Select Committee into the Epidemic in Submission from the Australian Health Policy Collaboration, University The Australian Health Policy Collaboration (AHPC) is pleased to have the opportunity to lodge a submission in response to the Submission to the Select Committee into the Obesity Epidemic in Australia. Key recommendation:  Australia should adopt the expert endorsed 2025 targets in Australia’s Health Tracker 2016: o Halt the rise in obesity o Halt the rise in new o A 10% reduction in insufficient physical activity  Australia should adopt the recommendations in the AHPC policy paper Active Travel to promote children walking, riding, scooting to and from school.

The AHPC at Victoria University works with and supports a collaborative national network of organisations and chronic disease experts, bringing together Australia’s leading chronic disease experts, scientists and clinicians to translate rigorous research into good policy. The national collaboration has developed health targets and indicators for 2025 that, together, can reduce preventable chronic diseases and reduce the health impacts of chronic conditions in the Australian population. These targets and indicators are aligned with the World Health Organisation (WHO) Global Action Plan for the Prevention of and Control of Non-Communicable Diseases 2013 – 2020, with the additional target area of mental health, and were tailored to the Australian context.

The targets and the performance of Australia against those targets is presented in Australia’s Health Tracker 2016. This includes a set of targets for obesity for children, adolescents and adults. Our national expert working group has recommended targets to ‘Halt the rise in obesity’ for adults and for children and young people.

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The AHPC recommends that the Senate Committee consider adopting the national obesity targets and indicators developed and endorsed by Australia’s leading public health and chronic disease organisations and experts. Further, we recommend that the Senate Committee consider adopting the national targets for diabetes and physical inactivity, which are correlated with obesity.

Adopting targets is an important first step in preventing and reducing overweight and obesity rates in Australia and help achieve a healthier, productive and more socially inclusive Australia. There is unanimous endorsement from Australia’s leading experts and health organisations on the importance of adopting these overarching set of national chronic disease targets and indicators as a means of measuring progress and enhancing accountability for action. Adopting these targets will also demonstrate commitment, leadership and investment into a national prevention agenda.

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About the Australian Health Policy Collaboration The Australian Health Policy Collaboration (AHPC) at Victoria University works with and supports a collaborative network of organisations and leading chronic disease experts, bringing together Australia’s leading thinkers to translate rigorous research into good policy. The AHPC is leading a national collaboration of more than 50 high-profile organisations and 70 chronic disease scientists, researchers and clinicians. The national collaboration has developed health targets and indicators for 2025 that together, will reduce preventable chronic diseases and reduce the health impacts of chronic conditions.

The AHPC has developed two integrated and interdependent programs of work:

 a national Health and Public Policy Strategy to prevent and reduce the impact of chronic diseases in the Australian population; and,

 the Growing Brimbank program, a unique place-based initiative between the AHPC, Victoria University and the Brimbank City Council in the western suburbs of Melbourne that has established a long-term translational research program to lift health, development, wellbeing and education outcomes in Brimbank. The Australian Health Tracker targets will be used to guide health and other interventions in this program.

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Targets and Indicators for Chronic Disease Prevention Australia is part to the World Health Organization’s (WHO) Global Action Plan for the Prevention and Control of Noncommunicable Diseases (NCD) 2013-2020. The WHO states that all countries need to set national NCD targets; develop and implement policies attain them; and establish a monitoring framework to track progress. In 2015, the collaboration drew on the agenda set by the WHO Global Action Plan and the Mental Health Action Plan 2013-2020, to develop a set of targets and indicators for achievement by the year 2025. The AHPC supported project established seven working groups to review the suitability of the WHO targets and proposed targets and indicators for their subject in the targets and indicators for chronic disease prevention in Australia report. A summary of the WHO targets and AHPC working groups are listed in Table 1.

Table 1 WHO targets and AHPC working groups The Diabetes and Obesity Expert Working Group The AHPC diabetes and obesity working group is one of seven expert working groups that have worked with the AHPC to develop the targets and indicators. This group is comprised of leading academics, implementers and policymakers. Refer to Appendix I for full membership.

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Below is an excerpt taken from the Diabetes and Obesity chapter in Targets and indicators for chronic disease prevention in Australia highlighting the importance of the 2025 targets.

