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Much evidence exists showing the very real threats to human survival, premature deaths and poor health outcomes from the nexus between the impacts of climate change and economic and social inequities.1,2 Given this crisis of planetary health equity — defined here as the equitable enjoyment of good health in a stable Earth system — preventive action is needed to address the common underlying drivers of climate change and health inequities. These drivers are located within the consumptogenic system, which is the web of institutions, actors, policies, commercial activities and norms that encourages and rewards the exploitation of natural resources, production of fossil fuels, and hyperconsumerism of fossil fuel‐reliant goods and services, which results in environmental degradation, climate change, and social and health inequities.2 In this perspective article, we relay the urgency — identified by researchers, senior bureaucrats, politicians, former business leaders and civil society groups in a Planetary Health Equity Hothouse Policy Symposium3 — for transforming the consumptogenic system, with a focus on economic models, policy coherence, and advocacy. We highlight the opportunities for the health sector to provide leadership in these issues.
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Sharon Friel receives funding through an Australian Research Council Laureate Fellowship.
No relevant disclosures.
Every year, about 1800 Australians die of hepatocellular carcinoma (HCC), the most common type of primary liver cancer.1
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Open access publishing facilitated by Monash University, as part of the Wiley ‐ Monash University agreement via the Council of Australian University Librarians.
Jessica Howell's salary is supported by an NHMRC Investigator Fellowship, NHMRC Program grant, Burnet Institute Program grant and University of Melbourne strategic grant. We gratefully acknowledge First Nations Australians as the original custodians of this land, who have generously shared their wisdom and stories that led to and informed this work.
Jessica Howell has received speaker fees and participated in advisory boards for Eisai, Astra Zeneca, Roche and Gilead; and received competitive grant funds from Gilead Sciences and Eisai. Troy Combo has participated in an advisory board for Astra‐Zeneca. Paula Binks has participated in advisory boards for Eisai and Astra‐Zeneca. Kylie Bragg has participated in an advisory board for Astra‐Zeneca. Kate Muller has participated in an advisory board for Astra‐Zeneca. Alan Wigg has participated in advisory boards for Eisai. Jacob George has participated in advisory boards and received honoraria for talks from Novo Nordisk, Astra‐Zeneca, Roche, BMS, Pfizer, Cincera, Pharmaxis, Boehringer Mannheim. Stuart Roberts has participated in advisory boards for Eisai, Astra‐Zeneca and Roche.
Objectives: To estimate notification rates for infectious syphilis in women of reproductive age and congenital syphilis in Australia.
Study design: Retrospective cohort study; analysis of national infectious syphilis and enhanced congenital syphilis surveillance data.
Setting, participants: Women aged 15–44 years diagnosed with infectious syphilis, and babies with congenital syphilis, Australia, 2011–2021.
Main outcome measures: Numbers and rates of infectious syphilis notifications, by Indigenous status and age group; numbers and rates of congenital syphilis, by Indigenous status of the infant; antenatal care history for mothers of infants born with congenital syphilis.
Results: During 2011–2021, 5011 cases of infectious syphilis in women aged 15–44 years were notified. The notification rate for Aboriginal and Torres Strait Islander women rose from 56 (95% confidence interval [CI], 45–65) cases per 100 000 in 2011 to 227 (95% CI, 206–248) cases per 100 000 population in 2021; for non‐Indigenous women, it rose from 1.1 (95% CI, 0.8–1.4) to 9.2 (95% CI, 8.4–10.1) cases per 100 000 population. The notification rate was higher for Aboriginal and Torres Strait Islander women than for non‐Indigenous women (incidence rate ratio [IRR], 23.1; 95% CI, 19.7–27.1), lower for 15–24‐ (IRR, 0.7; 95% CI, 0.6–0.9) and 35–44‐year‐old women (IRR, 0.6; 95% CI, 0.5–0.7) than for 25–34‐year‐old women, and higher in remote regions than in major cities (IRR, 2.7; 95% CI, 2.2–3.8). During 2011–2021, 74 cases of congenital syphilis were notified, the annual number increasing from six in 2011 to a peak of 17 in 2020; the rate was consistently higher among Aboriginal and Torres Strait Islander infants than among non‐Indigenous infants (2021: 38.3
Conclusions: The number of infectious syphilis notifications for women of reproductive age increased in Australia during 2011–2021, as did the number of cases of congenital syphilis. To avert congenital syphilis, antenatal screening of pregnant women, followed by prompt treatment for infectious syphilis when diagnosed, needs to be improved.
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Open access publishing facilitated by University of New South Wales, as part of the Wiley – University of New South Wales agreement via the Council of Australian University Librarians.
Data sharing:
Applications for access to the data we analysed for this study should be directed to the Australian Department of Health and Aged Care.
We acknowledge the contribution and valuable insights of the Kirby Institute Aboriginal and Torres Strait Islander Reference Group, and State and Territory Health Department surveillance officers.
