Living longer, smoking less but eating ourselves sick

WE ARE living longer, smoking less and fewer of our children are dying, but we are eating ourselves sick, we can't afford the dentist and we are catching diseases that vaccines could prevent.
Meanwhile, indigenous Australians are still being left behind as the overall national health outlook improves.
An extensive final report on health care by the Council of Australian Governments reform council paints a national picture of dramatic improvements over five years but significant challenges.
The chief concern raised by the report, according to COAG reform council chair John Brumby, is that most of us are fat and many of us don't know we have type 2 diabetes (strongly associated with obesity).
"While Australia's current rate of type 2 diabetes is not out of the ordinary … compared with most of the developed world, our rate of obesity is way out of line. We are amongst the three most obese nations," Mr Brumby said yesterday.
He said if diabetes went untreated, there was a great cost to the individual in terms of kidney, heart and eye disease, and limb amputation - "it's bad for the individual, bad for the economy and bad for the health system."
The report also raises alarming figures on preventable hospital stays - including a 16% increase for conditions that could have been prevented by vaccines.
Other concerns include:

• A sharp increase in the percentage of Australians waiting more than nine months for high residential aged care, while the growth of aged care services has stalled. In bad news for the regions, care places decrease as remoteness increases.
• The cost of dental care. Nearly one in five of us have delayed or avoided a visit to the dentist because it cost too much.
• Increased waiting times for most elective surgery. Patients outside major cities do not generally wait longer - unless they are indigenous.

Big wins in the report include:

• Life expectancy increase for both men and women.
• 20% drop in child death rates - but the rate for indigenous children is still double that of non-indigenous.
• Significant falls in heart disease and cancer - though the male heart attack rate is double that of women and there is still a big gap in heart attack rates between indigenous and other Australians.

A cut in the national rate of lung cancer has been led by a 34% drop in men affected since 2006 - but offset by a huge 88% increase in the female rate.
"We can't change what occurred 25-30 years ago," Mr Brumby said. "There was a peak in smoking rates among women then and we're now seeing that translate into a near-peak in women's lung cancer rates.
"Smoking rates are still a lot higher in the regions. We all think we're indestructible when we're young. But the women's statistics show overwhelmingly that there is a consequence 30 or 40 years on."
Despite the continuing gap in life expectancy and child deaths for indigenous Australians, Mr Brumby attributed the overall improvements partly to big reductions in indigenous infant mortality through "getting mums to stop smoking … better post-natal care, tackling things like domestic violence".
Other cancer figures show rates of cervical cancer rates have fallen and bowel and breast cancer rates have stabilised.
Melanoma rates have stabilised nationally but increased markedly in Queensland.
The big wins

• Life expectancy up (men 79.9 years, women 84.3) - among the highest in the world, but still much lower for indigenous Australians (69.1 and 73.7)
• Child deaths 20% down to 82.9 per 100,000
• Heart attacks and deaths from circulatory disease significantly down - except for indigenous Australians
• Daily smokers down to 16.3% - but a long way to go to meet COAG's target of 10% by 2018.

The big challenges

• 62.7% of adults are overweight or obese
• 1 in 25 Aussies have type 2 diabetes - and a quarter of them don't know it
• A huge, long-term increase in lung cancer among women
• A jump in the number of hospital stays due to vaccine-preventable conditions
• Despite improvements, our health system continues to fail Indigenous Australians.

By numbers for Queensland

• Avoidable deaths for 100,000 people: 155.4 (national figure 146.4)
• 73% of emergency patients treated within benchmark times (72%)
• Half of all patients waited at least 27 days for elective surgery (36)
• 64.4% of patients discharged from psychiatric inpatient services received follow-up (54.6%)
• 77.7 residential aged care places per 1000 seniors (81.9)
• 17.9% of adults smoke daily (16.3%)
• 30% of adults are obese (27.2%)
• 4.6% of adults have type 2 diabetes (4.3%)

