• Cost of living hikes a health danger
• Purple House making families well on Country
• The disease of racism
• Annual overview of First Nations health
• An ‘increasingly angry black woman’
• Consent education needs Blak voices
• Urban health professionals in remote communities
• Increasing tick-born dog disease awareness
• New process for job advertising
• Save the Date – World Tuberculosis Day; Primary Care COVID-19 update; National Advance Care Planning Week

Image in feature tile from Adult Learning Australia website Food in remote Australia is expensive section.

Cost of living hikes a health danger

The cost of basic household items has reached new heights in regional centres but also Aboriginal communities. In yesterday’s episode of ABC radio’s The World Today with Sally Sara experts Diane Temple, Mamu woman, Queensland, June Riemer, Gumbaynggirr woman and deputy CEO, First Peoples Disability Network and Dr Joy Linton, GP, Gurriny Yealamucka Health Services Aboriginal Corporation, Yarrabah discuss how the cost of living hikes are dangerous for Indigenous health. Health experts are worried the lack of access to fresh fruit and vegetables will cause serious health issues.

You can listen to the radio segment here and a related story Doctors fear impacts of more expensive fruit and veg, featuring Dr Kean-Seng Lin, GP in Mt Druitt, western Sydney and Professor Sharon Friel, Australian National University also on The World Today here.

Dietitians Australia say Improving food security for Aboriginal and Torres Strait Islander peoples living in remote, regional and urban parts of Australia is essential to achieving health equity. “Food security is a fundamental human right,” said Board Director of Dietitians Australia and Gamilaroi woman, Tracy Hardy. “The 2021 Close the Gap Report stated that we need strategies to manage food security in response to the rising cost of food, and the impact of climate change on food availability.” You can view the Dietitians Australian media release here.

Remote community stores across Australia are receiving $8 million to strengthen the supply of essential goods, groceries and other critical supplies. Minister for Indigenous Australians, the Hon Ken Wyatt MP, said the funding will provide 43 stores with the resources they need to improve their supply chains, storage and delivery of products in their communities. “In the 2021–22 Budget we committed $5 million to invest in remote stores to improve food security and strengthen supply chains,” Minister Wyatt said. “Since then, we’ve seen an increased need for reliable food security in remote communities, and we’re responding with increased support. “We’re now investing $8 million to directly support remote stores to fund infrastructure upgrades, cool and dry storage expansion, green energy systems and training for staff and management.”

To view the Minister Wyatt’s Securing Essential Supplies for Remote Australia media release click here.

Purple House making families well on Country

Western Desert Nganampa Walytja Palyantjaku Tjutaku Aboriginal Corporation is the official name for what is now more commonly known as the Purple House. The Purple House is an organisation dedicated to getting First Nations Peoples from remote communities back home on Country through the delivery of renal services. Its conception, design and delivery are based firmly in the values of Yanangu. It remains entirely Indigenous-owned and run, with an all-Yanangu Board of Directors who are elected by its members.

A translation of the Purple House’s official title means ‘making all our families well’. This is also the vision statement for the organisation. Since its beginnings in 2000, Purple House has concentrated on addressing the epidemic of renal disease inflicting remote First Nations communities. It has done this effectively and successfully, vastly improving the quality of life and life expectancy of renal patients. It is now possible to say that, in this space, the Purple House has not only closed the gap but has opened a gap on the national average.

The Purple House now operates 19 permanent remote dialysis clinics and two mobile units called Purple Trucks. The success of the model has led to an expansion of services, which now include aged care, disability, primary health and social support. However, there remains a constant call from other remote communities to support their needs as well.

To view the RAHC Partyline article in full click here.

The disease of racism

Veteran Queensland health professional, Bindal Elder Gracelyn Smallwood and Aboriginal businessman and human rights campaigner Dr Stephen Hagan have filed complaints with the Australian Human Rights Commission alleging they were recently racially discriminated against at a Townsville service station. Professor Smallwood told CAAMA Radio it was not unusual in Townsville and that nothing surprised her about the alleged incident. Following a phone call from Ms Smallwood, Dr Hagan drove to the same service station to fill up his car as a “test” – but says he too was also discriminated against by the same attendant because he was Aboriginal. Professor Smallwood says despite being stereotyped for decades because of her stand against racism the only way attitudes are going to change is by suing the perpetrators. You can listen to the interview in full here.

A related article looks at a study exploring the relationships between experiences of perceived racism, mental health and drug and alcohol use among Aboriginal Australians. The current research indicates that racism is still frequently experienced by Aboriginal Australians and is directly associated with poorer mental health, and indirectly with substance use through poorer mental health. The findings demonstrate a clear need for further research in this area. To view the Examining the Associations Between Experiences of Perceived Racism and Drug sand Alcohol Use in Aboriginal Australians article in full click here.

Annual overview of First Nations health

Australian Indigenous HealthInfoNet has just released its annual authoritative online publication The Overview of Aboriginal and Torres Strait Islander health status 2021. There is a featured section on the Coronavirus disease and its impact on Aboriginal and Torres Strait Islander people and their communities. During the pandemic, health authorities have reinforced that Aboriginal and Torres Strait Islander people are at greater risk but have praised the response of ACCHOs in delivering strong evidence based and culturally responsive prevention initiatives.

