NACCHO Tackling Indigenous Smoking NEWS : DOH tender for National Best Practice Unit for TIS

Smoking

Tobacco smoking is the most preventable cause of ill health and early death among Aboriginal and Torres Strait Islander people and is responsible for around one in five deaths,”

Through the Council of Australian Governments (COAG), the Australian government has committed to six targets to close the gap in disadvantage between Indigenous and non-Indigenous Australians across health, education and employment.

Two of these targets relate directly to the health portfolio: to close the gap in life expectancy within a generation (by 2031); and to halve the gap in mortality rates for Indigenous children under five within a decade (by 2018).”

SEE NACCHO REPORT HERE

As the federal government seeks to raise the average lifespan of Indigenous individuals closer to levels enjoyed by the rest of the population smoking remains under the gun, blamed for one-fifth of the Indigenous death rate.

A recent Health Department tender seeks to add a national organisation to run a drive against smoking by Aboriginal and Torres St Island individuals, to complement existing anti-tobacco regional programs run under the banner of Tackling Indigenous Smoking.

The organisation or consortium chosen to support the current TIS program will be referred to as the National Best Practice Unit for TIS.

Closing date for applications is September 1, Melbourne-based tenders specialist TenderSearch says. Contract execution is listed for October-November and release of operational guidelines for January-February 2016.

Download the 2 Tender documents here

Health-010-1516 – RFT

Health-010-1516 – DRAFT Contract for Services

The NBPU managing supervisory body will be expected to work mainly with grant recipients funded under the TIS program for regional tobacco control activities, with support and leadership from Professor Tom Calma, the national co-ordinator tackling Indigenous smoking.

The to-do list starts with developing and maintaining operational guidelines for tobacco use reduction among Aboriginal and Torres Strait Islander people. It will provide organisational support to grant recipients responsible for implementing evidence-based approaches to tobacco control.

It will help them develop and implement performance indicators and data collection methods, and

The NBPU will facilitate workforce development for the project, disseminating evidence and information on best practice, building a community of practice, and promoting a culture of evaluation and continuous improvement for the TIS program. There will also be advice and assistance to the department.

“Tobacco smoking is the most preventable cause of ill health and early death among Aboriginal and Torres Strait Islander people and is responsible for around one in five deaths,” the tender document said.

“Through the Council of Australian Governments (COAG), the Australian government has committed to six targets to close the gap in disadvantage between Indigenous and non-Indigenous Australians across health, education and employment.

“Two of these targets relate directly to the health portfolio: to close the gap in life expectancy within a generation (by 2031); and to halve the gap in mortality rates for Indigenous children under five within a decade (by 2018).

“Under the COAG National Healthcare Agreement, Australian governments have committed to halve the daily smoking rate among Aboriginal and Torres Strait Islander adults (18 or older) from 44.8 per cent in 2008 to 22.4 per cent by 2018.

“Work to reduce high rates of smoking has resulted in a reduction of seven percentage points since 2002, accompanied by a significant increase in the proportion of Aboriginal and Torres Strait Islander people who have never smoked.”

Indigenous-specific activities were required because the strong history and impact of mainstream action in Australia had failed to deliver equivalent reductions in smoking rates within the Aboriginal and Torres Strait Islander population, the tender document said.

The Medical Journal of Australia noted recently that the Talking About the Smokes health project from the Menzies School of Health Research indicated that the majority of Aboriginal and/or Torres Strait Islander smokers want to quit.

 

NACCHO Aboriginal Health :Dr Lesley M Russell: Analysis of Indigenous provisions in the 2015-16 Federal Budget

Aboriginal-Mobs

“Despite the need and the promises, Commonwealth funding for Indigenous Affairs as a percentage of both total outlays and GDP is in decline. And it is disconcerting to see Indigenous voices and input into decision-making being side-lined.  Indigenous groups and spokespeople have called the government on the absence of real engagement and consultation – something which has long been recognised as the key to failure or success in Indigenous affairs. “

Dr Lesley M Russell Adj Assoc Professor, Menzies Centre for Health Policy University of Sydney

It is not credible to suggest that one of the wealthiest nations in the world cannot solve a health crisis affecting less than 3 per cent of its citizens. Research suggests that addressing Aboriginal and Torres Strait Islander health inequality will involve no more than a 1 per cent per annum increase in total health expenditure in Australia over the next ten years. If this funding is committed, then the expenditure required is then likely to decline thereafter.”

Tom Calma, in his role as Aboriginal and Torres Strait Islander Social Justice Commissioner and Race Discrimination Commissioner, pointedly stated in 2008:

Notes

This work does not represent the official views of the Menzies Centre for Health Policy or NACCHO

DOWNLOAD THE FULL REPORT HERE

This analysis looks at the Indigenous provisions in the 2015-16 federal Budget. This is done in the light of current and past strategies, policies, programs and funding, and is supported, where this is possible, by data and information drawn from government agencies, reports and published papers.

Similar analyses from previous budgets are available on the University of Sydney e‐scholarship website.[1]

The opinions expressed are solely those of the author who takes responsibility for them and for any inadvertent errors.

Introduction

The 2015-16 Budget from the Abbott Government has no major announcements on Indigenous issues, and they did not rate a mention in the Treasurer’s budget night speech.

However the Budget is far from benign in its support for Indigenous programs and advocacy groups say   it has failed to undo the damage done  and anxiety caused by funding cuts in last year’s Budget.  Many programs and services must continue to operate with uncertain funding into the future and in the absence of clear strategies and policies from the Abbott Government.

This comes on top of the threat of remote community closures in Western Australia, attempts to weaken protection from racial vilification under the Racial Discrimination Act, and concerns about the implementation of and outcomes from the Indigenous Advancement Strategy (IAS) tendering process.  Indigenous organisations are losing out in the competition for funds to deliver Indigenous programs and services and after last year’s Budget cuts, there is no new funding for key representative groups such as the National Congress of Australia’s First Peoples.

Despite the need and the promises, Commonwealth funding for Indigenous Affairs as a percentage of both total outlays and GDP is in decline. And it is disconcerting to see Indigenous voices and input into decision-making being side-lined.  Indigenous groups and spokespeople have called the government on the absence of real engagement and consultation – something which has long been recognised as the key to failure or success in Indigenous affairs.

In March 2015 the Minister for Indigenous Affairs, Nigel Scullion, took delivery of ‘The Empowered Communities Report’, produced of a group of Indigenous leaders from across Australia brought together by the Jawun Indigenous Partnerships Corporation.  The report outlined ways for Indigenous communities and governments to work together to set priorities and streamline services at a regional level, in line with the Government’s approach. The Minister committed that the Government would consider carefully the report’s recommendations and respond ‘in due course’.  That has yet to happen.

What emerges most strikingly from this year’s Budget analysis is that little has been done over the past twelve months to assess the implications of commissioned reports and reviews, to capitalise on the restructure and realignment of Indigenous programs, to develop promised new policies and to roll them out.  All that has been done to date is to shift responsibility for programs to the Department of Prime Minister and Cabinet and to rebrand programs that may or may not be effective. It’s a policy-free zone, where ad hoc decisions are the norm and budgets continue to be constrained in ways that limit the effectiveness and reach of programs and services.

There are a number of examples where program funding has been provided at the expense of other needed programs – taking $11.5 million from Indigenous Safety and Wellbeing programs to reverse funding cuts to the Indigenous Legal Assistance Program is perhaps the most egregious example.

There are also concerns that proposed changes to mainstream programs such as increased co-payments and safety net threshold in health, reduced Commonwealth funding for public hospitals, increased costs for higher education, and changes to the collection of census data will have a disproportionate impact on Indigenous Australians.

Small wonder then that most Closing the Gap targets remain out of reach and the sector is struggling to keep programs functioning and retain staff.

The inequality gap between Indigenous peoples and other Australians remains wide and has not been progressively reduced. With a significant proportion of Indigenous Australians in younger age groups, and without funded commitments to actions now and into the next several decades to improve their socio-economic status, future demands for services will burgeon.

Implementation of the National Aboriginal and Torres Strait Islander Health Plan

The National Aboriginal and Torres Strait Islander Health Plan 2013-2023 was developed to provide an overarching framework which builds links with other major Commonwealth health activities and identifies areas of focus to guide future investment and effort in relation to improving Indigenous health.

On 30 May 2014 the Assistant Minister for Health, Fiona Nash, announced that an Implementation Plan would be developed for this Health Plan.

