Childhood Obesity: Weighing down a generation - AMA WA

80 Pages·2013·21.39 MB·English

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WESTERN AUSTsoRALIA WESTERN AUSTRALIA
cia Journal of the Australian Medical Association WA | April 2013 Volume 53 / Issue 3 | amawa.com.au
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Dear friends and colleagues,
3
This is an exciting time of the year for the Australian Medical Association (WA). This is when
we get to show you exactly what we do as the leading medical organisation in WA.
This edition of Medicus is our Universal Edition. This means that not only does it go to every
AMA (WA) member but also to other registered medical practitioners, State and Federal
politicians, members of the media and a wide range of other high-profile organisations and
individuals.
Within the covers of this Medicus special edition you will find a wide range of articles about our
activities with the overarching theme focused on the range of ways in which the Association
looks after the interests of our members and how we maintain our activities in WA health and
politics.
These articles, written by AMA (WA) staff and other experts, showcase our activities over the
past year in relation to industrial relations, work conditions, salaries, training, General Practice
and a vast number of other issues.
For our cover story this month, we have chosen the important subject of Childhood Obesity
as our focus – an increasingly serious problem for the future health of the Western Australian
population.
In addition to these features, this edition of Medicus also carries the usual pages such as Profile,
Research, For the Record, Food, Drive, Wine and Travel. And of course the perennially popular
On the Town section!
Importantly, this edition also looks at why you should join or maintain your membership with
the AMA (WA). Doing this is easy – just visit www.amawa.com.au, call [phone] or email
[email protected].
Over the past three decades, Medicus has provided a proud record of what the AMA does in WA
– its achievements, its health campaigns - and looks at the many personalities in the profession.
Medicus has explained what we do and why we do it. Looking back at previous issues of Medicus
clearly demonstrates the key role played by the AMA in our society.
It is not an exaggeration for me to say that Western Australia has become a better, safer and
healthier community over the last 50 years thanks, partially, to the AMA (WA).
Medicus has been there all the way.
I hope you enjoy reading the 2013 Universal Edition of Medicus.
With kind regards
Dr Richard Choong
President
AApprriill MMEEDDIICCUUSS 11
Council
President
Dr Richard Choong April 2013
Immediate Past President
A/Prof David Mountain
Vice Presidents
Dr Michael Gannon C o n tE n t S
Dr Andrew Miller
Honorary Secretary
Dr Omar Khorshid
Assistant Honorary Secretary
Dr Janice Bell
Honorary Treasurer
Dr Simon Towler
Councillors
Division of General Practice (WA)
Prof Bernard Pearn-Rowe
A/Prof Rosanna Capolingua
Division of Specialty Practice
Dr Tony Ryan
Prof Mark Khangure
Division of Salaried and State
Government Services
Dr Cassandra Host
Dr Daniel Heredia
Ordinary Members
Prof Gary Geelhoed
Dr Stuart Salfinger 12
Dr Marcus Tan
Co-opted Members
Dr Steve Wilson
A/Prof Frank Jones
A/Prof Peter Maguire
Your AMA
Prof Geoff Dobb
Dr Cassandra Host How the Association works for
Dr Melita Cirillo
members
Dr Ian Jenkins
Prof Ian Puddey
Prof Gavin Frost
Dr Alexandra Welborn
Ms Lee Fairhead
Ms Tahira Bhatti
AMA (WA) Office
6
Executive Director
Mr Paul Boyatzis 58
Director: Industrial & Legal
Ms Marcia Kuhne
Executive Officers
Mr Michael Prendergast
Cover Story: Childhood Obesity
Ms Christine Kane
Ms Clare Francis Show me the money! Concrete action is needed to save our
Mr Gary Bucknall kids from a bleak future
CBA seminar features Craig James
14 Stirling Highway
Nedlands WA 6009
[phone]
[email protected] FEatU rES
www.amawa.com.au
Medicus
Editor and Director of
Communications 40 Research: Maternal-Fetal 57 Event: Know your
Mr Robert Reid
Health Study Entitlements
Deputy Editor
Investigating the impact of AMA Seminar a success
Ms Janine Martin
Advertising Inquiries environmental exposures on
Phone Mr Des Michael [phone] pregnant women
Copy Submissions
Phone Ms Janine Martin [phone]
or [email protected] rEGUL arS
Services
Business Services Manager
Ms Noelle Jones
Financial Services Manager 04 President’s Desk 39 For the Record: 65 Wine
Mr John Gerrard
Medical Products Manager 05 From the Editor Dr Katherine Langdon 66 Drive
Mr Anthony Boyatzis 14, 27 Your AMA: Specialists 45 Dr YES 68 Member Benefits &
Health Training
Australia Manager 16 Profile: 46 Your AMA: Junior On the Town
Mr Geoff Jones Dr Stephen Langford Doctors & Interns 70 Classifieds
The publication of an advertisement, 18 Your AMA: GPs 54 Snippet Professional Appointments
article or inclusion of an insert does not 23 News 57 Event & Positions Vacant
imply endorsement by the AMA (WA) of
the views, service or product in question, 35 Your AMA: Senior Salaried 62 Travel
and neither the AMA (WA) nor its agents
Practitioners 64 Food
will have any liability for any information
contained therein.
