100 words for each one of them. in this response I want you to Read the responses of my classmates and respond to their posts in a way that contributes constructively to the class discussion. For example, you might disagree with a point, ask a clarifying question, or provide additional support for a position taken in the posting. this is the question;- Junk food policy Introduction Your group is tasked by the Ministry of Health to develop a strategy to lower the consumption of junk food in your country or in Australia. Post your response to the following prompts: Assess the state of knowledge about the relationship between junk food consumption and health system outcomes. Which interventions are likely to be effective in reducing junk food consumption? Which stakeholders might be affected by the policies you prescribe and how might those stakeholders be affected? Note that the effects on the different parties might vary by type of policy. first classmate post;- by Marguerite Dalmau - Wednesday, 21 September 2016, 10:44 PM Assess the state of knowledge about the relationship between junk food consumption and health system outcomes. Chronic health conditions are now the leading cause of morbidity and mortality in Australia with Ischaemic heart disease the main contributor (1). Junk food consumption and sedentary lifestyles are identified as the two main risk factors for overweight and obesity which are directly linked to these chronic health conditions (2). The economic burden is substantial with the related health problems of overweight and obesity accounting for $56.6 billion in 2005 ($21 billion directly and $35.6 indirectly) (3). The implication for health system outcomes is well recognised by the Australian Government and National Health and Medical Research Council with dedicated ‘round table discussions’ and research grants on how to clinically manage and prevent overweight and obesity for the different population groups in Australia (3). If the trend continues, with the majority of the population overweight or obese, the current health system will not be able to meet the chronic health needs of the population and thus call for significant health system reform. Which interventions are likely to be effective in reducing junk food consumption? As outlined in the module, a variety of viable options exist for attempting to shift health behaviour. Those for reducing junk food consumption are listed below. These are all likely to be effective if implemented thoroughly, though require varying degrees of resource support/regulation. - Social media: regulations around advertising of junk food, promotion of healthy food choices, education around health implications of junk food consumption, education around simple and healthy meal preparation (4). - Government intervention: higher taxation on junk food, incentives for purchasing/preparing healthier meals, limitations of food in schools, provision of healthy meals in schools (4). - Other: incentivising organisations to report on health outcomes, targeting organisations/employers with evidence on diet links to performance/productivity (4). Which stakeholders might be affected by the policies you prescribe and how might those stakeholders be affected? Buyers (individual) Negative: feeling of diminished ability to choose lifestyle/loss of freedom, discontent amongst healthy population who consume junk food on occasion (literally paying for others’ health choices), stress inducing (for those who choose junk food out of time constraints and cannot afford price increases). Positive: if incentives are offered – might allow choices that were otherwise unavailable for those who wish to change behaviours, appreciation for awareness raised, improved health. Buyers (collective) – general population Overall improved health status of population will improve many areas – not only health related. Better health will improve economic productivity with flow on effects for society as a whole. Sellers Stockists of health foods: improved business Producers/suppliers of junk food: diminished business potential/financial losses, lobbying costs. Marketing: reduced business for those advertising junk food, increased business for those advertising health food. Government Increased resources to implement, regulate and maintain taxes, incentives for individuals and incentives for businesses. Savings to health care system due to improved chronic health conditions if successful. References Institute for Health Metrics and Evaluation (IHME). Australia, both sexes, all ages, 2013, Deaths [Internet]. Global Burden of Disease Data Visualizations. 2013 [cited 2016 Sept 21]. Available from: http://vizhub.healthdata.org/gbd-compare/ AUSDIAB. The Australian diabetes, obesity and lifestyle study [internet]. 2013, Baker IDI Heart and Diabetes Institute [cited 2016 Sept 21]. Available from: https://www.bakeridi.edu.au/Assets/Files/Baker%20IDI%20Ausdiab%20Report_interactive_FINAL.pdf NHMRC. Overweight and Obesity [internet]. Health topics. 2015 [cited 2016 Sept 21]. Available from: https://www.nhmrc.gov.au/health-topics/obesity-and-overweight Gill T, King L, Bauman A, Vita P, Caterson I, Colagiuri S, et al. A “state of the knowledge” assessment of comprehensive interventions that address the drivers of obesity. The Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders. University of Sydney. 