NACCHO and @CancerAustralia Aboriginal Women’s Health and Breast Cancer #LotsToLiveFor video launch to share and educate

 ” Sharing Cancer Australia’s Lots to live for video on social media will start a conversation between Aboriginal and Torres Strait Islander people about breast cancer and how early detection can save lives.

If you are an Aboriginal and Torres Strait Islander women, it is vitally important you know the normal look and feel of your breasts, the symptoms to look out for and the importance of seeing their doctor if you find a change.

Breast cancer is the most common cancer among women in Australia, including among Aboriginal and Torres Strait Islander women, yet Indigenous women are 16 per cent less likely to survive than non-Indigenous women.”

Professor Jacinta Elston ( breast cancer survivor )  Chair of the Cancer Australia Leadership Group on Aboriginal and Torres Strait Islander Cancer Control : She is a descendent of both the Kalkadoon people of North-West Queensland and the South Sea Islander people.

See Key Facts Breast cancer in Aboriginal and Torres Strait Islander women or Part 2 Below

Part 1 Launch today of The Lots to live for video, which features NITV’s Marngrook Footy Show presenter Leila Gurruwiwi

VIEW HERE

A new breast awareness video designed for Aboriginal and Torres Strait Islander women to share with family and friends on social media aims to increase early detection of breast cancer and improve survival.

Cancer Australia CEO, Dr Helen Zorbas, said the video, titled Lots to live for, had been produced to put vital knowledge about the importance of breast awareness and early detection of breast cancer in the hands of Aboriginal and Torres Strait Islander women and communities.

“Finding breast cancer early, while it is still confined to the breast, significantly increases the chances of survival,” Dr Zorbas said. “Early detection of breast cancer through breast awareness and increasing participation in mammographic screening are important ways to improve survival outcomes and address the disparity in breast cancer survival between Indigenous and non-Indigenous women.”

Professor Jacinta Elston, Chair of the Cancer Australia Leadership Group on Aboriginal and Torres Strait Islander Cancer Control, and an Aboriginal woman from Townsville, supported the video’s message and encouraged women to share it on social media.

“Studies have shown that social media has been used effectively in getting health messages out into our community,” Professor Elston said.

See opening message

“Aboriginal and Torres Strait Islander women aged between 50 and 74 years are also encouraged to have a free breast screen every two years. Mammographic screening is the best early detection test for reducing deaths from breast cancer.”

Professor Elston, who is herself a breast cancer survivor, acknowledged that some Indigenous women may be reluctant to discuss a breast change, due to shame, embarrassment, fear or stigma, but that this could seriously impact on their breast cancer outcomes.

“Changes in your breast may not be due to cancer, but if you find a change that is new or unusual, it’s important to see a doctor without delay,” Professor Elston said. “We need to look after our health – for ourselves and our families.”

The Lots to live for video, which features NITV’s Marngrook Footy Show presenter Leila Gurruwiwi, is designed to be easily accessible and shareable on social media platforms widely used by Aboriginal and Torres Strait Islander people.

“Cancer Australia is committed to improving cancer outcomes for Aboriginal and Torres Strait Islander peoples,” Dr Zorbas said.

Visit www.canceraustralia.gov.au/atsi for more information.

Part 2 Key Facts Breast cancer in Aboriginal and Torres Strait Islander women

Key statistics

Incidence

• Breast cancer is the most common cancer among Aboriginal and Torres Strait Islander women.

• The number of breast cancer diagnoses among Aboriginal and Torres Strait Islander women increased by over 60% between the years 2004-08 and 2008-12.

Survival

• The breast cancer survival rate was 16% lower for Aboriginal and Torres Strait Islander women than for non-Indigenous women between 2006-2010.

Mortality

• Breast cancer was the second leading cause of cancer death among Aboriginal and Torres Strait Islander women after lung cancer (between 2007 and 2011).

• In 2010-2014, there were 154 deaths from breast cancer among Aboriginal and Torres Strait Islander women in Australia.

Factors affecting breast cancer outcomes among Aboriginal and Torres Strait Islander women

Aboriginal and Torres Strait Islander women:

are less likely than non-Indigenous women to have a screening mammogram

• may choose not to visit a doctor when they notice changes in their breasts.

• are less likely to undergo cancer treatment

• are less likely to complete cancer treatment

• are more likely to have 1 or more other health problems such as heart disease and/or diabetes.

As a result of these factors, breast cancer may be more advanced when diagnosed.

Key messages

Finding breast cancer early

1. Breast awareness and early detection of breast cancer for Aboriginal and Torres Strait Islander women

• Finding breast cancer early means there are more treatment options and the chances of survival are greatest.

• More than half of breast cancers are diagnosed after a woman or her doctor notices a change in the breast.

This shows how important it is that women are aware of the normal look and feel of their breasts and are confident in reporting unusual breast changes.

How can Aboriginal and Torres Strait Islander women get to know the normal look and feel of their breasts?

• Women of all ages, daughters, mothers, aunties and grandmothers, are encouraged to get to know the normal look and feel of their breast.

• They don’t need to be an expert or know a special way to check their breasts. They can do this as part of everyday activities such as dressing, looking in the mirror, or showering.

Changes to look out for

There are a number of changes to look out for:

• A new lump or lumpiness

• A change in the size or shape of your breast

• A change in the nipple

• Discharge from the nipple

• Any unusual pain

• A change in the skin of your breast

What to do if women find a change?

While most breast changes are not due to cancer, if a woman finds a change in her breast that is new or unusual for her, it’s important to see a doctor without delay.

Screening mammograms

• Aboriginal and Torres Strait Islander women aged between 50 and 74 years are encouraged to attend mammographic breast screening every two years. Mammographic screening is the best early detection test for reducing deaths from breast cancer.

Where to go to have a breast screen?

BreastScreen Australia provides free breast screening for women 50-74 years and has services in all states and territories. To find out more call 13 20 50.

Lots to Live For!

Cancer Australia’s new video Lots to Live For was developed to put vital knowledge about the importance of breast awareness and early detection of breast cancer in the hands of Aboriginal and Torres Strait Islander women and communities.

The Lots to Live For video, which features Marngrook Footy Show presenter Leila Gurruwiwi, is designed to be accessible and shareable on social media platforms widely used by Indigenous communities.

Visit https://www.facebook.com/canceraustralia/ or

https://twitter.com/CancerAustralia #LotsToLiveFor @CancerAustralia

For more information

Visit http://www.canceraustralia.gov.au/atsi

NACCHO Aboriginal Health and #Obesity : Download #TippingtheScales Report Leading health orgs set out 8 urgent actions for Federal Government

“Sixty-three per cent of Australian adults and 27 per cent of our children are overweight or obese.

This is not surprising when you look at our environment – our kids are bombarded with advertising for junk food, high-sugar drinks are cheaper than water, and sugar and saturated fat are hiding in so-called ‘healthy’ foods. Making a healthy choice has never been more difficult.

The annual cost of overweight and obesity in Australia in 2011-12 was estimated to be $8.6 billion in direct and indirect costs such as GP services, hospital care, absenteeism and government subsidies.1 “

 OPC Executive Manager Jane Martin 

Download the report HERE  tipping-the-scales

Read over 30 + NACCHO Obesity articles published last 5 years

Read over 30+ NACCHO Nutrition and Healthy foods published last 5 years

Thirty-four leading community, public health, medical and academic groups have today united for the first time to call for urgent Federal Government action to address Australia’s serious obesity problem.

In the ground-breaking new action plan, Tipping the Scales, the agencies identify eight clear, practical, evidence-based actions the Australian Federal Government must take to reduce the enormous strain excess weight and poor diets are having on the nation’s physical and economic health.

Led by the Obesity Policy Coalition (OPC) and Deakin University’s Global Obesity Centre (GLOBE), Tipping the Scales draws on national and international recommendations to highlight where action is required. Areas include:

  1. Time-based restrictions on TV junk food advertising to kids
  2. Set clear food reformulation targets
  3. Make the Health Star Rating mandatory by July 2019
  4. Develop a national active transport strategy
  5. Fund weight-related public education campaigns
  6. Introduce a 20% health levy on sugary drinks
  7. Establish a national obesity taskforce
  8. Develop and monitor national diet, physical activity and weight guidelines.

OPC Executive Manager Jane Martin said the eight definitive policy actions in Tipping the Scales addressed the elements of Australia’s environment which set individuals and families up for unhealthy lifestyles, rather than just focusing on treating the poor health outcomes associated with obesity.

Watch video HERE : How does junk food marketing influence kids

“Sixty-three per cent of Australian adults and 27 per cent of our children are overweight or obese. This is not surprising when you look at our environment – our kids are bombarded with advertising for junk food, high-sugar drinks are cheaper than water, and sugar and saturated fat are hiding in so-called ‘healthy’ foods. Making a healthy choice has never been more difficult,” Ms Martin said.

“The annual cost of overweight and obesity in Australia in 2011-12 was estimated to be $8.6 billion in direct and indirect costs such as GP services, hospital care, absenteeism and government subsidies.1 But Australia still has no strategy to tackle our obesity problem. It just doesn’t make sense.

“Without action, the costs of obesity and poor diet to society will only continue to spiral upwards. The policies we have set out to tackle obesity therefore aim to not only reduce morbidity and mortality, but also improve wellbeing, bring vital benefits to the economy and set Australians up for a healthier future.”

Professor of Epidemiology and Equity in Public Health at Deakin University, Anna Peeters, said the 34 groups behind the report were refusing to let governments simply sit back and watch as growing numbers of Australians developed life-threatening weight and diet-related health problems.

“For too long we have been sitting and waiting for obesity to somehow fix itself. In the obesogenic environment in which we live, this is not going to happen. In fact, if current trends continue, there will be approximately 1.75 million deaths in people over the age of 20 years caused by diseases linked to overweight and obesity, such as type 2 diabetes, cancer heart disease, between 2011-20501,” Professor Peeters said.

