NACCHO Aboriginal & Torres Strait Islander Health News: Action needed to reduce health inequalities

Image in the feature tile in from the Emerging Minds website.

Action needed to reduce health inequalities

Last month the Australian Health Promotion Association hosted an event titled Putting equity and the social determinants of health at the heart of prevention which included discussions by world renowned epidemiologist Professor Sir Michael Marmot and a panel of Australian health promotion and public health practitioners. Professor Marmot urged Australian colleagues to advocate for healthy public policy, including tackling discrimination. He encouraged colleagues to engage with different avenues of influence like local governments, international audiences, and anyone else who will listen.

Epidemiologist Dr Kalinda Griffiths spoke about the value of data to identify critical areas in the health of Aboriginal and Torres Strait Islander people. “The way we measure things provides important information on who needs what and where”, she said. “For example, Aboriginal people in NSW are twice as likely to die from lung cancer than non-Aboriginal people. However, Aboriginal people in outer regional and remote areas are eight times more likely to die of lung cancer, but Aboriginal people in metropolitan areas have the same outcomes as non-Aboriginal people. Data like this provides valuable insight for policy making.”

Edwina Macdonald, Co-Deputy CEO of the Australian Council of Social Services (ACOSS), presented a report showing income, employment, and socioeconomic status as strong indicators of health. Some key findings include that 50% of people under 65 whose main source of income is government support reported mental health issues compared to 18% of the general population. In addition, 60% of people on higher incomes report good health compared to 32% of people with lower incomes.

To view the Croakey Health Media article Can we build back fairer? Health promotion panel calls for more action to reduce inequalities in full click here.

Young girls play in Titjikala, An Aboriginal community 120km south of Alice Springs. Photo: AAP. Image source: SBS News.

Health Care Homes evaluation findings

The findings of a recently published evaluation (available here) of the Health Care Homes (HCH) trial show there is much to learn about how to implement future health reform initiatives and will be useful reading for the Federal Government and its new Strengthening Medicare Taskforce., according to Associate Professor Lesley Russell. HCH are general practices or Aboriginal Community Controlled Health Services (ACCHSs) that aim to provide better coordinated and more flexible care for Australians with chronic and complex illnesses.

The report says the initiative did not deliver on any of its promised outcomes due to its failure to faithfully implement the model for HCH as articulated by the Primary Health Care Advisory Group (PHCAG), to low levels of participation by general practitioners (GPs) and patients, and to an implementation timeframe that was too short.

An easy and economically viable implementation of the HCH model are exemplified in the primary care services that are specifically designed for Aboriginal and Torres Strait Islander people. 18 ACCHSs, all in the NT, entered the trial and 14 (with 1,025 patients) continued to the end. They saw bundled payments as a more viable, more appropriate payment approach that provided certainty of income and enabled staff to be paid for additional work.  The key enablers were the existing operational structure of the ACCHSs, and the existing relationships between communities, clinical staff and patients. The challenges for these primary care providers included: the transient nature of community populations, sub-optimal communications with other healthcare providers, the availability of staff to follow through on care plans, and that patients were largely unaware of Health Care Homes and the trial.

To view the Croakey Health Media article More than six years after a “revolutionary” health reform was announced, what have we learnt? in full click here. Below is a Health Care Homes introduction video from Jan 2018.

Health leaders call for transformational change

With new Australian PM Anthony Albanese putting Aboriginal and Torres Strait Islander peoples’ rights at the top of his Government’s agenda, stating he would implement the Uluru Statement from the Heart’s agenda in full, health sector advocates have underscored self-determination, truth-telling, cultural safety, and the elimination of racism as a matter of life or death for First Nations peoples.

The National Health Leadership Forum (NHLF), a peak body representing the views of 12 Aboriginal and Torres Strait Islander organisations working in health and wellbeing across domains including workforce, research, mental health and service delivery, has been advocating for the Uluru Statement and constitutional reform, arguing that this will support self-determination and transformational change across all aspects of government and public policy.

According to the NHLF, strengths-based, Indigenous-led and driven responses to intergenerational trauma must include a reckoning with history, and an acknowledgment that time’s up for a status quo built on racism and discrimination. “We won’t get transformational change across the health sector until we eliminate racism from the health sector,” explained former CEO of Australian Indigenous Doctors Association and NHLF chair Monica Barolits-McCabe, a Kungarakan woman from Darwin. “I think the real progress journey is just starting.”

To view the Croakey Health Media article As a new Government sets to work, Aboriginal and Torres Strait Islander health leaders call for transformational change in full click here.

Image source: Jobs & Skills WA.

Vision for more equitable healthcare

Growing up in a rural hotel as the son of a nurse, a young Kamilaroi boy called Brad Murphy spent his Saturday nights patching up patrons after brawls and tending to weary travellers as they spun him a yarn. In those formative years, he discovered both an aptitude for providing care and a love of stories that would cement his future. “I am a storyteller,” said Murphy, who works as a GP in the regional Queensland city of Bundaberg and is making an historic tilt at the presidency of the Royal Australian College of General Practitioners (RACGP). If elected, Murphy will be the first Indigenous person to hold the role and the first Indigenous president of an Australian medical college.

