Queensland Election Submission 2012 - SAVE LIVES REDUCE AVOIDABLE HOSPITAL ADMISSIONS KEEP OLDER QUEENSLANDERS HEALTHY AND AT HOME TACKLE OBESITY ...

 
Queensland Election Submission 2012 - SAVE LIVES REDUCE AVOIDABLE HOSPITAL ADMISSIONS KEEP OLDER QUEENSLANDERS HEALTHY AND AT HOME TACKLE OBESITY ...
Queensland Election Submission 2012

                SAVE LIVES

             REDUCE AVOIDABLE
            HOSPITAL ADMISSIONS

        KEEP OLDER QUEENSLANDERS
           HEALTHY AND AT HOME

              TACKLE OBESITY

           CLOSE THE GAP FASTER

        REDUCE HEALTH EXPENDITURE

      IMPROVE WORKFORCE PARTICIPATION
             AND PRODUCTIVITY

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Queensland Election Submission 2012 - SAVE LIVES REDUCE AVOIDABLE HOSPITAL ADMISSIONS KEEP OLDER QUEENSLANDERS HEALTHY AND AT HOME TACKLE OBESITY ...
Heart Foundation Queensland Election Submission 2012
Why take action on heart disease and stroke?                  Addressing the risk factors for cardiovascular
The Heart Foundation is seeking a commitment to               disease will improve outcomes for all major chronic
these policy proposals to address the devastating             diseases (see Appendix 1). Investment in prevention
impact of heart disease and stroke – two of                   will save costs, save lives, keep people in the
Queensland’s leading causes of death and burden of            workforce and keep Queensland families together.
disease.                                                      Queensland’s Chief Health Officer reports the
                                                              substantial untapped potential for prevention and the
Cardiovascular disease - including heart attack,
stroke, heart failure, angina, vascular disease and           indisputable evidence of the power of prevention1.
hypertension - is the most expensive disease group
in Australia and a major cause, if not the leading            Cardiovascular disease is Queensland’s costliest
cause, of potentially preventable hospitalisations.           disease:

These policy proposals offer a range of strategies            • cardiovascular disease costs more than any
and cost effective investments which will:                      other disease ($5.9 billion or 11% nationally in
                                                                2004/05)1
• save lives                                                  • the cost to Queenslanders was estimated to be
• reduce avoidable hospital admissions                          $1.16 billion per annum
• keep older Queenslanders healthy and living at              • hospital care is the leading cause of
  home
                                                                expenditure for cardiovascular disease,
• tackle obesity
• Close the Gap faster                                          accounting for 50% of all costs, with out-of
• reduce health expenditure                                     hospital medical services accounting for a
• improve workforce participation and productivity              further 19%1

Reducing cardiovascular disease is the key                    The costs of healthcare are not sustainable:
to improving the health of Queenslanders1.
Queenslanders need a government that will plan and            • hospitalisation rates are expected to double
create healthier communities and implement well                 from 1.52 million hospitalisations per year in
funded prevention policies.                                     Queensland in 2006/07–2007/08 to over 3
                                                                million by 20301
                                                              • health and residential aged care expenditure in
    The Heart Foundation is Australia’s leading                 Australia is projected to triple from $85 billion to
    heart health organisation representing:                     $246 billion from 2003 to 2033, representing an
                                                                increase from 9.3% of gross domestic product
    • 700,000 Queenslanders who live with heart                 to 12.4%1
      disease, stroke and blood vessel disease2
    • 114,000 Queenslanders who are at high risk
      of having a heart attack or stroke and                    Economic benefits
      hospitalisation in the next five years3
    • 90% of Queenslanders who have at least one                • investment in research, prevention and
      risk factor for cardiovascular disease4                     clinical management in Australia has been
    • all Queenslanders who want lead healthier
                                                                  shown to reduce heart attacks and heart
      lives
                                                                  disease deaths and arrest the growth in
                                                                  health costs
Many Queenslanders remain at higher risk of heart               • every dollar invested in cardiovascular
disease and stroke as a result of risk factors that can           research has provided an eight-fold return
mostly be prevented:                                              to the community; the highest return from
                                                                  any form of medical research5
• high blood pressure                                           • public health campaigns aimed at reducing
• high blood cholesterol                                          heart disease in Australia have an
• being physically inactive
• being overweight or obese                                       estimated benefit-cost ratio of more
• eating a diet high in saturated fats and low in                 than11:16
  fruit and vegetables
• smoking

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Queensland Election Submission 2012 - SAVE LIVES REDUCE AVOIDABLE HOSPITAL ADMISSIONS KEEP OLDER QUEENSLANDERS HEALTHY AND AT HOME TACKLE OBESITY ...
Heart Foundation Queensland Election Submission Summary 2012
                                                                          Annual        Heart Foundation   Government
                        Heart Care                                      Investment         to deliver       to deliver
Heart Attack Prevention and Care Program
  1. Save lives from heart attack by educating Queenslanders
      about the Warning Signs of Heart Attack
                                                                         $ 1 million          
  2. Provide the My Heart, My Life resource to all heart patients         $200,000            
Support people with heart disease and heart failure
  3. Improve clinical support for better treatment and
     management of heart disease and heart failure
                                                                          $250,000            
  4. Increase the number of Queenslanders participating in
     cardiac rehabilitation
                                                                         $ 5 million                           
  5. Increase the support from allied health professionals for
     Queenslanders living with heart failure
                                                                         $ 2 million                           
  6. Increase access to palliative care services in hospital
     and at home for people dying from heart failure
                                                                         $ 6 million                           
Regional Heart Health Program
  7. Support more Queenslanders living in regional and
     remote communities by investing in a regional heart
                                                                          $150,000            
     health program
Aboriginal and Torres Strait Islander Heart Health Program
  8. Provide My Heart My Family Our Culture resources to
     Aboriginal and Torres Strait Islander heart patients
                                                                          $200,000            
  9. Invest in cardiac trials for Indigenous people by allocating
     Closing the Gap funds to the State-wide Cardiac Clinical
     Network
                                                                         $ 1 million                           
                     Healthy Living
Obesity & Healthy Living Program
  10. Help older Queenslanders be active by supporting the
       Heart Foundation Walking program
                                                                          $250,000            
  11.   Invest in an ongoing campaign to increase fruit and
        vegetable consumption and production
                                                                          $3 million                           
  12.   Reform food policies to inform consumers:
        a) Ban junk food advertising to children
        b) Legislate kilojoule content on menu boards
                                                                          Low cost                             
  13.   Strengthen physical activity and healthy eating in
        schools
                                                                          Low cost                             
Active Transport and Congestion Busting Initiatives
  14. Invest in a campaign to increase active travel
        participation and public transport patronage
                                                                          $3 million                           
  15.   Reduce speed limits to 40kph in built up areas and
        30kph in heavy pedestrian areas, including schools
                                                                          Low cost                             
  16.   Invest in the implementation of the Queensland Cycle
        Strategy 2011-2021
                                                                        Match to need                          
  17.   Develop, fund and implement a Queensland Walking
        Strategy
                                                                        Match to need                          
Tobacco Control Program
  18. Increase investment in reducing the impact of tobacco,
       including prevention and education campaigns and Quit
                                                                         $10 million                           
  19.   Reform smoking laws to reduce smoking rates and
        reduce avoidable hospitalisations
                                                                          Low cost                             
                    Heart Research
Strategic Heart Research Initiative
   20. Invest in increasing Queensland’s heart research
        capacity to attract more competitive funding to
                                                                          $300,000                            
        Queensland

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Queensland Election Submission 2012 - SAVE LIVES REDUCE AVOIDABLE HOSPITAL ADMISSIONS KEEP OLDER QUEENSLANDERS HEALTHY AND AT HOME TACKLE OBESITY ...
Heart Attack Prevention and Care Program

  1. Save lives by educating Queenslanders about the warning signs of heart attack
  Annual Investment: $1 million
  Commitment: Investment in the Heart Foundation’s life saving Warning Signs of Heart Attack campaign.

