NACCHO Aboriginal Youth Health : Download 2019 @MissionAust Reports Including 20 pages top 3 issues for Aboriginal and Torres Strait Islander young people – #mentalhealth, #alcohol and drugs and equity and #discrimination. Plus #NACCHOYouth19 Interviews

” Young Aboriginal and Torres Strait Islander people were asked to list the three issues they considered were the most important in Australia today.

In 2019, the top three issues identified by Aboriginal and Torres Strait Islander young people were mental health, alcohol and drugs and equity and discrimination.

  • Nearly three in ten Aboriginal and Torres Strait Islander young people indicated that mental health (28.9%) and alcohol and drugs (28.1%) are important issues in Australia today.
  • Around one in four Aboriginal and Torres Strait Islander respondents reported that equity and discrimination (24.3%) and the environment (23.7%) are important national
  • Since 2018, the proportion of Aboriginal and Torres Strait Islander young people reporting the environment as a key national issue has more than tripled from 8% to 23.7%. Conversely, concerns about mental health and bullying have decreased since 2018.

Extract from Report What issues do young people think are the most important in Australia today? see Pages 37-57 

The Mission Australia Youth Survey is the largest annual survey of young people of its kind in Australia.

It provides a platform for young people aged 15 to 19 to share their values, aspirations and concerns.

The Youth Survey provides a platform for young people to ‘speak up’ about the issues they are concerned about and it offers valuable insights into the experiences, concerns, challenges and ambitions of young people living in Australia.

Mission Australia CEO James Toomey says “Our Youth Survey has come of age this year and we take very seriously our responsibility and commitment to elevating the voices of young people who come from all across Australia.”

The results of the Youth Survey are shared widely with governments, schools, not-for-profit and community organisations, so that NGOs, social commentators, decision-makers and policymakers have access to current evidence on what young people are thinking, feeling and hoping in 2019.

The Youth Survey gives us the vital evidence needed to advocate with young people, and for them, for the services and policy responses that they need.

Young people have a vital role in shaping our tomorrow. If we ensure young people have the right supports and opportunities to be heard, the future will be brighter for everyone. Through this survey, once again, they are speaking to us, speaking to people who need to listen to them and respond to their very real concerns and aspirations.

For more information or to register your interest for the 2020 Youth Survey, please contact: youthsurvey@missionaustralia.com.au.

Download full 2019 Youth Report

Mission Australia Youth Survey FULL Report 2019

Download 2019 Young Aboriginal and Torres Strait Islander people Report

MA Youth Survey 2019 ATSI-Web

Profile of respondents

A total of 1,579 (6.4%) respondents to Mission Australia’s 2019 Youth Survey identified as Aboriginal and/or Torres Strait Islander. Of this total, 1,310 (5.3%) respondents identified as Aboriginal, while 149 (0.6%) identified as Torres Strait Islander (the remaining 0.5% identified as both).

Gender breakdown

Nearly half (49.6%) of Aboriginal and Torres Strait Islander respondents were female and 42.7% were male.

Language background other than English

A total of 173 (11.1%) Aboriginal and Torres  Strait Islander respondents stated that they were born overseas and 298 (19.2%)     Aboriginal and Torres Strait Islander young people reported speaking a language other than English at home. Of the 43 languages other than English spoken at home by Aboriginal and Torres Strait Islander respondents, the most common were (in order of frequency): Indigenous languages, Chinese, Spanish, Kriol and Japanese.

Disability

A total of 216 (13.8%) Aboriginal and Torres Strait Islander respondents identified as living with a disability. Twice the proportion of Aboriginal and Torres Strait Islander males (14.4%) identified they were living with a disability (compared with 7.0% of females). The most frequently cited disabilities for Aboriginal and Torres Strait Islander respondents were (in order of frequency): autism, attention deficit hyperactivity disorder (ADHD), learning disabilities, anxiety disorder and deafness or hearing impairment.

Education

As indicated in Table 2.1, 83.1% of Aboriginal and Torres Strait Islander respondents were studying full-time, which is similar to the 83.3% of Aboriginal and Torres Strait Islander respondents studying full-time in 2018. A slightly higher proportion of Aboriginal and Torres Strait Islander females reported studying full-time (86.8% compared with 82.3% of males). Conversely, a slightly higher proportion of Aboriginal and Torres Strait Islander males reported they were not studying (11.6% compared with 8.1% of females).

Respondents who reported that they were currently studying were asked how satisfied they were with their studies. Responses to this question were rated on a 5-point scale that ranged from very satisfied to very dissatisfied. As in previous years, the majority of

Aboriginal and Torres Strait Islander respondents reported that they were either very satisfied (10.8%) or satisfied (45.7%) with their studies. Around one in ten Aboriginal and Torres Strait Islander respondents indicated they were dissatisfied (5.9%) or very dissatisfied (5.4%). As shown in Table 2.2, a slightly higher proportion of Aboriginal and Torres Strait Islander males reported feeling very satisfied (12.7% compared with 8.6% of females), yet a much higher proportion of Aboriginal and Torres Strait Islander females indicated they felt satisfied (52.2% compared with 41.2% of males).

Of those that were still at school, 89.7% of Aboriginal and Torres  Strait Islander respondents stated that they intended to complete       Year 12 (compared with 96.4% of non-Indigenous respondents). More than twice the proportion of Aboriginal and Torres Strait Islander males indicated that they did not plan to complete Year 12 (14.0% compared with 6.3% of females).

1 of 2 Interviews from our NACCHO Youth Conference Darwin 2019

This years NACCHO youth conference theme was ‘Healthy youth, healthy future’ with sessions follwing sub themes of leadership and resilience.

24 year old Gamilaroi and Dunghutti woman, and co-founder of Tiddas 4 Tiddas, Marlee Silva talked with our youth about the importance of social media among the Aboriginal and Torres Striat Islander population and how to use social media as activists to make a change for the better for our people!

“Tiddas 4 Tiddas is a social media based movement that is all about empowering and giving a voice to our Aboriginal and Torres strait Islander woman and girls.”

What issues are of personal concern to our young people?

Young people were asked to indicate how concerned they were about a number of issues over the past year, as shown in Figure 2.5. Responses were rated on a 5-point scale that ranged from extremely concerned to not at all concerned. The items were ranked in order of personal concern according to the summed responses for extremely concerned and very concerned for each item.

The top three issues of personal concern for Aboriginal and Torres Strait Islander young people were coping with stress, body image and mental health. The next most personally concerning issues were school or study problems and physical health.

  • Coping with stress was the top issue of concern, with nearly four in ten (38.4%) Aboriginal and Torres Strait Islander respondents indicating that they were extremely or very concerned about this
  • Around three in ten Aboriginal and Torres Strait Islander young people were extremely or very concerned about body image (31.7%), mental health (31.5%) and school or study problems (30.5%).
  • Around one quarter of Aboriginal and Torres Strait Islander respondents were extremely or very concerned about physical health (25.6%) and family conflict (23.3%).

2 of 2 Interviews from our NACCHO Youth Conference Darwin 2019

Amanda Sibosado from SAHMRI talks with NACCHO about her experience at the NACCHO Members’ Conference 2019 and tells us a little bit about the Young Deadly Free Project and her role as co-ordinator.

Amanda ran a workshop with our young proffesionals at the NACCHO Youth Conference held on the first day of our Members’ conference. The groups came up with some new ideas and input on how health services can assist young people in the approach to STI testing with shame gremlins and how services can work with young people to over come these.

Have our young people experienced bullying?

For the first time in 2019, young people were asked whether they had experienced bullying over the past twelve months. Three in ten (29.9%) Aboriginal and Torres Strait Islander young people reported that they had experienced bullying in the past twelve months (compared with 20.3% of non-Indigenous respondents).

A much higher proportion of Aboriginal and Torres Strait Islander females reported that they had experienced bullying over the past year (33.4% compared with 22.0% of males).

