“ The game itself should be once again an exciting, fast-paced battle with an emphasis on attacking footy, which highlights the natural ability of the Indigenous and Maori talent.
At the end of the day, though, it doesn’t necessarily matter who wins.
Both sides will give it their all, but the immense respect that will be shown by the two cultures is what makes it worthwhile.
The coming together of Maori and First Nations Australia and the positivity that will be taken into the communities in the lead-up to game is a reason why it’s an important date on the calendar.
I’ll be tuning in on Saturday wearing my Deadly Choice Indigenous jersey, taking a moment to be thankful to the medical services that have helped me with my health.
I’ll take a moment to think about my great grandmother, an Indigenous elder that raised me as a child when nobody else would. I’ll think about my roots to Wiradjuri and my family and elders that have paved the way for me to be where I am now.
It’s more than a pre-season trial game for me. It’s a game that pays respect to a part of me that might seem little to some, but is a big part of my identity.”
Jaydem Martin: Whose great grandmother Aunty Joyce Williams has contributed a lot to Aboriginal Health, she’s a Wiradjuri elder and was the founder of the Wellington Aboriginal Health Service in NSW.
Wiray Ngiyang Wiray Mayiny.” That’s the Wiradjuri translation of “no language, no people”.
This Saturday at Cbus Super Stadium on the Gold Coast, the NRL will feature another edition of the All Stars match when the Indigenous All Stars take on the Maori All Stars, returning to the ground where the modern concept began in 2010.
It’s the second year the two teams will be competing against each other, although they’ve met at various times in the past under different formats, with the Maori All Stars looking for revenge after losing to the Indigenous side last year in Melbourne 34-14.
Each year, unfortunately, a lot of people get caught up in the politics and debate of issues that the All Stars game bring up, but for those that think it’s nothing but a glorified trial game, it’s a lot more than that.
I was raised by my great grandmother, a Wiradjuri elder and Aboriginal activist, and grew up in Wellington, New South Wales, a town with a rich Indigenous history and a strong connection to the Wiradjuri nation.
What the All Stars game represents to me is a showcase of that tribe and the many different countries that make up Aboriginal Australia.
It’s an opportunity to celebrate the culture, the land, the language, the diversity of the traditional custodians, while also promoting positive initiatives such as Deadly Choices.
The Indigenous All Stars is a continuation of a legacy that dates back to 1973 when the first Australian Aboriginal team formed and won seven of nine matches in ten days, but it goes back even before that with the long history of the Redfern All Blacks.
Wearing the Indigenous jersey is more than wearing a strip for a modern concept, it’s wearing a symbol of pride and acknowledging the history that Aboriginal men and women have contributed to rugby league throughout the decades.
It’s also representing one of the oldest continuous cultures.
It’s celebrating the greats such as Arthur Beetson and Johnathan Thurston, players like Matty Bowen, John ‘Chicka’ Ferguson, David Peachey and Preston Campbell, the man responsible for the revival of the side, among many more. It’s also showing appreciation to the lesser known names.
Those that have dedicated their lives to country rugby league, like my great uncle, who was the chairman of the Wellington Cowboys up until his death.
It’s a thank you to all in administration that go out of their way to make the Koori Knockout and the Murri Carnival a success.
It’s a thank you to the nurses, the doctors and everyone involved in the Aboriginal medical centres that continue to work on improving the overall health of our people.
Most importantly it’s a game of hope.
For some of the players in the line-up this Saturday, their paths in life could’ve gone very differently.
Rugby league gave them a way to escape the negativity that can come from small town Australia and because of that, these players have become role models and examples to other Indigenous kids that aspire to play in the NRL.
I remember myself being a kid in Wellington with the dream of being like Preston Campbell, but the dream seemed too impossible, something I could never achieve.
Now there are kids growing up in the same town, and despite the issues that plague it, there’s a real sense of hope because they’ve seen people like Blake Ferguson, Brent Naden and Kotoni Staggs set their minds towards a goal and work hard to achieve it. They prove that the dream is possible.
Many people in Wellington will be tuning in and cheering on their hometown hero, Blake Ferguson, but also Tyrone Peachey, Josh Addo-Carr and Jack Wighton, three men that have strong ties to the town.
The game itself should be once again an exciting, fast-paced battle with an emphasis on attacking footy, which highlights the natural ability of the Indigenous and Maori talent.
At the end of the day, though, it doesn’t necessarily matter who wins. Both sides will give it their all, but the immense respect that will be shown by the two cultures is what makes it worthwhile. The coming together of Maori and First Nations Australia and the positivity that will be taken into the communities in the lead-up to game is a reason why it’s an important date on the calendar.
I’ll be tuning in on Saturday wearing my Deadly Choice Indigenous jersey, taking a moment to be thankful to the medical services that have helped me with my health.
I’ll take a moment to think about my great grandmother, an Indigenous elder that raised me as a child when nobody else would. I’ll think about my roots to Wiradjuri and my family and elders that have paved the way for me to be where I am now.
It’s more than a pre-season trial game for me. It’s a game that pays respect to a part of me that might seem little to some, but is a big part of my identity.
” A study of intake of six remote Aboriginal communities, based on store turnover, found that intake of energy, fat and sugar was excessive, with fatty meats making the largest contribution to fat intake.
Compared with national data, intake of sweet and carbonated beverages and sugar was much higher in these communities, with the proportion of energy derived from refined sugars approximately four times the recommended intake.
Recent evidence from Mexico indicates that implementing health-related taxes on sugary drinks and on ‘junk’ food can decrease purchase of these foods and drinks.
A recent Australian study predicted that increasing the price of sugary drinks by 20% could reduce consumption by 12.6%.
Revenue raised by such a measure could be directed to an evaluation of effectiveness and in the longer term be used to subsidise and market healthy food choices as well as promotion of physical activity.
It is imperative that all of these interventions to promote healthy eating should have community-ownership and not undermine the cultural importance of family social events, the role of Elders, or traditional preferences for some food.
