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How we diagnose and define obesity is set to change – here’s why, and what it means for treatment

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/louise-baur-5284">Louise Baur</a>, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/john-b-dixon-11630">John B. Dixon</a>, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a>; <a href="https://theconversation.com/profiles/priya-sumithran-1529047">Priya Sumithran</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>, and <a href="https://theconversation.com/profiles/wendy-a-brown-1665">Wendy A. Brown</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p>Obesity is <a href="https://www.niddk.nih.gov/health-information/weight-management/adult-overweight-obesity/health-risks#:%7E:text=Having%20overweight%20or%20obesity%20increases,the%20cells%20in%20your%20body">linked to</a> many common diseases, such as type 2 diabetes, heart disease, fatty liver disease and knee osteoarthritis.</p> <p>Obesity is currently defined using a person’s body mass index, or BMI. This is <a href="https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight">calculated</a> as weight (in kilograms) divided by the square of height (in metres). In people of European descent, the BMI for obesity is 30 kg/m² and over.</p> <p>But the risk to health and wellbeing is not determined by weight – and therefore BMI – alone. We’ve been part of a global collaboration that has spent the past two years discussing how this should change. Today we publish how we think obesity should be defined and why.</p> <p>As we outline in <a href="https://www.thelancet.com/commissions/clinical-obesity">The Lancet</a>, having a larger body shouldn’t mean you’re diagnosed with “clinical obesity”. Such a diagnosis should depend on the level and location of body fat – and whether there are associated health problems.</p> <h2>What’s wrong with BMI?</h2> <p>The risk of ill health depends on the relative percentage of fat, bone and muscle making up a person’s body weight, as well as where the fat is distributed.</p> <p>Athletes with a relatively high muscle mass, for example, may have a higher BMI. Even when that athlete has a BMI over 30 kg/m², their higher weight is due to excess muscle rather than excess fatty tissue.</p> <p>People who carry their excess fatty tissue <a href="https://www.abc.net.au/news/health/2017-09-06/waist-size-why-it-matters-and-when-its-a-risk/8839708">around their waist</a> are at greatest risk of the health problems associated with obesity.</p> <p>Fat stored deep in the abdomen and around the internal organs can release damaging molecules into the blood. These can then <a href="https://theconversation.com/body-fat-deep-below-the-surface-is-a-toxic-risk-especially-for-your-heart-146307">cause problems</a> in other parts of the body.</p> <p>But BMI alone does not tell us whether a person has health problems related to excess body fat. People with excess body fat don’t always have a BMI over 30, meaning they are not investigated for health problems associated with excess body fat. This might occur in a very tall person or in someone who tends to store body fat in the abdomen but who is of a “healthy” weight.</p> <p>On the other hand, others who aren’t athletes but have excess fat may have a high BMI but no associated health problems.</p> <p>BMI is therefore an imperfect tool to help us diagnose obesity.</p> <h2>What is the new definition?</h2> <p>The goal of the <a href="https://pubmed.ncbi.nlm.nih.gov/36878238">Lancet Diabetes & Endocrinology Commission on the Definition and Diagnosis of Clinical Obesity </a> was to develop an approach to this definition and diagnosis. The commission, established in 2022 and led from King’s College London, has brought together 56 experts on aspects of obesity, including people with lived experience.</p> <p>The commission’s <a href="https://www.thelancet.com/commissions/clinical-obesity">definition and new diagnostic criteria</a> shifts the focus from BMI alone. It incorporates other measurements, such as waist circumference, to confirm an excess or unhealthy distribution of body fat.</p> <p>We define two categories of obesity based on objective signs and symptoms of poor health due to excess body fat.</p> <p><strong>1. Clinical obesity</strong></p> <p>A person with clinical obesity has signs and symptoms of ongoing organ dysfunction and/or difficulty with day-to-day activities of daily living (such as bathing, going to the toilet or dressing).</p> <p>There are 18 diagnostic criteria for clinical obesity in adults and 13 in children and adolescents. These include:</p> <ul> <li> <p>breathlessness caused by the effect of obesity on the lungs</p> </li> <li> <p>obesity-induced heart failure</p> </li> <li> <p>raised blood pressure</p> </li> <li> <p>fatty liver disease</p> </li> <li> <p>abnormalities in bones and joints that limit movement in children.</p> </li> </ul> <p><strong>2. Pre-clinical obesity</strong></p> <p>A person with pre-clinical obesity has high levels of body fat that are not causing any illness.</p> <p>People with pre-clinical obesity do not have any evidence of reduced tissue or organ function due to obesity and can complete day-to-day activities unhindered.</p> <p>However, people with pre-clinical obesity are generally at higher risk of developing diseases such as heart disease, some cancers and type 2 diabetes.</p> <h2>What does this mean for obesity treatment?</h2> <p>Clinical obesity is a disease requiring access to effective health care.</p> <p>For those with clinical obesity, the focus of health care should be on improving the health problems caused by obesity. People should be offered evidence-based treatment options after discussion with their health-care practitioner.</p> <p><a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01210-8/abstract">Treatment</a> will <a href="https://www.thelancet.com/journals/landia/article/PIIS2213-8587(22)00047-X/fulltext">include</a> management of obesity-associated complications and may include specific obesity treatment aiming at decreasing fat mass, such as:</p> <ul> <li> <p>support for <a href="https://www.obesityevidencehub.org.au/collections/treatment/behavioural-interventions-for-the-management-of-overweight-and-obesity-in-adults">behaviour change</a> <a href="https://www.obesityevidencehub.org.au/collections/treatment/managing-overweight-and-obesity-in-children-and-adolescents">around</a> diet, physical activity, sleep and screen use</p> </li> <li> <p>obesity-management medications to reduce appetite, lower weight and <a href="https://www.obesityevidencehub.org.au/collections/treatment/medication-and-surgery-for-the-treatment-of-overweight-and-obesity-in-adults">improve health</a> outcomes such as blood glucose (sugar) and blood pressure</p> </li> <li> <p>metabolic <a href="https://theconversation.com/thinking-about-bariatric-surgery-for-weight-loss-heres-what-to-consider-184153">bariatric surgery</a> to treat obesity or reduce weight-related health complications.</p> </li> </ul> <h2>Should pre-clinical obesity be treated?</h2> <p>For those with pre-clinical obesity, health care should be about risk-reduction and prevention of health problems related to obesity.</p> <p>This may require health counselling, including support for health behaviour change, and monitoring over time.</p> <p>Depending on the person’s individual risk – such as a family history of disease, level of body fat and changes over time – they may opt for one of the obesity treatments above.</p> <p>Distinguishing people who don’t have illness from those who already have ongoing illness will enable personalised approaches to obesity prevention, management and treatment with more appropriate and cost-effective allocation of resources.</p> <h2>What happens next?</h2> <p>These new criteria for the diagnosis of clinical obesity will need to be adopted into national and international clinical practice guidelines and a range of obesity strategies.</p> <p>Once adopted, training health professionals and health service managers, and educating the general public, will be vital.</p> <p>Reframing the narrative of obesity may help eradicate misconceptions that contribute to stigma, including making false assumptions about the health status of people in larger bodies. A better understanding of the biology and health effects of obesity should also mean people in larger bodies are not blamed for their condition.</p> <p>People with obesity or who have larger bodies should expect personalised, evidence-based assessments and advice, free of stigma and blame.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/245164/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/louise-baur-5284"><em>Louise Baur</em></a><em>, Professor, Discipline of Child and Adolescent Health, <a href="https://theconversation.com/institutions/university-of-sydney-841">University of Sydney</a>; <a href="https://theconversation.com/profiles/john-b-dixon-11630">John B. Dixon</a>, Adjunct Professor, Iverson Health Innovation Research Institute, <a href="https://theconversation.com/institutions/swinburne-university-of-technology-767">Swinburne University of Technology</a>; <a href="https://theconversation.com/profiles/priya-sumithran-1529047">Priya Sumithran</a>, Head of the Obesity and Metabolic Medicine Group in the Department of Surgery, School of Translational Medicine, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>, and <a href="https://theconversation.com/profiles/wendy-a-brown-1665">Wendy A. Brown</a>, Professor and Chair, Monash University Department of Surgery, School of Translational Medicine, Alfred Health, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/how-we-diagnose-and-define-obesity-is-set-to-change-heres-why-and-what-it-means-for-treatment-245164">original article</a>.</em></p> </div>

Body

Despite decades of beach safety ads, at least 55 people have drowned in Australia this summer. It’s time to change tack

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/samuel-cornell-1418374">Samuel Cornell</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p>Australia is considered a nation of beach lovers. But with all this water surrounding us, drownings remain tragically common. At least <a href="https://www.royallifesaving.com.au/research-and-policy/drowning-research/summer-drowning-toll">55 people have drowned</a> in waterways in Australia so far this summer, most of whom drowned at the beach. And the season’s not over.</p> <p>Every drowning is a tragedy, and Australia is nowhere near the federal-government supported <a href="https://www.watersafety.com.au/australian-water-safety-strategy/">goal of zero drownings</a>.</p> <p>Public health agencies are <a href="https://www.news.com.au/breaking-news/australia-in-the-grip-of-a-disturbing-rise-in-summer-drownings/news-story/bf2b1595f36bb4b458b371b9fab4f7ed">concerned</a> about the drowning numbers. So how do we fix it? An important factor to consider is how beach safety messages are communicated.</p> <h2>Another season, another campaign</h2> <p>The peak water safety bodies in Australia, <a href="https://sls.com.au/">Surf Life Saving Australia</a> and <a href="https://www.royallifesaving.com.au/">Royal Life Saving Society – Australia</a>, work to reduce drownings in all Australian aquatic locations, from swimming pools to rivers to beaches.</p> <p>Their public safety campaigns aim to raise awareness of drowning and risks around the water. Australians are undoubtedly safer because of the work and advocacy of these organisations – but drowning numbers remain stubbornly high.</p> <p>Surf Life Saving Australia is running a new campaign this summer – <a href="https://sls.com.au/surf-life-saving-calls-in-hollywood-actor-angus-sampson-to-help-reach-men-at-high-risk-of-drowning/">Stop, Look, Stay Alive</a> – featuring Australian-born actor and filmmaker Angus Sampson.</p> <p>This campaign is one of many in recent years urging Australians to stay safe near the water. Others include:</p> <ul> <li>the “swim between the flags” message</li> <li>the “<a href="https://sls.com.au/surf-life-saving-australia-launches-new-summer-safety-campaign-give-an-f-about-the-flags/">give an F about the flags</a>” campaign</li> <li>the <a href="https://sls.com.au/slsa-draws-the-line-on-rips/">“think line”</a> campaign, which urges people to “stop, look and have a plan”</li> <li>the <a href="https://www.floattosurvive.au/">“float to survive”</a> campaign, which urges people to <a href="https://static1.squarespace.com/static/5f7cf9fd8c3f251339c3dfa8/t/65ea851cbcbf287ede28cdc3/1709868332878/Float+to+Survive+Report.pdf">float if they’re in trouble in the water or stuck in a rip</a></li> <li>the <a href="https://www.royallifesaving.com.au/about/campaigns-and-programs/respect-the-river">“respect the river”</a> campaign.</li> </ul> <p>But the tragic number of drownings, particularly during summer, suggests not everyone is heeding the message. In fact, <a href="https://www.sciencedirect.com/science/article/abs/pii/S0278434322000760#:%7E:text=However%2C%20there%20is%20no%20evidence,and%20hazards%20to%20the%20public.">Australian researchers in 2022 found</a> no evidence to suggest beach drowning deaths in Australia have reduced over the long term. This, the researchers said:</p> <blockquote> <p>rais[es] questions regarding the effectiveness of existing strategies designed to communicate messages and information about beach safety and hazards to the public.</p> </blockquote> <h2>Changing how we communicate</h2> <p><a href="https://sls.com.au/surf-life-saving-calls-in-hollywood-actor-angus-sampson-to-help-reach-men-at-high-risk-of-drowning/">According to Surf Life Saving Australia</a> the current Angus Sampson campaign aims to be:</p> <blockquote> <p>appealing to more Aussies, in particular men who continue to swim at unpatrolled locations and take unnecessary risks.</p> </blockquote> <p>As the <a href="https://sls.com.au/surf-life-saving-calls-in-hollywood-actor-angus-sampson-to-help-reach-men-at-high-risk-of-drowning/">organisation notes</a>, 86% of all drowning deaths on Australia’s coast last year were men.</p> <p>The campaign involves ads on television and online, as well as outdoor advertising. The decision to use a mix of platforms is wise.</p> <p>But the use of a TV and movie celebrity may not be effective. A <a href="https://archive.acrs.org.au/files/arsrpe/RS030057.pdf?utm">review looking at road safety campaigns</a>, for example, found limited evidence of celebrity effectiveness in improving safety outcomes.</p> <p>Could it be more effective to, for example, <a href="https://academic.oup.com/heapro/article/38/2/daad034/7143327">use a TikTok star</a> who is hugely popular among young males?</p> <p>Research suggests using the <a href="https://www.tandfonline.com/doi/full/10.1080/28355245.2024.2350155">right platform</a> and “<a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC7501494">voices that matter</a>” offer benefits when delivering safety messages. This is in part due to the <a href="https://www.tandfonline.com/doi/full/10.1080/17524032.2023.2237693">emotional connection</a> people form with these social media stars, which can result in behaviour change.</p> <p>When asked for evidence to show the current public messaging campaigns are working, Surf Life Saving Australia (SLSA) told The Conversation:</p> <blockquote> <p>SLSA is committed to preventing drowning through holistic, evidence-based approaches, combining awareness programs like Stop Look Stay Alive with lifesaving services, in-person programs, and education. This summer alone, lifesavers have performed over <a href="https://sls.com.au/coastal-safety/sls-research/national-summer-coastal-drowning-data/">2,500 rescues and 700,000 preventative actions</a>.</p> <p>Despite population growth, <a href="https://www.sciencedirect.com/science/article/pii/S1326020023000961">coastal drowning has remained stable</a>. This summer, 32 coastal drownings have been reported, fewer than the <a href="https://sls.com.au/coastal-safety/sls-research/national-summer-coastal-drowning-data/">same period last year</a>. SLSA focuses on behaviour change through initiatives like beachpassport.org.au (with 21,000+ “passports” issued already!), and on-beach programs that have provided active community learning <a href="https://www.sciencedirect.com/science/article/pii/S2212420924007040">opportunities</a>.</p> <p>It’s too early to comment on the broader effectiveness of Stop Look Stay Alive, however preliminary campaign results show positive impact and an evaluation will be conducted by <a href="https://www.beachsafetyresearch.com/">UNSW Beach Safety Research Group</a> later this year.</p> </blockquote> <h2>Rethinking ‘swim between the flags’</h2> <p>Many current beach messaging approaches, <a href="https://sls.com.au/1281-reasons-swim-flags/">including “swim between the flags”</a>, compel people to fit into what the system wants.</p> <p>But many beaches <a href="https://theconversation.com/australian-beachgoers-are-told-to-always-swim-between-the-flags-but-what-if-there-arent-any-220043">don’t have flags</a>. And not everyone stops or looks for flags, signs, or even the conditions before they go into the water.</p> <p>And studies show while most domestic beachgoers know to swim between the flags, <a href="https://www.sciencedirect.com/science/article/abs/pii/S0278434322000760#:%7E:text=However%2C%20there%20is%20no%20evidence,and%20hazards%20to%20the%20public">many choose not to</a> because, for example, people are located closer to beaches without flags or lifeguard patrols.</p> <p>What’s more, research suggests overseas visitors to Australia do not always understand <a href="https://www.sciencedirect.com/science/article/abs/pii/S0925753522003058">what “swim between the flags” means</a> or terms often used on common beach safety <a href="https://www.sciencedirect.com/science/article/pii/S0925753523003089">signage</a> such as “shore dump” and “shore break”. One 2021 <a href="https://www.sciencedirect.com/science/article/pii/S0925753523003089">study</a> found 21% of international students perceived “always swim between the flags” to mean that beachgoers who don’t or can’t swim need to stay outside the flags.</p> <p>This shows that current strategies aren’t resonating with all beach users, and there’s a need to reassess beach safety messaging.</p> <h2>Changing tack</h2> <p>Other forms of public safety messaging should also be considered when trying to reduce drowning numbers in Australia.</p> <p>For example, <a href="https://onlinelibrary.wiley.com/doi/full/10.1002/hpja.785">people who have been caught in rip</a> might be encouraged to tell their stories publicly. Research into other areas of <a href="https://journals.sagepub.com/doi/full/10.1177/10732748241237328">public health communication</a>, such as vaccines, suggest this can form the basis of an effective campaign.</p> <p><a href="https://www.sciencedirect.com/science/article/abs/pii/S0278434322000760#:%7E:text=However%2C%20there%20is%20no%20evidence,and%20hazards%20to%20the%20public.">Research also suggests</a> teaching beachgoers about coastal science can improve beach safety behaviour. For example, people can be taught about how rip currents work, using images of dye released into the water.</p> <p>Crucially, consensus is needed on which <a href="https://www.jsams.org/article/S1440-2440(06)00231-3/abstract">key messages to prioritise</a>. Too much differing messaging <a href="https://pmc.ncbi.nlm.nih.gov/articles/PMC8807320/?utm_source">may lead to message fatigue or confusion</a> about which message is most important to follow.</p> <p>Messaging on beach safety to date has surely prevented drowning. But the stubborn drowning toll highlights the need to evaluate what is not working. Clear and consistent messaging, using modern platforms and engaging influencers may help us to get to zero drownings sooner.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/245747/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/samuel-cornell-1418374">Samuel Cornell</a>, PhD Candidate, UNSW Beach Safety Research Group + School of Population Health, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/despite-decades-of-beach-safety-ads-at-least-55-people-have-drowned-in-australia-this-summer-its-time-to-change-tack-245747">original article</a>.</em></p> </div>