This was supposed to be available from 1 July 2015 to enable the progressive implementation of the new funding approach for the Indigenous Australian’s Health Program. The new approach will target funds to those regions whose populations experience high health need and population growth. The Budget Papers explicitly mention NACCHO as the nominated community stakeholders along with States/Territories in the development of this mechanism.

At June 2015 Senate Estimates PM&C officials said that the implementation plan was still being developed by DoH in collaboration with the National Health Leadership Forum, AIHW and PM&C. Its release was expected within a ‘short period of time’.

The Close the Gap Campaign Steering Committee believes that the Implementation Plan requires the following essential elements:

  • Set targets to measure progress and outcomes. Target setting is critical to achieving the COAG goals of life expectancy equality and halving the child mortality gap;
  • Develop a model of comprehensive core services across a person’s whole of life including end of life care with a particular focus, but not limited to, maternal and child health, chronic disease, and mental health and social and emotional wellbeing; and which interfaces with other key service sectors including, but not limited to, drug and alcohol, aged care and disability services;
  • Develop workforce, infrastructure, information management and funding strategies based on the core services model;
  • A mapping of regions with relatively poor health outcomes and inadequate services. This will enable the identification of service gaps and the development of capacity building plans, especially for ACCHS, to address these gaps;
  • Identify and eradicate systemic racism within the health system and improve access to and outcomes across primary, secondary and tertiary health care;
  • Ensure that culture is reflected in practical ways throughout Implementation Plan actions as it is central to the health and wellbeing of Aboriginal and Torres Strait Islander people;
  • Include a comprehensive address of the social and cultural determinants of health; and
  • Ensure the development and implementation of the National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Wellbeing 2014-2019 as a dedicated mental health plan for Aboriginal and Torres Strait Islander peoples, and in coordination with the implementation of the National Aboriginal and Torres Strait Islander Suicide Prevention Strategy and the National Aboriginal and Torres Strait Islander Drug Strategy.
  • Establish partnership arrangements between the Australian Government and state and territory governments and between ACCHS and mainstream services providers at the regional level for the delivery of appropriate health services.

The Health Portfolio Budget Statement says that in n 2015-16, the Government will implement a National Continuous Quality Improvement Framework for Indigenous primary health care through the expansion of the Healthy for Life activity. This will support the delivery of guideline-based primary health care and support improved health outcomes.

Health

There were no specific Indigenous issues included in the Health budget, and there are questions about the future of some programs.

Aboriginal Community Controlled Health Organisations

The Abbott Government has provided $1.4 billion /3 years ($448 million / per year) for Aboriginal Community Controlled Health Organisations (ACCHOs). This will include a 1.5% CPI increase over the 3 year period. NACCHO and Affiliate funding of $18 million is provided for 18 months and in that time DoH will commence a review of NACCHO’s role and function.[2]

NACCHO Budget Analysis HERE

In addition, NACCHO has secured confirmation of an extension of the exemption from Section 19.2  of the Health Insurance Act 1973 which expires on 30 June 2015, which enables ACCHOs to receive financial benefit from Medicare rebates in addition to Government funding.  This extension will be granted until June 2018.

The freeze on MBS rebate indexation will have a significant financial impact on ACCHOs as will any increase in Medicare and PBS co-payments.

Flexible Funds

In combination the 2014-15 and 2015-16 Budgets will cut $500 million / 4 years from 14 of the 16 DoH flexible funds.  There is still no clarity in relation to how these savings are to be achieved, although the Aboriginal and Torres Strait Islander Chronic Disease Fund will not be cut.  However cuts to other funds such as those that support the provision of essential services in rural, regional and remote Australia, that manage responses to communicable diseases and that deliver delivering substance abuse treatment services will affect  Indigenous Australians.

Aboriginal and Torres Strait Islander Chronic Disease Fund

Within the Health portfolio, the Aboriginal and Torres Strait Islander Chronic Disease Fund supports activities to improve the prevention, detection, and management of chronic disease in Indigenous Australians and to contribute to the target of closing the gap in life expectancy. The Fund consolidates 16 existing programs, including the majority of initiatives under the Indigenous Chronic Disease Package, into a single flexible fund. The three priority areas targeted are:

  • Tackling chronic disease risk factors
  • Primary health care services that can deliver
  • Fixing the gaps and improving the patient journey.

The Fund was established in the 2011 Budget and came into operation on 1 July 2011. The funding is $833.27 million / 4 years (from 1 July 2011 to 30 June 2015). The majority of funding has been directly allocated to organisations to support activities under the Fund’s Indigenous Chronic Disease Package programs.

At June 2015 Senate Estimates it was confirmed that most, but not all, of the activities under this fund were continuing.  Local community campaigns and the chronic disease self-management program were named as two programs that were not continued.

Tackling Indigenous Smoking Program

The 2014-15 Budget cut $130 million / 5 years from the Tackling Indigenous Smoking Program, despite the fact that 44% of Indigenous people smoke.    The program was reviewed in 2014 and the DoH website says that this review will “provide the Government with options to ensure the program is being implemented efficiently and in line with the best available evidence. The outcome of the review will inform new funding arrangements from 1 July 2015.” However there were no announcements in the Budget.

The redesigned program was announced on 29 May 2015, but with no increase in funding It is not clear when or if the review of this program, conducted by the University of Canberra, will be released.

Funding in 2014-15 was $46.4 million; this is reduced to $35.3 million in 2015-16.  Staffing levels have also fallen significantly, from 284 FTEs in May 2014 to 194 FTEs in May 2015. There will be further disruption to this important program as current contracts cease at the end of June 2015 and the 49 organisations that deliver the program must go through the IAS Invitation to Apply Process for further funding.  Transitional funding will be available for the next 6 months.

Australian Nurse Family Partnership Program and New Directions: Mothers and Babies Services

In the 2014-15 Budget there was additional funding for a Better Start to Life will improve early childhood outcomes :

  • $54 million expansion, from 2015-16, of New Directions from 85 to 137 sites (52 additional sites overall) to ensure more Indigenous children are able to access effective child and maternal health programs.
  • $40 million expansion, from 2015-16, of the Australian Nurse Family Partnership Program from 3 to 13 sites (10 additional sites overall) to provide targeted support to high needs Indigenous families in areas of identified need.

In 2015 the Australian Nurse Family Partnership Program will grow from three to five sites and New Directions: Mothers and Babies Services will reach an additional 25 services, bringing the total to 110 services, with an enhanced capacity to identify and manage Fetal Alcohol Spectrum Disorder in affected communities

Prevention – Shingles vaccine

The Budget provides for the listing of Zostavax vaccine for the prevention of shingles to be listed on the National Immunisation Program for 70 year olds from 1 November 2016.  This measure includes a 5-years program to provide a catch-up program for people aged 71-79.

There is concern that the 70-79 year old age cohort largely excludes Indigenous people because of their lower life expectancy.

Pharmaceutical Benefits Scheme

Close the Gap PBS Co-payment

This is an ongoing measure and although it was not mentioned in the Budget, it was stated in Senate Estimates that this would continue as currently.

QUMAX Program

The QUMAX program is a quality use of medicines initiative that aims to improve health outcomes for Indigenous people through a range of services provided by participating ACCHO and community pharmacies in rural and urban Australia. It commenced in 2008 as a two year pilot. It was later approved for a transition year outside the 4th Community Pharmacy Agreement and for a further four years under the  5th Community Pharmacy Agreement.

NACCHO and the Pharmacy Guild of Australia have been negotiating 1 year transition funding of QUMAX to enable development of an Implementation Plan under the 6th Community Pharmacy Agreement.  NACCHO will seek to expand QUMAX from 76 services to 134 services.

Medicare

MBS Practice Incentive Program (PIP) Indigenous Health Incentive

This is an ongoing program (although it may be subject to an indexation freeze).  It is expected to be considered as part of the new MBS Review.

Healthy Kids Check

The Budget cut Medicare funding for the Healthy Kids Check, a consultation with a nurse or GP to assess a child’s health and development before they start school, on the basis that this measure is a duplication with existing State and Territory based programs.  NACCHO states that this change will not impact ACCHOs or Indigenous children as ACCHOs can continue to bill health assessments through a separate item (MBS item 715).

Primary care – PHN Funding

The current transition of Medicare Locals (MLs) to Primary Health Networks (PHNs) is proceeding slowly and many details relating to specific programs remain unknown, perhaps even undecided.

To date, 21 of 61 MLs outsource the provision of services for Indigenous Australians directly to ACCHOs. The provision of these services will now move to a competitive commissioning process, leading to concerns about issues such as cultural safety and sensitivity.

