NACCHO Aboriginal & Torres Strait Islander Health News: ACCHOs prioritise social determinant approach

part of Aboriginal town camp on the outskirts of Alice Springs

The image in the feature tile is part of an Aboriginal town camp on the outskirts of Alice Springs. Photo: Helen Davidson. Image source: Guardian Australia article Australia’s Indigenous housing won’t cope with climate change, research finds, published on 4 November 2021.

The NACCHO Aboriginal and Torres Strait Islander Health News is a platform we use to showcase the important work being done in Aboriginal and Torres Strait Islander health focusing on the work of NACCHO, NACCHO members and NACCHO affiliates.

We also share a curated selection of news stories that are of likely interest to the Aboriginal and Torres Strait Islander health sector, broadly. The content included in these new stories are not necessarily NACCHO endorsed.

ACCHO social determinant approach to health

Homes should be safe and secure spaces that support our health and wellbeing. Our homes should provide us with shelter, access to efficient and healthy energy sources, sufficient space, as well as a sense of belonging, security and privacy. Dr Ben Ewald from the University of Newscastle says recent consumer research by Asthma Australia revealed that there are many asthma triggers in Australian homes. Their nationally representative survey of over 5,000 people focused on indoor air pollution from cooking, gas or wood heating, mould and dampness and pests (including ants, spiders, mice, cockroaches and dust mites). They found that many people are exposed to these triggers in their homes and that some population groups are more likely to be exposed to certain triggers. Those most at risk include people with asthma, Aboriginal and Torres Strait Islander people, people living in social housing and people with children in their homes.

Dr Benjamin Ewald, Conjoint Senior Lecturer at the School of Medicine and Public Health at The University of Newcastle previously worked for 10 years at Central Australian Aboriginal Congress Aboriginal Corporation in Alice Springs where ‘he saw for the first time a community health centre that could identify its community, and had a realistic involvement in their public health issues as well as the provision of sick care.’

Dr Ewald said the ACCHO model has prioritised the social determinant approaches. We consider housing security, daily living expenses, and access to the range of social financial support to be as important, sometimes more important, than prescription of medicine or referral to diagnostic tests or specialist appointments. The call by Dr Ewald for GPs to consider engaging with landlords and social housing providers to advocate for improved housing conditions for those most vulnerable is potentially significant and realistic. We already regularly advocate for individual patients for improvements to their housing that impacts their health. Such improvements might now include installing or servicing appliances that are known to reduce risk and harm, like rangehoods, convection stoves, and overall ventilation. Having a diagnostic test or prescribing inhalers is ineffective if I am just sending people back to the conditions causing their problem in the first place.

To view The Medical Republic article Gas Hazards in Homes: What’s the GP’s Role? in full click here. The quote about Dr Ewald’s time spent at CAAC is from the Staff Directory on The University of Newcastle website.

Irene Williams standing next to the stove in her kitchen of her Yarralin house

Irene Williams has no bathroom or kitchen sink in her Yarralin house. Photo: Jane Bardon, ABC News – 18 May 2018.

Diphtheria spreading in the north

Cases of toxigenic diphtheria are rising in north Queensland and experts warn that other states should be on alert for the potential spread of the disease. Between 2020 and 2022 there were 29 reported cases of diphtheria in North Queensland – eight respiratory diphtheria and 38 cutaneous diphtheria – compared to 46 cases in the two decades prior.

In that preceding decade, C. diphtheriae accounted for 87% of cases, according to data from Queensland Health’s Notifiable Conditions Register. Since 2020, a genomically linked clone of tox gene-carrying diphtheria bacteria has spread across North Queensland. This diphtheria outbreak, almost exclusively in Aboriginal and Torres Strait Islander communities, highlights the continuing impact of social determinants on disease in vulnerable populations.

Unvaccinated people were at highest risk of severe disease, including classic diphtheria, myocarditis and neuropathies. Vaccination remains imperative and timely vaccinations are essential.

To view The Medical Republic article Diphtheria spreading in the North in full click here. Below is July 2022 ABC News report about diptheria identified in two children in northern NSW – NSW’s first recorded cases of diptheria in 100 years.

Dementia – what it means for mob

The Dementia in Australian Summary report 2022 released by the Australian Institute of Health and Welfare (AIHW) last week, available here, shows that although dementia seems to occur in all socioeconomic groups relatively equally, how those different groups deal with dementia varies. The burden of disease is least in the highest socioeconomic group, hospitalisations are fewest for the rich, and those in the most affluent group are less likely to live in permanent residential aged care.

It will come as no surprise, given what we know about health inequities facing Aboriginal and Torres Strait Islander Australians, that dementia deaths in the Indigenous population have skyrocketed by 70% between 2011–15 (296 deaths) and 2016–20 (503 deaths), according to the AIHW. Dementia was the fifth leading cause of death among Indigenous people aged 65 and over during 2018–2020.

Between 137,600 and 354,200 Australians are “informal” carers for someone with dementia. That is, they are not “providing care to those living in permanent residential aged care and paid workers or volunteers arranged by an organisation or formal service”. The AIHW says those numbers are likely to be an underestimate. Three in four of those carers are women. Half of them are caring for their partner. According to the AIHW report, by 2058, 850,000 of us will be living with dementia. And yet aged care in general, and dementia care in particular, continues to be underfunded, underresourced, underserviced and underappreciated by politicians and policymakers.