Young people who reported that they had experienced bullying over the past year were then asked to identify from a list of suggested locations where the bullying took place. Table 2.6 shows that, of the 29.9% of Aboriginal and Torres Strait Islander respondents who had experienced bullying in the past year, nearly three quarters (72.5%) reported that the bullying took place at school/TAFE/university.

Four in ten (40.9%) indicated they had experienced bullying online/on social media, while three in ten (30.1%) stated they had experienced bullying at home. Around one in six reported that they experienced this in my neighbourhood (16.8%) or at work (15.8%).

The proportion of Aboriginal and Torres Strait Islander respondents who reported they had experienced bullying across the majority of locations was much higher than the proportion of non-Indigenous respondents

NACCHO Aboriginal Health and Alcohol other Drugs: Peak public health bodies @_PHAA_ And @FAREAustralia respond to Health Minister @GregHuntMP launch of National Alcohol Strategy 2019-28 : Download Here

The federal government will spend $140m on drug and alcohol prevention and treatment programs but has ruled out measures such as hiking taxes on cask wine.

Health Minister Greg Hunt announced the National Alcohol Strategy 2019-28 has been agreed with the states following protract­ed negotiations.

The strategy outlines agreed policy options in four priority areas: community safety, price and promotion, treatment and prevention.

Health lobby groups have pushed for reform in two major areas: the introduction of a minimum floor price for alcohol by state governments, and the introduction of a volumetric tax, based on the amount of alcohol in a beverage, by the commonwealth. ”

From The Australian Health Editor Natasha Robinson (See in full part 1 below )

Read over 200 Aboriginal health and Alcohol other drugs articles published by NACCHO over the past 7 years 

” Overall, Aboriginal and Torres Strait Islander people are more likely to abstain from drinking alcohol than non-Aboriginal and Torres Strait Islander people (31% compared with 23% respectively).

However, among those who did drink, higher proportions drank at risky levels (20% exceeding the lifetime risk guidelines) and were more likely to experience alcohol-related injury than non-Aboriginal and Torres Strait Islander people (35% compared to 25% monthly, respectively).

For this reason, Aboriginal and Torres Strait Islander people experience disproportionate levels of harm from alcohol, including general avoidable mortality rates that are 4.9 times higher than among non-Aboriginal and Torres Strait Islander people, to which alcohol is a contributing factor.

The poorer overall health, social and emotional wellbeing of Aboriginal and Torres Islander people than non-Aboriginal and Torres Strait Islander people are also significant factors which can influence drinking behaviours. ” 

Page 8 of National Strategy Aboriginal and Torres Strait Islander people

Download the full strategy HERE

national-alcohol-strategy-2019-2028

 ” The Public Health Association of Australia (PHAA) is pleased the National Alcohol Strategy 2019-2028 is finally out but said it lacked ambition to prevent Australians suffering adverse health impacts of alcohol consumption.

“It is good news to have this strategy now finalised, albeit many years in the making and with too much influence from the alcohol industry,”

PHAA CEO Terry Slevin  : See part 2 below for full press release 

Australia has not had a national strategy since 2011 and we congratulate Health Minister Greg Hunt for spearheading this successful outcome. 

Given the high burden of harm from alcohol, including 144,000 hospitalisations each year, we trust that the NAS will support proportionate action from the Commonwealth, states and territories to protect Australians and their families,

 FARE has also welcomed the Minister’s announcement that the Government will commission a report to estimate the social costs of alcohol to the community.  

Australia faces a $36 billion a year alcohol burden, with approximately a third due to alcohol dependence, a third caused by injuries, and the final third due to chronic diseases such as cancer and cardiovascular diseases,

FARE Director of Policy and Research Trish Hepworth. See part 3 below for full press release 

 ” Alcohol places an enormous burden on our healthcare resources on our society and ultimately on us as a nation.

Alcohol is currently the sixth leading contributor to the burden of disease in Australia, as well as costing Australian taxpayers an estimated $14 billion annually in social costs.

The AMA has previously outlined the priorities we would like to see reflected in the Strategy, including action on awareness, taxation, marketing, and prevention and treatment services.

Implementing effective and practical measures that reduce harms associated with alcohol misuse will benefit all Australians.”

AMA President, Dr Tony Bartone : See Part 4 Below for full Press Release 

Part 1 The Australian Continued 

The National Alcohol Strategy lists the introduction of a volumetric tax as one policy ­option, but Mr Hunt said the commonwealth was ruling out such taxation reform.

“The government considers Australia’s current alcohol tax settings are appropriate and has no plans to make any changes,” the minister’s office said.

Mr Hunt said there were “mixed views” among the states on the introduction of a minimum floor price for alcohol — the Northern Territory is the only jurisdiction to introduce this measure — but such policy remained an option for the states.

Mr Hunt said the national strategy had laid out a path towards Australia meeting a targeted 10 per cent reduction in harmful alcohol consumption.

“There’s a balance been struck, what this represents is an attempt to lay out a pathway to reducing alcohol abuse and reducing self-harm and violence that comes with it,” Mr Hunt said.

“The deal-maker here was the commonwealth’s investment in drug and alcohol treatment. That was the most important part. Now we’d like to see the states match that with additional funds, but we won’t make our funds ­dependent upon the states.”

Health groups welcomed the finalisation of the national strategy. Alcohol Drug Foundation chief executive Erin Lalor said it was now up to governments to act on the outlined policies. “The strategy means we can now start doing and stop talking, because it’s been in development for a ­really long time,” Ms Lalor said.

“We’ve now got really clear options that we can focus on and it’s up to governments around Australia and other groups working to reduce alcohol-related harm and the alcohol industry to start to take serious measures and evidence-based measures that will reduce the significant harm from alcohol.”

Ms Lalor was disappointed the government had ruled out a volumetric tax. “We have been advocating for a long time for volumetric tax to be introduced. The strategy outlines it and we would hope to see pricing and taxation of alcohol being adopted to reduce alcohol-related harms.”

Canberra will spend $140m on programs to combat alcohol and drug addiction.

Primary Health Networks will receive $131.5m to commission new and existing drug and ­alcohol treatment services, while the government will commission a new report to estimate the social costs of alcohol to society.

Part 2 Belated alcohol strategy is a missed opportunity

The Public Health Association of Australia (PHAA) is pleased the National Alcohol Strategy 2019-2028 is finally out but said it lacked ambition to prevent Australians suffering adverse health impacts of alcohol consumption.

“It is good news to have this strategy now finalised, albeit many years in the making and with too much influence from the alcohol industry,” PHAA CEO Terry Slevin said.

“The strategy recommends important policy options that can reduce alcohol related harm via both national and state level efforts.”

“All governments should invest in and commit to reducing the health and social burden of excess alcohol consumption,” Mr Slevin said.

“It is a shame the federal government has again ruled out the option of volumetric tax on alcohol, which is a fairer and more sensible way of taxing alcohol.

“This is about stopping people from getting injured, ill or dying due to alcohol, so why rule out this option?”

“The current alcohol tax system is a mess and is acknowledged as such by anyone who has considered the tax system in Australia.”

“We hope this important reform will again be considered at a time in the near future.“

“Let’s remember that alcohol is Australia’s number one drug problem. Harmful levels of consumption are a major health issue, associated with increased risk of chronic disease, injury and premature death,” Mr Slevin said.

“The announcement of funding for drug treatment services is modest but we welcome the support for a report assessing the social cost of alcohol.”

“When that report is completed we hope it will influence alcohol policy into the future.”

Part 3 The Foundation for Alcohol Research and Education (FARE) congratulates Federal, State and Territory Ministers for finalising the National Alcohol Strategy 2019–2028 (the NAS).

“Australia has not had a national strategy since 2011 and we congratulate Health Minister Greg Hunt for spearheading this successful outcome,” said FARE Director of Policy and Research Trish Hepworth.

“Given the high burden of harm from alcohol, including 144,000 hospitalisations each year, we trust that the NAS will support proportionate action from the Commonwealth, states and territories to protect Australians and their families,” she said.