Heart attacks tear families apart and create a huge
burden on the health system, with emergency care,                                     Why do we need a campaign?
expensive medical intervention and often lifelong
treatment costs. Many heart attacks can be avoided                                    • Queensland death rates from heart disease
and treated earlier to reduce deaths, heart damage                                      are 11% higher than the Australian average9
and costs. Improving people’s understanding and                                       • heart disease caused 32,728 hospitalisations
response to warning signs will provide the greatest                                     in Queensland in 2007/089
benefit.                                                                              • the 8,507 cardiovascular deaths in Queen
                                                                                        land in 2007 accounted for one-third of all
                                                                                        deaths – an increase of 781 or 10% on the
  • a heart attack is an urgent, life threatening                                       7,726 deaths in 20061. (Heart attack was the
    emergency                                                                           largest single cause of death)
  • one in every four people who have a heart                                         • the number of repeat heart attacks is
    attack die within one hour of their first ever                                      expected to increase by more than 40% by
    symptoms                                                                            20207
  • one half of all deaths from heart attack
    occur outside of hospital4
                                                                      The Heart Foundation pilot of this campaign
                                                                      on the Gold Coast in 201010 found that:
Heart Foundation Warning Signs of Heart Attack
Campaign                                                              • 70% of people with symptoms of heart attack
                                                                        were not recognising or responding to the
The Heart Foundation’s Warning Signs of Heart                           warning signs quickly
Attack campaign helps people recognise heart attack                   • one in four people with heart related
warning signs and understand the importance of                          complaints took more than 12 hours to
calling Triple Zero (000) quickly. Delays cost lives                    present to Hospital
and result in many heart attack survivors having                      • only 60% of people arrived at hospital by
more heart muscle damage, longer and more                               ambulance despite most living within 20km of
frequent future hospitalisations and permanent                          the Hospital
disability.

Australian hospitals treat 46,000 heart attack cases                                        Heart Attack: Time is Muscle
each year and more than 10,000 patients die1, many
                                                                                      100
unnecessarily. Early treatment within 1-2 hours of
symptoms saves lives and reduces disability, but the
                                                             Myocardial Salvage (%)

                                                                                      80
benefit rapidly declines with delays in treatment (see
Figure 1). Sadly, few people respond quickly enough                                   60
and average patient delay – the time to recognise
                                                                                      40
and respond to the warning signs – is 6.4 hours8.
Emergency ambulance services can save lives
                                                                                      20
and reduce heart muscle damage in the period
immediately following a heart attack4 but they are                                     0
not being accessed quickly enough.                                                          0       4        8      12        16        20                         24
                                                                                                Time From Symptom Onset to Reperfusion Therapy
                                                                                                                  (hours)
                                                                                                                       Gersh BJ, et al. JAMA . 2005;293:979-
                                                                                                                                               2005;293:979-986.

                                                                                                               Figure 1

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Queensland Election Submission 2012 - SAVE LIVES REDUCE AVOIDABLE HOSPITAL ADMISSIONS KEEP OLDER QUEENSLANDERS HEALTHY AND AT HOME TACKLE OBESITY ...
The My Heart, My Life information pack provides support by giving a comprehen
                        heart patients, their families and carers.

                  In Queensland, prior to My Heart, My Life, patients were not receiving a compre
  2. Provide the My Heart, My Life resource to all Queensland heart patients
                  information pack. Instead, they received incomplete or inaccurate brochures and
  Annual Investment: $200,000 or support when leaving hospital. Research with heart patients show
                  information
  Commitment: Continued
                  in-oneprovision of MyMy
                           My Heart,    Heart,
                                          LifeMy Life, the free, standard information pack for all heart
                                               resource.
  patients in Queensland. More than 110,000 Queenslanders have received the Heart Foundation’s My
  Heart, My Life since 2008. Current funding finishes on
                                                      11 30 June 2012.
                       Heart Foundation research has found that:
                          • 81% of patients who received My Heart, My Life found it useful and the in
Supporting people who have hadclear  language,
                                   a heart  attack easy toAunderstand       diagrams,
                                                              recent Deloitte             detailedReport,
                                                                              Access Economics      explanations
                                                                                                           ACS    of the
or heart surgery to understandinformation
                                and manage on   their      in Perspective:
                                                   making lifestyle changes The  importance   of secondary
condition saves lives, improves  quality of life, and
                          • 79% of patients stated they    prevention
                                                                 wouldhighlighted
                                                                      7
                                                                                     that thechanges
                                                                         make lifestyle       number ofafter reading th
reduces hospital re-admissions and health care             Australians  dying from  repeat  heart attacks is
                          • health professionals found the resource useful to provide to patients with
costs.                                                     expected to increase by over 40% by 2020. These
                              that prompts patients torepeat ask questions
                                                                   heart attacks are expected to demand an
The My Heart, My Life information pack provides         additional 9,000 hospital beds and claim the lives of
                        About    137,000
support by giving a comprehensive take-homeQueenslanders
                                                  guide    are7,500
                                                        over      living with coronary
                                                                       Australians         heart
                                                                                   each year.     disease.
                                                                                              Already         Most of th
                                                                                                        the annual
                                       12
to help heart patients, have    anginaand. carers.
                        their families     People need support      after heart
                                                        cost of repeat    a heart   attack
                                                                                attacks     to return
                                                                                        in Australia     to a normal life
                                                                                                     is $8.4
                        another heart attack and further     hospital
                                                        billion 7
                                                                  .      admissions. More than 20% of people
                        are likely to experience another heart attack, heart surgery or stroke within one
  In Queensland, prior to My Heart, My Life,                     The Report7 found that:
                        A recent
  patients were not receiving         Deloitte Access Economics Report, ACS in Perspective: The importanc
                                  a comprehensive
                        highlighted
  heart health information                      they number of• Australians
                                         that the
                             pack. Instead,                         86% of heartdying attack from
                                                                                               survivors don’theart
                                                                                                     repeat    know or
                                                                                                                     attacks is exp
  received incompleteby  or inaccurate    brochures                 underestimate       the  chances
                            2020. These repeat heart attacks are expected to demand an additional      of another heart  attack 9,00
  and photocopies or very
                        liveslittle information
                               of over                           •  fewer  than   one    in three understand
                                           7,500orAustralians each year. Already the annual cost of repeat hea that heart
  support when leaving     hospital.
                                 7    Research    with              disease is a chronic condition
                        billion .
  heart patients shows they prefer to receive the                •  one  in four fail to maintain positive lifestyle
  all-in-one My Heart, My Life resource.                            changes
                        The Report7 found that:                  • one in three stop taking their medication as
                             • 86% of heart attack survivors        directeddon’t know or underestimate the chances o
Heart Foundation research•11 has   fewer
                                      foundthan
                                              that:one in three understand that heart disease is a chronic condi
                             • one in four fail to maintain            positive
                                                                 The Report   7
                                                                                    lifestyle
                                                                                , based          changes
                                                                                            on patient research in 2011,
                             • one
 • 81% of patients who received        MyinHeart,
                                             threeMystop         strongly  recommends         the
                                                       Life taking their medication as directed   need  for high quality
     found it useful and the information valuable,               information for patients and their families to reduce
                                        7
                        The Report
     containing clear language,     easy ,tobased    on patientthe
                                             understand
                                                                     risk and burden
                                                                   research      in 2011,  of repeat  heart
                                                                                               strongly     attacks and the need
                                                                                                          recommends
                                                                 protect patients.
     diagrams, detailedpatients              theirfamilies to reduce the risk and burden of repeat heart attacks
                                     andoftheir
                          explanations
     conditions and step-by-step information on
     making lifestyle changes
 • 79% of patients stated they would make lifestyle
     changes after reading the resource
 • health professionals found the resource useful
     to provide to patients with easy to understand
     information that prompts patients to ask
     questions

