHealth and our partners Health Program of the the purpose of VicHealth’s activity among children. presented views from The edition looked at our Issue 25–2005 discrimination and its associated have funded in this area. focused on VicHealth’s individuals so intricately to raise awareness of Carter Center and The work in this area. It also featured a special a range of individuals and investment in research health, social and economic family-related projects. bound than during these In this issue the VicHealth violence against women Clifford Beers Foundation. In the foreword VicHealth interview with Australia’s organisations to discuss to make the critical costs, as well as some ideas early development years. Letter looked at the many and its impacts in the The Melbourne Charter for CEO Jerril Rechter prolific and well-known how the rates of physical link between research towards reducing it. ‘Victorian study leads This issue looked at building barriers to investing in community Mental Health Promotion introduced a refreshed social researcher, writer the way in family cancer the self-esteem of young activity can be improved. and practice. was an outcome of the VicHealth’s first Chief public health and examined TO YOUR HEALTH? VicHealth Letter edition on and commentator Hugh research’ – VicHealth- mums and helping women conference and formed Executive Officer Rhonda Professor Rob Moodie ‘Public Health: Winning what needs to be done EXPLORING WHAT’S the links between health Mackay, pictured. funded research into the with post-natal depression. part of the Victorian Galbally created a strong is joined by the Governor Dividends’ an interview to overcome these barriers. and the environment that genetic and environmental SAFE, SENSIBLE AND Government’s Mental brand for VicHealth in of Victoria John Landy, with the former Federal The articles cast light are beyond the obvious. factors contributing to SOCIAL Health Reform Strategy. her leadership role from AC, MBE at VicHealth’s Minister for Health and on a number of different the development of breast Issue 31–2007 ‘Together We Do Better’ Ageing The Hon. Kay facets of the interaction 1987 to 1998. and bowel cancer has campaign launch. Patterson on a report between health promotion become the world’s largest Alcohol is entrenched in our by the Commonwealth and prevention concepts, population based family society: we use it to celebrate, Department of Health our practice, and the cancer study. commiserate, relax and socialise. and Ageing examining decision-making process However, alcohol is a common the economic and social in our society. companion of violence and benefits of public health injury, unsafe sex, crime, poor programs in 2003. mental health, car smashes and workplace absenteeism. This VicHealth Letter explored the role of alcohol in our lives. 18 VicHealth Letter/40 19

Findings from the 2013 National Community Attitudes towards Violence Against AUSTRALIANS’ Women Survey (NCAS) ATTITUDES TO VIOLENCE AGAINST

WOMENWith the most recent evidence showing Research shows that many of the causes of violence against women The significance of this finding is explained in a comprehensive new that more than one in three Australian can be eliminated. VicHealth’s work over many years has found that VicHealth report, Australians’ attitudes to violence against women: the promotion of respectful relationships between men and women – Findings from the 2013 National Community Attitudes towards Violence 1 women, since they turned 15 years, has in the home, workplace and community – is one of the biggest themes Against Women Survey, that steps readers through the evidence relating experienced violence by a male perpetrator, for action. to the varied factors that drive violence against women. It states: VicHealth is actively working to drive The 2013 National Community Attitudes towards Violence Against People tend to see violence as caused primarily by the Women Survey (NCAS) touches at the heart of this theme by exploring evidence and best practice in this area. characteristics of individual men using violence. This is in contrast changes in community attitudes over time. to the evidence which shows that violence is learned behaviour NCAS is a unique and comprehensive Australia-wide piece of and that social factors such as the media, laws and the attitudes research that has been conducted at intervals: first in 