FARE has also welcomed the Minister’s announcement that the Government will commission a report to estimate the social costs of alcohol to the community.

“Australia faces a $36 billion a year alcohol burden, with approximately a third due to alcohol dependence, a third caused by injuries, and the final third due to chronic diseases such as cancer and cardiovascular diseases,” Ms Hepworth said.

“In implementation, we urge governments to take action to increase the community’s awareness of the more than 200 injury conditions and life-threatening diseases caused by alcohol,” she said.

FARE strongly encourages the Federal Government to revisit alcohol taxation reform, which would be the most effective way to reduce the death toll from alcohol-related harm, which is almost 6,000 people every year.

“We know from multiple reviews that alcohol taxation is the most cost-effective measure to reduce alcohol harm because measures can be targeted towards reducing heavy drinking, while providing government with a source of revenue,” Ms Hepworth said.

Part 4 AMA

The announcement that the National Alcohol Strategy 2019–2028 (the NAS) has been agreed to by all States and Territories is welcome, but it is disappointing that it does not include a volumetric tax on alcohol, AMA President, Dr Tony Bartone, said today.

“The last iteration of the NAS expired in 2011, so this announcement has been a long time coming,” Dr Bartone said.

“The AMA supports the positive announcements by the Government to reduce the misuse of alcohol. However, they simply do not go far enough.

“An incredibly serious problem in our community needs an equally serious and determined response.

“Doctors are at the front line in dealing with the devastating effects of excessive alcohol consumption. They treat the fractured jaws, the facial lacerations, the eye and head injuries that can occur as a result of excessive drinking.

“Doctors, and those working in hospitals and ambulance services, see the deaths and life-long injuries sustained from car accidents and violence fuelled by alcohol consumption.

“Healthcare staff, including doctors, often bear the brunt of alcohol-fuelled violence in treatment settings. Alcohol and other drugs in combination are often a deadly cocktail.

“Prolonged excessive amounts contribute to liver and heart disease, and alcohol is also implicated in certain cancers.

“All measures that reduce alcohol-fuelled violence and the harm caused by the misuse of alcohol, including taxing all products according to their alcohol content, should be considered in a national strategy.

“For this reason, we are extremely disappointed that the Government has ruled out considering a volumetric tax on alcohol.

“A national, coordinated approach to alcohol policy will significantly improve efforts to reduce harm.

“Alcohol places an enormous burden on our healthcare resources on our society and ultimately on us as a nation.

“Alcohol is currently the sixth leading contributor to the burden of disease in Australia, as well as costing Australian taxpayers an estimated $14 billion annually in social costs.

“The AMA has previously outlined the priorities we would like to see reflected in the Strategy, including action on awareness, taxation, marketing, and prevention and treatment services.

“Implementing effective and practical measures that reduce harms associated with alcohol misuse will benefit all Australians.”

Background

  • The Australian Institute of Health and Welfare found that alcohol and illicit drug use were the two leading risk factors for disease burden in males aged 15-44 in 2011.
  • The AIHW has linked alcohol use to 26 diseases and injuries, including six types of cancer, four cardiovascular diseases, chronic liver disease, and pancreatitis, and estimated that in 2013 the social costs of alcohol abuse in Australia was more than $14 billion.
  • A study conducted by the Australasian College for Emergency Medicine in 2014 found that during peak alcohol drinking times, such as the weekend, up to one in eight hospital patients were there because of alcohol-related injuries or medical conditions. The report noted that the sheer volume of alcohol-affected patients created more disruption to Emergency Departments than those patients affected by ice.

 

NACCHO Aboriginal Health and drug #ICE : New @HealthInfoNet review says strong connection to country and community can help reduce methamphetamine use by our mob 

” The use of methamphetamine and the related harms has been the subject of growing concern in Australia, with Australians rating it the drug of most concern in the 2016 National Drug Strategy Household Survey.

The most commonly used drugs in Aboriginal and Torres Strait Islander communities are tobacco, cannabis and alcohol.

However, Aboriginal and Torres Strait Islander people are experiencing a disproportionate burden of harm from amphetamines, including methamphetamine.’

Download a PDF Review of methamphetamine use among Aboriginal and Torres Strait Islander people

Review+of+methamphetamine+use+among+Aboriginal+and+Torres+Strait+Islander+people

Read over 70 Aboriginal Health and Drug Ice articles published by NACCHO in past 7 years 

The authors of the Australian Indigenous HealthInfoNet’s latest publication, the Review of methamphetamine use among Aboriginal and Torres Strait Islander people; Drs Mieke Snijder and Stephanie Kershaw from the University of Sydney say ‘This review shows how important it is to support individuals, families and communities and the urgent need to develop more culturally appropriate resources’.

The review describes the historical and social factors that influence the use of methamphetamine among Aboriginal and Torres Strait Islander people and how family, peers and community can be protective factors, including a strong connection to culture and country.

The review highlights new and emerging programs that are being implemented to address methamphetamine use, such as the Cracks in the Ice Toolkit for community and family members, and the Novel Interventions to Address Methamphetamine Use in Aboriginal and Torres Strait Islander Communities (NIMAC) study in South Australia.

This short video highlights a number of key facts about methamphetamine use among Aboriginal and Torres Strait Islander people.

It is based on the Review of methamphetamine use among Aboriginal and Torres Strait Islander people.

Information covered includes:

  • the prevalence of methamphetamine use among Aboriginal and Torres Strait Islander people
  • the health and social impacts of methamphetamine use
  • the evidence base for programs, strategies and treatment approaches for addressing harms from methamphetamine use.

There is currently no evidence on what are the most effective prevention and treatment strategies for Aboriginal and Torres Strait Islander people for methamphetamine use, however appropriate responses need to address social determinants as well as provide treatment services.

HealthInfoNet Director, Professor Neil Drew says ‘This review summarises many publications and data into one publication which ensures those working in the sector receive an authoritative update that is both accessible and timely’.

The Knowledge Centre has created some Knowledge Exchange tools for those who want the key facts and updates in a visual format: an animated video and factsheet https://aodknowledgecentre.ecu.edu.au/about/knowledge-exchange-products/

NACCHO Aboriginal Health and Alcohol Research : New ADAC APP a will be ‘game changer’ to gauge realistic drinking habits says @ScottADAC

“Obviously there’s people who want the research done to help their community.

Once we get this app going, it’ll become very clear very quickly where the money should be spent.

That doesn’t mean you’ve just got to chuck money at them, but having Aboriginal-controlled issues and understanding which way they want to go.”

Jimmy Perry, a Ngarrindjerri/Arrernte man and an Aboriginal health worker involved in the project, said communities had a positive response.

 Read over over 200 Aboriginal Health Alcohol and Other Drugs articles published by NACCHO over the past 7 years 

Download the APP Research

18-lee-developing-tablet-computer-app-bmc-med1_final-data

Originally published HERE 

Researchers say a new app has the potential to more accurately reflect the nation’s drinking habits.

The ADAC and app researchers hoped the app would be available to download by the end of the year.

Key points : 

  • App developers say it will get a more accurate drinking history than a face-to-face interview with a trained health professional
  • The Aboriginal Drug and Alcohol Council says the app could replace the National Drug Strategy Household Survey
  • Researchers say alcohol consumption among Aboriginal women is under-represented by up to 700 per cent in national surveys

The Grog App was designed for use by Indigenous Australians but could be used by anyone.

Dr Kylie Lee, a senior research fellow at the Centre of Research Excellence in Indigenous Health and Alcohol who was also involved in the app’s development, said the new technology would create a more accurate database.

“Aboriginal women, their drinking is under-represented in the national surveys by up to 700 per cent and 200 per cent in men.

“Undeniably we need to do better … this app offers a great opportunity to do that.”

Researchers believe the app would elicit greater detail than the National Drug Strategy Household Survey which has been used for more than 30 years.

Dr Lee said the prospect of collating improved data collection on the difficult topic of drug and alcohol consumption was “exciting”.

“I think it really could be a game changer because it’s giving an opportunity for a safe place where they can just tell their story in terms of what they use or what they drink,” she said.

