NACCHO #HealthElection16 : Labor policy on CLOSING THE GAP IN INDIGENOUS HEALTH released

 No 5 Deadly Choices

“A Shorten Labor Government will make a major commitment to preventive health strategies for Indigenous Australians, helping to close the shameful gap in chronic disease and life expectancy with non-Indigenous Australians.

Despite improvements in some areas of Indigenous health, an Aboriginal or Torres Strait Islander person born today can still expect to live an average of ten years less than other Australians. The burden of ill health among Aboriginal and Torres Strait Islander people is two-and-a-half times higher than that of other Australians.”

Full detail Indigenous Health Policy here

http://www.100positivepolicies.org.au/indigenous_health_fact_sheet

In large part this is due to the higher incidence of chronic diseases such as diabetes, cardiovascular disease, respiratory disease and kidney disease. Much of this is preventable.

This is not acceptable. It is a national shame – it is time to do more.

In addition to Labor’s investments in Medicare and affordable medicine for all Australians, Labor will invest in tailored, culturally-appropriate health programs aimed at preventing chronic disease for Indigenous people

Deadly Choices

Empowering Indigenous Australians to make their own healthy lifestyle choices is the first and most important step to improving health outcomes.

Deadly Choices is an initiative of the Institute of Urban Indigenous Health (IUIH) that aims to encourage Aboriginal and Torres Strait Islander people to improve their own and their families’ health by improving their diet, exercising regularly and quitting smoking. It has been running in South East Queensland since 2011 with great success.

A Shorten Labor government will provide $5.5 million a year per year to partner with the IUIH in rolling out Deadly Choices across the country.

Elements of the roll-out will include:

 National campaigns to promote positive health and lifestyle choices.  Partnerships with sporting organisations and sporting ambassadors.  Training and licensing for State and Territory affiliates.  Local Deadly Choices coordinators. Aboriginal and Torres Strait Islander Kidney Health Taskforce

Aboriginal and Torres Strait Islander people are more than twice as likely as other Australians to have indicators of chronic kidney disease. The incidence of end-stage kidney disease for Aboriginal and Torres Strait Islander people is especially high in remote and very remote areas, where treatment such as dialysis is not often readily available.

The patient pathway for Aboriginal and Torres Strait Islander kidney patients is often confusing, fragmented, isolating and burdensome.

A Shorten Labor government will convene a National Taskforce on Aboriginal and Torres Strait Islander kidney disease as a priority to look for holistic solutions to the current crisis. In particular, it will address coordination of the complex and fragmented health and social supports for Aboriginal and Torres Strait Islander families affected by kidney failure.

The Taskforce will bring together experts in Indigenous health, kidney disease, General Practice, health systems, consumer representation and the NGO sector to develop strategies in prevention, early identification, management, treatment and transplantation.

A Shorten Labor government will commit $295,000 to the National Kidney Health Taskforce.

Improving Indigenous eye health

Aboriginal and Torres Strait Islander adults are six times more likely to suffer from blindness. Shockingly – in a first world country such as Australia – 94 per cent of this vision loss is either preventable or treatable.

If this were addressed, it would alone account for an 11 per cent improvement in health outcomes between Aboriginal and Torres Strait Islander people and other Australians.

Australia is the only developed nation where the infectious and wholly preventable eye disease trachoma still exists at endemic levels, and it only exists among Aboriginal and Torres Strait Islander people.

There are some basic steps to take that would help to improve this situation. Around 35 per cent of Aboriginal and Torres Strait Islander adults have never had an eye exam.

We can eliminate trachoma from Australia by 2020 if we give this problem the attention it is due.

A Shorten Labor government will invest $9.5 million to close the gap in Aboriginal and Torres Strait Islander vision loss.

This will go toward increasing visiting optometry services, supporting specialist ophthalmology services, and investing in trachoma prevention activities recommended by the World Health Organisation.

Protecting Medicare

Only Labor will protect Medicare, ensuring universal and affordable healthcare is available to all Australians.

