investing in south australia’s heart health · we are ng onger but cardiovascular disease reans...

Investing in South Australia’s heart health THE BEST RETURN FOR THE STATE BUDGET

Budget submission 2020-21

HEART FOUNDATION SUBMISSION TO THE SA BUDGET 2020-21

WE ARE LIVING LONGER BUT CARDIOVASCULAR DISEASE REMAINS OUR BIGGEST KILLER AND MOST EXPENSIVE DISEASE

1 LIFELOST EVERY

13MINUTES*

$5BILLION^

INVESTING IN SOUTH AUSTRALIA’S HEART HEALTH • HEART FOUNDATION SUBMISSION TO THE SA BUDGET 2020-20212

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1. Support South Australians to make heart healthy choices

1.1 Wellbeing SA to develop a Walking Strategy in collaboration with other relevant Government Departments and stakeholders

1.2 Dept of Transport to conduct a Household Travel Survey

1.3 Wellbeing SA and Department for Education to renew healthy school food policy

2. Reduce smoking and vaping to prevent heart disease

2.1 Protect people living in multi-unit housing from secondhand smoke

2.2 SA Health to keep investing in mass marketing 3. Save lives through improved cardiac care SA Health to expand phone-based cardiac rehabilitation to the

Greater Adelaide area

Investing in South Australia’s heart health

Estimated costs

$200,000 over 4 years

$1m

Low cost initiative

Low cost initiative

Minimum $1.7m/year

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Heart disease continues to be the leading cause of death of South Australians.1

In 2017- 18 we had 43,000 people with heart disease in South Australia.2 There is continuing increasing rates of hospitalisations for atrial fibrillation and heart failure.

We urge the South Australian government to consider the following low-cost high-value proposals for the State Budget 2020 -2021:

Develop a walking strategy to get South Australians moving;

Encourage healthy eating and drinking in children;

Continue the fight against tobacco and vaping; and

Prevent readmission to hospital through cardiac rehabilitation programs

Together we can improve the health and wellbeing of our communities; in turn, reducing the burden on our health system.

Imelda Lynch

Chief Executive Officer, South Australia National Heart Foundation of Australia


Imelda Lynch, CEO Heart Foundation SA

The Heart Foundation is leading the fight to save Australian hearts

Empowering individuals and communities, and providing

supportive environments, is at the heart of our recommended actions.

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1. Support South Australians to make heart healthy choices

1.1 Develop and fund a Walking Strategy and Action Plans

Estimated cost $200,000 over 4 years

A staggering 83% of adults,2 and 80% of children do not meet recommended physical activity levels.2

Physical inactivity accounted for 2.6% of the total burden of disease and injuries in Australia in 2011,4 and leads to overweight and obesity, other chronic conditions and poor mental wellbeing.

Walking is the most equitable means of improving population health by increasing physical activity.

Our vision is one where people of all ages, both men and women, feel safe and comfortable to walk, and choose to walk to their destinations, for recreation and, for their health.

Action MUST be taken by the government (across Departments) to help South Australians include some physical activity, such as walking, into their day.

A walking strategy must include: Walking for transport, Walking for health and wellbeing, and Walking for recreation.

Development of a Walking Strategy will meet the agenda of multiple ministerial portfolios. This investment will return in health, economy, liveability and environment.

The Heart Foundation calls for the government to develop and implement a fully funded South Australian Walking Strategy and action plans.

1.2 Department of Transport to conduct a regular household travel survey

Estimated cost $1m

“What gets measured gets done”

The last household travel survey in SA was conducted in 1999.5

Such a survey is long overdue in South Australia.15

Up-to-date data will help us to understand how, when and why South Australians are walking. This information will inform the walking strategy along with public transport modelling and planning for cycling.

Walking data should be collected as part of a Household Travel Survey to inform infrastructure and planning decisions and to set targets, with the aim of getting more people walking more often.

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Low cost initiative

Good health is fundamental to a happy and prosperous life. Healthy eating, along with daily physical activity and other healthy habits are the building blocks for good health in childhood and into our adult years.