How it works

Take a Virtual Tour HERE

Participants answer a range of broad and specific questions on the app about alcohol and based on that information, they are allocated into a category on a sliding scale from ‘non-drinker’ to ‘high risk’.

Dr Lee said immediate feedback was very helpful.

She said the app could alleviate issues in the way alcohol data was typically collected, for example participants were more likely to be asked about standard drinks but not non-standard containers.

“Like a soft drink bottle, a juice bottle, a sports bottle et cetera so the app has facilities to show how much you put in the bottle,” Dr Lee said.

“It’s very exciting the level of detail you’re going to get.”

Professor Kate Conigrave, the app’s chief investigator and an addiction specialist at Royal Prince Alfred Hospital, agreed the new technology could provide greater clarity.

“I’m aware of the traps,” she said.

“One patient I saw had been recorded by a doctor as drinking three standard drinks a day but when I took a drinking history I said, ‘what do you drink them out of?’, and he showed me a sports bottle,” Professor Conigrave said.

“He was drinking three full sports bottles of wine a day, so that’s about 30 standard drinks a day.”

PHOTO: Professor Conigrave says the images used in the app can trigger the participant’s memory, making their drinking history more accurate. (Supplied: Kate Conigrave)

Professor Conigrave said the national health survey often contained “tiny” numbers from Indigenous communities.

“The sample sizes are so small, it’s hard to get a meaningful picture,” she said.

She said the app would provide a level of comfortability and anonymity which may lead to more accurate data, than an interview with a trained health professional.

“People can be a bit embarrassed about what they’re drinking and it can be a bit hard to admit to someone you know, ‘when I drink I have 12 cans of beer,'” she said.

Taking it to the communities

The app is in its second phase of testing.

In the first phase, Aboriginal and Torres Strait Islanders in remote, regional and urban parts of South Australia and Queensland were asked to describe their drinking habits.

Research on the app has now progressed to the second round, during which the focus was on the technology’s validity as an on-the-ground survey tool.

Scott Wilson, who was leading the development of the app at the Aboriginal Drug and Alcohol Council (ADAC), said the second phase was a “major prevalence study” which would include participants from the local hospital and prison.

The location for the trial has not been made public.

“In the big major surveys people in those areas are always excluded,” Mr Wilson said.

“When you consider that I might be in hospital for an alcohol-related illness or I might be in jail because of an alcohol or drug-related crime, my voice or results are never included.”

The ADAC and app researchers hoped the app would be available to download by the end of the year.

In the meantime, they planned to have discussions with the government over the future use of the app and pursue grant opportunities.

Dr Lee said she was excited for the potential of the new technology.

“Eventually I think it would be a great tool to roll out nationally … using it in the same way as the National Drug Strategy Household Survey,” she said

NACCHO Aboriginal Youth Health : ‘Dark days of old Don Dale’: John Paterson CEO @AMSANTaus and Human rights groups condemn #NT Government and Minister Dale Wakefield’s new youth justice laws

“ The NT government talks proudly about its commitment to Aboriginal-led solutions, to co-design and to collaboration,

So why was this bill kept from those who are part of those solutions and collaborations until the moment it was introduced into the parliament?

The bill went “far beyond” clarifying technical matters,

It does not reflect the royal commission recommendations or the government’s previous policy position to accept and implement those recommendations.

These amendments bring back the draconian treatment of young people and will see children restrained and isolated at the discretion of detention staff.

Far from reducing ambiguity as the minister claims, the amendments reintroduce ambiguity with subjective definitions and powers.

The Chief Executive Officer of AMSANT, John Paterson The Aboriginal Medical Services Alliance of the Northern Territory (AMSANT) today condemned the Labor Government and Minister Wakefield in the strongest possible terms for its behaviour in avoiding debate and scrutiny in order to ram through retrograde changes to the Youth Justice Act for the operation of youth detention.

Read The Guardian Amnesty coverage 

Read full AMSANT Press Releases Part 1 Below

Read over 60 NACCHO Aboriginal Health and Don Dale detention articles 

“The Territory Labor Government is creating generational change and safer communities by overhauling the Youth Justice system and putting at-risk young people back on track.

“The safety of youth detention staff and detainees is absolutely paramount. These amendments will help to better manage security risks that puts lives in danger.

“Last year we amended the Youth Justice Act to ensure that force, restraints and isolation could not be used for the purpose of disciplining a young person in detention.

“The new amendments provide clarity by removing ambiguities in the Act to ensure that youth detention staff can better respond to serious and dangerous incidents. Laws often need adjusting to reflect operational realities

Minister for Territory Families, Dale Wakefield Read Full Press release Part 2 Below 

Part 1

Mr Paterson, said “The Minister has been misleading and disingenuous in her speeches and answers to the limited questioning that was allowed in the Legislative Assembly. Despite the Minister’s assertions, these amendments are not mere technical clarifications.

They are substantive changes that erode the small improvements that were made in 2018 in response to the Royal Commission.

They will allow harsh treatment of young people in detention to continue unopposed and unscrutinised.”

WATCH TV NEWS COVERAGE

Mr Paterson said that the Bill passed this afternoon with no scrutiny, is clearly intended to retrospectively make lawful, actions that were unlawful under the law as it existed until today. “We must ask ourselves whether this unseemly and undemocratic haste is intended to defeat legal actions currently on foot by young people who believe their treatment in detention has been unlawful.

Does the government know that unlawful treatment occurred and is now seeking to avoid accountability? It is difficult to draw any other conclusion despite the Minister’s obfuscation in the Assembly” said Mr Paterson.

AMSANT believes that the harsh treatment of young people now permitted under the law will lead to increased tensions and incidents in detention. When the next major incident occurs, the government, not the young people, must be held to account. “Let’s not forget” said Mr Paterson “that a large proportion of young people in detention have significant cognitive disabilities.

The government is condoning the use of restraint, isolation and physical force against young people with disabilities because they do not have the capacity to comply with the demands of the detention environment.

Right now, young people are being restrained in handcuffs and waist shackles to simply walk from one part of Don Dale to another under the control of a guard.”

“AMSANT is disgusted by this behaviour by a government and calls on the Chief Minister to withdraw this legislation prior to it receiving the assent of the Administrator. To do otherwise is to walk away from the Royal Commission recommendations.” said Mr Paterson. Mr Paterson seeks to remind the Chief Minister of his words and apparent distress when he responded to the Royal Commission.

The Chief Minister said in November 2017, “Our youth justice and child protection systems are supposed to make our kids better, not break them, they are supposed to teach them to be part of society, not withdraw”. “This legislation is not consistent with that statement”, Mr Paterson concluded

Protestor at Alice Springs Market yesterday 

1.2 Youth Justice Amendment Bill a return to the bad old days!

Aboriginal Medical Services Alliance of the Northern Territory (AMSANT) Chief Executive Officer, John Paterson, today called on the Chief Minister to halt the progress of the Youth Justice Amendment Bill 2019 through the Legislative Assembly until Aboriginal people and organisations have the chance to have a say.

“The government talks proudly about its commitment to Aboriginal led solutions, to co-design and to collaboration” said Mr Paterson.

“So why was this Bill kept from those who are part of those solutions and collaborations until the moment it was introduced into the Parliament?”

“The Minister has said the Bill simply clarifies technical matters and keeps faith with 2018 amendments.” Mr Paterson said.

“The Bill goes far beyond that. It undoes the positive progress in the 2018 changes which were a start in implementing the Royal Commission recommendations. The government consulted with Aboriginal organisations and other youth advocates and we supported the 2018 amendments.”

Mr Paterson said that this Bill is a u-turn on the progress in 2018. It does not reflect the Royal Commission recommendations or the Government’s previous policy position to accept and implement those recommendations.

“These amendments bring back the draconian treatment of young people and will see children restrained and isolated at the discretion of detention staff. Far from reducing ambiguity as the Minister claims, the amendments reintroduce ambiguity with subjective definitions and powers.”