2 MEDICUS April
70 Classifieds
Professional Appointments
& Positions Vacant
WESTERN AUSTRALIA WESTERN AUSTRALIA
PRESIDENT’S DESK
Job well done, yet more to do
by Dr Richard Choong
AMA (WA) President
Politics has not played a major part in my life – until Dr Hames is the only health minister I have seen up
now. The last 10 months as AMA (WA) President close or even to have been involved with. I have been
has exposed me to a range of experiences, many of impressed by the way in which Dr Hames engages with
them utterly new. One of these is a full exposure to the the profession. There is a steely determination in his
wonders of the modern media. I have met and spoken to approach – a firm fairness if you like. He has always
more journalists and have read more media in the last few shown me courtesy, and a willingness to listen to
months than I have in my entire life. reasoned argument. He has never refused to negotiate
I would like to think that one day I can make some and believes an agreement is just that. At times, his
comments in my column on what I now understand is agreement to one of our proposals has come despite
called the ‘fourth estate’. strong opposition from other quarters.
However, a communications adviser to whom I talk As I said publicly at the time, Dr Hames’
regularly has told me to hold these comments fairly close re-appointment was great news for health in WA. I went
to my chest for a little while. On this occasion I will take on: “No-one in WA political history has overseen such a
his advice (Rob, see I do listen!). massive spending program in health as we have had over
But the last few months I have also been exposed to the last four and a half year years. We now look forward
politics in all its positives, and some of the negatives. to working with him over the new Government’s term.”
It seems only a few weeks ago I had a series of I congratulated Dr Hames on the Government’s win on
meetings with a number of politicians, some of them the night of the State Election and I said the Government
political leaders. They had already read the AMA (WA) of which he was part had introduced a number of
2013 State Election submission, and I had argued our reforms, initiatives and a range of major infrastructure
case on our five key issues. They had come to meet me programs over the last four years.
and other members of the AMA (WA) Council and to However, as I have already said, I have learnt more
hear our views on these key matters. than one thing from my time in close proximity to
But I have now seen the vagaries of politics up close. politicians and therefore I am keen to move onto a new
Some of these people are no longer battle – or as one politician said to me recently, “the
in a job. Their futures are caravan moves on”.
completely unknown and There are a number of major challenges in the health
I may never meet them portfolio facing Dr Hames.
again. Their staffers are The first major job that will face Dr Hames when he
in the same boat – out resumes his job as Health Minister will be the selection
of a job sometimes of a new Director General. This is a key appointment for
There are a number
with very few future health in WA and it is vital that the best person be found
of major challenges employment options. as quickly as possible. The other major challenge is to
And yet they gave ensure that planning for the successful opening of Fiona
in the health portfolio
me their time to talk Stanley Hospital continues.
facing Dr Hames about public health In the lead-up to the State Budget, the AMA will be
issues, to write to me talking to the newly-appointed Minister about our new
and to consider the list of key issues, but we will continue to emphasise
views of our Association. the five major points raised during the just-completed
But in politics, to the election campaign, including Capacity issues; Medical
victors go the spoils. And the Research; Rural Health; Mental Health Services; and
people of Western Australia have Relief from the Efficiency Dividend.
given the Liberal Party another four years I passionately believe that these are the issues that are
in government. Members may have seen my comments vital to health and medicine in WA and the Association
on the reappointment of the former Health Minister, the will continue to fight for them. And we will always do,
Honourable Kim Hames. irrespective of the political climate. ■
4 MEDICUS April
FroM tHE EDItor
Fighting
for solutions
As readers would certainly know by now, thanks to Representatives Inquiry, our survey of doctors and our
the President’s introduction, this month’s edition of presentation to the touring Committee members, we were
Medicus is generally known as the Universal Edition. able to push for recognition of the issue.
