NACCHO Aboriginal Health News: New funding for the Aboriginal and Torres Strait Islander community-controlled sector to close the gap

 

New funding for the Aboriginal and Torres Strait Islander community-controlled sector to close the gap

NACCHO welcomes a joint funding pool being established by Australian governments to strengthen the Aboriginal and Torres Strait Islander community-controlled sector to deliver vital services to communities and help deliver on the commitments of Priority Reform Two under the new National Agreement on Closing the Gap.

The Commonwealth Government has announced an initial contribution of $46.5 million over four years, with the Victorian Government adding an additional $3.3 million.

This funding comes on the heels of the unveiling of the new National Agreement on Closing the Gap which was signed last week.

Lead Convener of the Coalition of Peaks, Pat Turner AM, said that the Coalition of Peaks welcomes the leadership of Ken Wyatt, the Commonwealth’s Indigenous Australians Minister, in establishing the fund.

“The Coalition of Peaks fought hard to put Aboriginal and Torres Strait Islander community-controlled organisations at the centre of the new National Agreement on Closing the Gap. They deliver better services for our people, get better outcomes, protect our cultures and employ more First Nations people in their home communities,” Ms Turner said.

“This new funding for the initial delivery of Priority Reform Two will help strengthen and build the Aboriginal and Torres Strait Islander community-controlled sector to deliver additional services to First Nations people, including in new areas like housing and early childhood.” Ms Turner said.

“The joint funding pool complements the commitments in the National Agreement on Priority Reform Two which will also bring additional funding to community-controlled organisations over time and provide more jobs for First Nations people.”  Ms Turner said.

To read the full media release click here.

To view the full new National Agreement on Closing the Gap click here.

 

Culturally safe cancer care guide released

Cancer Australia recently released A guide to implementing the Optimal Care Pathway for Aboriginal and Torres Strait Islander people with cancer (the Guide), a companion guide to the Optimal Care Pathway for Aboriginal and Torres Strait Islander people with cancer (OCP).

The Guide is designed to support health services and clinicians in the planning and delivery of culturally safe and responsive cancer care. Using the OCP as the foundation for best practice, the Guide contains priorities for consideration at a system level, practical strategies to help health services plan for improvement and guidance for health professionals to consider in relation to their own practice.

Click here to view the Guide.

 

ATAGI Secretariat EOI request

The Australian Technical Advisory Group on Immunisation (ATAGI) Secretariat recently published a request for Expressions of Interest (EOI) to fill a vacant role on the ATAGI, to provide expertise with respect to the delivery of health services to and for Aboriginal and Torres Strait Islander people, commencing 31 August 2020.

The EOI deadline for this Aboriginal and Torres Strait Islander Representative member role on the ATAGI has been extended – EOIs must now be received by midnight 12 pm 6 August 2020.

EOIs can be submitted to ATAGI.Secretariat@health.gov.au

For more information on the role click here.

Syringe drawing from a vial

Source credit: AMA Website.

NACCHO Aboriginal Health Research Alert : @HealthInfoNet releases Summary of Aboriginal and Torres Strait Islander health status 2019 social and cultural determinants, chronic conditions, health behaviours, environmental health , alcohol and other drugs

The Australian Indigenous HealthInfoNet has released the Summary of Aboriginal and Torres Strait Islander health status 2019

This new plain language publication provides information for a wider (non-academic) audience and incorporates many visual elements.

The Summary is useful for health workers and those studying in the field as a quick source of general information. It provides key information regarding the health status of Aboriginal and Torres Strait Islander people across the following topics:

  • social and cultural determinants
  • chronic conditions
  • health behaviours
  • environmental health
  • alcohol and other drugs.

The Summary is based on HealthInfoNet‘s comprehensive publication Overview of Aboriginal and Torres Strait Islander health status 2019. It presents statistical information from the Overview in a visual format that is quick and easy for users to digest.

The Summary is available online and in hardcopy format. Please contact HealthInfoNet by email if you wish to order a hardcopy of this Summary. Other reviews and plain language summaries are available here.

Here are the key facts

Please note in an earlier version sent out 7.00 am June 15 a computer error dropped off the last word in many sentences : these are new fixed 

Key facts

Population

  • In 2019, the estimated Australian Aboriginal and Torres Strait Islander population was 847,190.
  • In 2019, NSW had the highest number of Aboriginal and Torres Strait Islander people (the estimated population was 281,107 people, 33% of the total Aboriginal and Torres Strait Islander population).
  • In 2019, NT had the highest proportion of Aboriginal and Torres Strait Islander people in its population, with 32% of the NT population identifying as Aboriginal and/or Torres Strait Islanders
  • In 2016, around 37% of Aboriginal and Torres Strait Islander people lived in major cities
  • The Aboriginal and Torres Strait Islander population is much younger than the non-Indigenous population.

Births and pregnancy outcomes

  • In 2018, there were 21,928 births registered in Australia with one or both parents identified as Aboriginal and/or Torres Strait Islander (7% of all births registered).
  • In 2018, the median age for Aboriginal and Torres Strait Islander mothers was 26.0 years.
  • In 2018, total fertility rates were 2,371 births per 1,000 for Aboriginal and Torres Strait Islander women.
  • In 2017, the average birthweight of babies born to Aboriginal and Torres Strait Islander mothers was 3,202 grams
  • The proportion of low birthweight babies born to Aboriginal and Torres Strait Islander mothers between 2007 and 2017 remained steady at around 13%.

Mortality

  • For 2018, the age-standardised death rate for Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT was 1 per 1,000.
  • Between 1998 and 2015, there was a 15% reduction in the death rates for Aboriginal and Torres Strait Islander people in NSW, Qld, WA, SA and the NT.
  • For Aboriginal and Torres Strait Islander people born 2015-2017, life expectancy was estimated to be 6 years for males and 75.6 years for females, around 8-9 years less than the estimates for non-Indigenous males and females.
  • In 2018, the median age at death for Aboriginal and Torres Strait Islander people in NSW, Qld, WA, SA and the NT was 2 years; this was an increase from 55.8 years in 2008.
  • Between 1998 and 2015, the Aboriginal and Torres Strait Islander infant mortality rate has more than halved (from 5 to 6.3 per 1,000).
  • In 2018, the leading causes of death among Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT were ischaemic heart disease (IHD), diabetes, chronic lower respiratory diseases and lung and related cancers.
  • For 2012-2017 the maternal mortality ratio for Aboriginal and Torres Strait Islander women was 27 deaths per 100,000 women who gave birth.
  • For 1998-2015, in NSW, Qld, WA, SA and the NT there was a 32% decline in the death rate from avoidable causes for Aboriginal and Torres Strait Islander people aged 0-74 years

Hospitalisation

  • In 2017-18, 9% of all hospital separations were for Aboriginal and Torres Strait Islander people.
  • In 2017-18, the age-adjusted separation rate for Aboriginal and Torres Strait Islander people was 2.6 times higher than for non-Indigenous people.
  • In 2017-18, the main cause of hospitalisation for Aboriginal and Torres Strait Islander people was for ‘factors influencing health status and contact with health services’ (mostly for care involving dialysis), responsible for 49% of all Aboriginal and Torres Strait Islander seperations.
  • In 2017-18, the age-standardised rate of overall potentially preventable hospitalisations for Aboriginal and Torres Strait Islander people was 80 per 1,000 (38 per 1,000 for chronic conditions and 13 per 1,000 for vaccine-preventable conditions).