Mr Paterson also questioned the need for retrospective effect of these amendments. “The only reason for retrospective effect is to legalise actions that were illegal when they were taken.” AMSANT said that the safety of both staff and young people is important and called on the government to work with Aboriginal organisations and other experts to explore the safety concerns and solutions. The government needs to think more carefully about the way forward. “

If the workforce cannot safely deliver a detention system under current laws which give quite considerable powers over the young people, the government needs to look at the skills, training and support of the workforce to ensure that they can. Attacking the human rights of young people is not the solution” Mr Paterson emphasised.

Mr Paterson noted that under the Diagrama Foundation which runs 70% of youth detention in Spain, for example, highly qualified staff with expertise in youth development, trauma and de-escalation work with young people in a therapeutic way that does not involve restraint, force and isolation. “Diagrama facilities rarely experience incidents of the kind seen last year at Don Dale.

Mr McGuire from Diagrama told audiences in Darwin last year that it is at least 10 years since there was a significant incident at a Diagrama facility. And Diagrama experiences a reoffending rate of only 20% across all its residents compared to 80% in the NT.”

Part 2

Passage of Youth Justice Act Amendments to Manage Security

Risks in the Territory’s Youth Detention Centres

March 2019

Today the Territory Labor Government passed amendments to the Youth Justice Act which will clarify and tighten the existing framework for managing safety and security risks within the youth detention centres.

The amendments will provide youth detention centre staff with a clear and unambiguous framework for exercising their powers, and will enable them to have a very clear guideline in their decision making when responding to dangerous and challenging situations.

The amendments include:

  • Clarify the circumstances in which force and restraints may be used, to account for situations where detainees mayact in a way that threatens the safety or security of a detention centre, but not in a way that presents an imminent risk
  • Create a consistent test to determine what is a reasonable use of force and restraints
  • Clarify the meaning of an emergency situation, which is relevant to the general application of all uses of force • Clarify the definition of separation
  • Enable screening and pat down searches of detainees in a broader range of circumstances
  • Include an express power to transfer a detainee from one detention centre to another

The amendments will remove any uncertainty around the operation of existing powers in the legislation, for both youth detention centre staff and detainees.

The amendments will apply retrospectively to the date in which the original provisions of the Act commenced (May 2018). This will remove any doubt about the original intention of these key provisions in the legislation.

NACCHO Aboriginal Health and Alcohol @FAREAustralia : Overcoming #Indigenous #FamilyViolence. Download new study from @marcialangton #unimelb where experts find success in Alcohol Management Plans but fear government failure to understand the magnitude of the alcohol problem

Our research found that average annual hospital admissions for assault fell from 32.25 per 1,000 people to 5.7 over 11 years, in line with tightening alcohol supply restriction,

We’ve identified propositions for better AMP outcomes long-term, through realistic financial support and stronger community-led governance “

The Associate Provost and Chair of Australian Indigenous Studies, Professor Marcia Langton, who co-authored the paper, says since the AMP was introduced there has been a reduction in violent assaults and the severity of family violence across the traditional lands of the Thaayorre and Mungkan peoples on the western coast of Cape York Peninsula

Paper Title: The Alcohol Management Plan at Pormpuraaw, Queensland, Australia: An ethnographic community-based study

Download Alcohol Management Plan Melbourne Uni

Authors: Kristen Smith, Marcia Langton, Richard Chenhall, Penelope Smith & Shane Bawden

Read over 200 NACCHO Aboriginal Health Alcohol and Other Drug articles published over pst 7 years 

Alcohol Management Plans (AMPs), including one that has helped dramatically reduce violent assault rates in the remote Indigenous community of Pormpuraaw in far north Queensland, are under threat.

Coinciding today with the 5th Annual Overcoming Indigenous Family Violence Forum in Melbourne, University of Melbourne researchers have released a new study on the successes and challenges of the Pormpuraaw AMP.

While the dramatic drop in hospital admissions showed the AMP was working extremely well, Foundation for Alcohol Research and Education (FARE) Chief Executive Michael Thorn is concerned that AMPs are under threat and riddled with problems stemming from government inertia.

Mr Thorn said the Pormpuraaw AMP study highlighted the need for genuine government investment overseen by a strong national alcohol strategy for protecting children, women, families and communities from alcohol harms.

“The good news is that an AMP can be an effective tool to significantly reduce alcohol harm, including family violence. But there’s a gulf between the well-intended rhetoric of governments to address harms in Indigenous communities and the unrealistic, unsustainable government action on the ground,” Mr Thorn said.

The University of Melbourne in-depth, community-based study investigated how AMP controls, restrictions and responses are understood and managed with Australian Aboriginal communities.

Research Fellow and lead author of the paper, Dr Kristen Smith, says most community members in

Pormpuraaw welcomed the reduced violence and community disharmony.

“There is strong community commitment to ‘place-based’ programs, but there are many issues that are being experienced in the community which are not being addressed,” Dr Smith said.

Dr Smith said the biggest concern was government failure to understand the magnitude of the alcohol problem and therefore underestimate resourcing.

“Underfunding is compounded over time through erratic political and policy decisions that fail to reliably meet the community’s needs for treatment services or address issues such as ‘sly-grogging’, gambling and criminalisation,” she said.

Professor Langton said the AMPs were too vulnerable to political and policy instabilities to ensure their long-term success. “We’ve identified propositions for better AMP outcomes long-term, through realistic financial support and stronger community-led governance,” she said.

NACCHO Aboriginal Health #Drugs #Alcohol : Minister @senbmckenzie An additional 72 Local Drug Action Teams #LDATs will be rolled out across the nation to tackle the harm caused by drugs and alcohol misuse on individuals and families.

 

“ It’s fantastic to welcome 72 new LDATs to the program who will develop and deliver local plans and activities to prevent alcohol and drug misuse in their local communities.

Today’s announcement brings the total number of LDATs to 244 across Australia, exceeding our target of 220 by 2020.

LDATs bring together community organisations to tackle substance misuse which can have devastating impacts on our communities – especially in rural and regional areas – and it’s clear that our communities are increasingly becoming empowered to take action at the local level.

The LDAT partnerships include local councils, service providers, schools, police, young people, Indigenous and primary health services and other non-government organisations, and the teams will have support from the Alcohol and Drug Foundation to assist in prevention activities,” 

Minister for Regional Services, Senator Bridget McKenzie

Download the list 

List of all LDATs by jurisdication and grant round Feb 2019

See NACCHO LDAT ACCHO Coverage HERE 

May 2018 : The Senator with Alcohol and Drug Foundation CEO Dr Erin Lalor and  General Manager of Congress’ Alice Springs Health Services, Tracey Brand in Alice Springs talking about the inspirational Central Australian Local Drug Action Team at Congress and announcing 92 Local Drug Action Teams across Australia building partnerships to prevent and minimise harm of ice alcohol & illicit drugs use by our youth with local action plans

Part 1 Press Release 

Speaking at the Wellington LDAT site in Sale, Victoria, the Minister for Regional Services, Senator Bridget McKenzie today congratulated the local community organisations, along with their partners, that will receive funding from the Federal Government through the fourth round of the successful Local Drug Action Team Program.

The new LDATs are being supported through the $298 million investment under the National Ice Action Strategy to combat drug and alcohol misuse across Australia.

Each of the 72 LDATs will receive an initial $10,000 to help them to refine a local community action plan. Each team will have an opportunity to apply for additional funding to support the delivery of local activities once their plans are finalised.

The Member for Gippsland Darren Chester welcomed today’s funding announcement.

“It’s important that we try to stop people in our community from trying illicit drugs for the first time and reduce binge drinking and alcohol abuse,” Mr Chester said. “One way of doing that is to ensure that everyone feels they are part of the community.”

”Gippsland is no different to other areas and drugs and alcohol are ruining lives and devastating families. Ice and other drugs do not discriminate.

“Many of us personally know families in our community who are dealing with the fallout of these insidious drugs.

“This funding enables the community to band together to fight the problem.”