“Obesity poses such an immense threat to Australia’s physical and economic health that it needs its own, standalone prevention strategy if progress is to be made. There are policies which have been proven to work in other parts of the world and have the potential to work here, but they need to be implemented as part of a comprehensive approach by governments. And they need to be implemented now.

“More than thirty leading organisations have agreed on eight priorities needed to tackle obesity in Australia. We would like to work with the Federal Government to tackle this urgent issue and integrate these actions as part of a long-term coordinated approach.”

In addition to the costs to society, the burden of obesity is felt acutely by individuals and their families.

As a Professor of Women’s Health at Monash University and a physician, Professor Helena Teede sees mothers struggle daily with trying to achieve and sustain healthy lifestyles for themselves and their families, while having to deal with the adverse impact of unhealthy weight, especially during pregnancy.

“As a mother’s weight before pregnancy increases, so does the substantive health risk to both the mother and baby. Excess weight gain during pregnancy further adds to these risks and is a key driver of infertility, long-term obesity, heart disease and type 2 diabetes, while for the child, their risk of becoming overweight or obese and developing chronic diseases in later life greatly increases,” Professor Teede said.

“The women I see are generally desperate for help to improve their lifestyle and that of their families. They want to set themselves and their families up for healthy, long lives.

“Currently, there is a lot of blame placed on individuals with unhealthy diets and lifestyles seen as being due to individual and family discipline. Women from all backgrounds and walks of life struggle with little or no support to achieve this. It is vital that we as a community progress beyond placing all responsibility on the individual and work towards creating a policy context and a society that supports healthy choices and tips the scales towards obesity prevention to give Australian families a healthy start to life.”

The calls to action outlined in Tipping the Scales are endorsed by the following organisations: Australian Chronic Disease Prevention Alliance (which includes the Heart Foundation, Cancer Council Australia, Kidney Health Australia, Diabetes Australia and the Stroke Foundation), Australian Health Policy Collaboration (AHPC), Australian Medical Students’ Association (AMSA), Australian & New Zealand Obesity Society (ANZOS), Australasian Society of Lifestyle Medicine, Baker Heart & Diabetes Institute, CHOICE, Consumers Health Forum of Australia, Deakin University’s Global Obesity Centre (GLOBE), Institute For Physical Activity and Nutrition (IPAN), Monash Centre for Health, Research and Implementation (MCHRI), LiveLighter, Menzies School of Health Research, The University of Melbourne’s Melbourne School of Population & Global Health, Melbourne Children’s (which includes The Royal Children’s Hospital Melbourne, Murdoch Children’s Research Institute and the University of Melbourne), the National Rural Health Alliance Inc, Nutrition Australia, Obesity Australia, Obesity Policy Coalition, Obesity Surgery Society of Australia & New Zealand, Parents’ Voice, Public Health Association of Australia and Sugar By Half.

Download the Tipping the Scales action plan and snapshot at opc.org.au/tippingthescales


1. Obesity Australia. Obesity: Its impact on Australia and a case for action. No time to Weight 2. Sydney, 2015.

NACCHO Research Alert : @NRHAlliance Aboriginal health risk factors #rural and #remote populations

 ” Health risk factors like smoking, excessive drinking, illicit drug use, lack of physical activity, inadequate fruit and vegetable intake and overweight have powerful influences on health, and there are frequently clear inter-regional differences between the prevalence of these.

While it can be argued that there is some degree of personal choice involved in whether individuals have a poor health risk profile, there is clear evidence that external factors such as environment, opportunity, and community culture each have very strong influences.

For example, access to affordable healthy food can often be poor in smaller communities and this, coupled with lower incomes in these areas, adversely affects the quality of peoples’ diets, the prevalence of overweight, and consequently the prevalence of chronic disease.”

From the National Rural Health Alliance Research View HERE

National data pertaining to personal health risk factors typically comes from the ABS National Health Survey and the AIHW National Drug Strategy Household Survey (NDSHS). Some State and Territory Health Departments run their own health surveys (which cannot be aggregated nationally with each other or with the ABS survey because of the different methodologies and definitions used (think different State rail gauges). Consequently data describing aspects of health in regional and especially remote areas can be thin (ie with imprecise estimates in some or all areas).

Example 1

Table 14: Fruit and vegetable consumption, Aboriginal and Torres Strait Islander people 15+ years, 2012-13

Roughly 60% of Aboriginal and Torres Strait Islander Australians 15+ in Major cities and regional/rural areas have inadequate fruit intake, closer to 50% in remote areas (compared with around 50% of all Australians 18+ in major cities and regional/rural areas).

Roughly 95% of Aboriginal and Torres Strait Islander Australians 15+ in Major cities and regional/rural areas have inadequate vegetable intake, perhaps higher (98%) in Very remote areas (compared with around 90%-94% of all Australians 18+ in major cities and regional/rural areas).

Example 2

NACCHO provided graphic

Table 16 Below : Overweight and Obesity, Aboriginal and Torres Strait Islander people 15+ years, 2012-13

Aboriginal and Torres Strait Islander people in rural/regional and Remote areas (29%-33%) were a little more likely to be overweight than those in Major cities (28%), with those in Very Remote areas (26%) least likely to be overweight.

Aboriginal and Torres Strait Islander people in Inner regional areas (41%) were more likely to be obese than those in Major cities (38%), but those in Outer regional (36%) and remote areas (~33%) were less likely to be obese.

Overall, Aboriginal and Torres Strait Islander people in Inner Regional areas were most likely to be overweight/obese (70%), those in Major cities, Outer Regional and Remote areas were less likely to be overweight/obese (~66%), while those in Very Remote areas were the least likely to be overweight/obese (59% )

At the time of writing, the most recent National Health Survey was conducted in 2014-15[1], while the most recent AIHW NDSHS[2] was conducted in 2016, with most recently available results from the 2013 NDSHS. The most recent ABS Australian Aboriginal and Torres Strait Islander Health Survey[3] was conducted in 2012-13.

Some organisations (eg the Public Health Information Development Unit (PHIDU)) have calculated modelled estimates for small areas (eg SLA’s and PHN’s), where the prevalence of some risk factors has been predicted based on the age, sex and socioeconomic profile of the population living there.

Some sites (eg ABS) present risk factor data as crude rates, other sites (eg PHIDU) present risk factor data as age-standardised rates.  The advantage of the age-standardised rates is that the effect of age is largely removed from inter-population comparisons.

For example, older populations (eg those in rural/regional areas) would be expected to have higher average blood pressure than younger (eg Major cities) populations even though the underlying age-specific rates happened to be identical in both populations (because older people tend to have higher blood pressure than younger people).

While crude rates for the older population will be higher, the age-standardised rates in such a comparison would be the same – indicating a higher rate that is entirely explainable by the older age of one of the populations.

Both crude and age standardised rates are useful in understanding the health of rural and remote populations.

 


[1] http://www.abs.gov.au/ausstats/abs@.nsf/mf/4364.0.55.001

[3] http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4727.0.55.0012012-13?OpenDocumentSmoking

Table 1: Smoking status, by remoteness, 2013 and 2014-15

MC

IR

OR/Remote

Percentage

Current daily smoker (18+) (crude) 2014-15 (a)

13.0

16.7

20.9

Current smoker (18+) (Age standardised) 2014-15 (b) (includes daily, weekly, social etc smoking)

14.6

19.0

22.4

MC

IR

OR

Remote+ Very Remote

Current smoker (daily, weekly, or fortnightly) 14+ (crude) 2013 (c)

14.2

17.6

22.6

24.6

Current smoker (daily, weekly, or fortnightly) 14+ (Age standardised) 2013 (d)

14.2

18.6

23.6

24.4

Mean number of cigarettes smoked per week, smokers aged 14 years or older 2013 (e)

85.9

113.1

109.4

126.2

Sources:

Compared with Major cities (13%), the prevalence of daily smoking by people 18 years and older in Inner regional (17%) and Outer regional/Remote areas (21%) is higher.

The NDSH survey reflects these trends albeit with a slightly different age group (14+) and a different definition of smoking (daily plus less frequently), but the NDSH survey adds detail for remote areas where smoking rates are higher again (around 25% versus around 23% in Outer regional).

In addition, the average number of cigarettes smoked by each smoker is higher in regional/rural areas (~110/week) than in Major cities (86/week), and higher again (126/week) in remote areas.

 

Smoking – exposure, uptake, establishment, quitting

Table 2: Smoking characteristics by Remoteness, 2013, 2014 and 2014-15

MC

IR

OR

remote

8.8

17.8

19.3

27.8

Proportion of pregnant women who gave birth and smoked at any time during the pregnancy (2013, crude, National Perinatal Data Collection, exposure tables, Table 5.1.2 )

8.5

17.0

18.9

27.5

Proportion of pregnant women who gave birth and smoked in the first 20 weeks of pregnancy (2013, crude, National Perinatal Data Collection) exposure tables, Table 5.2.2)

3.6

3.1

4.1

*9.4

Proportion of dependent children (aged 0–14) who live in a household with a daily smoker who smokes inside the home (2013, crude, NDSHS exposure tables, Table 6.3)

2.5

2.0

2.7

*2.9

Proportion of adults aged 18 or older who live in a household with a daily smoker who smokes inside the home (2013, crude, NDSHS, exposure tables, Table 7.3)

16.2

15.4

14.7

15.5

Average age at which people aged 14–24 first smoked a full cigarette (2013, crude, NDSHS, uptake tables, Table 9.3)

17.8

22.7

17.8

28.3

Proportion of 12–17 year old secondary school students smoking at least a few puffs of a cigarette (2014, crude, Australian Secondary Students Alcohol and Drug Survey 2014, uptake tables, Table 10.3

54.7

61.1

64.9

67.2

Proportion of persons (aged 18 or older) who have smoked a full cigarette (2013, crude,  NDSHS, uptake tables, Table 10.8)