The Minister for Health, Sussan Ley,  has advised NACCHO that funding for Complementary Care and Supplementary Services will transition to the PHNs.

Mental Health

The Budget has nothing that responds to the National Mental Health Commission’s review of programs and services. The report describes Indigenous mental health as ‘dire’. It’s a dominant over-arching theme throughout, and there is a recommendation to make Indigenous mental health a national priority and agree an additional COAG Closing the Gap target for mental health.

Despite this, the Government has delayed any action and has established an Expert Reference Group to develop implementation strategies.  There is no Indigenous representation on the Reference Group.

Substance and alcohol abuse  

Alcohol abuse

Alcohol abuse has been identified as a major public health concern among Indigenous people, with serious physical and social consequences. Indigenous Australians between the ages of 35 and 54 are up to eight times more likely to die than their peers, with alcohol abuse the main culprit and alcohol is associated with 40% of male and 30% of female Indigenous suicides.

Fewer Indigenous people drink alcohol than in the wider community, but those who do drink do so at levels harmful to their health. Culturally appropriate intervention approaches are needed and ‘dry zones’ are only seen as stop gap measures.

Cuts made in Flexible Funds affect drug and alcohol programs. Professor Kate Conigrave reports that there are now only 5 dedicated Indigenous drug and alcohol services nationally.

Ice campaign

This Budget commits $20 million / 2 years for a new stage of the National Drugs Campaign primarily aimed at the use of ice. No consultation has been undertaken in the lead up to the announcement of this health promotion campaign.

It almost certainly will not achieve tangible outcomes for Aboriginal people, despite concerns about a growing ice epidemic in remote Indigenous communities.

Opal fuel

There are 123 petrol stations selling Opal fuel in remote parts of Australia but some retailers in the roll-out zones don’t and there are pockets of sniffing near state borders. In December 2014 it was announced that a bulk storage tank for low-aromatic unleaded fuel (LAF or Opal ) is to be installed in northern Australia as part of the  roll-out of OPAL in the fight to curb the problem of petrol sniffing.

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REGISTRATIONS FOR 2015 NACCHO AGM and Members meeting NOW OPEN

AGM

 

NACCHO Chair Press Release: Anti smoking programs welcomed on World NO Tobacco Day

 

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Talking About The Smokes (TATS) is a model for how to do a large national epidemiological project in partnership with Aboriginal communities, the National Aboriginal Community Controlled Health Organisation (NACCHO) and the Aboriginal community-controlled health service (ACCHS) sector.
 
Research has not always been done well in or in partnership with Aboriginal and Torres Strait Islander communities, which can make undertaking research with the sector challenging.The TATS project, however, has always felt like a full and respectful partnership between the ACCHS sector and research organisations, and between Aboriginal and non-Aboriginal people. ”  

Lisa Briggs NACCHO CEO Download Report

NACCHO Talking About The Smokes Report MJA

The peak Aboriginal health organisation welcomed the Federal Government’s decision to continue investing in programs that reduce smoking in Aboriginal and Torres Strait Islander communities.
National Aboriginal Community Controlled Health Organisation (NACCHO) Chair, Matthew Cooke, said it was good news the Government had committed to fund tackling smoking programs for Aboriginal and Torres Strait Islander people.
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However, Mr Cooke said he was concerned there was no indication in the announcement of how much funding would be provided – after the Government last year cut funding for existing programs by a third – or $130 million over five years.
 “Smoking is responsible for one in every five deaths among Aboriginal and Torres Strait islander people,” Mr Cooke said.
“Smoking rates among Aboriginal people are two and a half times that of non-Indigenous Australians – 43% of Aboriginal and Torres Strait Islander people are daily smokers. In some communities that estimate is as high as 83%.
“However, a report released today shows that Aboriginal and Torres Strait Islander smokers are just as likely as other Australian smokers to want to quit and have recently tried to quit, but are less likely to make sustained attempts to quit.
“The report suggests that there are approaches that will work and that do work.
“If the Government is serious about meeting Closing the Gap targets to halve Indigenous smoking rates by 2018 we need more funding, not less – and we need to see programs that are targeted, benchmarked and tailored for Aboriginal people, run by Aboriginal people.”
Mr Cooke said health programs making the biggest gains in Closing the Gap in Indigenous health and reducing smoking rates were developed and are run by Aboriginal Community Controlled Health Organisations.
Mr Cooke welcomed the focus on performance monitoring and evaluation in the new funding round.
“Previously, the Department of Health lacked internally appropriate mechanisms to measure the success of the Tackling Tobacco Programme,” he said.
“I’m pleased the redesigned program will focus on accountability and local knowledge, allowing service provides to make decisions on how they tackle smoking in their region.”
The study, Talking About the Smokes, led by a national partnership that includes NACCHO, interviewed 522 Aboriginal and Torres Strait Islander community members in 35 locations, as well as 645 staff of local Aboriginal community controlled health services.
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INTRODUCTION FROM NACCHO CEO LISA BRIGGS

TATS

Talking About The Smokes (TATS) is a model for how to do a large national epidemiological project in partnership with Aboriginal communities, the National Aboriginal Community Controlled Health Organisation (NACCHO) and the Aboriginal community-controlled health service (ACCHS) sector.

Research has not always been done well in or in partnership with Aboriginal and Torres Strait Islander communities, which can make undertaking research with the sector challenging.

The TATS project, however, has always felt like a full and respectful partnership between the ACCHS sector and research organisations, and between Aboriginal and non-Aboriginal people. We have appreciated our involvement in all elements of the project, the clarity of the formal agreements, and the funding and support of project staff employed at NACCHO and in our member ACCHSs. Our concerns and priorities were always addressed.

The ACCHS sector recognises how important undertaking research is to reduce smoking in our communities. Because TATS has been done ethically, we can have confidence in using the evidence from this project to improve our policies and programs to reduce the damage that smoking does to our people and communities.

Lisa Briggs
Chief Executive Officer
National Aboriginal Community
Controlled Health Organisation

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NACCHO World No Tobacco Day: Nash makes major changes to Tackling Indigenous Smoking Programme

 

 

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“Tobacco smoking is the most preventable cause of ill health and early death among Aboriginal and Torres Strait Islander people,”
“Forty-four per cent of Indigenous Australians aged 15 years and over smoke; more than double the smoking rate of the general population and causes one in five Indigenous deaths. A more results focussed programme will help us reduce indigenous smoking rates.”

Minister  Fiona Nash said.

Smoking is particularly an issue for specific groups, with 42 per cent of indigenous Australian adults now daily smokers

World No Tobacco Day reports (see below)

“We know that when provided appropriately targeted information and encouraged to lead the solutions, Indigenous people are responding in an overwhelmingly positive manner.  

But, while the decline of smoking is encouraging, we need to be sure we don’t become complacent.  

The challenge to reduce smoking or not take it up is immense and will require a sustained and well-funded effort to really make a difference for our people and close the healthy inequality gap

The key message from Tom Calma National Coordinator for Tackling Indigenous Smoking

Photos above and below : The successful Programme run by the Victorian Aboriginal Health Service (VAHS) Melbourne

The Coalition Government’s redesigned Tackling Indigenous Smoking Programme will further reduce smoking in Aboriginal and Torres Strait Islander communities.

Applications from organisations who worked under the previous programme are currently being sought for the new, results based programme. Organisations who are currently funded will have funding extended during the Approach to Market process.

 

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The redesigned programme follows a University of Canberra review of the old programme. The new programme was based on the review and on discussion with experts on tobacco control in Aboriginal and Torres Strait Islander communities.

Assistant Minister for Health Fiona Nash said the redesigned programme focuses on results.

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“Tobacco smoking is the most preventable cause of ill health and early death among Aboriginal and Torres Strait Islander people,” Minister Nash said.

“Forty-four per cent of Indigenous Australians aged 15 years and over smoke; more than double the smoking rate of the general population and causes one in five Indigenous deaths.

“A more results focussed programme will help us reduce indigenous smoking rates.”

The new programme will build on the existing regional approach. Grant funding will be provided for regional activities that will reduce the number of people taking up smoking and encourage and support people to quit.

Grant funding will be provided for regional tobacco control activities, national support for workforce development, performance monitoring and evaluation, and leadership and coordination.

The redesigned programme will include a strong focus on accountability for delivering improvements in these areas.

Because local knowledge is always best, service providers will make decisions on how they tackle smoking in their region. New intensive tobacco control approaches will also be trialled through a number of pilot projects in communities with very high rates of smoking.