Food supply in Indigenous communities needs to ensure healthy, good quality foods are available at affordable prices.”
Extract from NACCHO Network Submission to theSelect Committee’s Obesity Epidemic in Australia Inquiry.
Several governments around the world have adopted taxes on sugary drinks in recent years. The evidence is clear: they work.
Last year, a summary of 17 studies found health taxes on sugary drinks implemented in Berkeley and other places in the United States, Mexico, Chile, France and Spain reduced both purchases and consumption of sugary drinks.
Reliable evidence from around the world tells us a 10% tax reduces sugary drink intakes by around 10%.
The United Kingdom soft drink tax has also been making headlines recently. Since its introduction, the amount of sugar in drinks has decreased by almost 30%, and six out of ten leading drink companies have dropped the sugar content of more than 50% of their drinks.
In Australia, modelling studies have shown a 20% health tax on sugary drinks is likely to save almost A$2 billion in healthcare costs over the lifetime of the population by preventing diet-related diseases like diabetes, heart disease and several cancers.
This is over and above the cost benefits of preventing dental health issues linked to consumption of sugary drinks.
Most of the health benefits (nearly 50%) would occur among those living in the lowest socioeconomic circumstances.
Myth 1: Sugary drink taxes unfairly disadvantage the poor
It’s true people on lower incomes would feel the pinch from higher prices on sugary drinks. A 20% tax on sugary drinks in Australia would cost people from low socioeconomic households about A$35 extra per year. But this is just A$4 higher than the cost to the wealthiest households.
Importantly, poorer households are likely to get the biggest health benefits and long-term health care savings.
What’s more, the money raised from the tax could be targeted towards reducing health inequalities.
In Australia, job losses from such a tax are likely to be minimal. The total demand for drinks by Australian manufacturers is unlikely to change substantially because consumers would likely switch from sugary drinks to other product lines, such as bottled water and artificially sweetened drinks.
Despite industry protestations, an Australian tax would have minimal impact on sugar farmers. This is because 80% of our locally grown sugar is exported. Only a small amount of Australian sugar goes to sugary drinks, and the expected 1% drop in demand would be traded elsewhere.
Myth 3: People don’t support health taxes on sugary drinks
There is widespread support for a tax on sugary drinks from major health and consumer groups in Australia.
In addition, a national survey conducted in 2017 showed 77% of Australians supported a tax on sugary drinks, if the proceeds were used to fund obesity prevention.
Myth 4: People will just swap to other unhealthy products, so a tax is useless
Taxes, or levies, can be designed to avoid substitution to unhealthy products by covering a broad range of sugary drink options, including soft drinks, energy drinks and sports drinks.
There is also evidence that shows people switch to water in response to sugary drinks taxes.
Myth 5: There’s no evidence sugary drink taxes reduce obesity or diabetes
Because of the multiple drivers of obesity, it’s difficult to isolate the impact of a single measure. Indeed, we need a comprehensive policy approach to address the problem. That’s why Dr Muecke is calling for a tax on sugary drinks alongside improved food labelling and marketing regulations.
Towards better food policies
The Morrison government has previously and repeatedly rejected pushes for a tax on sugary drinks.
But Australian governments are currently developing a National Obesity Strategy, making it the ideal time to revisit this issue.
We need to stop letting myths get in the way of evidence-backed health policies.
Let’s listen to Dr Muecke – he who knows all too well the devastating effects of products packed full of sugar.
” The National Aboriginal Community Controlled Health Organisation (NACCHO) and the Royal Australian College of General Practitioners (RACGP) have worked together to develop resources for GPs and other health professionals to support culturally responsive primary healthcare for Aboriginal and Torres Strait Islander people, wherever they seek care.”
A new resource hub has been launched : See Part 1 below
” AH&MRC has also partnered with the RACGP to develop a webinar series. The webinars are on topics relevant to healthcare professionals employed within the ACCHS sector.”
These webinars are published on the RACGP Website : See Part 2 below
Good practice tables – building on the five steps towards excellent Aboriginal and Torres Strait Islander healthcare and five good practice tables provide activities for all members of the practice team with each activity linked to accreditation
Quality 715 health check resource – this one-page resource provides an opportunity for practice teams to reflect on what they are doing well and what could be improved to support quality Medicare Benefits Schedule (MBS) item 715 health checks for Aboriginal and Torres Strait Islander people
National Guide check (unit 561) – this edition of check provides case studies involving Aboriginal patients
To complement the resource hub, RACGP Aboriginal and Torres Strait Islander Health has developed a new webinar series titled, ‘I can see clearly now: Good experiences and great health outcomes through effective, culturally safe primary healthcare’.
The webinar series is presented by:
Ms Jacinta McKenzie, Integrated Team Care Supervisor, Indigenous Health Project Officer, Wellness Our Way at Country and Outback Health
Dr Mary Belfrage, GP and RACGP Fellow
Ms Ada Parry, RACGP Cultural and Education Advisor.
Access RACGP Aboriginal and Torres Strait Islander Health, Aboriginal Health and Medical Research Council of NSW and NSW Health webinars on issues related to GPs and other health professionals working in the Aboriginal Community Controlled health Services (ACCHS) sector.
“The prevalence of most chronic diseases increases with age and affects not only physical health, but also the broader contributors to the well-being of older Aboriginal people, including participation in family, community and cultural leadership roles and connection with community networks.
Aboriginal people often receive a diagnosis at a more advanced stage of chronic disease, which means there’s less opportunity to prevent their condition and health deteriorating “
Professor Sanson-Fisher said chronic diseases continue to be a major contributor to unhealthy ageing among Aboriginal and Torres Strait Islander people. Timely diagnosis and appropriate management was vital to improving health outcomes for Aboriginal and Torres Strait Islander people. See Website
Consider these facts
In 2016-2017 just 27 per cent of Indigenous adults aged 15 to 24 had an annual health assessment.
Only 30 per cent of 25-to 54-year-olds, and 41 per cent of Indigenous adults over 55 had one.