About 137,000 Queenslanders are living with
coronary heart disease. Most of these have had a
heart attack or have angina12. People need support
after a heart attack to return to a normal life, to return
to work and to avoid another heart attack and further
hospital admissions. More than 20% of people who
have had a heart attack are likely to experience
another heart attack, heart surgery or stroke within
one to five years13.

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Queensland Election Submission 2012 - SAVE LIVES REDUCE AVOIDABLE HOSPITAL ADMISSIONS KEEP OLDER QUEENSLANDERS HEALTHY AND AT HOME TACKLE OBESITY ...
Support people with heart disease and heart failure

   3. Improve clinical support for better treatment and management of heart disease and heart
   failure
   Annual Investment: $250,000
   Commitment: Investment in the Heart Foundation’s clinical support program that provides training,
   resources and support for health professionals working with people with heart disease and heart failure.
   The Heart Foundation needs government funding to continue this work. Current funding ends on 30
   June 2013.

The Heart Foundation’s clinical support program                • 622 health professionals in Queensland have
includes a senior clinical role to lead and manage               attended a Motivational Interviewing workshop
the program. This role drives policy into practice,            • 269 health professionals across Queensland
delivers health professional training and produces               have attended a one day Motivational Interviewing
educational resources for health professionals to                intensive skill-building workshop
better support heart patients.

In collaboration with Queensland Health, general                 Health professionals report that as a result of
practice and other health stakeholders, the program              their training:
aims to:
                                                                 • “More patients will achieve better outcomes”
• improve self-management by people at risk of, or               • “Patients play an active role in their
  living with, heart disease or heart failure                       intervention and decide on the goals they
• provide educational resources and training                        wish to achieve, so outcomes are likely to
• provide access to the latest information for heath                positively impact upon a person’s life and be
  professionals and patients                                        long lasting”
• improve access to cardiovascular prevention and
  treatment
• assist people to identify and understand the
  warning signs of heart attack
• inform and educate women about their heart
  health risks
• evaluate clinical evidence and trends in health
  care delivery

Training in behaviour change management,
in particular Motivational Interviewing, was
overwhelmingly requested by acute cardiac hospital
staff14, to assist their patients to better manage their
heart health. Motivational Interviewing is a technique
used by health professionals to support clients to
make healthy lifestyle changes (such as being more
active, improving their nutrition, quitting smoking or
losing weight) in order to help to self-manage their
chronic disease, including heart disease and heart
failure.

The Heart Foundation has since worked with
Australian Motivational Interviewing experts to
provide Motivational Interviewing training from 2009-
2011, including:

• 3,802 health professionals have received a
  Professional Development Kit on Motivational
  Interviewing

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Queensland Election Submission 2012 - SAVE LIVES REDUCE AVOIDABLE HOSPITAL ADMISSIONS KEEP OLDER QUEENSLANDERS HEALTHY AND AT HOME TACKLE OBESITY ...
4. Increase the number of Queensland heart patients participating in cardiac rehabilitation
  Annual Investment: $5 million
  Commitment: Increase investment in cardiac rehabilitation services for all Queenslanders, including
  an increase in funding for a comprehensive state-wide cardiac rehabilitation service and ongoing
  funding of a State-wide Cardiac Rehabilitation Coordinator in Queensland Health.

Cardiac rehabilitation saves lives, improves                  People who attend cardiac rehabilitation improve
productivity and reduces hospitalisation and health           their exercise tolerance, symptoms, cholesterol
costs. All Queensland heart patients deserve the              levels, sense of wellbeing, their chances of quitting
opportunity to know about and participate in a                smoking and their survival rates. Patients who
cardiac rehabilitation program, but three out of four         don’t participate in cardiac rehabilitation have more
heart patients never receive cardiac rehabilitation           adverse risk profiles and poorer knowledge of risk
services.                                                     factors19.

Cardiac procedures in Australia have increased                Despite substantial evidence supporting the benefits
considerably from 1993-94 to 2007-08, with the                of cardiac rehabilitation, attendance and participation
number of hospitalisations for heart attack increasing        in existing programs is alarmingly low. In 200320,
by 80% and for unstable angina by 33%15. However,             70% of eligible patients in Queensland did not attend
once people are in hospital, they’re staying for a            cardiac rehabilitation and this has not improved over
shorter time. This means that, more than ever,                time16, due largely to a lack of dedicated funding and
people need cardiac rehabilitation support when they          low referral rates21. Current cardiac rehabilitation
return home after a cardiac event.
                                                              services also fail to meet the needs of some
                                                              individuals and people at the highest risk of cardiac
Patient research shows that 86% of heart attack
                                                              events, including Aboriginal and Torres Strait Islander
survivors either don’t know or underestimate the
                                                              people22.
chances of a repeat event, fewer than one third
understand the chronic nature of their condition, one
                                                              The Health Quality and Complaints Commission’s
in four fail to maintain positive lifestyle changes and
                                                              Management of acute myocardial infarction on or
one in three stop taking their medication as directed7.
                                                              following discharge or transfer standard (2010)23
The Heart Foundation strongly supports the ten                emphasises the need to ensure that all patients
recommendations from the State-wide Cardiac                   have access to lifestyle modification strategies and
Rehabilitation Reform Project and is calling                  are referred to a cardiac rehabilitation program on
for the allocation of adequate funding for their              discharge. Clearly, these standards are not being
implementation.                                               met.