Selected health conditions

Cardiovascular health

  • In 2018-19, around 15% of Aboriginal and Torres Strait Islander people reported having cardiovascular disease (CVD).
  • In 2018-19, nearly one quarter (23%) of Aboriginal and Torres Strait Islander adults were found to have high blood pressure.
  • For 2013-2017, in Qld, WA, SA and the NT combined, there were 1,043 new rheumatic heart disease diagnoses among Aboriginal and Torres Strait Islander people, a crude rate of 50 per 100,000.
  • In 2017-18, there 14,945 hospital separations for CVD among Aboriginal and Torres Strait Islander people, representing 5.4% of all Aboriginal and Torres Strait Islander hospital separations (excluding dialysis).
  • In 2018, ischaemic heart disease (IHD) was the leading specific cause of death of Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT

Cancer

  • In 2018-19, 1% of Aboriginal and Torres Strait Islander people reported having cancer (males 1.2%, females 1.1%).
  • For 2010-2014, the most common cancers diagnosed among Aboriginal and Torres Strait Islander people living in NSW, Vic, Qld, WA and the NT were lung cancer and breast (females) cancer.
  • Survival rates indicate that of the Aboriginal and Torres Strait Islander people living in NSW, Vic, Qld, WA, and the NT who were diagnosed with cancer between 2007 and 2014, 50% had a chance of surviving five years after diagnosis
  • In 2016-17, there 8,447 hospital separations for neoplasms2 among Aboriginal and Torres Strait Islander people
  • For 2013-2017, the age-standardised mortality rate due to cancer of any type was 238 per 100,000, an increase of 5% when compared with a rate of 227 per 100,000 in 2010-2014.

Diabetes

  • In 2018-19, 8% of Aboriginal people and 7.9% of Torres Strait Islander people reported having diabetes.
  • In 2015-16, there were around 2,300 hospitalisations with a principal diagnosis of type 2 diabetes among Aboriginal and Torres Strait Islander people
  • In 2018, diabetes was the second leading cause of death for Aboriginal and Torres Strait Islander people.
  • The death rate for diabetes decreased by 0% between 2009-2013 and 2014-2018.
  • Some data sources use term ‘neoplasm’ to describe conditions associated with abnormal growth of new tissue, commonly referred to as a Neoplasms can be benign (not cancerous) or malignant (cancerous) [1].

Social and emotional wellbeing

  • In 2018-19, 31% of Aboriginal and 23% of Torres Strait Islander respondents aged 18 years and over reported high or very high levels of psychological distress
  • In 2014-15, 68% of Aboriginal and Torres Strait Islander people aged 15 years and over and 67% of children aged 4-14 years experienced at least one significant stressor in the previous 12 months
  • In 2012-13, 91% of Aboriginal and Torres Strait Islander people reported on feelings of calmness and peacefulness, happiness, fullness of life and energy either some, most, or all of the time.
  • In 2014-15, more than half of Aboriginal and Torres Strait Islander people aged 15 years and over reported an overall life satisfaction rating of at least 8 out of 10.
  • In 2018-19, 25% of Aboriginal and 17% of Torres Strait Islander people, aged two years and over, reported having a mental and/or behavioural conditions
  • In 2018-19, anxiety was the most common mental or behavioural condition reported (17%), followed by depression (13%).
  • In 2017-18, there were 21,940 hospital separations with a principal diagnosis of International Classification of Diseases (ICD) ‘mental and behavioural disorders’ identified as Aboriginal and/or Torres Strait Islander
  • In 2018, 169 (129 males and 40 females) Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA, and the NT died from intentional self-harm (suicide).
  • Between 2009-2013 and 2014-2018, the NT was the only jurisdiction to record a decrease in intentional self-harm (suicide) death rates.

Kidney health

  • In 2018-19, 8% of Aboriginal and Torres Strait Islander people (Aboriginal people 1.9%; Torres Strait Islander people 0.4%) reported kidney disease as a long-term health condition.
  • For 2014-2018, after age-adjustment, the notification rate of end-stage renal disease was 3 times higher for Aboriginal and Torres Strait Islander people than for non-Indigenous people.
  • In 2017-18, ‘care involving dialysis’ was the most common reason for hospitalisation among Aboriginal and Torres Strait Islander people.
  • In 2018, 310 Aboriginal and Torres Strait Islander people commenced dialysis and 49 were the recipients of new kidneys.
  • For 2013-2017, the age-adjusted death rate from kidney disease was 21 per 100,000 (NT: 47 per 100,000; WA: 38 per 100,000) for Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and NT
  • In 2018, the most common causes of death among the 217 Aboriginal and Torres Strait Islander people who were receiving dialysis was CVD (64 deaths) and withdrawal from treatment (51 deaths).

Injury, including family violence

  • In 2012-13, 5% of Aboriginal and Torres Strait Islander people reported having a long-term condition caused by injury.
  • In 2018-19, 16% of Aboriginal and Torres Strait Islander people aged 15 years and over had experienced physical harm or threatened physical harm at least once in the last 12 months.
  • In 2016-17, the rate of Aboriginal and Torres Strait Islander hospitalised injury was higher for males (44 per 1,000) than females (39 per 1,000).
  • In 2017-18, 20% of injury-related hospitalisations among Aboriginal and Torres Strait Islander people were for assault.
  • In 2018, intentional self-harm was the leading specific cause of injury deaths for NSW, Qld, SA, WA, and NT (5.3% of all Aboriginal and Torres Strait Islander deaths).

Respiratory health

  • In 2018-19, 29% of Aboriginal and Torres Strait Islander people reported having a long-term respiratory condition .
  • In 2018-19, 16% of Aboriginal and Torres Strait Islander people reported having asthma.
  • In 2014-15, crude hospitalisation rates were highest for Aboriginal and Torres Strait Islander people presenting with influenza and pneumonia (7.4 per 1,000), followed by COPD (5.3 per 1,000), acute upper respiratory infections (3.8 per 1,000) and asthma (2.9 per 1,000).
  • In 2018, chronic lower respiratory disease was the third highest cause of death overall for Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT

Eye health

  • In 2018-19, eye and sight problems were reported by 38% of Aboriginal people and 40% of Torres Strait Islander people.
  • In 2018-19, eye and sight problems were reported by 32% of Aboriginal and Torres Strait Islander males and by 43% of females.
  • In 2018-19, the most common eye conditions reported by Aboriginal and Torres Strait Islanders were hyperopia (long sightedness: 22%), myopia (short sightedness: 16%), other diseases of the eye and adnexa (8.7%), cataract (1.4%), blindness (0.9%) and glaucoma (0.5%).
  • In 2014-15, 13% of Aboriginal and Torres Strait Islander children, aged 4-14 years, were reported to have eye or sight problems.
  • In 2018, 144 cases of trachoma were detected among Aboriginal and Torres Strait Islander children living in at-risk communities in Qld, WA, SA and the NT
  • For 2015-17, 62% of hospitalisations for diseases of the eye (8,274) among Aboriginal and Torres Strait Islander people were for disorders of the lens (5,092) (mainly cataracts).

Ear health and hearing

  • In 2018-19, 14% of Aboriginal and Torres Strait Islander people reported having a long-term ear and/or hearing problem
  • In 2018-19, among Aboriginal and Torres Strait Islander children aged 0-14 years, the prevalence of otitis media (OM) was 6% and of partial or complete deafness was 3.8%.
  • In 2017-18, the age-adjusted hospitalisation rate for ear conditions for Aboriginal and Torres Strait Islander people was 1 per 1,000 population.