1995, then of others are strong influences. (p10) 2009 and 2013. The 2013 survey was led by VicHealth and developed in partnership with The University of Melbourne, the Social Research The goal of the NCAS is to learn about community knowledge of, and Centre and experts across Australia, and supported by the Australian attitudes towards, violence against women, with the aim of using this Government Department of Social Services as part of the National Plan understanding to identify areas that need to be targeted in the future. to Reduce Violence against Women and their Children 2010–2022. The survey also helps to identify niche populations that could benefit The survey, which takes a snapshot of the nation’s attitudes and from anti-violence work. beliefs regarding violence against women, and gender roles and relationships, has identified that over the past four years the most significant shift has occurred among young adults. In 2009, around 38 per cent of young people had high attitudinal support for violence against women; this decreased to 31 per cent over the four-year period to 2013.2 Even more significantly, the attitudes of young men towards supporting violence against women dropped from 48 per cent in 2009 to 38 per cent in 2013.2 20 VicHealth Letter/40 21

The research featured more than 17,500 20-minute While these findings are encouraging for those working to reduce and Read the findings from the survey: NCAS FINDINGS AT A GLANCE telephone interviews with Australians aged 16 years and eliminate violence against women in our community, the survey also had Findings from the 2013 National older that were conducted between January and May some concerning findings: many people agree that women caught up in Community Attitudes towards Violence The majority of Australians have a good knowledge 2013. The data is evenly weighted to account for gender, family law cases make up claims of family violence; compared to 2009, Against Women Survey (NCAS): of violence against women and do not endorse most age, socioeconomic status and cultural background. more people believe that rape occurs because men cannot control their www.vichealth.vic.gov.au/ncas attitudes supportive of this violence. Other key findings indicate that most Australians do desire for sex (up from three in ten in 2009 to four in ten in 2013); and Watch the video for an overview not justify violence and see it as a serious issue: fewer people say they would know where to go for help with a partner On the whole, Australians’ understanding and attitudes of the findings from the survey: violence issue (57% in 2013 compared to 62% in 2009). www.vichealth.vic.gov.au/ remained stable between 2009 and 2013. However, when An overwhelming majority recognise that partner Recognising that much work lies ahead to change the community Publications/Video-Gallery/NCAS you look at the findings from individual questions, some violence (96%) and assault in a relationship (88%) are attitudes that underpin violence against women, VicHealth is partnering areas improved, whereas others became worse. against the law. with other agencies to assist in spreading knowledge about evidence- The media release: www.vichealth. based strategies to achieve positive results. vic.gov.au/Media-Centre/Media- Young people’s attitudes remain an area of concern; Few believe (4–6%, depending upon the scenario put to VicHealth CEO Jerril Rechter says the recent partnership with the newly Releases-by-Topic/Freedom-from- however, their attitudes are gradually improving over them) that violence against women can be justified and established national initiative aimed to prevent violence against women violence/Australians-views-on- time, particularly among young men. Fewer young people only a minority believe it can be excused. and their children, Our Watch (also known as the Foundation to Prevent violence-against-women-still-poor- in 2013 hold attitudes at the extreme end of the spectrum. in-2014 The understanding that violence against women is serious Violence Against Women and Their Children), will integrate the findings People’s understanding of violence against women and has remained consistently high (95%) over the 2009 and and resources of our work and elevate them to a national level. For more information on Our Watch their attitudes to gender equality have significant impacts 2013 Surveys. “We want to see primary prevention