ORGANIZATIONAL AFFILIATION
Proper Syringe Use:
Medical and Recreational Consumption of IV Drugs as a Public Health Concern
This is a photo of a syringe disposal box in one of the university bathrooms. It represents the dangers associated with IV drug use. The population affected by this public health issue is anyone who has ever received an injectable drug; the subpopulations are (1) people who receive injectable drugs under medical supervision and (2) people who self-administer drugs for recreational value. The use of injectable drugs is an international public health problem, as they are used for medical and non-medical reasons everywhere.
Subpopulation 1 faces a handful of essentially unavoidable health risks, the most prominent being infection from skin-dwelling and other infectious agents. One American study estimated the prevalence of blood borne infections as a result of improper aseptic IV technique to be c. 250,000 cases per year, with an associated $25,000 USD cost per infection (O'Grady et al 2002), to be borne by the national healthcare system.
Subpopulation 2 faces all of the same risks as subpopulation 1, in addition to substantial risks of blood borne disease transfer associated with the drug using ritual and lifestyle. A 2001 study by the University of New South Wales estimated the incidence of hepatitis C among injecting drug users to be as high as 66%.
One method to combat the spread of blood borne disease among the drug injecting population that has had success in Europe is the establishment of “injecting centres” – areas where clean needles and a sterile environment are provided to addicts for harm reduction purposes. Unfortunately, injecting centres have met some resistance in Australia, with Victorian Premier Ted Baillieu refusing to establish one in his state in 2011. Often, public officials are reluctant to embrace harm reduction strategies in order to avoid legitimizing drug use. This is a major public health concern that should be addressed in more detail by future administrations.
Littering as a Public Health Concern:
The Social, Economic and Environmental Impact of Improper Waste Disposal
This is a photo of the garbage disposal at my house in Newcastle city. It represents the public health impact of littering on society. Littering is an international issue – it harms our natural environment and detracts from the quality of life and value of property anywhere there is a large concentration of human life. A 2008 report on the effects of littering in Australia estimated its cost to local, city and state governments to be in the hundreds of thousands per annum.
The areas most directly affected by littering are residential areas, highways and parking lots, which account for nearly half of all littering. The most common form of litter is cigarette butts, which makes up almost half of all litter, as measured by the NEPC Service Corporation for 2007-2008. Cigarette butts are a particularly pernicious form of litter, as they are neither biodegradable nor consumed by local fauna.
Littering is perpetuated by the younger generations. A majority of persons under 18 years of age are litterers, a number which declines with age and reaches a minimum in the 55-64 age group. People are more likely to litter when in larger groups. In some cases, the incidence of littering can rise by as much as 10% for every two people added to a group. Generally, the least amount of littering occurs when a person is alone or in a group of two.
A number of public health initiatives are underway to address the problem of littering. In 2011, Victoria moved to re-institute a cash-for-cans program, which pays ten cents for every piece of aluminum litter taken off the streets. This proposal enjoyed widespread public support.
Tobacco Smoke and Public Health
This is a photo of a no smoking sign at the front door of the university library and it represents the threat to public health that tobacco smoking poses. Cigarette smoking is an international public health concern, as many people in every country in the world smoke. Tobacco smoking imposes a significant burden on the economy and public health system of Australia. Smoke exposure is linked to the development of cancer, as well as a number of cardiac conditions. Smoking has been calculated to account for nearly one-tenth of the total burden of Disability-Adjusted Life Years on the nation, outranking obesity and alcohol consumption as a public health issue.
Smoking is on the decline in Australia. The trends recorded by the National Health Surveys between 1989 and 2008 indicate that the incidence of smoking has fallen more than five percent in the past two decades. Men smoke more than women, consistently having a population of daily smokers approximately five percent higher than women over all time periods for which statistics are available.