This is our chance to remind you, or for first-time We are now fighting for solutions. Some of these will be
readers show you, what the Australian Medical Association based on the research into the health aspects of FIFO that
in Western Australia does and achieves. our submission called for.
Unfortunately, we are limited by space of how much A recent seminar on the issue and the Inquiry’s report
we can detail our activities and our successes and organised by the University of WA gave the AMA an
how membership can benefit each and every medical opportunity to meet and lobby directly the chairman of the
professional in WA. Inquiry, Independent MP for New England, Tony Windsor.
We are also limited because in some cases we have been Our argument to him was that Australia should not have
asked not to provide too much detail on how we have to wait until the Federal Government responded to the
helped specific members on the basis that even the most Report – this issue, we put to him, was important enough
general detail could identify individuals. for something to happen before that date.
Regular readers would know that this is the issue To this end, we argued that the Federal Government
of Medicus during the year that goes to all medical could allocate money for research now, through an
professionals – members and non-members. independent research body that will allocate money to
If you are a member, this is the issue of Medicus to raise academics and others to begin the research immediately.
with your fellow medical professionals. Membership grows We proposed the allocation of $5 million a year for
every day, but we look to our existing members to speak three years to the National Health and Medical Research
to non-members about the advantages and benefits of Council to get skilled researchers to begin their work now,
membership. Current members are our best advocates for rather than in a year’s time.
boosting membership. Look to future issues of Medicus for updates on
Within the pages of this edition of Medicus we detail movement in this area. But we remain confident that
some of the benefits of membership. money will be allocated for a further examination into this
As Medicus editor I know that to be an effective force in key issue earlier rather than later.
health in WA, you must become an active, powerful and But once again, our continued stand on FIFO is
effective voice in WA politics. Individuals can best do this another demonstration of what we as an Association do
through the collective membership of the AMA (WA). for our members and through them to the wider WA and
Every year, the vagaries of health and politics throws Australian population.
up issues that the AMA (WA) needs to respond to. In this ‘universal’ issue of Medicus we look specifically at
Increasingly these are not just seen as direct health issues, the sensitive but timely issue of childhood obesity through
but social issues. Often we ask ourselves: “If not us, who?” the eyes of a number of Australia’s top experts.
We were one of the first groups to specifically lobby As has been said before, the current generation of young
governments to ensure smoking rates were pushed down. people run the risk of being the first in our history to have
Now there are a myriad of anti-smoking groups and a shorter life expectancy than any other before them.
organisations fighting this important issue. Our travel team looks towards the nation of Laos, little
Our stand on synthetic cannabis just two years ago visited in the past but now increasingly on the agenda of
highlighted an issue that few were talking about. Now it not only the intrepid traveller but even a young family.
has spread like a wildfire across the world. We also look at how much membership of the AMA
More recently it was our decision to highlight the can save you ever year! A handy ready-reckoner for when
health impacts of our growing Fly-in Fly-out lifestyle. you talk to fellow professionals about joining YOUR
We were the first organisation to try and explain to the Association!
Parliamentary Inquiry established to look into FIFO that We hope you enjoy reading this edition of Medicus as
there was more than an economic or business impact. much as the Communications Team enjoyed writing and
Through first our written submission to the House of preparing it. ■
April MEDICUS 5
CoVEr S torY
From footy stadium seats to hospital beds, we are preparing restrictions through means such as curbing access and imposing
us for a world where obesity is the norm. Like other affluent taxes, and further action is likely. Obesity remains essentially
societies, we have not become a fat community overnight – it has untouched.
crept up on us over the last quarter of a century. The WA Health Department’s ‘WA Health Promotion Strategic
In just the 15 years from 1990 – 2005, the number of Framework 2012-2016’ notes that “… the overall prevalence of
overweight and obese adults increased by 2.8 million. And the obesity continues to increase. The impact of obesity on population
future for our children is bleak. As Holman and Smith concluded health is so substantial that without intervention, it has the
in 2008: “recent trends predict that the life expectancy for potential to reverse the improvements in life expectancy gained
Australian children alive today will fall two years by the time they over recent years”.
are 20 years old”. Approximately a quarter of our children are overweight or
Debates as to whether tobacco, alcohol or obesity is the largest obese, and among adults aged 16 and over in 2011, the Health
preventable problem we face are pointless – these are the big three. Department reports that two-thirds were overweight or obese.