Domestic Travel

Big change for new buses after Hunter Valley crash

<p>Australian buses and coaches fitted with seatbelts will soon be required to have announcements reminding people to buckle up, following the tragic Hunter Valley bus crash that killed 10 people almost two years ago. </p> <p>On Tuesday, the federal government announced that the new rule will require these vehicles to include visual and audio alerts reminding passengers to buckle up, similar to those on airplanes. </p> <p>“Travelling by bus is one of the safest forms of transport in Australia, and these new audible and visual signage requirements will ensure this continues to be the case,” federal assistant Regional Development Minister Anthony Chisholm said.</p> <p>The government also announced it had closed a loophole where some buses with seats under 1m high were exempted from requiring seatbelts. </p> <p>Under the regulations, all new bus and coach models must comply by November 1, 2026, while existing models will need to make the changes by November 1, 2027.</p> <p>“These safety outcomes further improve what is generally regarded as the most stringent seatbelt rules for buses in the world,” Bus industry confederation chair Tony Hopkins said. </p> <p>“With seat belt usage currently as low as 7 per cent on some services, this provides a simple but powerful message that reminds bus passengers to fasten a seat belt.</p> <p>“After all, if a seat belt is provided in a bus it must be worn by law.”</p> <p><em>Image: </em><em>Mino Surkala / Shutterstock.com</em></p>

Domestic Travel

Some ancient Romans got to retire with a pension at 42, but retirement’s changed a bit over the centuries

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/anthony-asher-247115">Anthony Asher</a>, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p>Over the ages, there have been broadly three reasons why people have retired.</p> <p>Some are forced to by poor health – theirs or someone they care for. Others have alternative income sources, meaning they don’t rely on a regular pay cheque. And some are made to retire by an employer who wants to overhaul staffing.</p> <p>But where did the idea of retirement come from? And how was it handled in ancient times?</p> <h2>Origins of support</h2> <p>Retirement support – which these days comes in the form of superannuation or a government pension – dates back to ancient history in various forms.</p> <p>Some forms of retirement support were funded by local taxes or tithes, others by donations. Some systems were corrupt and the coverage was patchy.</p> <p>Records are not readily available from other cultures, but we know a little about ancient Rome and English history since then.</p> <p>Emperor Augustus, who ruled after Julius Caesar died, set up a <a href="https://pensionresearchcouncil.wharton.upenn.edu/wp-content/uploads/2020/01/03Chap3.pdf">scheme</a> for Roman soldiers more than 2,000 years ago. The scheme aimed to ensure they retired while still strong and healthy, and would be less likely to cause trouble.</p> <p>The scheme paid a decent amount for soldiers after 25 years of service, so retirement age could be as young as 42.</p> <p>Pensions for older people in need also have ancient origins. The New Testament <a href="https://biblehub.com/1_timothy/5-9.htm">Bible</a> records the churches had schemes for needy widows right from the beginning.</p> <p>In the early Middle Ages, monasteries often provided for the needy, but Henry VIII famously <a href="https://en.wikipedia.org/wiki/Dissolution_of_the_monasteries">closed them</a> and took their assets. A fair share of their assets ended up with <a href="https://en.wikipedia.org/wiki/John_Russell,_1st_Earl_of_Bedford">high government officials</a> after the king’s takeover.</p> <p>Industry funds can also be seen to date back <a href="https://www.britannica.com/money/friendly-society">at least to the Middle Ages</a>, where the trade guilds provided for members and their families who fell on hard times.</p> <p>Retail funds mainly began as <a href="https://www.google.com/search?client=firefox-b-d&q=history+of+life+insurance">mutual life insurance companies</a> that began more than 200 years ago.</p> <p>In the 18th century, the East India Company and the Bank of England began <a href="https://sas-space.sas.ac.uk/9224/1/McIlvenna%20PhD%20final.pdf">offering pensions</a>. These were at first discretionary based on need and loyalty, but later covered all employees. This idea then spread to other larger companies such railways and banks.</p> <p>As modern states developed the capacity to collect income taxes, it became feasible to provide comprehensive retirement benefits funded by central government.</p> <p>Beginning with <a href="https://www.ssa.gov/history/ottob.html">Germany in 1889</a>, developed countries began introducing universal national age pension arrangements.</p> <p>Unfortunately, a number of countries, such as <a href="https://www.uncdf.org/article/8799/governor-innovation-key-to-expanding-insurance-and-pension-coverage-in-png">Papua New Guinea</a>, still do not have the capacity to provide a universal safety net to cover older people.</p> <h2>Retirement in Australia</h2> <p>Three Australian states <a href="https://treasury.gov.au/publication/economic-roundup-centenary-edition-2001/article-3-towards-higher-retirement-incomes-for-australians-a-history-of-the-australian-retirement-income-system-since-federation">began schemes</a> in 1900, and the federal government provided a universal (but means tested) scheme from 1909.</p> <p>Most Australian retirees seem to enjoy a favourable standard of living. The <a href="https://grattan.edu.au/news/5-key-takeaways-from-the-retirement-income-review/">Grattan Institute</a> finds that the poorest 30% are, in fact, better off in retirement.</p> <p>Massive house price and rental inflation in the last 30 years, however, has gutted the living standards of those who don’t own their own homes. This gap in the safety net needs to be addressed.</p> <h2>Retirement ages</h2> <p>The Roman army model persists in some countries to this day: retirement from the US military is available <a href="https://sgp.fas.org/crs/misc/RL34751.pdf">after 20 years</a> of service.</p> <p>Retirement this early is obviously very expensive. The church scheme mentioned in the New Testament had a minimum age of 60, which is still the normal retirement age in many countries.</p> <p>The <a href="https://www.oecd.org/en/publications/2023/12/pensions-at-a-glance-2023_4757bf20.html">OECD</a> reports the average age of retirement in their 38 member countries is just under 64 for women, and just over 64 for men.</p> <p>Australians now qualify for the <a href="https://www.servicesaustralia.gov.au/who-can-get-age-pension?context=22526">age pension</a> at 67, which is slightly older than average.</p> <p>Retirement ages are, however, rising to allow for “population ageing”, a longer life expectancy and lower birth rates. Life expectancy at retirement age is the important number when calculating the cost of pensions.</p> <p>In ancient Rome it was about seven years and was <a href="https://www-cambridge-org.wwwproxy1.library.unsw.edu.au/core/services/aop-cambridge-core/content/view/30ED00A164475432670833C87D2F9E97/S2046164X00000405a.pdf/contributions_to_the_history_of_insurance_and_of_the_theory_of_life_contingencies_with_a_restoration_of_the_grand_pensionary_de_wits_treatise_on_life_annuities_concluded_from_no_vi.pdf">about the same</a> in Sweden in the middle of the 18th century.</p> <p>In Australia, the life expectancy of a 65 year old woman has risen from 12 years in 1895 to <a href="https://aga.gov.au/sites/aga.gov.au/files/2020-07/Australian%20Life%20Tables%202015-17%20v5.pdf">23 years on average</a>.</p> <h2>Earnings-related pensions</h2> <p>The <a href="https://www.ssa.gov/history/ottob.html">1889 German scheme</a> paid a minimum pension, plus an earnings-related component. Workers had a book for stamps for each week’s earnings.</p> <p>The Australian age pension has always just paid a minimum “liveable” amount. This has been subject to different means tests over time, but retirees have been able to supplement it with their own savings.</p> <p>Until 1987, only 40% of Australian employees were covered by employer sponsored schemes. Then in 1992, the <a href="https://www.apra.gov.au/superannuation-australia-a-timeline">Superannuation Guarantee Scheme</a> was introduced. Under this, employers were required to contribute 3% into all exployees’ super.</p> <p>The standard rate will rise to 12% in July next year.</p> <h2>The future</h2> <p>A growing ageing population will mean the Australian government and superannuation industry will need to adjust current support systems.</p> <p><a href="https://treasury.gov.au/consultation/c2023-441613">Over the next decade</a>, about 2.5 million Australians will move from accumulation (where you’re building up your super) to join the 1.6 million already receiving super benefits.</p> <p>We can expect more people to be living into their nineties and needing pensions for life.</p> <p>One government <a href="https://treasury.gov.au/sites/default/files/2023-12/c2023-441613-dp.docx">priority</a> is to make lifetime pensions as much part of the Australian system as they are in <a href="https://www.mercer.com/en-au/about/newsroom/mercer-cfa-institute-global-pension-index-2024/">the rest of the world</a></p> <p>And after 30 years of growing complexity in the rules covering superannuation, regulators are <a href="https://www.alrc.gov.au/publication/superannuation-and-the-legislative-framework-for-financial-services-fsl11/">counting the cost</a>, and <a href="https://www.brokernews.com.au/news/breaking-news/asic-targets-regulation-overhaul-286067.aspx">planning some simplification</a>.</p> <hr /> <p><em>This article is part of The Conversation’s retirement series, in which experts examine issues including how much money we need to retire, retiring with debt, the psychological impact of retiring and the benefits of getting financial advice. Read the rest of the series <a href="https://theconversation.com/au/topics/retirement-series-2024-168372">here</a>.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/241121/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></em></p> <p><em><a href="https://theconversation.com/profiles/anthony-asher-247115">Anthony Asher</a>, Associate Professor in the UNSW Business School, <a href="https://theconversation.com/institutions/unsw-sydney-1414">UNSW Sydney</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/some-ancient-romans-got-to-retire-with-a-pension-at-42-but-retirements-changed-a-bit-over-the-centuries-241121">original article</a>.</em></p> </div>