“The key population-based strategy to halt the rise in obesity and diabetes is preventing weight gain in adults and unhealthy weight gain in children. This requires action over a variety of policy areas (summarised in the Appendix). The target for diabetes and obesity will be very challenging for Australia to achieve, but is a worthwhile goal that will have significant population health benefits. The WHO timeline of 2025 is ambitious. Monitoring is essential to this endeavour; reporting will not be possible without an ongoing commitment for a nationally representative data collection occurring at least every five years. Similarly, reporting standards need to be agreed to ensure relevant data results from these collections.”

In 2016, the AHPC together with the national collaboration produced Australia’s first comprehensive national report card on preventable chronic diseases. Australia’s Health Tracker builds on work undertaken by the expert working groups that produced health targets to support, guide and track progress towards a substantial change in the health of our nation. This national report card graphically highlights where preventative health policy efforts have been successful in tackling risk factors for chronic disease in Australia. It also shows where Australia is lagging behind world standards and failing to prevent chronic diseases.

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AHPC Response to the Terms of Reference The prevalence of overweight and obesity among children in Australia and changes in these rates over time Over the past forty years the prevalence of overweight and obesity among children has increased at an alarming rate. It remains high today and is expected to rise in the future (1-3). In Australia the prevalence of overweight/obesity in 1969 was approximately 8% among young males and 12% among young females (4) and is now 28% among males and 27% among females (2014-15; 5 to 17 years) (5). It is important to take note of the patterning of the rise. From the 1980s to the 2007 there was a very sharp increase then a lessening but the prevalence is still unacceptably high (2, 5). This pattern where whole populations increased in levels of overweight and obesity suggests environmental factors rather than individual factors like genetics drove the change. Australia’s food environment started changing in the 1970’s with the opening of fast food chain restaurants.

Prevalence of overweight and obesity Australian children 40

35

30

25

20

15

10

5

0 1969 1969-85 1995 2007-08 2011-12 2014-15

Males Females

Figure 1 Change in prevalence of overweight/obesity among Australian children from pre-1969 to 20114-15* The causes of the rise in overweight and obesity in Australia The causes of the rise in obesity are many. There are individual behaviours around food, physical activity, sedentary behaviours, mental health and sleep and wider influences such as obesogenic environments and policy environments (6-9). People are now eating more processed foods laden in kilojoules, drinking more sugary drinks, exercising less, spending more time in sedentary pursuits, and reporting poorer mental health, than in the past. All these factors contribute to overweight and obesity.

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The environments in which we live, play and work have also changed dramatically since the 1970’s. Participation in all forms of sport and physical activity has decreased. Up to 45% of adults, 71% of children and 92% of young people do not meet the recommended guidelines for physical activity in Australia (10). There needs a coordinated, systems approach through the life course from early childhood to older age to address these complex drivers of obesity (11-13). Education and work places need to encourage/mandate physical activity opportunities and physical environments need to cater for modes of active transport (14).

Driving has become the usual mode of transport and infrastructure has changed to enable this (15). Suburbs have become car friendly rather than pedestrian or bike or other modes of active transport friendly (15). The majority of children no longer use active transport to and from school as there are, unsupported, fears of danger (16-18). In reality, the crime statistics around danger to children walking to and from school have not increased over time (19, 20).

In addition to sedentary forms of transport, other forms of sedentary behaviour have increased, including the amount of time spent sitting (work, education or pleasure), watching TV and with electronic devices (computers, tablets, smart phones, gaming, etc.). Sedentary behaviours are detrimental to health irrespective of activity levels (21). For maximum effect of obesity levels both sedentary behaviours and physical activity levels need to be targeted.

The food environment has become more reliant on processed foods. There are more restaurants, cafes, take away food shops, general stores, concession stands and mobile food options with a high number of high fat, high sugar meal options (22-24). The aisles in the supermarkets are crowded with confectionary, chips, sugary drinks, juices, sweetened dairy, and other calorie-dense, nutrient-poor foods (25, 26). All of these unhealthy options are marketed heavily with many advertisements targeting children (27-29). These unhealthy options and fast food sources are often paired with sport (9, 30, 31). Sporting heroes then become, sometimes unwittingly, poor dietary role models.

Unhealthy food options are often paired with sugary drinks (32). Some sugary drinks contain around 10 teaspoons in a standard 375ml serve (33). At the same time that obesity increased, so did the standard serve of these drinks (34-36). Sugary dinks do not assuage hunger; they just add kilojoules (37). While there has been a welcome push by soft drink companies to decrease the sugar content of these drinks, this will not be enough to turn back the tide of obesity because it has been shown that even ‘no sugar’ diet drinks are associated with overweight and obesity (38). Making water the default, drink of choice is one piece of the complex puzzle in reducing overweight and obesity.