at the heart of efforts to tackle visit: www.ourwatch.org.au on their attitudes to violence against women. violence against women across Australia and to extend this work to more Most people recognise that violence against women everyday settings such as schools and workplaces,” said Ms Rechter. is about more than physical assault and that it Our Watch Board Chair, Natasha Stott Despoja, says the drive to includes a wide range of behaviours designed to control impact on the high level of violence against women must be harnessed and intimidate. to achieve change. WHY STUDY ATTITUDES? “The NCAS tells us that we have been able to challenge a culture that “ Further to the above point, there has been an increase in allows violence against women to occur. We know that further change While attitudes may influence behaviour directly, their the number of people agreeing that social and emotional is possible,” said Ms Stott Despoja. We want to main impact is through their influence on broader social abuse is serious (up from 70% to 79%). The Victoria Police is one of the agencies at the coalface when it comes see primary norms and cultures. This means that the strongest Most people think that tracking a partner via computer or to violence against women. Chief Commissioner Ken Lay is a vocal supporter influences on how people respond in situations are: mobile telephone without permission is serious (85%) and of the evidence about what drives violent behaviour. prevention at – what they believe other people, especially influential unacceptable (61%). “This survey clearly demonstrates we must educate men that people, believe or expect of them demeaning and sexist behaviour has a direct link to gender based violence. the heart of – expectations that are communicated through other formal The Indigenous community is more likely to identify that We need to change the language, the attitude and the misogynistic efforts to tackle social mechanisms, such as policies, rules or laws.3, 4 violence against women in common and regard certain behaviour that lies at the very heart of male violence towards women,’’ behaviours as serious. says Mr Lay. violence against Research from the report has found that attitudes contribute The most recent survey findings add to the understanding generated to violence against women in a number of ways: Most people do not believe that women should remain by research, funded by VicHealth and conducted by Dr Anastasia Powell women across – violence against women is more common in organisations in a violent relationship or that family violence ought be and the Social Research Centre, that bystander responses towards and communities in which violence-supportive attitudes Australia.” 5, 6, 7, 8, 9 kept private. disrespectful attitudes to women can make a difference to the social are common conditions that promote violence against women. – men who hold violence-supportive attitudes are more Most people say they would intervene or report if likely to commit, or say they would commit, violence.10,11 they witnessed violence, although they were more likely Evidence has shown that bystanders – that is, witnesses to sexism, to do so if the victim was a friend (98%) rather than discrimination or violence – can help reduce violence against women If you or someone you know is impacted by sexual assault by speaking up against sexist attitudes and discriminatory organisational a stranger (92%). or family violence, call 1800RESPECT on 1800 737 732 policies when they see them. By confronting the attitudes that support or visit www.1800RESPECT.org.au. In an emergency, violence against women when they see them, bystanders can help reduce call 000. the incidence of it in the community. Report co-author Dr Powell, of RMIT University, said to prevent violence we must work together to reject inequality and build a culture of respect. “Make no mistake, to address, and ultimately prevent, violence against women in our community we also have to challenge the sexism, stereotypes and discrimination that women experience every day,’’ says Dr Powell. 22 VicHealth Letter/40 23

“ 42% of young Victorian adults feel pressure to drink and many feel the need to use an excuse for saying no to another drink.”

THE CONVERSATION WE HAD TO HAVE ON ALCOHOL