No relevant disclosures.
In August 2023, an otherwise healthy 54‐year‐old woman presented to hospital with acute onset fevers and sweats, followed by four days of nausea, vomiting, generalised severe abdominal pain and diarrhoea. The diarrhoea was non‐bloody, with more than ten bowel motions per day. The patient worked as a support worker for older people, and denied previous diarrhoeal illness, sick contacts, consumption of undercooked food, and recent travel.
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Patient consent:
The patient provided written consent for publication.
We thank the Microbial Genomics Laboratory, NSW Health Pathology – Institute of Clinical Pathology and Medical Research, for genomic analysis of the isolate.
No relevant disclosures.
The early detection of adverse events following immunisation (AEFI) is essential to protect public health and to maintain confidence in vaccination. Vaccine pharmacovigilance — the monitoring, detection, investigation and actioning of vaccine safety signals — occurs across a collaborative landscape that includes the Therapeutic Goods Administration (TGA), the nationally funded surveillance initiative AusVaxSafety, and state and territory health departments.
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AusVaxSafety surveillance is funded under a contract with the Australian Department of Health and Aged Care. The authors acknowledge the participants and staff at the surveillance sites, state and territory health departments, and Telethon Kids Institute, and the contribution of the surveillance tools SmartVax, Vaxtracker, and Microsoft COVID Vaccine Management System. The authors also wish to thank the Therapeutic Goods Administration staff of the Vaccines Surveillance Section, Adverse Event and Medicine Defects Section, and Technical and Safety Improvement Section, who support the safety surveillance of influenza vaccines.
No relevant disclosures.
Australia has one of the highest rates of inflammatory bowel disease (IBD) in the world; its prevalence has increased significantly over the past 20 years and is projected to increase by > 250% from 2010 to 2030, to then affect 1% of the population.1 Although advances in clinical practice have led to increased identification, this increase is thought to be due to urbanisation of communities, with changes in sanitation and dietary practices. Such changes seen in Asia over the past 20 years have mirrored the rapidly increasing rates of IBD in the Western society, lending support to the “hygiene hypothesis”, and explaining, in part, the increasing burden of IBD on Australian health care due to our high rates of immigration.1,2
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Mark Ward has received educational grants and speaker fees from AbbVie, Takeda and Ferring; travel grants from Pfizer; and has served on advisory boards for AbbVie.
Raised blood pressure or hypertension is by far the leading risk factor for preventable deaths in Australia, contributing to over 25 000 deaths annually (Supporting Information, figure 1 and figure 2),1,2,3 mainly due to stroke, heart disease, kidney disease, heart failure, atrial fibrillation and dementia.3,4
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Aletta Schutte is supported by a National Health and Medical Research Council (NHMRC) investigator grant (APP2017504). Jun Yang is supported by an NHMRC investigator grant (APP1994576). Clara Chow is supported by an NHMRC investigator grant (APP1195326). The National Hypertension Taskforce would like to thank all members of the International Advisory Panel (Sheldon Tobe, Norm Campbell, Mike Rakotz, Janet Wright, Paul Muntner, Andrew Moran and Pedro Ordunez) for their time and helpful guidance. We acknowledge the input and collaboration of many Australians volunteering to join working groups, workshops and other meetings to inform our decisions. We express sincere gratitude towards the Australian Cardiovascular Alliance for excellent and continued strategic and administrative support.
Aletta Schutte is past president of the International Society of Hypertension, secretary of the Australian Cardiovascular Alliance, board member of Hypertension Australia. Garry Jennings is the chief medical advisor of the Heart Foundation of Australia and board member of Hypertension Australia. Markus Schlaich is the chair of Hypertension Australia, and treasurer of the World Hypertension League. Sharon James is a board director of the Australian Primary Health Care Nurses Association. Mark Nelson is deputy‐chair of the Research Advisory Committee, Stroke Foundation, co‐chair of the Expert Advisory Committee CVD Guidelines, member of the Board of Hypertension Australia. Lisa Murphy is chief executive officer of the Stroke Foundation, member of the Advisory Group for the CVD Risk Guidelines. James Sharman is a board member of Hypertension Australia. Taskeen Khan works at the World Health Organization, but the views do not represent the views of the organisation. Jun Yang is a member of the Endocrine Society Primary Aldosteronism Guideline Development Panel and lead of the Primary Aldosteronism Foundation Patient Engagement Committee. Breonny Robson is general manager, Clinical & Research at Kidney Health Australia, and member of the Advisory Group for the CVD Risk Guidelines. Aletta Schutte, Markus Schlaich, James Sharman, Garry Jennings, Mark Nelson, Lisa Murphy, Andrew Goodman are members of the National Hypertension Taskforce Steering Committee. Aletta Schutte has received speaker fees from Omron, Medtronic, Aktiia, Servier, Sanofi, Novartis and is advisory board member for Skylabs and Abbott. Mark Nelson has received speaker fees from Medtronic. Stephen Nicholls has received research support from AstraZeneca, Amgen, Anthera, CSL Behring, Cerenis, Eli Lilly, Esperion, Resverlogix, New Amsterdam Pharma, Novartis, InfraReDx and Sanofi‐Regeneron and is a consultant for Amgen, Akcea, AstraZeneca, Boehringer Ingelheim, CSL Behring, Eli Lilly, Esperion, Kowa, Merck, Takeda, Pfizer, Sanofi‐Regeneron, Vaxxinity, CSL Sequiris and Novo Nordisk. Geoffrey Cloud received speaker fees from Astra Zeneca and serves on their Advisory Board. Markus Schlaich has received research support from Medtronic, ReCor (Otsuka), Boehringer‐Ingelheim, Abbott, Idorsia, Janssen, and serves on scientific advisory boards for Medtronic, Abbott, Novartis and Astra Zeneca.