Funding will continue for enhancements to quit lines and training for frontline health and community workers who help Aboriginal and Torres Strait Islander smokers.

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WORLD No Tobacco Day is broadening its focus beyond health issues as Australian smoking rates reach their lowest recorded level. (From AAP) 

31 May marking of World No Tobacco Day, organised by the World Health Organisation and its partners, is also calling on countries to work together to end the illicit trade of tobacco products.

The illicit tobacco market may supply as many as one in 10 cigarettes consumed globally, studies suggest, and is a concern not just from a health view as it allows criminal groups to amass great wealth to finance other activities.

Smoking continues to be Australia’s single largest preventable cause of premature death and disease, says Assistant Minister for Health Fiona Nash. This is though daily smoking rates are the lowest ever – at 12.8 per cent for people 14 years or older, down from 17.5 per cent in 2004.

Smoking is particularly an issue for specific groups, with 42 per cent of indigenous Australian adults now daily smokers

. TOBACCO FACTS FROM WHO – Nearly six million people die each year from smoking – More than 600,000 of these are non-smokers breathing second-hand smoke – Fatality rate will grow to eight million people a year by 2030 without action – More than 80 per cent of these deaths will be among people in low- to middle-income countries

FIRST job, first love and first cigarette — while smoking rates have plunged across the state, new figures show young people are still choosing to light up.

Experts claim plain packaging, smoking bans and price increases are having a major impact, but more needs to be done to stop ­tobacco companies encouraging younger generations to start a habit.

The NSW government will today release a NSW Health population survey which reveals smoking rates have stabilised after a dramatic decline over 12 years.

The report, to be released on World No Tobacco Day, comes ahead of the ­implementation of the latest phase of the state’s smoking bans with restrictions on outdoor dining from July 6.

The figures show about one in six people in NSW were smoking last year compared with one in five in 2002.

Across the age groups, girls aged 16 to 24 years represented the biggest group of smokers and young men aged 25-34.

Smoking rates dropped in both groups from 26.8 per cent of the population in 2002 down to 16.4 per cent in 2012 before rising slightly over the past two years to 18.6 per cent.

Current smoking age by sex in NSW

AGE MALE FEMALE

16-24: 21%,16.1%

25-34: 27.7%, 14.4%

35-44: 22.6%, 13.5%

45-54 19.4%, 12.1%

55-64: 16.6%, 13.9%

65-74 8.8%, 9.4%

75+: 3.9%, 2%

All ages: 18.9%, 12.3%

Source: NSW Ministry of Health

The next biggest groups of smokers were females aged 55 to 64 years, while among men those still lighting up were aged 35 to 44 years.

Smokers tended to live in far western and south-western Sydney, with residents in the northern suburbs the least likely to have a habit.

Sydney University School of Public Health research fellow Dr Becky Freeman said most smokers tended to be young as it was historically part of the rite of passage from teenager to adulthood.

Further efforts needed to be focused on younger people who remained the key focus of clever tobacco company campaigns, she said.

Dr Freeman highlighted the Peter Stuyvesant + Loosie product, which offered the “gimmick” of an extra cigarette in its pack of 20, which appealed to cash-poor teens.

“We know plain packaging, smoking bans and price increases are working, but ­tobacco companies are still recruiting marketing people, they are still offering retailers inducements to carry their products, and they are coming up with products attractive to young people such as the Loosie,” she said.

Dr Freeman said measures to stop young people from taking up smoking could ­include regulating how many cigarette vendors there were in a suburb in the same way bottle shops were controlled.

NSW Health Minister Jillian Skinner said bans ­restricting smoking from within four metres of a pedestrian entry or exit from a hospitality venue were ­expected to be embraced by the community.

Smokers disobeying the “four metre law” will face ­on-the-spot fines of $300, with $5500 for business owners.

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NACCHO Aboriginal Health News: Overview of Australian Indigenous health status released

WADEYE ABORIGINAL CLINIC NT

The Overview of Australian Indigenous health status 2014 (Overview) has been released providing a comprehensive summary of the most recent indicators of the health of Aboriginal and Torres Strait Islander people.

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DOWNLOAD the REPORT HERE overview_of_indigenous_health_2014

The Overview shows that the health of Aboriginal and Torres Strait Islander people continues to improve slowly.

The Overview confirms that there have been declines in infant mortality rates and an increase in life expectancy. There have also been improvements in a number of areas contributing to health status such as increased immunisation coverage and a slight decrease in the prevalence of tobacco use among Indigenous people.

The Overview is an important part of the HealthInfoNet‘s translation research, which contributes to ‘closing the gap’ in health between Indigenous and other Australians by making research and other knowledge available in a form that is easily understood and readily accessible to both practitioners and policy makers.

View Website for report info

HealthInfoNet Director, Professor Neil Drew, said ‘The Overview is our flagship publication and has proved to be a valuable resource for a very wide range of health professionals, policy makers and others working in the Aboriginal and Torres Strait Islander health sector.

The Overview provides an accurate, evidence based summary of many health conditions in a form that makes it easy for time poor professionals to keep up to date with the current health status of Aboriginal and Torres Strait Islander people throughout Australia.

This year, as part of our ongoing commitment to quality improvement we have made some important changes, including a statement on the appropriate use of terminology and a commitment to enhancing a strengths based approach to understanding health issues

Key facts

Population

  • At 30 June 2014, the estimated Australian Indigenous population was 713,600 people.
  • For 2014, it was estimated that NSW had the highest number of Indigenous people (220,902 people, 31% of the total Indigenous population).
  • For 2014, it was estimated that the NT had the highest proportion of Indigenous people in its population (30% of the NT population were Indigenous).
  • In 2011, around 33% of Indigenous people lived in a capital city.
  • There was a 21% increase in the number of Indigenous people counted in the 2011 Census compared with the 2006 Census.
  • The Indigenous population is much younger than the non-Indigenous population.

Births and pregnancy outcome

  • In 2013, there were 18,368 births registered in Australia with one or both parents identified as Indigenous (6% of all births registered).
  • In 2013, Indigenous mothers were younger than non-Indigenous mothers; the median age was 24.9 years for Indigenous mothers and 30.8 years for all mothers.
  • In 2013, total fertility rates were 2,344 births per 1,000 for Indigenous women and 1,882 per 1,000 for all women.
  • In 2012, the average birthweight of babies born to Indigenous mothers was 3,211 grams compared with 3,373 grams for babies born to non-Indigenous mothers.
  • In 2012, the proportion of low birthweight babies born to Indigenous women was twice that of non-Indigenous women (11.8% compared with 6.2%).

Mortality

  • In 2006-2010, the age-standardised death rate for Indigenous people was 1.9 times the rate for non-Indigenous people.
  • Between 1991 and 2010, there was a 33% reduction in the death rates for Indigenous people in WA, SA and the NT.
  • For Indigenous people born 2010-2012, life expectancy was estimated to be 69.1 years for males and 73.7 years for females, around 10-11 years less than the estimates for non-Indigenous males and females.
  • In 2008-2012, age-specific death rates were higher for Indigenous people than for non-Indigenous people across all age-groups, and were much higher in the young and middle adult years.
  • For 2010-2012, the infant mortality rate was higher for Indigenous infants than for non-Indigenous infants; the rate for Indigenous infants was highest in the NT.
  • From 1998 to 2012, there were significant declines in infant mortality rates for Indigenous infants.
  • For 2012, the leading causes of death among Indigenous people were cardiovascular disease, neoplasms (almost entirely cancers), and injury.
  • In 2006-2010, for direct maternal deaths the rate ratio was almost 4 times higher for Indigenous women than for non-Indigenous women.

Hospitalisation

  • In 2012-13, 4.0% of all hospitalisations were of Indigenous people.
  • In 2012-13, the age-standardised separation rate for Indigenous people was 2.7 times higher than for other Australians.
  • In 2012-13, the main cause of hospitalisation for Indigenous people was for care involving dialysis, responsible for 48% of Indigenous separations.

Selected health conditions

Cardiovascular disease

  • In 2012-2013, 13% of Indigenous people reported having a long-term heart or related condition; after age-adjustment, these conditions were around 1.2 times more common for Indigenous people than for non-Indigenous people.
  • In 2012, hospitalisation rates for circulatory disease were 1.6 times higher for Indigenous people than for non-Indigenous people.
  • In 2012, cardiovascular disease was the leading cause of death for Indigenous people, accounting for 25% of Indigenous deaths.
  • In 2012, the age-adjusted death rate for Indigenous people was 1.6 times the rate for non-Indigenous people.