2.5

3.4

2.5

3.7

Proportion of secondary school students (aged 12–17) who have smoked more than 100 cigarettes in their lifetime (2014, crude, Australian Secondary Students Alcohol and Drug Survey 2014, transition tables, Table 2.3)

20.2

25.9

44.1

45.2

Proportion of young people (aged 18–24) who have smoked more than 100 cigarettes in their lifetime (2013, crude, NDSHS, transition tables, Table 2.6)

21.3

16.8

19.0

15.5

Quitting: Proportion successfully gave up for more than a month (2013, crude, NDSHS, cessation tables, Table 4.3)

29.2

34.2

31.7

32.9

Quitting, Proportion unsuccessful (2013, crude, NDSHS, cessation tables, Table 4.3)

46.3

48.0

47.4

45.2

Quitting: Proportion any attempt (2013, crude, NDSHS, cessation tables, Table 4.3)

35.2

36.3

36.1

36.0

Mean age at which ex-smokers aged 18 or older reported no longer smoking (2013, crude, NDSHS, cessation tables, Table 11.2)

53.1

51.5

46.3

45.0

The proportion of ever smokers aged 18 or older who did not smoke in the last 12 months (2013, crude, NDSHS, cessation tables, Table 12.3)

4.9

6.0

4.8

7.0

Proportion of secondary school students (aged 12–17) who were weekly smokers (2014, crude, Australian Secondary Students Alcohol and Drug Survey 2014, established tables, Table 1.3)

6.9

9.3

6.8

10.4

Proportion of secondary school students (aged 12–17) who were monthly smokers (2014, crude, Australian Secondary Students Alcohol and Drug Survey 2014, established tables, Table 13.3)

13.0

16.7

21.2

18.8

Proportion of adults aged 18 or older who are daily smokers (2014-15, crude, ABS NHS, established tables, Table 3.3)

10.9

7.8

2.9

n.p.

Proportion of smokers aged 18 or older who are occasional smokers (smoke weekly or less than weekly) (2014-15, crude, ABS NHS, established tables, Table 14.3)

40.1

44.7

42.3

52.7

Proportion of Aboriginal and Torres Strait Islander people aged 18 or older who are daily smokers (2012-13, crude, ABS Australian Aboriginal and Torres Strait Islander Health Survey 2012–13, established tables, Table 8i.3)

Source: http://www.aihw.gov.au/alcohol-and-other-drugs/data/ (sighted 11/7/17)
Note: Those estimates above with asterix have large standard errors and should be treated carefully.

Women in rural and remote areas were much more likely to smoke during pregnancy, with 28% of women in remote areas smoking during pregnancy, compared with 18-19% in regional/rural areas, and 9% in Major cities.

It is unclear whether exposure to environmental tobacco smoke varies by remoteness.

Young people outside major cities appeared to have their first cigarette at an earlier age (~15 years as opposed to ~16 years in Major cities.

Secondary school students in Inner regional (~23%) and remote (~28%) areas were more likely to have had at least a few puffs of a cigarette than those in major cities (~18%).

While 20% of young people in Major cities had smoked more than 100 cigarettes in their lifetime, 26%, 44% and 45% of young people in Inner regional, Outer regional and remote areas had done so.

People outside Major cities were as likely or slightly more likely to have attempted to quit smoking, but were less likely to be successful (and more likely to be unsuccessful).

A higher proportion of secondary students outside Major cities were weekly or monthly smokers (6%, 5% and 7% in IR, OR and remote areas versus 5% in Major cities weekly, 9%, 7%, and 10% in IR, OR and remote areas versus 7% in Major cities monthly).

Table 3: Current daily smoker, Aboriginal and Torres Strait Islander people 15+ years, by Remoteness, 2012-13

MC

IR

OR

R

VR

Crude Percent

Current daily smoker

36.2

40.9

39.8

47.4

51.1

Source: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4727.0.55.0012012-13?OpenDocument Table 2 (sighted 12/7/17)

Prevalence of smoking amongst Aboriginal and Torres Strait Islander people 15 years and older is around 35%-40% in Major cities and regional/rural areas, and close to 50% in remote areas. Note that while the pattern is similar in Table 2 and Table 3 above, the figures for 18+ and 15+ year olds are slightly different.

Smoking Trends

Table 4: Comparison of declines in smoking rate estimates across remoteness areas, people 18+, based on ABS NHS surveys, 2001 to 2011-12

Survey year

MC

IR

OR/Rem

Australia

Crude percent daily smokers

2001

21.9

21.9

26.5

22.4

2004-05

19.9

23.0

26.2

21.3

2007-08

17.5

20.1

26.1

18.9

2011-12

14.7

18.3

22.2

16.1

2014-15

13.0

16.7

20.9

14.5

Source: ABS National Health Surveys

From Table 4 above, rates of smoking have clearly declined in Major cities areas, but have been slower to decline in Inner regional and Outer regional/Remote areas. Rates of smoking in rural areas, apparently static last decade, now appear to be declining. Rates in Major cities and Inner regional areas have declined to 0.59 and 0.76 times the 2001 rates in these areas. The 2014-15 rate in Outer regional areas is 0.79 times the 2001 rate.

Figure 1: Daily smokers 18 years and older, 2007-08, 2011-12 and 2014-15, NHS

Figure 1: Daily smokers 18 years and older, 2007-08, 2011-12 and 2014-15, NHS

Source: ABS NHS http://www.aihw.gov.au/alcohol-and-other-drugs/data/ established tables, Table 3.3 (sighted 11/7/17)

Figure 2: Smokers 14 years and older, 2007, 2010 and 2013, NDSHS

Figure 2: Smokers 14 years and older, 2007, 2010 and 2013, NDSHS

Source: AIHW NDSHS http://www.aihw.gov.au/alcohol-and-other-drugs/data/ tobacco smoking table S3.12 (sighted 11/7/17)

Note: Smokers include daily, weekly and less frequent smokers.

Figures 1 and 2 above both show clear declines in Major cities and Inner regional areas, but the trend in Outer regional and Remote areas is less clear, with ABS data showing a decline in daily smoking rates for people aged 18+ between 2007-8 and 2014-15, but NDSHS data showing little change in smoking rates for people 14+ between 2007 and 2013.

Alcohol

Table 5: Alcohol risk status, by remoteness, 2013 and 2014-15

Alcohol consumption

MC

IR

OR/Rem

Exceeded 2009 NHMRC lifetime risk guidelines, people 18+, crude %, 2014-15 (a)

16.3

18.4

23.4

Exceeded 2009 NHMRC lifetime risk guidelines, people 15+, age standardised %, 2014-15 (b)

15.7

17.4

22.0

Exceeded 2009 NHMRC single occasion risk guidelines, people 18+, crude %, 2014-15 (a)

42.7

48.5

46

MC

IR

OR

R/VR

Abstainer/ex-drinker, crude %, 14+, 2013 (c)

23.1

18.9

20.5

17.5

Low lifetime risk, crude %, 14+, 2013 (c)

60.2

62

56.9

47.6

High lifetime risk, crude %, 14+, 2013 (c)

16.7

19.1

22.6

34.9

low single occasion risk, crude %, 14+, 2013 (c)

40.4

41.8

38.1

30.8

Single occasion risk less than weekly, crude %, 14+, 2013 (c)

23.5

24.4

23.6

22.8

Single occasion risk at least weekly, crude %, 14+, 2013 (c)

13

14.9

17.8

28.9

Sources:

Table 6: Alcohol consumption against 2009 NHMRC guidelines, Aboriginal and Torres Strait Islander people 15+ years, by Remoteness 2012-13

MC

IR

OR

R

VR

Percent

Exceeded lifetime risk guidelines

18.0

18.7

18.2

22.5

14.3

Exceeded single occasion risk guidelines

56.7

57.4

50.7

59.0

41.4

Source: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4727.0.55.0012012-13?OpenDocument Table 2 (sighted 12/7/17)

The figures in Table 6 are not strictly comparable with those for the total population in Table 5, because  Table 6 refers to people who are 15 years and older, while Table 5 refers to people who are 18 years and older.

The percentage of the 15+ ATSI population exceeding 2009 NHMRC Lifetime risk guidelines is around 15-20% with little apparent inter-regional variation, compared with, for the total population 18+,  16% in Major cities, increasing to 23% in Outer regional/remote areas.

The percentage of the 15+ ATSI population exceeding the 2009 single occasion risk guidelines is around 50-60%, and around 40% in Very remote areas, compared with, for the total population 18+,  40-50% in Major cities, rural and regional areas.

Alcohol trends

Table 7: Type of alcohol use and treatment for alcohol, by remoteness area (per 1,000 population)

MC

IR

OR

R/VR

single occasion risk (monthly) 2004

287

304

321

370

2007

285

292

312

437

2010

274

312

329

413

2013

250

273

315

422

lifetime risk 2004

200

215

234

262

2007

199

210

238

314

2010

189

225

251

310

2013

167

191

226

349

very high risk – yearly 2004

167

185

206

243

2007

172

183

206

288

2010

161

183

218

266

2013

151

166

194

258

very high risk – monthly 2004

77

84

104

130

2007

78

89

100

153

2010

79

94

113

154

2013

70

70

100

170

very high risk – weekly 2004

21

27

41

38

2007

24

28

24

50

2010

37

43

54

78

2013

27

28

38

70

Closed treatment episodes 2004–05

61

72

60

58

2007–08

76

84

80

129

2010–11

69

96

87

135

2013–14

68

79

93

155

Source: NDSHS,  http://www.aihw.gov.au/alcohol-and-other-drugs/data/  alcohol -supplementary data tables, Table S18

Notes:
Single occasion risk (monthly): Had more than 4 standard drinks at least once a month
Lifetime risk: On average, had more than 2 standard drinks per day
Very high risk (yearly): Had more than 10 standard drinks at least once a year
Very high risk (monthly): Had more than 10 standard drinks at least once a month
Very high risk (weekly): Had more than 10 standard drinks at least once a week

There is a clear increase in the prevalence of people who drink alcohol in such a way as to increase their single occasion risk (eg from car accident, assault, fall, etc) and their lifetime risk (eg from chronic disease – liver disease, dementia, cancer etc) as remoteness increases.