2010 [cited 2016 Sept 21]. Available from: https://www.nhmrc.gov.au/_files_nhmrc/file/your_health/obesity/boden_report_rapid_assessment_december_2010.pdf second classmate post;- by Emma Millard - Wednesday, 21 September 2016, 2:24 PM Junk food can be defined as food which is high in calories but has low nutritional value (1), and regular consumption of junk food is known to be a major contributing factor to weight gain and obesity. (2) Weight gain and obesity are known have a significant impact on health, and are commonly associated with conditions such as diabetes, cardiovascular disease, cancer and musculoskeletal issues, as well as an increased risk of morbidity and mortality. (3) With this in mind, the relationship between increased consumption of junk food, resulting weight gain and obesity and resulting burden on health status is well understood. Understandably this relationship does not only impact upon the individual, but also has more wide-spread impact on health system outcomes. In regards to intermediate outcomes, this relationship will lead to an increasing demand and requirement for healthcare services which will result in increases in healthcare costs and (likely) issues with accessibility. In regards to ultimate outcomes, this relationship will lead to reducing individual and population health and increasing financial risks relating to ill health. It is reported that more than half of Australian adults and nearly one quarter of Australian children are either overweight or obese (2), and obesity has been described as an epidemic at both national and global levels. (4) These figures highlight the importance of the issue of obesity and the need for significant attention and action in the area of reform in order to address this issue. A number of interventions targeting behaviour and regulation could be implemented in attempt to reduce the consumption of junk food, including: Regulation around the advertising of junk food (4) Regulation around labelling of junk food (2, 5) Regulation around the provision of nutritional information for junk food (2) Regulation around the expansion of fast food chains Taxation on junk food (4) Subsidies for purchase of healthy food (eg. fruit and vegetables) (5) Improving access to healthy food (5) Mass-media ‘shock’ campaigns around the impact of consumption of junk food Education programs targeting children and adolescents (4) Prohibition of sale of junk food in schools, hospitals, sporting facilities, workplaces etc. (4) Each of these possible interventions is likely to have a varying level of effectiveness in reducing junk food consumption. Given the substantial level of power which the junk food/fast food industry holds, any attempts to impose regulation or reform in this area will be met with resistance. Further to this, there is also a seemingly high level of resistance from the public around the implementation of taxes on junk food. Similar levels of resistance have been seen with the implementation of taxes on tobacco and alcohol, however over time these now appear to have been accepted. I believe that the two interventions which are most likely to be effective in reducing the consumption of junk food consumption are implementation of a tax on the purchase of junk food (6, 7), and a subsidy on the purchase of health foods (eg. fruits and vegetables) (5). The tax on junk food acts as a disincentive, and the subsidy as an incentive to influence behaviour. (8) A number of stakeholders are likely to be affected by the implementation of regulation and reform around the consumption of junk food including: Public (buyers) Fast food chains, convenience stores, grocery stores etc. (buyers and sellers) Suppliers (eg. Coca-Cola) (sellers) Other corporates (eg. advertisers, sponsors) References (1) Merriam-Webster. Dictionary: junk food [Internet]. 2016 [cited 2016 Sept 21]. Available from: http://www.merriam-webster.com/dictionary/junk%20food (2) Cancer Council. Fast food: Exposing the truth [Internet]. Sydney (NSW). 2013 [cited 2016 Sept 21]. 28p. Available from: http://www.cancercouncil.com.au/wp-content/uploads/2013/02/Fast-Food-Exposing-the-Truth-22-February-2013.pdf (3) The Department of Health. About overweight and obesity [Internet]. Canberra (AUS). 2009 [cited 2016 Sept 21]. Available from: http://www.health.gov.au/internet/main/publishing.nsf/Content/health-pubhlth-strateg-hlthwt-obesity.htm (4) World Health Organisation. The healthy food environment policy index: findings of an expert panel in New Zealand [Internet]. Auckland (NZ). 2015 [cited 2016 Sept 21]. Available from: http://www.who.int/bulletin/volumes/93/5/14-145540/en/ (5) Preventative Health Taskforce. Technical report 1: Obesity in Australia: a need for urgent action [Internet]. 2009 [cited 2016 Sept 21]. 128p. Available from: http://www.preventativehealth.org.au/internet/preventativehealth/publishing.nsf/Content/tech-obesity (6) Sacks G, Veerman JL, Moodie M, Swinburn B. ‘Traffic-light’ nutritional labelling and ‘junk-food’ tax: a modelled comparison of cost-effectiveness for obesity prevention. Int J Obes [Internet]. 2010 [cited 2016 Sept 21]; 35: 1001-1009. Available from: http://www.nature.com/ijo/journal/v35/n7/abs/ijo2010228a.html (7) Mytton O, Clarke D, Rayner M. Taxing unhealthy food and drinks to improve health. BMJ [Internet]. 2012 [cited 2016 Sept 21]. Available from: http://user37685.vs.easily.co.uk/wp/wp-content/uploads/2013/10/mytton2012.pdf (8) Rowe H. Module 5 Workbook: Behavioural interventions and regulation [Internet]. 