People with poor mental health are known to consume an unhealthier diet, participate in less physical activity and are more likely to be in the overweight or obese range than their peers with no mental health problems (39-41). The direction of causality is contentious so both mental health and weight need to be targeted at the population level through their shared risk factors (42, 43). The short and long-term harm to health associated with obesity, particularly in children in Australia The link between obesity and poor health outcomes is well established. Health indicators include factors relating to physical, social and psychological outcomes.

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Children with overweight and obesity are more likely to experience poorer health status, lower emotional functioning, and school-related problems. Overweight and obesity in childhood is linked to asthma, allergies, headaches, poor quality of life, bullying and other negative outcomes. is associated with a higher likelihood of poor general health, restricted activity, repeating grades at school, ADHD, , learning disability, and ear infections among others (44-46).

The increase in obesity means that some chronic diseases that were once the domain of adults are now being diagnosed in children. Metabolic risk factors such as large waist circumference, hypertension, high triglycerides, hyperglycaemia, low HDL cholesterol are being seen in children with obesity (47).

In addition to the immediate health implications, there is a link between childhood obesity and adult onset , coronary heart disease and hypertension (48). Overweight and obesity in childhood and adolescence have adverse consequences on premature mortality and physical morbidity in adulthood (49). The short and long-term economic burden of obesity, particularly related to obesity in children in Australia The costs of obesity are wide ranging. There are costs to governments in the form of increased spending on health, obesity interventions, welfare payments, lower taxes revenue, workers compensation, special hospital equipment, hospital infrastructure, transportation and research (50). There are individual costs such as premature mortality, increased morbidities, lower quality of life, higher spending on healthcare, higher likelihood of disability and depression, discrimination, impacts on employment and higher spending on food (50). There are also impacts on transportation costs, environmental impacts, and lower economic growth (50). There are also impacts on private health insurers, families and employers (50). When all these costs are taken into account, the total cost was estimated to be $8.6 billion in 2011-12 (50). Adding in the ‘loss of well-being’ the actual cost of obesity in Australia was $58.2 billion in 2008 (51). Given that the obesity levels are rising and costs are rising, the spending would be much greater now and projections for the future would include continued rises.

Children with obesity place a heavy cost on the health system compared to their peers in the normal weight range. They are more likely to be hospitalised, the annual direct healthcare costs of children in the two to four-year age group was around $17 million (2016), and the excess cost per child with obesity, compared to healthy weight, was $367 (95% CI $54-$1,066) (52). The costs to Medicare of overweight and obesity among Australian children aged four to five years in 2004-2005 was $9.8 million higher than for children in the normal weight range (53). These are expected to rise in the future unless the levels of overweight and obesity are turned around. Evidence-based measures and interventions to prevent and reverse childhood obesity, including experiences from overseas jurisdictions Obesity prevention can only be achieved with a sustained, coordinated, multi-sectoral approach. A dedicated national governing body is required to ensure consistency across states and territories. Any intervention must be multi-focused, multi-level, and aimed at entire populations (54). Upstream and downstream drivers of obesity need to be tackled simultaneously as it is very difficult to change

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individual behaviours without changing environments (54). The default for environments in which people live, work and play must be making the healthy choice the easy choice.

Changes to the policy environment are often low-cost and effective across populations. The AHPC has brought together evidence from expert working groups, the peer reviewed literature and examples of successful interventions from other countries to formulate the following evidence-based intervention strategies in our publication Getting Australia’s Health on Track (10):

 Introduce a 20% health levy (flat-rate caloric tax) on sugar-sweetened beverages.  Implement restrictions on exposure of children (under 16 years of age) to unhealthy food and drink marketing on free-to-air television up to 9pm.  Implement a framework for national physical activity and invest in the local implementation of active travel initiatives to and from school for all school-age groups.

The AHPC has published a policy paper, Active Travel: Pathways to a Healthy Future (55) and an accompanying technical paper, which includes recommendations to improve active travel to and from school:

 A national active school travel infrastructure grants program should be established under the National Infrastructure Investment Fund to foster and/or build active environments adjacent to all schools to prioritise pedestrians and cyclists through a targeted needs based infrastructure investment strategy.  All Australian Governments should adopt a national target to reduce physical inactivity in children and young people by 10% by 2025.  A national active school travel strategy should include and support a national virtual knowledge hub and clearinghouse for best practice active school travel initiatives.

Implementation of this proposed framework for active travel would cost $90 million over three years.