In 2013, single occasion risk ranged from 25% of people 14 years or older in major cities to 42% of people in remote areas, while lifetime risk increased from 17% in major cities to 35% in remote areas.

In 2013, The prevalence of people who drank more than 10 standard drinks in one sitting at least once per week, increased from just under 3% in Major cities to 7% in remote areas.

In 2013-14, there were just under 70 closed treatment episodes per 1,000 people living in Major cities, increasing to around 80 and 90 per 1,000 population in Inner and Outer regional areas, to 155 per 1,000 people living in remote Australia.

 

Illicit drug use 2013

Table 8: Illicit drug use, “recent users” 14+, 2013

MC IR OR remote

Crude percent

Cannabis

9.8

10.0

12.0

13.6

Ecstasy

2.9

1.5

1.6

*1.8

Meth/amphetamine

2.1

1.6

2.0

*4.4

Cocaine

2.6

0.8

*1.1

*2.5

Any illicit drug

14.9

14.1

16.7

18.7

Source: AIHW National Drug Strategy Household Survey, 2013. http://www.aihw.gov.au/alcohol-and-other-drugs/data/  Illicit drug use (supplementary) tables S5.6, S5.11, S5.17, S5.21, S5.26.

Note: * indicates large standard error (therefore some degree of uncertainty)

Illicit drug use appears to be higher in Outer regional and remote areas compared with Major cities and Inner regional areas, in large part due to higher rates of cannabis use in these areas, but with apparent lower use of ecstasy and cocaine in regional areas compared with Major cities.

 

Physical activity

Table 9: Physical inactivity, people 18+, 2014-15

MC

IR

OR/Remote

Percentage of people aged 18+ who undertook no or low exercise in the previous week (crude) (a)

64.3

70.1

72.4

Percentage of people aged 18+ who undertook no or low exercise in the previous week (age standardised) (b)

64.8

68.6

71

Sources:
(a) ABS NHS (http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0012014-15?OpenDocument Table 6.3)
(b) PHIDU (ABS NHS data) (http://phidu.torrens.edu.au/social-health-atlases/data#social-health-atlas-of-australia-remoteness-areas) sighted 18/7/2017

Note that level of exercise is based on exercise undertaken for fitness, sport or recreation in the last week.

Physical inactivity appears to be more prevalent with remoteness, increasing from 65% of people in Major cities to 71% in Outer regional/remote areas.

Table 10: Average daily steps, 2011-12

MC

IR

OR/Rem

Average daily steps, 18+ years, 2011-12 (a)

7,393

7,388

7,527

Average daily steps, 5-17years, 2011-12 (b)

9,097

9,266

9,160

Sources:

In 2011-12, adults living in Outer regional/Remote areas took slightly more steps than those living in Major cities or Inner regional areas, while the number of steps taken by children and adolescents in regional/Remote areas was slightly greater compared with those in Major cities.

Table 11: Average time spent on physical activity and sedentary behaviour by persons aged 18+, 2011-12

MC

IR

OR/Remote

Australia

Hours

Physical activity(a)

3.9

3.4

3.9

3.8

Sedentary behaviour (leisure only)(b)

29.3

28.0

27.9

28.9

Sedentary behaviour (leisure and work)(b)

40.2

35.2

36.0

38.8

Notes:
(a) Includes walking for transport/fitness, moderate and vigorous physical activity.
(b) Sedentary is defined as sitting or lying down for activities.

Source: ABS 2011-12 Australian Health Survey (Physical activity) http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0042011-12?OpenDocument  Table 5.1

Adults living in Inner regional and Outer regional/Remote areas were about as likely as (or very slightly less likely than) those in Major cities to be sedentary in their leisure time, but appeared to be slightly less likely to be sedentary overall (ie their work involved a greater level of physical activity).

Table 12: Whether children aged 2-17 years met physical and screen-based activity recommendations, 2011-12

MC

IR

OR/Rem

Crude percentage

Met physical activity recommendation on all 7 days(a)(b)

27.5

34.3

34.2

Met screen-based activity recommendation on all 7 days(b)(c)

28.0

29.7

31.0

Met physical activity and screen-based recommendations on all 7 days (a)(b)(c)

9.7

10.9

14.2

Notes:
(a) The physical activity recommendation for children 2–4 years is 180 minutes or more per day, for children 5-17 years it is 60 minutes or more per day. See Physical activity recommendation in Glossary.
(b) In 7 days prior to interview.
(c) The screen-based recommendation for children 2–4 years is no more than 60 minutes per day, for children 5-17 years it is no more than 2 hours per day for entertainment purposes.

Source:
ABS 2011-12 Australian Health Survey (Physical activity) http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0042011-12?OpenDocument  Table 14.3

Children in rural and regional Australia appeared more likely (34% vs 28%) to meet physical activity recommendations and slightly more likely (30%vs 28%) to meet screen-based activity recommendations than their Major cities counterparts.

 

Fruit and vegetable consumption

Table 13: Fruit and vegetable consumption, people 18+ years, by remoteness, 2014-15

MC

IR

OR/Remote

Crude Percentage

Inadequate fruit consumption(a)

50.0

50.6

51.2

Inadequate fruit consumption(b)

50.4

48.3

48.0

Inadequate vegetable consumption(a)

93.4

93.5

89.3

Inadequate vegetable consumption(b)

n.p.

n.p.

n.p.

Sources:
(a) ABS NHS (http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0012014-15?OpenDocument Table 6.3)
(b) PHIDU (ABS NHS data) (http://phidu.torrens.edu.au/social-health-atlases/data#social-health-atlas-of-australia-remoteness-areas) sighted 18/7/2017

Note that adequacy of consumption is based on comparison with 2013 NHMRC guidelines.

Half of adult Australians eat insufficient fruit, with little clear difference between major cities and regional/rural areas.

Around 90% of adult Australians ate insufficient vegetables, with little clear difference between major cities and regional/rural areas.

Table 14: Fruit and vegetable consumption, Aboriginal and Torres Strait Islander people 15+ years, 2012-13

MC

IR

OR

R

VR

Crude Percent

Inadequate daily fruit consumption (2013 NHMRC Guidelines)

59.0

60.6

56.9

54.9

49.1

Inadequate daily fruit consumption (2003 NHMRC Guidelines)

62.1

63.6

59.8

58.3

51.6

Inadequate daily vegetables consumption (2013 NHMRC Guidelines)

95.9

93.5

93.6

94.5

97.9

Inadequate daily vegetables consumption (2003 NHMRC Guidelines)

93.8

90.6

90.5

91.2

96.1

Source: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4727.0.55.0012012-13?OpenDocument Table 2 (sighted 12/7/17)

Roughly 60% of Aboriginal and Torres Strait Islander Australians 15+ in Major cities and regional/rural areas have inadequate fruit intake, closer to 50% in remote areas (compared with around 50% of all Australians 18+ in major cities and regional/rural areas).

Roughly 95% of Aboriginal and Torres Strait Islander Australians 15+ in Major cities and regional/rural areas have inadequate vegetable intake, perhaps higher (98%) in Very remote areas (compared with around 90%-94% of all Australians 18+ in major cities and regional/rural areas).

 

 

Overweight and Obesity

Table 15: Overweight and Obesity, people 18+ years, by remoteness, 2014-15

MC

IR

OR/Remote

Crude Percentage

Persons, overweight/obese (a)

61.1

69.2

69.2

Age standardised percentage

Males overweight (b)

43.8

41.1

34.3

Males obese (b)

25.8

33.1

38.2

Females overweight (b)

28.9

28.3

30.1

Females obese (b)

25.0

32.4

33.7

People  overweight (b)

36.2

34.4

31.4

People obese (b)

25.4

32.6

35.8

Sources:
(a) ABS NHS (http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0012014-15?OpenDocument Table 6.3)
(b) ABS NHS http://phidu.torrens.edu.au/social-health-atlases/data#social-health-atlas-of-australia-remoteness-areas

Adults in rural/regional areas are more likely to be overweight or obese than people in Major cities (69% vs 61%).

However, there were inter-regional BMI and gender differences:

  • Compared with those in Major cities, males in Inner regional and especially Outer-regional areas were less likely to be overweight (41% and 34%, vs 44%) but much more likely to be obese (33% and 38% vs 26%).
  • Compared with those in Major cities, females in Inner regional and Outer-regional areas were about as likely to be overweight (~29%) but much more likely to be obese (~33% vs 25%).

 

Table 16: Overweight and Obesity, Aboriginal and Torres Strait Islander people 15+ years, 2012-13

MC

IR

OR

R

VR

Crude Percent

Overweight

27.5

28.8

30.1

32.5

26.4

Obese

37.9

41.3

36.2

33.1

32.3

Overweight/obese

65.4

70.1

66.2

65.6

58.8

Aboriginal and Torres Strait Islander people in rural/regional and Remote areas (29%-33%) were a little more likely to be overweight than those in Major cities (28%), with those in Very Remote areas (26%) least likely to be overweight.

Aboriginal and Torres Strait Islander people in Inner regional areas (41%) were more likely to be obese than those in Major cities (38%), but those in Outer regional (36%) and remote areas (~33%) were less likely to be obese.

Overall, Aboriginal and Torres Strait Islander people in Inner Regional areas were most likely to be overweight/obese (70%), those in Major cities, Outer Regional and Remote areas were less likely to be overweight/obese (~66%), while those in Very Remote areas were the least likely to be overweight/obese (59%).

These figures compare with 61% – the prevalence of overweight/obesity for (predominantly non-Indigenous) people living in Major cities.