Oral health

  • In 2014-15, the proportion of Aboriginal and Torres Strait Islander children aged 4-14 years with reported tooth or gum problems was 34%, a decrease from 39% in 2008.
  • In 2012-2014, 61% of Aboriginal and Torres Strait Islander children aged 5-10 years had experienced tooth decay in their baby teeth, and 36% of Aboriginal and Torres Strait Islander children aged 6-14 years had experienced tooth decay in their permanent teeth.
  • In 2016-17, there were 3,418 potentially preventable hospitalisations for dental conditions for Aboriginal and Torres Strait Islander The age-standardised rate of hospitalisation was 4.6 per 1,000.

Disability

  • In 2018-19, 27% of Aboriginal and 24% of Torres Strait Islander people reported having a disability or restrictive long-term health
  • In 2018-19, 2% of Aboriginal and 8.3% of Torres Strait Islander people reported a profound or severe core activity limitation.
  • In 2016, 7% of Aboriginal and Torres Strait Islander people with a profound or severe disability reported a need for assistance.
  • In 2017-18, 9% of disability service users were Aboriginal and Torres Strait Islander people, with most aged under 50 years (82%).
  • In 2017-18, the primary disability groups accessing services were Aboriginal and Torres Strait Islander people with a psychiatric condition (24%), intellectual disability (23%) and physical disability (20%).
  • In 2017-18, 2,524 Aboriginal and Torres Strait Islander National Disability Agreement service users transitioned to the National Disability Insurance Scheme.

Communicable diseases

  • In 2017, there were 7,015 notifications for chlamydia for Aboriginal and Torres Strait Islander people, accounting for 7% of the notifications in Australia
  • During 2013-2017, there was a 9% and 9.8% decline in chlamydia notification rates among males and females (respectively).
  • In 2017, there were 4,119 gonorrhoea notifications for Aboriginal and Torres Strait Islander people, accounting for 15% of the notifications in Australia.
  • In 2017, there were 779 syphilis notifications for Aboriginal and Torres Strait Islander people accounting for 18% of the notifications in Australia.
  • In 2017, Qld (45%) and the NT (35%) accounted for 80% of the syphilis notifications from all jurisdictions.
  • In 2018, there were 34 cases of newly diagnosed human immunodeficiency virus (HIV) infection among Aboriginal and Torres Strait Islander people in Australia .
  • In 2017, there were 1,201 Aboriginal and Torres Strait Islander people diagnosed with hepatitis C (HCV) in Australia
  • In 2017, there were 151 Aboriginal and Torres Strait Islander people diagnosed with hepatitis B (HBV) in Australia
  • For 2013-2017 there was a 37% decline in the HBV notification rates for Aboriginal and Torres Strait Islander people.
  • For 2011-2015, 1,152 (14%) of the 8,316 cases of invasive pneumococcal disease (IPD) were identified as Aboriginal and Torres Strait people .
  • For 2011-2015, there were 26 deaths attributed to IPD with 11 of the 26 deaths (42%) in the 50 years and over age-group.
  • For 2011-2015, 101 (10%) of the 966 notified cases of meningococcal disease were identified as Aboriginal and Torres Strait Islander people
  • For 2006-2015, the incidence rate of meningococcal serogroup B was 8 per 100,000, with the age- specific rate highest in infants less than 12 months of age (33 per 100,000).
  • In 2015, of the 1,255 notifications of TB in Australia, 27 (2.2%) were identified as Aboriginal and seven (0.6%) as Torres Strait Islander people
  • For 2011-2015, there were 16 Aboriginal and Torres Strait Islander people diagnosed with invasive Haemophilus influenzae type b (Hib) in Australia
  • Between 2007-2010 and 2011-2015 notification rates for Hib decreased by around 67%.
  • In 2018-19, the proportion of Aboriginal and Torres Strait Islander people reporting a disease of the skin and subcutaneous tissue was 2% (males 2.4% and females 4.0%).

NACCHO Aboriginal Health and #WorldCancerDay @CancerAustralia and @HealthInfoNet Many cancers are preventable among Aboriginal and Torres Strait Islander people

” In Australia, the poorest among us are 30% more likely to die of cancer than the richest.

There is also a big gap in cancer outcomes for our Indigenous Australian population, where incident rates from cancer are 10% higher than non-Indigenous Australians and mortality rates are 30% higher.

Similarly, cancer incidence (particularly cancers with poorer prognoses) and mortality are significantly higher outside capital cities, with outcomes worsening in step with remoteness.

So why are money, cultural background, geographic location and cancer types leading to some Australians being left behind?

More research is required to definitively pinpoint why these trends are occurring, but several factors stand out. More needs to be done to promote healthy lifestyles and cancer prevention to some parts of our community.

As an example, we know that smoking rates are higher in Indigenous populations and among poorer Australians and also link to cancers with poorer prognosis such as lung cancer.

Continued investment in anti-smoking campaigns tailored to these communities is critical in reducing this disparity. Currently around 40% of Indigenous Australians smoke compared with 12.2% of the general Australian population. In remote communities, this rises to around 60%.

Other unhealthy lifestyles that can increase cancer risk, including excessive alcohol consumption, physical inactivity, an unhealthy diet and obesity, are also more prevalent among socio-economically disadvantaged populations

Professor Sanchia Aranda is the CEO of Cancer Council Australia

Read over 75 Aboriginal Health and Cancer articles published by NACCHO last 8 years

According to the Cancer Council Australia 1 in 3 cancers could be preventable through lifestyle choices.

We know that preventing cancer is one of the most effective ways of creating a cancer free future.

At least one in three cancer cases could be prevented and the number of cancer deaths could be reduced significantly by choosing a cancer smart lifestyle.

Each year, more than 13,000 cancer deaths are due to smoking, sun exposure, poor diet, alcohol, inadequate exercise or being overweight.

Fortunately, there are a number of simple lifestyle changes you can make to help reduce your risk of cancer such as:

  • Maintaining a healthy weight
  • Eat a healthy diet
  • Regular exercise
  • Quitting smoking
  • Reducing alcohol intake
  • Being SunSmart
  • Get checked

Read more about the seven steps to reducing your cancer risk in Cancer Council’s cancer prevention lifestyle fact sheets.

Read full article and link to resources

” The review shows that cultural safety in service provision, increased participation in breast, bowel and cervical screening and reduction in risk factors will improve outcomes for cancer among Aboriginal and Torres Strait Islander people.

The good news is that many cancers are considered to be preventable. Lung cancer is the most commonly diagnosed cancer among Aboriginal and Torres Strait Islander people, followed by breast cancer, bowel cancer and prostate cancer.

Tobacco smoking is still seen as the greatest risk factor for cancer’.

HealthInfoNet 

“Aboriginal and Torres Strait Islander Community Controlled Health Services

Aboriginal and Torres Strait Islander Community Controlled Health Services are located in all jurisdictions and are funded by the federal,state and territory governments and other sources [91].

They are planned and governed by local Aboriginal and Torres Strait and Torres
Strait Islander communities and aim to deliver holistic and culturally appropriate health and health-related services.

Services vary in the primary health care activities they offer. Possible activities include: diagnosis and treatment of illness or disease; management of chronic illness; transportation to medical appointments; outreach clinic services; immunisations; dental services; and dialysis services.

Aboriginal and Torres Strait Islander cancer support groups have been identified as important for improving cancer awareness and increasing participation in cancer screening services [92].

Aboriginal women attending these support groups have reported an increased
understanding of screening and reported less fear and concern over cultural appropriateness, with increases in screening rates [19].