Schools and their canteens have the potential to model behaviours and encourage healthy eating.7

Some progress has been made to improve the food and drink sold and provided at school and school events and enhance the teaching and learning of food and nutrition.

Still, only 4.9% of South Australian children meet the government’s fruit and vegetable daily recommendations.6

As approximately one third of a child’s diet is consumed at school, promotion of fruit and vegetables and healthy food choices through school canteens is important, as is encouraging children to bring nutritious food from home for lunch and recess.

Schools are required to comply with the Right Bite Strategy but there is no evidence of adherence.

The Heart Foundation calls for the government to refresh and fund school food and drink policy with improved monitoring and support for parents, carers and schools.

1.3 Wellbeing SA and Department for Education to renew healthy school food policy

CASE STUDY

Why I Care about this issue Associate Professor Jennifer Keogh, Heart Foundation Fellowship Alumni

In our community 26% of children and 67% of adults are overweight or obese. Strong evidence suggests that obese or overweight children are likely to become overweight or obese adults leading to lifelong chronic health problems such as heart disease and diabetes.

Habits developed in childhood, including a healthy diet is one of the cornerstones of good health. Healthy food habits developed as a child are likely to be maintained throughout life leading to healthy weight and wellbeing.

Schools and canteens have an important role to play in encouraging and role modelling healthy food and healthy eating.

I have been researching food and nutrition for many years and support the Heart Foundation in their efforts to promote healthy food choices in schools to support their learning and ability to make healthier choices across their lifespan.

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Smokers have around triple the risk of dying from cardiovascular disease compared to people who have never smoked.9

That’s why the Heart Foundation strongly supports greater investment in tobacco control and strict regulation of e-cigarettes.

The battle against tobacco and vaping is far from over.

The tobacco and e-cigarette industry continue to target children and young people and exploit vulnerable groups.

2.1 Protect people living in multi-unit housing from secondhand smoke

Low cost initiative

Breathing in other people’s second-hand smoke is considered a significant cause of disease in adults and children.

People living in multi-unit housing are more likely to be exposed to second-hand smoke (“neighbor smoke”) due to smoke-drift and the proximity to others and shared spaces.

Smoke drifts through vents, windows, balconies, air-conditioning, cracks and plumbing systems.

The current pandemic has changed the way we work and live, with more people working from home, the risk of exposure is even higher.

2. Reduce smoking and vaping to prevent heart disease

The Heart Foundation calls on the government to take action to protect residents from exposure to smoke-drift in multi-unit developments. The Government must introduce a model by-law for residential strata schemes to allow multi-unit building to become smoke-free.

2.2 Maintain investment in evidence-based tobacco control mass media campaigns

Estimated cost - minimum $1.7m/year

Now, more than ever, we need to support people to quit smoking.

While overall smoking rates have reduced, rates remain high in some vulnerable populations; including people living in socioeconomic disadvantage, Aboriginal and Torres Strait Islander and people who have survived a heart attack. We know that more than half of heart attack survivors who smoke prior to their heart attack continue to smoke. We know that there are productivity costs after a heart attack, with one in four heart attack survivors not able to resume work and a further quarter resuming work, but not at the same level as prior to their heart attack.3

The Heart Foundation is calling on the South Australian Government to maintain its contribution to evidence-based levels of tobacco control mass media campaigns, particularly to support vulnerable populations to quit smoking.

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South Australian hospitals manage around 39,000 heart disease related admissions per year*

Cardiac rehabilitation is a coordinated program delivered over several weeks, educating the patient around lifestyle modification10 and includes physical activity, nutrition, stress management, medication management and advice.

It is a vital step in a patient’s recovery after a heart attack and international studies report that within one year cardiac rehabilitation can reduce hospital readmissions by up to 56% and deaths by 30%.12 It also results in improvements in exercise capacity, quality of life and psychological well-being, and is now recommended in international guidelines.

However, only 30% of eligible patients take-up a cardiac rehabilitation programs, the exception being the very successful CATCH program run in Country SA which has 70% uptake, and continues to have a very high completion rate (up to 97%), improving patient risk factors and mortality rates.8

For the first time our regional areas are receiving a level of best practice care better than their metropolitan counterparts.