It’s telling that the only times we Evidence abounds about the ways alcohol is woven into our social It encouraged young people to share their experiences and thoughts VicHealth’s communication with young people on alcohol continues fabric. It’s to be found in everyday life and at special occasions, about drinking via questions on the NameThatPoint website and social with phase two of the Alcohol Cultural Change program, a campaign consider drinking inappropriate are from having a couple of quiet ones on a weeknight to booze-fuelled media. They discussed subjects including their drinking habits, how called No Excuse Needed, launched on September 24. To inform and at church, at a baby shower or in weddings, parties and funerals. But our relationship with alcohol is they avoid intoxication and their views on the positives and negatives support this program VicHealth, with funding from the Victorian a study group. Virtually everywhere double-edged: on the one hand, according to VicHealth research,2 of alcohol. Law Enforcement Drug Research Fund, and working with the Social Victorians admit they are fond of drinking – it makes socialising fun, Central to NameThatPoint was a competition to name the moment in Research Group, conducted an Australian-first population-wide survey else, the research tells us, it’s reduces stress and smooths the path to new friendships. On the other the evening when clear thinking turns to more drinking. The campaign, to measure Victoria’s alcohol culture. culturally acceptable for Victorians hand, there is disquiet about the negative effects: hangovers, violence, run over 17 weeks (December 2013 to March 2014), had quite an Our research shows that 42 per cent of young Victorian adults (aged to drink.1 the financial cost and the mistakes made after too many drinks.3 impact: the video was viewed over 143,000 times, there were nearly 16–29) feel pressure to drink and many feel the need to use an excuse Although the negative health effects of heavy drinking are broadly 46,000 unique visits to the website and 1,800 submissions to the for saying no to another drink5. In fact 61 per cent of young Victorian recognised risky drinking continues to be much more common among competition. Michael Sanders, a 24-year-old from Fitzroy, won for his drinkers do not drink to get drunk,6 which indicates that the majority those aged 16–29.4 submission ‘The Chill Point’, which he described as “the point in the of young people want to drink moderately, but need to be empowered As part of Reducing the Alcohol and Drug Toll: Victoria’s plan night where you have to chill out, reassess and have clarity so you can to do so. 2013–2017, the Victorian Government partnered with VicHealth to continue your night in a safe and fun manner.” The No Excuse Needed campaign uses humour to show young engage and empower young people to challenge Victoria’s heavy An evaluation of NameThatPoint conducted by Colmar Brunton, a Victorians they don’t need an excuse if they don’t want to keep drinking. drinking culture and, ultimately, influence social norms around how market research agency, which included a survey of people who took Young Victorians perceive intoxication as acceptable behaviour because we are drinking. The Alcohol Cultural Change project is funded for part in the campaign, found it was effective in reaching the target audience they believe most of their peers drink the same or more than they two years and comprises two phases. VicHealth CEO Jerril Rechter and prompting them to think about alcohol and its place in their lives. do. However, this isn’t the case and such misperceptions create an describes the first phase of the campaign as “the conversation we Colmar Brunton Managing Director Jenny Witham said there was unhealthy drinking culture where moderation gives way to excess. as a society needed to have – to enable us to come up with solutions an overwhelmingly large amount of positive feedback for the campaign as a community”. by the public. The campaign, NameThatPoint, was unlike other public health “Respondents said they thought it was a realistic campaign because To find out more about the Alcohol Cultural Change program visit: marketing efforts to reduce excessive alcohol consumption in it wasn’t trying to stop people drinking entirely but to be sensible about www.vichealth.vic.gov.au/alcoholculturalchange Australia, which depict harms from drinking alcohol. NameThatPoint it. They also found it to be non-judgmental, entertaining and relatable. For selected findings from the Alcohol Cultural Change report, took a different approach by trying something new and engaging “While it wasn’t the primary purpose of the campaign, we were A snapshot of Victoria’s alcohol culture: Selected findings, go to: people in a positive conversation about Victoria’s drinking culture. also very pleased to see that a significant proportion of users – three in www.vichealth.vic.gov.au/alcohol-culture-report 10 – reported they had modified their behaviour and drank less alcohol More on the No Excuse Needed campaign at: as a result.’’ www.noexcuseneeded.com.au 24 VicHealth Letter/40 25

