“RESTORING HOPE” – REFUGEE WEEK 2014

You may know that Sunday 15 June to Saturday 21 June 2014 is Refugee Week. Held annually in Australia to coincide with World Refugee Day on the 20th June, Refugee Week is Australia’s peak annual activity to raise awareness about issues affecting refugees and celebrate the positive contributions made by refugees to Australian society.

The Refugee Council of Australia (RCA) has chosen ‘Restoring Hope’ as the theme for this year’s Refugee Week to remind us that ‘while a refugee’s journey begins with danger, it also begins with hope. Refugees flee their homelands not only because they fear persecution, but also because they have hope: they hope to find freedom from persecution, and safety and security for themselves and their families; they hope to be given a chance to start a new life and recover from past trauma’.

The RCA also makes the point that the theme calls attention to the role of countries that offer protection to refugees and provide them with an opportunity to rebuild their lives and restore hope for a future free from fear, persecution, violence and insecurity. Despite fluctuating (and recently, increasingly harsh) policies of deterrence towards asylum seekers who arrive in Australia by boat, our government also offers permanent settlement to between 13,000 and 14,000 refugees annually through the UNHCR (United Nations High Commissioner for Refugees) resettlement program. While permanent settlement offers opportunities for a new life, it is also accompanied by significant challenges. Refugees settling in Australia come from diverse backgrounds but face a common need to deal with experiences of loss, family disruption, long periods in refugee camps or seeking asylum and the trauma that forced them to flee their homes. Following resettlement, they must negotiate a new language and culture, unfamiliar health, education and welfare systems and are also likely to experience social isolation, poverty and discrimination. Over 40% of people settling in Australia from refugee backgrounds are under the age of 18 and some of these face additional obstacles associated with disrupted – or even non-existent – formal education, prior to arrival.

We know that despite these challenges, most refugee settlers go on to become successful and productive members of Australian society. We also know that providing appropriate support, particularly in the early stages of settlement, can be crucial to enable this to happen. I, along with others in the Jack Brockhoff Child Health and Wellbeing Program are engaged in a number of projects where we work in partnership with others across the University and with community organisations to investigate and promote conditions that support refugee-background children and families to overcome barriers to social inclusion, participation and wellbeing.

Completed projects include evaluations we have conducted of programs such as Ucan2 – which assists young people transitioning from language schools and centres into mainstream education settings – and the Foundation House School Support Program – which supports schools to provide an inclusive environment for refugee-background children and families. We have also explored barriers for refugee-background parents in accessing Maternal and Child Health Services and investigated ways to support driver education for refugees settling in regional Victoria.

Current projects include an exploration of the experiences of refugee-background parents and young children who attend supported playgroups run by Save the Children Australia, and a new project focused on sports participation as a means to promoting social inclusion and wellbeing for refugee-background children. We are also about to begin a project looking at ways the University of Melbourne can provide enhanced opportunities and support to tertiary students from refugee-backgrounds.

Underpinning all of these projects is the understanding that improving support for those new to Australia can make all the difference when it comes to them being able to create the new life that they hope for. Some of the remarkable stories of Australians from diverse backgrounds who first came here as refugees with hope for a better future have been collected by Melbourne University’s Researchers for Asylum seekers. You can read some of those stories celebrating their lives and contributions here.

Written by Dr Karen Block
Research Fellow, Jack Brockhoff Child Health & Wellbeing Program
The University of Melbourne

keblock@unimelb.edu.au
                 

World Refugee Day http://stories.unhcr.org/?_ga=1.91771994.1973195338.1402975368

Restoring Hope http://www.refugeeweek.org.au/

Resettlement program http://www.unhcr.org/pages/4a16b1676.html

Ucan2 http://www.unhcr.org/pages/4a16b1676.html

School Support Program http://www.tandfonline.com/doi/abs/10.1080/13603116.2014.899636#.U6DBJChhsTB

Maternal and Child Health http://www.biomedcentral.com/1472-6963/12/117

Driver education https://www104.griffith.edu.au/index.php/inclusion/article/view/440

Refugee-background parents and young children http://www.socialequity.unimelb.edu.au/the-lived-experience-of-refugee-background-children-in-australia/

Here http://www.ras.unimelb.edu.au/stories.html

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Obesogenic Australia: Would you like any chocolates with that?