Around 37 per cent of the burden of disease in Aboriginal people could be prevented by reducing risk factors
An intervention designed to help Close the Gap, by increasing the number of Aboriginal and Torres Strait Islander people who receive an annual health check by their GP, will be implemented and evaluated by a new National Health and Medical Research Council (NHMRC) project.
Renowned population health researcher, Laureate Professor Rob Sanson-Fisher of the University of Newcastle and Hunter Medical Research Institute, will lead a team of expert Aboriginal and non-Aboriginal researchers in the five-year research project – which was awarded $745,056 following a Targeted Call for Research** for Healthy Ageing of Aboriginal and Torres Strait Islander People.
Indigenous people die about eight years earlier than non-Indigenous Australians. For Aboriginal and Torres Strait Islander Australians born in 2015-17, the life expectancy is 71.6 years for men and 75.6 years for women – about 8.6 and 7.8 years less than non-Aboriginal men and women respectively.
Twenty-two mainstream general practice clinics within the central Coast and New England regions will participate in the research project.
The intervention package will comprise strategies such as continuing medical education, recall and reminder systems, and mailed invitations to patients.
The project will also test whether the intervention increases doctors’ adherence to best practice care and improves patient outcomes.
More than 60 per cent of Indigenous people regularly visit mainstream general practice services – a key opportunity to deliver an annual ‘715’ health assessment, which forms an integral part of the Australian Government’s Closing the Gap commitment.
The aim of the Aboriginal and Torres Strait Islander Health Assessment (Medicare Benefits Schedule item 715) is to help ensure Indigenous Australians receive primary health care matched to their needs, by encouraging early detection, diagnosis and intervention for common and treatable conditions that cause morbidity and early death.
The health assessment is an annual service and covers the full age spectrum..
Key contributing chronic conditions include cardiovascular diseases (19 per cent of the chronic disease prevalence gap), mental and substance use disorders (14 per cent), cancer (9 per cent), chronic kidney disease, diabetes, vision loss, hearing loss and respiratory, musculoskeletal, neurological and congenital disorders.
Around 37 per cent of the burden of disease in Aboriginal people could be prevented by reducing risk factors.
The risk factors causing the most burden are tobacco use (12 per cent of the total burden), alcohol use (8 per cent), high body mass (8 per cent), physical inactivity (6 per cent), high blood pressure (5 per cent) and high blood glucose levels (5 per cent).
“Mainstream general practice is a crucial setting to impact on prevention, timely diagnosis and appropriate management of chronic disease for Aboriginal people, which is imperative to help Close the Gap,” Professor Sanson-Fisher said.
In 2017–18, Indigenous primary health services were delivered from 383 sites (Table 3). Most sites provided clinical services such as the diagnosis and treatment of chronic illnesses (88%), mental health and counselling services (88%), maternal and child health care (86%), and antenatal care (78%). Around two-thirds provided tobacco programs (69%) and substance-use and drug and alcohol programs (66%).
Most organisations provided access to a doctor (86%) and just over half (54%) delivered a wide range of services, including all of the following during usual opening hours: the diagnosis and treatment of illness and disease; antenatal care; maternal and child health care; social and emotional wellbeing/counselling services; substance use programs; and on‑site or off-site access to specialist, allied health and dental care services.
Most organisations (95%) also provided group activities as part of their health promotion and prevention work. For example, in 2017–18, these organisations provided around:
8,400 physical activity/healthy weight sessions
3,700 living skills sessions
4,600 chronic disease client support sessions
4,100 tobacco-use treatment and prevention sessions.
In addition to the services they provide, organisations were asked to report on service gaps and challenges they faced and could list up to 5 of each from predefined lists. In 2017–18, around two-thirds of organisations (68%) reported mental health/social and emotional health and wellbeing services as a gap faced by the community they served.
This was followed by youth services (54%). Over two-thirds of organisations (71%) reported the recruitment, training and support of Aboriginal and Torres Strait Islander staff as a challenge in delivering quality health services.
This is the tenth national report on organisations funded by the Australian Government to provide health services to Aboriginal and Torres Strait Islander people.
Indigenous primary health services
Primary health services play a critical role in helping to improve health outcomes for Aboriginal and Torres Strait Islander people. Indigenous Australians may access mainstream or Indigenous primary health services funded by the Australian and state and territory governments.
Information on organisations funded by the Australian Government under its Indigenous Australians’ health programme (IAHP) is available through two data collections: the Online Services Report (OSR) and the national Key Performance Indicators (nKPIs). Most of the organisations funded under the IAHP contribute to both collections (Table 1).
The OSR collects information on the services organisations provide, client numbers, client contacts, episodes of care and staffing levels. Contextual information about each organisation is also collected. The nKPIs collect information on a set of process of care and health outcome indicators for Indigenous Australians.
This tenth national OSR report presents information on organisations funded by the Australian Government to provide primary health services to Aboriginal and Torres Strait Islander people. It includes a profile of these organisations and information on the services they provide, client numbers, client contacts, episodes of care and staffing levels. Interactive data visualisations using OSR data for 5 reporting periods, from 2013–14 to 2017–18, are presented for the first time.
A wide range of primary health services are provided to Aboriginal and Torres Strait Islander people. In 2017–18:
198 organisations provided primary health services to around 483,000 clients, most of whom were Aboriginal and Torres Strait Islander (81%).
These organisations provided around 3.6 million episodes of care, with nearly 3.1 million (85%) delivered by Aboriginal Community Controlled Health Services (ACCHSs).
More than two-thirds of organisations (71%) were ACCHSs. The rest included government-run organisations and other non-government-run organisations.
Nearly half of organisations (45%) provided services in Remoteand Very remote
Services were delivered from 383 sites across Australia. Most sites provided the diagnosis and treatment of chronic illnesses (88%), social and emotional wellbeing services (88%), maternal and child health care (86%), and antenatal care (78%). Around two-thirds provided tobacco programs (69%) and substance-use and drug and alcohol programs (66%).