Support groups have also been found to help in follow up and ongoing care for cancer survivors [19, 93], particularly where they are shaped to meet the needs of Aboriginal and Torres Strait Islander people [73, 94].”

See Page 12 of 2018 Review

Download Review+of+cancer+among+Aboriginal+and+Torres+Strait+Islander+people

The Australian Indigenous HealthInfoNet (HealthInfoNet) at Edith Cowan University published a in 2018 Review of cancer among Aboriginal and Torres Strait Islander people.

The review, written by University of Western Australia staff (Margaret Haigh, Sandra Thompson and Emma Taylor), in conjunction with HealthInfoNet staff (Jane Burns, Christine Potter, Michelle Elwell, Mikayla Hollows, Juliette Mundy), provides general information on factors that contribute to cancer among Aboriginal and Torres Strait Islander people.

It provides detailed information on the extent of cancer including incidence, prevalence and survival, mortality, burden of disease and health service utilisation.

This review discusses the issues of prevention and management of cancer, and provides information on relevant programs, services, policies and strategies that address cancer among Aboriginal and Torres Strait Islander people.

The review provides:

  • general information on factors (historical/protective/risk) that contribute to cancer among Aboriginal and Torres Strait Islander people
  • detailed information on the extent of cancer among Aboriginal and Torres Strait Islander people, including: incidence, prevalence and survival data; mortality and burden of disease and health service utilisation
  • a discussion of the issues of prevention and management of cancer
  • information on relevant programs, services, policies and strategies that address cancer among Aboriginal and Torres Strait Islander people
  • a conclusion on the possible future directions for combating cancer in Australia

Selected Extract

2018 Lung Cancer Framework: Principles for Best Practice Lung Cancer Care in Australia is released
2016 National Framework for Gynaecological Cancer Control is released
2015 First National Aboriginal and Torres Strait Islander Cancer Framework is released
2015 Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan is released
2014 Second Cancer Australia Strategic Plan 2014–2019 is published
2013 First National Aboriginal and Torres Strait Islander Health Plan 2013–2023 is published
2011 First Cancer Australia Strategic Plan 2011–2014 is published
2008 National Cancer Data Strategy for Australia is released
2003 Report Optimising Cancer Care in Australia is published
1998 First National health priority areas cancer control report is published
1996 Cancer becomes one of four National health priority areas (NHPA)
1988 Health for all Australians report is released
1987 First National Cancer Prevention Policy for Australia is published

Concluding comments

Despite considerable improvements in cancer detection and treatment over recent decades, Aboriginal and Torres Strait Islander people diagnosed with cancer generally experience poorer outcomes than non-Indigenous people for an equivalent stage of disease [2797]. This is highlighted by statistics which showed that, despite lower rates of prevalence and hospitalisation for all cancers combined for Aboriginal and Torres Strait Islander people compared with non-Indigenous people, between 1998 and 2015, the age-standardised mortality rate ranged from 195 to 246 per 100,000 while the rate for non-Indigenous people decreased from 194 to 164 per 100,000 [2].

Furthermore for 2007–2014, while 65% of non-Indigenous people had a chance of surviving five years after receiving a cancer diagnosis, only 50% of Aboriginal and Torres Strait Islander people did [2].

The disparities are particularly pronounced for some specific cancers – for lung cancer the age-standardised incidence rate for Aboriginal and Torres Strait Islander people was twice that for non-Indigenous people, while for cervical cancer the rate was 2.5 times the rate for non-Indigenous people for 2009–2013 [2].

The factors contributing to these poorer outcomes among Aboriginal and Torres Strait Islander people are complex. They reflect a broad range of historical, social and cultural determinants and the contribution of lifestyle and other health risk factors [6], combined with lower participation in screening programs, later diagnosis, lower uptake and completion of cancer treatment, and the presence of other chronic diseases [2798155]. Addressing the various factors that contribute to the development of cancer among Aboriginal and Torres Strait Islander people is important, but improvements in some of these areas, particularly in reducing lifestyle and behavioural risk factors, are likely to take some time to be reflected in better outcomes.

Current deficiencies in the prevention and management of cancer suggest there is considerable scope for better services that should lead to improvements in the short to medium term. Effective cancer prevention and management programs that are tailored to community needs and are culturally appropriate are vital for the current and future health of Aboriginal and Torres Strait Islander people [5657]. Providing effective cancer prevention and management also requires improved access to both high quality primary health care services and tertiary specialist services. Effective and innovative programs for the prevention and management of cancer among Aboriginal and Torres Strait Islander people do exist on an individual basis and, in some cases, the efforts made to engage Aboriginal and Torres Strait Islander people in screening programs, in particular, are impressive. However, a more coordinated, cohesive national approach is also required.

Reducing the impact of cancer among Aboriginal and Torres Strait Islander people is a crucial aspect in ‘closing the gap’ in health outcomes. The National Aboriginal and Torres Strait Islander cancer framework [56] may be an important first step in addressing the current disparity in cancer outcomes and raises the probability of real progress being made. Cancer Australia has recently released the Optimal Care pathway for Aboriginal and Torres Strait Islander people which recommends new approaches to cancer care and with the aim of reducing disparities and improving outcomes and experiences for Aboriginal and Torres Strait Islander people with cancer [156]. As encouraging as these developments are, substantial improvements will also depend upon the effective implementation of comprehensive strategies and policies that address the complexity of the factors underlying the disadvantages experienced by Aboriginal and Torres Strait Islander people.

Action beyond the health service sector that addresses the broader historical, social and cultural determinants of health are also required if real progress is to be made [6]

 

NACCHO Aboriginal Women’s Health  : October is #BreastCancerAwarenessMonth Our Feature Story @VACCHO_org BreastScreen Victoria’s hot pink breast screening vans Plus Download Resources from @CancerAustralia

 ” October, Australia’s Breast Cancer Awareness Month, provides an opportunity for us all to focus on breast cancer and its impact on those affected by the disease in our community.

Breast cancer remains the most common cancer among Australian women (excluding non-melanoma skin cancer). Survival rates continue to improve in Australia with 89 out of every 100 women diagnosed with invasive breast cancer now surviving five or more years beyond diagnosis.

Take the time this month to find out what you need to know about breast awareness and share this important information with your family, friends and colleagues.

Breast cancer is the most common cancer experienced by Aboriginal and Torres Strait Islander women and is the second leading cause of cancer death after lung cancer. Research shows that survival is lower in Aboriginal and Torres Strait Islander women diagnosed with breast cancer than in the general population.

Cancer Australia is committed to working with Aboriginal and Torres Strait Islander communities to provide women with important information about breast cancer awareness, early detection as well as breast cancer treatment and care.

Looking after your breasts – Find breast cancer early and survive see Part 2 Below

See BCNA story Part 4 Below

BreastScreen Victoria and the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) are saying goodbye to the days of sterile, cold mammograms under fluorescent flickering lights and saying hello to mammograms in hot pink vans, with beautifully created cultural shawls and lots of love and giggles.

October is Breast Cancer Awareness Month and the organisations have introduced a program which enables Aboriginal women living in regional and remote areas of Victoria to access safe, free and comforting breast screening facilities.

 “ The idea for the program was born from conversations between BreastScreen Victoria CEO, Vicki Pridmore and VACCHO Manager of Public Health and Research, Susan Forrester.

Ms Forrester said that most women shy away from breast screening due to the safety aspect.

“Why we use the word safe is because there are lots of layers around health and some of the themes that were emerging were that women may have felt a bit uncomfortable being screened for multiple reasons and at times, the staff they had contact with across the health system, although [they] may have been very well meaning, lacked cultural awareness.”