Guest blog by Alexandria Hoare, Dietitian (APD, AN)

On my half hour commute home from work each day I directly pass 4 McDonalds, 2 KFC’s and 1 Hungry Jacks. Recently, I had to stop off to fill up with petrol on my way home. The service station was packed wall to wall with chips, chocolates, icecreams and sugar filled drinks. As I went to pay I was not greeted with ‘hello, how are you?’ but ‘would you like any chocolates, 2 for $3?’ I got back into my car (chocolate free) and as I drove I listened to the ads on the radio telling me that I had to get in quick to try the limited addition burger from McDonalds, how Coca-Cola brings happiness to summer and how I can win tickets to the tennis if I eat Drumsticks. I decided to go out of my way to go to the supermarket (as I do not directly pass any, unlike the fast food restaurants).  As I entered I was faced with front end advertising promoting sales on soft drink, chips and sugary lunch box fillers. I decided not to purchase these products but just in case I changed my mind I was greeted with more calorie dense, nutrient poor food at the checkout.

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This is what you call an obesogenic environment. Where the environment we live in makes unhealthy choices the easier option. And that’s just looking at half the picture. Don’t forget the endless amounts of labour saving devices which allow you to stay in the comfort of your own home for days, months, even years on end if you wish. People are told to eat healthy and to be physically active but how can they achieve that when the environment is encouraging them to do the exact opposite? If we are serious about tackling the obesity epidemic we need to create supportive environments. Environments where the healthy choice is the easy choice. 

Many countries worldwide have started to step up their efforts to tackle their obesogenic environments. In the UK and Korea national programs have been launched to reduce trans fats in food, in Japan employees have mandatory waist measurements enforced by their insurance company, Hungary has a tax of high sugar foods, Finland a tax on confectionary, France a tax on soft drinks and Denmark introduced a tax on foods that contain more than 2.3% saturated fat. Some of these strategies are showing some promising results, others are not, but at least they’re trying.

What can we do about obesogenic Australia? I don’t have the answer but let’s at least try to do something. What about restrictions on the marketing and promotion of high calorie, sugary foods or food policies to reduce the price of fresh produce, introducing a traffic light system on food packaging, menu labelling at restaurants, limitations on product placement in supermarkets,  working with food industries to make healthier more affordable foods, mandatory nutrition and physical education in schools, healthier foods to be available at school canteens, sporting venues and service stations, better urban planning to promote physical activity, accessible healthy food and active commuting?

Let’s put more funding into research, collecting evidence and determining what interventions are more successful. What lessons can we learn from countries like Japan, Switzerland and Norway where they have some of the lowest rates of obesity in the developed world?

For these changes to occur the whole of society will need to get on board. Federal, state and local governments, non-government organisations, schools, communities, health and food industries, sporting clubs and the media all have the potential to make some changes for the better, to promote a healthy lifestyle and to help reduce our obesogenic environment.  

If we are serious about tackling obesity our environment needs to change. We need to create supportive environments so the healthy choice is the easy choice. 

 

Written by Alexandria Hoare
Dietitian (APD, AN)
BHSc, MDiet

https://www.facebook.com/TheDietitiansPantry

https://twitter.com/DietitianPantry

Research with culturally and linguistically diverse communities

Encouraging people to participate in research can be a tough gig. We are usually asking people to volunteer their time just for a small piece of information, which is sometimes only relevant and generalisable if large numbers provide this same, small piece of information. As researchers we know the enormous value that gathering this information can have to inform change at the policy, practice and the community level. But the general population sometimes does not place the same value on research or understand how important the research and outcomes can be. So, how do we encourage people to participate in research? And in particular, how do we encourage those from culturally and linguistically diverse backgrounds, where research may not be a common concept or practice.

