Investing in South Australia's heart health - THE BEST RETURN FOR THE STATE BUDGET 2021
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Budget submission 2020-21 Investing in South Australia’s heart health THE BEST RETURN FOR THE STATE BUDGET HEART FOUNDATION SUBMISSION TO THE SA BUDGET 2020-21
Investing in South Australia’s heart health
Estimated costs
1. Support South Australians to make heart healthy choices
1.1 Wellbeing SA to develop a Walking Strategy in collaboration with $200,000 over 4 years
other relevant Government Departments and stakeholders
1.2 Dept of Transport to conduct a Household Travel Survey $1m
1.3 Wellbeing SA and Department for Education to renew healthy school Low cost initiative
food policy
2. Reduce smoking and vaping to prevent heart disease
2.1 Protect people living in multi-unit housing from secondhand smoke Low cost initiative
2.2 SA Health to keep investing in mass marketing Minimum $1.7m/year
3. Save lives through improved cardiac care
SA Health to expand phone-based cardiac rehabilitation to the
Greater Adelaide area
WE ARE LIVING LONGER BUT CARDIOVASCULAR DISEASE
REMAINS OUR BIGGEST KILLER AND MOST EXPENSIVE DISEASE
1 LIFE
LOST EVERY
$5
13
MINUTES*
13
BILLION^
14
NATI O NAL HE ART FO U N DATI O N O F AU STR ALIA
2 INVESTING IN SOUTH AUSTRALIA’S HEART HEALTH • HEART FOUNDATION SUBMISSION TO THE SA BUDGET 2020-2021
Empowering individuals and
communities, and providing
supportive environments, is at the
heart of our recommended actions.
Imelda Lynch, CEO Heart Foundation SA
The Heart Foundation is leading the fight to save Australian hearts
Heart disease continues to be the leading cause of death of South Australians.1
In 2017- 18 we had 43,000 people with heart disease in South Australia.2 There is continuing increasing
rates of hospitalisations for atrial fibrillation and heart failure.
We urge the South Australian government to consider the following low-cost high-value proposals for
the State Budget 2020 -2021:
Develop a walking strategy to get South Australians moving;
Encourage healthy eating and drinking in children;
Continue the fight against tobacco and vaping; and
Prevent readmission to hospital through cardiac rehabilitation programs
Together we can improve the health and wellbeing of our communities; in turn, reducing the burden
on our health system.
Imelda Lynch
NATI O NAL HE ART FO U N DATI O N O F AU STR ALIA
Chief Executive Officer, South Australia
National Heart Foundation of Australia
INVESTING IN SOUTH AUSTRALIA’S HEART HEALTH • HEART FOUNDATION SUBMISSION TO THE SA BUDGET 2020-2021 3
1. Support South Australians to
make heart healthy choices
1.1 Develop and fund a Walking Strategy and
Action Plans
Estimated cost $200,000 over 4 years
A staggering 83% of adults,2 and 80% of children do not
meet recommended physical activity levels.2
Physical inactivity accounted for 2.6% of the total burden
of disease and injuries in Australia in 2011,4 and leads to
overweight and obesity, other chronic conditions and
poor mental wellbeing.
Walking is the most equitable means of improving
population health by increasing physical activity.
Our vision is one where people of all ages, both men and
women, feel safe and comfortable to walk, and choose to
walk to their destinations, for recreation and, for their health.
Action MUST be taken by the government (across
Departments) to help South Australians include some
physical activity, such as walking, into their day.
A walking strategy must include: Walking for transport,
Walking for health and wellbeing, and Walking for
recreation.
Development of a Walking Strategy will meet the agenda
of multiple ministerial portfolios. This investment will return
in health, economy, liveability and environment.
The Heart Foundation calls for the government to
develop and implement a fully funded South Australian
Walking Strategy and action plans.
1.2 Department of Transport to conduct a regular
household travel survey
Estimated cost $1m
NATI O NAL HE ART FO U N DATI O N O F AU STR ALIA
“What gets measured gets done”
The last household travel survey in SA was conducted in
1999.5
Such a survey is long overdue in South Australia.15
Up-to-date data will help us to understand how, when
and why South Australians are walking. This information
will inform the walking strategy along with public transport
modelling and planning for cycling.
Walking data should be collected as part of a Household
Travel Survey to inform infrastructure and planning
decisions and to set targets, with the aim of getting more
people walking more often.