Gunnedah-born Murphy will be the first to admit he took the road less travelled into medicine, a circuitous journey subverted by racism and the tyranny of low expectations, and fuelled by a love for Country and community. He dreamed of being a doctor, but left school in Year 10 after a maths teacher told him he “wouldn’t amount to anything” and should pursue an apprenticeship. He joined the Navy when he was just 15, and after leaving the Navy became an intensive care paramedic. Years later he was one of five Aboriginal students in the first cohort of medical students at the James Cook University. Murphy was among the two that graduated, relishing the course’s focus on rural, remote, Indigenous and tropical health.

“I worked myself into the ground. I was getting by on sort of two to four hours sleep a day, and after three weeks you just couldn’t string a sentence together,” said Murphy of the “terribly unsafe” working conditions, which culminated in him running off the road and narrowly missing a tree. “Small country town medicine, it’s so hard when the system doesn’t support you.” As someone who has lived the challenges of a remote posting, Murphy is passionate about doctors in training who are sent to rural areas to fulfil their clinical obligations.

To read the Croakey Health Media article Profiling Dr Brad Murphy and a vision for more equitable healthcare in full click here.

Dr Brad Murphy. Image source: Bundaberg Now.

Colleges commit to cultural education

Earlier this month senior representatives from the Royal Australian College of General Practitioners (RACGP) and the Australian College of Rural and Remote Medicine (ACRRM) met in Melbourne with the GP Training Cultural Educators and Cultural Mentors Network (CECM Network) Governance group. The meeting was a timely opportunity for both colleges to engage with leaders in the field of Aboriginal and Torres Strait Islander health training and recognises their critical importance to the delivery of the Australian General Practice Training (AGPT) program and the colleges’ long-term commitment to improving health outcomes for Aboriginal and Torres Strait Islander people.

The ACRRM and the RACGP said the recognise that all community members, in particular our disadvantaged and vulnerable communities, are deserving of care that is culturally appropriate, safe and high quality. Nationally, Cultural Educators and Cultural Mentors shape the capability of our next generation of General Practitioners and Rural Generalists to meet those needs through the unique cultural knowledge, experience and skills they share through the AGPT program. To this end, the RACGP and ACRRM have committed to continuing the agreed current Aboriginal and Torres Strait Islander Health Training Strategic Plan strategies for 2023.

To view the medianet. article Joint college commitment to continue the critical role Cultural Educators and Cultural Mentors play in GP training in full click here.

Clinical Yarning eLearning program

The WA Centre of Rural Health of The University of WA has announced the launch of the Clinical Yarning eLearning program. Effective communication between clinicians and patients is the foundation to high quality health care however unfortunately, ineffective communication is common when there are cultural and language differences between clinicians and patients.

Clinical Yarning is a framework to assist clinicians improve the effectiveness of their communication in Aboriginal health care. The framework looks to improve the quality and cultural security of care for Aboriginal patients and their families. The Clinical Yarning eLearning program was developed as a resource to improve the effectiveness of communication of health care clinicians who work with Aboriginal patients, by using the Clinical Yarning model.

The online course is available to health science students and health care providers and is around two hours long, with the opportunity to stop and start progress throughout the course at your own pace. By completing the survey at the end of the course, it’s possible to download a Course Completion Certificate.

To view The University of WA article Clinical Yarning eLearning program to improve communication in Aboriginal health care in full click here and to access the Clinical Yarning website click here.

Racial discrimination and the right to health

Yesterday the Committee on the Elimination of Racial Discrimination held a day of general discussion on its proposed general recommendation on racial discrimination and the right to health. The day was comprised of three panel discussions focusing on racial discrimination in health as experienced by individuals and groups; legal obligations regarding the prohibition of racial discrimination and the right to health under international human rights law; and monitoring, accountability and redress for racial discrimination in the right to health.

It was noted that Indigenous peoples were victims of collective trauma and inequitable services since the time of colonialism. Indigenous peoples required greater healthcare services, had worse health, and had greater difficulty accessing quality health services, compared to non-indigenous people. It was vital for disaggregated data on indigenous and ethnic minorities to be collected, to ensure that equal access to healthcare services could be provided, and to eliminate all forms of discrimination. Indigenous peoples had proved to be one of the most marginalised groups during the pandemic. Lack of information in indigenous languages and lack of respect for the culture impacted indigenous peoples from being able to access health services. The vaccination of indigenous peoples was not guaranteed, and was often carried out without consulting the local populations, resulting in their reluctance to be vaccinated. In many countries across the world, business activities had directly impacted the right to health for indigenous peoples.

To read The National Tribune article Committee on Elimination of Racial Discrimination Holds Day of General Discussion on its Proposed General Recommendation on Racial Discrimination and the Right to Health in full click here.

Image source: RACGP.

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.

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