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References 1. Wang Y, Lobstein T. Worldwide trends in childhood overweight and obesity. International Journal of Pediatric Obesity. 2006;1(1):11-25. 2. Magarey AM, Daniels LA, Boulton T. Prevalence of overweight and obesity in Australian children and adolescents: reassessment of 1985 and 1995 data against new standard international definitions. The Medical Journal of Australia. 2001;174(11):561-4. 3. de Onis M, Blossner M, Borghi E. Global prevalence and trends of overweight and obesity among preschool children. The American journal of clinical nutrition. 2010;92(5):1257-64. 4. Booth ML, Chey T, Wake M, Norton K, Hesketh K, Dollman J, et al. Change in the prevalence of overweight and obesity among young Australians, 1969-1997. The American journal of clinical nutrition. 2003;77(1):29-36. 5. Australian Institute of Health and Welfare. A picture of overweight and obesity in Australia. : AIHW; 2017. 6. Lesser L. Prevalence and Type of Brand Name Fast Food at Academic-affiliated Hospitals2006. 526-7 p. 7. Zive MM, Elder JP, Prochaska JJ, Conway TL, Pelletier RL, Marshall S, et al. Sources of dietary fat in middle schools. Preventive medicine. 2002;35(4):376-82. 8. Cohen D. Evidence on the food environment and obesity Preventing Childhood Obesity; Evidence policy and practice. Oxford: Wiley-Blackwell: BMJ Books; 2010. p. 113-9. 9. Kelly B, Chapman K, King L, Hardy L, Farrell L. Double standards for community sports: promoting active lifestyles but unhealthy diets. Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals. 2008;19(3):226-8. 10. Lindberg R, Fetherston H, Calder R, McNamara K, Knight A, Livingston M, et al. Getting Australia’s Health on Track 2016. Melbourne: Australian Health Policy Collaboration, Victoria University; 2016. 11. Lee BY, Bartsch SM, Mui Y, Haidari LA, Spiker ML, Gittelsohn J. A systems approach to obesity. Nutrition reviews. 2017;75(suppl 1):94-106. 12. Johns Hopkins Bloomberg School of Public Health. Using a Systems Approach for Obesity Prevention & Control Baltimore, USA: Global Obesity Prevention Centre; 2018 [Available from: http://www.globalobesity.org/the-systems-approach/index.html. 13. Hammond R. Getting Obesity Under Control: The Importance of a Systems Approach Wahington DC, USA: Brookings Institute; 2012 [Available from: https://www.brookings.edu/on-the- record/getting-obesity-under-control-the-importance-of-a-systems-approach/. 14. Brown V, Moodie M, Mantilla Herrera AM, Veerman JL, Carter R. Active transport and obesity prevention - A transportation sector obesity impact scoping review and assessment for Melbourne, Australia. Preventive medicine. 2017;96:49-66. 15. Zapata-Diomedi B, Knibbs LD, Ware RS, Heesch KC, Tainio M, Woodcock J, et al. A shift from motorised travel to active transport: What are the potential health gains for an Australian city? Plos One. 2017;12(10):e0184799-e. 16. Schoeppe S, Tranter P, Duncan MJ, Curtis C, Carver A, Malone K. Australian children's independent mobility levels: secondary analyses of cross-sectional data between 1991 and 2012. Children's Geographies. 2016;14(4):408-21. 17. Salmon J, Timperio A. Prevalence, trends and environmental influences on child and youth physical activity. In: Tomkinson G, Olds TS, editors. Pediatric Fitness Secular Trends and Geographic Variability. Basel, Karger: Medicine and sport science; 2007. p. 183-99.

