Still time to submit your article: Equity in Primary Health Care Provision – More than 50 years of the Inverse Care Law

Dr Liz Sturgiss and I are guest editing a special issue of the Australian Journal of Primary Health on Equity in Primary Health Care Provision – More than 50 years of the Inverse Care Law.

There’s still time to submit your EOI for inclusion in the special issue, in the form of abstracts are due by 30 March 2022. Full submissions are due by 15th July 2022.

Key areas

We welcome submissions of primary research as well as commentary and review papers from anywhere in the world. We particularly seek submissions based on:

  • Comprehensive primary health care for specific populations, including
    – prison populations
    – Aboriginal and Torres Strait Islander health and First Nations
    – culturally and linguistically diverse communities
    – people living in poverty
    – populations experiencing homelessness and unhoused people
    – rural and remote health
  • Models of care and health services research
  • Team based care and exploration of scope of practice
  • Policy innovations and funding models
  • Community-based responses to the needs of marginalised and oppressed groups

More information on the Australian Journal for Primary Health website.

Revisiting the 2020 Summit: The renewed urgency for a long-term strategy for Australia’s future

Cover of the Australia 2020 Summit report

I was wondering about the Australia 2020 Summit tonight, prompted by seeing former Prime Minister Rudd on television talking about the Ruby Princess. For those who don’t remember, it was a sort of festival of ideas convened by the still-new Gillard-Rudd government in 2008. It was supposed to shape a long-term strategy for Australia’s future, one that was sadly never realised.

If I’m honest I imagined that the report would be full of naïve assumptions and misguided aspirations (much like Mr Rudd’s comments this evening). The horrors of the summer bushfires and the global COVID-19 pandemic mean we’re living in a world I didn’t imagine even a year ago, even though I’ve been worried about climate change, biodiversity loss, and water scarcity for a while. It must have been inconceivable twelve years ago.

Instead I was surprised by how many of the ideas remain relevant and, by and large, unaddressed. The topics in the table of contents should be part of any long-term strategy we’d develop today, albeit with much greater urgency about climate change.

An example of the ideas captured in the report, this from page 385.

There are even some of my pet topics in the report, like health impact assessments, which I’d entirely forgotten.

A call for health impact statements of all new policies and an audit of the impacts of taxation on healthy, from page 155 in the report.

I won’t attempt to summarise the report. It’s 399 pages, and quite densely packed with ideas. It’s definitely worth reading if you have a chance.

Mostly, I’m left with a sense of sadness about how we’ve wasted the last twelve years. I hope the crisis we face due to COVID-19 forces us to reconsider our direction as a society, and the renewed urgency for a long-term strategy for Australia’s future.

“…remarkably similar to alcohol industry rhetoric…”

Very interesting reading in FARE’s analysis of the drafts of the National Alcohol Strategy:

The strategy has been modified to re-frame alcohol consumption as a positive part of Australian culture. This is closely in line with alcohol industry rhetoric, but is at odds with the objective of the strategy which is to minimise harm from alcohol.

“Australia is regularly reported or casually referred to as having an “alcohol culture” where not consuming alcohol can be viewed as being “unAustralian”. There are many Australians for whom this perception of the cultural norm contributes to increased risk of serious harm and the development of harmful drinking patterns. Examples of alcohol being embedded in the Australian culture include drinking to intoxication being seen as a rite of passage to adulthood, the perception that celebration and consuming alcohol are intrinsically linked, public figures are glorified for drinking alcohol, widespread alcohol availability and accessibility of cheap alcohol products, social and peer pressure/expectation to consume alcohol and exposure to alcohol advertising and promotion.”

“Alcohol is an intrinsic part of Australian culture and it plays a central role in most people’s social lives. Research clearly illustrates that whether people are celebrating, socialising, networking, relaxing, commiserating, or rewarding themselves—alcohol plays an integral role.”

Alcohol industry fingerprints: analysis of the modifications to the National Alcohol Strategy

Heatwaves: Changes in frequency and intensity

I’ve found myself thinking a lot about this paper by Herold et al. over the past few days. It describes the far-reaching implications of climate change for health and agriculture across different regions within Australia.

In particular I keep thinking about the implications of these two graphs:

The first graph shows heatwave frequency and the second one shows heatwave amplitude for different Australian cities for the recent past (blue), near-future (green) and far-future (red). Bottom and top of boxes indicate the 25th and 75th percentiles.

NB: For those not familiar with it, heatwave amplitude is a way of measuring and modelling the hottest day of the hottest heatwave within a year. This is different from the other common way of measuring heatwave intensity– magnitude–that looks at the average temperature across all heatwave days within a year. °C2 is a heatwave unit of measurement and isn’t the same thing as degrees Celsius.

There are many impacts and consequences associated with this model, but the frequency and scale of near- and far-future heatwaves alone should terrify us.

Source: Herold, N., M. Ekström, J. Kala, J. Goldie, and J. P. Evans. 2018. “Australian Climate Extremes in the 21st Century According to a Regional Climate Model Ensemble: Implications for Health and Agriculture.” Weather and Climate Extremes 20:54–68.

Australian climate extremes in the 21st century according to a regional climate model ensemble: Implications for health and agriculture

Estimated increases in daily excess mortality due to daytime temperatures above 30 °C are highest for Sydney and Brisbane under a far future climate (76.8 and 32.5 more deaths, respectively). For Sydney this is largely a result of the population’s sensitivity to high temperatures, whereas for Brisbane it is largely due to the increase in the number of hot days.

Source: Australian climate extremes in the 21st century according to a regional climate model ensemble: Implications for health and agriculture – ScienceDirect