See full story Part 3 below

Picture opening graphic  : Almost all the DWECH BreastScreen Team. Rose Hollis DWECH Community Worker, Allira Maes DWECH Aboriginal Health Worker, Joanne Ronald BSV Radiographer, Lisa Joyce BSV Health Promotion Officer

Part 1 Cancer Australia is committed to working with Aboriginal and Torres Strait Islander communities to reduce the impact of cancer on Indigenous Australians

About 3 Aboriginal and Torres Strait Islander Australians are diagnosed with cancer every day. Indigenous Australians have a slightly lower rate of cancer diagnosis but are almost 30 per cent more likely to die from cancer than non-Indigenous Australians1.

Cancer Australia is committed to working with Aboriginal and Torres Strait Islander communities to reduce the impact of cancer on Indigenous Australians.

Our work includes:

  • raising awareness of risk factors and promoting awareness and early detection for the community
  • developing evidence-based information and resources for Aboriginal and Torres Strait Islander people affected by cancer and health professionals
  • providing evidence-based cancer information and training resources to Aboriginal and Torres Strait Islander Health Workers
  • increasing understanding of best-practice health care and support, and
  • supporting research.

We have a range of resources which provide information to support you and the work you do:

Breast Cancer: a handbook for Aboriginal and Torres Strait Islander Health Workers

This handbook has been written to help health professionals support Aboriginal and Torres Strait Islander people with breast cancer. Increasing the understanding of breast cancer may help to encourage earlier investigation of symptoms, and contribute to the quality of life of people living with breast cancer.

This handbook has been written for Aboriginal and Torres Strait Islander Health Workers, Health Practitioners and Aboriginal Liaison Officers involved in the care of Aboriginal and Torres Strait Islander people with breast cancer in community and clinical settings.

Download HERE

Part 2 BE BREAST AWARE

Finding breast cancer early provides the best chance of surviving the disease. Remember you don’t need to be an expert or use a special technique to check your breasts.

Changes to look for include:

  • new lump or lumpiness, especially if it’s only in one breast
  • change in the size or shape of your breast
  • change to the nipple, such as crustingulcerredness or inversion
  • nipple discharge that occurs without squeezing
  • change in the skin of your breast such as redness or dimpling
  • an unusual pain that doesn’t go away.

Most changes aren’t due to breast cancer but it’s important to see your doctor without delay if you notice any of these changes.

My breast cancer journey: a guide for Aboriginal and Torres Strait Islander women and their families

Cancer Australia has developed a new resource My breast cancer journey: a guide for Aboriginal and Torres Strait Islander women and their families which outlines the clinical management of the early breast cancer journey to support Aboriginal and Torres Strait Islander women with breast cancer and their families.

DOWNLOAD HERE

Part 3 BreastScreen Victoria and the Victorian Aboriginal Community Controlled Health Organisation (VACCHO) are saying goodbye to the days of sterile, cold mammograms under fluorescent flickering lights

Read full story from NIT 

The program was trialled, a screen-friendly shawl was designed using artwork by Lyn Briggs, and the shawls were gifted to each woman who was screened.

The trial was a result of a team of around 15 women who screened 14 First Nations women. The feedback received was exactly what BreastScreen Victoria’s Senior Health Promotion’s Officer, Lisa Joyce had hoped for.

“The feedback included things like, I feel safe, protected by culture, cultural safety blanket, made me proud of who I am and visible, the shawl was a screen from feeling shame and it was beautiful, easy to wear and makes you feel comfortable and safe,” Ms Joyce said.

BreastScreen Victoria and VACCHO have partnered with eight Aboriginal Community Controlled Health Organisations (ACCHOs) who will receive visits from Nina and Marjorie – BreastScreen Victoria’s hot pink breast screening vans.

The vans will work with ACCHOs to provide Aboriginal women with free mammograms, which assist in the identification of breast cancer in its early stages. The program is aimed particularly at women between 50 and 74, who are at higher risk of breast cancer.

Picture above :Rose Hollis who is a DWECH Community Worker had her breast screen and then spent the rest of her day driving Community members to their screenings.

The program will also gift a shawl to 50 women from each centre – which will be printed with a design of their country.

Amber Neilley, VACCHO’s State-wide Health Services Program Officer said artworks have been created by artists both established and emerging.

“Each shawl has been designed by a local artist, we are taking the shawls with the designs back to country,” Ms Neilley said.

Ms Joyce said that bringing the vans onto ACCHO sites offers leadership to those centres.

“We are playing into self-determination in that way as the organisation is in control of who screens and what happens in their community in that time,” Ms Joyce said.

“Many of the sites we are going to … have permanent breast screening facilities in the town but we know that Aboriginal women aren’t attending those clinics so we are trying to increase that by bringing it to a familiar place.”

“Taking the van and using the shawls is the first step in improving Aboriginal women’s experiences when they come to breast screens. I think unfamiliarity, lack of trust and potential fear is why we don’t have that contact with many women.”

Research shows that once a woman has screened for breast cancer, she is more likely to regularly screen – a hope the team have for the women in these communities.

“We hope that when the project leaves town the shawl will be in the permanent screening space and people will become involved,” Ms Forrester said.

“We want to be able to say here is a strength-based, culturally-led model that can go national, and international. The CEO of BreastScreen has just been at the World Indigenous Cancer Conference in Canada and presented this on our behalf and she has had a world of interest.”

Dates and locations for BreastScreen Victoria’s screening vans include:

  • 30/9 – 4/10 at Dhauwurd-Wurrung Elderly and Community Health Service (DWECH)
  • 7/10 – 10/10 at Winda-Mara Aboriginal Corporation
  • 14/10 – 18/10 at Gunditjmara Aboriginal Cooperative
  • 21/10 – 24/10 at Kirrae Health Service
  • 28/10 – 1/11 at Wathaurong Aboriginal Cooperative
  • 11/11 – 15/11 at Rumbalara Aboriginal Cooperative
  • 18/11 to 22/11 at Ramahyuck District Aboriginal Corporation.

For more information, visit: https://www.breastscreen.org.au/.

Part 4 Aboriginal and Torres Strait Islander women share their breast cancer experience in new BCNA video

Aboriginal and Torres Strait Islander women have come together to share their stories and experiences as breast cancer survivors as part of a  video produced by BCNA.

See Website 

The video shares the experiences of Aboriginal and Torres strait Islander women affected by breast cancer and aims to encourage other Aboriginal and Torres Strait Islander women to connect, seek support and information on breast cancer.

A number of women in the video, including Aunty Josie Hansen, highlight the importance of early detection.

‘Early detection is really important; not just for women, but for men too,’ Aunty Josie said.

‘Being diagnosed with breast cancer isn’t a death sentence, there’s always hope … as long as you have breath there’s hope,’ she said.

Aunty Thelma reflected that breast cancer is ‘just a terrible disease’.

‘I think it’s so important that women go and have their breast screens done,’ she said.

The video was filmed at the Aboriginal and Torres Strait Islander Think Tank at BCNA’s National Summit in March. The Think Tank was facilitated by BCNA board member Professor Jacinta Elston.  Jacinta said that Aboriginal and Torres Strait Islander women’s outcomes are poorer both in survival and at diagnosis.

The Think Tank 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.

The group worked to develop and prioritise future action to improve support and care for Aboriginal and Torres Strait Islander women diagnosed with breast cancer.