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18. Foster S, Villanueva K, Wood L, Christian H, Giles-Corti B. The impact of parents’ fear of strangers and perceptions of informal social control on children's independent mobility. Health & Place. 2014;26:60-8. 19. Shutt JE, Miller JM, Schreck CJ, Brown NK. Reconsidering the Leading Myths of Stranger Child Abduction. Criminal Justice Studies. 2004;17(1):127-34. 20. Davis B, Dossetor K. (Mis)perceptions of crime in Australia Canberra: Australian Institute of Criminology; 2010 [updated 6 November 2017 Available from: https://aic.gov.au/publications/tandi/tandi396. 21. Vic Health. Physical activity and sedentary behaviour. Evidence summary Melbourne: Vic Health; 2016 [Available from: file:///C:/Users/e5109681/Downloads/2016%20Physical%20Activity%20and%20Sedentary%20Behav iour.pdf. 22. Thornton LE, Lamb KE, Ball K. Fast food restaurant locations according to socioeconomic disadvantage, urban–regional locality, and schools within Victoria, Australia. SSM - Population Health. 2016;2:1-9. 23. QSR Media. emma Out of Home Dining Report 2014 [Available from: https://qsrmedia.com.au/solution-center/emma/emma-airlines-report. 24. Vic Health. Obesity and healthy eating in Australia. Evidence summary Melbourne: Vic Health; 2016 [Available from: file:///C:/Users/e5109681/Downloads/Obesity%20and%20healthy%20eating%20in%20Australia%20 summary.pdf. 25. Thornton LE, Cameron AJ, McNaughton SA, Worsley A, Crawford DA. The availability of snack food displays that may trigger impulse purchases in Melbourne supermarkets. BMC Public Health. 2012;12(March):-1. 26. Thornton LE, Cameron AJ, McNaughton SA, Waterlander WE, Sodergren M, Svastisalee C, et al. Does the availability of snack foods in supermarkets vary internationally? International Journal of Behavioral Nutrition & Physical Activity. 2013;10:56-64. 27. Watson WL, Lau V, Wellard L, Hughes C, Chapman K. Advertising to children initiatives have not reduced unhealthy food advertising on Australian television. Journal of Public Health. 2017;39(4):787-92. 28. Roberts M, Pettigrew S, Chapman K, Quester P, Miller C. Children's exposure to food advertising: An analysis of the effectiveness of self-regulatory codes in Australia. Nutrition & Dietetics. 2014;71(1):35-40. 29. Watson WL, Johnston A, Hughes C, Chapman K. Determining the 'healthiness' of foods marketed to children on television using the Food Standards Australia New Zealand nutrient profiling criteria. Nutrition & Dietetics. 2014;71(3):178-83. 30. Bestman A, Thomas SL, Randle M, Thomas SDM. Children's implicit recall of junk food, alcohol and gambling sponsorship in Australian sport. BMC Public Health. 2015;15(1):1-9. 31. Kelly B, Bauman AE, Baur LA. Population estimates of Australian children's exposure to food and beverage sponsorship of sports clubs. Journal Of Science And Medicine In Sport. 2014;17(4):394- 8. 32. Mathias KC, Slining MM, Popkin BM. Foods and beverages associated with higher intake of sugar-sweetened beverages. American journal of preventive medicine. 2013;44(4):351-7. 33. Council Victoria. Rethink Sugary Drinks Melbourne: Cancer Council Victoria; 2018 [Available from: http://www.rethinksugarydrink.org.au/how-much-sugar. 34. Rangan A, Hector D, Louie C, Flood V, Gill T. Soft drinks, weight status and health: health professional update. Sydney, Australia: NSW Cluster of Public Health Nutrition; 2009.