Retirement Income

Bunnings announce game-changing venture

<p>Everyone is well-acquainted with multiple trips to Bunnings for forgotten items, but now the retail giant's new venture with Uber could make life just a little easier before Christmas. </p> <p>The retail giant is teaming up with the rideshare and courier service to equip over 100 regional and metropolitan stores with same day parcel delivery.</p> <p>So shoppers looking for a last minute Christmas gift can get same day parcel delivery for orders placed by 2pm right up until December 23rd. The packages will be delivered by 7pm that day. </p> <p>With Australia Post Christmas delivery cut-offs set to take effect from December 20, the retail giants same-day delivery service with Uber makes it much easier for shoppers over the holiday season. </p> <p>The service will operate via the Bunnings website, at a flat fee of $15 for any purchases.</p> <p>The only condition is that for some regional outlets, the same-day delivery guarantee is subject to geographical limits, a radius of 15 kilometres from any store.</p> <p>“We’re committed to offering our customers the best experience, widest range and lowest prices, and same day parcel delivery across regional Australia is another way we can improve this offering”, Bunnings Chief Operating Officer, Ryan Baker said. </p> <p>“This builds on our current same day parcel delivery offering across metro Australia, bringing more convenience to our regional customers, and hopefully helping to ease some of the stress this time of year can bring.”</p> <p>Baker also emphasised that this service would not replace the in-store experience Aussies love.</p> <p>“Some customers value coming into the store to browse, talk to the team and enjoy the Bunnings experience such as a coffee in the cafe or the sausage sizzle hosted by a local community group. But for others, the convenience of delivery is preferred,” he said.</p> <p><em>Image: haireena / Shutterstock.com</em></p>

Home & Garden

Planning for old age? Here’s what the aged care changes mean for you

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/anam-bilgrami-1179543">Anam Bilgrami</a>, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p>Last week, Parliament passed sweeping reforms to Australia’s aged care system. These “<a href="https://www.health.gov.au/ministers/the-hon-anika-wells-mp/media/once-in-a-generation-aged-care-reforms">once-in-a-generation</a>” changes, set to begin next year on July 1, aim to improve how care is provided to older Australians at home, in their communities and in nursing homes.</p> <p>The new Aged Care Act focuses on <a href="https://insideageing.com.au/new-aged-care-act-passes-parliament-ushering-in-historic-reforms/">improving quality and safety, protecting the rights</a> of older people and ensuring <a href="https://www.myagedcare.gov.au/news-and-updates/big-changes-aged-care-sector">the financial sustainability</a> of aged care providers.</p> <p>A key change is the introduction of a new payment system, requiring wealthier people to contribute more for non-clinical services.</p> <p>If you – or a loved one – are planning for aged care, here’s what the changes could mean for you.</p> <h2>What to expect from the home care overhaul</h2> <p>Over the past decade, there’s been a noticeable shift towards “ageing at home”. The number of Australians using home care has <a href="https://www.gen-agedcaredata.gov.au/getmedia/2fbaacd8-1fbf-4ef5-ab1c-72dfc4c727bf/People-using-aged-care-fact-sheet-2023.pdf?ext=.pdf">more than quadrupled</a>, surpassing those in nursing homes.</p> <p>To meet growing demand, the government is adding <a href="https://www.health.gov.au/ministers/the-hon-anika-wells-mp/media/press-conference-parliament-house-25-november?language=en">107,000 home care places</a> over the next two years, with a goal to reduce wait times to just three months.</p> <p>Starting July 1 2025, <a href="https://www.health.gov.au/our-work/support-at-home/about">Support at Home</a> will replace the <a href="https://www.myagedcare.gov.au/help-at-home/home-care-packages">Home Care Packages</a> program. The table below shows some of the key differences between these two programs.</p> <figure class="align-center zoomable"><a href="https://images.theconversation.com/files/636472/original/file-20241205-19-phkljj.png?ixlib=rb-4.1.0&q=45&auto=format&w=1000&fit=clip"><img src="https://images.theconversation.com/files/636472/original/file-20241205-19-phkljj.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&fit=clip" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px" srcset="https://images.theconversation.com/files/636472/original/file-20241205-19-phkljj.png?ixlib=rb-4.1.0&q=45&auto=format&w=600&h=546&fit=crop&dpr=1 600w, https://images.theconversation.com/files/636472/original/file-20241205-19-phkljj.png?ixlib=rb-4.1.0&q=30&auto=format&w=600&h=546&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/636472/original/file-20241205-19-phkljj.png?ixlib=rb-4.1.0&q=15&auto=format&w=600&h=546&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/636472/original/file-20241205-19-phkljj.png?ixlib=rb-4.1.0&q=45&auto=format&w=754&h=686&fit=crop&dpr=1 754w, https://images.theconversation.com/files/636472/original/file-20241205-19-phkljj.png?ixlib=rb-4.1.0&q=30&auto=format&w=754&h=686&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/636472/original/file-20241205-19-phkljj.png?ixlib=rb-4.1.0&q=15&auto=format&w=754&h=686&fit=crop&dpr=3 2262w" alt="" /></a><figcaption><span class="attribution"><span class="source">Department of Health 2024</span></span></figcaption></figure> <p>Home Care Packages are currently delivered under <a href="https://www.myagedcare.gov.au/help-at-home/home-care-packages">four annual government subsidy levels</a>, covering care and provider management costs. Under Support at Home, <a href="https://www.health.gov.au/our-work/support-at-home/features">the number of home care budget levels will double to eight</a>, with the highest level increasing to A$78,000.</p> <p>This aims to provide more tailored support and accommodate those needing higher levels of care.</p> <p>Under the new system, recipients will receive quarterly budgets aligned to their funding level and work with their chosen provider to allocate funds across <a href="https://www.health.gov.au/sites/default/files/2024-11/support-at-home-service-list.pdf">three broad service categories</a>:</p> <ul> <li> <p>clinical care, such as nursing or physiotherapy</p> </li> <li> <p>independence support, including personal care, transport and social support</p> </li> <li> <p>everyday living assistance, such as cleaning, gardening and meal delivery.</p> </li> </ul> <p>Clinical care services will be fully government-funded, as these are crucial to supporting health and keeping people out of hospitals.</p> <p>But recipients will contribute to the costs of independence and everyday living services under a new payment model, reflecting the government’s stance that these are services people have traditionally funded themselves over their lifetimes.</p> <p>This will replace the basic daily fee and income-tested care fee that some people currently pay. Contributions will vary by income and assets (based on the <a href="https://www.servicesaustralia.gov.au/who-can-get-age-pension?context=22526">age pension means test</a>) and by service type.</p> <p>Support at Home also includes additional funding for specific needs:</p> <ul> <li> <p>older Australians with less than three months to live will receive priority access to $25,000 in funding over 12 weeks</p> </li> <li> <p>up to $15,000 will be available for assistive technologies and home modifications, <a href="https://www.health.gov.au/sites/default/files/2024-09/support-at-home-fact-sheet.pdf">eliminating the need</a> to reserve home care budgets for these.</p> </li> </ul> <h2>What if I or my loved one is already receiving a Home Care Package?</h2> <p>If you were receiving a package, on the <a href="https://www.health.gov.au/our-work/hcp/about/how-it-works">waiting list</a>, or assessed as eligible for one on September 12 2024, the government’s “<a href="https://www.health.gov.au/ministers/the-hon-anika-wells-mp/media/once-in-a-generation-aged-care-reforms#:%7E:text=in%20aged%20care-,A%20no%20worse%20off%20principle%20will%20provide%20certainty%20to%20people,greater%20contribution%20to%20their%20care.&text=When%20Home%20Care%20participants%20transition,and%20retain%20any%20unspent%20funds.">no worse off</a>” principle guarantees you won’t pay more under the new system.</p> <p>Current recipients will have their Support at Home budget aligned with their existing package, and any unspent funds will roll over.</p> <h2>How nursing home fees will change</h2> <p>Australia’s nursing home sector is struggling financially, with <a href="https://www.australianageingagenda.com.au/executive/sectors-annual-financial-report-lands/">67% of providers</a> operating at a loss. To ensure sustainability and support upgrades to facilities, the government is introducing major funding changes.</p> <h2>What stays the same?</h2> <p>The Basic Daily Fee, that everyone in nursing homes pays, set at 85% of the basic age pension (currently <a href="https://www.health.gov.au/sites/default/files/2024-09/schedule-of-fees-and-charges-for-residential-and-home-care.pdf">$63.57 a day</a> or $23,200 annually), will not change.</p> <h2>What’s changing?</h2> <p>The government currently pays a Hotelling Supplement of $12.55 per day per resident to cover everyday living services like cleaning, catering and laundry ($4,581 annually).</p> <p>From July 1 2025, this supplement will become means-tested. Residents with annual incomes above $95,400 or assets exceeding $238,000 (or some combination of these) will <a href="https://www.health.gov.au/sites/default/files/2024-09/response-to-the-aged-care-taskforce-residential-care-contributions.pdf">contribute partially or fully</a> to this cost.</p> <p>Currently, residents with sufficient means also pay a means-tested care fee <a href="https://www.myagedcare.gov.au/aged-care-home-costs-and-fees">between $0–$403.24</a> per day. This will be replaced by a “<a href="https://www.health.gov.au/sites/default/files/2024-09/response-to-the-aged-care-taskforce-residential-care-contributions.pdf">non-clinical care contribution</a>”, capped at $101.16 daily and payable for the first four years of care. Only those with assets above $502,981 or incomes above $131,279 (or some combination of these) will pay this contribution.</p> <p>Importantly, no one will pay more than $130,000 in combined contributions for Support at Home and non-clinical care in nursing homes over their lifetime.</p> <h2>Changes to accommodation payments</h2> <p>The way nursing home accommodation costs are paid is also changing from July 1 2025:</p> <ul> <li> <p>residents <a href="https://theconversation.com/lump-sum-daily-payments-or-a-combination-what-to-consider-when-paying-for-nursing-home-accommodation-207405">who pay</a> their room price via a refundable lump sum will have <a href="https://www.health.gov.au/sites/default/files/2024-09/response-to-the-aged-care-taskforce-accommodation-reform.pdf">2% of their payment retained annually</a> by the provider, up to a maximum of 10% over five years. For example, a $400,000 lump sum payment would result in $360,000 being refunded if a person stays five years or more, with the provider keeping $40,000</p> </li> <li> <p><a href="https://www.health.gov.au/sites/default/files/2024-09/response-to-the-aged-care-taskforce-accommodation-reform.pdf">daily accommodation payments</a> (a rent-style interest charge) will no longer remain fixed for the duration of a person’s nursing home stay. Instead, these payments will be indexed twice annually to the Consumer Price Index</p> </li> <li> <p>providers will be able to set room prices up to $750,000 without government approval, an increase from the current $550,000 limit.</p> </li> </ul> <p>People with lower means (those who are fully subsidised by the government for their accommodation costs) will not be affected by these changes.</p> <h2>What if I own my home?</h2> <p>The treatment of the family home in means testing for nursing home costs will <a href="https://www.health.gov.au/sites/default/files/2024-09/response-to-the-aged-care-taskforce-residential-care-contributions.pdf">remain unchanged</a>.</p> <p>Its value is only assessed if no “protected person” (such as a spouse) lives in it, and even then, it’s capped at $206,039 (as at September 20 2024).</p> <h2>What happens to current nursing home residents?</h2> <p>The new rules for contributions and accommodation will apply only to those entering nursing homes from July 1 2025.</p> <p>Existing residents will maintain their current arrangements and be <a href="https://www.health.gov.au/ministers/the-hon-anika-wells-mp/media/once-in-a-generation-aged-care-reforms#:%7E:text=in%20aged%20care-,A%20no%20worse%20off%20principle%20will%20provide%20certainty%20to%20people,greater%20contribution%20to%20their%20care.&text=When%20Home%20Care%20participants%20transition,and%20retain%20any%20unspent%20funds.">no worse off</a>.</p> <h2>Feeling overwhelmed?</h2> <p>These reforms aim to improve care delivery, fairness and sustainability, with the government emphasising that many older Australians – particularly those with <a href="https://www.health.gov.au/ministers/the-hon-anika-wells-mp/media/once-in-a-generation-aged-care-reforms#:%7E:text=in%20aged%20care-,A%20no%20worse%20off%20principle%20will%20provide%20certainty%20to%20people,greater%20contribution%20to%20their%20care.&text=When%20Home%20Care%20participants%20transition,and%20retain%20any%20unspent%20funds.">lower incomes and assets</a> – will not pay more.</p> <p>The government has provided case studies to illustrate how <a href="https://www.health.gov.au/sites/default/files/2024-09/case-studies-support-at-home_0.pdf">home care</a> and <a href="https://www.health.gov.au/sites/default/files/2024-09/case-studies-residential-care_0.pdf">nursing home</a> costs will differ under the new system for people at various income and asset levels.</p> <p>Still, planning for aged care can be daunting. For more <a href="https://www.myagedcare.gov.au/financial-support-and-advice">tailored advice and support</a>, consider reaching out to financial advisors, <a href="https://www.servicesaustralia.gov.au/aged-care-specialist-officer-my-aged-care-face-to-face-services?context=55715">services</a>, or online tools to help you navigate the changes and make informed decisions.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/244816/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/anam-bilgrami-1179543"><em>Anam Bilgrami</em></a><em>, Senior Research Fellow, Macquarie University Centre for the Health Economy, <a href="https://theconversation.com/institutions/macquarie-university-1174">Macquarie University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/planning-for-old-age-heres-what-the-aged-care-changes-mean-for-you-244816">original article</a>.</em></p> </div>

