La rueda judicial

Reduce the prevalence of high-risk consumption and dependence on alcohol

While consumption of alcohol is an accepted and common cultural practice among Queenslanders, drinking behaviours in Queensland are among the riskiest in Australia. Increasingly, young people between the age of 14 and 24 years are consuming alcohol in a risky and high-risk manner. Drinking above the recommended National Health and Medical Research Council guidelines increases the long-term risk of alcohol related problems, which include heart disease and stroke. The Queensland Alcohol Action Plan and Meeting the challenges of substance misuse – A strategy addressing the misuse of substances, including alcohol,

in Aboriginal and Torres Strait Islander Queensland describe the Queensland Government’s commitment to preventing and reducing harm associated with alcohol misuse. These documents also reflect the goals and evidence-based approach of both the National Alcohol Strategy: A Plan for Action 2001-2003/04

and the National Drug Strategy Aboriginal and Torres Strait Islander Peoples’ Complementary Action Plan 2003-2006. Initiatives that address alcohol use are balanced against, and developed in unison with, other drug use concerns, such as tobacco and volatile substance misuse, to ensure a comprehensive effective and efficient approach overall.

Improve nutritional status of the population

Optimum nutrition is essential for the normal growth and the physical and cognitive development of infants and children, enhanced resilience and quality of life, good physical and mental health throughout life, resistance to infection and protection against chronic disease and premature death.

Dietary habits and eating behaviour are affected by knowledge, attitudes, skills, abilities and access to food. Policies and social, physical and economic factors all influence the food people eat. Some of these factors include access to consistent, readily understood nutrition information, food advertising practices, food supply systems and transport costs, food prices, and the availability of healthy options in schools and childcare settings and the take-away and restaurant sector. National Nutrition Surveys in 1985 and 1995 indicated that energy intake had increased significantly by four per cent for adults and increased substantially by 11 per cent for girls and 15 per cent for boys aged 10-15 years. This dramatic increase was due mainly to increased consumption of snacks, fast foods and soft drinks. Priority groups at greatest risk are Aboriginal and Torres Strait Islander people, lower socioeconomic groups, rural communities, and people from some culturally and linguistically diverse backgrounds. Key strategies that are driving action to improve nutrition in Queensland are Eat Well Queensland 2002-2015: Smart Eating for a Healthier State, Queensland’s response to Eat Well Australia 2000-2010 – the National Public Health Partnership’s nutrition strategy and action plan, and the National Aboriginal and Torres Strait Islander Nutrition Strategy and Action Plan 2000-2010.

Queensland, like the rest of the developed world, is in the midst of an epidemic of overweight and obesity. In Australia, over half of all adults and almost one in four children are affected. Amongst Australian children, the rate of overweight doubled and the rate of obesity trebled in the decade to 1995, and new data indicate that an additional one percent of children in Australia are becoming overweight each year, which is amongst the highest rates of increase in the world.

New evidence indicates that due to this epidemic, it is likely that the present generation of Queensland children will be the first to die at a younger age than their parents. Based on present trends, poor nutrition and physical inactivity, which cause obesity, will soon overtake tobacco smoking as the major cause of death. Eat Well, Be Active – Healthy Kids for Life is the Queensland Government’s action plan for healthy weight in children and young people.

Increase physical activity

There is overwhelming evidence about the health benefits of physical activity, and the crucial role it plays in the prevention and management of a wide range of chronic diseases (including musculoskeletal disorders and some cancers). Physical activity is also beneficial for both falls and injury prevention, confers mental health benefits and contributes to obesity prevention.

Despite the numerous benefits, physical activity participation rates in Queensland are declining. National data indicates that 20 to 25 per cent of Australian children do not participate in sufficient physical activity to gain health benefit. In 2000, 55 per cent of Queensland children participated in organised sport, which was lower than the national average of 59 per cent. The greatest decline in participation in physical activity of children and young people occurs during early adolescence. Preliminary findings suggest only 40 per cent of adults in Queensland are

sufficiently active for health benefits (a decline of nine per cent since 1997), and participation declines with increasing age.

The range of interventions to influence physical activity participation rates include population-focused interventions such as public policy and the creation

of physical-activity-friendly social and physical environments, as well as targeted interventions for specific settings, individuals and priority population groups. The range of stakeholders with responsibility for developing policy and environments to support increased physical activity in Queensland is diverse, spanning portfolios within government, both state and local government and the non-government sector. Initiatives of particular relevance include Queensland Transport’s commitment to ‘active transport’, Sport and Recreation Queensland’s

Get Active Queensland Children and Young People Strategy and Education Queensland’s Safe and Healthy Schools initiative.

Improve identification and management of lifestyle and behavioural risk factors

Health care professionals are well placed to identify opportunities to promote health and address risk factors for chronic disease. Identifying and providing support to people to change behaviour and reduce risks to their health is important both in order to prevent disease, and to reduce morbidity and slow disease

progression.

There is strong evidence to support the effectiveness of brief interventions. Key components of brief interventions include asking individuals about their health behaviours, assessing readiness to change and providing advice, support and referral where appropriate, then arranging follow-up.

There are critical and sensitive periods of development along the lifespan that present particular opportunities for health gain. For example, smoking, alcohol consumption and poor nutrition in pregnancy have major adverse impacts on birth outcomes and subsequent lifelong health. The number of planned interactions between parents, children and the health system both antenatally and in the early years of life provides a strategic opportunity for more effective interventions to target lifestyle and behavioural risk factors during a period of heightened readiness to change.

A number of tools and guidelines are available to assist health care professionals to identify and manage risk factors. These include:

■ Smoking Cessation Guidelines for Australian General Practice

■ SmokeCheck for health professionals working with Aboriginal and Torres Strait

Islander clients who smoke

■ standard questionnaires to detect people with risky drinking habits such as the Alcohol Use Disorders Identification Test (AUDIT) and the Quantity-Frequency Index

■ Australian Dietary Guidelines

■ Australian Physical Activity Guidelines

■ NHMRC Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults, Children and Adolescents

■ Active Script Program, green scripts, lifestyle prescriptions, and the Royal

Australian College of General Practitioners’ SNAP: A Population Health Guide to Behavioural Risk Factors in General Practice.

Enhancing the capacity of the primary health care sector to improve identification and management of risk factors is considered a key requirement.