Organisations made on average nearly 13 contacts per client
In 2017–18, organisations providing Indigenous primary health services made around 6.1 million client contacts, an average of nearly 13 contacts per client (Table 2). Over half of all client contacts (58%) were made by nurses and midwives (1.8 million contacts) and doctors (1.7 million contacts). Contacts by nurses and midwives represented half (49%) of all client contacts in Very remote areas compared with 29% overall.
At 30 June 2018, organisations providing Indigenous primary health services employed nearly 8,000 FTE staff and over half of these (54%) were Aboriginal or Torres Strait Islander. These organisations were assisted by around 270 visiting staff not paid for by the organisations themselves, making a total workforce of around 8,200 FTE staff.
Nurses and midwives were the most common type of health worker (14% of employed staff), followed by Aboriginal and Torres Strait Islander health workers and practitioners (13%) and doctors (7%). Nurses and midwives represented a higher proportion of employed staff in Very remote areas (22%).
Social and emotional health and wellbeing services are the most commonly reported service gap
Organisations can report up to 5 service gaps faced by the community they serve from a predefined list of gaps. Since this question was introduced in 2012–13, the most commonly reported gap has been for mental health and social and emotional health and wellbeing services. In 2017–18, this was reported as a gap by 68% of organisations.
” A 715 it’s a health check that Aboriginal and Torres Strait on the people’s can have done on an annual timetable.
But it should be comprehensive in nature, and offer you not just the usual, hi, how are you?
What’s your name? Where do you live?
But take full consideration of your social background and social histories, ask you about your family history.
Is there anything important not just in your own personal medical background, but that of your family, so we can take that into consideration?
We know that we have many families with long backgrounds of chronic disease, for example, diabetes, cardiovascular risk, and they’re super important we’re considering how we tailor our history, our examination, our investigations, and then a treatment plan for you.
It goes through the steps of that history and they’ll ask you questions about, you got a job at the moment, where are you working?
What are you exposed to? What are your interest? Do you play sport?
Are you involved in any other sort of social activities, cultural activities, for example, which I think is really important.
They’ll then make determinations around the kinds of examination if they need to tailor that at all, depending upon your age, and where you live and your access to services and what your history brought up, for example, male, female, young or old.
And then the investigations and X-ray, for example, or some bloods taken, and referrals as appropriate.
For allied health professionals, pediatrists, nutritionists, diabetes educators, but also perhaps you might need to see a cardiologist or a diabetes and endocrinologist as a specialist.
And then we wrap that all up in a specific and individualised kind of plan for you, that we discuss and we negotiate and we try to educate so that you then are able to play a part in your own health and take responsibility for some of those aspects.
But also you then get to choose what you share with family and the other providers.
It’s supposed to be a relationship and partnership for your health, that you understand, that you agree to and then together, you can move forward on how to be healthy and stay healthy.
Annual health checks for Aboriginal and Torres Strait Islander Australians
Aboriginal and Torres Strait Islander people can access a health check annually, with a minimum claim period of 9 months. 715 health checks are free at Aboriginal Medical Services and bulk bulling clinics to help people stay healthy and strong.
We acknowledge that many individuals refer to themselves by their clan, mob, and/or country. For the purposes of the health check, we respectfully refer to Aboriginal and Torres Strait Islander people as Aboriginal and Torres Strait Islander throughout.
Your Health is in Your Hands
Having a health check provides important health information for you and your doctor.
Staying on top of your health is important. It helps to identify potential illnesses or chronic diseases before they occur. It is much easier to look at ways to prevent these things from occurring, rather than treatment.
The 715 Health Check is designed to support the physical, social and emotional wellbeing of Aboriginal and Torres Strait Islander patients of all ages. It is free at Aboriginal Medical Services and bulk billing clinics.
What happens at the health check?
Having the health check can take up to an hour. A Practice Nurse, Aboriginal Health Worker or Aboriginal and Torres Starlit Islander Health Practitioner may assist the doctor to perform this health check. They will record information about your health, such as your blood pressure, blood sugar levels, height and weight. You might also have a blood test or urine test. It is also an opportunity to talk about the health of your family.
Depending on the information you’ve provided, you might have some other tests too. You’ll then have a yarn with the doctor or health practitioner about the tests and any follow up you might need. It’s also good to tell them about your family medical history or any worries you have about your health.
Information for patients
Only about 30 per cent of Aboriginal and Torres Strait Islander people are accessing the 715 health check. Resources have been developed to help improve the uptake of 715 health checks in the community.
These are available for patients, community organisations, PHNs and GP clinics to download or order
Health checks might be different depending on your age.
Having the health check should take between 40-60 minutes. A health practitioner might check your:
blood sugar levels
height and weight
You might also a have blood test and urine test.
It’s also good to tell your health practitioner about your family medical history or any worries you have about your health.
Follow up care
Once you finish the check, the Practice Nurse, Aboriginal Health Worker or Doctor might tell you about other ways to help look after your health. They might suggest services to help you with your:
You may also get help with free or discounted medicines you might need. Your Doctor can give you information about Closing the Gap scripts if you have or at risk of having a chronic disease.
Where can you access a 715 health check?
You can choose where you get your 715 health check. If you can, try to go to the same Doctor or clinic.
This helps make sure you are being cared for by people who know about your health needs.
Do I need to pay for the 715 health check?
The health check is free at your local Aboriginal Medical Service. It is also free at bulk billing health clinics. If you are unsure whether it will be free at your local Doctor, give them a call to ask about the 715 health check before you book.
Why Should I Identify?
It’s important to tell the Doctor if you are Aboriginal and/or Torres Strait Islander so that they can make sure you get access to health care you might need. Medicare can help record this for you, and their staff are culturally trained to help.
Call the Aboriginal and Torres Strait Islander Access line on 1800 556 955.
Report 1 : Indigenous health checks and follow-ups
Through Medicare (MBS item 715), Aboriginal and Torres Strait Islander people can receive Indigenous-specific health checks from their doctor, as well as referrals for Indigenous-specific follow-up services.