Money & Banking

Former William Tyrrell suspect changes story

<p>Paul Savage, an 80-year-old pensioner who was once questioned by detectives over the disappearance of William Tyrrell, has shared a different version of his actions to what he previously told police. </p> <p>Savage told news.com.au's podcast on the case <em>Witness: William Tyrrell</em>, that he spotted part of a child’s Spider-Man costume – matching the one William was famously last seen wearing – a day earlier than he had reported to police.</p> <p>In 2017, detectives ran a covert surveillance operation while Savage was being pursued as a person of interest. At the time, they set up a Spider Man suit on the bushtrack the pensioner walked each day near his Benaroon Dr home. </p> <p>On the first day of the sting, the surveillance team saw him stop and look in the direction of the suit for 12 seconds before continuing on.</p> <p>Detectives believed Savage had seen the suit, but he insisted that he did not see it until the second day it was there, saying: “I’ve never seen it the day before.</p> <p>“Why would I leave it a day and then go down and ring up? Why would I do that?”</p> <p>The 80-year-old has now told news.com.au that he did see part of the suit on the first day, but as it was only the top, he wasn't sure if it was William's and thought to himself “I don’t know about that”, he claimed.</p> <p>On the second day when he said he saw the whole suit, Savage "thought it was probably his [William's]." </p> <p>When asked why he didn't tell police of his sighting on the first day, he told the podcast: “I’ve left it a bit longer than I should have but it will come out eventually.”</p> <p>The podcast also revealed the secret police recordings made inside the pensioner's house, which were previously tendered in court. </p> <p>The police had been listening in to a bug in Savage's home and car for several weeks and continued to use audio surveillance on him until November 2017 following his police interview. </p> <p>Savage, who had lost his wife in his mid 70s, would often speak to himself or appeared to be talking to her. In one of the recordings after the police interview, he was recorded saying: "Make sure you don’t tell anyone, Love,” the court heard.</p> <p>“They’re right after me. Don’t tell anyone, Love. Please, they’re right after me. Sorry,” he continued. </p> <p>At other times he was heard saying: “I couldn’t hurt a kid,” and later “You’re sick. You bastards want to pin it on me. You can’t do your job so you want to pin it on me." </p> <p>Savage, who lives across the road from where William vanished, has never been charged and denies any knowledge of what happened to him. </p> <p>He also told the publication that police had not formally spoken with him after former lead detective Gary Jubelin, who questioned him, was taken off the case. </p> <p>He has never been officially informed whether he is still a person of interest in their investigation. </p> <p><em>Images: news.com.au</em></p>

Legal

How hip pain led Sydney karate master to life-changing weight loss journey

<div> <p>Sydney-based karate instructor and personal trainer Glenn Stephenson knows the toll that joint pain and extra weight can take on physical activity. Despite decades of experience as a martial arts coach, Glenn found himself increasingly limited by severe hip pain and unwanted weight gain.</p> </div> <div> <p>In 2021, at 95 kilograms, the 64-year-old’s arthritis and reduced mobility affected not only his work but also his confidence. “I couldn’t move around like I wanted to, and as a master instructor, it felt wrong to be teaching students while carrying so much extra weight,” he admits.</p> </div> <div> <p>Glenn’s pain and discomfort prompted him to make a drastic change. Instead of resorting to extreme dieting, he adopted a more sustainable approach to weight loss to reduce joint and liver inflammation, and regain his mobility. He shed 20 kilograms and now walks four kilometres daily. “I can move better, my mental health has improved, and I feel more capable of guiding my students,” he says.</p> </div> <div> <p>Today, Glenn encourages others struggling with weight to take a balanced approach to fitness and health. “I look the part now, which gives me confidence as a master instructor to show my students that staying active is achievable at any age.”</p> </div> <div> <p>Dietitian Kirby Sorenson, from health platform <a title="https://www.getmosh.com.au/?utm_term=mosh&utm_campaign=Cross_Search_Brand_Mosh&utm_source=paid-search&utm_medium=adwords&utm_content=100740202037&hsa_acc=5792635568&hsa_cam=1701000406&hsa_grp=100740202037&hsa_ad=697110582898&hsa_src=g&hsa_tgt=kwd-295213997936&hsa_kw=mosh&hsa_mt=p&hsa_net=adwords&hsa_ver=3&gclid=CjwKCAiAxKy5BhBbEiwAYiW--5qfGzQVQBG-CmA6baVMEeP5Zmk_oB_GOstA1n2vabFrLzbeDrEEnxoCM4YQAvD_BwE" href="https://www.getmosh.com.au/?utm_term=mosh&utm_campaign=Cross_Search_Brand_Mosh&utm_source=paid-search&utm_medium=adwords&utm_content=100740202037&hsa_acc=5792635568&hsa_cam=1701000406&hsa_grp=100740202037&hsa_ad=697110582898&hsa_src=g&hsa_tgt=kwd-295213997936&hsa_kw=mosh&hsa_mt=p&hsa_net=adwords&hsa_ver=3&gclid=CjwKCAiAxKy5BhBbEiwAYiW--5qfGzQVQBG-CmA6baVMEeP5Zmk_oB_GOstA1n2vabFrLzbeDrEEnxoCM4YQAvD_BwE" data-outlook-id="bc4b923a-a4a3-4af0-80db-e837cd64b4c7">Mosh</a>, is encouraging Australians to ditch the Body Mass Index (BMI) in favour of more modern diagnostics to determine the risk of disease linked to higher body fat, declaring it’s unfairly categorising people as being overweight.</p> </div> <div> <p>Ms Sorenson says knowing your Body Roundness Index (BRI) as well as your Basal Metabolic Rate (BMR) can more accurately predict the risk of diseases like high blood pressure, type 2 diabetes and heart disease because it works out body fat levels based on height and waist circumference, rather than the BMI method which relies on height and weight.</p> </div> <div> <p>“BMI has long been criticised for inaccurately categorising people as overweight or obese because it doesn’t differentiate between those who carry a lot of muscle and individuals with fat in the wrong places,” Ms Sorenson says.</p> </div> <div> <p>“The problem is that it only looks at overall weight, while the BRI focuses on fat held around the abdomen which is the riskiest fat in terms of overall health.</p> </div> <div> <p>Once the BRI is determined, Ms Sorenson says it can help to know your Basal Metabolic Rate, which is largely determined by your total lean mass to help determine a healthy path to maintaining a healthy weight range.</p> </div> <div> <p>“The basal metabolic rate or BMR gives you an idea of how many calories your body burns doing the bare minimum; breathing, blood circulation, brain and nerve function. It can vary greatly from person to person, which explains why individual weight loss journeys can be so different,” Ms Sorenson said.</p> </div> <div> <p>For more information visit Moshy’s online <a title="https://www.getmoshy.com.au/weight-loss/basal-metabolic-rate-calculator?srsltid=AfmBOoobS-PiI_4sJn2ykpEG6vzq6qkvQXammfLv4Rm-mS5nwll6EN0m" href="https://www.getmoshy.com.au/weight-loss/basal-metabolic-rate-calculator?srsltid=AfmBOoobS-PiI_4sJn2ykpEG6vzq6qkvQXammfLv4Rm-mS5nwll6EN0m" data-outlook-id="800f9af2-0a34-4ac4-801b-d16714c7ec2e">BMR calculator</a>.</p> <p><em>Image credits: Supplied</em></p> </div>

Body

Major driver's licence change for Victorian drivers

<p>A major drivers licence change has been implemented in Victoria. </p> <p>Up to 800,000 learner and provisional drivers in the state will soon have electronic access to their licence in a bid to make "it easier for them to go about their lives". </p> <p>They join the 1.2 million motorists in the state who already have the capability to access their licence digitally, a feature that was only introduced in Victoria in May this year. </p> <p>While the digital licences are optional, the state government said that feedback from the public has been overwhelmingly positive.</p> <p>Like other digital licences, it features a highly secure, timed QR code" that can be scanned by businesses and other authorities to verify authenticity and prevent fraudulent use.</p> <p>Victoria Minister for Roads and Road Safety Melissa Horne said the initiative aims to simplify life for young drivers in the state. </p> <p>"We’ve seen more than 1.2 million Victorians access their licence on their phones since we launched this technology in May, and I’m sure we’ll continue to see a strong take up from our younger drivers," she said. </p> <p>The licences can also be updated in real-time if there are changes to conditions, personal information or if a licence has been cancelled or suspended. </p> <p>The state government is also working with venues to ensure licences are compatible with major scanning technology making it easier for both customers and venues across Victoria.</p> <p><em>Image: Shutterstock</em></p> <p> </p>

Legal

Your Go-To guide to game-changing Christmas skincare

<p dir="ltr">When it comes to Christmas presents, it’s hard to go wrong with skincare, makeup or anything in the general “self-care” space. </p> <p dir="ltr">This Christmas, <a href="https://gotoskincare.com/collections/holiday-2024">Go-To</a> (the revolutionary skincare brand founded by Zoe Foster-Blake) have released their most beautiful collection yet in collaboration with Alémais to deliver the very best in feeling good, for any budget. </p> <p dir="ltr">With 11 extremely limited gifts and sets to help you spread some serious cheer this season, you’ll find something for everyone, whether it’s for your daughter, granddaughter, neighbour, or that one friend that is always looking to level up their skincare routine. </p> <p dir="ltr">For the second year running, Go-To’s undeniably unique print and packaging is thanks to a local collaboration with Alémais, celebrating the very vibrant and zesty DNA of both brands.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/p/DBsyJSnxTMY/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/p/DBsyJSnxTMY/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Go-To (@gotoskincare)</a></p> </div> </blockquote> <p dir="ltr">The gorgeous gift sets start at just $26 with Perfect Present, or for those looking more on the luxury side, the $300 must-have Facial In A Box has everything you need.</p> <p dir="ltr">You’ll also spot several never-before-seen items from Go-To, like, Bon Bons, a trio of tinted lip balms, and custom tarot cards.</p> <p dir="ltr">In addition to all the stunning skincare, Go-To have created gifts that live on as keepsakes, such as the signature silk pillowcase and matching silk eye mask.</p> <p dir="ltr">Or, if you can’t pick just one gift for that special someone, or you want to treat yourself and just can’t wait until December 25th, the 12 Days Of Go-To advent calendar is filled with so many merry items of merch paired with the effective, quality, clinically-proven skincare you know, love and need.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/reel/DBrsRwlJRsG/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/DBrsRwlJRsG/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Go-To (@gotoskincare)</a></p> </div> </blockquote> <p dir="ltr">The Go-To treats are ones you can feel good about in more ways than one, as Go-To is donating $1 from all marked gifts and sets, to their 2024 charity partner, Orange Sky: a not-for-profit that provides complimentary laundry services and warm showers to people in the community who are experiencing homelessness and hardship.</p> <p dir="ltr">With this glorious fusion of colour, wonderfully wacky motifs, and giving to those in need in the spirit of Christmas, Go-To has a gift for everyone in their most coveted holiday collection to date.</p> <p dir="ltr">The Go-To Christmas range is available at <a href="https://www.mecca.com/en-au/go-to/">Mecca</a>, both in-store and online, and on the official <a href="https://gotoskincare.com/collections/holiday-2024">Go-To</a> website.</p> <p dir="ltr"><em>Image credits: Shutterstock / Instagram </em></p> <p><span id="docs-internal-guid-bb2c25c8-7fff-6953-de80-1b3c24792a23"></span></p>

Beauty & Style

Woman cured of Type 1 diabetes in life-changing clinical trial

<p>Marlaina Goedel was diagnosed with Type 1 diabetes when she was just five-years-old, and not only was the disease controlling her, but it almost cost her life. </p> <p>"I've crashed my car into a brick building before having a diabetic attack while driving," Goedel recalled. </p> <p>Her condition was so extreme that she felt robbed of a normal childhood, telling the <em>Daily Mail </em>that she was in and out of hospital with life-threatening diabetic ketoacidosis, which causes toxic chemicals to build up in the blood due to a lack of insulin.</p> <p>Now 30-years-old, the Illinois woman no longer needs daily insulin shots and can finally enjoy sugar again thanks to a pioneering stem cell therapy that has cured her of type 1 diabetes. </p> <p>Goedel was one of three Americans who have been cured of their type 1 diabetes thanks to the clinical trial involving an islet cell transplant. </p> <p>It is a one-off infusion that involved transplanting islet cells into her liver to help her body produce insulin on its own. </p> <p>After four weeks, she no longer needed to take insulin. </p> <p>"[My doctor] said, ‘Mark it on your calendar. Today is the day. Stop all insulin,'" Goedel said of the life-changing moment. </p> <p>"I just went quiet and finally said, ‘I’m here. I’m in shock. I’m going to need you to repeat that.’"</p> <p>The trial was being run at the University of Chicago Medicine Transplant Institute. </p> <p>While Islet cell transplants isn't a new procedure, the current anti-rejection medication used can be toxic to the transplanted cells, potentially making it less effective over time. </p> <p>The clinical trial that ran at the university tested out a new antibody called tegoprubart, which was given to Goedel and the two other patients. </p> <p>Tegoprubart is made from lab-made antibodies that trick the immune system into thinking the body made the cells on its own, preventing them from being rejected. </p> <p>The patients were then given islet cells from a deceased donor's pancreas, which were then infused into the patient's small blood vessels in their liver. Those cells then lodged into the blood vessels and started producing insulin. </p> <p>For Goedel the only side effect of the procedure was "feeling like I got punched in the ribs," with the procedure lasting just an hour. </p> <p>"The cure is out there," Goedel told the <em>Daily Mail. </em></p> <p>With her new lease on life, Goedel plans to go back to school and go horse riding without worrying about suffering an attack and causing an accident. </p> <p>"It took a while to get used to saying, 'I am cured. I am diabetes free.' It's been very freeing," she said.</p> <p>"No one should have to live with this disease. I know that now more than ever."</p> <p><em>Images: Good Morning America/ UChicago Medicine</em></p> <p> </p>

