Policy context

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Policy context


In recent years there has been a growing focus on the role of lifestyle factors such as overweight and obesity, physical inactivity, and poor nutrition in the development of chronic diseases including cancer. An increased understanding of the role of these factors in chronic disease has led to the development of a framework of policy, both globally and in an Australian setting, aimed at reducing their impact.

International resources include:

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Australian government initiatives

National Partnership Agreement on Preventive Health

The National Partnership Agreement on Preventive Health was established by the Council of Australian Governments in 2008 to address lifestyle risk factors for chronic disease. The Agreement sets a target to increase the proportion of children and adults with a healthy body weight by three per cent within 10 years, and to increase the proportion of children and adults meeting healthy eating and physical activity guidelines by 15% within six years[5].

The Agreement provides $872 million over six years in preventive health initiatives targeting overweight and obesity, physical inactivity and poor nutrition, along with alcohol and tobacco use. The initiatives funded through the Agreement have a heavy focus on settings based interventions and social marketing, together with significant infrastructure investment.

See the National Partnership Agreement on Preventive Health website for up to date information on the Agreement.

The Australian National Preventive Health Agency

The Australian National Preventive Health Agency (ANPHA) was established in 2011 as a key infrastructure initiative of the National Partnership Agreement on Preventive Health. The need for a national preventive health agency was also supported by the recommendations of the National Preventative Health Taskforce (see below).

ANPHA plays a role in the coordination of preventive health policy across governments and has an advisory capacity to support all Australian Health Ministers. The Agency is responsible for the implementation of a number of the initiatives of the National Partnership Agreement on Preventive Health. This includes the management of a preventive health research fund, conducting an audit of the preventive health workforce, and implementing national social marketing campaigns targeting obesity and smoking. ANPHA is responsible for monitoring the marketing of unhealthy food to children.

See the ANPHA website for up to date information on ANPHA activities.

National Preventative Health Taskforce

In 2009, Australia’s first comprehensive preventive health strategy was developed by the National Preventative Health Taskforce. The National Preventative Health Strategy comprises a comprehensive approach to reducing the impact of smoking, nutrition, alcohol, and physical activity on chronic disease[6].

The obesity control component of the Strategy supports the specific obesity targets set by the National Partnership Agreement on Preventive Health[5] (see above) and further, aims to halt and reverse the rise in overweight and obesity in Australia by 2020[6].

The Strategy outlines a series of evidence-based recommendations that provide a comprehensive approach to targeting the underlying determinants of obesity. The recommendations focus on preventive health program priorities and infrastructure requirements.

The Taskforce recommendations are consistent with global strategies including the World Health Organization Global Strategy on Diet, Physical Activity and Health[7] and the World Cancer Research Fund report, Policy and Action for Cancer Prevention: Food, Nutrition and Physical Activity, a Global Perspective[4].

See the National Preventative Health Taskforce website for up to date information on Taskforce activities.

State and territory initiatives

A range of strategies have been undertaken by state and territory governments to address overweight and obesity, physical inactivity, and poor nutrition on a state level.

Recent examples include the Get Healthy Information and Coaching Service in NSW, and the development of the Active Living for All framework. State level urban design initiatives promoting healthy living include the Liveable Neighbourhoods Project in Western Australian, and Designing Places for Active Living in New South Wales[6].

In South Australia the Health in All Policies model has been adopted, in which the health impact of government policies across all portfolios is taken into consideration[8].

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Physical activity

Many of the factors influencing physical activity do not typically sit within the scope of the health sector. To address this, the 2009 National Preventative Health Strategy outlined a recommendation for the development and implementation of a National Framework for Active Living[6]. The Framework was designed to integrate local government, urban planning, the building industry, developers, health, transport, and sport and active recreation in order to achieve preventive health outcomes[6]. The government response to the National Preventative Health Strategy stated that the establishment of ANPHA provided sufficient infrastructure in this area without the need for a new Framework[9].

Built environment

The Healthy Spaces and Places project is a national, evidence-based guide for planning urban environments that are supportive of active living and wellbeing. The first phase of the project, supported by the Federal Government, culminated in the release of a free web-based resource in 2009. The resource provides guidance to planners on how they can incorporate active living principles in the design of the built environment.