In 2017–18, 230,000 Indigenous Australians had one of these health checks (29%).
The proportion of Indigenous health check patients who had an Indigenous-specific follow-up service within 12 months of their check increased from 12% to 40% between 2010–11 and 2016–17.
Report 2 : Regional variation in uptake of Indigenous health checks and in preventable hospitalisations and deaths
Potentially preventable hospitalisations (PPH) and potentially avoidable deaths (PAD) are hospitalisations and deaths that are considered potentially preventable through timely access to appropriate health care.
While the risk of these health outcomes depends on population characteristics to some degree, relatively high rates indicate a lack of access to effective health care.
In Australia, Aboriginal and Torres Strait Islander people have PPH and PAD rates that are more than 3 times as high as those for non-Indigenous people.
All Indigenous Australians are eligible for Indigenous-specific health checks, which are a part of the Australian Government’s efforts to improve Indigenous health outcomes. The health checks are conducted by GPs and are listed as item 715 on the Medicare Benefits Schedule.
In this report, we contrast the geographical variation in Indigenous PPH and PAD with the variation in uptake of Indigenous-specific health checks at the local-area level (Statistical Area Level 3), by Primary Health Network and by state or territory.
Overall, areas with large Indigenous populations tend to have high rates of PPH and PAD and high uptake rates of Indigenous health checks. That areas with high rates of health checks also tend to have high rates of PPH and PAD may seem counterintuitive. However, any effects of the health checks on the rates of PPH and PAD are likely to become more apparent over time as there has recently been a dramatic increase in the rates of Indigenous health checks in many parts of Australia. It is reasonable to expect that there will be some lag time between an increase in the uptake of health checks and when positive effects on health outcomes can be seen.
We use a regression model to identify areas with unexpectedly high or low rates of PPH given the demographic composition of their populations and other characteristics of the areas (such as remoteness). Cape York, Tasmania and the northern parts of the Northern Territory stand out as regions with unexpectedly low rates of PPH. Regions with unexpectedly high rates include Central Australia, the Kimberley and some inner parts of Darwin, Perth and Brisbane.
Unexpectedly high or low rates of PPH can be due to a number of factors including:
performance of the local health-care services, including past performance affecting the health of local people
accessibility of hospitals and relative use of hospitals or other health-care services
people with poor health moving from areas without services to areas with services (for high rates)
unaccounted factors that influence the risk of PPH
These factors are all potentially important. How they influence reported health outcomes needs to be better understood to ensure that policy and management decisions are based on the best available information.
Aboriginal and Torres Strait Islander people can receive an annual health check, designed specifically for Indigenous Australians and funded through Medicare (Department of Health 2016).
This Indigenous-specific health check was introduced in recognition that Indigenous Australians, as a group, experience some particular health risks.
The aim of the Indigenous-specific health check is to encourage early detection and treatment of common conditions that cause ill health and early death—for example, diabetes and heart disease.
NACCHO note : Many of ACCHO’s throughout Australia offer incentives like Deadly Choices shirts to have a 715 Health Check
During the health check, a doctor—or a multidisciplinary team led by a doctor—will assess a person’s physical, psychological and social wellbeing (Department of Health 2016). The doctor can then provide the person with information, advice, and care to maintain and improve their health.
The doctor may also refer the person to other health care professionals for follow-up care as needed—for example, physiotherapists, podiatrists or dieticians.
This report presents information on the use of:
health checks provided under the Indigenous-specific Medicare Benefits Schedule (MBS) item 715; and
follow-up services provided under Indigenous-specific MBS items 10987 and 81300 to 81360.
The data include all Indigenous-specific health checks and follow-ups billed to Medicare by Aboriginal Community Controlled Health services or other Indigenous health services, as well as by mainstream GPs and other health professionals.
Note that the data are limited to Indigenous-specific MBS items, so do not provide a complete picture of health checks and follow-ups provided to Indigenous Australians.
For example, Indigenous Australians may receive similar care through other MBS items (that is, items that are not specific to Indigenous Australians), or through a health care provider who is not eligible to bill Medicare (see also Data sources and notes).
Throughout the report, ‘Indigenous-specific health checks’ is used interchangeably with ‘health checks’ to assist readability. Similarly, ‘Indigenous-specific follow-ups’ is used interchangeably with ‘follow-ups’.
Indigenous-specific health checks and follow-ups: data summary
Number of health checks
In 2017–18, there were about 236,000 Indigenous-specific health checks provided to about 230,000 Aboriginal and Torres Strait Islander people. The minimum time allowed between checks is 9 months, and so people can receive more than 1 health check in a year.
Between 2010–11 and 2017–18, the number of Indigenous Australians receiving a health check more than tripled—from about 71,000 to 230,000 patients.
Figure 3 shows the rate of Indigenous-specific health checks by four different geographic classifications—state/territory, remoteness area, Primary Health Network (PHN), and Statistical Areas Level 3 (SA3s).
This analysis is based on the postcode of the patient’s given mailing address. As a result, the data may not reflect where the person actually lived—particularly for people who use PO Boxes. This is likely to impact some areas more than others, and will also have a greater impact on the SA3 data than the larger geographic classifications. See Data sources and notes for information on areas most likely to be affected.
across states and territories, the Northern Territory had the highest rate of Indigenous-specific health checks (with 38% of the Aboriginal and Torres Strait Islander population receiving an Indigenous health check), followed by Queensland (37%). Tasmania had the lowest rate (13%).
across PHNs, the rate of Indigenous-specific health checks ranged from 4% (in Northern Sydney) to 42% (in Western Queensland).
Based on needs identified during a health check, Aboriginal and Torres Strait Islander people can access Indigenous-specific follow-up services—from allied health workers, practice nurses, or Aboriginal and Torres Strait Islander Health practitioners—through MBS items 10987, and 81300–81360 (see also Box 2).