Cancer

  • In 2005-2009, age-adjusted cancer incidence rates were slightly lower for Indigenous people than for non-Indigenous people.
  • In 2004-2008, the most common cancers diagnosed among Indigenous people were lung and breast cancer.
  • In 2012-13, age-standardised hospitalisation rates for cancer were lower for Indigenous people than for non-Indigenous people.
  • In 2012, the age-standardised death rate for cancer for Indigenous people was 1.5 times higher than for non-Indigenous people.

Diabetes

  • In 2012-2013, 8% of Indigenous people reported having diabetes; after age-adjustment, Indigenous people were 3.3 times more likely to report having some form of diabetes than were non-Indigenous people.
  • In 2013-14, age-adjusted hospitalisation rates for diabetes for Indigenous males and females were 3 and 5 times the rates for other males and females.
  • In 2012, Indigenous people died from diabetes at 7 times the rate of non-Indigenous people.

Social and emotional wellbeing

  • In 2012-13, 69% of Indigenous adults experienced at least one significant stressor in the previous 12 months.
  • In 2012-13, after age-adjustment, Indigenous people were 2.7 times as likely as non-Indigenous people to feel high or very high levels of psychological distress.
  • In 2008, 90% of Indigenous people reported feeling happy either some, most, or all of the time.
  • In 2011-12, after age-adjustment, Indigenous people were hospitalised for ICD ‘Mental and behavioural disorders’ at 2.1 times the rate for non-Indigenous people.
  • In 2012-13, there were 16,393 hospital separations with a principal diagnosis of ICD ‘Mental and behavioural disorders’ identified as Indigenous.
  • In 2012, the death rate for ICD ‘Intentional self-harm’ (suicide) for Indigenous people was 2.0 times the rate reported for non-Indigenous people.

Kidney health

  • In 2009-2013, after age-adjustment, the notification rate of end stage renal disease was 6.2 times higher for Indigenous people than for non-Indigenous people.
  • In 2012-13, care involving dialysis was the most common reason for hospitalisation among Indigenous people.
  • In 2008-2012, the age-standardised death rate from kidney disease was 2.6 times higher for Indigenous people than for non-Indigenous people.

Injury

  • In 2012-13, after age-adjustment, Indigenous people were hospitalised for injury at nearly twice the rate for other Australians.
  • In 2012-13, the hospitalisation rate for assault was 34 times higher for Indigenous women than for other women.
  • In 2012, injury was the third most common cause of death among Indigenous people, accounting for 15% of Indigenous deaths.

Respiratory disease

  • In 2012-2013, 31% of Indigenous people reported having a respiratory condition. After age-adjustment, the level of respiratory disease was 1.2 times higher for Indigenous than non-Indigenous people.
  • In 2012-2013, 18% of Indigenous people reported having asthma.
  • In 2012-13, after age-adjustment, rates for Indigenous people were 4.4 times higher for chronic obstructive pulmonary disease, 3.3 times higher for influenza and pneumonia, 1.8 times higher for asthma, 1.8 times higher for acute upper respiratory infections and 1.4 times higher for whooping cough, than for their non-Indigenous counterparts.
  • In 2012, after age-adjustment, the death rate for respiratory disease for Indigenous people was 2.2 times that for non-Indigenous people.

Eye health

  • In 2012-2013, eye and sight problems were reported by 33% of Indigenous people.
  • In 2008, the rate of low vision for Indigenous adults aged 40 years and older was 2.8 times higher than for their non-Indigenous counterparts.
  • In 2008, the rate of blindness for Indigenous adults aged 40 years and older was 6.2 times higher than for their non-Indigenous counterparts.

Ear health and hearing

  • In 2012-2013, ear/hearing problems were reported by 12% of Indigenous people.
  • In 2012-13, the hospitalisation rate for ear/hearing problems for Indigenous children aged 0-3 years was 0.8 times lower the rate for non-Indigenous children and the rate for Indigenous children aged 4-14 years was 1.6 times higher than the rate for non-Indigenous children.

Oral health

  • In 2007-2008 in NSW, SA, Tas and the NT, Indigenous children had more dental problems than non-Indigenous children.
  • In 2004-2006, caries and periodontal diseases were more prevalent among Indigenous adults than among non-Indigenous adults.

Disability

  • In 2008, after age-adjustment, Indigenous people were 2.2 times as likely as non-Indigenous people to have a profound/core activity restriction.

Communicable diseases

  • In 2006-2010, after age-adjustment, the notification rate for tuberculosis was 12.5 times higher for Indigenous people than for Australian-born non-Indigenous people.
  • In 2011-2013, the crude notification rate for hepatitis B was 5 times higher for Indigenous people than non-Indigenous people.
  • In 2011-2013, the crude notification rate for hepatitis C for Indigenous people was 3.7 times higher for Indigenous people than for non-Indigenous people.
  • In 2007-2010, notification rates for Haemophilus influenza type b were 12.9 times higher for Indigenous people than for non-Indigenous people.
  • In 2011, the age-standardised rate of invasive pneumococcal disease was 8 times higher for Indigenous people than for other Australians.
  • In 2007-2010, the age-standardised notification rate of meningococcal disease was 2.7 times higher for Indigenous people than for other Australians; the rate for Indigenous children aged 0-4 years was 3.8 times higher than for their non-Indigenous counterparts.
  • In 2013, Indigenous people had higher crude notification rates for gonorrhoea, syphilis and chlamydia than non-Indigenous people.
  • In 2013, age-standardised rates of human immunodeficiency virus (HIV) diagnosis were 1.3 times higher for Indigenous than non-Indigenous people.
  • In some remote communities, more than 70% of young children had scabies and pyoderma.

Factors contributing to Indigenous health

Nutrition

  • In 2012-2013, less than one half of Indigenous people reported eating an adequate amount of fruit (42%) and only one-in-twenty ate enough vegetables (5%) on a daily basis.

Physical activity

  • In 2012-13, 46% of Indigenous adults met the target of 30 minutes of moderate intensity physical activity on most days.
  • In 2012-2013, after age-adjustment, 62% of Indigenous people in non-remote areas reported that they were physically inactive, a similar level to that of non-Indigenous people.

Bodyweight

  • In 2012-2013, 66% of Indigenous adults were classified as overweight or obese; after age-adjustment, the level of obesity/overweight was 1.2 times higher for Indigenous people than for non-Indigenous people.

Immunisation

  • In 2013, 93% of Indigenous children aged 5 years were fully immunised against the recommended vaccine-preventable diseases.

Breastfeeding

  • In 2010, breastfeeding initiation levels were similar among Indigenous and non-Indigenous mothers (87% and 90% respectively).

Tobacco use

  • In 2012-13, 44% of Indigenous adults were current smokers; after age-adjustment, this proportion was 2.5 times higher than the proportion among non-Indigenous adults.
  • Between 2002 and 2013, there has been a decline in the number of cigarettes smoked daily among Indigenous people.
  • In 2011, 50% of Indigenous mothers reported smoking during pregnancy.

Alcohol use

  • In 2012-13, 23% of Indigenous adults abstained from alcohol; this level was 1.6 times higher than among the non-Indigenous population.
  • In 2012-2013, after age-adjustment, lifetime drinking risk was similar for both the Indigenous and non-Indigenous population. In 2008-10, after age-adjustment, Indigenous males were hospitalised at 5 times and Indigenous females at 4 times the rates of their non-Indigenous counterparts for a principal diagnosis related to alcohol use.
  • In 2006-2010, the age-standardised death rates for alcohol-related deaths for Indigenous males and females were 5 and 8 times higher respectively, than those for their non-counterparts.

Illicit drug use

  • In 2012-13, 22% of Indigenous adults reported that they had used an illicit substance in the previous 12 months.
  • In 2005-2009, the rate of drug-induced deaths was 1.5 times higher for Indigenous people than for non-Indigenous people.

 

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NACCHO smoke free news: Aboriginal smoking program cuts risk widening the gap

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Tobacco use is the leading cause of preventable disease and early death among Indigenous Australians, with smoking responsible for about one in every five deaths.

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Among Indigenous Australians, tobacco use contributes to 80% of all lung cancer deaths, 37% of heart disease, 9% of all strokes and 5% of low birth-weight babies. And in central Australia, rates of pneumonia among children are reported to be the highest in the world, reaching 78.4 cases per 1,000 children every year.

Although we are seeing reductions in smoking rates across Australia, 42% of Aboriginal and Torres Strait Islander (TSI) people are daily smokers, compared to 16% in the non-Indigenous population. In some remote communities this estimate is as high as 83%.