ALCOHOL KILLS INEQUITIES IN ALCOHOL AND NEW VICHEALTH RESEARCH National Health and Medical Research Centre CHRONIC DISEASES INNOVATION GRANTS ROUND, (NHMRC) Partnership Grants and the ARC Linkage Grants. A Turning Point study has revealed men ARC LINKAGE GRANT ROUND AND FUTURE FUNDING Expressions of interest for NHMRC and the middle aged are among those most Partnership Grants will open in January 2015. VICHEALTH NT likely to suffer from wholly alcohol-caused VicHealth’s 2014 Research Innovation Grants 116 QLD Look out for more details on our website: 1,143 chronic diseases. round aims to provide an opportunity for WA Funded by VicHealth, the Inequities research teams to trial an innovative idea, ARC Linkage Projects: RESEARCH UPDATE 592 www.vichealth.vic.gov.au/Research/VicHealth- SA in alcohol-related chronic disease in Victoria research a new concept or methodology, 426 Research-Grants/ARC-Linkage-Projects NSW report found men accounted for seven out or develop better supporting evidence NHMRC Partnership Project Grants: 1,837 of ten wholly alcohol-attributable chronic for health promotion in support of our Action ACT www.vichealth.vic.gov.au/NHMRC-Partnership- 73 disease (WACD) hospital patients and deaths Agenda. Previously offered in 2010 and 2012, VIC Project-Grants in Victoria. a refreshed innovation grants round will 1,214 VicHealth Innovation Research Grant: Australians TAS Chronic diseases can include cardiovascular, open on Monday, 3 November 2014. every day 155 www.vichealth.vic.gov.au/Research/VicHealth- 15 digestive and neurological conditions as well VicHealth’s most recent Australian Research-Grants/Innovation-Grants Australians as a range of cancers. Research Council (ARC) Linkage grant round each year 5,554 People with WACD have a hospitalisation closed on 7 July 2014, with 38 expressions of median age range from 47 to 49 years interest to partner with VicHealth received. and a median age of death range from 58 We congratulate Dr Rebecca Bentley to 62 years. (The University of Melbourne) and colleagues “ The research examined a range of factors on their success with the 2013 research It is predicted that in 2,087 3,467 that influence alcohol consumption and project titled ‘The Association of Local and per year per year vulnerability to alcohol-related harms Regional Accessibility with Active Travel 11 years, 44 per cent in Victoria, including age, gender, residential and Physical Activity: Health and Economic location and social disadvantage. Impacts’ in which VicHealth will be an of people with the Infectious & parasitic Cancers 31% 25% industry partner. diseases 6% 4% Download the Inequities in alcohol-related chronic greatest disadvantage As an industry partner, VicHealth will also Cardiovascular disease in Victoria report: Injuries 12% 36% diseases 34% 13% www.vichealth.vic.gov.au/Publications/ continue to support significant investigator- and least resources Digestive diseases Neuropsychiatric  Alcohol-Misuse/Inequities-in-alcohol-related- led research funding rounds including the 11% 16% diseases 6% 7% chronic-disease will be obese.” ALCOHOL’S BURDEN OF DISEASE IN AUSTRALIA ALCOHOL The first study in a decade of the impact THE FUTURE OF OBESITY of drinking on Australians’ health shows HOSPITALISES IN AUSTRALIA significant increases in injury, disease and death due to alcohol. A report on obesity in Australia contains The Alcohol’s burden of disease in Australia highlights from nine years of research report was funded by VicHealth and the NT by world-leading obesity expert Associate 2,708 QLD Foundation for Alcohol Research and 33,974 Professor Anna Peeters, while she was Education (FARE). It found that alcohol causes WA VicHealth’s Research Fellow from 2004 17,448 15 deaths and hospitalises 430 Australians SA to 2013. 