In 2011 the Australian Government launched Creating Places for People: An Urban Design Protocol for Australian Cities[10]. The protocol was developed in collaboration with industry, community groups and all levels of government and established twelve principles for quality urban places. Safety and 'walkability' (ensuring spaces are enjoyable and easy to walk and bicycle around) were identified as two key principles[10].

Active transport

Currently, financial incentives from the Australian Government do little to encourage active transport, such as walking, cycling and public transport. The National Preventative Health Taskforce identified a range of government transport policies that discourage activity by effectively promoting private motor vehicle use and discouraging walking, cycling and public transport use[6]. Similarly, the report An Australian Vision for Active Transport, prepared by the Australian Local Government Association with active transport and public health groups, outlines a policy framework calling on government to increase support for active transport[11].

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Food policy

The Australian Government is currently developing Australia’s first National Food Plan to provide an overarching approach to food policy. The plan will take a comprehensive approach to issues affecting food access including food safety and security, health and nutrition, supporting a competitive, productive and efficient food industry, trade opportunities, and sustainability[12].

Public consultation on the plan was undertaken in 2011, with Cancer Council Australia providing a submission seeking greater emphasis on health and nutrition. A summary of stakeholder feedback highlighted the importance of protecting and promoting public health and nutrition outcomes[13].

The National Food Plan will be developed with further public consultation. For current information on the development process, visit the National Food Plan website.

Front-of-pack food labelling

Food Standards Australia New Zealand (FSANZ) is the statutory authority for food standards and regulation. They are responsible for setting standards for the production and sale of food in Australia covering food labelling, including nutrition and health claims.

In 2011 the final report of an independent review of food labelling in Australia was released. Prepared by the Panel for the Review of Food Labelling Law and Policy, the report made a series of recommendations prioritising public health in Australia’s food labelling system[14]. The Review of Food Labelling Law and Policy report recommended the introduction of an interpretive front-of-pack labelling system in order to assist consumers to make healthy choices at a glance. Specifically, a recommendation was made for voluntary introduction of a 'multiple traffic lights' system[14].

The Government response to the report outlined a plan for reaching consensus on interpretive front-of-pack labelling through a collaborative design process involving public health groups, consumers and industry. Any decision on the introduction of a specific front-of-pack labelling system is dependent on the outcomes of this process[15].

Information resources

Nutrition and health claims

In response to the 2003 Policy Guideline on Nutrition, Health and Related Claims, FSANZ began the development of the Proposal for Nutrition, Health and Related Claims, known as Proposal P293. The aim of the Proposal was to develop a standard for the use of scientifically valid nutrition, health and related claims for food products, with reference to the recent Policy Guideline.

At the culmination of a four year consultative process, FSANZ released its Final Assessment Report in 2008[16]. The report outlined options for the regulation of health claims on food products and recommended the introduction of regulation through the draft Standard for Nutrition, Health and Related Claims[16]. The proposal requires that foods carrying general and high level health claims must also meet nutrient profiling scoring criteria to assess the overall healthiness of the food[16].

Several further rounds of public consultation have been undertaken[17][18], and timelines extended to incorporate the findings of the independent Review of Food Labelling Law and Policy[14], as such the Proposal has not yet been finalised.

Cancer Council Australia supports regulation and advocates that products carrying nutrient content and health claims be subject to nutrient profiling to enable consumers to made decisions based on an overall nutritional profile rather than based on just sugar or energy content. For further information on Cancer Council Australia's position and an overview of submissions on Proposal P293, check the Submissions to government page on the Cancer Council Australia website.

Food marketing

Television food marketing in Australia operates under a system of co-regulation. The Australian Communications and Media Authority (ACMA) is responsible for the Children’s Television Standards. These standards include regulations for limiting unhealthy food advertising to children. The Advertising Standards Bureau administers the industry codes of practice, developed by Free TV Australia, the Australian Food and Grocery Council and the Australian Association of National Advertisers. The codes of practice add very little to statutory regulations.

Two self-regulatory codes have been developed by the food industry to oversee food marketing to children. These are the Responsible Children’s Marketing Initiative, established by the Australian Food and Grocery Council, and the Australian Quick Service Restaurant Industry Initiative for Responsible Advertising and Marketing to Children, established by the 'fast food' restaurant industry.