Caring

Could a recent ruling change the game for scam victims? Here’s why the banks will be watching closely

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/jeannie-marie-paterson-6367">Jeannie Marie Paterson</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nicola-howell-1160247">Nicola Howell</a>, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a></em></p> <p>In Australia, it’s scam victims who foot the bill for the overwhelming majority of the money lost to scams each year.</p> <p>A 2023 <a href="https://download.asic.gov.au/media/mbhoz0pc/rep761-published-20-april-2023.pdf">review</a> by the Australian Securities and Investments Commission (ASIC) found banks detected and stopped only a small proportion of scams. The total amount banks paid in compensation paled in comparison to total losses.</p> <p>So, it was a strong statement this week when it was revealed the Australian Financial Conduct Authority (AFCA) had <a href="https://my.afca.org.au/searchpublisheddecisions/kb-article/?id=f9f8941f-7379-ef11-ac20-000d3a6acbb4">ordered</a> a bank – HSBC – to compensate a customer who lost more than $47,000 through a sophisticated bank impersonation or “spoofing” scam.</p> <p>This decision was significant. An AFCA determination is binding on the relevant bank or other financial institution, which has <a href="https://www.afca.org.au/make-a-complaint#:%7E:text=Any%20determinations%20we%20make%20are,service%20is%20free%20to%20access">no direct right of appeal</a>. It could have implications for the way similar cases are treated in future.</p> <p>The ruling comes amid a broader push for sector-wide reforms to give banks more responsibility for <a href="https://www.fico.com/blogs/detection-prevention-tackling-scams-every-angle">detecting</a>, deterring and responding to scams, as opposed to simply telling customers to be “more careful”.</p> <p>Here’s what you should know about this landmark ruling, and what it might mean for consumers.</p> <h2>A highly sophisticated ‘spoofing’ scam</h2> <p>You might be familiar with “push payment” scams that trick the victim into paying money to a dummy account. These include the “<a href="https://www.acma.gov.au/articles/2024-01/scam-alert-re-emergence-hi-mum-scam">mum I’ve lost my phone</a>” scam and some <a href="https://www.scamwatch.gov.au/types-of-scams/online-dating-and-romance-scams">romance</a> scams.</p> <p>The <a href="https://www.smh.com.au/national/dragged-kicking-and-screaming-banking-giant-loses-battle-against-scam-victim-20241015-p5kide.html">recent case</a> concerned an equally noxious “bank impersonation” or “spoofing” scam. The complainant – referred to as “Mr T” – was tricked into giving the scammer access to his HSBC account, from which an unauthorised payment was made.</p> <p>The scammer sent Mr T a text message, purportedly asking him to investigate an attempted Amazon transaction.</p> <p>In an effort to respond to the (fake) unauthorised Amazon purchase, Mr T revealed security passcodes to the scammer, enabling them to transfer $47,178.54 from his account and disappear with it.</p> <p>The fact Mr T was dealing with scammers was far from obvious – scammers had information about him one might reasonably expect only a bank would know, such as his bank username.</p> <p>On top of this, the scam text message appeared in a thread of other legitimate text messages that had previously been sent by the real HSBC.</p> <h2>AFCA’s ruling</h2> <p>HSBC argued to AFCA that having to pay compensation should be ruled out under the <a href="https://download.asic.gov.au/media/lloeicwb/epayments-code-published-02-june-2022.pdf">ePayments Code</a>, a voluntary code of practice administered by ASIC.</p> <p>Under this code, a bank is not required to compensate a customer for an unauthorised payment if that customer has disclosed their passcode. The bank argued the complainant had voluntarily disclosed these codes to the scammer, meaning the bank didn’t need to pay.</p> <p>AFCA disagreed. It noted the very way the scam had worked was by creating a sense of urgency and crisis. AFCA considered that the complainant had been manipulated into disclosing the passcodes and had not acted voluntarily.</p> <p>AFCA awarded compensation covering the vast majority of the disputed transaction amount, lost interest charged to a home loan account, and $5,000 towards Mr T’s legal costs.</p> <p>It also ordered the bank to pay compensation of $1,000 for poor customer service in dealing with the matter, including communication delays.</p> <h2>Other cases may be more complex</h2> <p>In this case, the determination was relatively straightforward. It found Mr T had not voluntarily disclosed his account information, so was not excluded from being compensated under the ePayments Code.</p> <p>However, many payment scams fall outside the ePayments Code because they involve the customer directly sending money to the scammer (as opposed to the scammer accessing the customer’s account). That means there is no code to direct compensation.</p> <p>Still, AFCA’s jurisdiction is broader than merely applying a code. In considering compensation for scam losses, AFCA must consider what is “fair in all the circumstances”. This means taking into account:</p> <ul> <li>legal principles</li> <li>applicable industry codes</li> <li>good industry practice</li> <li>previous AFCA decisions.</li> </ul> <p>Relevant factors might well include whether the bank was proactive in responding to known scams, as well as the challenges for individual customers in identifying scams.</p> <h2>Broader reforms are on the way</h2> <p>At the heart of this determination by AFCA is a recognition that, increasingly, detecting sophisticated scams can be next to impossible for customers, which can mean they don’t act voluntarily in making payments to scammers.</p> <p>Similar reasoning has informed a range of recent reform initiatives that put more responsibility for detecting and responding to scams on the banks, rather than their customers.</p> <p>In 2023, Australia’s banking sector committed to a new “<a href="https://www.ausbanking.org.au/scam-safe-accord/">Scam-Safe Accord</a>”. This is a commitment to implement new measures to protect customers, including a confirmation of payee service, delays for new payments, and biometric identity checks for new accounts.</p> <p>Changes on the horizon could be more ambitious and significant.</p> <p>The proposed <a href="https://treasury.gov.au/consultation/c2024-573813">Scams Prevention Framework</a> legislation would require Australian banks, telcos and <a href="https://pursuit.unimelb.edu.au/articles/accc-vs-big-tech-round-10-and-counting">digital platforms</a> to take reasonable steps to prevent, detect, report, disrupt and respond to scams.</p> <p>It would also include a compulsory external dispute resolution process, like AFCA’s, for consumers seeking compensation for when any of these institutions fail to comply.</p> <p>Addressing scams is not just an Australian issue. In the United Kingdom, newly introduced <a href="https://www.bbc.com/news/articles/cy94vz4zd7zo">rules</a> make paying and receiving banks responsible for compensating customers, for scam losses up to £85,000 (A$165,136), unless the customer is grossly negligent.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/241558/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/jeannie-marie-paterson-6367">Jeannie Marie Paterson</a>, Professor of Law, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a> and <a href="https://theconversation.com/profiles/nicola-howell-1160247">Nicola Howell</a>, Senior lecturer, <a href="https://theconversation.com/institutions/queensland-university-of-technology-847">Queensland University of Technology</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/could-a-recent-ruling-change-the-game-for-scam-victims-heres-why-the-banks-will-be-watching-closely-241558">original article</a>.</em></p> </div>

Money & Banking

Readers response: How do you handle changes in energy levels as you age?

<p>As we get older, our levels of energy, ability and agility can slowly start to decrease, making us change our day-to-day lifestyles. </p> <p>We asked our readers how they handle these changes, and the response was overwhelming. Here's what they said. </p> <p><strong>Margo Courtney</strong> - Eat clean and healthy and your body will reward you with heaps of energy and vitality. I have a very big green smoothie most days as one of my 2 meals, along with 2 litres of water a day, and I don't even need much sleep.</p> <p><strong>Ron Stubbs</strong> - Up at 8am, can’t be late for my walk in the sun, and feeling great. Don’t need afternoon snooze then. I’m 77.</p> <p><strong>Kristeen Bon</strong> - I don’t handle them. I flop on the couch most afternoons for a quick five minute interior eye check!</p> <p><strong>Sylvia Brice</strong> - I have an autoimmune disease so my levels of energy are way down. I do what l can in small bursts and rest when l need to. Luckily l read and craft so can always do them. It's very hard to adapt but that's life and l am so much better for off than younger people with my disease. Think positive.</p> <p><strong>Judie Fisher</strong> - Do chores in small stretches, and have regular breaks.</p> <p><strong>Diane Green</strong> - Adjust. I do what I can, and what I can't just has to wait.</p> <p><strong>Raymond Richards</strong> - As they told us at the heart clinic, if you have something you HAVE to do - do it first.</p> <p><strong>Janis St George</strong> - Listen to your body - rest awhile when you need to.</p> <p><strong>Kaylene Samuels</strong> - Have a SCAN..... Seniors Compulsory Afternoon Nap.</p> <p><em>Image credits: Shutterstock </em></p>

Body

Eight simple changes to our neighbourhoods can help us age well

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/jerome-n-rachele-251972">Jerome N Rachele</a>, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a>; <a href="https://theconversation.com/profiles/james-f-sallis-407885">James F Sallis</a>, <a href="https://theconversation.com/institutions/university-of-california-san-diego-1314">University of California, San Diego</a>, and <a href="https://theconversation.com/profiles/venurs-loh-118864">Venurs Loh</a>, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a></em></p> <p>Where we live can play a big part in ageing well, largely because of the links between physical activity and wellbeing. <a href="https://www.ahuri.edu.au/__data/assets/pdf_file/0012/2181/AHURI_Final_Report_No214_Downsizing-amongst-older-Australians.pdf">Research shows</a> that two-thirds of Australians prefer to age in place. That is, we want to live independently in our homes for as long as we can. Our neighbourhoods and their design can then improve or hinder our ability to get out of the house and be physically active.</p> <p>The rapid ageing of Australia’s population only adds to the importance of neighbourhood design. In 2016, 15% of Australians were aged 65 or older. That proportion is <a href="https://www.aihw.gov.au/reports-statistics/population-groups/older-people/overview">projected to double</a> by 2056.</p> <p>These trends present several <a href="https://www.aihw.gov.au/reports-statistics/population-groups/older-people/reports">social and economic challenges</a>, particularly for the health sector. Designing neighbourhoods in ways that promote physical activity can help overcome these challenges.</p> <h2>Eight simple steps</h2> <p>The following is a short list of <a href="https://ijbnpa.biomedcentral.com/articles/10.1186/s12966-017-0471-5">evidence-based steps</a> local and state governments can take to assist older people to be physically active. These involve minor but effective changes to neighbourhood design.</p> <p><strong>Improve footpaths:</strong> Research indicates that older people have a <a href="https://theconversation.com/why-older-people-get-osteoporosis-and-have-falls-68145">higher risk of falls</a>. Ensuring footpaths are level and crack-free, and free from obstructions, will encourage walking among older people – especially those with a disability.</p> <p><strong>Connected pedestrian networks:</strong> Introducing footpaths at the end of no-through-roads and across long street blocks reduces walking distances to destinations. This makes walking a more viable option.</p> <p><strong>Slowing traffic in high-pedestrian areas:</strong> Slowing traffic <a href="https://www.heartfoundation.org.au/images/uploads/publications/Safe-Speed-Evidence-Report.pdf">improves safety</a> by reducing the risk of a collision. It also reduces the risk of <a href="https://www.ncbi.nlm.nih.gov/pubmed/28557669">death and serious injury</a> in the event of a collision.</p> <p><strong>Age-friendly street crossings:</strong> Installing longer pedestrian crossing light sequences gives older pedestrians <a href="https://academic.oup.com/ageing/article/41/5/690/47318/Most-older-pedestrians-are-unable-to-cross-the">more time to cross</a>, and installing refuge islands means those who walk more slowly can cross the street in two stages.</p> <p><strong>Disabled access at public transport:</strong> Although a form of motorised transport, public transport users undertake more incidental physical activity compared with car users. This is because they walk between transit stops and their origins and destinations. Improving disabled access helps make public transport a viable option for more older people.</p> <p><strong>Places to rest:</strong> <a href="https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-13-1054">Providing rest spots</a> such as benches enables older people to break up their walk and rest when needed.</p> <p><strong>Planting trees:</strong> Planting trees <a href="http://www.sciencedirect.com/science/article/pii/S0277953614004109?via%3Dihub">creates more pleasant scenery</a> to enjoy on a walk. It also provides shade on hot days.</p> <p><strong>Improving safety:</strong> Ensuring that streets are well-lit and reducing graffiti and signs of decay are likely to <a href="https://www.ncbi.nlm.nih.gov/pubmed/24552845">improve perceptions of safety</a> among older people.</p> <h2>Why physical activity matters</h2> <p>Physical function – the ability to undertake everyday activities such as walking, bathing and climbing stairs – often declines as people age. The reason for this is that ageing is often accompanied by a reduction in muscle strength, flexibility and cardiorespiratory reserves.</p> <p>Regular physical activity can <a href="https://www.ncbi.nlm.nih.gov/pubmed/14552936">prevent or slow the decline</a> in physical function, even among those with existing health conditions.</p> <p>Middle-to-older aged adults can reduce their risk of physical function decline <a href="https://ijbnpa.biomedcentral.com/articles/10.1186/1479-5868-7-38">by 30%</a> with regular physical activity (at least 150 minutes per week). This includes recreational physical activity, like walking the dog, or incidental physical activity, such as walking to the shops or to visit friends.</p> <p>By making minor changes as outlined above, the health and longevity of our elderly population can be extended. Such changes will help our elderly age well in place.</p> <p><em><a href="https://theconversation.com/profiles/jerome-n-rachele-251972">Jerome N Rachele</a>, Research Fellow in Social Epidemiology, Institute for Health and Ageing, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a>; <a href="https://theconversation.com/profiles/james-f-sallis-407885">James F Sallis</a>, Professorial Fellow, Institute for Health and Ageing, Australian Catholic University, and Emeritus Professor, Department of Family Medicine and Public Health, <a href="https://theconversation.com/institutions/university-of-california-san-diego-1314">University of California, San Diego</a>, and <a href="https://theconversation.com/profiles/venurs-loh-118864">Venurs Loh</a>, PhD Candidate, Institute for Health and Ageing, <a href="https://theconversation.com/institutions/australian-catholic-university-747">Australian Catholic University</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/eight-simple-changes-to-our-neighbourhoods-can-help-us-age-well-83962">original article</a>.</em></p> </div>