Labor’s three-part pledge on Medicare includes:

 Protecting bulk-billing by abolishing Malcolm Turnbull’s GP Tax by stealth.  Keeping medicines affordable by scrapping the Liberals’ price hikes.  Legislating to protect Medicare from creeping privatisation.

Only Labor cares about our health system for all Australians, and addressing the long-standing injustice of poor health outcomes for Indigenous Australians.

We must do everything we can to accord Aboriginal and Torres Strait Islander peoples the most fundamental right of all: the right to grow old.

FULL DETAILS

Despite improvements in many areas of Indigenous health, there remain significant health and life expectancy gaps between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians.

According to the most recent Close the Gap report, there is some good news.

Since 1998, Indigenous child mortality rates have declined and the target to halve the gap in child mortality by 2018 is on track.

Similarly, Indigenous mortality rates have declined by 16 per cent since 1998, although we are not currently on track to meet the target of halving the life expectancy gap by 2031.

Sadly, an Aboriginal or Torres Strait Islander person born today can still expect to live an average of ten years less than other Australians.

Whilst there have been improvements in health care access amongst Indigenous Australians, in some other areas things are either not improving, or they are getting worse. Indigenous cancer mortality rates, for example, are rising and the gap is widening.

Labor is committed to meeting the Close the Gap targets that we set in Government, and improving health outcomes for Aboriginal and Torres Strait Islander Australians.

But it is clear that there is still a lot more to do.

In addition to Labor’s investments in Medicare and affordable medicine, a Shorten Labor Government will continue to invest in tailored, culturally appropriate health programs aimed at improving the lives of Indigenous Australians around the country.

The burden of poor health for Indigenous Australians

Aboriginal and Torres Strait Islander people experience a higher burden of ill health – two and a half times that of other Australians.

This is due in large part to the higher incidence of chronic diseases such as diabetes, cardiovascular disease, chronic respiratory disease and chronic kidney disease.

Preventable chronic diseases are major contributors to the health equality gap:

  • Cardiovascular disease is the largest contributor to the gap in life expectancy between Aboriginal and Torres Strait Islander people and other Australians, accounting for almost one quarter (24 per cent) of the gap.
  • Aboriginal and Torres Strait Islander adults are 3.5 times more likely than non-Indigenous adults to have diabetes and are twice as likely to have signs of chronic kidney disease.
  • In remote areas, Aboriginal and Torres Strait Islander peoples are six times as likely to have diabetes and five times as likely to have chronic kidney disease as other Australians. [1]

These diseases appear earlier, progress faster and cause more premature death in Aboriginal and Torres Strait Islander people than non-Indigenous people.

These chronic diseases share many common risk factors including poor quality diet, physical inactivity, smoking and obesity.

They are also preventable.

Addressing risk factors reduces the risk of onset of the disease, as well as positively impacting the progression of the disease and reducing health complications.

Labor understands that we will not close the gap in health equality if we do not empower and support Aboriginal and Torres Strait Islander people to make good decisions about their own health.

Effort must be focused on improving health education, access and awareness early in life to encourage healthy choices that promote good health and reduce the risk of chronic disease

Deadly Choices

A Shorten Labor Government will partner with the Institute of Urban Indigenous Health (IUIH) to roll out the successful Deadly Choices program across the country.

Deadly Choices is an initiative of the IUIH in South East Queensland that aims to encourage Aboriginal and Torres Strait Islander peoples to improve their own and their families’ health by eating nutritional food, exercising regularly and giving up smoking.

The program is a school and community based chronic disease prevention and education initiative aimed at Aboriginal and Torres Strait Islander people aged 10 years and over.

Deadly Choices has been implemented across South East Queensland since 2011, reaching young people aged between 13 and 18 years of age. It has been delivered in a variety of settings, including a men’s group at an Aboriginal health service and a youth detention centre.

The IUIH would lead the expansion of the Deadly Choices program to other regions across the country.

The Deadly Choices crew have developed a series of television ads featuring well known rugby league players to promote healthy lifestyles and make positive lifestyle choices.