In 2011 ACMA undertook a review of these codes to determine if industry self-regulation adequately addressed community concern regarding food advertising to children[19]. The monitoring report identified ongoing community concerns and concluded that there was insufficient evidence to suggest that the implementation of the self-regulatory codes had any effect on food marketing to children. In the report, ACMA noted their decision not to continue monitoring of the effectiveness of the industry codes, nor to develop new television standards on food and beverage advertising to children, deferring to ANPHA for leadership on the issue[19].

Information resources

Food reformulation

In 2009 the Australian Government established the Food and Health Dialogue, a joint initiative bringing together government, public health groups and industry. The Food and Health Dialogue aims to address poor dietary choices through a food reformulation program.

In consultation with industry members, the program develops voluntary targets to reduce salt and saturated fat levels in processed foods. The initiative has had some success, with voluntary targets being set for reducing salt levels in a range of food categories, with further plans to engage with the quick-serve restaurant sector to develop reformulation targets for the fast food industry.

For up to date information on the activities of the Food and Health Dialogue initiative, check the Food and Health Dialogue website.

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Australian guidelines

Guidelines developed by the Australian Government outline recommendations for healthy eating and physical activity to reduce the risk of the development of diet and lifestyle-related diseases. In general, these recommendations are consistent with recommendations to reduce cancer risk and are endorsed by Cancer Council Australia.

The Australian Dietary Guidelines provide evidence-based recommendations on types and amounts of foods, food groups and dietary patterns to promote health and reduce the risk of chronic disease[20]. The guidelines include specific dietary advice for children, adolescents, adults and older Australians.

The National Physical Activity Guidelines for Australians provide evidence-based recommendations on minimum levels of physical activity required to gain a health benefit, and specifically to reduce cancer risk[21]. Specific guidelines are provided for children, adolescents, adults and older Australians.

The Clinical Practice Guidelines for the Management of Overweight and Obesity in Adults, Adolescents and Children in Australia provide evidence-based guidelines to clinicians regarding the management of individuals who have a body mass index greater than 25[22]. In addition, the Australian Government are coordinating the development of a National Healthy Weight Guide for Australians, designed to provide advice on how to achieve and maintain a healthy weight.