 

High blood pressure

Table 17: High blood pressure, people 18+, by Remoteness, 2014-15

MC

IR

OR/Remote

Percentage

Crude % (a)

21.9

27.1

24

Age standardised % (b)

22.7

24.6

22.1

Sources:

(a) ABS NHS (http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0012014-15?OpenDocument Table 6.3)
(b) ABS NHS http://phidu.torrens.edu.au/social-health-atlases/data#social-health-atlas-of-australia-remoteness-areas

Age for age, people in rural/regional Australia appeared to be as likely, or very slightly more likely to have high blood pressure than their counterparts in Major cities (~23% vs ~24%). However, because people in rural/regional areas are older (on average), the prevalence of people with high blood pressure is higher (~26% vs 22%) than

Updated 31/07/2017
To view archived Risk Factors click here

NACCHO Aboriginal Health and Smoking : Download Tackling Indigenous Smoking Program prelim. evaluation report

 ” The overall goal of the national Tackling Indigenous Smoking (TIS) program is to improve the health of Aboriginal and Torres Strait Islander people through local population specific efforts to reduce harm from tobacco.

The purpose of this preliminary report is to provide a mid-term evaluation of progress to date in implementing the first year of the three year (2015-2018) TIS program.

The TIS programme with a budget of $116.8 million over 3 years ($35.3 million in 2015-16; $37.5 million in 2016-17 and $44 million in 2017-18) was announced by the Government, on 29 May 2015.”

Download 133 page PDF report Here :

NACCHO Download Dept Health Tackling Indigenous Smoking Evaluation June 2017

The report found the program is operating effectively, using proven approaches to change smoking behaviours, and delivering evidence-based local tobacco health promotion activities. I am pleased the report recommends it continues,

Smoking is the most preventable cause of disease and early death among Aboriginal people and accounts for almost one-quarter of the difference in average health outcomes between indigenous and non-indigenous Australians.

“The program provides grants in 37 urban, rural, regional and remote areas to assist local communities to develop localised anti-smoking campaigns

Minister Ken Wyatt

Read over 100 plus NACCHO articles published in past 5 years

This mid-term evaluation looks at progress to date of the TIS program, particularly in terms of regional grants delivering localised Indigenous tobacco interventions.

Source of intro

See list all 35 Recipients below

It does not look at long-term impact in relation to a reduction of smoking rates at a national level.

Findings focus on (see in full below 1-9)

  • the shift to TIS
  • community engagement and partnerships
  • localised health promotion
  • access to quit support
  • contribution to evidence base
  • National Best Practice Unit and TIS portal
  • governance and communications.

A number of key recommendations emerging from the evaluation are included in the report.(see Below Part 2)

Findings

1. Shift to TIS

Since the implementation of the TIS program, all grant recipients are primarily focused on planning for, and/or delivering, targeted and tailored activities that directly address reduction of smoking prevalence within communities.

For some grant recipients, broader health promotion activities without a clear link to tobacco reduction have dropped off significantly as a result of the shift to TIS, whilst for others the integration of healthy lifestyle and tobacco control strategies has been successful. There are varying degrees of clarity among grant recipients about the extent to which there is flexibility to tap into healthy lifestyle activities under the new guidelines.

2.Community engagement and partnerships

Community engagement and involvement in the design and planning of localised TIS programs is a key priority for grant recipients, and a key indicator of successful TIS activities.

While challenges were identified in terms of handling competing priorities in community, adhering to cultural protocols, and the change in focus of the TIS program and uncertainty about ongoing funding, in the main, grant recipients have demonstrated substantial progress in involving community in design and planning and garnering support for TIS activities.

This is evidenced by the popularity of community events hosted/attended by the TIS team and the proactivity of local community and Elders in advocating for tobacco control.

The success of the TIS program and the capacity for grant recipients to operate as a multi-level population health program in their region is highly dependent upon the quality and reach of partnerships between grant recipients and other agencies/organisations.

Whilst challenges to regional collaborations were reported, overall there has been a noticeable increase in the reporting of grant recipient collaboration and partnerships, representing an important shift to both a wider regional focus and wider community approach to tobacco reduction.

3.Localised health promotion

At the local level, a range of multi-component health promotion activities around tobacco control are being undertaken by grant recipients, in collaboration with external stakeholders. Local partnerships are crucial to the successful implementation of localised health promotion activities through facilitating access to priority populations, supporting capacity-building and enabling a broader population reach to achieve awareness and understanding of the health impacts of smoking and quitting pathways. viii

Increased levels of community support and ownership for local solutions to tackling Indigenous smoking are being seen across the TIS sites.

4.Community education

Community education, is being undertaken by all grant recipients. This manifests in a range of ways, including health promotion activities at community/sporting events, drama shows and comedy and social marketing.

The involvement of local champions and Elders in local education and awareness raising events and activities is recognised as central to tobacco control messages resonating with target audiences.

It has also been recognised that targeting priority groups, such as young people and pregnant women, requires the adaptation of messages so that they resonate with those groups.

Grant recipients are partnering with key local organisations (e.g. schools, other AMS etc.) to overcome some of the challenges around access to these priority groups.

Many grant recipients have established or showed progress in establishing social marketing campaigns to supplement other health promotion activities. Campaigns are developed largely through a strength-based approach, with ‘local faces and local places’ taking precedence. Grant recipients have acknowledged the challenges in measuring the impact of social marketing campaigns although some are demonstrating a commitment to collecting data on awareness, and influences on motivations and attempts to quit.

5.Smoke-free environments

An area that has been recognised by grant recipients as requiring attention is the promotion and establishment of smoke-free environments, particularly in rural and remote locations. Modelling smoke-free environments within the grant recipients’ own workplace is one way in which this issue is being addressed, with some evidence of success.

Challenges to the implementation of smoke-free workplaces include getting support from senior leaders or Board members who smoke, and organisations where tobacco control is not the main priority. Monitoring the compliance of smoke-free environments presented an additional challenge to grant recipients. Some external organisations have requested support to become smoke-free, and successful examples of smoke-free environments including smoke-free community events are evident.

Shifting attitudes around second-hand smoke (e.g. smoking indoors and in cars) and some evidence of behaviour change were reported by grant recipients and community members.

6.Access to quit support

TIS funded organisations are encouraged to take a systems approach to activity planning. The TIS program is part of a larger preventive health care system, all connected in different ways such as through referral pathways, and client appointments.

A key component of the TIS program is therefore enhancement of referral pathways and promoting access to quit support. Grant recipients have developed a range of opportunities for community members to achieve smoking cessation, with referral pathways having been established in two key areas: clinic-based referrals within their organisation and referrals made during localised TIS health promotion activities.

For some, successful referral pathways are dependent upon grant recipients partnering with external organisations.

Improving access to culturally appropriate support to quit has been a key focus of the grant recipients over the past 12 months.

Quitline enhancements are a component of the TIS program and data suggests that referrals to Quitline are higher in urban and some rural areas. Continuing to build strong partnerships between grant recipients and Quitline will be key to increasing referrals from local TIS programs into Quitline where appropriate.

Another key focus for grant recipients has been in increasing the skills of TIS workers and other professionals in contact with Aboriginal and Torres Strait Islander people to provide smoking cessation education and brief interventions. Quits kills training, and other smoking cessation education programs, have been accessed to support this goal.

7.Contributions to evidence base

The shift to delivering activities based in evidence and focusing more on outcomes than outputs has been welcomed by grant recipients, in the main, and has provided greater direction for activities and a goal to work towards.

A range of activities were undertaken by grant recipients to develop or strengthen their evidence base and work towards measurable outcomes. Collecting data remained challenging for some remote grant recipients operating in contexts with low literacy levels and where English is not the first language. Health service grant recipients wanting to collect population level data was also challenging when services are operating on different databases within a region and where there was an unwillingness to share data.

Overall, grant recipients expressed a willingness to focus on outcomes, and the confidence and capability to obtain data, although interpreting and reporting on data was presented as a challenge.

8.National Best Practice Unit and TIS portal

Advice and guidance around monitoring, measuring and further improving local TIS programs is provided to grant recipients through the NBPU TIS. Grant recipients have indicated that they value the support and advice provided through the NBPU TIS and this has aided in building their confidence and capacity to undertake monitoring and evaluation activities.

Some grant recipients reported that an additional level of support from NBPU TIS was needed. Resistance to change is common in any business when new processes are set in place. NBPU TIS therefore expected, and has witnessed, some resistance to this change. However, it continues to engage with grant recipients and support significant processes of change, not just reporting and compliance.

Another component of the work of the NBPU TIS is the development and ongoing maintenance and improvement of the Tackling Indigenous Smoking Resource and Information Centre (TISRIC) and its home, the TIS Portal (hosted by Australian Indigenous HealthInfoNet).

Information and resources to support grant recipients in planning, monitoring, and evaluating activities, as well as information on workforce development is provided through the TIS Portal.

In addition, the Portal hosts an online forum (TIS Yarning Place) that enables grant recipients from across the country to share information and ask questions. Evaluation findings suggest that, whilst grant recipients are utilising the TIS Portal, some grant recipients have identified opportunities to enhance the useability of the TIS Portal.

9.Governance and communications

Various components of support are provided to grant recipients by the department and the NBPU TIS regarding the new focus and priorities and expectations of the TIS program.

To ensure consistent program messaging, and to enhance performance reporting, a range of initiatives were undertaken in the latter half of 2016 to clarify the roles and responsibilities of the various ‘players’ in the national TIS program.

The loss of experienced staff due to funding uncertainty has represented a significant challenge for several grant recipients in their planning and implementing activities.

Particularly in remote areas, recruitment has been an issue for many grant recipients due to the mix of skills demanded of TIS staff. Grant recipients report continued issues attracting and retaining staff with only short term contracts under the new TIS program.

Despite these concerns, indications are that providing grant recipients are given sufficient time and support to execute their Action Plans, they are on track for achieving stated tobacco reduction outcomes. The key risk to this is workforce stability, which would be mitigated by timely advice about the outcome of ongoing funding arrangements.