Indigenous Australians may receive follow-up care through other MBS items that are also available to non-Indigenous patients. For example, if a person is diagnosed with a chronic health condition, the GP might prepare a GP Management Plan, or refer the person to a specialist. Data in this report relate to Indigenous-specific items only.
In 2017–18, there were about 324,000 Indigenous-specific follow-up services provided to 133,000 Indigenous Australians. This was an increase from around 18,500 follow-ups provided to 9,900 patients in 2010–11 (Figure 7).
Wednesday by 4.30 pm for publication Thursday /Friday
Feature article this week
1.1 National : Relationships key to better Indigenous Health – and the 715 health check is paving the way says Dr Mark Wenitong
“You really have to engage with the local Aboriginal community, so they feel comfortable to come in and get their 715.
You need to understand cultural sensitivities to get a proper medical history – you can’t diagnose if you don’t know what’s really going on with a patient, so building that trust is really critical.
Aboriginal and Torres Strait Islander people have the worst health outcomes of any community in Australia.
We have a responsibility as health professionals to take care of this community, the same way that we take care of any part of our community.
Our people can actually take care of themselves if they have the education and the information in their hands.”
Dr Mark Wenitong Apunipima Health Service
Mark is one of a kind. Descending from the Kabi Kabi tribal group of South Queensland, Mark is one of the first Aboriginal men to graduate as a Doctor and is now a powerful advocate for improving Indigenous health outcomes.
Mark says he was inspired to become a Doctor by his mother who was one of the first Aboriginal Health Workers to be trained in Queensland. Her work with the Cape York community, in particular tackling the surge of sexually transmitted diseases in the region at the time, inspired a passion for better health within the family.
“Mum’s legacy was what really made me want to become a Doctor. I wanted to be able to help our mob to look after their own health, to provide a cultural lens. For me, that’s why it’s so important that Aboriginal Doctors are part of our service system, we can translate research, evidence and even program work into real practice” says Mark.
“With more Aboriginal Doctors, we can relate to our people, overcome barriers and build cultural resonance.”
After studying and graduating from the University of Newcastle in 1995, Mark is now based in Cairns at Apunipima Health Service, working with the local Aboriginal and Torres Strait communities up north, both in the clinic and out in communities.
Mark says, the annual health check for Aboriginal and Torres Strait Islander people, item 715 under the Medicare Benefits Schedule, provides enormous opportunities for GPs to engage with Indigenous communities about their health needs.
“The importance of 715s can’t be overstated – it’s one of the most important innovations that Medicare, and the Government, has brought in. We needed to do it, because we needed to get an understanding of what people’s health profile was before they were unwell. Why wait until patients come to us with a chronic disease? Let’s start screening early,” says Mark.
With Aboriginal and Torres Strait Islander people 2.3 times more likely to suffer a chronic condition, the annual health check is designed to provide early detection and prevention. Mark says the assessment is critically important in improving Indigenous health outcomes.
“There’s a couple of aspects to a 715 that are really important. The first is the screening – there are lots of people that are asymptomatic – meaning they aren’t showing symptoms yet – that could have early disease like diabetes, hypertension. These patients may not come in until they get symptoms because people still think they have to be sick to come to a clinic. It’s an important way to engage the community, so they know they can come to a clinic whenever they need do,” says Mark.
“The other important aspect is that it’s a comprehensive assessment – a complete head to toe. By screening a broad array of physical, social and emotional factors, we get a really good picture of individual and community level health. Because we can identify problems early, we can also start early treatment.
“At a community level, we get really great data from undertaking the 715. We work with the local Elders groups to deliver 715 health check days out in the community, and screen people that otherwise wouldn’t come to the clinic. It gives us an idea of what the issues are at a really local level. We can then look at broader issues that affect the whole community, like immunisation, dementia, mental health and social wellbeing and can work to develop appropriate programs that tackle the specific issue a community might be experiencing.”
The annual health check is available for Aboriginal and Torres Strait Islander people of all ages, however nationally less than 30 per cent of patients are accessing the check.
Mark says it’s important to engage young patients with getting a 715 early as part of educating people about how to stay healthy.
“I see young people come in for their 715 and they’re very well. But I talk to them about health maintenance, talk to them about what they could end up like. Their uncle whose overweight, with no teeth and smoking outside. Our young people want to look deadly and fit, so we can help them with information and tips to stay in good health.
But with Aboriginal and Torres Strait Islander Doctors representing less than 1% of the general practitioner workforce it’s important that all GPs understand the benefits of a 715 for Aboriginal and Torres Strait Islander patients.
Mark says the key to improving mainstream health services for Aboriginal and Torres Strait Islander patients is to encourage practices to engage with their local community to build cultural competency.
“If Aboriginal people walk into a service and don’t feel welcome, they won’t come back. Access is a big issue – creating a safe space for people to feel welcome is important,” says Mark.
“You really have to engage with the local Aboriginal community, so they feel comfortable to come in and get their715. You need to understand cultural sensitivities to get a proper medical history – you can’t diagnose if you don’t know what’s really going on with a patient, so building that trust is really critical.
“Most GPs can do this fairly well with most people, so it’s just a matter of then learning a little bit more about Aboriginal social and cultural issues to be able to relate to these patients in the right way. If you do, you’ll make a big difference.
“Some mainstream practices I’ve worked with have done really simple things, like putting Aboriginal health posters up in the waiting room or hiring and Aboriginal Health Worker or Aboriginal receptionist to help people feel welcome.”
Mark’s message to health professionals is simple – help your Aboriginal and Torres Strait Islander patients in the same way you help any others.
“Aboriginal and Torres Strait Islander people have the worst health outcomes of any community in Australia. We have a responsibility as health professionals to take care of this community, the same way that we take care of any part of our community. Our people can actually take care of themselves if they have the education and the information in their hands.”
The 715 health check is available annually to Aboriginal and Torres Strait Islander people of all ages. Further information, including resources for patients and health practitioners is available at www.health.gov.au/715-health-check.