Smoking is also higher among vulnerable groups: up to two-thirds of Indigenous women continue to smoke during pregnancy, and around 39% of young people aged 15 to 24 years are smoking daily.

You’d think governments would be redoubling their efforts to address the problem. Not so. In fact, the Australian government has recently announced funding cuts of A$130 million over five years to the Tackling Indigenous Smoking program, which amounts to more than one-third of the program’s annual funding.

Tackling Indigenous Smoking funds teams of six health workers to run tailored anti-smoking programs. Each is designed with input and involvement from each community and employ local quit-smoking role models who help other smokers quit by offering advice and support.

Benefits of quitting

We know that quitting smoking reduces the risks of heart disease, lung cancer and other smoking-related issues.

But there are also significant benefits for the health-care system and Australian longer-term budget’s. A recent South Australian study led by Professor Brian Smith, for instance, helped smokers to quit while in hospital and found a direct saving to the hospital budget of A$6,646 per successful quitter within just 12 months.

Another study estimated that the economic impact from just an 8% reduction in the prevalence of tobacco smoking in Australia would result in 158,000 fewer incident cases of disease, 5000 fewer deaths, 2.2 million fewer lost working days and 3000 fewer early retirements. Overall, an 8% reduction in smoking would reduce health sector costs by AU$491 million.

Assessing and funding what works

One of the complicating factors is that the success of Indigenous anti-smoking programs has been patchy. A review I recently published in the Cochrane Collaboration found significant shortcomings for Indigenous quit smoking and youth tobacco prevention programs.

Only one quit smoking study, which was performed in the Northern Territory by Dr Rowena Ivers, met the quality criteria. Dr Ivers’ study found that free nicotine patches might benefit a small number of Indigenous smokers. But none of the study participants completed the full course of nicotine patches and only seven people from the original total of 111 reported that they had quit smoking at six months.

This study suggests programs using nicotine patches can help Indigenous smokers to quit. But much more evidence is needed to determine what options really are the most effective.

Likewise, another review of tobacco prevention programs among young people found potentially harmful results, with one of the three identified studies showing lower smoking rates in the control population. This means that children who received the tailored tobacco prevention program did worse than the youth in the control group who received nothing at all.

It is important to continue evaluating Tackling Indigenous Smoking programs so we know whether or not they work and can direct funding to programs that make a difference. So it’s concerning that part of the funding that is being cut from the budget relates to reviewing these programs.

A long way to go

Five years into the Tackling Indigenous Smoking project, the government has invested a substantial amount of time and money into developing these culturally-tailored programs. Preliminary data released by the government in April found a 3.6% fall in Indigenous daily smoking rates between 2008 and 2013 and a reduction in smoking during pregnancy of 3%.

But cutting resources will make it impossible to meet the program’s ambitious goal of halving Indigenous smoking rates by 2018.

There is still a long way to go. Research shows many health-care workers and some doctors who treat smokers do not believe they have the skills or ability to offer effective preventive health advice. Worryingly, they also admit to the attitude of “even if I did, it’s not going to work, so why bother”.

This response tells us that much more work and subsequently funding is needed to really address the health gaps that remain between Indigenous and non-Indigenous Australians. Tobacco use will remain a problem within our society for as long as we continue to allow it to be one.

NACCHO Aboriginal health :Cats give healthy living message a kick forward

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Travis Varcoe chats with Warrnambool’s Fiona Clarke at the Gunditjmara co-operative’s health Centre yesterday.

EATING healthy can become an empty message — unless you’re hearing it from Geelong midfielder Travis Varcoe.

Warrnambool’s Gunditjmara Aboriginal Co-operative’s health clinic yesterday enlisted visiting Geelong players to help it target obesity and smoking.

Varcoe, Hamish McIntosh, Joel Hamling and Brad Hartman shared their health and fitness knowledge with a small indigenous audience.

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All four said they dreamt of playing at the top level from a young age, leaving no place for poor diet or smoking.

“(Footy) is a great driving tool — we could stand there and bat on about healthy eating and get a lot more out of it than a teacher trying to get the same message across,” Varcoe said.

“You don’t realise until you get out there how much joy footy does for people.

“It’s great for us Aboriginal boys to get out here and just meet the community and share a bit of our knowledge with them.”

Co-operative active lifestyle and tobacco action worker Ken Brown said football was a good way to target health changes in young people.

“It’s all ages but it’s starting with the younger ages because teenagers are smoking younger now,” Mr. Brown said.

“Having these blokes here is a big bonus but it is hard. It’s not a quick fix.

“Hopefully we can get it through that smoking will kill you.”

s.mccomish@fairfaxmedia.com.au

You can hear more about Aboriginal health and Close the Gap at the NACCHO SUMMIT

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The importance of our NACCHO member Aboriginal community controlled health services (ACCHS) is not fully recognised by governments.

The economic benefits of ACCHS has not been recognised at all.

We provide employment, income and a range of broader community benefits that mainstream health services and mainstream labour markets do not. ACCHS need more financial support from government, to provide not only quality health and wellbeing services to communities, but jobs, income and broader community economic benefits.

A good way of demonstrating how economically valuable ACCHS are is to showcase our success at a national summit.

SUMMIT WEBSITE FOR MORE INFO

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NACCHO Healthy Futures Summit Melbourne 24-26 June 2014 : Invitation to submit abstracts

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On behalf of the NACCHO Board and Secretariat it is my pleasure to invite you to submit an abstract to the NACCHO Healthy Futures Summit at the Melbourne Convention and Exhibition Centre 24-26 June 2014.

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ALL ABSTRACTS MUST BE SUBMITTED VIA THE ABSTRACT PORTAL

The importance of our NACCHO member Aboriginal community controlled health services (ACCHS) is not fully recognised by governments.

The economic benefits of ACCHS has not been recognised at all.

We provide employment, income and a range of broader community benefits that mainstream health services and mainstream labour markets do not. ACCHS need more financial support from government, to provide not only quality health and wellbeing services to communities, but jobs, income and broader community economic benefits.

A good way of demonstrating how economically valuable ACCHS are is to showcase our success at a national summit.

SUMMIT WEBSITE FOR MORE INFO REGISTER

NACCHO would like to demonstrate to the government at this summit how investing more in ACCHS is the best way of promoting better health more employment, more jobs and greater community economic benefits.

ABSTRACT SUBMISSIONS ONLINE

NACCHO Healthy futures Summit-Melbourne 24-26 June 2014

NACCHO invites abstracts submission from its members the Aboriginal Community Controlled Health Organisations, Affiliates and key stakeholder organisations to showcase policy frameworks, best practice and investment in Aboriginal Health.

The delegates will be a representation from all over Australia in clinical practice, policy and research.

IMPORTANT DATES

Call for Abstracts open 25 February
All Abstracts Due 21 Mar 2014
Abstract Notifications 4 April 2014
Presenter Registration Due 18 April 2014
Early bird registrations open 25 February 2014
Early-Bird registrations Closes 18 April 2014
Program released 4 April 2014
Exhibition and sponsorship 16 May 2014
NACCHO 2014 Summit 24 -26 June 2014

Program Streams

1.Economic Development

  • Economic models of investment  into Aboriginal Community Controlled Health Organisation
  • Economic models of investment through partnership
  • Income generation through Aboriginal Community Controlled Health Organisations
  • Brokerage Modelling with Aboriginal Community Controlled Health Organisation

2.Health Reform

2.1 Workforce

Abstract that demonstrates best practice within Aboriginal Community Controlled Health Organisations, Affiliates and key stakeholders that reflect these themes:

  • National, State, Regional and Local Workforce Needs Analysis
  • Models of success
  • Recruitment and Retention Strategies
  • Mentoring Programs
  • Workforce Innovation Partnership
  • Career pathways that incorporate Scope of Practice within ACCHO’s

2.2 Continuous Quality Improvement

  • Affiliate Registered Training Organisations Capacity Building of ACCHO’s through scope of practice
  • Accreditation
  • Clinical Standards

3.Healthy Futures

Abstract that demonstrates best practice within Aboriginal Community Controlled Health Organisations, Affiliates and key stakeholders that reflect these themes:

  • Clinic Practice/frontline servicing
  • Mental Health
  • Social Emotional Wellbeing
  • Drug & Alcohol
  • Mums & Babies
  • Women’s Health
  • Men’s Health
  • Oral Health
  • Aged Care
  • Disabilities
  • Adolescent
  • Sexual Health

4.Youth

Abstract that demonstrates best practice within Aboriginal Community Controlled Health Organisations, Affiliates and key stakeholders that reflect these themes:

  • Investment in Youth by Aboriginal Community Controlled Health Organisations
  • Career pathways within an ACCHO, Affiliates and key stakeholders
  • Youth Leadership
  • Mentoring
  • Healthy Lifestyles and Youth
  • Health Promotion Strategies

5.Research & Data

Abstract that demonstrates best practice within Aboriginal Community Controlled Health Organisations, Affiliates and key stakeholders that reflect these themes:

  • Population Health
  • Best practice models
  • Gap and Needs analysis
  • Research within Aboriginal Community Controlled Health Organisations
  • Research Partnerships
  • Health Information
  • Importance of Data
  • Cultural protocols into practice
  • What’s the Aboriginal Community Controlled Health Data telling us?