2016 [cited 2016 Sept 21]. Available from: http://moodle.vle.monash.edu/mod/book/view.php?id=3081105 the third classmate post;- by Cherann-Lee Edwards - Tuesday, 20 September 2016, 5:59 PM The excessive consumption of junk food is likely to lead to overweight (which is classified as a BMI ≥ 25) and obesity (BMI ≥ 30), which are in turn associated with a range of diseases including but not limited to type 2 diabetes, coronary artery disease, stroke, cancer, and mental illness. (1) A recent report estimated the cost of obesity in Australia (which has one of the highest obesity rates in the world) in 2011-12 to be $8.6 billion dollars (in 2014-15 dollars). (2) These costs are borne by a range of stakeholders including the Commonwealth and state governments, private health insurers, individuals and their families, carers and employers, as well as society as a whole. (2) There are a number of interventions in the form of regulations, taxation, and information provision that may be effective in reducing junk food consumption. In this initial post I will consider two regulatory measures, each of which is likely to affect a range of different stakeholders: Health Star Rating System The voluntary Health Star Rating (HSR) system introduced in June 2014 aims to provide consumers with a simple and standardised way to evaluate the ‘healthiness’ of packaged foods by assigning products a rating from ½ to 5 stars. Consumer research carried out prior to the system’s introduction indicated that there is a role for tools which assist people to better understand the products they are purchasing (3), and that consumers assign a similar level of importance to food labelling systems as to other more fundamental drivers such as taste and price. (4) However, challenges associated with the HSR system are that it does not provide information about exactly how much of these foods should be consumed in a healthy and balanced diet, and the fact that it is voluntary means that manufacturers of foods with a low HSR can just choose not to display it. The Public Health Association and consumer groups such as the Heart Foundation and the Consumer Health Forum welcomed the introduction of the HSR as a strategy for the prevention of obesity, however it was widely agreed by such groups that the system should be made mandatory. (5) However the Australian Food & Grocery Council was strongly in favour of the voluntary scheme, stating that ‘it can be expensive for cash strapped companies to adopt major labelling changes’. (6) Planning for an independent five year review of the program is currently underway, and it will be interesting to see whether or not a move to a mandatory scheme is recommended. Banning Junk Food Advertising There have been repeated calls by health and consumer groups for governments to ban junk food advertising, particularly in relation to children, and this issue has been given a lot of exposure in the media. A 2007 briefing paper by the Coalition on Food Advertising to Children stated that there was a large body of evidence suggesting strong links between junk food advertising and the food consumption patterns of exposed children, and argued that a government ban on television advertising to children would be a cost-effective obesity prevention strategy. (7) In contrast however, the Australian Association of National Advertisers (AANA) has argued that the general public is clearly aware that the blame lies with the sedentary existence associated with computer games, rather than with junk food advertising. (8) A ban on junk food advertising would clearly impact on food and drink companies, and would also affect the advertising revenues of commercial television stations. The Federal or state governments would also be affected by the costs associated with the introduction of new regulations. References: The health effects of overweight and obesity [Internet]. Atlanta (GA): Centers for disease control and prevention; 2015 [updated 2015 Jun 5; cited 2016 Sep 20]. Available from: http://www.cdc.gov/healthyweight/effects/ Weighing the cost of obesity: a case for action [Internet]. Sydney (AU): PricewaterhouseCoopers; 2015 Oct [cited 2016 Sep 20]. Available from: http://www.obesityaustralia.org/files/Weighing-the-cost-of-obesity-Final.pdf Proposed Front-of-Pack Food Labelling Designs: Qualitative Research Outcomes [Internet]. Melbourne (AU): Hall & Partners Open Mind; 2013 Mar 1 [cited 2016 Sep 20]. Available from: https://www.health.gov.au/internet/main/publishing.nsf/Content/CF7E670597F383ADCA257BF0001BAFF5/$File/FOPL%20Qualitative%20Report%20FINAL%20Accessible%20version%20(D13-2197171).pdf Proposed Front-of-Pack Food Labelling Designs: Quantitative Research Outcomes [Internet]. Melbourne (AU): Hall & Partners Open Mind; 2013 Apr 17 [cited 2016 Sep 20]. Available from: https://www.health.gov.au/internet/main/publishing.nsf/Content/CF7E670597F383ADCA257BF0001BAFF5/$File/FOPL%20Quantitative%20Report%20FINAL%20Accessible%20version%20(D13-2197158).pdf Hagan K. Health star rating system for packaged foods should be compulsory: poll [Internet]. The Sydney Morning Herald. 2015 January 20 [cited 2016 Sep 20]. Available from: http://www.smh.com.au/national/health/health-star-rating-system-for-packaged-food-should-be-compulsory-poll-20150119-12thnn.html AFGC welcomes changes to food rating system implementation [media release on the Internet]. Canberra (AU): Australian Food & Grocery Council; 2014 Jun 27 [cited 2016 Sep 20]. Available from: http://www.afgc.org.au/2014/06/afgc-welcomes-changes-to-food-rating-system-implementation/ Children’s health or corporate wealth?: the case for banning television food advertising to children [Internet]. Sydney (AU): Coalition of Food Advertising to Children. 2007 Jan [cited 2016 Sep 20]. Available from: http://cfac.net.au/downloads/briefing_paper.pdf Advertising industry claims links between obesity and advertising are “nonsense” [Internet]. Melbourne (AU): Australian Food News; 2012 Nov 15 [cited 2016 Sep 20]. Available from: http://www.ausfoodnews.com.au/2012/11/15/advertising-industry-claims-links-between-obesity-and-advertising-are-%E2%80%9Cnonsense%E2%80%9D.html