                                                              The recent Deloitte Access Economics7 report
  Reduce hospital re-admissions and health                    recommends that in response to the increase in
  care costs                                                  the number of Australians dying from repeat heart
  • more than 20% of people who have                          attacks, action is needed to provide:
    previously had a heart attack are likely to
    experience another heart attack or stroke                 1. A structured framework for patients post hospital
    within one to five years13                                   discharge for long term management and support
  • after a heart attack, cardiac rehabilitation              2. 100 per cent referral to rehabilitation programs
    reduces people’s chances of returning to                     and services with active follow up post discharge
    hospital with another heart attack, but                   3. High quality ongoing maintenance programs to
    only 25% of people ever receive cardiac                      support lifestyle changes
    rehabilitation services16                                 4. Access for patients to psychosocial support
                                                                 services post event - and proactive follow-up post
                                                                 event
Cardiac rehabilitation benefits people of all ages and        5. High quality information for patients and their
is associated with reduced hospital re-admissions,               families to support sound decision making
better quality of life and improved symptoms .
Research has found a 35% increase in survival five
years after a heart attack or coronary artery blockage
among people who attended cardiac rehabilitation
compared with those who did not18.
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Queensland Election Submission 2012 - SAVE LIVES REDUCE AVOIDABLE HOSPITAL ADMISSIONS KEEP OLDER QUEENSLANDERS HEALTHY AND AT HOME TACKLE OBESITY ...
5. Increase the access to and support from allied health professionals for Queenslanders living
   with heart failure
   Annual Investment: $ 2 million
   Commitment: Increased funding for the state-wide heart failure multidisciplinary care program to
   improve access to allied health professionals, especially psychologists and dietitians.

Heart failure is a chronic, progressive, incurable           Multidisciplinary heart failure care includes25.
condition. It occurs when the heart muscle becomes
increasingly too weak to pump blood throughout the           •   biomedical care
                                                             •   self-care education and support
body as effectively as normal. Heart failure is caused
                                                             •   psychosocial care
by heart muscle damage from a heart attack, quite            •   palliative care
often because of patient delay responding to warning
signs, or by poorly managed high blood pressure,             Many people whose condition is not managed
both of which are prevalent conditions.                      effectively continue to frequent hospital, often
                                                             unnecessarily.
The Heart Foundation represents the 60,000
                                                             The number of Queenslanders living with heart
Queenslanders who are living with heart failure24.           failure will continue to grow and we need to manage
                                                             their care more effectively to improve their health
People living with heart failure need support from           and quality of life and to reduce the soaring costs
a multi-disciplinary team of health professionals            of hospital re-admissions. It is estimated that
in acute and primary health care to manage their             heart failure accounted for 7.7% of avoidable
                                                             hospitalisations for chronic conditions in 2001-0226
condition. Heart failure has distressing symptoms
                                                             and, unless systematically addressed, the costs of
that can last and worsen for many months or years            avoidable hospitalisations will significantly grow.
before people die. There is convincing evidence that
people who have been hospitalised with heart failure         A comprehensive heart failure program is needed
and receive multidisciplinary care have better health        in Queensland. The current state-wide heart failure
outcomes and fewer hospitalisations than those who           service in Queensland provides 23 multidisciplinary
                                                             care services to patients with heart failure. However,
do not25.
                                                             10% of people over 65 will develop heart failure25 and
                                                             current heart failure services will simply not cope.

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Queensland Election Submission 2012 - SAVE LIVES REDUCE AVOIDABLE HOSPITAL ADMISSIONS KEEP OLDER QUEENSLANDERS HEALTHY AND AT HOME TACKLE OBESITY ...
re reaches their end stage of life, access to palliative care service
eart Foundation is calling for improved access to palliative care ser
ailure.
         6. Increase access to palliative care services in hospital and at home for people dying from heart
         failure
 achieve the best possible quality of life for the individual, their car
         Annual Investment: $6 million
 care does not depend on any specific medical diagnosis, but on th
         Commitment: Increased investment in palliative care services for people dying from heart failure
         because current services are inadequate.
f life by addressing physical symptoms such as pain or nausea, as
                                27
al andMany social     needswho
           people in Queensland    .have
                                     It also      provides
                                         heart failure, Recent physical        and
                                                               national data show      psychosocial
                                                                                  that 84% of all palliative s
       a chronic, progressive and incurable condition, are             care beds nationally are allocated for people with
       dying without the support of palliative care services           cancer but only 3% are allocated to people with
       to assist their end of life. This is due to a lack of           cardiovascular disease28. The Queensland data show
       availability of heart failure beds in the acute hospital        a similar trend, with 86% of all palliative care beds
at 84% of all palliative care beds nationally are allocated for people
       setting, as well as poorly funded and resourced
       services to support those who wish to die at home.
                                                                       allocated for people with cancer, and only 3.4% to
                                                                       28
                                                                       cardiovascular disease. As a result, palliative care
 eople    with cardiovascular disease . The Queensland data show a
    Once a person with heart failure reaches their end
                                                                       services in Queensland are inadequate to support
bedsstageallocated
           of life, access tofor    people
                              palliative          with
                                         care services in cancer, and only 3.4% to cardiovas
                                                                       the needs of the large and increasing number of
                                                                       Queenslanders dying from heart failure.
    Queensland is limited. The Heart Foundation is
vices    inforQueensland
    calling                              are inadequate
                 improved access to palliative  care services     to support the needs of the la
                                                              As well as a shortage of palliative care beds, there is
    for people with end stage heart failure.
landers dying from heart failure. a lack of coordination of medical, nursing and allied
       The aim of palliative care is to achieve the best               services for people who are terminally ill with heart
       possible quality of life for the individual, their carers       failure. People with heart failure are increasingly
 tive care beds, there is a lack of coordination of medical, nursing a
       and their family. The need for palliative care does
       not depend on any specific medical diagnosis, but
                                                                       choosing to be cared for at home during the end
                                                                       stages of life and need more support.
erminally ill with heart failure. People with heart failure are increasin
       on the person’s needs27. It maintains quality of life
       by addressing physical symptoms such as pain
g the end stages of life and need more support.
       or nausea, as well as helping with emotional,
       spiritual and social needs27. It also provides
       physical and psychosocial support from diagnosis
       to end-of-life care.