Our society has recognised the need to reduce and ultimately A recent Productivity Commission review reported that 25 per
end smoking. While generating action on alcohol is painfully cent more young people are in unhealthy weight ranges than four
slow, there has long been recognition that this problem requires years ago. This same report noted that in Western Australia 47
66 MMEEDDIICCUUSS AApprriill
CoVEr S torY
per cent of young women are overweight or obese, compared to their recommendations are not followed; and all too often
35 per cent in New South Wales and 21 per cent in Victoria; while governments see the establishment of further committees and
in young men, WA featured at 53 per cent, compared with 42 per reports as a wonderful means of looking like doing something
cent in NSW and 37 per cent in Victoria. but deferring the need for action, preferably for years.
Overweight and obesity bring massive costs to the community, • Soft, low-key, poorly-funded, short-term public
but the prime reason for seeking change is to ensure that all in education programs.
our community lead healthier lives and, indeed, live for as long as • Industry ‘education’ programs. Why would they work,
possible without the burdens and distress caused by the rising tide when the duty of companies to shareholders is to sell as much
of obesity-related conditions. That said, the costs of diabetes alone of the product as possible? Who can seriously believe that
in decades to come is projected to place demands on our hospitals a Coca Cola advertising campaign about obesity (‘Coming
and health system that should cause health planners and treasury Together’) is actually intended to reduce use of their products?
officers alike to panic. • Bringing in the industry to help design and develop
Here, as in the US, portion sizes are getting larger. Junk food is policies and programs, and self-regulation of advertising.
all too often cheap, tasty and easier to access or provide to a family In the words of UK obesity expert Dr Tim Lobstein, “Asking
than healthy food. Our environment is still a driver’s delight, with the companies to restrict their own marketing is like asking a
incentives and opportunities for physical activity far too limited. burglar to fix the locks on your front door. They will say you
Advertising and promotion for unhealthy are protected, but you are not.”
products is ubiquitous. Governments provide • Tiny, hard-to read-and-understand
financial support to confectionery and junk nutritional information on packaging.
food companies; and even at the recent UN • Minor product reformulation, spruiked
High Level Meeting on Non-Communicable as examples of industry cooperation, but with
Diseases (NCD), the food industry was minimal real world impact.
prominent. • Over-complicating the problem. A UK
None of the concerns expressed about report was supposed to provide straightforward
obesity should be interpreted as ‘blaming’ guidance as to the action needed. The spaghetti
children, young people or those whose obesity diagram they came up with may have made the
may result from a range of other causes. authors feel good, but achieved nothing.
We should of course recognise their special • Expecting health professionals alone to
needs and provide appropriate support. Any solve the problem. Various forms of care and
stigmatising should be focused not on those treatment have important roles to play – but
who are obese, but on those who promote Professor Mike Daube measures such as bariatric surgery should not be
obesogenic products, or fail to take the action seen as population approaches.
that might reduce obesity. • Just blaming kids. Sure, we want to change
A recent landmark Lancet paper (‘Profits and Pandemics; trends among kids, but they are even worse among adults,
Prevention of harmful effects of tobacco, alcohol and ultra- who are crucial exemplars.
processed foods and drink industries’) focused on the global • And an absence of comprehensive, whole-of-government
nature of companies responsible for manufacturing, selling and strategies: health departments and health professionals alone
promoting unhealthy foods, their “systematic and aggressive cannot be expected to resolve this major challenge for the
mass marketing campaigns”, their influence on governments community.
worldwide, their phoney “education” and “blame-the-victim” So what does work? There is no magic bullet – but we know
educational activities, and their remarkably effective opposition to many of the answers and do not need more and more reports to
any constraints on their sales or promotions. come up with the same conclusions over and over again.
Junk food promotion ranges from global marketing campaigns As the National Preventative Health Taskforce report noted, we
for unhealthy products to ensuring that their products are need a comprehensive approach, including:
accessible and promoted to potential consumers in developing • Reshaping the food supply towards lower risk products
countries and vulnerable communities. When a leading for the entire population.
Australian health researcher, Professor Kerin O’Dea, proposed • Encouraging more physical activity.
that Coca-Cola might withdraw its products from Northern • Protecting children and others from inappropriate
Territory Indigenous Community stores, Coca-Cola responded: marketing of unhealthy foods and beverages.
“We want to give people the choice. We want to be in there, • Strong, well-funded, sustained and independently run
helping to deliver the best health outcomes to these communities”. public education and information, along with clear
As public awareness of obesity has grown, we have learned what labelling based on proper market research.
does not work in addressing the problem. • Reshaping the urban environment towards healthy
• Expressions of concern, whether from governments or junk options.
food companies. Indeed, they are all too often an indication • Strengthening skilling and supporting primary
that nothing will happen.
