The aim of the National Health Priority Area (NHPA) initiative is to promote cooperation between government and non-government organisations to monitor, report on and develop strategies to improve health outcomes for Australians.
The seven existing NHPAs (cancer control, injury prevention and control, cardiovascular health, mental health, diabetes mellitus, asthma and musculoskeletal conditions) were selected on the basis of their profound burden on the health of Australians.
Up to eighty per cent of Australians will experience back pain at some point in their lives and 10% will experience significant disability as a result.
Back pain disrupts individuals’ quality of life and accounts for an enormous cost to the community.
Integrating back pain into the NHPA framework has many potential benefits, including more systematic development and implementation of programs aimed at minimising back pain-related disability by providing a focus for policy, legislation and public awareness; and promotion of best-practice management of the condition.
A disadvantage of making back pain an NHPA is the risk that back pain management could become further medicalised and ineffective interventions could become more accepted.
Coordinated action on back pain is needed, and integrating back pain into the NHPA framework is one solution.
Informed decision making through consultation with key stakeholders is a necessary first step towards ensuring that favourable outcomes are achieved.
- 1. Australian Government Department of Health and Ageing. Department of Health and Ageing Factbook 2006 [rescinded]. Canberra: DoHA, 2006. http://www.health.gov.au/internet/main/publishing.nsf/Content/Factbook2006-1 (accessed Mar 2009).
- 2. Australian Institute of Health and Welfare and Commonwealth Department of Health and Family Services. First report on National Health Priority Areas, full report. Canberra: AIHW and DHFS, 1997. http://www.aihw.gov.au/publications/index.cfm/title/121 (accessed Mar 2009).
- 3. Australian Institute of Health and Welfare. Why are risk factors included in the National Health Priority Areas initiative? Canberra: AIHW, 2005. http://www.aihw.gov.au/nhpa/riskfactors/index.cfm (accessed Mar 2009).
- 4. National Health Priority Action Council. National Chronic Disease Strategy. Canberra: Australian Government Department of Health and Ageing, 2006. http://www.health.gov.au/internet/main/publishing.nsf/Content/7E7E9140A3D3A3BCCA257140007AB32B/$File/stratal3.pdf (accessed Mar 2009).
- 5. Australian Labor Party. National obesity campaign [media statement]. Canberra: ALP, 17 Oct 2008. http://www.alp.org.au/media/1008/msheag170.php (accessed Mar 2009).
- 6. Australian Institute of Health and Welfare. Australia’s health 2006. The tenth biennial health report of the Australian Institute of Health and Welfare. Canberra: AIHW, 2006. (AIHW Cat. No. AUS 73.) http://www.aihw.gov.au/publications/index.cfm/title/10321 (accessed Mar 2009).
- 7. Walker BF, Muller R, Grant WD. Low back pain in Australian adults. Prevalence and associated disability. J Manipulative Physiol Ther 2004; 27: 238-244.
- 8. Jeffries LJ, Milanese SF, Grimmer-Somers KA. Epidemiology of adolescent spinal pain. A systematic overview of the research literature. Spine 2007; 32: 2630-2637.
- 9. Australian Bureau of Statistics. Australian social trends 2007. Work-related injuries. Canberra: ABS, 2007. (ABS Cat. No. 4102.0.) http://www.abs.gov.au/ausstats/abs@.nsf/latestproducts/63ED457234C2F22DCA25732C002080A7?opendocument (accessed Mar 2009).
- 10. Australian Bureau of Statistics. National health survey. Summary of results 2004–05. Canberra: ABS, 2006. (ABS Cat. No. 4364.0.) http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.02004-05?OpenDocument (accessed Mar 2009).
- 11. Council of Australian Governments. 10 February 2006 communiqué. Canberra: COAG, 2006. http://www.coag.gov.au/coag_meeting_outcomes/2006-02-10/docs/coag100206.pdf (accessed Mar 2009).
- 12. Leboeuf-Yde C, Kyvik KO. At what age does low back pain become a common problem? A study of 29424 individuals aged 12–41years. Spine 1998; 23: 228-234.
- 13. Taimela S, Kujala UM, Salminen JJ, et al. The prevalence of low back pain among children and adolescents — a nationwide, cohort-based questionnaire survey in Finland. Spine 1997; 22: 1132-1136.
- 14. Watson KD, Papageorgiou AC, Jones GT, et al. Low back pain in schoolchildren: occurrence and characteristics. Pain 2002; 97: 87-92.
- 15. Hakala P, Rimpela A, Salminen JJ, et al. Back, neck and shoulder pain in Finnish adolescents: National cross sectional surveys. BMJ 2002; 325: 743-745.
- 16. Dionne CE, Dunn KM, Croft PR. Does back pain prevalence really decrease with increasing age? A systematic review. Age Ageing 2006; 35: 229-234.
- 17. Hartvigsen J, Christensen K. Pain in the back and neck are with us until the end — a nationwide interview-based survey of Danish 100-year-olds. Spine 2008; 33: 909-913.
- 18. Wyatt M, Underwood MR, Scheel IB, et al. Back pain and health policy research. The what, why, how, who, and when. Spine 2004; 29: E468-E475.
- 19. Victorian Government Department of Premier and Cabinet. The history of the National Reform Agenda. Melbourne: DPC, 2007. http://www.dpc.vic.gov.au/CA256D800027B102/Lookup/NationalReformAgendaHistory/$file/The%20History%20of%20the%20NRA%20For%20Website.pdf (accessed Mar 2009).
- 20. Australian Acute Musculoskeletal Pain Guidelines Group. Evidence-based management of acute musculoskeletal pain. A guide for clinicians. Brisbane: Australian Academic Press, 2004.
- 21. Henschke N, Maher CG, Refshauge KM, et al. Prognosis in patients with recent onset low back pain in Australian primary care: inception cohort study [abstract]. BMJ 2008; 337: a171.
- 22. Buchbinder R. Self-management education en masse: effectiveness of the Back Pain: Don’t Take It Lying Down mass media campaign. Med J Aust 2008; 189 (10 Suppl): S29-S32. <MJA full text>
- 23. Loisel P, Buchbinder R, Hazard R, et al. Prevention of work disability due to musculoskeletal disorders: the challenge of implementing evidence. J Occup Rehabil 2005; 15: 507-524.
- 24. Cameron ID, Rebbeck T, Sindhusake D, et al. Legislative change is associated with improved health status in people with whiplash. Spine 2008; 33: 250-254.
- 25. Buchbinder R, Staples MP, Jolley DJ. Doctors with a special interest in back pain have poorer knowledge about how to treat back pain. Spine 2009. In press.
- 26. Ireland DCR. Australian repetition strain injury phenomenon. Clin Orthop Relat Res 1998; 351: 63-73.
Publication of your online response is subject to the Medical Journal of Australia's editorial discretion. You will be notified by email within five working days should your response be accepted.