NACCHO Aboriginal & Torres Strait Islander Health News: NT youth speaks out on heart disease

feature tile image: Elder with young girl in bush; text '“I don’t know any of my relatives who have died of old age” 14 year-old Warumungu and Mudbarra-Jingili girl, Nambi Henderson'

The image in the feature tile is from a Ninti One slide show Applying traditional knowledge for sustainable livelihoods in environmental management presented at the 12th Annual Conference of Parliamentary Public Works and Environment Committees, Parliament House, Darwin 19–21st Sept Session on traditional knowledge and management on 19 September 2007.

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.

NT youth speaks out on heart disease

“Another day. Another family member dies. Another funeral. I feel as though I attend more funerals than birthday celebrations. And I’d like that to change for the sake of future generations.” These are the opening lines in a letter from Nambi Henderson, which was read out in Parliament by Labor MP Luke Gosling on Thursday last week (16 November 2023) during Youth Voice in Parliament Week. The 14-year-old Warumungu and Mudburra-Jingili girl from north of Tennant Creek, NT, currently lives in Darwin, in Mr Gosling’s electorate of Solomon.

Nambi said in the letter that her family are Warumungu, Mudburra and Jingili people, and despite having a rich history on the land, she laments: “Unfortunately, our future doesn’t look so bright. I don’t know any of my relatives who have died of old age. They have all died from alcoholism or chronic diseases like renal disease, diabetes and rheumatic heart disease (RHD).” Nambi spoke of her cousin-brother Troy, who at 17 is fit, tall and strong with dreams of the future, but who suffers from RHD. “There’s no cure. But it is totally preventable,” Nambi said. “I wish my people didn’t have to suffer through these diseases. It’s hard to watch. And it’s even harder to say goodbye. I know Aboriginal people have so much to contribute to this country, and that’s why every day I hope that we can turn the tables on this situation.”

Mr Gosling, while praising Nambi for highlighting the shocking health disparity between Indigenous and non-Indigenous people both in the NT and around Australia, said the disproportionately high occurrence of RHD among Aboriginal people is a “disgrace.” He said that Labor’s election promise to deliver an $11.6m Danila Dilba Clinic in Palmerston was on track. “The new facility will enable the ACCHO to expand their services, massively strengthening our collective efforts to combat a disease that should have already made Australia’s medical history books,” he said. “Within our first six months, the Albanese Government also doubled the funding to NACCHO to $14.2m to combat RHD in high-risk communities over the next three years. “We continue to work in close partnership with NACCHO, community-controlled and other health services to close the gap in First Nations health outcomes.”

To view the National Indigenous Times article “I don’t know any of my relatives who have died of old age” – NT youth speaks out on heart disease in full click here.

Federal NT MPs Luke Gosling and Marion Scrymgour during a visit to the Senate

Federal NT MPs Luke Gosling and Marion Scrymgour during a visit to the Senate. Photo: Mick Tsikas, AAP. Image source: National Indigenous Times.

Indigenous health a priority for new ACEM chief

Improving Indigenous health and encouraging more urban-based doctors to head to the bush to hone their emergency skills will be key priorities of the new president of the Australasian College for Emergency Medicine (ACEM). Dr Stephen Gourley, who officially starts in the role today (Monday 20 November 2023), is the first regionally based head of ACEM, which oversees the primary training body for specialist emergency physicians in Australia and NZ. He has spent the past 16 years in Alice Springs, where he is now director of the hospital’s emergency department.

“I’m really proud to be the first rural and regional president of the college,” he said. Dr Gourley said he was excited about having the opportunity to encourage other health professionals to “take the plunge” to live and work outside urban centres. “The big thing that I want to get out of this is to highlight to our trainees, but also to other fellows, that working in rural and remote Australia is a fantastic opportunity,” he said.

“You get to practise some really amazing medicine. You work at the top of your scope. “And there are so many opportunities for career development.” Dr Gourley said improving Indigenous health outcomes was vital, as more than half of the presentations to the Alice Springs emergency department were Indigenous people. “It’s taken a long time to learn the differences and how they work [along with] the different illnesses that we see here and the different injury patterns,” he said. “I think a lot of the issues also apply to the First Nations people in NZ. So Māori health actually has some very similar challenges.” Dr Gourley said in order to close the gap, the social determinants of healthcare also needed to be addressed.

To view the ABC News article Indigenous health, rural medicine key priorities of new ACEM chief Stephen Gourley in full click here.

the outside of the Alice Springs Hospital

The outside of the Alice Springs Hospital in Central Australia. Photo: ABC Alice Springs: Xavier Martin. Image source: ABC News.

Positive cultural connections key to health equity

An article by Ngiare Brown, Peter Azzopardi and Fiona Stanley was published online today (Monday 20 November 2023) in The Medical Journal of Australia. In the article they say positive cultural connections has been identified as key to achieving equity in health and wellbeing for all people; however, action towards culture in health has remained largely neglected. The intent of this article, they said, was not to debate any singular aspect of culture, identity, Indigeneity, or indeed Indigenous cultural identity, but to promote the application of a human rights and cultural lens across social determinant‐informed policy making, to facilitate positive health impacts and nurture and maintain wellbeing.

“Positive sense of identity and culture” is one of seven domains considered in the MJA supplement on the Future Healthy Countdown 2030. While culture and identity is of importance to all people, it is especially relevant to children and adolescents given it is during early life that culture and identify are formed. Childhood and adolescence are also where individuals are exposed to, and where they can shape, the social determinants of health. Moreover, in this article, we argue that positive cultural practices and a strong sense of identity are protective factors for child and adolescent wellbeing.

To view The Medical Journal of Australia article Aragung buraay: culture, identity and positive futures for Australian children in full click here.