Minister McKenzie said the LDATs announced will be supported to identify and deliver evidence based prevention, promotion and harm-reduction activities which will work for their local community.

Minister McKenzie acknowledged the importance of LDATs for driving change at a local level and highlighted the great work coming out of the program.

“The Hepburn LDAT, for instance, in Victoria is working to prevent and minimise harm from alcohol and drug misuse by improving access to education and skills development for young people,” Minister McKenzie said.

“The team has developed a 19-week program to up-skill young people and help them to build confidence, improve their knowledge about health and reconnect with their community.”

The Local Drug Action Team Program is a key component of the National Ice Action Strategy.

For free and confidential advice about alcohol and other drugs treatment services, please call the National Alcohol and Other Drug Hotline on 1800 250 015.

More information about LDATs can be found on the Alcohol and Drug Foundation website.

Alcohol and other drug-related harms are mediated by a number of factors – those that protect against risk, and those that increase risk. For example, factors that protect against alcohol and other drug-related harms include social connection, education, safe and secure housing, and a sense of belonging to a community.

Factors that increase risk of alcohol and other drug-related harms include high availability of drugs, low levels of social cohesion, unstable housing, and socioeconomic disadvantage. Most of these factors are found at the community level and must be targeted at this level for change.

Alcohol and other drugs are a community issue, not just an individual issue. Community action to prevent alcohol and other drug-related harms is effective because:

  • the solutions and barriers (protective/risk factors) for addressing alcohol and other drug-related harm are community-based
  • it creates change that is responsive to local needs
  • it increases community ownership and leads to more sustainable change

We encourage Local Drug Action Teams (LDATs) to link with and/or build on existing activity approaches that have been shown to work.

Select an existing evidence-based activity

Existing activities may have an alcohol and other drug focus, or possibly a different overall focus such as preventing gambling harm, or enhancing mental wellbeing. Be prepared to look outside the alcohol and other drug sector for possible approaches; for example, activities that share a focus on strengthening communities to improve other health and social outcomes.

A limited number of existing activities are listed below. You may also find other activities through local health services, peak bodies and by drawing on local knowledge and networks you have access to.

Existing strong and connected community activities in Australia:

Delivered by the Alcohol and Drug Foundation , the Good Sports Program works with local sporting clubs across Australia to provide a safe and inclusive environment, where everyone can get involved. The activity has run for nearly two decades and is proven to reduce harm and positively influence health behaviours, as well as strengthen club membership and boost participation.

Established 25 years ago, Big hART engages disadvantaged communities around Australia in art.

Community Hubs provides a welcoming place for migrant women and their children to learn about the Australian education system. With strong evaluation to support the effectiveness of the program, Community Hubs focuses on engagement, English, early-years and vocational pathways.

A national organisation that uses sport and art to improve the lives of people experiencing complex disadvantage.

If you have found some existing activities that could be incorporated, it is useful to seek out further information to find out if it is relevant.

You might want to consider the following questions (some answers may be available online, others you may have to seek directly from the organisation):

  • Does the activity align with your community needs?
  • Is the activity available in your geographic area? If face-to-face delivery is not available, is remote access an option?
  • Has the activity been shown to be effective at strengthening community cohesion and connection, and reducing and preventing alcohol and other drug-related harms? What evidence is available to demonstrate this?

Due to the limited number of existing activities available and the need for tailored approaches, many Local Drug Action Teams will work with partners to develop and deliver a targeted activity in their community. Review the paragraph below d. Determine resources required and Map your steps for insight into what is required when developing new approaches.

NACCHO and @RACGP Aboriginal Women’s Health and #FamilyViolence : How to identify and provide early intervention for victims and perpetrators.

About four in 10 women who were physically injured [as a result of family violence] visited a health professional for their injuries
 
This information [from the report] offers important insights for those involved in family and domestic violence policy, as well as organisations which provide services for Aboriginal and Torres Strait Islander peoples, aimed at preventing violence and supporting those affected by violence.’

ABS Director of the Centre of Excellence for Aboriginal and Torres Strait Islander Statistics, Debbie Goodwin said.

 ” Chapter 16 of the RACGP NACCHO National Guide : ‘Family abuse and violence’, provides key recommendations on prevention interventions – screening, behavioural and environmental.

These recommendations aim to support healthcare professionals to develop a high level of awareness of the risks of family abuse and violence, and how to identify and provide early intervention for victims and perpetrators.”

National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people (

Published by NewsGP Morgan Liotta

The report forms part of the Australian Bureau of Statistics’ (ABS) publication National Aboriginal and Torres Strait Islander Social Survey, 2014–15 and compares sociodemographic factors of Aboriginal and Torres Strait Islander women who experienced family violence with those who did not in the year prior to the 2014–15 survey.

Key findings show that, among Aboriginal and Torres Strait Islander populations, around two in three women (72%) compared with one in three men (35%) were likely to identify an intimate partner or family member as at least one of the perpetrators in their most recent experience of physical violence.

Approximately one in 10 Aboriginal and Torres Strait Islander women experienced family violence based on their most recent experience of physical violence.

Almost seven in 10 (68%) women who had experienced family violence reported that alcohol and/or other substances contributed to the incident:

  • More than half of women (53%) who had experienced family violence reported alcohol (by itself or with other substances) was a contributing factor
  • More than one in 10 (13%) reported that other substances alone were a contributing factor

When compared with Aboriginal and Torres Strait Islander women who had not experienced any physical violence, those who had were:

  • more likely to report high or very high levels of psychological distress (69% compared with 34%)
  • more likely to have a mental health condition (53% compared with 31%)
  • more likely to report they had experienced homelessness at some time in their life (55% compared with 26%)
  • less likely to trust police in their local area (44% compared with 62%)
  • just as likely to trust their own doctor (77% compared with 83%)

The report underlines the role of GPs’ support for such people.

GP resources

  • The RACGP and the National Aboriginal Community Controlled Health Organisation (NACCHO)’s National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people (National Guide), Chapter 16: ‘Family abuse and violence’, provides key recommendations on prevention interventions – screening, behavioural and environmental. These recommendations aim to support healthcare professionals to develop a high level of awareness of the risks of family abuse and violence, and how to identify and provide early intervention for victims and perpetrators.
  • The RACGP’s Abuse and violence: Working with our partners in general practice (White book), Chapter 11: ‘Aboriginal and Torres Strait Islander violence’, outlines statistics and recommendations for healthcare professionals to show leadership at a community level through local organisations by advocating for provision of services that meet the needs of Aboriginal and Torres Strait Islander peoples experiencing family violence.

NACCHO Aboriginal Health and #SocialDeterminants : Download @AIHW Report : Indicators of socioeconomic inequalities in #cardiovascular disease #heartattack #stroke, #diabetes and chronic #kidney disease @ACDPAlliance

 ” Most apparent are inequalities in chronic disease among Aboriginal and Torres Strait Islander people and non-Indigenous Australians. Social and economic factors are estimated to account for slightly more than one-third (34%) of the ‘good health’ gap between the 2 groups, with health risk factors such as high blood pressure, smoking and risky alcohol consumption explaining another 19%, and 47% due to other, unexplained factors.

 An estimated 11% of the total health gap can be attributed to the overlap, or interactions between the social determinants and health risk factors (AIHW 2018a).

Download the AIHW Report HERE aihw-cdk-12

‘By better understanding the role social inequality plays in chronic disease, governments at all levels can develop stronger, evidence based policies and programs aimed at preventing and managing these diseases, leading to better health outcomes across our community,’

AIHW spokesperson Dr Lynelle Moonn noted that these three diseases are common in Australia and, in addition to the personal costs to an individual’s health and quality of life, they have a significant economic burden in terms of healthcare costs and lost productivity

AIHW Website for more info 

Government investment is essential to encourage health checks, improve understanding of the risk factors for chronic disease, and implement policies and programs to reduce chronic disease risk, particularly in areas of socioeconomic disadvantage,

Chair of the Australian Chronic Disease Prevention Alliance Sharon McGowan said that the data revealed stark inequities in health status amongst Australians.