A number of key recommendations have emerged out of the evaluation findings:

Overall recommendations

1. Department: The TIS program in its current form should be continued, with a move away from short-term funding cycles.

2. Department: Provide immediate advice about the funding of TIS from June 2017 to end of current funding cycle.

Shift to TIS

3. Department: Provide clarity around what is allowable in relation to healthy lifestyle activities within the current iteration of the TIS program  Community engagement and partnerships

4. Grant recipients: Continue to broker partnerships and leverage relationships.

5. NBPU TIS: Continue to build capability of grant recipients to broker partnerships and leverage relationships through the distribution and promotion of relevant resources.

Community education and awareness

6. Grant recipients: Continue to identify and prioritise key groups, especially pregnant women.

7. Grant recipients: Ensure evidence-based best practice community education models (including monitoring and evaluation approaches) are sought and adopted where appropriate.

8. NBPU TIS: Ensure the evidence-based best practice community education models (including monitoring and evaluation approaches) are available, particularly for priority target groups such as pregnant women and activities around social marketing.

Smoke-free environments

9. Grant recipients: Continue to explore implementing smoke-free workplaces and enhance support for smoke-free public spaces.

10. National Coordinator: Lead a dialogue between regional leaders, including CEOs, Board members of TIS and non-TIS funded organisations around establishing smoke-free environments.

Access to quitting support

11. Grant recipients: Continue to strengthen partnerships with Quitline and other quit support structures where appropriate.  Contribution to larger evidence base

12. Grant recipients: Build on routine and existing data sources to reduce data collection burden.

National support

13. Grant recipients: Continue to seek feedback from NBPU TIS regarding M&E activities where required.

14. NBPU TIS: Continue to respond to feedback from GRs around M&E needs and TIS portal content and use ability.

15. Department: Articulate the role of the National coordinator  in the context that the program has evolved and as such his role has evolved. Governance and communication

16. Department: Provide greater clarification of TIS funding parameters, especially in terms of incorporation of healthy lifestyle activities and one-on-one smoking cessation support.

The Tackling Indigenous Smoking (TIS) regional tobacco control grants aim to improve the wellbeing of Aboriginal and Torres Strait Islander people through population health activities to reduce tobacco use. It is an initiative of the Australian Government Department of Health (DoH).

At the end of 2015, a number of organisations were notified of their success in gaining a TIS grant for culturally appropriate tobacco cessation programs. The grants were awarded to a variety of service providers across the nation.

The 35 organisations that have commenced their programs are:

With the program funding provided until 2018, the successful organisations will work towards the intended outcomes of the TIS programme, including:

  • encouraging community involvement in and support for local tobacco control activities
  • increasing community understanding of the dangers of smoking and chewing tobacco
  • improving knowledge, skills and a better understanding of the health impacts of smoking.

Aboriginal #MensHealthWeek @HeartAust @CancerCouncilOz : Make sure you have a regular #ACCHO health check fellas !

 ” Heart disease was the leading cause of death for Aboriginal and Torres Strait Islander people, who experience and die from cardiovascular disease at much higher rates than other Australians.

When compared with other Australians, Aboriginal and Torres Strait Islander people were 1.3 times as likely to have cardiovascular disease, three times more likely to have a major coronary event, such as a heart attack and more than twice as likely to die in hospital from coronary heart disease.”

Aboriginal Chronic Care Officer with Northern NSW Local Health District, Anthony Franks speaking at the #MensHealthWeek Heart Foundation sponsored workshop in Grafton : Workshop photos Colin Cowell NACCHO media

Part 1 Heart Foundation Aboriginal Resources

We have a a variety of information sheets about heart conditions and risk factors for Aboriginal and Torres Strait Islander peoples.

View and download the PDFs here, or call our Health Information Service on 1300 36 27 87 to order copies.

Part 2 For Cancer Council info see separate NACCHO Men’s Health promotion below

Let’s face it, your nuts don’t get a lot of love.

Give them a bit of a feel, it’s the polite thing to do. If something doesn’t feel right, go see an ACCHO  doctor. It’s an important step in detecting testicular cancer early

See info below or here

Pictured above Dave Ferguson from NACCHO Member Service  Bulgarr Ngaru AMS : Below some of the workshop participants with trainee doctors from Wollongong University experiencing Aboriginal health prevention

ABORIGINAL and Torres Strait Islander men are 19 times more likely to die from chronic rheumatic heart disease, so a series of workshops in Ballina and Grafton was held to raise awareness of the risk factors for heart disease among Aboriginal and Torres Strait Islander men.

It’s all part of a program across Northern NSW for Men’s Health Week which will run from June 12-19.

The workshops provided a comfortable environment for Aboriginal and Torres Strait Islander men to learn and ask questions about ways to reduce their chances of experiencing heart disease.

All workshop participants had to complete a health questionnaire and have a blood pressure test

“The idea of these workshops is to raise awareness around the different signs and symptoms of heart disease, and also around prevention and management of the disease,” Mr Franks said,

“This is a new, collaborative approach to addressing this issue, working together with existing avenues such as healthy lifestyle and exercise programs to assist participants to make the most of what they’ll be learning.”

At the workshops men will learn about the importance of heart health checks, stress reduction, quitting smoking and healthy eating from community health practitioners, hospital cardiac nurses, and other health practitioners in a culturally safe environment.

Examples of Men’s Health Week International

 

See Link or read below

What is testicular cancer?

Testicular cancer is the second most common cancer in young men (aged 18 to 39).1

The most common type is seminoma, which usually occurs in men aged between 25 and 50 years. The other main type is non-seminoma, which is more common in younger men, usually in their 20s.

In 2013, 721 new cases of testicular cancer were diagnosed in Australia. For Australian men, the risk of being diagnosed with testicular cancer by age 85 is 1 in 218. The rate of men diagnosed with testicular cancer has grown by more than 50% over the past 30 years, however the reason for this is not known.

The five-year survival rate for men diagnosed with testicular cancer is close to 98%.

In 2014, there were 23 deaths from testicular cancer.


Testicular cancer symptoms

Testicular cancer may cause no symptoms. The most common symptom is a painless swelling or a lump in a testicle.

Less common symptoms include:

  • feeling of heaviness in the scrotum
  • swelling or lump in the testicle
  • change in the size or shape of the testicle
  • feeling of unevenness
  • pain or ache in the lower abdomen, the testicle or scrotum
  • back pain
  • enlargement or tenderness of the breast tissue (due to hormones created by cancer cells).

Causes of testicular cancer

Some factors that may increase a man’s risk of testicular cancer include:

  • undescended testicle (when an infant)
  • family history (having a father or brother who has had testicular cancer).

There is no known link between testicular cancer and injury to the testicles, sporting strains, hot baths or wearing tight clothes.


Diagnosis for testicular cancer

Tests used to diagnose testicular cancer include:

  • ultrasound (to confirm the presence of a mass) and
  • blood tests for the tumour markers alpha-fetoprotein, beta human chorionic gonadotrophin and lactate dehydrogenase.

However, the only way to definitely diagnose testicular cancer is by surgical removal of the affected testicle. While many other types of cancers are diagnosed by biopsy (removing a small piece of tissue from the tumour), cutting into a testicle could spread the cancer to other parts of the body. Hence the whole testicle needs to be removed if cancer is strongly suspected.


Treatment for testicular cancer

Staging

In addition to the results of the diagnostic tests above, a chest X-ray and CT scans of the chest, abdomen and pelvis are done to determine whether and how far the cancer has spread.

Stage 1 means the cancer is found only in the testicle, stage 2 means it has spread to the lymph nodes in the abdomen or pelvis, and stage 3 means the cancer has spread beyond the lymph nodes to other areas of the body such as the lungs and liver.

If the cancer is found only in the testicle (stage 1), removal of the testicle (orchidectomy) may be the only treatment needed. If the cancer has spread beyond the testicle, chemotherapy and/or radiotherapy may be used as well.

Treatment team

Depending on your treatment, your treatment team may include a number of the following professionals:

  • GP who looks after your general health and coordinates specialist treatment
  • urologist who specialises in the treatment of diseases of the urinary system and male reproductive system
  • medical oncologist who prescribes chemotherapy treatment
  • radiation oncologist who prescribes radiation therapy
  • cancer nurses
  • endocrinologist who specialises in diagnoses and treatment of disorders of the endocrine system. For men who have had both testicles removed, this will include testosterone replacement
  • other health professionals such as dietitians, social workers and physiotherapists.

Palliative care

In some cases of testicular cancer, your medical team may talk to you about palliative care. Palliative care aims to improve your quality of life by alleviating symptoms of cancer.

As well as slowing the spread of testicular cancer, palliative treatment can relieve pain and help manage other symptoms. Treatment may include radiotherapy, chemotherapy or other drug therapies.


Screening for testicular cancer

There is no routine screening test for testicular cancer. While it is important to get to know the regular look and feel of your testicles and let your doctor know if you notice anything unusual, there is little evidence to suggest that testicular self-examination detects cancer earlier or improves outcomes.

 


Prognosis for testicular cancer

Prognosis means the expected outcome of a disease. An individual’s prognosis depends on the type and stage of cancer as well as their age and general health at the time of diagnosis. You may wish to discuss your prognosis and treatment options with your doctor, but it is not possible for any doctor to predict the exact course of your disease.

All testicular cancers can be treated and most testicular cancers are successfully treated.


Preventing testicular cancer

There are no proven measures to prevent testicular cancer.


Source

Understanding Testicular Cancer, Cancer Council Australia © 2016. Last medical review of source booklet: September 2016.

Australian Institute of Health and Welfare (AIHW) 2017. Cancer in Australia 2017. Cancer series no. 101. Cat. no. CAN 100. Canberra: AIHW.

Australian Institute of Health and Welfare. ACIM (Australian Cancer Incidence and Mortality) Books. Canberra: AIHW.

1) Excluding non-melanoma skin cancer, which is the most commonly diagnosed cancer according to general practice and hospitals data, however there is no reporting of cases to cancer registries.