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Queensland Election Submission 2012 - SAVE LIVES REDUCE AVOIDABLE HOSPITAL ADMISSIONS KEEP OLDER QUEENSLANDERS HEALTHY AND AT HOME TACKLE OBESITY ...
Foundation Regional Heart Health Program
                     Annual Investment: $150,000
                     Commitment:    Investment
                               Regional   HeartinHealth
                                                   the Heart Foundation’s Regional Heart Health Pro
                                                          Program
                     incidence of poor heart health in regional Queensland, including amongst Aborig
                     people.
  7. Support Queenslanders living in regional and remote communities by investing in the Heart
  Foundation Regional
                  TheHeart  Health Program
                       state-wide   Regional Heart Health Program aims to reduce the high burden
                  regional
  Annual Investment:        and remote Queensland, including Aboriginal and Torres Strait Islande
                     $150,000
  Commitment: Investment in the Heart Foundation’s Regional Heart Health Program to reduce the high
                     The health
  incidence of poor heart HeartinFoundation   will provide
                                  regional Queensland,      strategic
                                                       including      direction,
                                                                 amongst Aboriginalleadership   and operationa
                                                                                     and Torres Strait
  Islander people. Queensland-wide program to prevent, manage and reduce the burden of heart a
                     disease in regional communities.
The state-wide Regional Heart Health Program aims           The state-wide manager role will work to integrate
                     This Regional Heart Health Program will encompass:
to reduce the high burden of cardiovascular disease         heart health priorities across the breadth of work by
                          management
in regional and remote• Queensland,       and coordination
                                    including              of aFoundation;
                                                      the Heart team of Regional   Heart
                                                                           implementing theHealth
                                                                                           followingpositions
                          byIslander
Aboriginal and Torres Strait  privatecommunities.
                                      business. BHP Billiton  Cannington
                                                    priority actions         hasQueensland:
                                                                     in regional agreed to fund a North Qu
                         Health Manager based in Townsville over the next three years. The Heart Fo
                         of six people working in regional Queensland and is seeking Queensland Go
The Heart Foundation will provide strategic direction, • Maximise the uptake of Heart Foundation Walking
                         state-wide manager role.
leadership and operational management of a                     groups
                   • strengthening
Queensland-wide program                and maintaining
                        to prevent, manage             relationships
                                                  • Improve           with peak
                                                             tobacco control      bodies and
                                                                             implementation     other rele
                                                                                            locally
                         Indigenous and mainstream
and reduce the burden of heart attack and other
                                                    health sectors to improve the heart health of reg
                                                  • Better hospital care for Aboriginal and Torres Strait
                         Queenslanders, including Aboriginal and Torres Strait Islander people.
cardiovascular disease in regional communities.                Islander people experiencing heart attack
                      The state-wide manager role will       work tothe
                                                        • Increase    integrate
                                                                         uptake ofheart  health priorities
                                                                                   cardiovascular health   across
                      Heart   Foundation;     implementing
This Regional Heart Health Program will encompass:          the following    priority actions
                                                           checks in primary healthcare        in regional Queens
                      • Maximise the uptake of Heart        Foundation
                                                        • Disseminate       Walking
                                                                         consumer     groupsincluding; My
                                                                                    resources
                      • Improve tobacco control implementation
• management and coordination of a team of
                                                                          locally
                                                           Heart, My Life and My Heart My Family Our
                      • Better hospital care for Aboriginal and Torres Strait Islander people experien
   Regional Heart Health positions and operations          Culture
                      • Increase the uptake of cardiovascular health checks in primary healthcare
   to be funded by private business. BHP Billiton       • Support the roll out of the Warning Signs of Heart
                      • Disseminate consumer resources including; My Heart, My Life and My Heart
   Cannington has agreed to fund a North                   Attack campaign locally
                      • Support the roll out of the Warning Signs of Heart Attack campaign locally
   Queensland Regional Heart Health Manager             • Trial health professional education and training
                      • Trial health professional education and training program; Motivational Intervie
   based in Townsville• over the next with
                          Integrate   three the  Queenslandprogram;
                                             years.                  Motivational Interviewing Toolkit
                                                             Government’s       Rheumatic Heart Disease Proje
   The Heart Foundation    aims to build a team of  six •  Integrate with  the Queensland
                      • Advocate for the improved heart health of regional Queenslanders,  Government’s including
   people working in regional  Queensland
                          Islander   peopleand is          Rheumatic Heart Disease Project
  seeking Queensland Government funding for the             • Advocate for the improved heart health of regional
  state-wide manager role.                                     Queenslanders, including Aboriginal and Torres
• strengthening and maintaining relationships with             Strait Islander people
  peak bodies and other relevant stakeholders
  in both the Indigenous and mainstream health
  sectors to improve the heart health of regional and
  remote Queenslanders, including Aboriginal and
  Torres Strait Islander people.

                                                        9
Aboriginal and Torres Strait Islander Heart Health Program

  8. Provide My Heart My Family Our Culture resources to health professionals and Aboriginal and
  Torres Strait Islander heart patients to Close the Gap faster
  Annual Investment: $200,000
  Commitment: Investment in the state-wide dissemination of culturally appropriate heart health resources
  for Aboriginal and Torres Strait Islander people who have had a heart attack, and those at high risk.

To Close the Gap on Indigenous life expectancy, it is          • 94% of respondents believed the pack improved
critical that we improve the heart health of Aboriginal          their client’s awareness and knowledge about
and Torres Strait Islander people. Cardiovascular                prevention of heart disease and risk factors
disease is the biggest killer and the greatest single          • 77% believed it improved their own awareness
contributor to the gap in life expectancy between              • 65% of respondents had talked their clients
Aboriginal and Torres Strait Islander people and                 through the resources; not just distributed the
non-Indigenous Australians. Approximately 28%                    package
(146,000) of Australia’s total Indigenous population           • 55% of respondents had personally handed out
resides in Queensland.                                           the packs to their Indigenous patients

Death rates for coronary heart disease, mainly heart           These resources are now ready to be further
attack, among Aboriginal and Torres Strait Islander            developed and disseminated throughout Queensland
people in Queensland are about double non-                     Aboriginal and Torres Strait Islander communities.
Indigenous rates1. Significantly, Indigenous people            Health professionals strongly believe that neither
aged 25-45 years are 15 times more likely to suffer
                                                               patients nor health services should have to pay for
from a fatal heart event than other Australians1.
                                                               these resources for a patient group with high need.
The Heart Foundation has developed the
My Heart My Family Our Culture education program
to address the critical shortage of targeted heart
health resources for Indigenous people and
communities. The resources include materials for
health professionals and for Indigenous people. The
development of My Heart My Family Our Culture
has involved a great deal of community consultation
and has been widely praised for its content and
usefulness.

The My Heart My Family Our Culture resources have
been successfully trialled and used in group settings
including family groups, as well as with individuals
in community and hospital settings. The resources
have evaluated well, receiving very positive feedback
from health professionals. It helped them to engage
appropriately with Aboriginal clients and they felt the
resources were culturally relevant and extremely
useful.

The evaluation of My Heart My Family Our Culture
among health professionals found that:

• 89% of respondents believed the pack helped
  to communicate the message to the Indigenous
  community

                                                          10
9. Invest in cardiac trials for Indigenous people by allocating existing Closing the Gap funds to
  the State-wide Cardiac Clinical Network
  Annual Investment: $1 million
  Commitment: Allocation of existing funding through the Closing the Gap Implementation Plan to ensure
  the significant gap in cardiac care for Aboriginal and Torres Strait Islander people is closed.

