Volume 220 Issue 2

Articles in this issue highlight how critically entwined health is with politics and society more widely and how decisions made by policy makers outside of health portfolios can affect health at a social level. This concept is behind the advocacy for the Health in All Policies approach (https://www.who.int/activities/promoting‐health‐in‐all‐policies‐and‐intersectoral‐action‐capacities), which the World Health Organization (WHO) and a number of countries promote. The research article by Christopher Sexton and colleagues (doi: 10.5694/mja2.52196) investigates the relationship between socio‐economic status and access to fluoridated water in Queensland. Access to fluoridated water is important because of its role in prevention of dental caries and, ultimately, quality of life, and has been an accepted part of preventive health measures since the 1950s, when the WHO endorsed its use. In their study, the authors find that in Queensland, where since 2012 fluoridation has been devolved to local councils for decision in implementation, fluoridation is not universal. They conclude that although “almost 80% of Queenslanders have access to fluoridated water … access is concentrated in the southeast of the state, and fluoridation is more likely in areas of higher socio‐economic status”. This is a shocking finding with regard to public health and the authors urge the Queensland Government to revise its policy. As they state: “The alternative is to accept poorer access to fluoridated water in poorer areas of Queensland, where the burden of oral disease is already high”. In their perspective, Janet Stajic and colleagues (doi: 10.5694/mja2.52181) discuss how the increase in First Nations population in Australia's capital cities requires a focus on improving health and wellbeing outcomes for these urban First Nations peoples. They note that “Urbanisation can contribute to significant health inequities and can diminish opportunities for facilitating social and cultural cohesion, which are important for First Nations peoples in maintaining cultural identity, culture, and connection to kin” and that “Urbanisation places additional pressures and burden on an already extended health care system, especially in the context of First Nations health care, affecting health system performance and access to, and utilisation of, health care services by First Nations people”. They conclude by calling on “governments and research funding bodies to reimagine understandings of First Nations health research in Australia and to provide greater policy focus and funding allocation to urban First Nations health research”. Finally, the perspective by Jennifer Lacy‐Nichols and Katherine Cullerton (doi: 10.5694/mja2.52187) discusses how health policy can be affected by lobbying. They describe the importance of transparency around lobbying activities, and highlight the steps taken by Queensland, which has recently made it easier to examine its lobbyist register. As the authors say, “The Queensland contact log gives us a sense of the volume of lobbying done on behalf of each client;” though they note the lack of standard reporting. They conclude that “Making information about commercial political activities more transparent is a first step in challenging undue influence and making government more accountable. Transparency also enables greater scrutiny of how governments make decisions that have an impact on the health and wellbeing of populations”. As health and policy becomes evermore intertwined, this concept of transparency should resonate across the health system.

Virginia Barbour

Making information about commercial political activities more transparent is a first step in challenging undue influence

Jennifer Lacy‐Nichols · Katherine B Cullerton

Governments and research funders should should focus greater attention on urban First Nations health research

Janet Stajic · Adrian Carson · James Ward

A balance must be found between underuse and overuse of pathology and radiology investigations

Ian A Scott · Carmel Crock · Matthew Twining

A two-year-old girl presented in distress after a minor fall in a sandpit at a childcare facility

Anneliese Willems · Lauren Weston · Susan Robertson

Queensland water fluoridation policy should be revised so that all residents can benefit from this evidence-based public health intervention

Christopher T Sexton · Diep H Ha · Thu Le · Ratilal Lalloo · Pauline Ford · Loc G Do · Nicole Stormon

ICI therapy could benefit a broader range of people with advanced CSCC than are eligible for clinical trials

Luke S McLean · Annette M Lim · Mathias Bressel · Jenny Lee · Rahul Ladwa · Alexander D Guminski · Brett Hughes · Samantha Bowyer · Karen Briscoe · Samuel Harris · Craig Kukard · Rob Zielinski · Muhammad Alamgeer · Matteo Carlino · Jeremy Mo · John J Park · Muhammad A Khattak · Fiona Day · Danny Rischin

Our outpatient triage model can efficiently facilitate care for people with persistent symptoms after COVID-19

Anne E Holland · Daniel Fineberg · Tunya Marceau · Melissa Chong · Jessica Beaman · Lisa Wilson · Jo‐Anne Buchanan · Jacqueline Uren · Simone Dal Corso · Natasha A Lannin · Mariana Hoffman · Christie R Mellerick · Kathya Fernando · Janet Bondarenko

The rising prevalence of steatotic liver disease parallels that of obesity in regional and rural Victoria

Karl Vaz · William W Kemp · Ammar Majeed · John Lubel · Dianna Magliano · Kristen Glenister · Lisa Bourke · David Simmons · Stuart K Roberts

The NHMRC e-cigarette statement assists consumers and policy makers in understanding the current evidence relevant to the marketing and use of e-cigarettes, their impact on smoking initiation and cessation, and their overall implications on individual and population health

Becky Freeman · Matthew J Peters · Renee Bittoun · Richard Brightwell · Dallas R English · David P Thomas · Margaret FA Otlowski · Nicholas A Zwar · Catherine Chamberlain

Rosalie Schultz

Nick S R Lan · Mikhail Alexander · Abdul Rahman Ihdayhid