 

Aboriginal Women’s Health #Breastcancer and @BCNAPinkLady : Sharing experiences and encourage you to connect, seek support and information.

” The theme of this year’s Breast Cancer Network Australia (BCNA) Summit was Making A Difference, and played host to many firsts, including the first-ever Aboriginal and Torres Strait Islander Think Tank focusing on the experiences of Aboriginal and Torres Strait Islander Australians with breast cancer.

The Think Tank was facilitated by BCNA board member Professor Jacinta Elston, and brought together 48 Aboriginal and Torres Strait Islander women from around Australia to share issues around treatment and survivorship of breast cancer in their communities.

The key outcome of the Think Tank was the development of a three year Action Plan that outlines BCNA’s key future work, in partnership with national peak Aboriginal health organisations.

VIEW BCNA Interview VIDEO of the women above HERE

More than 200 delegates gathered on the Sunshine Coast to help people in their community with breast cancer at BCNA’s 2017 National Summit

Breast Cancer Network Australia 2017 Summit at Novotel Twin Waters Resort, Sunshine Coast. photography by Lou O’Brien

More broadly, people across Australia were invited to participate in a range of workshops and lectures at Summit.

In various streams, delegates learnt new skills for helping others and managing emotions that come along with supporting other people with cancer.

As a result of activities at Summit, BCNA will be able to implement key strategic projects and services that will better support a wide range of communities and demographics.

Consultations helped informed BCNA about issues affecting Australians affected by breast cancer, but most importantly, looked at what solutions could be implemented at a local level.

These learnings will feed into BCNA’s State of The Nation project, to be launched in 2018. A dinner also took place to thank delegates for their participation, and gave attendees the opportunity to meet some of BCNA’s corporate partners, and exchange stories of their breast cancer experience.

BCNA would like to say a big thank you to our members, health professionals and corporate partners who attended this year’s National Summit.

We would like to extend our gratitude to those that gave up their own time to share experiences and learn from each other about how together we can improve the lives of all Australians affected by breast cancer. –

Resources

Early detection can boost your chances of surviving breast cancer. Many women have no signs or symptoms. However, some women do and there are things you can look out for.

Being ‘breast aware’ means becoming familiar with the normal look and feel of your breasts and reporting any unusual breast changes to your doctor as soon as possible.

Breast Health and Awareness info HERE

Aboriginal and Torres Strait Islander Peoples

This is a private group for Aboriginal and Torres Strait Islander peoples affected by breast cancer.

Closed Group Chat

NACCHO Aboriginal Health #WorldNoTobaccoDay : Cape York mob are saying “Don’t Make Smokes Your Story.”


“Wasting a lot of money to buy cigarettes and it was making me sick, coughing a lot, and getting up late, and it smells on your clothes a lot. So I said to myself I would have to cut down smoking.”

“You don’t have to buy cigarettes, you don’t have to afford cigarettes for other people, you don’t have to get cigarettes. Just be strong and stand up for yourself and say no!”

Selena Possum, who has lived in Pormpuraaw for the last 20 years, is now a non-smoker. She says smoking affected her a lot

NACCHO Aboriginal Health #smoking #ACCHO events 31 May World #NoTobacco Day #QLD #VIC #WA #NT #NSW

May 31st is World No Tobacco Day and people from Cape York are saying “Don’t Make Smokes Your Story.”

Apunipima Cape York Health Council Tackling Indigenous Smoking (TIS) staff have been engaging with Cape York communities to develop an anti-smoking campaign.

The locally appropriate ‘Don’t Make Smokes Your Story’ campaign aims to raise awareness of the harms of smoking and passive smoking, the benefits of a smoke-free environment, and available quit support.

The Cape York ‘Don’t Make Smokes Your Story’ Campaign enables community members to share on film their stories about quitting, trying to quit and the impact of smoking on families and communities. It is hoped that by sharing their stories, others will be encouraged to share their stories too.

Coen local Amos James Hobson has never smoked in his life. He sees many young people start smoking “Just to be cool, to pick up a chick.” He says to all the young people out there, “Our people didn’t smoke, don’t smoke, it’s not good. It’s not our culture and it’s not our way.”

WATCH AMOS VIDEO STORY HERE HERE

Thala Wallace from Napranum has tried to quit three times and says “Every time it gets easier.” Her strategy is to “Try to find ways to occupy myself, snack-out on fruit or go to the gym, getting out and hanging out more with people who don’t smoke.”

Watch Thala story video here

The stories, as well as posters, social media posts and radio advertisements will be released from May 31st as Apunipima launches the Cape York ‘Don’t Make Smokes Your Story’ campaign.

The videos, including those featuring Amos, and Thala, will be distributed on the ‘What’s Your Story, Cape York?’ Facebook page and will be available on the Apunipima YouTube Channel here.

Apunipima received a Tackling Indigenous Smoking (TIS) Regional Tobacco Control Grant as part of the National Tackling Indigenous Smoking program.

To effectively reduce smoking rates in Cape York, Apunipima TIS staff have been engaging with communities to develop and implement a locally appropriate social marketing campaign to influence smoking behaviours and community readiness to address smoke-free environments. The Cape York campaign will align with a national ‘Don’t Make Smokes Your Story’ campaign.

NACCHO Aboriginal Health #Smoking #WNTD @AMAPresident awards #NT Dirty Ashtray Award for World #NoTobacco Day

“Research shows that smoking is likely to cause the death of two-thirds of current Australian smokers. This means that 1.8 million Australians now alive will die because they smoked.

The Northern Territory, a serial offender in failing to improve tobacco control, has been announced as the recipient of the AMA/ACOSH Dirty Ashtray Award for putting in the least effort to reduce smoking over the past 12 months.

But it seems that the Northern Territory Government still does not see reducing the death toll from smoking as a priority. Smoking is still permitted in pubs, clubs, dining areas, and – unbelievably – in schools.

The NT Government has not allocated funding for effective public education, and is still investing superannuation funds in tobacco companies.

“It is imperative that Governments avoid complacency, keep up with tobacco industry tactics, and continue to implement strong, evidence-based tobacco control measures.”

Ahead of World No Tobacco Day on 31 May, AMA President, Dr Michael Gannon, announced the results today at the AMA National Conference 2017 in Melbourne.

Previous NACCHO Press Release Good News :

NACCHO welcomes funding of $35.2 million for 36 #ACCHO Tackling Indigenous Smoking Programs

The Northern Territory, a serial offender in failing to improve tobacco control, has been announced as the recipient of the AMA/ACOSH Dirty Ashtray Award for putting in the least effort to reduce smoking over the past 12 months.

It is the second year in a row that the Northern Territory Government has earned the dubious title, and its 11th “win” since the Award was first given in 1994.

AMA President, Dr Michael Gannon, said that it is disappointing that so little progress has been made in the Northern Territory over the past year.

“More than 22 per cent of Northern Territorians smoke daily, according to the latest National Drug Strategy Household Survey, well above the national average of 13.3 per cent,” Dr Gannon said.

“Smoking will kill two-thirds of current smokers, meaning that 1.8 million Australian smokers now alive will be killed by their habit.

“But it seems that the Northern Territory Government still does not see reducing the death toll from smoking as a priority. Smoking is still permitted in pubs, clubs, dining areas, and – unbelievably – in schools.

“The Government has not allocated funding for effective public education, and is still investing superannuation funds in tobacco companies.”

Victoria and Tasmania were runners-up for the Award.

“While the Victorian Government divested from tobacco companies in 2014, and has made good progress in making its prisons smoke-free, its investment in public education campaigns has fallen to well below recommended levels, and it still allows price boards, vending machines, and promotions including multi-pack discounts and specials,” Dr Gannon said.

“It must end the smoking exemption at outdoor drinking areas and the smoking-designated areas in high roller rooms at the casino.

Learn more about the great work our Tackling Indigenous Smoking Teams are doing throughout Australia 100 + articles HERE

“Tasmania has ended the smoking exemption for licensed premises, gaming rooms and high roller rooms in casinos, but still allows smoking in outdoor drinking areas.

“While Tasmania has the second highest prevalence of smoking in Australia, the Tasmanian Government has not provided adequate funding to support tobacco control public education campaigns to the evidence-based level.  It should provide consistent funding to the level required to achieve reductions in smoking.”

Tasmania should also ban price boards, retailer incentives and vending machines, and divest the resources of the Retirement Benefits Fund (RBF) from tobacco companies, limit government’s interactions with the tobacco industry and ban all political donations, ACOSH said.

It should also ban all e-cigarette sale, use, promotion and marketing in the absence of any approvals by the Therapeutic Goods Administration.

Promotion

Download the app today & prepare to quit for World No Tobacco Day

Queensland has topped the AMA/ACOSH National Tobacco Control Scoreboard 2017 as the Government making the most progress on combating smoking over the past 12 months.

Queensland narrowly pipped New South Wales for the Achievement Award, with serial offender the Northern Territory winning the Dirty Ashtray Award for putting in the least effort.

Judges from the Australian Council on Smoking and Health (ACOSH) allocate points to each State and Territory in various categories, including legislation, to track how effective government has been at combating smoking in the previous 12 months.

“Disappointingly, no jurisdiction scored an A this year, suggesting that complacency has set in,” Dr Gannon said.

“Research shows that smoking is likely to cause the death of two-thirds of current Australian smokers. This means that 1.8 million Australians now alive will die because they smoked.

“It is imperative that Governments avoid complacency, keep up with tobacco industry tactics, and continue to implement strong, evidence-based tobacco control measures.”

The judges praised the Queensland Government for introducing smoke-free legislation in public areas, including public transport waiting areas, major sports and events facilities, and outdoor pedestrian malls, and for divesting from tobacco companies.

However, they called on all governments to run major media campaigns to tackle smoking, and to take further action to protect public health policy from tobacco industry interference.