Travel Tips

Why hurricanes like Milton in the US and cyclones in Australia are becoming more intense and harder to predict

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/andrew-dowdy-119002">Andrew Dowdy</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/liz-ritchie-tyo-1509061">Liz Ritchie-Tyo</a>, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>, and <a href="https://theconversation.com/profiles/savin-chand-1351050">Savin Chand</a>, <a href="https://theconversation.com/institutions/federation-university-australia-780">Federation University Australia</a></em></p> <p>Tropical cyclones, known as hurricanes and typhoons in other parts of the world, have caused huge damage in many places recently. The United States has just been hit by <a href="https://www.nhc.noaa.gov/graphics_at4.shtml?start">Hurricane Milton</a>, within two weeks of <a href="https://theconversation.com/how-hurricane-helene-became-a-deadly-disaster-across-six-states-240522">Hurricane Helene</a>. Climate change <a href="https://www.worldweatherattribution.org/climate-change-key-driver-of-catastrophic-impacts-of-hurricane-helene-that-devastated-both-coastal-and-inland-communities/">likely made their impacts worse</a>.</p> <p>In Australia, the tropical cyclone season (November to April) is approaching. The Bureau of Meteorology this week released its <a href="http://www.bom.gov.au/climate/cyclones/australia/">long-range forecast</a> for this season.</p> <p>It predicts an average number of tropical cyclones, 11, are likely to form in the region. Four are expected to cross the Australian coast. However, the risk of severe cyclones is higher than average.</p> <p>So what does an average number actually mean in our rapidly changing climate? And why is there a higher risk of intense cyclones?</p> <p>The bureau’s forecast is consistent with scientific evidence suggesting climate change is likely to result in fewer but more severe tropical cyclones. They are now more likely to bring stronger winds and <a href="https://hess.copernicus.org/articles/28/1251/2024/hess-28-1251-2024.pdf">more intense rain and flooding</a>.</p> <h2>Climate change is making prediction harder</h2> <p>Our knowledge of tropical cyclones and climate change is based on multiple lines of evidence <a href="https://doi.org/10.1175/BAMS-D-18-0189.1">globally</a> and for the Australian region. This work includes our studies based on <a href="https://www.nature.com/articles/s41558-022-01388-4">observations</a> and <a href="https://link.springer.com/article/10.1007/s00382-018-4497-4">modelling</a>.</p> <p>The bureau’s seasonal outlook in recent years has assumed an average of 11 tropical cyclones occurring in our region (covering an area of the southern tropics between longitudes 90°E and 160°E). It’s based on the average value for all years back to 1969.</p> <p>However, for the past couple of decades the annual average is below nine tropical cyclones. In earlier decades, it was over 12. This long-term downward trend adds to the challenge of seasonal predictions.</p> <p>The most recent above-average season (assuming an average of 11) was almost 20 years ago, in the <a href="http://www.bom.gov.au/cyclone/tropical-cyclone-knowledge-centre/history/climatology/">2005–06 summer with 12 tropical cyclones</a>. Since then, any prediction of above-average tropical cyclone seasons has not eventuated.</p> <h2>El Niño and La Niña influences may be changing too</h2> <p>Historical observations suggest more tropical cyclones tend to occur near Australia during La Niña events. This is a result of warm, moist water and air near Australia, compared with El Niño events. The shifting between El Niño and La Niña states in the Pacific region is known as the El Niño-Southern Oscillation (ENSO).</p> <p>Such events can be predicted with a useful degree of accuracy several months ahead in some cases. For example, the US National Oceanic and Atmospheric Administration (NOAA) has <a href="https://www.cpc.ncep.noaa.gov/products/analysis_monitoring/lanina/enso_evolution-status-fcsts-web.pdf">forecast</a>:</p> <blockquote> <p>La Niña is favored to emerge in September–November (71% chance) and is expected to persist through January–March 2025.</p> </blockquote> <p>Based on that, one might expect a higher-than-average number of tropical cyclones for the Australian region. However, the <a href="https://rmets.onlinelibrary.wiley.com/doi/abs/10.1002/asl2.502">ENSO influence on tropical cyclones has weakened</a> in our region. It’s another factor that’s making long-range predictions harder.</p> <p>The <a href="http://www.bom.gov.au/climate/enso/outlook/">bureau’s ENSO outlook</a> is somewhat closer to neutral ENSO conditions, based on its modelling, compared to NOAA’s leaning more toward La Niña. The bureau says:</p> <blockquote> <p>Should La Niña form in the coming months, it is forecast to be relatively weak and short-lived.</p> </blockquote> <p>The bureau’s prediction of an average number of tropical cyclones this season is broadly consistent with its prediction of close-to-average ENSO conditions.</p> <h2>So what does this all mean for this cyclone season?</h2> <p>If we end up getting an average Australian season for the current climate, this might actually mean fewer tropical cyclones than the historical average. The number might be closer to eight or nine rather than 11 or 12. (Higher or lower values than this range are still possible.)</p> <p>However, those that do occur could have an increased chance of being <a href="http://www.bom.gov.au/cyclone/tropical-cyclone-knowledge-centre/understanding/categories/">category 4 or 5 tropical cyclones</a>. These have stronger winds, with gusts typically exceeding 225km per hour, and are more likely to cause severe floods and coastal damage.</p> <p>If we end up getting more than the recent average of eight to nine tropical cyclones, which could happen if NOAA predictions of La Niña conditions eventuate, that increases the risk of impacts. However, there is one partially good news story from climate change relating to this, if the influence of La Niña is less than it used to be on increasing tropical cyclone activity.</p> <p>Another factor is that the <a href="http://www.bom.gov.au/climate/ocean/sst/#/anom/global/weekly/20241006">world’s oceans are much warmer than usual</a>. Warm ocean water is one of several factors that provide the energy needed for a tropical cyclone to form.</p> <p>Many ocean heat <a href="https://climatereanalyzer.org/clim/sst_daily/?dm_id=world2">records have been set</a> recently. This means we have been in “uncharted waters” from a temperature perspective. It adds further uncertainty if relying on what occurred in the past when making predictions for the current climate.</p> <h2>Up-to-date evidence is vital as climate changes</h2> <p>The science makes it clear we need to plan for tropical cyclone impacts in a different way from what might have worked in the past. This includes being prepared for potentially fewer tropical cyclones overall, but with those that do occur being more likely to cause more damage. This means there are higher risks of damaging winds, flooding and coastal erosion.</p> <p>Seasonal prediction guidance can be part of improved planning. There’s also a need for enhanced design standards and other climate change adaptation activities. All can be updated regularly to stay consistent with the best available scientific knowledge.</p> <p>Increased preparedness is more important than ever to help reduce the potential for disasters caused by tropical cyclones in the current and future climate.</p> <hr /> <p><em>The authors acknowledge the contribution of CSIRO researcher <a href="https://theconversation.com/profiles/hamish-ramsay-19549">Hamish Ramsay</a> during the writing of this article.</em><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/241000/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/andrew-dowdy-119002"><em>Andrew Dowdy</em></a><em>, Principal Research Scientist in Extreme Weather, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a>; <a href="https://theconversation.com/profiles/liz-ritchie-tyo-1509061">Liz Ritchie-Tyo</a>, Professor of Atmospheric Sciences, <a href="https://theconversation.com/institutions/monash-university-1065">Monash University</a>, and <a href="https://theconversation.com/profiles/savin-chand-1351050">Savin Chand</a>, Associate Professor, Applied Mathematics and Statistics, <a href="https://theconversation.com/institutions/federation-university-australia-780">Federation University Australia</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-hurricanes-like-milton-in-the-us-and-cyclones-in-australia-are-becoming-more-intense-and-harder-to-predict-241000">original article</a>.</em></p> </div>

Travel Trouble

Readers response: What’s one small change you’ve made that’s had a big impact on your physical health?

<p>When it comes to our overall health, sometimes it's the minor changes that can make all the difference in the long run. </p> <p>We asked our readers what one small change has had the biggest impact on their health overall, and the response was overwhelming. Here's what they said. </p> <p><strong>Marlene Hassett</strong> - I adopted a retired greyhound that makes sure I go for a walk every morning.</p> <p><strong>Judith Leoni</strong> - No small change and it was hardest thing I have ever done, but giving up smoking!</p> <p><strong>Sharolynn Marshman</strong> - Twice weekly exercise classes with my husband.</p> <p><strong>Steve Smith</strong> - Severely reduced alcohol consumption.</p> <p><strong>Deb Moore</strong> - Stop thinking about it. Look after myself. Eat good food, drink good wine, enjoy the fact that I wake up each day. Life is so special and so fragile. If you treasure your life, it will treasure and nurture you.</p> <p><strong>Julieanne Ditchfield</strong> - Mindfulness, meditation and breathing techniques.</p> <p><strong>Deedee Cullum</strong> - Having an afternoon rest. </p> <p><strong>Margaret Dixon</strong> - Going to an exercise physiologist.</p> <p><strong>Bill Nicholson</strong> - Retiring!</p> <p><strong>Margaret Bandiera</strong> - Cut out sugar, dairy, gluten and alcohol.</p> <p><em>Image credits: Shutterstock</em></p>