General guidelines for submissions

  • Abstracts will only be accepted by submitting through the online process below .
  • Abstracts must be a maximum of 300 words .
  • All abstracts must be original work.
  • The abstract will contain text only; no diagrams, illustrations, tables or graphics.
  • All presenting authors must register and pay for their registration for the conference by 18 April 2014 otherwise the presentation will be removed from the program.
  • The NACCHO advisory group reserves the right to accept and reject abstracts for inclusion in the program and allocate to a format that may not have been initially specified by the author/presenter.
  • The conference organisers will not be held responsible for submission errors caused by internet service outages, hardware or software delays, power outages or unforeseen events.
  • It is the responsibility of the presenting author to ensure that the abstract is submitted correctly. After an author has submitted their abstract, they should check their abstract was uploaded successfully.
  • All authors will receive notification of the outcome of their submission on 4 April 2014.
  • Responsibility for the accuracy of abstracts rests with the author.
  • Where there are co-authors, only one abstract is to be submitted. The presenting author is responsible for ensuring the co-authors agree with and are aware of the content before submitting the abstract.
  • An abstract which does not adhere to these requirements will not be accepted

ALL ABSTRACTS MUST BE SUBMITTED VIA THE ABSTRACT PORTAL

For further information contact the NACCHO SUMMIT TEAM 02 6246 9300 or EMAIL

NACCHO Aboriginal health research:Ten key principles relevant to Aboriginal health research

Male Health Summit - Ross River Resort - July 2013

Implementing any research methodology among Indigenous Australian groups will work best when the following 10 principles are met. These principles are reflected in the many documents related to working and researching with Indigenous Australians; for example, the National Health and Medical Research Council (NHMRC) ethical guidelines for research among Aboriginal and Torres Strait Islander people. In this article, we set out these principles in one short, accessible document

Working with Indigenous communities towards research that is relevant, effective and culturally respectful

Lisa M Jamieson, Yin C Paradies, Sandra Eades, Alwin Chong, Louise Maple-Brown, Peter Morris, Ross Bailie, Alan Cass, Kaye Roberts-Thomson and Alex Brown

Picture above Remote communities Male Health Summit Ross river 2013

As published in the MJA

Writing in the Journal about Indigenous health in 2011, Sir Michael Marmot suggested that the challenge was to conduct research, and to ultimately apply findings from that research, to enable Indigenous Australians to lead more flourishing lives that they would have reason to value. As committed Indigenous health researchers in Australia, we reflect Marmot’s ideal – to provide the answers to key questions relating to health that might enable Indigenous Australians to live the lives that they would choose to live.

As a group, we have over 120 collective years experience in Indigenous health research. Over this time, particularly in recent years as ethical guidelines have come into play, there have been many examples of research done well. However, as the pool of researchers is constantly replenished, we hold persisting concerns that some emerging researchers may not be well versed in the principles of best practice regarding research among Indigenous Australians populations.

Implementing any research methodology among Indigenous Australian groups will work best when the following 10 principles are met. These principles are reflected in the many documents related to working and researching with Indigenous Australians; for example, the National Health and Medical Research Council (NHMRC) ethical guidelines for research among Aboriginal and Torres Strait Islander people. In this article, we set out these principles in one short, accessible document.

ESSENTIAL PRINCIPLES

 1.Addressing a priority health issue as determined by the community

No group is more aware of the health inequalities between Indigenous and non-Indigenous Australians than Indigenous Australians themselves. Researchers need to work in close partnership with the community so that their own objectives and ideas do not mask the community’s own priority areas. This will require both parties to learn how to work together to manage potentially conflicting agendas, including differences in priority perceptions, community politics and interpretation of findings. The communities and participants need to be engaged as equal partners in all phases of the research process with a flexible agenda responsive to broader environmental demands.

2.Conducting research within a mutually respectful partnership framework

An open and transparent relationship with key community groups is critical to the success of implementing research projects among Indigenous Australians. This can be neither rushed nor faked. Indigenous communities are more likely to embrace working with researchers with whom they have an established rapport than with someone unfamiliar, regardless of the eminence of the researchers, sophistication of the study design or amount of funding available. Researchers should ideally have a commitment to continuing to work with a given Indigenous group (especially if reasonably secure employment opportunities might be possible) following cessation of the study.

In addition, within any given community it is vital to identify key champions for the study and those who are likely to block access. The team of champions might take months or years to foster but their involvement will make an enormous difference in peoples willingness to enrol in and continue with the study. We have learnt (sometimes the hard way) the importance understanding the local “lay of the land” in terms of governance and in working hard to foster open and trusting relationships with those whose support the study’s success will rely on.

3.Capacity building is a key focus of the research partnership, with sufficient budget to support this

Investigators must have a commitment to employ Indigenous staff and provide opportunities for such staff to continue and develop their research careers if at all possible. As well as allowing capacity building of Indigenous staff, this will create substantial learning opportunities for non-Indigenous staff, this will create substantial learning opportunities for non-Indigenous personnel. Different models of employing Indigenous staff may be required in different situations, and partnering with Aboriginal controlled health services can be critical.

Many projects are underfunded. Personnel costs are high and staff turnover might be excessive, more time than anticipated might be required for community engagement, trips may need to be rescheduled, it may take much longer to recruit and unforeseen circumstances (eg, cultural – based delays to the study) are almost certainly guaranteed. It can be difficult to achieve the desired sample size when undertaking research with Indigenous Australians. These issues are not unique to Australia, with other investigations involving Indigenous populations internationally also having been abandoned due to recruiting difficulties. Researchers need to be realistic about these well documented difficulties when planning budgets.

4.Flexibility in study implementation while maintaining scientific rigour

Flexible study implementation may relate to issues such as the need to adjust the planned geographic location, modify eligibility criteria while maintaining scientific rigour, or revise the study protocol based on community feedback. In the United States, many intervention studies among the Native American population have reported no effects, when in fact the lack of results stemmed from poor implementation of the intervention rather than from shortcomings in the intervention itself.

Researchers have suggest that future interventions should “place greater emphasis on the involvement of community members and organizational leaders in the development and implementation of intervention” and that “community –based approach is key to sustainability and acceptability”.

5.Respecting communities past and present experience of research

On one level, the history of Australia’s Indigenous populations – involving forced policies of assimilation, imposed removal of children, profound and sustained social disadvantage, and dislocation from mainstream life – needs to be recognised. In the context of research Indigenous Australians past experience of involvement in research needs to be understood when conducting community consultation in order to foster support and trust. Researchers also have to be ready for communities to say “no” at any point during a study/

Finally, communities have a right to expect that if they agree to be involved in research, it will be of sufficiently high quality and rigour to generate meaningful results and change health outcomes.

Desirable principles

6.Recognising the diversity of Indigenous Australian populations

Although Australia’s Indigenous population represents a small proportion of the total population (2.6% in the 2006 Census), there is great heterogeneity among the many Indigenous groups. This diversity is not such an issue when studies are based within a localised geographic area (although even in small geographic areas the differences may be greater than appreciated), but needs to be carefully planned for when implementing research (such as national population-level surveys) that may include many different language and culturally distinct groups.

7.Ensuring extended timelines do not jeopardise projects

In our collective experience, timelines for conducting research with Australian Indigenous groups sometimes need to be extended. Reasons include delays in obtaining ethical approvals (many studies require formal approval from Aboriginal human research ethics committees, which frequently require written letters of support from key Indigenous stakeholder groups); delays and interruptions to community consultation sessions; delays to interviewing and employing local community members as staff ; unforeseen community – based events (eg, funerals community meetings, council or health service instability).