If we increase completion rates from 30% to 50% in SA we can save more than $13.5m in health care costs.10

The Heart Foundation recommends extending the CATCH program throughout Greater Adelaide.

* Private and public hospitals combined

3. Save lives through improved cardiac care

Invest in cardiac rehabilitation for patients in the Greater Adelaide area

As with all cardiologists, I want my patients to have the best possible life after their cardiac event. I refer my eligible patients to cardiac rehabilitation because it leads to better health. I strongly support increasing the options available for my patients to enable them to complete cardiac rehab.

Now more than ever we need to support recovery and keep people out of hospital.

Source: saheart.com.au

CASE STUDY

Why I Care about this issue Associate Professor Matthew Worthley11, Cardiologist

Cardiac rehabilitation can reduce hospital readmissions by up to 56%

and deaths by 30%.

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References

1 Australian Bureau of Statistics 2018. Causes of Death 2017, cat NO. (3303.0), September.

2 Australian Bureau of Statistics 2018. National Health Survey: First results 2017-18.

3 Heart Foundation Heart Attack Survivor Survey 2018.

4 AIHW. 2017. Impact of physical inactivity as a risk factor for chronic conditions: Australian Burden of Disease Study

5 Transport South Australia for the Department of Planning, Urban Planning and the Arts: Metropolitan Adelaide Household Travel Survey (AHTS) 1999.

6 Australian Bureau of Statistics, Australian Health Survey 2014/15

7 Waters, et al. 2011. Interventions for preventing obesity on children. Cochrane Database of Systematic Reviews.

8 Government of SA. COUNTRY HEALTH SA LOCAL HEALTH NETWORK 2018-19 Annual Report.

9 Banks E et al. Tobacco smoking and risk of 36 cardiovascular disease subtypes: fatal and non-fatal outcomes in a large prospective Australian study, 2019.

10 De Gruyter, et al. 2016. Economic and social impact of increasing uptake of cardiac rehabilitation services. Heart, Lung and Circulation.

11 Private correspondence 2019

12 National Health Service of the United Kingdom. NHS Improvement; Heart. Making the case for cardiac rehabilitation: modelling potential impact on readmissions. London: National Health Service 2013.

13 Australian Bureau of Statistics 2019, Causes of Death 2018, cat. no. 3303.0, September

14 Australian Institute of Health and Welfare 2017, Australian Health Expenditure – demographics and diseases: hospital admitted patient expenditure 2004-05 to 2012-13, Supplementary tables, Health Expenditure and Welfare series no. 59, cat. No. HWE 69.

15 Stopher, P et al. 2014. National Household Travel Surveys: The Case for Australia

For heart health information and support, call our Helpline on 13 11 12 or visit heartfoundation.org.au

© 2020 National Heart Foundation of Australia, ABN 98 008 419 761 (Heart Foundation)

Terms of use: This material has been developed for information and educational purposes only. It does not constitute medical advice.

Please consult your health care provider if you have, or suspect you have, a health problem. The information contained in this material has been independently researched and developed by the Heart Foundation and is based on the available scientific evidence at the time of writing. It is not an endorsement of any organisation, product or service.

The Heart Foundation and its employees do not accept any liability, including for any loss or damage, resulting from the reliance on the content, or in regards to its accuracy, currency and completeness. Any use of Heart Foundation material by another person or organisation is done at the user’s own risk.

This work, except as identified below, is licensed by the Heart Foundation under a Creative Commons Attribution – Non commercial – No Derivative Works (CC BY-NC-ND) 4.0 Australia licence. To view a copy of this licence, visit: http://creativecommons.org.au/. You are free to copy and communicate this publication (however in no way commercialise the material), in accordance with the rules of attribution set out at https://creativecommons.org.au/learn/howto/.

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The Heart Foundation acknowledges the Traditional Owners and custodians of Country throughout Australia and their continuing connection to land, waters and community. We pay our respect to them and their cultures, and Elders past, present and future.

HH-SCPE-002.1.1219

For further information contact:

Ms Tuesday Udell

Senior Policy Advisor

Heart Foundation

155 Hutt Street Adelaide SA

T: 08 8224 2863

E: [email protected]

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