Elements of the program expansion include:

  • National campaigns to promote positive health and lifestyle choices.
  • Partnerships with sporting organisations and sporting ambassadors.
  • Training and licensing for State and Territory affiliates.
  • Local Deadly Choices coordinators.

Deadly Choices has proven results. Its innovative approach to increasing community engagement with local health services has facilitated the uptake of health checks for young people in the program.

Labor will provide $5.5 million a year for four years to roll out this program around Australia.

Aboriginal and Torres Strait Islander Kidney Health Taskforce

A Shorten Labor Government will convene a National Taskforce on Aboriginal and Torres Strait Islander kidney disease to improve coordination of the complex and fragmented health and social supports for Aboriginal and Torres Strait Islander families devastated by kidney failure.

The National Taskforce will bring together experts in Indigenous health, kidney disease, general practice, health systems, consumer representation, health program delivery and the NGO sector to:

  • Provide advice to Government on improving Indigenous kidney awareness and education, through the National Aboriginal and Torres Strait Islander Health Plan and other mechanisms.
  • Engage health services around detection and early intervention to slow the progression of chronic kidney disease in Aboriginal and Torres Strait Islander peoples.
  • consider plans for existing dialysis infrastructure and workforce support in remote and regional areas.
  • Provide advice on patient support services and models to address short-term accommodation, public housing supply, transport and travel inconsistencies.
  • Develop key strategies to address the challenges in prevention, early identification, management, treatment and transplantation.

The National Taskforce would be convened for a period of six months.

The Taskforce will undertake community consultations and work with community-controlled health services, major hospitals, home dialysis training centres and other related support services.

Once the National Taskforce has completed its strategy, it is envisaged non-government organisations would commence implementing recommended projects with government, corporate and philanthropic funding support.

Aboriginal and Torres Strait Islander people are more than twice as likely as other Australians to have indicators of chronic kidney disease.

Almost one in five (18 per cent) of Aboriginal and Torres Strait Islander adults have indicators of chronic kidney disease. Alarmingly, nine in ten Aboriginal and Torres Strait Islander people with signs of chronic kidney disease are not aware they have it. [2]

This means that Aboriginal and Torres Strait Islander people are more likely to progress to end stage kidney disease and be hospitalised or die with chronic kidney disease than other Australians.

The incidence of end stage kidney disease for Aboriginal and Torres Strait Islander people is especially high in remote and very remote areas of Australia, with rates up to 20 times those of comparable non-Indigenous peoples. [3]

The patient pathway for Aboriginal and Torres Strait Islander kidney patients is often confusing, fragmented, isolating and burdensome.

Addressing the high incidence of chronic kidney disease in Aboriginal and Torres Strait Islander communities includes issues of healthy living (food supply, physical activity and the social determinants of health); prevention (appropriate and targeted messaging); early detection (adequate and targeted primary care); and support (dialysis, carers and respite).

Labor will commit $295,000 to the National Kidney Health Taskforce.

Improving Indigenous Eye Health

A Shorten Labor Government will invest $9.5 million to close the gap in Aboriginal and Torres Strait Islander vision loss.

Shockingly, Aboriginal and Torres Strait Islander adults are six times more likely to suffer from blindness. However, 94 per cent of this vision loss is either preventable or treatable.

Addressing vision loss alone would account for around 11 per cent of the gap in health outcomes between Aboriginal and Torres Strait Islander people and other Australians.

Australia is the only developed nation where the infectious and wholly preventable eye disease of trachoma still exists at endemic levels.

And it only exists among Aboriginal and Torres Strait Islander peoples – where it is endemic in two out of three remote communities.

Leaders such as the Vision 2020 alliance of health organisations, including the Fred Hollows Foundation and the Indigenous Eye Health Unit at the University of Melbourne, are making great progress in improving Indigenous eye health.

Labor is determined to do more to support their great efforts and ensure that we finish the job and eliminate trachoma across the country.

Equitable access to specialist and general eye health care services is critical to reducing high rates of preventable blindness among Aboriginal and Torres Strait Islander people.