• Reviews and reports. The best reports achieve nothing if
Continued on page 8
AApprriill MMEEDDIICCUUSS 77
CoVEr StorY
by Associate Professor Rosanna Capolingua
Chair, Healthway
The incidence of overweight and obese children in Australia is sports. The claim that sponsorship of adult sport has no effect
a topic of popular discussion on the news and in many homes. on children has been blown away. We know that kids develop
Given the prosperity and affluence of our State, it is sad to think brand identification, market loyalty and pursue these products.
that we have such a growing health problem among our kids, who It is a high pressure environment for parents when the kids are
are the future of our community. calling for fast food on the way home. Too much unhealthy
In General Practice, it is a reality that we see a lot of children soft drink and processed foods are being consumed too often.
who have a body mass which is sub optimal to a healthy life, let In many cases, high calorie intake cannot be matched with the
alone self-image and self-esteem. It can be a difficult problem to exercise required to expend the energy. No amount of exercise
tackle and even broach with family or the child. It is often a result can compensate for an unhealthy diet and the result is kids that
of multiple factors. Today’s obesity in kids is a result of some of are overweight and obese.
our new ‘social determinants’ – busy parents both working and Healthway is leading the way by taking the unhealthy
needing access to easy meals for families; electronic entertainment pressure off when it comes to our sponsored partners.
and social media engagement resulting in more sedentary time Parents and all but a few sports in WA are with us. There
passed; anxiety of an unsafe environment outside the home; really is no place for junk food sponsorship of sport at any
and significantly, the heavy marketing and ready availability of level. It is incongruous for Coke to be part of the London
unhealthy foods such as fast foods, sugary drinks and processed Olympic parade and for mini bottles of Coke to be handed
supermarket foods. to the kids standing alongside. The partnership between
Heathway has always had a role in breaking ground and cricket and KFC in Australia (along with that of alcohol
changing the environment through its ability to sponsor sport sponsors) will one day come to an end. The Eagles have
and the Arts in a relationship, which has the goal of promoting moved away from Hungry Jacks to Bank West. Things are
and protecting the health of Western Australians. Sport and the changing, but in the mean time we have an epidemic of kids
Arts involve participation, which provides health benefits through who need an environment in which they can readjust their
physical activity and social connectedness. These are crucial to weight to a healthy one, so that they can enjoy a healthy
the community. In addition, both deliver role models and heroes. longevity. We must also prevent more kids rolling down this
Australians in particular, hang off their sporting codes like zealots, path.
celebrating victories and imitating heroes with a passionate Healthway operates on evidence and is consistent in its
following. No wonder alcohol and junk food companies hold approach in evaluating unhealthy sponsors. Of course,
lucrative marketing positions in some sporting codes. shielding sport from junk food advertising is threatening to
Healthway has been ‘buying’ out unhealthy partners in sport the marketing and sales of these products, so we sometimes
and the Arts. We have been able to work with sports to assist them see the sort of backlash that occurred when tobacco
to move away from exploitation by unhealthy sponsors. advertising was being challenged in the same way.
Research by UWA’s Simone Pettigrew in January this year We often reflect that that must mean we are making a
clearly showed that children identified brands with certain difference. ■
Continued from page 7 (let alone tobacco, alcohol, drugs and sexual health) will not be
Chew on this! mandatory. Action on food reformulation and labelling has been
• Health care workers and the public health workforce to cosmetic. The prospect of using tax measures to address has not
support healthier choices. even touched the edges of policy-makers’ thinking, even though a
• Workforce initiatives. simple tax on sugary drinks (a ‘soda tax’) could bring in massive
• Targeted programs in maternal and child health. revenue for governments, reduce consumption of a useless product,
• Special focus on closing the gap for disadvantaged and subsidise healthy foods for disadvantaged communities.
communities. Junk food outlets and marketing continue to target not only the
• And underpinning the work on food, a health-focused overall population, but vulnerable, low education and low-income
national food strategy for Australia. groups in particular. Many planners recognise the importance of
While progress on tobacco following the Taskforce’s supporting physical activity rather than the all-powerful motor car
recommendations has been exciting, action on obesity has – but action in this area too has been limited.
been glacial. Even at the soft end, the new Australian Schools There are some slivers of hope. Just as WA led the nation
Curriculum does not include health and physical education in the in forceful media campaigns on tobacco, so the Livelighter
top two tiers, so education for children on obesity-related matters campaign on obesity, with its initial “toxic fat” and “grabbable
88 MMEEDDIICCUUSS AApprriill