31 May is World No Tobacco Day Tweet using “Protect health,reduce poverty, promote development”

Aboriginal Health #racism and #cancer #WCPH2017 : The inoperable, unstoppable @Proudblacksista Colleen Lavelle and other strong stories

“People will forget what you said, people will forget what you did,

but people will never forget how you made them feel. – Maya Angelou

These strong words are so true. I look at how my behaviour has changed with the brain tumour. I shudder when I think of the things I have said to my children.

I think it was about eight or nine years ago I was diagnosed with a brain tumour,

The reason I’m vague on it is I actually don’t think it’s a day to remember. It’s not a celebratory day.

Thinking about my four children motivates me to keep going

I’ll be buggered if I am going to have the [child safety] department or someone like that come in and take care of my kids.”

Cancer is a leading cause of death among Indigenous Australians, but fear, stigma and shame mean it is rarely spoken about.

Ms Colleen Lavelle’s a Wakka Wakka woman, from Queenslandknown as @Proudbacksista  tumour has been deemed inoperable, which means it’s considered terminal.

Hear or Download hear her Radio National Interview 

Or

Watch ABC TV report

Photo above from previous NACCHO News Alert

NACCHO Aboriginal Health : Death by #racism: Is bigotry in the health system harming Indigenous patients ?

NACCHO and Cancer over 60 articles

NACCHO Cultural Safety

Federal Government Website

Cancer in Aboriginal and Torres Strait Islander people of Australia

Colleen lives in Brisbane and through her blog she has become a support person for other Aboriginal people facing cancer, helping them with practical matters and being a friendly voice on the other end of a phone line.

She also accompanies some patients to hospital appointments and would like to see it made easier for Aboriginal volunteers to do such work.

“If you come from the Torres Strait and you’ve come down here and someone’s speaking to you really fast, rattling off all these medical things you’ll kind of be going, ‘what?’,” she said.

“If you’ve got someone, one of your own mob there it makes it easier.”

 Recently Colleen wrote for Croakey /We Public Health

Close the Gap should be so much more than a photo opportunity or a morning tea. There are ways that everyone can help. I am going to share ten simple ones that I have been trying to get happening for years.

  1. More Indigenous hospital liaison officers – Whatever title you use, we need more people in the hospital working for us. Big hospitals often only employ two, that is not even close to being enough. They should be employed around the clock.
  2. Indigenous hospital volunteers – Hospitals need to have a separate army of volunteers, who deal exclusively with Indigenous patients, to spend time with the person from a remote area in a city hospital. To sit with someone having a long treatment. Just a friendly face in an alien environment.
  3. Cultural Awareness Training (CAT) – Should be compulsory with all hospital staff, from the cleaner to the director. This training should address the issues and problems in health, but also needs to be localised to have the Traditional Owners from the area to share their knowledge. To truly let people understand, I am not talking a one of two-hour session a year, but a long, fully-formed training, with refresher courses each year. All medical and Allied Health professionals should do, and be assessed on, Cultural Awareness on a regular basis, and this needs to be registered. It is not good enough when a health professional does one course on Indigenous People and 20 years later still think that was enough. General Practice also need to have CAT, even if they are not signed on to CTG, because they are going to be seeing Indigenous patients.
  4. General Practice incentive payments – GPs must lose their incentive payments if they sign on for the incentive and, during that time they don’t see an Indigenous patient. Again, they should lose the bonus if they are signed up and do not annotate the prescriptions for patients.
  5. Indigenous people have the right of choice – We should be able to see a private GP or the local Indigenous Medical Service, or both if we want, but some funding seems to steer us towards the Indigenous Medical Service. This can be hard if it’s a long way from your home and you have to depend on public transport.
  6. Employ more Indigenous people in the health sector, not just  doctors – It can be as simple as a receptionist, who makes a difference.
  7. Indigenous patients must be heard – Not just in the surgery but on national committees. Our experiences must be more than just fodder for researchers or funding applications.
  8. Buck-passing – PHNs, Division of General Practices and other organisations, must stop handing over Indigenous units to others. You have patients that see so many doctors, you have to be responsible. Handing units over to Indigenous Medical Services etc, is passing the buck. It takes away our free choice. It is a way of saying you are not interested in our wellbeing.
  9. Respect – Invite Elders to your hospital, clinic, whatever, on a regular basis, consider having an Elder in residence at your local hospital.
  10. Recognise and celebrate our important dates – It smacks of racism if a hospital is decked out in green and shamrocks everywhere for St Patrick’s day and come NAIDOC, there is a morning tea, hidden away, with only a few people involved. Share it. Don’t even get me started on Australia Day. (Okay, just a little bit) Understand that we don’t think it’s great to wave the flag or want to be in your premises when you have complete overkill of decorations and start talking about how wonderful it is.

The unspoken illness: Cancer in Aboriginal communities

Cancer is a leading cause of death among Indigenous Australians, but fear, stigma and shame mean it is rarely spoken about.

Aboriginal Australians are less likely to be diagnosed with cancer, but significantly more likely to die of the disease.

Often, symptoms and diagnoses are ignored because of the fear surrounding cancer.

Cancer in Aboriginal communities:

  • Indigenous Australians have a slightly lower rate of cancer diagnosis than non-Indigenous Australians
  • The Aboriginal cancer mortality rate is 30 per cent higher
  • Indigenous Australians are more likely to be diagnosed when cancer is advanced
  • They are less likely to participate in cancer screening programs
  • Lung cancer is the most common cancer among Indigenous Australians

Lateline spoke to some Aboriginal people about how they dealt being diagnosed and how they’re trying to break down taboos in their communities.

Rodney Graham: Bowel cancer

Rodney

Rodney Graham literally ran away from his diagnosis in 2015.

For seven months he didn’t go back to his doctor after he was told he had bowel cancer.

Eventually though, he mustered the courage to deal with the diagnosis and get treatment.

He had to travel 700 kilometres from his community of Woorabinda, in central Queensland, to Brisbane to be operated on.

“A big city like that, I don’t even like going to [Rockhampton] really. I can’t stand Rocky. But Brisbane that was a step up you know,” he said.

Now Mr Graham is happy to talk about his illness and wants to help others in his community face up to cancer.

“It might happen to someone else and they say, ‘Well we’ll go see Rodney, he knows all about it’,” he said.

“I’ll give them some advice and see how it goes from there.”

Mr Graham gave up drinking years ago and he said it probably saved his life.

“I think if I was still drinking I wouldn’t be here, you know what I mean,” he said.

Aunty Tina Rankin: Cervical cancer

Aunty Tina has survived cancer, but seen several close relatives succumb to the disease.

“One minute you’re sitting down there with that person, that person is so healthy, and then the next time you see them they’re that sick, they’re that small you can hardly recognise them,” she said.

“People think of it as the killer disease.

“They see people in cancer wards and to look at those people it puts them into a depressed state, and they go home thinking that they’re going to end up like that.”

Aunty Tina said people need to know there is help available for cancer sufferers.

She is part of the Woorabinda Women’s Group who are working to raise awareness in the community about cancer so sufferers don’t feel isolated.

“When you’re well and up and running, you’ve got that many friends,” she said.

“All of a sudden you get sick, you find out you’ve got cancer, you’ve got nobody, it feels as if you’re on your own.

“There were times when I just wanted to go and commit suicide through the depression.

“But I sit down and think about things, I pull myself out of that deep hole.”

Sevese Isaro: Lost his father to cancer

Sevese Isaro, or Tatay as he’s known locally, is Woorabinda’s radio host.

He knows first-hand how hard it can be to talk about cancer, having lost his father to the disease just a few years ago.

“Everyone just tried to stop talking about it,” he said.

“I fell back into drinking, everybody just went their own way.”

He said many people don’t go to the doctor when they suspect they could have cancer.

“They know that there’s something wrong with them, but they don’t want to go because they’re frightened of the answer,” he said.

“I guess people once they hear the word cancer they start getting frightened and they automatically give up hope.”

If you or anyone you know needs help contact your local ACCHO or call

NACCHO Aboriginal Health and #Smoking : @KenWyattMP announces $35.2 million funding #ACCHO Anti-smoking programs

These health services are all delivering frontline services to prevent young Indigenous people taking up smoking and to encourage existing smokers to quit.

Reducing smoking rates is central to the Government’s efforts to close the gap in life expectancy, but requires a consistent, long-term commitment”

Minister for Indigenous Health, Ken Wyatt

Over 100 NACCHO Articles about smoking

REDUCING INDIGENOUS SMOKING TO CLOSE THE GAP

The Australian Government will provide $35.2 million next financial year to continue anti-smoking programs targeted to Aboriginal and Torres Strait Islander people in regional and remote areas.

Minister for Indigenous Health, Ken Wyatt, said the Government had approved the continuation of funding to 36 Aboriginal Community ControlledHealth Services and one private health service.

“These health services are all delivering frontline services to prevent young Indigenous people taking up smoking and to encourage existing smokers to quit,”  .

“Reducing smoking rates is central to the Government’s efforts to close the gap in life expectancy, but requires a consistent, long-term commitment.

“Smoking causes the greatest burden of disease, disability, injury and earlydeath among Indigenous people and accounts for 23 per cent of the health gap between Indigenous and non-Indigenous Australians.”

Under the Council of Australian Governments (COAG) National Healthcare Agreement, all governments have committed to halving the 2008 adult daily smoking rate among Indigenous Australians, of 44.8 per cent, by 2018.

“The rate of smoking among Aboriginal and Torres Strait Islander people is still far higher than among other Australians and is damaging their health in many ways,” Minister Wyatt said.

It’s unlikely now that we will meet the COAG target, but we are making progress.

“It’s important that anti-smoking programs are meaningful for Indigenous people and changes made in recent years have ensured that only programs which are evidence based and effective are receiving grants.”

Continued funding for the 37 health services follows a preliminary evaluation of the Tackling Indigenous Smoking program which found that it was operating effectively and using proven approaches to changing smoking behaviour.