Massachusetts Bans Smoking On Beaches

If you’re planning on heading up to the Cape Cod beaches this summer, leave your cigarettes at home. Massachusetts recently passed legislation banning smoking in all lifeguard-protected areas beginning June 19.
The new smoking prohibition results from a number of complaints from visitors who have been affected by secondhand smoke in public areas, NBC News reports.
“The smoking prohibition is the result of a number of complaints from visitors who have been affected by second-hand smoke on the guarded beaches,” park superintendent George Price, said in an issued statement.
Price added that cigarettes on beaches are not only a health concern but also an environmental concern, as they prove very difficult to clean up. Cigarette butts can often become buried in sand before they can be properly disposed of, and thus cause much extra work for beach staff.
Historically, Massachusetts has been a leader among states for restrictions on smoking in public places. In 2004, Mitt Romney placed a statewide ban on covering smoking in the workplace, bars and restaurants. The ban, which aimed to promote “worker safety,” placed a harsh fine on violators. Although the first of its kind, many states have followed suit in the years since.
While governor, Romney also proposed a bill that would make it illegal to smoke in apartment buildings, as to further reduce exposure to secondhand smoke fumes. This bill did not pass.
This new smoking ban covers many of the famous Cape Cod, Massachusetts, beaches including Coast Guard Beach and Nauset Light Beach in Eastham, Marconi Beach in Wellfleet, Head of the Meadow Beach in Truro, and Race Point Beach and Herring Cove Beach in Provincetown.
Cape Cod National Seashore is not the first seashore in the United States to take this step. Fire Island National Seashore in New York has similar prohibitions.

What’s the Best Way to Sum Up the Risks From Smoking?

Maybe you can help me with a math problem. We hear about the number of smoking-related deaths annually, but we never hear them reported as a  percentage of smokers. Reports indicate that approximately 20 percent of adults in this country are  smokers, which amounts to about 50 million Americans. I’ve also heard that roughly 500,000 people die each year from smoking- related  illnesses. This translates to only 1 percent of all smokers!  Despite the hysteria, it appears that a relatively small percentage of smokers die as a direct result of smoking. Am I off-base here?

Marilyn responds:
Yes! Those deaths occur every year, not just once. The World Health Organization states that up to half of current users will eventually die of a tobacco-related disease.
Regardless, the sheer volume of news stories with incorrectly reported statistics is causing a backlash from smart people like you who know perfectly well that nonsmokers also die of cancer and heart attacks, but when smokers die of those same  diseases, they are said to be related to their smoking. So let’s sum up those statistics with one that can’t be misreported: According to a study published last year in The New England Journal of Medicine, lifelong smokers die about 10 years  earlier than  nonsmokers.

Second and final reading of an ordinance that expands the smoking ban in the city

In an unexpected twist, the City Commission at a special meeting Tuesday approved the second and final reading of an ordinance that expands the smoking ban in the city.
The commission approved the final reading as it did the first reading last week at the commission’s regular meeting – on a 3-2 vote.
Commissioners Danny Castillo, Tudor Uhlhorn, and Victor Leal approved the new smoking ordinance while commissioners Mike Mezmar and Chino Sanchez voted against the ordinance. Mezmar’s understanding is that the extended ban goes into effect July 1.
The ordinance exempts fraternal organizations, private clubs, the Valley Race Park, retail tobacco and e-cigarette stores, outdoor seating at restaurants and bars and, “between the tee of the first hole and the green for the final hole” at golf courses.
Proponents have argued that smoking should be banned because it affects innocent bystanders with second-hand smoke. Opponents argue that it is not fair to exempt some or to dictate what people can and cannot do.
Although the ordinance excludes private clubs, the ban would apply when used for a function to which the general public is invited. However, “the exception to this exemption for events held in the facility to which the general public is invited shall not become effective until Jan. 1, 2016,” the ordinance states. The exemption for Valley Race Park would expire Jan. 1, 2016, although smoking would be allowed in the park’s outdoor area after that date.
The new ordinance also notes that one can smoke 10 feet outside entrances, windows and ventilation systems of enclosed spaces and in designated smoking areas.
The ordinance was included on the agenda of Tuesday’s special meeting that the commission said last week would be held to consider adopting a resolution nominating VHS Harlingen Hospital Company, LLC as a Texas Enterprise Project. The commission approved the resolution.