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References

  1. World Health Organization. 2008-2013 Action plan for the global strategy for the prevention and control of noncommunicable diseases. Geneva: WHO; 2009 Available from: http://whqlibdoc.who.int/publications/2009/9789241597418_eng.pdf.
  2. International Union Against Cancer, Sancho-Garnier H, Anderson A, Biedermann A, Lynge E, Slama K, et al. Evidence-based cancer prevention: strategies for NGOs. A UICC handbook for Europe. Geneva: UICC; 2004 Available from: http://www.uicc.org/sites/default/files/private/Evidence%20based%20cancer%20prevention_EN_0.pdf.
  3. Butland B, Jebb S, Kopelman P, McPherson K, Thomas S, Mardell J, et al. Foresight. tackling obesities: future choices - project report. Second edition. UK: Government Office for Science; 2007 Available from: http://www.bis.gov.uk/assets/foresight/docs/obesity/17.pdf.
  4. 4.0 4.1 World Cancer Research Fund, American Institute for Cancer Research. Policy and action for cancer prevention. Food, nutrition, and physical activity: a global perspective. Washington DC: AICR; 2009 Available from: http://www.dietandcancerreport.org/cancer_resource_center/downloads/chapters/pr/Introductory%20pages.pdf.
  5. 5.0 5.1 Council of Australian Governments. National partnership agreement on preventive health. Sydney: COAG; 2008 Available from: http://www.federalfinancialrelations.gov.au/content/npa/health/_archive/health_preventive_national_partnership.pdf.
  6. 6.0 6.1 6.2 6.3 6.4 6.5 National Preventative Health Taskforce. Australia: the healthiest country by 2020. National preventative health strategy – the roadmap for action. Canberra: Commonwealth of Australia; 2009 Jun 30 Available from: http://www.preventativehealth.org.au/internet/preventativehealth/publishing.nsf/Content/nphs-roadmap/$File/nphs-roadmap.pdf.
  7. World Health Organization. Global strategy on diet, physical activity and health. Geneva: WHO; 2004 Available from: http://www.who.int/nmh/wha/59/dpas/en/.
  8. Kickbusch I, McCann W, Sherbon T. Adelaide revisited: from healthy public policy to Health in All Policies. Health Promot Int 2008 Mar;23(1):1-4 Abstract available at http://www.ncbi.nlm.nih.gov/pubmed/18272532.
  9. Australian Government. Taking preventative action: Government's response to Australia: the healthiest country by 2020. Canberra: Department of Health and Ageing; 2010 Available from: http://yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/report-preventativehealthcare.
  10. 10.0 10.1 Department of Infrastructure and Transport. Creating places for people: an urban design protocol for Australian cities. DIT; 2011 Available from: http://www.urbandesign.gov.au/downloads/files/INFRA1219_MCU_R_SQUARE_URBAN_PROTOCOLS_1111_WEB_FA2.pdf.
  11. Australian Local Government Association, Bus Industry Confederation, Cycling Promotion Fund, National Heart Foundation of Australia, International Association of Public Transport. An Australian vision for active transport.; 2010 Available from: http://www.heartfoundation.org.au/SiteCollectionDocuments/Active-Vision-for-Active-Transport-Report.pdf.
  12. Department of Agriculture, Fisheries and Forestry. Issues paper to inform development of a national food plan. Canberra: DAFF; 2011 Available from: http://www.daff.gov.au/__data/assets/pdf_file/0009/1926315/nfp_-_final.pdf.
  13. Department of Agriculture, Fisheries and Forestry. Summary of stakeholder feedback in response to the issues paper to inform development of a national food plan. [homepage on the internet] Canberra: DAFF; 2012 [cited 2013 Sep 30; updated 2013 May 25]. Available from: http://www.daff.gov.au/nationalfoodplan/development/issues-paper/summary-of-stakeholder-feedback.
  14. 14.0 14.1 14.2 Blewett N, Goddard N, Pettigrew S, Reynolds C, Yeatman H. ‘Labelling logic’ – the final report of the review of food labelling law and policy. Canberra: Commonwealth of Australia; 2011 Available from: http://www.foodlabellingreview.gov.au/internet/foodlabelling/publishing.nsf/content/48C0548D80E715BCCA257825001E5DC0/$File/Labelling%20Logic_2011.pdf.
  15. Legislative and Governance Forum on Food Regulation. Response to the recommendations of labelling logic: review of food labelling law and policy. Canberra: Legislative and Governance Forum on Food Regulation; 2011 Available from: http://www.foodlabellingreview.gov.au/internet/foodlabelling/publishing.nsf/Content/ADC308D3982EBB24CA2576D20078EB41/$File/FoFR%20response%20to%20the%20Food%20Labelling%20Law%20and%20Policy%20Review%209%20December%202011.pdf.
  16. 16.0 16.1 16.2 Food Standards Australia New Zealand. Final assessment report for proposal P293 - nutrition, health and related claims. FSANZ; 2008 Available from: http://www.foodstandards.gov.au/code/proposals/documents/P293%20Health%20Claims%20FAR%20Attach%2010%20FINAL.pdf.
  17. Food Standards Australia New Zealand. Proposal P293: nutrition, health & related claims - consultation paper for first review. FSANZ; 2009 Mar 20 Available from: http://www.foodstandards.gov.au/code/proposals/documents/P293%20Health%20Claims%20Cons%20Paper%20FINAL.pdf.
  18. Food Standards Australia New Zealand. Call for submissions - proposal P293: nutrition, health & related claims. FSANZ; 2012 Feb 17 Available from: http://www.foodstandards.gov.au/code/proposals/documents/P293%20Nutrition_Health_related%20claims%20consult%20paper1.pdf.
  19. 19.0 19.1 Australian Communications and Media Authority. Industry self-regulation of food and beverage advertising to children. ACMA monitoring report. Commonwealth of Australia; 2011 Dec Available from: http://www.acma.gov.au/webwr/_assets/main/lib310132/industry_self-regulation-advertising_to_children_monitoring_report-dec2011.pdf.
  20. National Health and Medical Research Council. Australian dietary guidelines. Canberra: NHMRC; 2013 Available from: http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n55_australian_dietary_guidelines_130530.pdf.
  21. Department of Health. Physical activity guidelines. [homepage on the internet] Canberra: DoH; 2014 Feb 6 [cited 2014 Feb 10]. Available from: http://www.health.gov.au/internet/main/publishing.nsf/content/health-pubhlth-strateg-phys-act-guidelines.
  22. National Health and Medical Research Council. Clinical practice guidelines for the management of overweight and obesity in adults, adolescents and children in Australia. Melbourne: NHMRC; 2013 Available from: http://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n57_obesity_guidelines_130531.pdf.

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