Aboriginal dancers perform the WugulOra Morning Ceremony at Walumil Lawn at Barangaroo Reserve as part of the 2016 Australia Day celebrations in Sydney

Aboriginal dancers perform the WugulOra Morning Ceremony at Walumil Lawn at Barangaroo Reserve as part of the 2016 Australia Day celebrations in Sydney. Photo: Dean Lewins. AAP. Image source: SBS NITV.

Apunipima trials new service model in Napranum

Apunipima Cape York Health Council has teamed up with a number of key service providers in the Weipa region to trial an expanded approach to health care that encompasses the social factors that impact on health and wellbeing. The Coordinated Case Care trial being implemented by Apunipima is based on successful ‘social prescribing’ trials overseas with the focus being a full holistic assessment of individual and family need. The trial’s development also draws on local consultation as well as research from other remote areas in Australia and has been tailored specifically to focus on the social determinants of health that impact on the health and wellbeing of Cape York communities.

This trial is designed to connect Apunipima clients with key service providers in community who will collaborate with the aim of eliminating the separation of health care from the social determinants that affect health and wellbeing. The result will be a ‘whole of family’ care system that, if successful, will draw the community social factors into the wider health sphere. “Health is not just about our physical wellbeing, we know that social, emotional and cultural factors impact on our health and wellbeing as Aboriginal and Torres Strait Islander people. ACCHOs understand this but we need to be better at working collaboratively with other care providers so that individuals and families have access to health care and support services that appropriately respond to their needs’ said Apunipima CEO Debra Malthouse.

The trial will work with the members of five families and aims to look at all the social aspects of community life, from food security and fitness right through to home life, employment and financial health. Mrs Malthouse believes the more stakeholders working together, the better placed Apunipima will be to implement a service model that benefits the community member. “When you expand the care provider group to include any service that deals with the social aspects of community life, such as Council, employment agencies and Justice Groups, it brings many more voices to the table, and this trial is about engaging with and bringing those services into the health conversation,” she said.

To view Apunipima Cape York Health Council media release Apunipima trials new service model in Napranum in full click here.

aerial view of Napranum Beach - site for Apunipima new service model trial

Napranum Beach. Image source: Apunipima Cape York Health Council.

Breast cancer policies ‘failing Indigenous women’

Australia’s breast cancer policies do not meet the needs of Indigenous women and there are ways that this can be improved. Indigenous women in Australia are less likely to have breast cancer but more likely to die of it. Breast cancer is the most common cancer experienced by Indigenous women in Australia, presenting at an earlier age and more likely to be experienced with comorbid conditions. Australia’s present approach to breast cancer detection and management must be adapted to meet the cultural and community needs of Aboriginal and Torres Strait Islander women in order to improve their outcomes.

There are several factors that contribute to this, including lower participation in screening services, socio-economic disadvantage, younger age at diagnosis, geographic remoteness, comorbid conditions and a more advanced stage of cancer at the time of diagnosis. There is also evidence that Indigenous women are younger at diagnosis. Australia’s present approach to breast cancer detection and management must be adapted to meet the cultural and community needs of Aboriginal and Torres Strait Islander women in order to improve their outcomes.

In Australia, governing bodies set the priorities and expectations for health care practice and provide the framework for funding and outcomes. There is a growing body of literature about the importance of customising policy and implementation to improve health care outcomes. Including Indigenous women in policy development is vital to their needs being addressed. The effectiveness of policy depends on a number of factors, many of which are government controlled.

To view the InSight+ article Australia’s breast cancer policies ‘failing Indigenous women’ in full click here.

ATSI woman's torso, hands to chest & pink breast cancer awareness ribbon

Breast cancer is the most common cancer experienced by Indigenous women in Australia. Photo: Gustova Svetlana / Shutterstock. Image source: InSight+.

Tracking health and wellbeing of Australian kids

Perhaps the most basic measure of societal progress is that our children will be better off than their parents, building a thriving, more equitable and sustainable Australia for future generations. Today, it seems we are failing in this basic measure of societal achievement. Despite many gains, such as increased immunisation rates and educational attainment, inequities have increased steadily in Australia over the past two decades and children and young people are faring poorly across core metrics. For example, one in six children live in poverty, one in four experience overweight or obesity, three in five adults report experiencing some form of child maltreatment, one in two adolescents are very or extremely worried about climate change, and one in seven children and adolescents have a mental disorder. For children and young people in priority populations (e.g. Aboriginal or Torres Strait Islander origin or low income households), health and wellbeing outcomes are often far worse.

As a wealthy nation, we have the tools to redirect the current trajectory for children and young people and ensure we create a thriving, sustainable and equitable society. However, turning this around will require considerable societal focus, political will and policy effort. Measuring what matters to children and young people needs to be placed at the heart of policy decision making, with government commitment to regular reporting and with clear accountability mechanisms.

The inaugural MJA supplement proposes a path forward for Australia to create policy environments that centre on the health and wellbeing of our children and young people and future generations. This requires systemic policy change. It means thinking about upstream root causes, such as the social determinants of health (eg, commercial, structural, political and economic determinants), prevention, and pre‐distribution of spending (rather than redistribution), and should involve young people and children’s voices in decision making. This necessitates an economy that works for the people and the planet — where children’s and young people’s health and wellbeing are considered the real and measurable profit to the current and future economy.

To view The Medical Journal of Australia article A framework for the Future Healthy Countdown 2030: tracking the health and wellbeing of children and young people to hold Australia to account in full click here.

diagram centre circle 'Future Healthy Countdown 2030' overlapping circles" Health; Material Basics; Learning & Employment pathways; Participating; Positive sense of Identity & Culture; Valued, loved, safe; Environments & sustainable futures

Image source: The Medical Journal of Australia.

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