Body

Why isn’t dental included in Medicare? It’s time to change this – here’s how

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/peter-breadon-1348098">Peter Breadon</a>, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> and <a href="https://theconversation.com/profiles/kate-griffiths-94706">Kate Griffiths</a>, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a></em></p> <p>When the forerunner of Medicare was established in the 1970s, dental care was left out. Australians are still suffering the consequences half a century later.</p> <p>Patients pay much more of the cost of dental care than they do for other kinds of care.</p> <p><a href="https://www.commonwealthfund.org/sites/default/files/2021-08/Schneider_Mirror_Mirror_2021.pdf">More</a> Australians delay or skip dental care because of cost than their peers in most wealthy countries.</p> <p>And as our dental health gets <a href="https://theconversation.com/reform-delay-causes-dental-decay-its-time-for-a-national-deal-to-fund-dental-care-217914">worse</a>, fees keep on rising.</p> <p>For decades, a litany of reports and inquiries have called for universal dental coverage to solve these problems.</p> <p>Now, with the Greens <a href="https://greens.org.au/news/media-release/tax-big-corporate-profits-fix-peoples-teeth-greens">proposing</a> it and Labor backbenchers <a href="https://www.theaustralian.com.au/nation/politics/dental-on-medicare-must-be-next-frontier-for-labor-backbenchers/news-story/1c69314d7609815b937ced5af4542ba0">supporting</a> it, could it finally be time to put the mouth into Medicare?</p> <h2>What’s stopping us?</h2> <p>The Australian Dental Association <a href="https://ada.org.au/ada-responds-to-the-greens-dentistry-in-medicare-proposal">says</a> the idea is too ambitious and too costly, pointing out it would need many more dental workers. They say the government should start small, focusing on the most vulnerable populations, initially seniors.</p> <p>Starting small is sensible, but finishing small would be a mistake.</p> <p>Dental costs aren’t just a problem for the most vulnerable, or the elderly. More than <a href="https://www.abs.gov.au/statistics/health/health-services/patient-experiences/2022-23/patient_experience_202223_tables_13_to_15.xlsx">two million</a> Australians avoid dental care because of the cost.</p> <p>More than <a href="https://www.aihw.gov.au/getmedia/a053aa74-c471-436e-ab7e-a82e83ae73a3/aihw_den_231_dentalcare_oralhealthanddentalcareinaustralia_tranche7_21NOV2023.xlsx">four in ten</a> adults usually wait more than a year before seeing a dental professional.</p> <p>Bringing dental into Medicare will require many thousands of new dental workers. But it will be possible if the scheme is <a href="https://grattan.edu.au/wp-content/uploads/2019/03/915-Filling-the-gap-A-universal-dental-scheme-for-Australia.pdf">phased in</a> over ten years.</p> <p>The real reason dental hasn’t been added to Medicare is it would cost billions of dollars. The federal government doesn’t have that kind of money lying around.</p> <p>Australia has a <a href="https://theconversation.com/the-budget-is-full-of-good-news-but-good-news-isnt-the-same-as-good-management-230110">structural budget problem</a>. Government spending is growing faster than revenue, because we are a relatively <a href="https://grattan.edu.au/news/can-we-talk-about-a-fairer-more-prosperous-australia/">low-tax country with high service expectations</a>.</p> <p>The growing cost of health care is a major contributor, with hospitals and medical benefits among the top six fastest-growing major payments.</p> <p>The structural gap is only <a href="https://treasury.gov.au/publication/2023-intergenerational-report">likely to grow</a> without major policy changes.</p> <p>So, can we afford health care for all? We can. But we should do it with smart choices on dental care, and tough choices to raise revenue and reduce spending elsewhere.</p> <h2>Smart choices about a new dental scheme</h2> <p>The first step is to avoid repeating the mistakes of Medicare.</p> <p>Medicare payments to private businesses haven’t attracted them to a lot of the communities that need them the most. Many rural and disadvantaged areas are <a href="https://theconversation.com/if-you-live-in-a-bulk-billing-desert-its-hard-to-see-a-doctor-for-free-heres-how-to-fix-this-204029">bulk-billing deserts</a> with too few GPs.</p> <p>The poorest areas have more than <a href="https://grattan.edu.au/wp-content/uploads/2022/12/A-new-Medicare-strengthening-general-practice-Grattan-Report.pdf">twice</a> the psychological distress of the wealthiest areas, but they get about half the Medicare-funded mental health services.</p> <p>As a result, government money isn’t going where it will make the biggest difference.</p> <p>There are about <a href="https://www.aihw.gov.au/reports/dental-oral-health/oral-health-and-dental-care-in-australia/contents/hospitalisations/potentially-preventable-hospitalisations">80,000</a> hospital visits each year for dental problems that could have been avoided with dental care. If there is too little care in disadvantaged and rural communities, where oral health is worst, that number will remain high.</p> <p>That’s why a significant share of new investment should be quarantined for public dental services, with those services targeted to areas where people are missing out on care.</p> <p>Another problem with Medicare is its payments often have little relationship to the cost of care, or the impact that care has on the patient’s health.</p> <p>To tamp down costs, Medicare funding for dental care should exclude cosmetic treatments and orthodontics. It should be based on efficient workforce models where dental assistants and therapists use all their skills – you might not always need to see a dentist.</p> <p>The funding <a href="https://apo.org.au/sites/default/files/resource-files/2019-06/apo-nid241086.pdf">model</a> should take account of a patient’s needs, reward giving them ongoing care, and have a <a href="https://grattan.edu.au/wp-content/uploads/2019/03/915-Filling-the-gap-A-universal-dental-scheme-for-Australia.pdf">cap</a> on spending per patient.</p> <p>Oral health should be measured and recorded, to make sure patients and taxpayers are getting results.</p> <h2>Tough choices to balance the budget</h2> <p>Those steps would slash the cost of The Greens’ plan, which is hard to estimate but might reach more than <a href="https://www.pbo.gov.au/sites/default/files/2024-09/Putting%20dental%20care%20into%20Medicare.pdf">$20 billion</a> a year once it’s phased in. Instead, the cost would fall to roughly <a href="https://grattan.edu.au/report/filling-the-gap/">$7 billion</a> a year.</p> <p>That would be a good investment. But if you’re worried about where the money will come from, there are good ways to pay for it.</p> <p>Many reforms could reduce government health budgets without harming patients.</p> <p>There is waste in government funding of <a href="https://grattan.edu.au/wp-content/uploads/2016/02/935-blood-money.pdf">pathology</a> tests and <a href="https://grattan.edu.au/wp-content/uploads/2015/06/823-Premium-Policy4.pdf">less cost-effective</a> medicines.</p> <p>In some hospitals, there are <a href="https://grattan.edu.au/wp-content/uploads/2014/03/806-costly-care.pdf">excessive costs</a> and potentially harmful <a href="https://qualitysafety.bmj.com/content/qhc/28/3/205.full.pdf">low-value care</a>.</p> <p>Over the longer-term, investments in <a href="https://grattan.edu.au/wp-content/uploads/2023/02/The-Australian-Centre-for-Disease-Control-ACDC-Highway-to-Health-Grattan-Report.pdf">prevention</a> can reduce demand for health care. A <a href="https://grattan.edu.au/wp-content/uploads/2024/05/Sickly-Sweet-Grattan-Institute-Report-May-2024.pdf">tax on sugary drinks</a>, for example, would improve health while raising hundreds of millions of dollars a year.</p> <p>Measures like this would help the government pay for more dental care. But demand for health care will keep growing as the population ages, and as expensive <a href="https://www.abc.net.au/news/2024-09-11/proposal-to-speed-up-medicine-approvals/104338766">new treatments</a> arrive.</p> <p>This means a broader strategy is needed to meet the three goals of balancing the budget, keeping up with growing health-care demand, and bringing dental into Medicare.</p> <p>There are no easy solutions, but there are many options to reduce spending and boost revenue without hurting economic growth.</p> <p>Choosing Australia’s infrastructure and defence megaprojects <a href="https://grattan.edu.au/report/back-in-black-a-menu-of-measures-to-repair-the-budget/">more wisely</a> could save several billion dollars each year.</p> <p>Undoing Western Australia’s special GST funding deal – <a href="https://www.austaxpolicy.com/western-australia-gst-deal-the-worst-australian-public-policy-decision-of-the-21st-century-thus-far/">described</a> by economist Saul Eslake as “the worst Australian public policy decision of the 21st Century thus far” – would save another <a href="https://grattan.edu.au/report/back-in-black-a-menu-of-measures-to-repair-the-budget/">$5 billion</a> a year.</p> <p>Reducing income tax breaks and tax minimisation opportunities – including by reining in superannuation tax concessions, reducing the capital gains tax discount, limiting negative gearing, and setting a minimum tax on trust distributions – could raise more than <a href="https://grattan.edu.au/report/back-in-black-a-menu-of-measures-to-repair-the-budget/">$20 billion</a> a year.</p> <p>Major tax reform like this offers economic benefits while creating space for better services such as universal dental coverage.</p> <p>No one likes spending cuts and tax hikes, but they will be needed <a href="https://theconversation.com/chalmers-has-a-70-billion-a-year-budget-hole-here-are-13-ways-to-fill-it-203331">sooner or later</a> regardless. Dental coverage might be just the sweetener taxpayers need to accept it.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/239086/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/peter-breadon-1348098"><em>Peter Breadon</em></a><em>, Program Director, Health and Aged Care, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a> and <a href="https://theconversation.com/profiles/kate-griffiths-94706">Kate Griffiths</a>, Deputy Program Director, Budgets and Government, <a href="https://theconversation.com/institutions/grattan-institute-1168">Grattan Institute</a></em></p> <p><em>Image credits: Shutterstock</em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/why-isnt-dental-included-in-medicare-its-time-to-change-this-heres-how-239086">original article</a>.</em></p> </div>

Money & Banking

Climate change threatens Australian tourism more than is widely believed. Here’s why

<div class="theconversation-article-body"><em><a href="https://theconversation.com/profiles/freya-higgins-desbiolles-181651">Freya Higgins-Desbiolles</a>, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p>Right now, Australia is one of the <a href="https://www.weforum.org/publications/travel-tourism-development-index-2024/">top five</a> tourist destinations in the world, a distinction the World Economic Forum says it shares with only the United States, France, Spain and Japan.</p> <p>So important is tourism to Australia’s economy that the best estimates are it employs <a href="https://www.tra.gov.au/en/economic-analysis/state-of-the-industry">655,000</a> people, 12 times as many as <a href="https://www.abs.gov.au/statistics/labour/employment-and-unemployment/labour-force-australia-detailed/jul-2024">Australia’s coal industry</a>.</p> <p>And most of them are employed in <a href="https://www.zurich.com.au/content/dam/au-documents/files/zurich-mandala-climate-risk-index-the-impact-of-climate-change-on-the-australian-tourism-industry.pdf">regional locations</a>, where jobs are scarce.</p> <p>This month a report by the Zurich insurance group and the economic consultancy Mandala found <a href="https://www.zurich.com.au/content/dam/au-documents/files/zurich-mandala-climate-risk-index-the-impact-of-climate-change-on-the-australian-tourism-industry.pdf">half</a> of Australia’s top 178 tourism assets were at risk from foreseeable climate change.</p> <p>There are reasons to believe its findings underplay what we are facing.</p> <h2>All major airports, all national parks at risk</h2> <p>The Zurich-Mandala report examines the impact of a 2⁰C increase in global temperatures on only eight so-called “climate perils”: wind, flood, heat, storm, drought, bushfire, hail and rain.</p> <p>It found that more than half of Australia’s top tourism assets faced a “significant risk from multiple perils” over the next 25 years, including all of Australia’s major airports.</p> <p>Scheduling disruptions and the closure of airports in extreme weather conditions were set to have major impacts on the transport of goods, the transport of tourists and accessibility for emergency services.</p> <p>All of Australia’s vineyards, national parks, scenic roads and railways were at risk.</p> <p>Queensland had the highest number of sites facing significant risk (79%) followed by Western Australia (69%) and the Northern Territory (63%).</p> <p>The report uses the impact of the 2019-20 <a href="https://www.aph.gov.au/About_Parliament/Parliamentary_Departments/Parliamentary_Library/pubs/rp/rp1920/Quick_Guides/AustralianBushfires">black summer bushfires</a> to estimate that 176,000 jobs might be at risk nationwide from predictable climate change, most of them outside of Australia’s capital cities.</p> <h2>Multiple and interacting threats</h2> <p>Here is why I am fearful that the report underplays the threat Australia’s tourism industry is facing.</p> <p>There are many more threats to tourism from climate change than wind, flood, heat, storm, drought, bushfire, hail and rain.</p> <p>One is the threat to biodiversity. Iconic animals and habitats are an important part of Australia’s brand.</p> <p><a href="https://www.abc.net.au/news/2020-07-28/3-billion-animals-killed-displaced-in-fires-wwf-study/12497976">Three billion</a> animals were killed or displaced in the black summer bushfires.</p> <p>The deaths caused <a href="https://www.theguardian.com/australia-news/2023/apr/01/alexis-wright-black-summer-bushfires-vigil-sydney-speech-3-billion-animals-killed-are-our-relatives-they-deserve-to-be-mourned">loss and grief</a> that risk indexes are incapable of capturing, but that nonetheless might make tourism less attractive.</p> <p>And biodiversity helps in another way by <a href="https://www.australianwildlife.org/wp-content/uploads/2019/12/Hayward-Et-Al.-2016-Could-biodiversity-loss-have-increased-Australias-bushfire-threat.pdf">protecting against bushfires</a>, meaning that as species vanish, other risks to tourism climb in ways that aren’t captured in the assumptions used to evaluate risk.</p> <h2>Threats unexamined</h2> <p>What makes holiday locations unattractive is hard to measure, but is fed by extreme weather events.</p> <p>Although temporary, the smoke and heat from the 2019-20 bushfires made parts of Sydney, Melbourne and Canberra almost unlivable for a while, damaging the reputations of Australian capital cities in a way that is <a href="https://www.smh.com.au/national/nsw/not-a-good-look-bushfire-smoke-threatens-to-pollute-sydney-s-tourist-image-20191206-p53hpl.html">probably ongoing</a>.</p> <p>Another curious omission, especially curious given that the report was prepared by an insurance company, is the damage extreme weather events do to the insurability of tourism assets.</p> <p>The report is also silent on the effort to reduce carbon emissions on Australia’s desirability as an international destination.</p> <p>For many tourists, air travel is the only way to get to Australia and it is likely to become more expensive and also less attractive as tourists try to reduce their <a href="https://www.sciencedirect.com/science/article/abs/pii/S0959652614011810">carbon footprints</a>.</p> <p>Australia might increasingly become an Australian rather than an international destination.</p> <p>Our biggest upcoming international promotion, the 2032 Brisbane Olympic Games, might lose a good deal of its shine, with Queensland tourism assets at the greatest risk from climate change, and those risks set to climb over time.</p> <h2>The higher the temperature the bigger the threats</h2> <p>Zurich and the Mandala consultancy are to be commended for identifying 178 top tourism assets and examining eight types of risk they face.</p> <p>Their finding that just over half of them face serious threats from those risks is likely to be an underestimate because it excludes other risks and fails to examine the way in which some risks can intensify others.</p> <p>And they will be an underestimate if global temperatures climb by more than 2⁰C.</p> <p>The report says if global temperatures climb to 3⁰C above pre-industrial levels, 80% of the Australian sites it examined will face serious threats.</p> <p>Australia could attempt to limit the increase in global temperatures by taking up the opportunity to co-host the <a href="https://theconversation.com/its-a-big-deal-if-australia-and-the-pacific-are-chosen-to-host-un-climate-talks-heres-why-238320">2026 UN climate talks</a> with Pacific nations.</p> <p>It would give us a shot at making a difference and drawing attention to our present status as one of the world’s top tourism destinations.<img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/238768/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><em><a href="https://theconversation.com/profiles/freya-higgins-desbiolles-181651">Freya Higgins-Desbiolles</a>, Adjunct professor and adjunct senior lecturer in tourism management, <a href="https://theconversation.com/institutions/university-of-south-australia-1180">University of South Australia</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/climate-change-threatens-australian-tourism-more-than-is-widely-believed-heres-why-238768">original article</a>.</em></p> </div>