4 INVESTING IN SOUTH AUSTRALIA’S HEART HEALTH • HEART FOUNDATION SUBMISSION TO THE SA BUDGET 2020-2021
CASE STUDY
1.3 Wellbeing SA and Department for Education to
renew healthy school food policy
Why I Care about this issue
Associate Professor Jennifer Keogh,
Low cost initiative Heart Foundation Fellowship Alumni
Good health is fundamental to a happy and prosperous In our community 26% of children and 67% of adults
life. Healthy eating, along with daily physical activity and are overweight or obese. Strong evidence suggests
other healthy habits are the building blocks for good that obese or overweight children are likely to become
health in childhood and into our adult years. overweight or obese adults leading to lifelong chronic
Schools and their canteens have the potential to model health problems such as heart disease and diabetes.
behaviours and encourage healthy eating.7 Habits developed in childhood, including a healthy
Some progress has been made to improve the food and diet is one of the cornerstones of good health. Healthy
drink sold and provided at school and school events and food habits developed as a child are likely to be
enhance the teaching and learning of food and nutrition. maintained throughout life leading to healthy weight
and wellbeing.
Still, only 4.9% of South Australian children meet
the government’s fruit and vegetable daily Schools and canteens have an important role to play
recommendations.6 in encouraging and role modelling healthy food and
healthy eating.
As approximately one third of a child’s diet is consumed
at school, promotion of fruit and vegetables and healthy I have been researching food and nutrition for many
food choices through school canteens is important, as is years and support the Heart Foundation in their efforts
encouraging children to bring nutritious food from home to promote healthy food choices in schools to support
for lunch and recess. their learning and ability to make healthier choices
across their lifespan.
Schools are required to comply with the Right Bite
Strategy but there is no evidence of adherence.
The Heart Foundation calls for the government to refresh
and fund school food and drink policy with improved
monitoring and support for parents, carers and schools.
NATI O NAL HE ART FO U N DATI O N O F AU STR ALIA
INVESTING IN SOUTH AUSTRALIA’S HEART HEALTH • HEART FOUNDATION SUBMISSION TO THE SA BUDGET 2020-2021 5
NATI O NAL HE ART FO U N DATI O N O F AU STR ALIA 6 INVESTING IN SOUTH AUSTRALIA’S HEART HEALTH • HEART FOUNDATION SUBMISSION TO THE SA BUDGET 2020-2021
2. Reduce smoking and vaping to The Heart Foundation calls on the government to take
action to protect residents from exposure to smoke-
prevent heart disease drift in multi-unit developments. The Government must
introduce a model by-law for residential strata schemes
Smokers have around triple the risk of dying from to allow multi-unit building to become smoke-free.
cardiovascular disease compared to people who have
never smoked.9 2.2 Maintain investment in evidence-based tobacco
That’s why the Heart Foundation strongly supports greater control mass media campaigns
investment in tobacco control and strict regulation of
e-cigarettes. Estimated cost - minimum $1.7m/year
The battle against tobacco and vaping is far from over.
The tobacco and e-cigarette industry continue to target Now, more than ever, we need to support people to quit
children and young people and exploit vulnerable groups. smoking.
While overall smoking rates have reduced, rates remain
high in some vulnerable populations; including people
2.1 Protect people living in multi-unit housing from
living in socioeconomic disadvantage, Aboriginal and
secondhand smoke
Torres Strait Islander and people who have survived
a heart attack. We know that more than half of heart
Low cost initiative
attack survivors who smoke prior to their heart attack
continue to smoke. We know that there are productivity
Breathing in other people’s second-hand smoke is costs after a heart attack, with one in four heart attack
considered a significant cause of disease in adults and survivors not able to resume work and a further quarter
children. resuming work, but not at the same level as prior to their
heart attack.3
People living in multi-unit housing are more likely to be
exposed to second-hand smoke (“neighbor smoke”) due
The Heart Foundation is calling on the South
to smoke-drift and the proximity to others and shared
Australian Government to maintain its contribution
spaces.
to evidence-based levels of tobacco control mass
Smoke drifts through vents, windows, balconies, air- media campaigns, particularly to support vulnerable
conditioning, cracks and plumbing systems. populations to quit smoking.
The current pandemic has changed the way we work
and live, with more people working from home, the risk of
exposure is even higher.
NATI O NAL HE ART FO U N DATI O N O F AU STR ALIA
INVESTING IN SOUTH AUSTRALIA’S HEART HEALTH • HEART FOUNDATION SUBMISSION TO THE SA BUDGET 2020-2021 73. Save lives through improved CASE STUDY
cardiac care
Why I Care about this issue
Associate Professor Matthew Worthley11,
Invest in cardiac rehabilitation for patients in the Cardiologist
Greater Adelaide area
South Australian hospitals manage around 39,000 heart As with all cardiologists, I want my patients to have
disease related admissions per year* the best possible life after their cardiac event. I refer
Cardiac rehabilitation is a coordinated program delivered my eligible patients to cardiac rehabilitation because
over several weeks, educating the patient around lifestyle it leads to better health. I strongly support increasing
modification10 and includes physical activity, nutrition, the options available for my patients to enable them
stress management, medication management and to complete cardiac rehab.
advice. Now more than ever we need to support recovery
It is a vital step in a patient’s recovery after a heart attack and keep people out of hospital.
and international studies report that within one year
cardiac rehabilitation can reduce hospital readmissions
by up to 56% and deaths by 30%.12 It also results in
improvements in exercise capacity, quality of life and
psychological well-being, and is now recommended in
international guidelines.