I am currently working on a large scale child oral health research project entitled ‘Teeth Tales’, being conducted in partnership with government and community agencies  and Australian families from refugee and migrant backgrounds. Oral health is included in the Victorian Health and Wellbeing Plan 2011 – 2015 as a priority area for preventative health, as it is one of the most preventable diseases, particularly for children. Tooth decay is Victoria’s most prevalent health problem, with more than half of all children and almost all adults affected (1). Initial qualitative research was conducted with mothers from Lebanese, Iraqi and Pakistani backgrounds exploring oral health practices, beliefs and service needs. We learnt about many cultural differences and the real interest these communities have to learn more about keeping their children’s teeth healthy. From this earlier research, a community-based trial was developed to include an oral health education program for parents delivered by a trained educator from the same cultural background. This peer educator is able to talk about traditional beliefs and practices and introduce parents to the key Dental Health Services Victoria oral health messages of ‘Eat Well, Drink Well, Clean Well and Stay Well’. The program also included a site visit to local dental and family services. In addition to this education program, local services underwent a review of their practices to improve their competence in dealing with culturally diverse communities.

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Photo from:  http://www.dshs.state.tx.us/dental/promo_oh.shtm

For this trial we recruited Lebanese, Iraqi and Pakistani families in metropolitan Melbourne with children aged 1 – 4 years. We wanted to make sure that the research was as useful and relevant to families as possible so we sought the advice and expertise of relevant cultural organisations. They provided guidance on the cultural practices and beliefs of the target cultural groups, and the cultural appropriateness of our research methodology. They also helped us to recruit families, conduct the trial, interpret the findings and they provided language assistance. If it wasn’t for these partnerships we may have been lucky to recruit 10 families rather than the over 500 families who ended up participating! The advice and support of these cultural partners is invaluable when trying to recruit families with a refugee or migrant background, some of whom may be unfamiliar with research conduct, health promotion and the Australian health system.

In order to evaluate the success of the program we needed to check children’s teeth before and after the trial, as well as ask parents to complete a questionnaire. The free dental screenings for the children proved to be a key incentive for parents to register for the study. Oral health is one of the most contentious current health issues in Australia as access to fast, affordable dental care is often not available. The private dental system is run as a business and many walk out of the service with an expensive bill. The public dental system has huge waiting lists and strict eligibility for access. We found that many parents were not aware that children and refugee and asylum seekers in Victoria are considered a priority group for public dental services access. So when our study offered a free dental screening for children many families jumped at the opportunity!

The strategies outlined above helped us to successfully recruit over 500 families into our study. Engaging culturally and linguistically diverse groups in research can be difficult, but is very important, particularly for health services that need to respond to the evolving health needs of refugee and migrant and groups.

To read more about the ‘Teeth Tales’ study please visit:  http://mccaugheycentre.unimelb.edu.au/research/current/intergenerational_health/teeth_tales

Blog by Dana Young

Research Fellow, Child Public Health

The University of Melbourne

e: dana.young@unimelb.edu.au

References

  1. NACOH. 2004, Healthy mouths healthy lives: Australia’s National Oral Health Plan 2004-2013. Adelaide, National Advisory Committee on Oral Health, Australian Health Ministers’ Advisory Council.

How voting for equity will make life better now and in the future

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This article was originally published on The Conversation.

With the upcoming election, we wanted to provide our perspective to the ongoing debate. This article outlines some of our key thoughts regarding pressing election issues.

The impending federal election provides a good opportunity to pause and ask ourselves what kind of society we want to live in. The decision we make will impact both our lives and that of our children as they develop into adults and become tomorrow’s decision-makers.

At times, real policy messages can get lost in the noise of the election campaign and we are left thinking that the only rational option is to vote for selfish reasons.

But what if living in a society in which some of us are much better off than others is actually bad for all of us – even those of us who are most privileged?

The problem with inequality

There’s considerable evidence that more unequal societies have lower life expectancy and higher mortality rates; higher rates of stress and mental illness; more crime and higher imprisonment rates; and reduced quality of life.