Existing funding urgently needs to be allocated to:
                                                                  A report from the Australian Institute of Health
                                                                  and Welfare30 found that compared with other
• conduct specific trials using multiple strategies in a
                                                                  Australians, Aboriginal and Torres Strait Islander
  cardiac setting such as Aboriginal Liaison Officers
                                                                  people had:
  in hospital cardiac wards, cultural competency
  training and identification processes
                                                                  • 3 times the rate of major coronary events,
• continue funding a full-time Queensland Health
                                                                    such as heart attack
  Coordinator role to progress these priority actions
                                                                  • 1.4 times the out-of-hospital death rate from
  in collaboration with the State-wide Cardiac
                                                                    coronary heart disease
  Clinical Network
                                                                  • more than twice the in-hospital death rate
                                                                    from coronary heart disease
Death rates for coronary heart disease among
                                                                  • a 40% lower rate of being investigated by
Indigenous Queenslanders are about double those
                                                                    angiography
for non-Indigenous people1. By reducing these death
                                                                  • a 40% lower rate of coronary angioplasty or
rates to that of the total population, Indigenous
                                                                    stent procedures
Australians could gain 6.5 potential years of life
                                                                  • a 20% lower rate of coronary bypass surgery
expectancy29.

One area where significant gains could be made is
                                                                The Heart Foundation is advocating for the
in improving hospital care. There is strong evidence
                                                                implementation of 15 key recommendations31
that Aboriginal and Torres Strait Islander people who
                                                                to address these disparities in care. These
present to hospital with a heart attack do not receive
                                                                recommendations offer practical measures for
hospital care equivalent to other Australians with the
                                                                clinicians, health services and hospitals to deliver
same condition.
                                                                quality care.

                                                                Hospital care for Aboriginal and Torres Strait
                                                                Islander people continues to be inequitable and it
                                                                is essential that Queensland’s State-wide Cardiac
                                                                Clinical Network can access funds to conduct
                                                                cardiac trials specifically with, and for, Aboriginal
                                                                and Torres Strait Islander people. There is currently
                                                                no transparent mechanism to access Closing the
                                                                Gap Implementation Plan funding across multiple
                                                                strategies.

                                                           11
Obesity and Healthy Living Program

   10. Help older Queenslanders be active by supporting the Heart Foundation Walking program
   Annual Investment: $250,000 ($750,000 over 3 years)
   Commitment: Ongoing investment in the Heart Foundation Walking program. Current funding with the
   Queensland Government, through Sport and Recreation Queensland, finishes on
   30 June 2012.

Heart Foundation Walking provides Queensland’s
largest network of free community walking groups,                 Heart Foundation Walking Successes:
with 320 free walking groups and 4,800 regular
walkers. Over 20,000 Queenslanders have                           • 2000 new walkers recruited in 2011
participated over the past 12 years. We work in
                                                                  • 49 local government regions covered
partnership with area coordinators in local agencies
to establish walking groups in local communities led              • 17 shopping centre groups where
by volunteer walk organisers.                                       people can walk in a safe air-conditioned
                                                                    environment
Heart Foundation Walking is accessible to people                  • 3 remote Aboriginal and Torres Strait Island
who most need it and have few choices in physical                   groups run by local people (Torres Strait,
activity programs; including:                                       Woorabinda Aboriginal Shire and Aurukun
                                                                    Aboriginal Shire)
• previously inactive, older women and men                        • 3 Culturally and Linguistically Diverse
• people living in greater socio-economic                           walking groups (Ethiopian, Hazaran and
  disadvantage                                                      Liberian women)
• people living alone or with relatively few social               • 90% of participants continue to walk after
  connections                                                       one year – much higher than the 50%
                                                                    achieved by a typical community based
Free walking programs keep people out of hospital                   physical activity program at 6 months
and actively engaged in their community. A survey of
over 4,000 Queenslanders in the Heart Foundation’s
recent Heart Health Challenge found that 57% of              Heart Foundation Walking has succeeded in
people said they would be more active if there were          increasing people’s physical activity levels. Among
local walking or cycling groups near where they live.        walkers who were still participating after 12 months33
                                                             we found that:
Heart Foundation Walking provides a safe, healthy
and social community environment. Of walkers                 • people who were sedentary when they joined
surveyed32, 85% reported the program is important              increased their walking by 3 hours and their total
for their social and mental wellbeing and 94% for              physical activity by nearly 4 hours per week
their physical wellbeing. This suggests that walkers         • people who were insufficiently active when they
join for the health benefits, but stay for the social          joined increased their walking by 1 hour and their
benefits.                                                      total physical activity by 2 hours per week
                                                             • people who were already sufficiently active when
                                                               they joined maintained their walking and total
                                                               physical activity levels.

                                                             Increasing the physical activity of adults who are
                                                             sedentary or insufficiently active, is one of, if not the
                                                             best, investments in public health. Heart Foundation
                                                             Walking achieves this.

                                                        12
11. Invest in an ongoing campaign to increase fruit and vegetable consumption and
   production
   Annual Investment: $3 million
   Commitment: Increased investment in social marketing campaigns to support healthier eating in our
   community. The Heart Foundation is recommending that the successful Go for 2 and 5 campaign be
   re-funded in Queensland due to its early success.

Only 8% of Queensland adults are eating enough                 Re-instating this campaign would support the
vegetables and fruit. Low intake of vegetables and             implementation plan activities in the Social Marketing
fruit is estimated to cause 31% of heart disease and           Initiative (SMI) of the National Partnership Agreement
11% of strokes1. To counteract this unhealthy trend            on Preventive Health37, designed to complement
and the daily exposure to advertising of unhealthy             the national social marketing campaign; Swap It,
foods, governments need to invest in evidence-                 Don’t Stop It. It would also help increase demand for
based social marketing to support people to make               vegetables and fruit and provide economic benefit for
healthier food choices.                                        Queensland farmers and regional communities.