Download Press Release Here : australianchronicdiseasepreventionalliance

The Australian Chronic Disease Prevention Alliance is calling on the Government to target these health disparities by increasing the focus on prevention and supporting targeted health checks to proactively manage risk.

AIHW Press Release

Social factors play an important role in a person’s likelihood of developing and dying from certain chronic diseases, according to a new report from the Australian Institute of Health and Welfare (AIHW).

The report, Indicators of socioeconomic inequalities in cardiovascular disease, diabetes and chronic kidney disease, examines the relationship between socioeconomic position, income, housing and education and the likelihood of developing and dying from several common chronic diseases—cardiovascular disease (which includes heart attack and stroke), diabetes and chronic kidney disease.

Above image NACCHO Library

The report reveals that social disadvantage in these areas is linked to higher rates of disease, as well as poorer outcomes, including a greater likelihood of dying.

‘Across the three chronic diseases we looked at—cardiovascular disease, diabetes and chronic kidney disease— we saw that people in the lowest of the 5 socioeconomic groups had, on average, higher rates of these diseases than those in the highest socioeconomic groups,’ said AIHW spokesperson Dr Lynelle Moon.

‘And unfortunately, we also found higher death rates from these diseases among people in the lowest socioeconomic groups.’

The greatest difference in death rates between socioeconomic groups was among people with diabetes.

‘For women in the lowest socioeconomic group, the rate of deaths in 2016 where diabetes was an underlying or associated cause of death was about 2.4 times as high as the rate for those in the highest socioeconomic group. For men, the death rate was 2.2 times as high,’ Dr Moon said.

‘Put another way, if everyone had the same chance of dying from these diseases as people in the highest socioeconomic group, in a one year period there would be 8,600 fewer deaths from cardiovascular disease, 6,900 fewer deaths from diabetes, and 4,800 fewer deaths from chronic kidney disease.’

Importantly, the report also suggests that in many instances the gap between those in the highest and lowest socioeconomic groups is growing.

‘For example, while the rate of death from cardiovascular disease has been falling across all socioeconomic groups, the rate has been falling more dramatically for men in the highest socioeconomic group—effectively widening the gap between groups,’ Dr Moon said.

The report also highlights the relationship between education and health, with higher levels of education linked to lower rates of disease and death.

‘If all Australians had the same rates of disease as those with a Bachelor’s degree or higher, there would have been 7,800 fewer deaths due to cardiovascular disease, 3,700 fewer deaths due to diabetes, and 2,000 fewer deaths due to chronic kidney disease in 2011–12,’ Dr Moon said.

Housing is another social factor where large inequalities are apparent. Data from 2011–12 shows that for women aged 25 and over, the rate of death from chronic kidney disease was 1.5 times as high for those living in rental properties compared with women living in properties they owned. For men, the rate was 1.4 times as high for those in rental properties.

Dr Moon noted that these three diseases are common in Australia and, in addition to the personal costs to an individual’s health and quality of life, they have a significant economic burden in terms of healthcare costs and lost productivity.

‘By better understanding the role social inequality plays in chronic disease, governments at all levels can develop stronger, evidence based policies and programs aimed at preventing and managing these diseases, leading to better health outcomes across our community,’ she said

Underlying causes of socioeconomic inequalities in health

There are various reasons why socioeconomically disadvantaged people experience poorer health. Evidence points to the close relationship between people’s health and the living and working conditions which form their social environment.

Factors such as socioeconomic position, early life, social exclusion, social capital, employment and work, housing and the residential environment— known collectively as the ‘social determinants of health’—can act to either strengthen or to undermine the health of individuals and communities (Wilkinson & Marmot 2003).

These social determinants play a key role in the incidence, treatment and outcomes of chronic diseases. Social determinants can be seen as ‘causes of the causes’—that is, as the foundational determinants which influence other health determinants such as individual lifestyles and exposure to behavioural and biological risk factors.

Socioeconomic factors influence chronic disease through multiple mechanisms. Socioeconomic disadvantage may adversely affect chronic disease risk through its impact on mental health, and in particular, on depression. Socioeconomic gradients exist for multiple health behaviours over the life course, including for smoking, overweight and obesity, and poor diet.

When combined, these unhealthy behaviours help explain much of the socioeconomic health gap. Current research also seeks to link social factors and biological processes which affect chronic disease. In CVD, for example, socioeconomic determinants of health have been associated with high blood pressure, high cholesterol, chronic stress responses and inflammation (Havranek et al. 2015).

The direction of causality of social determinants on health is not always one-way (Berkman et al. 2014). To illustrate, people with chronic conditions may have a reduced ability to earn an income; family members may reduce or cease employment to provide care for those who are ill; and people or families whose income is reduced may move to disadvantaged areas to access low-cost housing.

Action on social determinants is often seen as the most appropriate way to tackle unfair and avoidable socioeconomic inequalities. There are significant opportunities for reducing death and disability from CVD, diabetes and CKD through addressing their social determinants.

Summary

Australians as a whole enjoy good health, but the benefits are not shared equally by all. People who are socioeconomically disadvantaged have, on average, greater levels of cardiovascular disease (CVD), diabetes and chronic kidney disease (CKD).

This report uses latest available data to measure socioeconomic inequalities in the incidence, prevalence and mortality from these 3 diseases, and where possible, assess whether these inequalities are growing. Findings include that, in 2016:

  • males aged 25 and over living in the lowest socioeconomic areas of Australia had a heart attack rate 1.55 times as high as males in the highest socioeconomic areas. For females, the disparity was even greater, at 1.76 times as high
  • type 2 diabetes prevalence for females in the lowest socioeconomic areas was 2.07 times as high as for females in the highest socioeconomic areas. The prevalence for males was 1.70 times as high
  • the rate of treated end-stage kidney disease for males in the lowest socioeconomic areas was 1.52 times as high as for males in the highest socioeconomic areas. The rate for females was 1.75 times as high
  • the CVD death rate for males in the lowest socioeconomic areas was 1.52 times as high as for males in the highest socioeconomic areas. For females, the disparity was slightly less, at 1.33 times as high
  • if all Australians had the same CVD death rate as people in the highest socioeconomic areas in 2016, the total CVD death rate would have declined by 25%, and there would have been 8,600 fewer deaths.

CVD death rates have declined for both males and females in all socioeconomic areas since 2001— however there have been greater falls for males in higher socioeconomic areas, and as a result, inequalities in male CVD death rates have grown.

  • Both absolute and relative inequality in male CVD death rates increased—the rate difference increasing from 62 per 100,000 in 2001 to 78 per 100,000 in 2011, and the relative index of inequality (RII) from 0.25 in 2001 to 0.53 in 2016.

Often, the health outcomes affected by socioeconomic inequalities are greater when assessed by individual characteristics (such as income level or highest educational attainment), than by area.

  • Inequalities in CVD death rates by highest education level in 2011–12 (RII = 1.05 for males and 1.05 for females) were greater than by socioeconomic area in 2011 (0.50 for males and 0.41 for females).

The impact on death rates of socioeconomic inequality was generally greater for diabetes and CKD than for CVD.

  • In 2016, the diabetes death rate for females in the lowest socioeconomic areas was 2.39 times as high as for females in the highest socioeconomic areas. This compares to a ratio 1.75 times as high for CKD, and 1.33 for CVD. For males, the equivalent rate ratios were 2.18 (diabetes), 1.64 (CKD) and 1.52 (CVD).viii

Part 2

 

NACCHO Aboriginal #MentalHealth and #SuicidePrevention : @ozprodcom issues paper on #MentalHealth in Australia is now available. It asks a range of questions which they seek information and feedback on. Submissions or comments are due by Friday 5 April.

 ” Many Australians experience difficulties with their mental health. Mental illness is the single largest contributor to years lived in ill-health and is the third largest contributor (after cancer and cardiovascular conditions) to a reduction in the total years of healthy life for Australians (AIHW 2016).