The release of the key findings from the Australian Burden of Disease Study 2018 for Aboriginal and Torres Strait Islander people provides promising news for specific diseases. There was a decline in total burden for coronary heart disease, type 2 diabetes, stroke, rheumatoid arthritis, hearing loss and chronic obstructive pulmonary disease.

Improvements in birth and pregnancy outcomes for Aboriginal and Torres Strait Islander mothers and babies continue, with evidence of an increase in the proportion of mothers attending antenatal care in the first trimester (increased from 49% in 2012 to 67% in 2019), a decrease in the rate of mothers smoking during pregnancy, and a slight decrease in the proportion of babies born small for gestational age. The national target for childhood immunisation has been met for 5 year olds with 97% coverage.

Of all specific causes of death, ischaemic heart disease was  the leading cause of Aboriginal and Torres Strait Islander deaths in NSW, Qld, WA, SA and the NT combined in 2020.  Injury was the leading cause of hospitalisation in 2019–20 (excluding dialysis).

HealthInfoNet Director, Professor Neil Drew, said ‘Our annual authoritative Overview is a comprehensive evidenced based resource for those working in the Aboriginal and Torres Strait Islander health sector. The overall data shows it is critical to also address environmental health factors  – such as housing and hygiene – that underpin the spread of many infectious diseases.”

As part of the HealthInfoNet’s commitment to knowledge exchange, a plain language infographic Summary version of the Overview’s key topics has been produced here with PowerPoint slides of the key points.

An ‘increasingly angry black woman’

In an article for the Canberra City News Winnunga CEO Julie Tongs refers to a feature in The Guardian written by South African writer, activist and political analyst Sisonke Msimang. Msimang says “while I have been full of admiration, each time Tame has earned the spotlight, I have imagined the response if I had behaved that way, or if any number of black and Indigenous women in the public domain had dared to do the same. I am yet to see black women’s anger greeted with the same kind of public solidarity or sympathy. And yet black women have been expressing anger for years as they address racist police and education systems, as they try to create opportunities for themselves and face the double burden of sexism and racism.”

Julie Tongs agrees with Msimang, saying “I will mention just two of the many issues that I, an increasingly angry black woman, have raised loudly, publicly and repeatedly over a number of years. However, the depth of the silence with which my entreaties for the scandalous treatment of Aboriginal women and children in Canberra to be addressed can, in my opinion, be best explained by reference to the fact that these issues are being raised and agitated by a black woman on behalf of other black women and their children. Frankly, what other explanation can there be?”

“Despite the lengths I have gone to, I have not generated any meaningful response from the ACT government or more than a scintilla of interest, concern or serious response from local media including the ABC, the Canberra community or the sisterhood. Those two issues are the rates of incarceration of black women and the number of Aboriginal children subject to care and protection orders in Canberra, the national capital and alleged haven of progressivity.”

To view the City News article in full click here.

Consent education needs Blak voices

The Teach Us Consent movement – founded by Chanel Contos in 2021 – has gained bipartisan political support to mandate consent education in Australian schools from 2023. The movement was rapidly successful after collecting over 6,600 stories of people who had experienced sexual assault by someone when they were at school. This was followed quickly by the federal government committing $189 million over five years to strengthen prevention and early intervention efforts in family, domestic and sexual violence.

Issues of sexual violence and consent are gaining momentum at a national level., yet, within these important discussions, the voices, experiences and needs of First Nations people are not widely represented or heard. Drawing on the current momentum and interest in consent education, there is an opportunity to fund place-based, culturally appropriate and co-designed consent education with First Nations young people.

The response to sexual violence must move beyond simply adding “dot paintings” to mainstream curricula to address the conditions that make sexual violence an issue for many. To have a real impact on young people and our communities, we need to be telling the whole story of women, gender and sexual violence in Aboriginal and Torres Strait Islander people’s lives against the backdrop of colonisation.

Urban health professionals in remote communities

Since 2008, the Commonwealth-funded Remote Area Health Corps (RAHC) has been supporting urban-based health professionals wanting to work in remote Aboriginal and Torres Strait Islander communities in the NT. In that time, more than 1,700 registered nurses, GPs, dentists, dental therapists, dental assistants, audiologists and allied health professionals have taken up over 7,000 placements throughout the Territory.

RAHC’s main priority for 2022 is to assist in reducing health disadvantage among Aboriginal and Torres Strait Islander people, addressing the Close the Gap strategy. More than a recruitment agency, RAHC provides cultural orientation and ongoing clinical support to healthcare professionals going out on placement. “Developing rapport with a community provides an experience that encourages health professionals to stay with us long-term,” says Clinical Manager Emma Thomas.

Acting National Manager Tess McGuigan adds, ‘We help improve the health and wellbeing of those living in rural, regional and remote areas of the NT with regular professional development, both online and through personal consultations with a clinical coordinator and cultural development adviser. It builds knowledge and confidence so our team can deliver high-quality health care tailored to the unique needs of that community.’