Queensland’s new economic development
framework, Food for a growing economy, commits                   Economic benefits from increasing fruit and
to delivering evidence-based nutrition messages,                 vegetable intake from 3.5 serves to 4.6 serves
promoting fresh Queensland fruit and vegetables34.               per day:

Ongoing campaigns to reduce smoking have been                    • estimated savings of $50 million per year
some of the most successful campaigns proving                      in acute treatment services throughout
that reductions are highly related to the levels of                Queensland while Go for 2 and 5 was
media expenditure35. Well-funded, sustained media                  running36
campaigns rank second only to price increases as a               • an extra $9.3 million in retail sales of fruit and
key to reducing smoking.                                           vegetables in Brisbane in the first month of
                                                                   the campaign38. The report concluded that
Like all social marketing campaigns, to achieve                    the Go for 2 and 5 campaign investment
ongoing behavioural change, enough money                           contributed to this positive impact on demand
needs to be spent. Based on 15 years experience                  • economic benefits would also be realised
in Australia and from international studies, it has                from further spending on Go for 2 and 5
been recommended that media spending on QUIT                       by individuals and businesses through
campaigns should be high enough to achieve at least                production gains in working, household
700 TARPS (Target Audience Rating Points) per                      activities and leisure, and by government
month35.                                                           through taxation gains as a result of people
                                                                   not becoming ill or retiring from the workforce
The Go for 2 and 5 campaign successfully achieved                  prematurely39
its aim to increase fruit and vegetable consumption
with an increase from 3.5 serves to 4.6 serves per
day while the campaign was running; even though                It has been estimated in Australia that an increase
the full four years funding was not spent ($4.4 million        in two extra daily serves of vegetables or one
over 4.5 years). Queensland Health survey results              extra daily serve of fruit per person would result
after the campaign showed36:                                   in a decrease of 1,250 new cases of disease, 780
                                                               deaths, and 9,400 DALYs (Disability Adjusted Life
• 57% of survey respondents had tried to make                  Years) each year39. This would reduce the estimated
  changes to their diet in the last two months and             $206 million of national preventable ill-health sector
  half of these said they had tried to eat more fruit          costs in 2008 associated with inadequate fruit and
  and vegetables                                               vegetable consumption by 34% ($71 million).
• 91% of these reported they were successful

                                                          13
12. Reform food policies to inform consumers:
  a) Ban junk food advertising to children
  b) Legislate kilojoule content on menu boards of fast food chains
  Annual Investment: Low cost
  Commitment: Instigate regulation and legislation to protect children and inform consumers about the
  food they are eating. This kind of reform can bring about positive social change and support individuals
  who want to make healthier food choices.

The next Queensland Government can effectively                 Australian children are being exposed to about 10
use legislation and regulation to protect children from        food advertisements every day, most for unhealthy
junk food advertising and help Queenslanders make              foods and the research concluded that this is
healthier choices by supporting legislation to provide         contributing to the prevalence of childhood obesity by
nutrition information on menu boards. In addition,             an estimated 10% to 28%45.
the Queensland Government should continue to                   Removing the advertising of foods and beverages
support federal reform to ensure a good front of pack          high in sugar and fat from 7-8am and 3-9pm Monday
labelling system on nutrition content of the foods we          to Friday and 6am-1pm Saturday and Sunday, was
buy in supermarkets.                                           by far the most cost-effective of 13 interventions
                                                               assessed for reducing adolescent and childhood
Overweight and obesity are now the leading cause of            obesity46.
premature death and disability in Queensland, with
1 in 3 adults overweight and 1 in 4 obese, and 1 in
4 children overweight or obese1 . Despite a target to
cut overweight and obesity in Queensland by one-
third by 2020, these rates have increased by 3.3%
for men and 6.3% for women40. Doing nothing is no
longer an option.

a) Ban junk food advertising to children
The Heart Foundation is seeking a commitment to
ban junk food advertising to children. Almost 90% of
people favour stronger government restrictions41.

Television advertising influences children’s food
preferences, purchase requests and consumption
patterns42 and most of the extensive marketing                 Advertising restrictions would also help to maximise
directed at children is for foods with a high content          returns on government investment in social
of fat, added sugar and/or salt. Restricting television        marketing campaigns as there would be less
advertising of high fat and/or high sugar food and             competition with advertisements for unhealthy foods.
beverages was found to be one of the most cost-                Research has found that advertising nutritious
effective, population-based interventions available            foods promotes positive attitudes and beliefs about
today43.                                                       these foods, and yet we continue to see 73% of
                                                               all advertisements shown during kids programs
Despite the introduction of self-regulation by the             promoting foods and drinks that are high in fat, salt
food industry in 2009, a recent study by the CSIRO44           and sugar, with little nutritional value47.
found that there has been no change in the level of
junk food advertising in the hours that most children
are watching television. Self-regulation is clearly not
working, so legislative reform is needed.

                                                          14
d at home.

 ACT,b) the    legislation
         Legislate  for fast foodwould
                                  chains toapply      to cafés,
                                             show kilojoule        quick
                                                               As in NSW and service       restaurants
                                                                                 the ACT, the legislation wouldand
                                                                                                                apply snac
e outlets
      contentinon Queensland
                   menu boards          or 50 outlets nationally.
                                                               to cafés, quickFood      outlets would
                                                                               service restaurants   and snack be
                                                                                                               food requir
                                                               chains that have 20 or more outlets in Queensland or
      The Heart Foundation is seeking political
  of standard
      commitment tofood       items
                       pass the        onlegislation
                                proposed    their menu
                                                     to       boards
                                                               50 outlets at  the point
                                                                          nationally.         of sale.
                                                                                      Food outlets         This
                                                                                                    would be        will he
                                                                                                             required
 pareensure
         theQueensland
               energy consumers
                            contentareofgiven meals     and make
                                                  the same              informed
                                                               to display                choices
                                                                          the kilojoule content        about
                                                                                                of standard foodthe
                                                                                                                 itemsitem
                                                               on their menu boards at the point of sale. This will
ume.information   on the kilojoule content of food on sale at
      fast food outlets as consumers in NSW and the ACT.
                                                               help Queenslanders compare the energy content of
                                                                  meals and make informed choices about the items
                                                                  they purchase and consume.
umers, retailers will also need to display the total daily energy intake for com
     To support the needs of consumers for
energy  intake is 8700 kJ.
     information about what they’re eating away
                                                To further help consumers, retailers will also need to
                                                display the total daily energy intake for comparison:
         from home, the Heart Foundation published an             The average adult daily energy intake is 8700 kJ.
u board is to make it quick and easy for The
                                         theaimconsumer
         independent review of the available evidence to
                                                               to understand how ma
                                                  of the menu board is to make it quick and
         guide policy and legislation in this area48:
 they choose the menu item.              easy for the consumer to understand how many
         • eating out has become part of our                      kilojoules they will consume if they choose the menu
                                                                  item.
           daily routine, but we often significantly
rt Foundation is calling for a full nutrition information panel for all standard foo
           underestimate the energy in foods we buy,
his would give consumers a fuller pictureIn    addition, the Heart Foundation is calling for a full
                                               of what they’re eating, including sat
           which is why it’s important to give people
                                             nutrition information panel for all standard food items
d sugars and fibre.
           the facts                         onsite and online. This would give consumers a fuller
         • in 2009, 4.5 million Australians visited a fast        picture of what they’re eating, including saturated fat,
           food outlet (chain and independent store)              trans fat, salt, added sugars and fibre.
on also wants to see incentives for the food industry to reformulate food recip
           every day
                                         The Heart Foundation also wants to see incentives
         • food eaten away from home has been shown
king methods to make them healthier. An      independent industry-funded, healt
                                         for the food industry to reformulate food recipes,
           to be more energy dense and of larger
n campaign is also needed.               ingredients and cooking methods to make them
           portion size than meals prepared at home48.
                                                                  healthier. An independent industry-funded, health
                                                                  driven consumer education campaign is also needed.