Domestic Travel

What the government’s home care changes mean for ageing Australians

<div class="theconversation-article-body"> <p><em><a href="https://theconversation.com/profiles/tracy-comans-696663">Tracy Comans</a>, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/frances-batchelor-2209350">Frances Batchelor</a>, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p>The Albanese government has this week announced it will introduce one of the <a href="https://www.health.gov.au/ministers/the-hon-anika-wells-mp/media/once-in-a-generation-aged-care-reforms">largest reforms</a> to Australia’s aged-care sector to date.</p> <p>The package includes a A$4.3 billion investment in home care, now called “<a href="https://www.health.gov.au/our-work/support-at-home">Support at Home</a>”, to come into effect from July 2025. This reflects both the desire of many people to remain living at home as they age, and the government’s desire to reduce the costs of residential aged care.</p> <p>So what changes is the government making to home care packages? And what will these changes mean for ageing Australians?</p> <h2>Reducing waiting times</h2> <p>One of the major complaints about the current home care system is the long waiting times. Estimates suggest there’s a <a href="https://www.gen-agedcaredata.gov.au/getmedia/447b425c-63d6-4b96-a1fc-4dac805066ba/Home-Care-Packages-Program-data-report-1-January-%E2%80%93-31-March-2024">6–to-12-month wait</a> for the higher level 3 and 4 home care packages. For people with the highest needs, this is far too long.</p> <p>As of March this year, around <a href="https://www.gen-agedcaredata.gov.au/getmedia/447b425c-63d6-4b96-a1fc-4dac805066ba/Home-Care-Packages-Program-data-report-1-January-%E2%80%93-31-March-2024">45,000 people</a> were waiting for any level of home care. An additional 14,000 were already receiving a package, but on a lower level of home care than they were entitled to.</p> <p>With additional funding, the new system will <a href="https://www.health.gov.au/ministers/the-hon-anika-wells-mp/media/once-in-a-generation-aged-care-reforms">support more participants</a>. It aims to shorten wait times to <a href="https://www.health.gov.au/sites/default/files/2024-09/support-at-home-fact-sheet.pdf">an average of three months</a> from July 2027.</p> <h2>Changes to services</h2> <p>The new system will replace the current four levels of home care packages with <a href="https://www.health.gov.au/ministers/the-hon-anika-wells-mp/media/once-in-a-generation-aged-care-reforms">eight classifications</a> of funding for services. When participants are assessed, they will be assigned the most suitable category. There’s currently very limited information on what these classifications are, but the idea is they will provide more targeted services.</p> <p>A number of short-term supports will also be available. These include assistive technology (such as mobility aids) and home modifications. Some people will be able to access 12 weeks of restorative care – a more intensive program designed to build function after injury or illness – as well as palliative care support.</p> <p>The way different types of services are subsidised is also changing. Previously, the same means-tested co-contribution applied regardless of the type of service.</p> <p>Under the new system, services are categorised into clinical care (for example, physiotherapy or wound care), independence (such as help with bathing or cooking) and everyday living (for example, gardening or home maintenance). The new reforms fully subsidise clinical services regardless of income, whereas independence and everyday living services will attract co-contributions based on means testing.</p> <p>For example, <a href="https://www.health.gov.au/sites/default/files/2024-09/case-studies-support-at-home.pdf">a self-funded retiree</a> would pay nothing out of pocket for physiotherapy, but would pay 50% for help with showering and 80% towards gardening costs. A full pensioner would also pay nothing for physiotherapy, but pay 5% for help with showering and 17.5% of the cost of gardening.</p> <p>This is a positive change. Our research has previously highlighted a tendency for people with home care packages to choose everyday living services <a href="https://onlinelibrary.wiley.com/doi/full/10.1155/2023/4157055">such as gardening</a> and cleaning and refuse clinical care such as allied health and nursing as these types of services were more expensive.</p> <p>These changes should make older people more likely to choose allied health and clinical care services, which will help them maintain their function and stay fitter for longer.</p> <h2>Some challenges</h2> <p>For the government’s reforms to deliver faster and better support at home, a number of issues need to be addressed.</p> <p>As people stay at home for longer, we also see that these <a href="https://academic.oup.com/ageing/article/52/5/afad058/7147101">people are frailer</a> and have more health conditions than in the past. This requires a different and more highly skilled home care workforce.</p> <p>The current <a href="https://www.health.gov.au/sites/default/files/documents/2021/10/2020-aged-care-workforce-census.pdf">home care workforce</a> consists largely of personal care and domestic support workers alongside a much smaller skilled workforce of registered nurses and allied health professionals.</p> <p>But with the changing profile of people receiving care at home, there will need to be a greater focus on maintaining functional capacity. This might mean more allied health input will be required, such as from physiotherapists and occupational therapists.</p> <p>It’s difficult to source an appropriately skilled workforce across the sector, and almost impossible in <a href="https://www.ruralhealth.org.au/sites/default/files/publications/fact-sheet-allied-health.pdf">rural and remote areas</a>. Alternative models, such as training personal care workers to act as allied health assistants, and effectively using technology such as telehealth, will be necessary to meet demand without compromising on quality of care.</p> <p>One example of the need for upskilling in specific areas relates to caring for people with dementia. The majority of people who are living with dementia at home receive care from family carers, supported by home care workers. It’s vital that these care workers have adequate knowledge and skills specific to dementia.</p> <p>However, research has shown the home care workforce may <a href="https://pubmed.ncbi.nlm.nih.gov/31646701/">lack the knowledge and skills</a> to provide best-practice care for people living with dementia. Specialised <a href="https://onlinelibrary.wiley.com/doi/10.1002/gps.6140">dementia training</a> for home care workers is effective in improving knowledge, attitudes and sense of competence in providing care. It should be rolled out across the sector.</p> <h2>What about unpaid care at home?</h2> <p>Unpaid carers, such as family members, provide <a href="https://www.pmc.gov.au/resources/draft-national-strategy-care-and-support-economy/goal-1-quality-care-and-support/support-for-informal-carers">significant amounts of care</a> for older people. The value of this unpaid care is estimated to be in the billions. As older people stay at home for longer, this is set to increase even further.</p> <p>However, carers with high care burdens are particularly vulnerable to <a href="https://www.sciencedirect.com/science/article/pii/S2352827316300283#s0025">poor physical and mental health</a>. Without adequate support, we may find extra caring pressures lead to a breakdown in caring relationships and an increase in other health-care costs for both the carer and care recipient.</p> <p>So we need to ensure carers have adequate financial, psychological and practical support. But the currently available detail on the reforms doesn’t indicate this has been adequately addressed.</p> <p>With careful implementation and ongoing evaluation, these reforms have the potential to significantly enhance the home care system. However, their success will depend on addressing workforce challenges, ensuring adequate support for unpaid carers, and maintaining a focus on the holistic needs of older Australians.</p> <p><em>More information about Support at Home is <a href="https://www.health.gov.au/our-work/support-at-home/about">available online</a>.</em><img style="border: none !important; box-shadow: none !important; margin: 0 !important; max-height: 1px !important; max-width: 1px !important; min-height: 1px !important; min-width: 1px !important; opacity: 0 !important; outline: none !important; padding: 0 !important;" src="https://counter.theconversation.com/content/238890/count.gif?distributor=republish-lightbox-basic" alt="The Conversation" width="1" height="1" /></p> <p><a href="https://theconversation.com/profiles/tracy-comans-696663"><em>Tracy Comans</em></a><em>, Executive Director, National Ageing Research Institute; Professor, Centre for Health Services Research, <a href="https://theconversation.com/institutions/the-university-of-queensland-805">The University of Queensland</a> and <a href="https://theconversation.com/profiles/frances-batchelor-2209350">Frances Batchelor</a>, Director Clinical Gerontology & Senior Principal Research Fellow, National Ageing Research Institute, <a href="https://theconversation.com/institutions/the-university-of-melbourne-722">The University of Melbourne</a></em></p> <p><em>Image credits: Shutterstock </em></p> <p><em>This article is republished from <a href="https://theconversation.com">The Conversation</a> under a Creative Commons license. Read the <a href="https://theconversation.com/what-the-governments-home-care-changes-mean-for-ageing-australians-238890">original article</a>.</em></p> </div>

Legal

Chaos erupts over last-minute cruise itinerary change

<p>Passengers onboard a Carnival Cruise have demanded refunds after their travel itinerary changed once they had already boarded the ship. </p> <p>Guests aboard Carnival’s Vista had booked the eight-night Southern Caribbean cruise out of Port Florida on August 10th intending to stop in Aruba, Curacao and Turks and Cacaos, with the eight-day cruise averaging $11,700 per person.</p> <p>However, as boarding was taking place, the cruise line sent passengers a notification saying their had been a change of plans due to an engine problem.</p> <p>Carnival crew members had discovered a “technical issue affecting the ship’s cruising speed” which forced the cruise line to alter the itinerary, the cruise line told the New York Post, with Vista instead traveling to the Bahamas, making stops at Nassau, Princess Cays, Freeport, and Half Moon Cay. </p> <p>While a cruise worker was trying to explain the situation to passengers, some started chanting "Give us our money!" while staff tried to diffuse the situation.</p> <blockquote class="instagram-media" style="background: #FFF; border: 0; border-radius: 3px; box-shadow: 0 0 1px 0 rgba(0,0,0,0.5),0 1px 10px 0 rgba(0,0,0,0.15); margin: 1px; max-width: 540px; min-width: 326px; padding: 0; width: calc(100% - 2px);" data-instgrm-permalink="https://www.instagram.com/reel/C_OYKHVvIIh/?utm_source=ig_embed&utm_campaign=loading" data-instgrm-version="14"> <div style="padding: 16px;"> <div style="display: flex; flex-direction: row; align-items: center;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 40px; margin-right: 14px; width: 40px;"> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 100px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 60px;"> </div> </div> </div> <div style="padding: 19% 0;"> </div> <div style="display: block; height: 50px; margin: 0 auto 12px; width: 50px;"> </div> <div style="padding-top: 8px;"> <div style="color: #3897f0; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: 550; line-height: 18px;">View this post on Instagram</div> </div> <div style="padding: 12.5% 0;"> </div> <div style="display: flex; flex-direction: row; margin-bottom: 14px; align-items: center;"> <div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(0px) translateY(7px);"> </div> <div style="background-color: #f4f4f4; height: 12.5px; transform: rotate(-45deg) translateX(3px) translateY(1px); width: 12.5px; flex-grow: 0; margin-right: 14px; margin-left: 2px;"> </div> <div style="background-color: #f4f4f4; border-radius: 50%; height: 12.5px; width: 12.5px; transform: translateX(9px) translateY(-18px);"> </div> </div> <div style="margin-left: 8px;"> <div style="background-color: #f4f4f4; border-radius: 50%; flex-grow: 0; height: 20px; width: 20px;"> </div> <div style="width: 0; height: 0; border-top: 2px solid transparent; border-left: 6px solid #f4f4f4; border-bottom: 2px solid transparent; transform: translateX(16px) translateY(-4px) rotate(30deg);"> </div> </div> <div style="margin-left: auto;"> <div style="width: 0px; border-top: 8px solid #F4F4F4; border-right: 8px solid transparent; transform: translateY(16px);"> </div> <div style="background-color: #f4f4f4; flex-grow: 0; height: 12px; width: 16px; transform: translateY(-4px);"> </div> <div style="width: 0; height: 0; border-top: 8px solid #F4F4F4; border-left: 8px solid transparent; transform: translateY(-4px) translateX(8px);"> </div> </div> </div> <div style="display: flex; flex-direction: column; flex-grow: 1; justify-content: center; margin-bottom: 24px;"> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; margin-bottom: 6px; width: 224px;"> </div> <div style="background-color: #f4f4f4; border-radius: 4px; flex-grow: 0; height: 14px; width: 144px;"> </div> </div> <p style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; line-height: 17px; margin-bottom: 0; margin-top: 8px; overflow: hidden; padding: 8px 0 7px; text-align: center; text-overflow: ellipsis; white-space: nowrap;"><a style="color: #c9c8cd; font-family: Arial,sans-serif; font-size: 14px; font-style: normal; font-weight: normal; line-height: 17px; text-decoration: none;" href="https://www.instagram.com/reel/C_OYKHVvIIh/?utm_source=ig_embed&utm_campaign=loading" target="_blank" rel="noopener">A post shared by Only in Florida (@onlyinfloridaa)</a></p> </div> </blockquote> <p>“Ladies and gentlemen, the way you’re going about this with the noise and chaos isn’t going to solve any issues,” one cruise employee explained to the passengers, according to video obtained by Inside Edition.</p> <p>The passengers were given several choices once the cruise line determined the need for an itinerary change, as the cruise line said in a statement. </p> <p>“We communicated directly with guests on board regarding their options for the sailing,” Carnival said.</p> <p>“Those that sailed were given an on-board credit as well as a future cruise credit toward another cruise to make up for the unexpected change, and those who preferred not to sail were offered a 100 per cent refund.” </p> <p>Even with the choice of not cruising to the Bahamas, passengers were still frustrated with Carnival for the last-minute announcement.</p> <p>“They knew about the problem prior to us getting onto the ship,” Ashley Ball told the outlet. “They just didn’t say that until we were already on the ship, and, you know, went through customs and the lines and securities and all that, and then decided to display that information.”</p> <p><em>Image credits: Instagram</em></p>

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