This included identifying locally based cultural healing projects, to allow breast cancer survivors to connect and support each other in culturally safe spaces. A weaving project in Queensland and a possum skin cloak project in Victoria is being undertaken and used to support the training of health professionals in local culture and knowledge. The Culture is Healing projects are supported by Cancer Australia.

This video was produced as part of BCNA’s ongoing commitment to better support Aboriginal and Torres Strait Islander women diagnosed with breast cancer.

You can watch the video below:

NACCHO Aboriginal Health and #Cancer #Smoking : Report from Canada where 400 delegates are meeting at #WICC2019 with theme ‘Respect, Reconciliation and Reciprocity “ discussing cancer and its impact on Indigenous peoples.

“Cancer has been largely overlooked amongst Indigenous populations world-wide and remains the second leading cause of death among Aboriginal and Torres Strait Islander people “

Professor Gail Garvey, who convened the first WICC and is co-chair of WICC 2019 :Pictured above with Professor Tom Calma and Blackfoot Fancy Feather Dancer Kyle Agapi.

“Smoking is the single biggest contributor to early deaths, including cancer deaths, of Aboriginal and Torres Strait Islander people – which is why it is so important that we encourage people not to take up smoking and assist smokers to stop “

Professor Tom Calma AO, National Coordinator, Tackling Indigenous Smoking, and member of the Cancer Australia Aboriginal and Torres Strait Islander Cancer Leadership Group

Read over 80 Aboriginal Health and Cancer articles published by NACCHO in past 7 years

Read over 130 Aboriginal Health and Smoking articles published by NACCHO in past 7 years

Indigenous communities, consumers and health experts from around the world have come together at the opening of the second World Indigenous Cancer Conference (WICC) at the Calgary Telus Convention Centre in Canada.

The conference, which has drawn a large contingent of Australian delegates, follows on from the success of the inaugural WICC held in Brisbane, Australia in 2016.

The WICC 2019 theme is ‘Respect, Reconciliation and Reciprocity,’ with over 400 delegates from across the globe discussing cancer and its impact on Indigenous peoples.

World-wide, Indigenous peoples bear a disproportionately higher cancer burden than non-Indigenous peoples, which makes WICC 2019 so very important.

Hosted by the Canadian Indigenous Research Network Against Cancer (CIRNAC) in partnership with the host sponsor Alberta Health Services, this premier event is supported by the Alberta First Nations Information Governance Centre, Canadian Institutes of Health Research, Canadian Partnership Against Cancer, and the International Agency for Research on Cancer (IARC) which is the specialized cancer agency of the World Health Organization.

 Professor Gail Garvey , Blackfoot Piikani Chief Stan Grier and Professor Tom Calma 

WICC 2019 has drawn expertise of leading cancer researchers, public health practitioners, clinicians, advocacy groups, Indigenous community leaders and consumers.

They are coming together to share knowledge about critical issues across the cancer continuum from prevention and treatment to survivorship and end of life.

Several Aboriginal and Torres Strait Islander delegates with a lived experience of cancer are making an important contribution to the conference.

Des McGrady, an Aboriginal cancer survivor, said “An international meeting is important for the information sharing that we can pass on to community and people working in this space. This will allow us to work in partnership to drive positive change.”

The burden of cancer among Indigenous populations is of major public health importance and forums for collaboration such as this conference will strengthen research and service delivery and help accelerate progress in improving cancer outcomes.

Indigenous leadership, culturally sound service delivery and encouragement of mainstream services to prioritise Indigenous cancer are critical to these efforts and central to WICC 2019.

For more details about the conference, please visit the website: http://wicc2019.com

NACCHO Aboriginal Health and #CancerAwareness : @JacintaElston @KelvinKongENT Hey you mob It’s ok to talk about #cancer – For assistance download #YarnforLife resources

“Yarn for Life aims to reduce feelings of shame and fear associated with cancer and highlights the importance of normalising conversation around cancer and encouraging early detection of the disease.

It also emphasises the value of support along the patient journey.”

Professor Jacinta Elston, Pro Vice-Chancellor (Indigenous), Monash University, said that finding cancer early gave people the best chance of surviving and living well.

“Yarn for Life seeks to empower Aboriginal and Torres Strait Islander people to participate in screening programs, discuss cancer with their doctor or health care worker openly, and if cancer is diagnosed, complete their cancer treatment.”

Australia’s first Australian Aboriginal surgeon Associate Professor Kelvin Kong, University of Newcastle : continued below 

Download Yarn for Life Resources HERE

Read over 80 Aboriginal and Torres Strait Islander Cancer Awareness articles published by NACCHO over past 7 years 

In a national first, Cancer Australia has launched Yarn for Life, a new initiative to reduce the impact of cancer within Aboriginal and Torres Strait Islander communities by encouraging and normalising discussion about the disease.

Cancer is a growing health problem and the second leading cause of death among Indigenous Australians who are, on average, 40 percent more likely to die from cancer than non-indigenous Australians.

The multi-faceted health promotion Yarn for Life has been developed by and with Indigenous Australians, and weaves the central message that it is okay to talk about cancer by sharing personal stories of courage and survivorship from Aboriginal and Torres Strait Islander people.

Yarn for Life features 3 individual experiences of cancer which are also stories of hope.

“While significant gains have been made with regard to cancer overall, Aboriginal and Torres Strait Islander people continue to experience disparities in cancer incidence and outcomes. Cancer affects not only those diagnosed with the disease but also their families, carers, Elders and community,” said Dr Helen Zorbas, CEO, Cancer Australia.

Associate Professor Kong said it was also important for health services to support better outcomes for Indigenous patients by being culturally aware.

“For Aboriginal and Torres Strait Islander people, health and connection to land, culture community and identity are intrinsically linked. Optimal care that is respectful of, and responsive to, the cultural preferences, sensitivities, needs and values of patients, is critical to good health care outcomes.”

The Yarn for Life initiative is supported by two consumer resources which outline what patients should expect at all points on the cancer pathway.

Yarn for Life will feature television, radio and social media resources designed to be shared with friends, family and the community, to carry on the Yarn for Life conversation online.

SEEING YOUR DOCTOR OR HEALTH WORKER

Finding cancer early gives you the best chance of getting better and living well. The good news is there are things you can do to find cancer early. If there are any changes in your body that could be due to cancer, it’s really important to have them checked out. Speak to your health worker about:

  • any new or unusual changes in your body
  • how you are feeling
  • whether you are in any pain
  • whether anyone in your family has or had cancer
  • any other problems that are worrying you.

Free screening programs

It’s also important that you and your family participate in screening programs for breast, bowel and cervical cancers.

You can find out more about these free programs including how old you need to be to participate at cancerscreening.gov.au. Remember most of us will need to go to a check-up or screening at some point in our lives—so there’s no shame in talking to family or friends about it as well as your health care worker.

 

NACCHO Aboriginal Health and #chronicdisease @SandroDemaio How #obesity ups your chronic disease risk and what to do about it

” Almost two in every three Australian adults are now overweight or obese, as are one in four of our children.

This rising obesity burden is the outcome of a host of factors, many of which are beyond our individual control – and obesity is linked to a number of chronic diseases.”

Dr Sandro Demaio is an Aussie medical doctor and global expert on non-communicable diseases. Co-host of the ABC TV series ‘Ask the Doctor’, author of 30 scientific papers and ‘The Doctor’s Diet’ (a cookbook based on science) see Part 2 below 

This article was originally published HERE 

Part 1 NACCHO Policy

” The committee heard that Aboriginal Community Controlled Health Organisations (ACCHOs) run effective programs aimed at preventing and addressing the high prevalence of obesity in Aboriginal and Torres Strait Islander communities.