To view the RAHC Partyline article in full click here.

Increasing tick-borne dog disease awareness

An NT campaign to increase awareness in remote communities of a serious tickborne disease has been given a $150,000 boost by the Australian Government. Minister for Agriculture and Northern Australia David Littleproud said the disease ehrlichiosis is caused by the tick-borne bacteria Ehrlichia canis and is carried by the brown dog tick, which is present across northern Australia. “The number of infections in dogs is continuing to increase in northern Australia’s vulnerable Indigenous communities, with prevalence rates of up to 100% in some places,” Minister Littleproud said.

“This disease is relatively new to Australia, having first been detected in WA in May 2020. It was then confirmed in the NT and SA within a year. Dog mortality rates range from 10–30%. However, the disease can be effectively controlled through a combination of antibiotic treatment, preventative measures such as tick collars and containing infected dogs. It’s not just an animal-health issue, dogs are an integral social part of many rural people’s lives.”

To view Minister Littleproud’s media release in full click here.

New process for job advertising

NACCHO have introduced a new system for the advertising of job adverts via the NACCHO website and you can find the sector job listings here.

Click here to go to the NACCHO website where you can complete a form with job vacancy details – it will then be approved for posting and go live on the NACCHO website.

World Tuberculosis Day

March 24 marks the day in 1882 when Dr Robert Koch announced that he had discovered the bacterium that causes TB, which opened the way towards diagnosing and curing this disease. However, TB still claims 4,100 people lives each day and close to 27,000 people fall ill with this preventable and curable disease. The emergence of drug-resistant TB poses a major health threat that could put at risk the gains made to end the global TB epidemic. World TB Day is an opportunity to focus on the people affected by this disease and to call for accelerated action to end TB suffering and deaths. For more information about World Tuberculosis Day 2022 click here.

Disparities in tuberculosis (TB) rates exist between Indigenous and non-Indigenous populations in many countries, including Australia. The social determinants of health are central to health inequities including disparities in TB rates. There are limitations in the dominant biomedical and epidemiological approaches to representing, understanding and addressing the unequal burden of TB for Indigenous peoples represented in the literature. This paper applies a social determinants of health approach and examines the structural, programmatic and historical causes of inequities for TB in Indigenous Australia.

Development of TB policies and programmes requires reconfiguration. Space must be given for Indigenous Australians to lead, be partners and to have ownership of decisions about how to eliminate TB. Shared knowledge between Indigenous Australians, policy makers and service managers of the social practices and structures that generate TB disparity for Indigenous Australians is essential.

To view the research article The missing voice of Indigenous Australians in the social, cultural and historical experiences of tuberculosis: a systemic and integrative review click here.

Primary Care COVID-19 update

The latest in a series of webinars to update primary care on the COVID-19 response and the vaccine rollout will be held from 11:30 AM–12:00 PM (AEDT) Thursday 24 March 2022.

The panel this week will include Australian Government Department of Health Dr Lucas de Toca, First Assistant Secretary, COVID-19 Primary Care Response, and Dr Michael Bonning, Medical Director, Inner West GP Respiratory Clinic, Balmain Village Health.

GPs and all health professionals are welcome to attend the webinar and can join using this link. If you’re unable to view this webinar live, you can view it on-demand using the same link, within a few hours of the live stream ending.

National Advance Care Planning Week

National Advance Care Planning week, Monday 21 to Sunday 27 March 2022, an initiative of Advance Care Planning Australia, is a reminder for Australians to talk to their loved ones about who they would want to speak for them if they become too sick to speak for themselves. Advance Care Planning Australia ambassador and AMA Vice President Dr Chris Moy said while advance care planning conversations might be confronting, they are important. “Advance care planning is a process of planning for your future health and personal care by ensuring your values, beliefs and preferences are known to guide those who will make health care decisions on your behalf, should you lose capacity in the future,” Dr Moy said.

“Without such a plan, you may have no voice to guide those decisions and no choice as to what decisions are made on your behalf, instead placing the burden of decision-making on loved ones who may have no idea what care you would actually want – which can bring a legacy of guilt on families which extends after death.

The AMA strongly supports advance care planning as it benefits everyone, the patient, their family, carers and health professionals and is particularly important for people with advanced chronic illness, a life-limiting illness, who are aged 75+ years or at risk of losing competence. The AMA strongly agrees with Advance Care Planning Australia that having an advance care plan can reduce anxiety, depression, stress and increase satisfaction with care for the patient’s family members. In addition, advance care planning assists healthcare professionals and organisations by reducing unnecessary transfers to acute care and unwanted treatment,” Dr Moy said.

Advance Care Planning Australia has found less than 15% of people have documented their health care preferences in an advance care directive.  Dr Moy said advance care planning discussions, and clearly delineating ‘goals of care’, should become a key part of routine healthcare conversations across Australia. He said the Advance Care Planning Australia website is an excellent resource for individuals, families, friends, carers and health professionals.

The AMA’s Position Statement on End of Life Care and Advance Care Planning can be found here and you can view a Palliative Care Australia video on Indigenous Advance Care Plans below.