” Apunipima services around 7,500 people living in 11 remote and very remote Cape York communities. In 2015-16 over 80% of Cape York’s Aboriginal and Torres Strait Islander population have accessed Apunipima’s services.
Apunipima runs the health service in Mossman Gorge, has opened new health care facilities in Aurukun and Napranum, and will be opening a new facility in Coen this year.
There is incontrovertible evidence that community driven, community led, culturally appropriate primary health care is key to improving health outcomes amongst Aboriginal and Torres Strait Islander people.”
Photo above :Apunipima Cape York Health Council carried out 127 health screenings for students at the Cape York Aboriginal Australian Academy. AURUKUN youngsters received a free health check last week in a bid to prevent chronic disease
16 March marks Close the Gap Day – a day to bring awareness to the Close the Gap campaign and to work out how best to address the challenges of closing the health, employment and education gap for Aboriginal and Torres Strait Islander people.
The Prime Minister’s 2017 Close the Gap Report highlights the health challenges facing Aboriginal and Torres Strait Islander people. Apunipima continues to work across physical, social, and emotional challenges to close the gap for the Aboriginal and Torres Strait Islander people of Cape York.
People living in remote communities have worse health outcomes than those living in rural, regional and metropolitan areas
‘14 % of Aboriginal and Torres Strait Islander people live in very remote areas and make up 45% of very remote populations’
What Apunipima is doing:
See opening quote
By increasing the number of community controlled facilities in our communities, we improve access to healthcare and health literacy, employ local people and build community and individual capacity.
Halve the gap in mortality rates for Indigenous children under five within a decade (by 2018)
Nationally, this target is not on track.
‘Our investment in the early years is twofold: improving integration of services across health, child care, early childhood education and school resulting in better access to the right services; and intensive support for the children and families who need it most.’
What Apunipima is doing:
Apunipima’s Maternal and Child Health team’s award winning Baby One Program™ is an Aboriginal and Torres Strait Islander Health Worker led program designed to support women, babies and families from pregnancy until the bub is 1000 days old (nearly three).
In 2015-16,
- 85 per cent of pregnant women and their families in Cape York were signed up to the Baby One Program™
- 45 per cent accessed antenatal care before the thirteenth week of their pregnancy
- 100 per cent received five or more antenatal visits during pregnancy with an average of more than 13 antenatal contacts per pregnancy 83 per cent of babies were born within normal weight range
- 91 per cent of Cape York babies were born after 36 weeks gestation
- 80 per cent of children under five were recorded as fully immunised
Close the gap in life expectancy between Indigenous and non-Indigenous Australians within a generation (by 2031).
Nationally, this target is not on track.
‘Over the longer term, Indigenous mortality rates have declined significantly by 15 per cent since 1998. There have been significant improvements in the Indigenous mortality rate from chronic diseases, particularly from circulatory diseases (the leading cause of death) since 1998. However, Indigenous mortality rates from cancer (second leading cause of death) are rising and the gap is widening. There have been improvements in health care access and reductions in smoking which should contribute to long-term improvements in the health of Aboriginal and Torres Strait Islander peoples.’
What Apunipima is doing:
As chronic disease accounts for three quarters of the mortality gap Apunipima is dedicated to preventing and managing chronic disease on Cape York.
Diabetes and chronic kidney disease accounts for the greatest burden of chronic disease amongst our patients.
We employ three Diabetes Nurse Educators, and a Care Coordination team that helps chronic disease patients navigate the health system and access specialist care.
Apunipima provides a GP in each of the 11 communities in which we work.
We are actively working to reduce smoking and improve nutrition, through a range of activities including working closely with community stores, drafting healthy eating guidelines and community cooking demonstrations and classes. These are both key factors in achieving good health.
‘While smoking rates have continued to decline in Australia, the smoking rates of Indigenous Australians aged 15 and over are significantly higher than the broader population.’
What Apunipima is doing:
Apunipima received a Tackling Indigenous Smoking Regional Grant as part of the National Tackling Indigenous Smoking program.
Nationally, the goal of the program is to improve the health of Aboriginal and Torres Strait Islander people through local efforts to reduce harm from tobacco.
