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Overweight and Obesity in Australia

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Overweight and Obesity in Australia RURAL DOCTORS ASSOCIATION OF AUSTRALIA POLICY POSITION 1 Overweight and obesity in Australia There is a worldwide obesity epidemic. Obesity levels across the globe are almost three times what they were in 19751. In Australia, there are multiple causes contributing to the rising rates of overweight and obesity, and halting and reversing the trend will require significant effort and investment over the longer term. No single policy or program will be sufficient to address these increasing rates or their consequences, and there must be initiatives that target the general population as well as specific population groups, including rural and remote Australians. Current evidence suggests that overweight and obesity is more prevalent in rural and remote communities, particularly those that are disadvantaged. A comprehensive, co-ordinated, sustainable and bipartisan strategic approach to connect overweight and obesity policies and programs at all levels of government and across sectors will be necessary to make a difference. This strategy must be: • developed in parallel with nutrition and physical activity strategies as key aspects of the prevention and management of overweight and obesity issues • closely aligned with other national health strategies and initiatives • informed by the Australian and international evidence • supported by operative frameworks that set out clear and achievable targets and timeframes • underpinned by adequate and secure levels of funding for consequent programs and initiatives to achieve desired outcomes. All options to tackle overweight and obesity as a significant and burgeoning preventable health issue should be considered. Identifying and addressing issues for rural and remote Australians and the prevention of childhood overweight and obesity must be priority areas for action and may include, but not be limited to: • recognition of and support for the central role that rural doctors and primary health care plays in preventing and managing overweight and obesity in rural and remote areas • provision of appropriate education and training in relevant areas for all health professionals involved in providing information, advice, treatment, counselling or other support to people experiencing problems with overweight and obesity in rural and remote areas • Commonwealth and jurisdictional review of food supply and security, including identification of communities at risk of limited healthy food supplies in remote areas and actions to redress the issues for these communities • development and dissemination of a range of multi-media educational resources about overweight and obesity as health risk factors • promotion of healthy lifestyles • legislation to restrict food and beverage products that may be harmful to health • taxation measures. Policymakers and planners must ensure that adequate and secure funding underpins programs and initiatives to maximise the likelihood for success in rural and remote areas. 1 World Health Organization Fact Sheet http://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight Viewed 28 November 2018. RURAL DOCTORS ASSOCIATION OF AUSTRALIA POSITION PAPER RDAA Overweight and Obesity in Australia Policy Position RDAA believes the following specific measures should be implemented: • strategies to support rural and remote doctors and their practices to prevent and manage overweight and obesity health risks and harms in rural and remote communities, including o funding general practice telehealth consultations as part of a cycle of care o making viable innovative models of care whereby a range of health professionals, including dieticians and physiotherapists, can be employed in rural general practices or be part of a mixed service model o developing guidelines for GPs and practice staff to work with parents and carers on nutrition and weight management of children • up-skilling of practice and community nurses, Aboriginal Health Workers, and other rural and remote health professionals in nutrition and counseling through the development and provision of relevant education and training modules • targeted social marketing campaigns to improve health literacy by providing health messages and community education that resonates with rural and remote Australians (for example, anecdotal evidence suggests that the light-hearted and humorous tone of the Northern Territory’s No Germs on Me campaign to promote the benefits of regular face washing and hand washing with soap had broad appeal in rural and remote Australia, particularly with children) • Commonwealth and jurisdictional review of issues related to food security and affordable healthy food options in rural and remote communities and actions to address these issues, including improving access to fresh fruit and vegetables through introducing breakfast programs in schools, childcare centres (including home childcare) and pre-schools in rural and remote communities • community and local government collaborative projects to provide exercise appropriate areas and equipment in rural and remote areas • engagement with rural and remote Aboriginal and/or Torres Strait Islander communities to develop local initiatives • regular review and strengthening of national and jurisdictional food standards, labelling and advertising requirements (including mandated accountability for breaches) to mitigate against the high levels of consumption of cheap high-saturated fat, high-salt and high-sugar packaged and fast foods and sugar-sweetened beverages (SSBs). These requirements should be nationally consistent and include o point-of-sale and vending machine restrictions in hospitals and health facilities, schools and entertainment venues that primarily target children and young people o restrictions on advertising and promotion, including offering “up-sizing” (particularly to children) o mandatory, clearly visible front-of-package labelling. A range of taxation measures that could be used in combination with each other and with non-tax measures to reduce unnecessary consumption of sugar should also be considered. Revenue raised from taxes should be hypothecated to: • provide targeted funding for the prevention and treatment of overweight and obesity health harms being experienced by people in rural, remote and very remote areas • support the primary sugar industry to refocus and adapt to changes to mitigate against financial and other stressors that contribute to these health harms. 2 RURAL DOCTORS ASSOCIATION OF AUSTRALIA POSITION PAPER RDAA Overweight and Obesity in Australia Policy Position Background and detailed position The overweight and obesity epidemic has been a global and national public health issue for several decades. Overweight and obesity has become one of the leading causes of preventable illness and death in Australia. As such, unless it is effectively managed, overweight and obesity will be the most significant health-related challenge for this country into the future and a continuing drain on health resources. The individual and population health implications of overweight and obesity and strategies to address them, including for children, have been the subject of a range of inquiries and research. Despite efforts to address the issue there has been a marked increase in numbers of overweight and obese people in Australia since the 1980s2,3. The most recent data indicates that nearly 2 in 3 (63%) adults and more than 1 in 4 children are overweight or obese in Australia4. The causes of overweight and obesity in Australia are complex: biological, familial, psycho-behavioural, social, cultural, environmental and lifestyle factors all play a part5,6,7. Changes in each and all of these factors have contributed to the rise of overweight and obesity across the population. There is also a link between income as a social determinant of health and likelihood of obesity8,9,10. The chronic conditions associated with being overweight or obese can compromise the capacity of people to fully participate in economic, social and community activities which in turn further compromises their health. It is important to note that health harms associated with obesity are not limited to physical health harms. Mental health is also impacted at all ages. Effectively addressing these health outcomes of overweight and obesity will be challenging, particularly in rural, remote and very remote Australia where a range of unique circumstances impact on health policy and program implementation and service delivery. Although recognised as a National Health Priority Area there is as yet no national strategy to combat the rise in overweight and obesity. Overweight and obesity remains a burgeoning public health issue in Australia. Given the enormity of the overweight and obesity response task, prioritising effort and investment will be difficult but unless there is immediate action to arrest the rise in prevalence of overweight and obesity, the negative consequences for individual and population health and for the health system will be substantial and burdensome. A national overweight and obesity strategy that aligns closely with other national strategies and initiatives will be necessary to halt and reverse the overweight and obesity trend. A strategic approach that is bipartisan, multi-faceted and holistic, and encompasses targeted and sustainable individual, community and population-wide policies and programs, is necessary to prevent and manage the effects of overweight and obesity and the impact on Australians. It will require Commonwealth Government leadership
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