Ms Pat Turner, Chief Executive Officer of National Aboriginal Community Controlled Health Organisation (NACCHO), gave the example of the Deadly Choices program, which is about organised sports and activities for young people.

She explained that to participate in the program, prospective participants need to have a health check covered by Medicare, which is an opportunity to assess their current state of health and map out a treatment plan if necessary.

However, NACCHO is of the view that ACCHOs need to be better resourced to promote healthy nutrition and physical activity.

Access to healthy and fresh foods in remote Australia

Ms Turner also pointed out that ‘the supply of fresh foods to remote communities and regional communities is a constant problem’.

From NACCHO Submission Read here 

” Many community members in the NT who suffer from chronic illnesses would benefit immensely from using Health Care Homes.

Unfortunately, with limited English, this meant an increased risk of them being inadvertently excluded from the initiative.

First, Italk Alice Springs produced the English version of the story. Then using qualified interpreters, they produced Aboriginal language versions in eight languages: Anmatyerre, Alyawarr, Arrernte, East Side Kriol, West Side Kriol, Pitjatjantjara, Warlpiri and Yolngu Matha

Read Article HERE

Figure 2.22-1 Proportion of persons 15 years and over (age-standardised) by BMI category and Indigenous status, 2012–13
Proportion of persons 15 years and over (age-standardised)

Source: ABS and AIHW analysis of 2012–13 AATSIHS

Read over 60 Aboriginal Health and Obesity articles published by NACCHO over past 7 Years

What is chronic disease?

Chronic disease is a broad term, which includes type 2 diabetes, heart disease, cancers, certain lung conditions, mental illness and genetic disorders. They are often defined by having complex and multiple causes, and are long-term or persistent (‘chronic’ actually means long-term).

How is obesity linked to chronic disease?

Obesity increases the risk of developing certain chronic diseases, including cardiovascular diseases (heart disease and stroke), sleep disorders, type 2 diabetes and at least 13 types of cancer.

Type 2 diabetes and obesity:

Obesity is the leading risk factor for type 2 diabetes, and even being slightly overweight increases this risk. Type 2 diabetes is characterised physiologically by decreased insulin secretion as well as increased insulin resistance due to a combination of genetic and environmental factors. Left uncontrolled, this can lead to a host of nasty outcomes like blindness, kidney problems, heart disease and even loss of feeling in our hands and feet.

Obstructive sleep apnoea and obesity:

This is another chronic disease often linked to obesity. Sleep apnoea is caused when our large air passage is partially or fully blocked by a combination of factors, including the weight of fat tissue sitting on our neck. It can cause us to jolt awake, gasping for oxygen. It leads to poor sleep, which adds physiological pressure to critical organs.

A woman preparing vegetables for a meal

Cancer and obesity:

This is a disease of altered gene expression. It originates from changes to the cell’s DNA caused by a range of factors, including inherited mutations, inflammation, hormones, and external factors including tobacco use, radiation from the sun, and carcinogenic agents in food. Strong evidence also links obesity to a number of cancers including throat cancer, bowel cancer, cancer of the liver, gallbladder and bile ducts, pancreatic cancer, breast cancer, endometrial cancer and kidney cancer.

Obesity is also associated with high blood pressure and increased risk of heart attack and stroke.

This might sound overwhelming, but it’s not all bad news. Here are a few things we can all start to do today to reduce our risk of obesity and associated chronic disease:

1. Eat more fruit and veg

Most dietary advice revolves around eating less. But if we can replace an unhealthy diet with an abundance of fresh, whole fruits and vegetables – at least two servings of fruit per day and five servings of vegetables – we can reduce our risk of obesity whilst still embracing our love for good food.

2. Limit our alcohol consumption

Forgo that glass of wine or beer after a long hard day at work and opt instead for something else that helps us relax. Pure alcohol is inherently full of energy – containing twice the energy per gram as sugar. This energy is surplus and non-essential to our nutritional needs, so contributes to our widening waistlines. And whether we’re out for drinks with mates or at a function, we can reduce our consumption by spacing out our drinks and holding off before reaching for another glass.

3. Get moving

While not everyone loves a morning sprint, there are many enjoyable ways to maintain a sufficient level of physical activity. Doing some form of exercise for at least 30 minutes each day is an effective way of keeping our waistlines in check. So, take a break to stretch out the muscles a few times during the workday, spend an afternoon at the local pool, get out into the garden or take some extra time to ride or walk to work. If none of these appeal, do some research to find the right exercise that will be fun and achievable.

Two women exercising in a park together

4. Buddy up

There’s nothing like a bit of peer pressure to get us healthy and active. Pick a friend who has the same goals and encourage each other to keep going. Sign up for exercise classes together, meet for a walk, have them over for a healthy meal, share tips and seek out support when feeling uninspired.

5. Prioritise sleep

Some argue that sleep is the healthy icing on the longevity cake. The benefits of a good night’s sleep are endless, with recent research suggesting it can even benefit our decision-making and self-discipline, making it easier to resist that ‘between-meal’ treat. Furthermore, lack of sleep can increase our appetite and see us lose the enthusiasm to stay active.

Above all, we need to foster patience and perseverance when it comes to achieving a healthy weight. It might not happen overnight, but it is within reach.

Let’s start today!

Co-host of the ABC TV series ‘Ask the Doctor’, author of 30 scientific papers and ‘The Doctor’s Diet’ (a cookbook based on science), Dr Sandro Demaio is an Aussie medical doctor and global expert on non-communicable diseases.

NACCHO Aboriginal Health and #Obesity : #refreshtheCTGrefresh : Download the Select Committee into the #Obesity Epidemic in Australia 22 recommendations : With feedback from @ACDPAlliance @janemartinopc

The Federal Government must impose a tax on sugary drinks, mandate Health Star Ratings and ban junk food ads on TV until 9 pm if it wants to drive down Australia’s obesity rates, a Senate committee has concluded.

The Select Committee into the Obesity Epidemic, comprising senators from all major parties and chaired by Greens leader Richard Di Natale, has tabled a far-reaching report with 22 recommendations.”

See SMH Article Part 1 below

Download PDF copy of report

Senate Obesity report

Extract from Report Programs in Aboriginal and Torres Strait Islander communities

The committee heard that Aboriginal Community Controlled Health Organisations (ACCHOs) run effective programs aimed at preventing and addressing the high prevalence of obesity in Aboriginal and Torres Strait Islander communities.

Ms Pat Turner, Chief Executive Officer of National Aboriginal Community Controlled Health Organisation (NACCHO), gave the example of the Deadly Choices program, which is about organised sports and activities for young people.

She explained that to participate in the program, prospective participants need to have a health check covered by Medicare, which is an opportunity to assess their current state of health and map out a treatment plan if necessary.

However, NACCHO is of the view that ACCHOs need to be better resourced to promote healthy nutrition and physical activity.

Access to healthy and fresh foods in remote Australia

Ms Turner also pointed out that ‘the supply of fresh foods to remote communities and regional communities is a constant problem’.

From NACCHO Submission Read here 

Recommendation 21 see all Recommendations Part 2

The committee recommends the proposed National Obesity Taskforce is funded to develop and oversee culturally appropriate prevention and intervention programs for Aboriginal and Torres Strait Islander communities.

Recommendation 22

The committee recommends the Commonwealth develop additional initiatives and incentives aimed at increasing access, affordability and consumption of fresh foods in remote Aboriginal and Torres Strait Islander communities.