However, there is a significant unmet need – around 35 per cent of Aboriginal and Torres Strait Islander adults have never had an eye exam.

Labor will deliver additional funding to increase visiting optometry services for Aboriginal and Torres Strait Islander people to address the gap in general eye health.

Labor will also increase funding for ophthalmology services for Aboriginal and Torres Strait Islander people to address the gap in specialist eye health care service delivery.

To continue to drive progress towards the elimination of trachoma in Australia, Labor will invest in trachoma prevention activities recommended by the World Health Organisation.

With Labor’s additional funding we can eliminate trachoma from Australia by 2020 and begin to turn the tide on this endemic health problem.

Labor Will Protect Medicare and Keep Medicine Affordable

Like all Australians, Indigenous Australians rely on Australia’s world-class universal health care system to keep them healthy and well.

Labor built Medicare so that every Australian would have access to quality health care, no matter who they are or where they live.

But Malcolm Turnbull wants to destroy Medicare by freezing indexation on the Medicare Benefits Schedule, increasing the price of medicines and privatising the Medicare payments system.

If he gets his way, Australia risks going down the path of America, where quality health care is available only to the privileged few.

In contrast, Labor will protect Medicare for future generations.

Labor’s Medicare Guarantee will see an elected Shorten Labor Government:

  • Protect bulk-billing by re-indexing the MBS from 1 January 2017.
  • Ensuring affordable medicine by scrapping the Liberals’ planned medicine price hikes.
  • Legislating to protect Medicare.

This election the choice is clear: only Labor will protect universal health care in Australia.

Labor’s record

Labor understands that investing in prevention is the most effective way to reduce the burden of chronic disease and close the gap in life expectancy between Aboriginal and Torres Strait Islander peoples and other Australians.

Labor developed the Close the Gap framework, to drive change in six key areas of Indigenous disadvantage, including mortality and child mortality.

In Government, Labor supported localised, community-driven health initiatives through investment in Aboriginal and Torres Strait Islander community-controlled health organisations (ACCHOs).

Labor remains committed to supporting ACCHOs to deliver holistic and cultural healthcare, recognising their role as key drivers of improvement in health outcomes through their connection to community.

Labor understands that working with Aboriginal and Torres Strait Islander health services and communities will deliver better health outcomes. That’s why the previous Labor Government developed a ten-year National Aboriginal and Torres Strait Islander Health Plan (NATSIHP) in partnership with Indigenous health services and communities.

This proposal builds on the previous Labor Government’s investment in preventative health, particularly through the Indigenous Chronic Disease Package.

Malcolm Turnbull and the Liberal’s Record

The Liberal Government has cut preventative health programs, ripping $121.8 million from Indigenous health programs.

Notably, the Liberal Government made deep cuts to the Indigenous Tackling Smoking and Healthy Lifestyles program, led by Dr Tom Calma.

There has been no commitment from the Liberal Government to fund the implementation of the National Aboriginal and Torres Strait Islander Health Plan, which emphasises the importance of prevention in improving Indigenous health outcomes.

We simply cannot close the gap in life expectancy without investment in proven and effective preventative health programs.

Only Labor understands the importance of investing in community-led preventative health initiatives to close the gap in health equality.

Financial Implications ($m)

Net Impact

2016-17

3

2017-18

9

2018-19

9

2019-20

9

Total [4]

29

2016-17

2017-18

2018-19

2019-20

Total [4]

Net Impact

3

9

9

9

29


[1] Christopher Holland, Close the Gap Progress and Priorities Report 2016, Close the Gap Campaign Steering Committee, p 25.

[2] Australian Bureau of Statistics. 2014. Australian Aboriginal and Torres Strait Islander Health Survey: Biomedical Results, 2012-13. Report No: 4727.0.55.003, Canberra.

[3] Stumpers S, Thomson N. Review of kidney disease among Indigenous people. Australian Indigenous Health Bulletin 2013;13(2).

[4] Totals may not sum due to rounding

 

NNEWS

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