This recent decline is mostly due to the efforts of the National Tobacco Campaign. The current campaign, which has been in effect since 2011, is referred to as the More Targeted Approach. It is hoped that this campaign will effect a further five percent drop by 2018, reducing the incidence of daily cigarette smoking to less than ten percent. The campaign consist of advertisements made to target a myriad of different cultural and linguistic sub-populations. The campaign includes ads targeted at Chinese, Arabic, Persian, Spanish, Thia, Vietnamese and Pacific Islander populations. It is comprised of messages that make an appeal on the basis of family health, financial strain as well as targeted ads that detail the health benefits of quitting for both men and women.
Air Quality:
The Public Health Impact of Air Pollution at Home and Abroad
This is a photograph of a mouth mask at my office. It represents the public health issue of air quality. As the world becomes more industrialized and concentrations of human life rise, air quality is becoming a progressively larger public health concern. A recent survey of global environmental outlook by the Organisation for Economic Co-operation and Development, of which Australia is a member, estimated that, by 2050, there will be 3.6 million early deaths due to heavily polluted air worldwide. The bulk of this statistic will, they predict, be borne by China and India due to the poor environmental controls in these two nations, but the report also depicts high death rates in Australia due to high concentrations of ground-level ozone.
Air pollution is on the rise in Australia. In 2009 alone, residents of Sydney were subjected to 37 days of high air pollution – defined as levels of pollution that breach the national guidelines for acceptable concentrations of pollutants – was more than double the 19 days of the previous year. It has been estimated that high levels of pollution in the Sydney Basin, the area of Australia with the lowest air quality, amasses more than $4.7 billion in costs to human health every year.
The Australian government is taking significant measures to combat the negative impact on public health that stems from air pollution. The primary branch of this attack on poor air quality is the National Environment Protection Measure (NEPM), which was implemented in November 2009. Unfortunately, the monitoring methods that the NEPM requires are not in widespread use, as they are extremely resource intensive. On October 2011, some minor changes were made to the NEPM in order to make its standards easier to adhere to, and it is hoped that these will meet the general acceptance that the law originally sought.
References
Arup, T. (2012, March 17). Death stalks us in the air, says oecd in its outlook. Sydney Morning Herald. Retrieved from http://www.smh.com.au/national/death-stalks-us-in-the-air-says-oecd-in-its-outlook-20120316-1vaya.html
Air quality in sydney breaches safe levels 19 times. (2010, January 17). Sydney Morning Herald. Retrieved from http://www.smh.com.au/environment/air-quality-in-sydney-breaches-safe-levels-19-times-20100117-me85.html
Dowling, J. (2011, March 4). Cash-for-cans plan revived. Sydney Morning Herald. Retrieved from http://www.smh.com.au/victoria/cashforcans-plan-revived-20110303-1bgg1.html
Enviorment Protection and Heritage Council, (n.d.). Air toxics nepm. Retrieved from website: http://www.ephc.gov.au/taxonomy/term/35
Enviorment Protection and Heritage Council, (2008). Litter management in australia. Retrieved from website: http://www.ephc.gov.au/sites/default/files/WasteMgt_Rpt_Litter_Management_In_Australia_200811.pdf
Keep Australia Beautiful / McGregor Tan Research, 2008, National Litter index Charts 2007/2008
Habib SE, Lovejoy FH, Aspin C. Hepatitis C prevalence and risk behavior of injecting drug users in Sydney: a continuing concern. Southeast Asian J Trop Med Public Health. 2001 Dec;32(4):823-34. PubMed PMID: 12041560.
Merhab, B. (2011, May 18). Baillieu won't approve a heroin centre . Sydney Morning Herald. Retrieved from http://news.smh.com.au/breaking-news-national/baillieu-wont-approve-a-heroin-centre-20110518-1es7k.html
O'Grady, N. (2011). Retrieved from Centers for Disease Control website: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5110a1.htm
Preventative Health Taskforce, 2008, Technical Report No 2: Tobacco control in Australia: making smoking history, p. v.
Quitnow. (2012, January 29). quitnow. Retrieved from http://www.quitnow.gov.au/internet/quitnow/publishing.nsf/Content/mta-2011-12
(2009). Smoking, risky drinking and obesity. Australian Social Trends, Retrieved from http://www.abs.gov.au/AUSSTATS/abs@.nsf/Lookup/4102.0Main Features30Dec 2009