1.2 National : Donnella Mills Acting @NACCHOChair broadcast interview at Lowitja Conference in Darwin
1.3 National : Donnella Mills Acting @NACCHOChair and John Paterson CEO AMSANT presents at Lowitja the Coalition of ACCO Peaks on #ClosingtheGap
2. NSW : Katungul ACCHO newly appointed CEO for the next 12 months, Joanne Grant talks about what motivates her to get out of bed every day
What motivates you to get out of bed every day to come and work at Katungul and why?
I firstly want to pay my respects to the Walbunja peoples, some of whom are family, of the Yuin nation and I am really honoured to be able to work on their land and with the local Aboriginal Communities along the far South Coast of NSW.
There is well documented evidence of the disparity faced by Aboriginal people in Australia and still today our people are denied their basic human rights. The opportunity to make a change for our people is what really motivates me.
Working in the health sector has been an eye opening experience for me as we see daily the ‘real’ effects of colonisation and trans-generational trauma which presents in many forms, for our mob eg AOD, mental health, chronic disease, family breakdown to name a few. To be able to work in an organisation like Katungul, that can provide services and programs directly to our communities, and who value cultural safety is what I believe will make a genuine difference.
What are you most excited about taking on in the next 12 months?
I am keen for the challenge that lies ahead of me. Whilst I have been apart of the executive team at Katungul for nearly 4 years, to take the reins of our organisation requires a whole new level of responsibility, way of thinking and commitment.
I see my role as an opportunity to build on our successes and have us recognised for the work we do.
It disappoints me at times that our Government still does not fully value the significant role of an Aboriginal community controlled organisation, which is evident when you look at the funding options that bypass us. I believe, we hold the vital keys and answers to our solutions! I am keen to take the lead and have us write our own narrative of change as we move forward.
What can you personally bring to you role?
MMM.. talking myself up is not a big strength of mine, but when I look at my employment history I believe I can bring 30 plus years of demonstrated experience and commitment of working with Aboriginal and Torres Strait Islander Peoples with me.
When I left year 12 my first real job was with the Human Rights Commission, handling complaints of racial discrimination around Australia. This was a not just a job but a real life lesson for me, at that young age.It really opened my eyes up to the injustices my people faced. These stories have stayed with me throughout my employment journey and always motivates me to champion change.
What do you think will be your biggest challenges?
Working in any Aboriginal organisation is a hard ask, as we face many political challenges, at all levels including by our own communities. There seems to be a perception out there that we, Aboriginal organisations, receive a plethora of funding and are able to address ALLissues faced by our communities.
Unfortunately this is not the case, and we need to be clear and concise about what we can and cannot do and exceed where we are able to. Living in regional Australia itself is a challenge as local resources are limited which means we have to access support and services for our clients out of area. This is clearly evident in the AOD space with all clients requiring residential treatment/care having to leave the area and their family and Kinship networks which at times can be problematic.
What can the community expect to see from you in this role?
They can expect to see an Aboriginal woman lead with integrity, take on the challenges as they arise and to put the needs of the communities we serve at the centre of our business.
3. VicMDAS Family and Community Services team supports our clients as they strive to achieve their own goals in life.
We have specialist teams focussing on the different needs within our community:
• Aged and Disability
• Children’s Placement Services
• Family Services
• Youth Services
• Homelessness and Housing Services
Our staff work from a “Best-Interest Case Practice Model” – that means we support clients to achieve their goals and maintain their connections to their community, their families and, importantly, their culture.
4. QLD :QAIHC CEO sleeps out to raise vital funds for homelessness : Please Donate HERE
Last night ( Thursday 20 June ) the Queensland Aboriginal and Islander Health Council (QAIHC) CEO, Neil Willmett, slept out on the cold, hard concrete of Brisbane’s Powerhouse as part of the Vinnies CEO Sleepout.
The annual event raises much needed funds and awareness to address homelessness in Australia. For the CEOs involved it is one night of discomfort, but for more than 116,427 Australians, including more than 22,000 Queenslanders, homelessness is a constant reality.
This is the third year that Mr Willmett has participated in the CEO Sleepout, a cause close to his heart.
“It is well known that Aboriginal and Torres Strait Islander peoples are over-represented in the homeless population. Across Australia, approximately 25% of people who access specialist homelessness services identified as being Aboriginal and/or Torres Strait Islander,” said Mr Willmett.
Mr Willmett is striving to raise a minimum of $5,000 to help the St Vincent de Paul Society Queensland (Vinnies) provide support to people in crisis.
“I am proud to participate in the Vinnies CEO Sleepout. As the CEO of QAIHC, I lead an organisation whose membership has a positive impact on the most vulnerable. Across the whole of Queensland, the homeless population is in the thousands. Homelessness can have profound and ongoing effects on people and their health and wellbeing,” Mr Willmett said.
Funds raised at the Vinnies CEO Sleepout enables Vinnies to provide vital services to people experiencing homelessness. Vinnies provides emergency accommodation, advocacy support, budgeting services, living skills programs, emergency relief, transitional housing and access to programs that help rebuild the lives of Australians living in poverty.
Lot 4669 Forrest Avenue, Carey Park which is known as Jaycee Park will be transferred to SWAMS with the city agreeing to waive the development application fee of $34,196.
City of Bunbury Mayor Gary Brennan said the health hub would be a welcomed addition to the region.
“We are pleased to be able to provide the land to SWAMS for their health precinct and council would like to acknowledge all the hard work they do as well as the excellent service they provide to the community,” he said.
“By expanding their practice they will be able to do even more for their clients and make health care available and more accessible to those who need it.”
SWAMS chief executive Lesley Nelson thanked council for prioritising Indegenous health.
“This is about looking at a one-stop health hub to bring all of our programs and services under the one roof, in the one location,” she said.
“Strong local commitment and continuity are required to close the gap and that is why this purpose built, local facility is so important.”
During planning for the new purpose-built hub, SWAMS has partnered with University of Technology Sydney, to ensure an innovative, cutting edge design which will deliver positive outcomes for clients.
The build will include clinical and research facilities, administrative offices, dedicated maternal and child health facility and an outdoor Indigenous park in the one location.