The Apunipima Tackling Indigenous Smoking (TIS) Team will work closely with Cape York communities to deliver locally appropriate programs and activities that aim to:
- Engage community members in tobacco cessation activities
- Improve access to culturally appropriate quit support
- Encourage and support smokers to quit
- Encourage and support non-smokers to avoid uptake
- Raise awareness in communities about the health impacts of smoking and passive smoking
- Support communities to establish smoke-free homes, workplaces and public spaces
Apunipima’s strategic objectives aim to reduce overall smoking rates by 25 % by 2018 and antenatal smoking rates by 75 % by 2018.
‘Governments are working together to develop the Fifth National Mental Health Plan to improve the wellbeing of all Australians and prioritise Aboriginal and Torres Strait Islander mental health and suicide prevention.’
What Apunipima is doing:
Recognising that mental health is as important as physical health, Apunipima has developed a Social and Emotional Wellbeing Strategy and appointed a team to deliver a range of programs designed to improve people’s capacity and resilience.
Programs include Healthy Relationship training, working with prisoners at Lotus Glen, and Community Support Groups which provide social and emotional wellbeing education and support, especially for Men’s Health.
Apunipima’s Maternal and Child Health team includes a social worker and we also have a Partners in Recovery Coordinator who helps people who have been in mental health facilities reintegrate into community.
Apunipima’s Health Promotion and Men’s Health teams also support a range of community groups like Women’s and Men’s Groups, as well as on-country cultural activities.
‘Between 2006 and 2015 there was a significant decline in the Indigenous kidney disease mortality rate (by 47 per cent)’
What Apunipima is doing:
Apunipima employs a nurse with a special interest in kidney health to support the management of chronic kidney disease on the Cape.
Aboriginal and Torres Strait Islander people are three and a half times more likely to suffer from type 2 diabetes than their non-Aboriginal and Torres Strait Islander counterparts.
Diabetes is the leading cause of chronic kidney disease amongst Aboriginal and Torres Strait Islander people who are nine times more likely to experience end stage kidney disease than their non-Aboriginal and Torres Strait Islander counterparts.
As part of addressing the rates of renal failure on Cape York, Apunipima has been monitoring and managing the renal function tests of those at risk with around half of the diabetic patients and 2/3 of the Cardio-Vascular Disease patients up to date over the last six months, for this annual check.
‘However, cancer mortality rates are rising and the gap between Indigenous and non-Indigenous Australians dying from cancer is widening. Between 1998 and 2015, there was a 21 per cent increase in the cancer mortality rate for Indigenous Australians and a 13 per cent decline for non-Indigenous Australians.’
What Apunipima is doing:
Apunipima provides a GP in each of the 11 communities in which we work.
We encourage people to come for health checks and assist people to travel and stay in Cairns if they are in need of further tests.
We are actively working to reduce smoking through Tackling Indigenous Smoking and improve nutrition, (through a range of activities including working closely with community stores, drafting healthy eating guidelines and community cooking demonstrations and classes) both key factors in achieving good health.
Health workforce
‘It is important to have a strong Indigenous health and aged care workforce to provide culturally appropriate services to the Aboriginal and Torres Strait Islander community, and for the mainstream health care system to employ Indigenous health professionals’
What Apunipima is doing:
Apunipima has a workforce of around 180 employees, with 52% identifying as Aboriginal and/or Torres Strait Islander.
Currently around 25% of Apunipima employees are community based (both living and working in community), which is contributing to Apunipima’s strategic objective to build capacity in Cape York communities.
Apunipima employs 95 people who identify as Aboriginal and/or Torres Strait Islander, of which 36 are employed as Health Workers in Queensland, making it one of the largest non- government employers of health workers in the state.
We ensure our Health Workers are provided with appropriate qualifications (with 23 health workers currently enrolled in either Cert III or Cert IV PHC Practice), and are supported to pursue Australian Health Practitioners Regulation Agency registration as Health Practitioners should they choose to do so.
63% of our current Health Workers are community based, increasing community employment numbers and helping to address the social determinants of health.
Suicide
‘Indigenous suicide rates are double that of non-Indigenous Australians. During 2011 to 2015, among Indigenous Australians, 71 per cent of suicides were male.’
What Apunipima is doing:
Apunipima is addressing this issue through on country and cultural activities, supporting community to develop local solution, increasing community employment, working with men, women, girls and boys to create safe spaces to share challenges and solutions, building community capacity, providing a social worker, engaging with partner agencies and organisations and building our Social and Emotional Wellbeing team.