This issue starts with three editorials that argue a viewpoint without reporting research results. David Whiteman argues for the importance of blue sky research, where a researcher seeks inspiration from the wide blue yonder. In contrast, the other two editorials focus on the age-old concerns of public health. We need to look both backward and forward when analysing infectious diseases like tuberculosis (Linda Robertus and colleagues) and leprosy (Niyi Awofeso).
The Communicable Disease section has three articles on hepatitis B, adding to earlier work advocating a coordinated public health response to this important but relatively neglected disease.1 Benjamin Cowie argues that we need to translate information resources for people living with hepatitis B into relevant community languages, especially Chinese and Vietnamese. Stephanie Williams and colleagues argue for improved methods of surveillance for chronic hepatitis B, including more complete notifications for people born in high prevalence countries. The problem of country of birth is also addressed by Caroline Turnour and colleagues who compare two methods for estimating the prevalence and distribution of hepatitis B by local government area and country of birth thus helping health authorities plan prevention and treatment services. Margot McLean and Amanda D'Souza turn to a less common problem: two cases of life-threatening cellulitis after traditional Samoan tattooing.
The section on Indigenous Health adds to some of the issues raised in our special issue on Indigenous Health in July 2010. Lixin Ou and colleagues draw on the Longitudinal Study of Australian Children to show that many parents of infants perceive that their needs are not met by health care services but both ethnic and Indigenous parents are worse off. For Indigenous parents, access to services was of particular importance. We need to take this into account in programs addressing poor health outcomes for Indigenous infants but we also need to address the possibly neglected problems facing ethnic communities. Anton Clifford and colleagues reviewed the literature on Indigenous-specific interventions addressing the risk factors of smoking, nutrition, alcohol and physical inactivity. They found that the few existing studies are methodologically weak and show weak intervention effects. This leads them to call for more rigorous evaluation research. Smoking prevention in Indigenous communities is a difficult issue. While earlier research on six remote predominantly Aboriginal communities showed high smoking prevalence but daily smoking rates lower than in the wider community,2 smoking cessation remains an important focus for alleviating health disparities. Marlene Thompson and colleagues also reviewed the literature to show some evidence that it is difficult for Indigenous Health Workers to advocate smoking cessation when they are smokers themselves. This suggests the need for programs to help these workers quit smoking, but these need to be underpinned by sound research.
The section on Health Promotion starts with an article by Graeme Lindsay and colleagues arguing that the health benefits of moving urban trips from cars to bicycles far outweigh the downside of these programs, an increase in cyclist road accidents. Paul Ward and colleagues used Medicare data to show that participation rates in the population-based National Bowel Cancer Screening Program are lower for men, poor people and people living in remote areas but, once again, participation is also lower for Indigenous people and people speaking a language other than English at home.
The section on Smoking Prevention starts with a note of caution. Television news gives a sympathetic portrayal of people with lung cancer if they are non-smokers, argue Ross MacKenzie and colleagues. This may stigmatise smokers with lung cancer causing them to delay in seeking treatment. In addition it diverts attention from the role of the tobacco industry in promoting smoking. Effective tobacco control requires a number of different strategies consistent with the 2009 National Preventive Health Taskforce,3 the most important of which is argued to be increased tax to raise prices. This is relevant to the study of Molly McCarthy and colleagues who showed that cigarettes are being discounted in price near secondary schools in poorer communities. Mass media campaigns remain important: Trish Cotter and colleagues show that modernising the iconic advertisement depicting smokers’ lungs as a sponge filled with tar has an impact on a new, younger group of smokers. George Thompson and colleagues used survey data in New Zealand to show a relatively unusual finding: that ‘setting an example to children’ was an important reason to quit smoking, supporting an emphasis on family health in social marketing campaigns.
Our Letters grow in importance with topics including health promotion, study design, screening and good news from China on hepatitis B vaccination. You may also enjoy an unusual study on coughing in the doctor's face during examination.