To read The Medical Republic article Let’s Fix Aged Care, if Only Out of Selfishness in full click here. You can find a range of resources, including the video below, for Aboriginal and Torres Strait Islander communities on the Dementia Australia website here.

KAMS to support Kimberley flood victims

The Australian Government is providing $300,000 for social and emotional wellbeing (SEWB) support for Aboriginal communities in the flood ravaged Kimberley region of WA. Cyclone Ellie struck last month leading to record flooding, leaving thousands of people displaced, isolated and experiencing trauma. Funding for a trusted local community organisation, the Kimberley Aboriginal Medical Services (KAMS) will provide support to people affected by flooding over the coming months.

This will include air travel to communities that are inaccessible, enabling the social and emotional wellbeing workforce to meet people where they are and respond to the unique needs of isolated remote communities. KAMS will deliver this project in partnership with its member services – the Broome Regional Aboriginal Medical Service (BRAMS) and the Derby Aboriginal Health Service Council (DAHSC). They will ensure services are culturally safe and prioritise the needs of Aboriginal and Torres Strait Islander peoples.

KAMS CEO Vicki O’Donnell OAM said “The Kimberley Floods have had a significant impact for many people in our region. The immediate need to increase the scope and reach of our SEWB services is urgent. KAMS and our Member Services, DAHSC and BRAMS will be able to use this initial support from NIAA to increase our travel and direct support to those in immediate need. We endeavour to work alongside all agencies involved to make sure we effectively support our community members through this crisis and secure ongoing resources as we recover and rebuild our communities over the coming years.”

To view the Hon Linda Burney MP’s media release Support For Flood Ravaged Kimberley Communities in full click here.

Part of the Great Northern Highway bridge across the Fitzroy River at Fitzroy Crossing appears to have completely washed away

Part of the Great Northern Highway bridge across the Fitzroy River at Fitzroy Crossing appears to have completely washed away. Photo: Neville Ripp. Image source: ABC News, 9 January 2023.

Digital wound imaging for diabetic foot ulcers

A NZ-developed digital wound imaging platform to improve treatment of diabetic foot ulcers is being used in Perth hospitals and rural clinics, as well as health facilities across Australia, NZ and the world. The electronic wound assessment system monitors and manages wound healing, aiming to reduce diabetes-related foot complications and ultimately reduce amputations.

NZ healthcare informatics company ARANZ Medical developed its Silhouette suite of products for imaging, measuring and documenting soft tissue and skin lesions including wounds. Royal Perth Hospital vascular surgeon and medical co-director Olufemi Oshin pioneered the use of this technology in Broome in 2019 when Diabetes WA funded seven cameras and SilhouetteLite+ for Aboriginal health workers from Kimberley Aboriginal Medical Services (KAMS) to use in Broome and remote communities.

Australia has the second highest rate of diabetic amputations in the developed world with diabetic foot disease being responsible for about 4,400 amputations nationwide every year or 12 a day. Dr Oshin said “We know that 85% of diabetes related amputations are preventable but only if wounds are detected early and managed appropriately. We have a lot of people who present very late, sadly where there is not much option but amputation.” KAMS medical director Lorraine Anderson said the system had been used in the Kimberley Foot Initiative for nearly four years to increase access to multidisciplinary care for Aboriginal and Torres Strait Islanders with or at risk of diabetic foot disease.

To read the Pulse+IT article Perth hospitals using NZ-developed digital wound imaging system for diabetic foot ulcers in full click here.

Aboriginal Health Workers and Diabetes WA staff using Silhouette at the Kimberley Foot Initiative kickoff

Aboriginal Health Workers and Diabetes WA staff using Silhouette at the Kimberley Foot Initiative kickoff. Photo: ARANZ Medical. Image source: Pulse+IT.

Health researcher to participate in talks program

Parrtjima – A Festival in Light returns to illuminate the Red Centre in April this year in more ways than one, with some of Australia’s most prominent Aboriginal identities set to participate in the In Conversation talks program, where a range of topics, from science and sport to literature and The Voice, will be discussed.

The theme for this year’s Parrtjima is Listening with Heart. Inspired by the artwork surrounding the Statement from the Heart, Listening with Heart embodies the concept of coming together, meeting and taking the time to contemplate, reflect and heal. The In Conversation program is just one part of this festival. Roxanne Ngarulya Highfold, an Aboriginal health researcher who has worked with numerous organisations, including Central Australian Aboriginal Congress (CAAC) and Central Land Council, will take part in a talk on Tuesday, 11 April on the topic of ‘The spirit of Alice’.

A mother of one, Roxanne Ngarulya Highfold has maternal ties with Central and Eastern Arrernte, and paternal ties with the Wirangu and Nurrunga peoples of SA. She works full time at the Central Land Council, supporting Aboriginal communities through economic growth and development. She is also studying a dual degree in Bachelor of Health Sciences/Masters in Nutrition. Roxanne is an experienced Aboriginal health researcher with a demonstrated history of working in the early childhood, child protection and primary healthcare industry.

To view the Global Travel Media article Parrtjima 2023 talks program filled with leading Indigenous voices in full click here. Details about Roxanne Ngarulya Highfold were sourced from the Parrtjima – A Festival of Light website here.

portrait shot of Roxanne Ngarulya Highfold

Roxanne Ngarulya Highfold. Image source: Parrtjima – A Festival of Light website.

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