                                                             15
that activity. Smart Moves requires that every student is provided an effective 3
           every day at school. However, teachers often don’t feel adequately prepared to
           need training and support. The Heart Foundation is calling for adequate teache
           Movesphysical
   13. Strengthen  is successful.
                           activity and healthy eating in schools
   Annual Investment: Low cost
          The TravelSmart
   Commitment:   Strengthen measuresSchools     program
                                          to increase       is activity
                                                      physical another  and initiative  to increase
                                                                             healthy eating               children’s ph
                                                                                            in our schools.
          increase
   Programs            the number
            such as Smart                of children
                             Choices, Smart    Moves andwalking,
                                                         TravelSmart cycling
                                                                        Schoolsorhave
                                                                                    using
                                                                                       goodpublic     transport
                                                                                              intentions, but    to get
          38 schools participated in the program and 135 schools will be targeted in 2012
   have been less effective in their implementation.

           While this program has achieved some success, progress will be slow while ch
School is an ideal setting for physical activity           The TravelSmart Schools program is another
and healthyto   large
              eating      volumes
                     initiatives. Whileofa fast traffic,
                                           number   of   mostly  made
                                                           initiative      up of children’s
                                                                      to increase  concerned       parents
                                                                                            physical   activity dropping
                                                                                                                levels.
             need
initiatives have beensupportive      legislation
                       introduced into    Queenslandsuch as:
                                                           It seeks to increase the number of children walking,
schools, they• arereducing
                   not achieving   their potential.
                                 speed     limits around schools
                                                           cycling orto    30kph
                                                                        using public transport to get to and from
            • increased
Too many children               public ortransport
                   are still overweight    obese. A services at discounted fares
                                                         school. In 2011, 38 schools participated in the
                                                         program and 135 schools will be targeted in 2012.
            • 49incentives
national survey                 to leave
                 of 12,000 students         cars
                                      in years 8-11at home.
across 237 schools found that:

• 1 in 4 students are overweight or obese, with a
  significantly higher rate in low socio-economic
  areas
• 85% of students don’t engage in sufficient activity
  for health
• 76% are not meeting the daily recommended
  intake of four vegetable servings daily
• 59% are not meeting the daily recommended
  intake of three servings of fruit daily
• 1 in 3 drink four or more cups of soft drink, cordial
  or sports drink a week
• more than half (51%) tried a new food or
  drink product in the past month that they saw
  advertised

Smart Choices was introduced into Queensland
schools to ensure all food and drink supplied in state
schools reflects the Australian Guide to Healthy
Eating50 and the Dietary Guidelines for Children and
Adolescents in Australia51. This policy applies to all         While this program has achieved some success,
situations where food and drink is supplied in the             progress will be slow while children continue to be
school environment (tuckshops, vending machines,
                                                               exposed to large volumes of fast traffic, mostly made
school excursions, fundraising, classroom rewards,
                                                               up of concerned parents dropping their children to
sports days etc).
                                                               school. Parents need supportive legislation such as:
The Heart Foundation supports the strengthening of
Smart Choices to improve its effectiveness so that             • reducing speed limits around schools to 30kph
all students benefit from healthier choices. Increased         • increased public transport services at discounted
monitoring and accountability is essential.                      fares
                                                               • incentives to leave cars at home.
Smart Moves was introduced to increase student
participation in physical activity and to improve the
quality of that activity. Smart Moves requires that
every student is provided an effective 30 minutes
of physical activity every day at school. However,
teachers often don’t feel adequately prepared
to provide effective activities and need training
and support. The Heart Foundation is calling for
adequate teacher training to ensure Smart Moves is
successful.
                                                          16
Active Transport and Congestion Busting Initiatives

   14. Invest in a campaign to increase active travel participation (walking, cycling, public
   transport) and public transport patronage
   Annual Investment: $3 million
   Commitment: Investment in a comprehensive campaign to encourage the benefits of public transport
   and increase patronage. On average, people using public transport spend 41 minutes walking and/or
   cycling as part of their daily travel, compared to 8 minutes per day for people using private transport 52.

Active travel and planning for healthy communities             We urgently need to reduce car trips and introduce
must be a priority for a healthy Queensland                    measures to increase active travel for the health and
because of its great potential to reduce congestion            economic benefits to our community. Congestion is
and pollution and increase the physical activity of            not only inconvenient, but it’s costly. It’s estimated
Queenslanders. People who are not physically active            that the social costs of congestion in Australia are
are more likely to have risk factors for heart disease         rising strongly, to an estimated $20.4 billion by
and most other preventable chronic diseases.                   202056.
Integrated land use and transport planning will
provide the best long term gains in levels of physical
                                                               Investing in congestion busting measures is also
activity.
                                                               popular with the community. An Auspoll survey57,
Practical guides for planners and legislators on               commissioned by a consortium including the Heart
how to plan for healthier communities have been                Foundation, found that 87% of Australians support
developed by the Heart Foundation in partnership               government investment in addressing congestion
with government and planning stakeholders; Healthy             and 85% want the Government to fund better
Spaces and Places53 and Queensland’s Active,                   planning to make walking and cycling for transport
healthy communities resources54.                               more convenient.

The Heart Foundation recommends that people                    An Australian Vision for Active Transport58, developed
achieve a minimum of 30 minutes a day of moderate-             by key stakeholders including the Heart Foundation,
intensity physical activity for health. People who             advocates for increased active transport with the
actively travel don’t need to find an extra 30 minutes         following recommendations:
a day of physical activity, because they are achieving
it as part of their everyday life.                             1. Reorientate transport policy to prioritise and fund
                                                                  an integrated approach to walking, cycling and
A social marketing campaign to promote active
                                                                  public transport
travel and these benefits should result in increased
                                                               2. Set clear goals and targets for walking, cycling
public transport patronage, cycling and walking;
thereby reducing congestion as well. Supportive                   and public transport use and ensure they are met
infrastructure and policy changes are also needed              3. boost funding for infrastructure that supports
to get the greatest benefit out of this campaign,                 active transport and monitor and evaluate this
including:                                                        investment
                                                               4. Provide programs that increase use of existing
• increase the capacity of the public transport                   and new active transport infrastructure – eg
  system through more regular connected services                  school-based cycling education courses,
• make public transport more affordable                           community walking and cycling programs, social
• continue timetable improvements                                 marketing initiatives
• prioritise infrastructure projects such as the Cross-        5. Support urban redesign through the Healthy
  River Rail Project and station refurbishments.                  Spaces and Places Project53 to promote active
                                                                  communities
Improving the affordability of public transport would          6. Introduce physical activity impact assessments
increase patronage, instead of current trends. Public             on all planning and policy decisions
transport costs have increased by 48% in Brisbane              7. Support work-based programs and incentives to
over the last five years55. Affordability has had a               encourage walking, cycling and public transport
further blow with a new 15% increase on fares from                use; such as walk and ride to work programs,
1 January 2012.                                                   subsidised cycle fleets and bus passes
                                                          17
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