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35. Hafekost K, Mitrou F, Lawrence D, Zubrick SR. Sugar sweetened beverage consumption by Australian children: Implications for public health strategy. BMC Public Health. 2011;11(1):950. 36. Clifton PM, Chan L, Moss CL, Miller MD, Cobiac L. Beverage intake and obesity in Australian children. Nutrition & metabolism. 2011;8:87. 37. Pan A, Hu FB. Effects of carbohydrates on satiety: differences between liquid and solid food. Current opinion in clinical nutrition and metabolic care. 2011;14(4):385-90. 38. Ruanpeng D, Thongprayoon C, Cheungpasitporn W, Harindhanavudhi T. Sugar and artificially sweetened beverages linked to obesity: a systematic review and meta-analysis. QJM : monthly journal of the Association of Physicians. 2017;110(8):513-20. 39. McElroy S, Kotwal R, Malhotra S, Nelson E, Keck P, Nemeroff C. Are Mood Disorders and Obesity Related? A Review for the Mental Health Professional2004. 634-51, quiz 730 p. 40. O’Neil A, Quirk S, Housden S, L Brennan S, Williams L, Pasco J, et al. Relationship Between Diet and Mental Health in Children and Adolescents: A Systematic Review2014. e31-e42 p. 41. Mikkelsen K, Stojanovska L, Polenakovic M, Bosevski M, Apostolopoulos V. Exercise and mental health. Maturitas. 2017;106:48-56. 42. Rajan TM, Menon V. Psychiatric disorders and obesity: A review of association studies. Journal of Postgraduate Medicine. 2017;63(3):182-90. 43. Mannan M, Mamun A, Doi S, Clavarino A. Prospective Associations between Depression and Obesity for Adolescent Males and Females- A Systematic Review and Meta-Analysis of Longitudinal Studies. PLoS ONE. 2016;11(6):e0157240. 44. Sahoo K, Sahoo B, Choudhury AK, Sofi NY, Kumar R, Bhadoria AS. Childhood obesity: causes and consequences. Journal of Family Medicine and Primary Care. 2015;4(2):187-92. 45. Pulgaron ER. Childhood obesity: a review of increased risk for physical and psychological comorbidities. Clinical therapeutics. 2013;35(1):A18-32. 46. Halfon N, Larson K, Slusser W. Associations between obesity and comorbid mental health, developmental, and physical health conditions in a nationally representative sample of US children aged 10 to 17. Academic pediatrics. 2013;13(1):6-13. 47. Koyuncuoğlu Güngör N. Overweight and Obesity in Children and Adolescents. Journal of Clinical Research in Pediatric Endocrinology. 2014;6(3):129-43. 48. Reilly JJ, Kelly J. Long-term impact of overweight and obesity in childhood and adolescence on morbidity and premature mortality in adulthood: systematic review. International journal of obesity (2005). 2011;35(7):891-8. 49. Park MH, Falconer C, Viner RM, Kinra S. The impact of childhood obesity on morbidity and mortality in adulthood: a systematic review. Obesity reviews : an official journal of the International Association for the Study of Obesity. 2012;13(11):985-1000. 50. PWC. Weighing the cost of obesity: A case for action. 2015. 51. Access Economics. The growing cost of obesity in 2008: three years on. Canberra: Diabetes Australia; 2008. 52. Hayes A, Chevalier A, D'Souza M, Baur L, Wen LM, Simpson J. Early childhood obesity: Association with healthcare expenditure in Australia. Obesity (Silver Spring, Md). 2016;24(8):1752-8. 53. Au N. The Health Care Cost Implications of Overweight and Obesity during Childhood. Health Services Research. 2012;47(2):655-76. 54. McKinsey Global Institute. Overcoming obesity: An initial economic analysis. 2014. 55. Duggan, M, Fetherston, H, Harris, B, LIndberg, R, Parisella, A, Shilton, T, Greenland, R & Hickman, D 2018, Active School Travel: Pathways to a Healthy Future, Australian Health Policy Collaboration, Victoria University, Melbourne.

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Appendix I: Members of the Targets and Indicators Diabetes and Obesity Expert Working Group 2016

Chair Professor Stephen Colagiuri, Boden Institute, University of Sydney

Co-chair Professor Anna Peeters, Institute for Healthcare Transformation, Deakin University

A/Prof Sharlen O’Reilly, School of Agriculture & Food Science, University College Dublin

Professor Boyd Swinburn, Alfred Deakin Professor, Deakin University and School of Population Health, University of Auckland

Professor David rawford, Centre for Physical Activity and Nutrition Research, Deakin University

Professor Helena Teede, Monash Partners Academic Health Sciences Centre, Monash University

Ms Jane Martin, Executive Manager, Obesity Policy Coalition, Cancer Council Victoria

Dr Julie Brimblecombe, Nutrtion Program Lead Menzies School of Health Research, Darwin

Professor Louise Baur AM, Professor of Paediatrics & Child Health, Associate Dean and Head, The Children’s Hospital at Westmead Clinical School, University of Sydney and The Children’s Hospital Westmead

Professor Stephen Simpson AC, Director, Charles Perkins Institute, University of Syydney and Obesity Australia

Professor Steve Allender, Co-Director WHO Collaborating Centre for Obesity Prevention, Deakin University

Professor Timothy Gill, Research Programs Director, Boden Institute, University of Sydney

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Appendix II: Timeline of the AHPC national collaboration work November 2015 Launch of the Targets and indicators for chronic disease prevention in Australia report

July 2016 Launch of the Australia’s Health Tracker 2016 national report cards – adult and children and young people report cards.

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November 2016 Launch of policy roadmap, Getting Australia’s Health on Track 2016

2017 Launch of Heart Health, a national implementation strategy from Getting Australia’s Health on Track

Launch of a national report card Australia’s Health Tracker by Socio-Economic Status

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To June 2018 Launch of a world-first national report card, Australia’s Oral Health Tracker – adults and children and young people

Launch of Active Travel, a national implementation strategy from Getting Australia’s Health on Track

Launch of Better Data for Better Decisions, a national implementation strategy from Getting Australia’s Health on Track

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