This is not just because less egalitarian societies have more poor people, whose health and social outcomes pull down the average. Even the relatively wealthy in more unequal societies (such as the United States) do worse than others with similar levels of income living in societies with a more even spread of wealth (such as Scandinavian nations).

In Australia, rising average incomes over the last three decades have been accompanied by increases in inequality. Although polls suggest that voters’ greatest concern is the economy, research shows that beyond a certain level, increases in a country’s wealth are not associated with increased health, happiness or longevity for its people.

This is not only true for adults, a UNICEF report looking at the well-being of children in wealthy countries draws a similar picture.

This idea underpins much of our focus on inequalities within child public health research; social and economic inequalities will determine future economic status, educational achievement, and social inclusion of children.

So, what are the implications of an “equity lens” for considering the array of policies presented to us as the federal election looms? If inequality is bad for all of us, how should we weigh up the major parties’ offerings on disability support, paid parental leave, same-sex marriage, and asylum seekers?

Disability issues

Some policies appear to be moving in the right direction. DisabilityCare Australia (the National Disability Insurance Scheme) for example, is a significant policy that has bipartisan support.

At present, the level of support a person receives depends on the state in which they live, whether their disability is congenital or acquired, and how it is acquired.

When fully rolled out, DisabilityCare will result in funding being allocated directly to an individual or, in the case of children, their parents or legal guardians, to provide the support necessary to meet their needs.

While the implications for equity will ultimately be determined by how services are delivered, the policy ensures assistance for a far greater proportion of families dealing with disability.

Parental leave

Paid parental leave is an international indicator for child health and well-being. So how do the major parties’ schemes measure up?

Much of the Labor party’s criticism of the Coalition’s more “generous” plan to provide women on salaries of up to A$150,000 with 100% of their income for six months focuses on its affordability. Perhaps the more concerning issue is its impact on equity.

Many of the most disadvantaged families in our society – those with parents not in paid employment, or in insecure, low-paid, intermittent, or casual jobs – may be worse off than under current arrangements. This is particularly so if the baby bonus (the A$5,000 to which they are now entitled) is reduced or abolished to fund the new scheme.

If paid parental leave is intended to provide children with the best possible start in life, then surely we need to ensure that its provision does not widen the gap between rich and poor.

Same-sex marriage

Marriage equality is an area of contrast between the two major parties. Although the Labor party changed 85 pieces of federal legislation in 2008 to bring “equality” to same-sex parented families, the negative rhetoric and lack of leadership from both sides of politics (until Kevin Rudd’s very recent declaration of support for same-sex marriage) has a significant impact on same-sex attracted parents and their families.

In fact, stigma resulting from inequity is linked to poorer child health outcomes. Although children with same-sex attracted parents are generally doing well, a lack of equitable recognition by politicians is an ongoing source of disadvantage.

Asylum seekers

It can be difficult to keep up with the shifts in asylum seeker policy as the major parties vie with each other to be seen as the most “hardline” and more capable of “stopping the boats”.

Important human rights arguments and international legal obligations aside, what are the implications for global equity of reducing foreign aid to pay for ever more expensive policies of deterrence?

In the national context, we are spending billions of dollars annually on off-shore processing of refugees. The same amount of money could provide better and more productive settlement outcomes for many more refugees in Australia. And there would be funds left to contribute to high-quality government education, health care, and public transport for all of us.

We also now have policies whereby asylum seekers “lucky enough” to be living in our community rather than detained, are denied the right to work or be reunited with other members of their family. What kind of under-class are we creating, and how will the children growing up in those families experience the future?

Everybody’s business

Typically, concern with social justice is associated with the political left. And it appears to be something we’re all too ready to jettison for the supposed benefits of greater economic growth.

But if inequality is bad for all of us, then it’s actually in our own self interest to prevent it. And it certainly is in the interests of our children for us to consider the impact of policies on social equity when casting our votes this weekend.

Authors: Dr Karen Block, Dr Elise Davis, Prof Elizabeth Waters, Dr Lisa Gibbs & Dr Simon Crouch