10,560 every day. NSW 48,152 Key research findings: The research, conducted by Turning Point ACT – By 2025, an estimated 83 per cent of men Alcohol & Drug Centre, led by Dr Belinda 2,273 Researcher profile VIC and 75 per cent of women will be obese Lloyd, found that the Northern Territory 39,381 Dr Belinda Lloyd leads the Population or overweight, some 16.9 million Australians. had the highest proportion of alcohol- Australians TAS Health Research Program at Turning Point every day 2,636 – It is predicted that in 11 years, 44 per cent related deaths – at three times the national 430 Alcohol & Drug Centre. Dr Lloyd has a of people with the greatest disadvantage and average. Nationally, nearly 9 per cent of Australians PhD in epidemiology, utilising large-scale each year least resources will be obese, compared to hospitalisations for men and 5.3 per cent for 157,132 longitudinal data. She is a regular presenter 31 per cent of those with the most resources. women were linked to alcohol consumption. at national and international conferences on Multiple strategies, policies and programs will There were clear distinctions between the epidemiological research relating to alcohol be needed to turn the tide as Australia is now drinking habits of men and women, with some and other drugs. home to the world’s fastest increasing rate 13 per cent of men consuming more than of obesity. four standard drinks per day, compared with Alcohol’s burden of disease in Australia report 55,707 101,425 per year per year 3.3 per cent of women. The alcohol-related can be found at: Download Negative growth: the future of www.vichealth.vic.gov.au/alcoholandinequity deaths and hospitalisations also varied Obesity in Australia research highlights and recommendations: between the sexes, with injuries – such as Infectious & parasitic www.vichealth.vic.gov.au/Publications/ Cancers 9% 5% car accidents and falls – comprising a higher diseases 7% 5% Healthy-Eating/Research-summaries/The-future- proportion (36 per cent) of alcohol-related Cardiovascular of-Obesity-in-Australia Injuries 32% 47% deaths for men, while cardiovascular disease diseases 6% 7% caused the alcohol-related deaths of more Digestive diseases Neuropsychiatric  5% 7% diseases 41% 30% women (34 per cent). 26 VicHealth Letter/40

ACKNOWLEDGEMENTS REFERENCES

VicHealth would like to thank the Innovative ideas to lead health promotion 6 Bleecker, ET & Murnen, S 2005, ‘Fraternity following for their contribution: in a new direction Membership, the display of degrading sexual images of women, and rape myth acceptance’, Sex Roles Dr Shin Young-soo, Regional Director for the 1 Thaler, R 2010, ‘David Cameron’s ‘nudge unit’ aims vol. 53, no. 7-8, pp. 487-493. Western Pacific, World Health Organization to improve economic behaviour’, The Guardian, viewed 10 September 2014, http://www. 7 Koenig, MA, Stephenson, R, Ahmed, S, Jejeebhoy, Atika Fraval of Ellis Jones theguardian.com/society/2010/sep/09/cameron- SJ & Campbell J, 2006, ‘Individual and contextual Amy Coopes, freelance writer nudge-unit-economic-behaviour. determinants of domestic violence in north India’, American Journal of Public Health, vol. 96, no. 1, Jan Owen AM, Doctor Jenny Proimos, 2 Office Behavioural Insights Team 2010, pp. 132-138. Associate Professor Jane Burns, Applying behavioural insight to health, discussion Winthrop Professor Stephen Zubrick paper, viewed July 2014, www.gov.uk/government/ 8 Locke, BD & MAhalik, JR 2005, ‘Examining Professor David Hill, Associate Professor uploads/system/uploads/attachment_data/ masculinity norms, problem drinking and athletic Anna Peeters, Professor Billie Giles-Corti, file/60524/403936_BehaviouralInsight_acc.pdf?. involvement as predictors of sexual aggression Professor Sir Gustav Nossal AC, CBE, FRS, in college men’, Journal of Counseling Psychology Building resilience for young people to flourish FAA, Professor Rob Moodie, The Honourable vol. 52, pp. 279-283. Alex Chernov AC QC, Doctor Nigel John 1 Keyes, CLM 2002, ‘The mental health continuum: 9 York, MR 2011, Gender Attitudes and Violence Against Gray AO and Mr Paul Briggs From languishing to flourishing in life’, Journal of Women, El Paso, Texas: LFB Scholarly Publishing. Health and Social Behaviour, 43, pp.207-222. Nicole Brady, freelance writer 10 Abrahams, N, Jewkes, R, Laubscher, R & Hoffman, 2 Huppert, FA & So, TTC 2013, ‘Flourishing across Julia May, freelance writer M 2006, ‘Intimate partner violence: prevalence and Europe: Application of a new conceptual framework risk factors for men in Cape Town, South Africa’, Greg Alford, freelance editorial services for defining wellbeing’, Social Indicators Research, Violence and Victims, vol. 21, no. 2, pp. 247-264. Shareen Wong, Romany Mollison design 110, pp.837-861. 