Almost half of all Australian adults have met the diagnostic criteria for an anxiety, mood or substance use disorder at some point in their lives, and around 20% will meet the criteria in a given year (ABS 2008). This is similar to the average experience of developed countries (OECD 2012, 2014).”

Download the PC issues paper HERE mental-health-issues

See Productivity Commission Website for More info 

“Clearly Australia’s mental health system is failing Aboriginal people, with Aboriginal communities devastated by high rates of suicide and poorer mental health outcomes. Poor mental health in Aboriginal communities often stems from historic dispossession, racism and a poor sense of connection to self and community. 

It is compounded by people’s lack of access to meaningful and ongoing education and employment. Drug and alcohol related conditions are also commonly identified in persons with poor mental health.

NACCHO Chairperson, Matthew Cooke 2015 Read in full Here 

Read over 200 Aboriginal Mental Health Suicide Prevention articles published by NACCHO over the past 7 years 

Despite a plethora of past reviews and inquiries into mental health in Australia, and positive reforms in services and their delivery, many people are still not getting the support they need to maintain good mental health or recover from episodes of mental ill‑health. Mental health in Australia is characterised by:

  • more than 3 100 deaths from suicide in 2017, an average of almost 9 deaths per day, and a suicide rate for Indigenous Australians that is much higher than for other Australians (ABS 2018)
  • for those living with a mental illness, lower average life expectancy than the general population with significant comorbidity issues — most early deaths of psychiatric patients are due to physical health conditions
  • gaps in services and supports for particular demographic groups, such as youth, elderly people in aged care facilities, Indigenous Australians, individuals from culturally diverse backgrounds, and carers of people with a mental illness
  • a lack of continuity in care across services and for those with episodic conditions who may need services and supports on an irregular or non-continuous basis
  • a variety of programs and supports that have been successfully trialled or undertaken for small populations but have been discontinued or proved difficult to scale up for broader benefits
  • significant stigma and discrimination around mental ill-health, particularly compared with physical illness.

The Productivity Commission has been asked to undertake an inquiry into the role of mental health in supporting social and economic participation, and enhancing productivity and economic growth (these terms are defined, for the purpose of this inquiry, in box 1).

By examining mental health from a participation and contribution perspective, this inquiry will essentially be asking how people can be enabled to reach their potential in life, have purpose and meaning, and contribute to the lives of others. That is good for individuals and for the whole community.

Background

In 2014-15, four million Australians reported having experienced a common mental disorder.

Mental health is a key driver of economic participation and productivity in Australia, and hence has the potential to impact incomes and living standards and social engagement and connectedness. Improved population mental health could also help to reduce costs to the economy over the long term.

Australian governments devote significant resources to promoting the best possible mental health and wellbeing outcomes. This includes the delivery of acute, recovery and rehabilitation health services, trauma informed care, preventative and early intervention programs, funding non-government organisations and privately delivered services, and providing income support, education, employment, housing and justice. It is important that policy settings are sustainable, efficient and effective in achieving their goals.

Employers, not-for-profit organisations and carers also play key roles in the mental health of Australians. Many businesses are developing initiatives to support and maintain positive mental health outcomes for their employees as well as helping employees with mental illhealth continue to participate in, or return to, work.

Scope of the inquiry

The Commission should consider the role of mental health in supporting economic participation, enhancing productivity and economic growth. It should make recommendations, as necessary, to improve population mental health, so as to realise economic and social participation and productivity benefits over the long term.

Without limiting related matters on which the Commission may report, the Commission should:

  • examine the effect of supporting mental health on economic and social participation, productivity and the Australian economy;
  • examine how sectors beyond health, including education, employment, social services, housing and justice, can contribute to improving mental health and economic participation and productivity;
  • examine the effectiveness of current programs and Initiatives across all jurisdictions to improve mental health, suicide prevention and participation, including by governments, employers and professional groups;
  • assess whether the current investment in mental health is delivering value for money and the best outcomes for individuals, their families, society and the economy;
  • draw on domestic and international policies and experience, where appropriate; and
  • develop a framework to measure and report the outcomes of mental health policies and investment on participation, productivity and economic growth over the long term.

The Commission should have regard to recent and current reviews, including the 2014 Review of National Mental Health Programmes and Services undertaken by the National Mental Health Commission and the Commission’s reviews into disability services and the National Disability Insurance Scheme.

The Issues Paper
The Commission has released this issues paper to assist individuals and organisations to participate in the inquiry. It contains and outlines:

  • the scope of the inquiry
  • matters about which we are seeking comment and information
  • how to share your views on the terms of reference and the matters raised.

Participants should not feel that they are restricted to comment only on matters raised in the issues paper. We want to receive information and comment on any issues that participants consider relevant to the inquiry’s terms of reference.

Key inquiry dates

Receipt of terms of reference 23 November 2018
Initial consultations November 2018 to April 2019
Initial submissions due 5 April 2019
Release of draft report Timing to be advised
Post draft report public hearings Timing to be advised
Submissions on the draft report due Timing to be advised
Consultations on the draft report November 2019 to February 2020
Final report to Government 23 May 2020

Submissions and brief comments can be lodged

Online (preferred): https://www.pc.gov.au/inquiries/current/mental-health/submissions
By post: Mental Health Inquiry
Productivity Commission
GPO Box 1428, Canberra City, ACT 2601

Contacts

Inquiry matters: Tracey Horsfall Ph: 02 6240 3261
Freecall number: Ph: 1800 020 083
Website: http://www.pc.gov.au/mental-health

Subscribe for inquiry updates

To receive emails updating you on the inquiry consultations and releases, subscribe to the inquiry at: http://www.pc.gov.au/inquiries/current/mentalhealth/subscribe

 

 Definition of key terms
Mental health is a state of wellbeing in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community.

Mental illness or mental disorder is a health problem that significantly affects how a person feels, thinks, behaves and interacts with other people. It is diagnosed according to standardised criteria.

Mental health problem refers to some combination of diminished cognitive, emotional, behavioural and social abilities, but not to the extent of meeting the criteria for a mental illness/disorder.

Mental ill-health refers to diminished mental health from either a mental illness/disorder or a mental health problem.

Social and economic participation refers to a range of ways in which people contribute to and have the resources, opportunities and capability to learn, work, engage with and have a voice in the community. Social participation can include social engagement, participation in decision making, volunteering, and working with community organisations. Economic participation can include paid employment (including self-employment), training and education.

Productivity measures how much people produce from a given amount of effort and resources. The greater their productivity, the higher their incomes and living standards will tend to be.

Economic growth is an increase in the total value of goods and services produced in an economy. This can be achieved, for example, by raising workforce participation and/or productivity.

Sources: AIHW (2018b); DOHA (2013); Gordon et al. (2015); PC (2013, 2016, 2017c); SCRGSP (2018); WHO (2001).

An improvement in an individual’s mental health can provide flow-on benefits in terms of increased social and economic participation, engagement and connectedness, and productivity in employment (figure 1).

This can in turn enhance the wellbeing of the wider community, including through more rewarding relationships for family and friends; a lower burden on informal carers; a greater contribution to society through volunteering and working in community groups; increased output for the community from a more productive workforce; and an associated expansion in national income and living standards. These raise the capacity of the community to invest in interventions to improve mental health, thereby completing a positive reinforcing loop.

The inquiry’s terms of reference (provided at the front of this paper) were developed by the Australian Government in consultation with State and Territory Governments. The terms of reference ask the Commission to make recommendations to improve population mental health so as to realise higher social and economic participation and contribution benefits over the long term.

Assessing the consequences of mental ill-health

The costs of mental ill-health for both individuals and the wider community will be assessed, as well as how these costs could be reduced through changes to the way governments and others deliver programs and supports to facilitate good mental health.

The Commission will consider the types of costs summarised in figure 4. These will be assessed through a combination of qualitative and quantitative analysis, drawing on available data and cost estimates, and consultations with inquiry participants and topic experts. We welcome the views of inquiry participants on other costs that we should take into account.