However, only 30% of eligible patients take-up a cardiac
rehabilitation programs, the exception being the very
successful CATCH program run in Country SA which
has 70% uptake, and continues to have a very high
completion rate (up to 97%), improving patient risk factors
and mortality rates.8
For the first time our regional areas are receiving a level
of best practice care better than their metropolitan
counterparts.
If we increase completion rates from 30% to 50% in SA we
can save more than $13.5m in health care costs.10
The Heart Foundation recommends extending the CATCH
program throughout Greater Adelaide.
* Private and public hospitals combined
Source: saheart.com.au
NATI O NAL HE ART FO U N DATI O N O F AU STR ALIA
Cardiac rehabilitation can reduce
hospital readmissions by up to 56%
and deaths by 30%.
8 INVESTING IN SOUTH AUSTRALIA’S HEART HEALTH • HEART FOUNDATION SUBMISSION TO THE SA BUDGET 2020-2021References
1 Australian Bureau of Statistics 2018. Causes of Death 2017, cat NO. (3303.0), September.
2 Australian Bureau of Statistics 2018. National Health Survey: First results 2017-18.
3 Heart Foundation Heart Attack Survivor Survey 2018.
4 AIHW. 2017. Impact of physical inactivity as a risk factor for chronic conditions: Australian Burden of Disease Study
5 Transport South Australia for the Department of Planning, Urban Planning and the Arts: Metropolitan Adelaide
Household Travel Survey (AHTS) 1999.
6 Australian Bureau of Statistics, Australian Health Survey 2014/15
7 Waters, et al. 2011. Interventions for preventing obesity on children. Cochrane Database of Systematic Reviews.
8 Government of SA. COUNTRY HEALTH SA LOCAL HEALTH NETWORK 2018-19 Annual Report.
9 Banks E et al. Tobacco smoking and risk of 36 cardiovascular disease subtypes: fatal and non-fatal outcomes in a
large prospective Australian study, 2019.
10 De Gruyter, et al. 2016. Economic and social impact of increasing uptake of cardiac rehabilitation services. Heart,
Lung and Circulation.
11 Private correspondence 2019
12 National Health Service of the United Kingdom. NHS Improvement; Heart. Making the case for cardiac rehabilitation:
modelling potential impact on readmissions. London: National Health Service 2013.
13 Australian Bureau of Statistics 2019, Causes of Death 2018, cat. no. 3303.0, September
14 Australian Institute of Health and Welfare 2017, Australian Health Expenditure – demographics and diseases: hospital
admitted patient expenditure 2004-05 to 2012-13, Supplementary tables, Health Expenditure and Welfare series no.
59, cat. No. HWE 69.
15 Stopher, P et al. 2014. National Household Travel Surveys: The Case for Australia
NATI O NAL HE ART FO U N DATI O N O F AU STR ALIA
INVESTING IN SOUTH AUSTRALIA’S HEART HEALTH • HEART FOUNDATION SUBMISSION TO THE SA BUDGET 2020-2021 9For heart health information and support, call our Helpline on 13 11 12 or visit heartfoundation.org.au For further information contact: Ms Tuesday Udell Senior Policy Advisor Heart Foundation 155 Hutt Street Adelaide SA T: 08 8224 2863 E: tuesday.udell@heartfoundation.org.au © 2020 National Heart Foundation of Australia, ABN 98 008 419 761 (Heart Foundation) Terms of use: This material has been developed for information and educational purposes only. It does not constitute medical advice. Please consult your health care provider if you have, or suspect you have, a health problem. The information contained in this material has been independently researched and developed by the Heart Foundation and is based on the available scientific evidence at the time of writing. It is not an endorsement of any organisation, product or service. The Heart Foundation and its employees do not accept any liability, including for any loss or damage, resulting from the reliance on the content, or in regards to its accuracy, currency and completeness. Any use of Heart Foundation material by another person or organisation is done at the user’s own risk. This work, except as identified below, is licensed by the Heart Foundation under a Creative Commons Attribution – Non commercial – No Derivative Works (CC BY-NC-ND) 4.0 Australia licence. To view a copy of this licence, visit: http:// creativecommons.org.au/. You are free to copy and communicate this publication (however in no way commercialise the material), in accordance with the rules of attribution set out at https://creativecommons.org.au/learn/howto/. Third party material that is not licenced under a Creative Commons licence may be referenced within this document. All content not licensed under a Creative Commons licence is all rights reserved. Please contact the relevant third-party copyright owner if you wish to use this material. The Heart Foundation acknowledges the Traditional Owners and custodians of Country throughout Australia and their continuing connection to land, waters and community. We pay our respect to them and their cultures, and Elders past, present and future. HH-SCPE-002.1.1219
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