11 Bohner, G, Siebler, F & Schmelchers, J 2006, ‘Social 3 Foresight Mental Capital and Wellbeing Project norms and the likelihood of raping: perceived 2008, ‘Final Project Report – Executive Summary’, rape myth acceptance of others affects men’s London: The UK Government Office for Science. IMAGES rape proclivity’, Personality and Social Psychology 4 Bernard, M, Stephanou, A & Urbach, D 2007 Bulletin, vol. 32, no. 3, pp. 286-297. Front cover design: Emerystudio ‘Student Social and Emotional Health Report’, The conversation we had to have on alcohol Melbourne: Australian Scholarships Group. Internal images: p4, main image Carla 1 VicHealth 2013, Drinking-related lifestyles: exploring Gottgens for VicHealth; (smaller images 5 Resnick MD, Bearman P, Blum R 1997. ‘Protecting the role of alcohol in Victorians’ lives, Victorian Health from left to right): Thinkstock, Joseph Fiel, adolescents from Harm: Findings of the National Promotion Foundation, Melbourne. Thinkstock, p5 Getty Images, p7 Fairfax Longitudinal Study on Adolescent Health’, JAMA, Media Syndication, p8 Joseph Fiel, p11 278(1), pp.823-832. 2 VicHealth 2013, VicHealth Alcohol Cultural Change (headshots left to right) photo courtesy Research, Qualitative Report: Results of Integrated 6 Bond L, Butler H, Thomas L, Carlin J, Glover S, of Foundation for Young Australians, photo Groups, Victorian Health Promotion Foundation, Bowes G & Patton G, ‘2007 Social and school courtesy of Department of Education and Melbourne (unpublished). Early Childhood Development (Victoria), connectedness in early secondary school as photo courtesy of Young and Well Research predictors of late teenage substance use, mental 3 Ibid. health, and academic outcomes’, Journal of Centre, photo courtesy of Telethon 4 Foundation for Alcohol Research and Education Adolescent Health, 40, e9-e18. Kids Institute, pp12–13 photo courtesy 2013, Foundation for Alcohol Research and Education of Andrew Lucas Photography for Cancer 7 Ibid. Poll: attitudes and behaviours, Foundation for Council Victoria, photo courtesy of Baker Alcohol Research and Education, Canberra. IDI Heart and Diabetes Institute, photo Australians’ attitudes to violence against women 5 VicHealth 2014, A snapshot of Victoria’s alcohol courtesy of Professor Billie Giles-Corti, 1 ABS (Australian Bureau of Statistics) 2013, culture: Selected findings, Victorian Health photo courtesy of The University of Personal Safety Survey 2012, cat. no. 4906.0. Promotion Foundation, Melbourne. Melbourne, photo courtesy of Professor viewed 20 July, www.abs.gov.au/ausstats/abs@. Rob Moodie, photo courtesy of The nsf/mf/4906.0. 6 Ibid. Honourable Alex Chernov AC QC, photo courtesy of Cancer Council Victoria, p24 2 VicHealth 2014, Australians’ attitudes to violence (main image) Thinkstock, photo courtesy against women. Findings from the 2013 National of Turning Point Alcohol & Drug Centre, Community Attitudes towards Violence Against p25 Thinkstock. Women Survey (NCAS), Victorian Health Promotion Foundation, Melbourne, Australia.

3 Flood, M & Pease, B 2006, The Factors Influencing Community Attitudes in Relation to Violence Against Women: a Critical Review of the Literature, Victorian Health Promotion Foundation, Melbourne, Australia.

4 Flood, M & Pease, B 2009, ‘Factors influencing attitudes to violence against women’, Trauma, Switching sugary soft drinks to water can reduce tooth decay. Design: Emerystudio Violence and Abuse, vol. 10, no. 2, pp. 125-142. It’ll make you smile so much you may never want to switch back. Printer: Invicium Pty Ltd 5 Antai, D 2011, ‘Traumatic physical health consequences of intimate partner violence against Products, services and brands that are women: what is the role of community-level mentioned or appear in this publication are factors?’ BMC Women’s Health, vol. 11, no. 1, p. 56. owned by and/or registered trademarks of H3OChallenge.com.au their respective proprietors. Authorised by the Victorian Government, 1 Treasury Place, Melbourne.

VHE 0044 297x210 Water_Soft Drink_Press.indd 1 24/09/14 3:59 PM