The need for longer recruitment times’ unforeseen weather events; and difficulties in securing appropriate travel and accommodation. In addition, the myriad demands placed on Indigenous communities and their members require research to “wait its turn”. Projects that have run on time and within budget have usually taken account of these challenges in the planning stages.

8.Preparing for Indigenous leadership turnover

Leadership turnover among key Indigenous stakeholder groups can be high. This occurs at both high-end governance and grassroot community levels. There is enormous, often unreasonable, pressure placed on many Indigenous Australians in leadership, both from within their own communities and from mainstream structures.

Non-Indigenous researchers would do well to anticipate this in advance rather than rely on a small number of key Indigenous leaders to promote and advocate their study. Indigenous advisory committees are invaluable in offering further advice on this issue, as are local Aboriginal ethics committees and community – controlled health organisations. Maintaining close and trusting relationships with a number of local Indigenous leaders (and recognising that these may take years to establish) may help researchers prepare for such occurrences.

9.Supporting community ownership

In the past, the rights interests and concerns of Indigenous participants were frequently ignored by non-Indigenous participants were frequently ignored by non-Indigenous researchers. We now know that the sustainability of research projects is achieved only when there has been substantive community input and ownership.

From the outset, research projects need to be directed by the relevant Indigenous communities, by forming Indigenous advisory committees where possible, and by researchers constantly reviewing their study goals ideal, membership of advisory or steering committees can place a substantial burden and expectation on the relatively small number of people who have the time, interest and skills to sit on them, If it is not possible to form such a committee, the role of Indigenous staff and Indigenous community members becomes even more critical.

10. Developing systems to facilitate partnership management in multicentre studies

Investigations involving Indigenous Australians are becoming increasingly multicentre, both within Australia and with International collaborators. Ensuring that equitable and transparent processes are in place for managing partnerships, community engagement and recruitment, ethics, intervention implementation, use of new technologies, and compliance with privacy requirements is critical for the wellbeing of both study participants and the wider research community.

CONCLUSION

These 10 principles should be considered from the initial design stage of the project, ideally when consulting with the community and writing funding applications”

This may have policy implications for funding bodies, as substantially more funding will likely be necessary to ensure that specific principles can be followed – eg, regarding capacity building (3) and extended timelines (7). Application of the principles should not affect the accurate reporting of trials using tools such as the Consolidated Standard of Reporting Trials. The principles support, and could be considered in harmony with existing NHMRC ethics guidelines.

Most of the principles have been reported before with respect to research involving marginalised peoples, Indigenous Australians, other Indigenous peoples and the general population. They should also be seen in their broad context – We believe that the 10 principles are relevant to all Indigenous health- related research. If considered, they may, in a small way, help research projects among Indigenous Australians be implemented in the most effective and culturally respectful way possible.

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NACCHO health alert: Report documents Aboriginal people are 50 per cent more likely to die from cancer than other Australians

Cancer

Cancer in Aboriginal and Torres Strait Islander peoples of Australia: an overview is one of a series of reports commissioned by Cancer Australia and developed in collaboration with the Australian Institute of Health and Welfare.

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Report

This report provides, for the first time, a comprehensive summary of population-level cancer statistics across a number of states and territories in Australia for Aboriginal and Torres Strait Islander peoples alongside comparative figures for non-Indigenous Australians

. It aims to document key cancer statistics to inform health professionals, policy makers, health planners, educators, researchers and the broader public of relevant data to understand and work towards reducing the impact of cancer for Indigenous Australians.

On average, per day, around two Aboriginal and Torres Strait Islander people are diagnosed with cancer and there is just over one cancer-related death.

Somokes

Importantly, this report identifies significant differences between Indigenous Australians and their non-Indigenous counterparts. While incidence rates for cancer overall were marginally higher for Indigenous peoples, mortality and survival differences between the two population groups were more marked with cancer mortality rates 1.5 times higher and survival percentages 1.3 times lower for Aboriginal and Torres Strait Islander peoples.

This report also looks at the 10 most commonly diagnosed cancers as well as the 10 most commonly reported causes of cancer deaths for Aboriginal and Torres Strait Islander peoples of Australia, accounting for over 60% of cancers in these groups. Lung cancer was both the most commonly diagnosed cancer and the leading cause of cancer deaths for this population group. Differences between gender and across age groups are also identified.

Transcript of the ABC interview:

In a recent interview on ABC’s , Mark Colvin discussed findings from the Australian Institute of Health and Cancer Australia which indicates that Indigenous people are 50 per cent more likely to die from cancer than other Australians.

MARK COLVIN: It may be the most deadly reality of closing the gap: Indigenous people are 50 per cent more likely to die from cancer than other Australians. And that’s just one of the shocking findings contained in a new report from the Australian Institute of Health and Welfare and Cancer Australia. It’s the first comprehensive investigation into increased cancer rates among Indigenous Australians.

MANDIE SAMI: Cancer in Aboriginal and Torres Strait Islander Peoples of Australia: An Overview is the first comprehensive summary of cancer statistics for Indigenous Australians.

The head of the Australian Institute of Health and Welfare’s cancer and screening unit, Justin Harvey, says the report reveals disturbing facts.

JUSTIN HARVEY: Indigenous Australians are approximately 50 per cent more likely to die from cancer than non-Indigenous Australians and that’s quite a big difference between the two. The rate of new cases for Indigenous Australians is also higher and survival from cancer is poorer.

MANDIE SAMI: Kristin Carson is the chair of the Indigenous Lung Health working party for the Thoracic Society of Australia and New Zealand. She says it’s sad that she’s not shocked by the findings.

KRISTIN CARSON: This is something that has been going on for such a long time. I mean, we know that there is a disparity in health between Indigenous and non-Indigenous Australians. It’s actually atrocious.

A lot of Aboriginal and Torres Strait Islander Australians who see this probably already know it. They live this. This is the reality and I guess it’s these types of more shocking statistics that bring the kind of problems that we’re having to light.

MANDIE SAMI: The CEO of Cancer Australia, Professor Helen Zorbas, says there are a number of reasons why there’s such a huge discrepancy between Indigenous and non-Indigenous Australians.

HELEN ZORBAS: Those factors definitely include tobacco smoking, alcohol consumption, poor diet, lower levels of physical activity and higher levels of infections such as hepatitis B. In addition to that, Indigenous peoples are less likely to participate in screening programs.

Also, the proportion of Indigenous people who live in regional and rural and remote areas is higher than for non-Indigenous people and therefore access to care and services – we have a higher proportion of Indigenous people who discontinue treatment.

MANDIE SAMI: The head of the Institute’s cancer and screening unit, Justin Harvey, says even the types of cancer most prevalent among Indigenous Australians are different.

JUSTIN HARVEY: In terms of the most commonly diagnosed cancers for Indigenous Australians, these were lung cancer, followed by breast cancer in females and bowel cancer. Whereas for non-Indigenous Australians, the most commonly diagnosed were prostate cancer, followed by bowel cancer and breast cancer in females.

MANDIE SAMI: Mr Harvey says the report shows there needs to be more health promotion campaigns and services targeting Indigenous Australians.

JUSTIN HARVEY: The most important thing is that the information is used in looking at what are the needs and how best to address those needs.

MANDIE SAMI: That call has been backed by Kristin Carson. She says there’s also a need to evaluate whether current campaigns like these are working.

ACTOR, ANTI-SMOKING AD: I was smoking but I quit. If I can do it, I reckon we all can.

ACTOR 2, ANTI-SMOKING AD: Not quitting is harder.

MANDIE SAMI: Ms Carson says all Australians have a moral obligation to ensure that improving the health of Indigenous Australians is a national priority.

KRISTIN CARSON: Talk with community members, find out what we should be doing, and again, it highlights that we really need to be looking at research or evaluations in this area to try and better address this problem.

MANDIE SAMI: Associate Professor Gail Garvey is a senior researcher in cancer and Aboriginal and Torres Strait Islander Health at the Menzies School of Health.

She hopes the findings will make policymakers realise the devastating effect cancer is having on Indigenous populations.

GAIL GARVEY: Other areas, you know, such as cardiovascular disease, diabetes, kidney disease, which are all very important in their own right, tend to get the sort of focus, where cancer has just been sort of creeping behind all the other illnesses and diseases thus far.

So I think this report will give us a chance and give governments and health professionals and communities an opportunity now to actually look at what’s happening, you know, in black and white in this report, what’s happening nationally. And hopefully we can do something more about it than what’s currently being done.

MARK COLVIN: Associate Professor Gail Garvey, ending Mandie Sami’s report

For more information visit the ABC’s 2pm website

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