There will also be a fenced-off children’s playground, landscaped gardens and new toilet facilities all open to the public.
Ms Nelson said they were still looking for funding partners and had sent the health hub plans out to a number of ministers.
“The total project will be around $28 million but if there is opportunities to undertake work at different stages that’s what we’ll do,” she said.
“We’re positive that it will happen, the first stage we’ll be looking at is building the health and wellbeing community centre and the landscaping and the park.
“That will get us started and showcase to the local community that something is happening on the site that is exciting.
“We know it’s important and this is part of trying to close the gap at a local level from the community – in terms of driving what they want to see here.”
SWAMS will now submit the development application to the City for assessment.
Once it has been approved, construction is expected to be completed within 12 months.
5.2 WA : AHCWA Starts new course in Aboriginal and/or Torres Strait Primary Health Care Practice
NEW COURSE STARTING THURSDAY JULY 25th 2019
If you are interested in completing the Certificate IV in Aboriginal and/or Torres Strait Primary Health Care Practice” course or would like more information please email email@example.com. or phone 92771631.
6. SA :AHCSA_ Study redefines gender policy for Aboriginal and Torres Strait Islander Peoples
7. NT : Minister Ken Wyatt Visits AMSANT office in Darwin after opening Day 2 Lowitja Conference
8.ACT : Winnunga ACCHO adviser says reports expose ACT disinterest in Aboriginal care
” THE release in late 2018 of two reports – “The Family Matters Report 2018”, which concerns Aboriginal and Torres Strait Islander children in out-of-home care or in touch with the child protection system, and the Bureau of Statistics report “Prisoners in Australia 2018″– are a wake-up call for Canberra.”
Jon Stanhope is employed as an adviser at Winnunga Nimmityjah Aboriginal Health and Community Service
“The Family Matters Report 2018”, which measures the trends in over-representation of Aboriginal children in out-of-home-care is as depressing as it is distressing. The report includes a jurisdiction-by-jurisdiction report card on the implementation of best practice in child protection as represented by the Aboriginal Child Placement Principles and the four building blocks of the Family Matters Roadmap. “The Family Matters Report” is a collaborative effort of SNAICC-National Voice for our Children, the University of Melbourne and Griffith University. In other words, it is rigorous and credible.
In summary, the report reveals (and not for the first time) that the ACT is among the worst-performing jurisdictions in Australia and, on a number of specific and major measures, the worst-performing jurisdiction in Australia when it comes to the care of Aboriginal children in contact with the child-protection system.
In relation to the Aboriginal Child Placement Principles, recognised nationally as of fundamental importance to the management and care of Aboriginal children in out-of-home care, the ACT is identified as the only jurisdiction in Australia that has refused to include in its child-protection legislation any of the recognised elements of self-determination or a human-rights-based framework for participation in child protection decision making such as consulting Aboriginal community controlled organisations and involving them in decisions about the placement or care of Aboriginal children.
In light of the ACT government’s practice of excluding Aboriginal participation in child protection it is no surprise that the ACT has the highest rate of Aboriginal children in touch with the care and protection system in Australia and the third highest rate of removal of Aboriginal children from their families in Australia. An Aboriginal child in the ACT is 14 times more likely than a non-Aboriginal child to be in out-of-home care.
Stunningly, despite these quite shameful outcomes the ACT has the lowest level of funding in Australia for intensive family support and the second lowest level of family support generally.
Unsurprisingly, there are clear linkages between children who have been removed from their family by care and protection services and poverty, disadvantage and ultimately contact with the criminal justice system. The ABS report – “Prisoners in Australia 2018” – to the extent that it exposes and details the over-representation of Aboriginal men and women in prison in the ACT, confirms the depth of the failure of the ACT government and justice system to address either the causes of or appropriate response to Aboriginal offending.
The headline finding in the ABS report is that the ACT has the highest ratio of Aboriginal people in jail in Australia. An Aboriginal person in Canberra is 17.5 times more likely than a non-Aboriginal person to be sent to prison. The next highest is WA with a ratio of 16 followed by the NT where the ratio is 12. The ACT also stands out as the jurisdiction with the highest increase in relative imprisonment of Aboriginal people between 2008 and 2018, with an increase over the 10 years of a massive 100 per cent. In that same period WA and SA reduced the relative imprisonment rate by 9 per cent and 1 per cent respectively.
There is perhaps no single better illustration of the extent of inequality in Canberra than that the city with the highest median household income, the highest rates of home ownership and private health insurance, the fastest growing median house price and the highest mean income in the nation also has the highest rate of indigenous incarceration.
There is a range of other data reported by the ABS that is as equally shocking as the raw rate of indigenous incarceration. For instance the rate of prior imprisonment (or recidivism rate) of Aboriginal prisoners currently in the AMC is a mind blowing 90 per cent, the highest in Australia. Of the 109 Aboriginal detainees in the AMC on June 30 a staggering 99 of them were recidivists.
Equally alarming is the rate of increase in the ACT in the crude imprisonment rate of Aboriginal and Torres Strait Islander people. Between 2017 and 2018 the rate in the ACT increased by 12 per cent to produce an increase over the six-year period from 2012 to 2018 of 89 per cent against a national average of 24 per cent. By way of comparison the growth in incarceration, over the same six years, in the NT, WA and SA was 8 per cent, 15 per cent and 18 per cent respectively.
That the rate of increase in the incarceration of Aboriginal people in the ACT, over the last six years, is 65 per cent higher than the national average and that the rate of relative imprisonment has doubled in the last 10 years is deeply alarming and surely demands immediate and independent investigation and an urgent response. However, for that to occur there needs to be someone in government who actually cares.
My fear is that the ACT government has sensed that the Canberra community doesn’t really care that much about the level of indigenous disadvantage and poverty in Canberra and has accordingly decided that there is no need for it to either.
Jon Stanhope is employed as an adviser at Winnunga Nimmityjah Aboriginal Health and Community Service.