The osteoarthritis burden in Australia is growing,1 partly because of population growth, population ageing, and high rates of obesity and sports‐related knee injuries.2 Joint replacement is an effective treatment for people with advanced osteoarthritis; the number of procedures performed in Australia increased markedly during 2003–2019, and is projected to rise further.3
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Correspondence: c.wall@uq.edu.au
Open access:
Open access publishing facilitated by the University of Queensland, as part of the Wiley – the University of Queensland agreement via the Council of Australian University Librarians.
Data sharing:
Patient‐level AOANJRR data are not publicly available for sharing.
Open access publishing facilitated by the University of Queensland, as part of the Wiley – the University of Queensland agreement via the Council of Australian University Librarians.
Christopher Wall, Christopher Vertullo, David Gill, and Paul Smith are clinical directors of the Australian Orthopaedic Association National Joint Replacement Registry (AOANJRR). Richard Page is a clinical advisor to the AOANJRR. Christopher Wall has received payments from Stryker for educational presentations. Christopher Vertullo is director of Knee Research Australia. Christopher Vertullo and David Gill are members of Prosthesis List Advisory Committee clinical advisory groups. Paul Smith is chair of the Canberra Orthopaedic Research and Education Foundation, and director of the Trauma and Orthopaedic Research Unit at the Australian National University. Richard Page and Paul Smith have received institutional support from various orthopaedic device companies.
Objectives: To determine the proportion of Australian adolescent girls who experience menstrual pain (dysmenorrhea); to assess associations of dysmenorrhea and period pain severity with adolescents missing regular activities because of their periods.
Study design: Prospective, population‐based cohort study; analysis of Longitudinal Study of Australian Children (LSAC) survey data.
Setting, participants: Female adolescents in the nationally representative cross‐sequential sample of Australian children recruited in 2004 for the Kinder cohort (aged 4–5 years at enrolment). Survey data from waves 6 (mean age 14 years), wave 7 (16 years) and wave 8 (18 years) were analysed.
Main outcome measures: Severity of period pain during the preceding three months (very, quite, a little, or not at all painful); number of activity types missed because of periods; relationship between missing activities and period pain severity.
Results: Of the 1835 participating female members of the LSAC Kinder cohort at waves 6 to 8, 1600 (87%) responded to questions about menstruation during at least one of waves 6 to 8 of data collection. At wave 6 (14 years), 227 of 644 respondents (35%) reported dysmenorrhea, 675 of 1341 (50%) at wave 6 (16 years), and 518 of 1115 (46%) at wave 8 (18 years). Of the 366 participants who reported period pain severity at all three waves, 137 reported no dysmenorrhea at all three waves (37%), 66 reported dysmenorrhea at all three waves (18%), 89 reported increasing period pain over time (24%), and 38 reported declining pain (10%). At wave 6, 223 of 647 participants reported missing at least one activity because of their periods (34%), 454 of 1341 at wave 7 (34%), and 344 of 1111 at wave 8 (31%). Of the participants who experienced very painful periods, 72% (wave 6), 63% (wave 7), and 65% (wave 8) missed at least one activity type because of their periods, as did 45% (wave 6), 36% (wave 7), and 40% (wave 8) of those who experienced quite painful periods.
Conclusions: A large proportion of adolescent girls in Australia experience period pain that affects their engagement in regular activities, including school attendance. Recognising adolescent period pain is important not only for enhancing their immediate quality of life with appropriate support and interventions, but also as part of early screening for chronic health conditions such as endometriosis.
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The study was funded by the Endo Help Foundation (https://endohelp.com.au), a not‐for‐profit advocacy organisation. This article uses unit record data from the Longitudinal Study of Australian Children (LSAC), conducted by the Australian Government Department of Social Services (DSS) (doi: 10.26193/QR4L6Q). The findings and views reported in this article, however, are those of the authors and should not be attributed to the Australian government, DSS, or any of contractors or partners of DSS.
No relevant disclosures.
Summary