“Unhealthy weight is a major risk factor for cancer, diabetes, heart disease, stroke and kidney disease. Preventing obesity in children is particularly important, as it is difficult to reverse weight gain once established,” 

Chair of the Australian Chronic Disease Prevention Alliance Sharon McGowan said limiting unhealthy food marketing would reduce children’s exposure to unhealthy food and its subsequent consumption.See in full Part 3

“Obesity in this country has reached epidemic proportions, but it is not a problem without a solution. Today’s report demonstrates a willingness from representatives across all political parties to investigate the systemic causes of obesity and develop a way forward.”

A key recommendation from the Inquiry’s report is the introduction of a tax on sugary drinks; something the OPC has led calls for, and which has been supported by around 40 public health, community and academic groups in the Tipping the Scales report.

Jane Martin, Executive Manager of the Obesity Policy Coalition, said that when two thirds of Australians are overweight or obese, the Inquiry’s comprehensive report provides an acknowledgement of the scale of the problem and a blueprint for tackling it .See part 4 Below for full press release

Part 1 SMH Article 

About 63 per cent of Australian adults are overweight or obese.

In a move that will likely delight health groups and enrage the food and beverage industries, it has recommended the government slap a tax on sugar-sweetened beverages (SSB), saying this would reduce sugar consumption, improve public health and push manufacturers to reformulate their products.

“The World Health Organisation has recommended governments tax sugary drinks and, at present, over 30 jurisdictions across the world have introduced a SSB tax as part of their effort and commitment toward preventing and controlling the rise of obesity,” the report said.

While health groups, such as Cancer Council, have demanded a 20 per cent levy, the committee suggested the government find the best fiscal model to achieve a price increase of at least 20 per cent.

“The impacts of sugary drinks are borne most by those on low income and they will also reap the most benefits from measures that change the behaviour of manufacturers,” it said.

About 63 per cent of Australian adults and 27 per cent of children aged 5 to 17 are overweight or obese, which increases the risk of developing heart disease and type 2 diabetes.

At the heart of the report is the recognition of the need for a National Obesity Taskforce, comprising government, health, industry and community representatives, which would sit within the Department of Health and be responsible for a National Obesity Strategy as well as a National Childhood Obesity Strategy.

“Australia does not have an overarching strategy to combat obesity,” it said.

“Many of the policy areas required to identify the causes, impacts and potential solutions to the obesity problem span every level of government.”

The committee has also urged the government to mandate the Health Star Rating (HSR) system, which is undergoing a five-year review, by 2020.

The voluntary front-of-pack labelling system has come under fire for producing questionable, confusing ratings – such as four stars for Kellogg’s Nutri-Grain – and becoming a “marketing tool”.

“Making it mandatory will drive food companies to reformulate more of their products in order to achieve higher HSR ratings,” the report said.

“The committee also believes that, once the HSR is made mandatory, the HSR calculator could be regularly adjusted to make it harder to achieve a five star rating.”

Pointing to a conflict-of-interest, it has recommended the HSR’s Technical Advisory Group expel members representing the industry.

“Representatives of the food and beverage industry sectors may be consulted for technical advice but [should] no longer sit on the HSR Calculator Technical Advisory Group,” it said.

The government has also been asked to consider introducing legislation to restrict junk food ads on free-to-air television until 9pm.

The group said existing voluntary codes were inadequate and also suggested that all junk food ads in all forms of media should display the product’s HSR.

The committee is made up of seven senators – two  Liberals, two Labor, one each from the Greens and One Nation and independent Tim Storer.

The Liberals wrote dissenting statements, saying a taskforce was unnecessary, HSR should remain voluntary, there shouldn’t be a sugar tax, and current advertising regulations were enough.

“No witnesses who appeared before the inquiry could point to any jurisdiction in the world where the introduction of a sugar tax led to a fall in obesity rates,” they said.

Labor senators also said there was no need for a sugar tax because there isn’t enough evidence.

“Labor senators are particularly concerned that an Australian SSB would likely be regressive, meaning that it would impact lower-income households disproportionately,” they said.

Committee chair, Dr Di Natale said: “We need the full suite of options recommended by the committee if we’re serious about making Australians happier, healthier, and more active.”

Part 2 ALL 22 Recommendations

Recommendation 1

The committee recommends that Commonwealth funding for overweight and obesity prevention efforts and treatment programs should be contingent on the appropriate use of language to avoid stigma and blame in all aspects of public health campaigns, program design and delivery.

Recommendation 2

The committee recommends that the Commonwealth Department of Health work with organisations responsible for training medical and allied health professionals to incorporate modules specifically aimed at increasing the understanding and awareness of stigma and blame in medical, psychological and public health interventions of overweight and obesity.

Recommendation 3

The committee recommends the establishment of a National Obesity Taskforce, comprising representatives across all knowledge sectors from federal, state, and local government, and alongside stakeholders from the NGO, private sectors and community members. The Taskforce should sit within the Commonwealth Department of Health and be responsible for all aspects of government policy direction, implementation and the management of funding

Recommendation 3.1

The committee recommends that the newly established National Obesity Taskforce develop a National Obesity Strategy, in consultation with all key stakeholders across government, the NGO and private sectors.

Recommendation 3.2

The committee recommends that the Australian Dietary Guidelines are updated every five years.

Recommendation 6

The committee recommends the Minister for Rural Health promote to the Australia and New Zealand Ministerial Forum on Food Regulation the adoption of the following changes to the current Health Star Rating system:

  • The Health Star Rating Calculator be modified to address inconsistencies in the calculation of ratings in relation to:
  • foods high in sugar, sodium and saturated fat;
  • the current treatment of added sugar;
  • the current treatment of fruit juices;
  • the current treatment of unprocessed fruit and vegetables; and
  • the ‘as prepared’ rules.
  • Representatives of the food and beverage industry sectors may be consulted for technical advice but no longer sit on the HSR Calculator Technical Advisory Group.
  • The Health Star Rating system be made mandatory by 2020.

Recommendation 7

The committee recommends Food Standards Australia New Zealand undertake a review of voluntary front-of-pack labelling schemes to ensure they are fit-forpurpose and adequately represent the nutritional value of foods and beverages.

Recommendation 8

The committee recommends the Minister for Rural Health promote to the Australia and New Zealand Ministerial Forum on Food Regulation the adoption of mandatory labelling of added sugar on packaged foods and drinks.

Recommendation 9

The committee recommends that the Council of Australian Governments (COAG) Health Council work with the Department of Health to develop a nutritional information label for fast food menus with the goal of achieving national consistency and making it mandatory in all jurisdictions.

Recommendation 10

The committee recommends the Australian Government introduce a tax on sugar-sweetened beverages, with the objectives of reducing consumption, improving public health and accelerating the reformulation of products.

Recommendation 11

The committee recommends that, as part of the 2019 annual review of the Commercial Television Industry Code of Practice, Free TV Australia introduce restrictions on discretionary food and drink advertising on free-to-air television until 9.00pm.

Recommendation 12

The committee recommends that the Australian Government consider introducing legislation to restrict discretionary food and drink advertising on free-toair television until 9.00pm if these restrictions are not voluntary introduced by Free TV Australia by 2020.

Recommendation 13

The committee recommends the Australian Government make mandatory the display of the Health Star Rating for food and beverage products advertised on all forms of media.

Recommendation 14

The committee recommends the proposed National Obesity Taskforce is funded to develop and oversee the implementation of a range of National Education Campaigns with different sectors of the Australian community. Educational campaigns will be context dependent and aimed at supporting individuals, families and communities to build on cultural practices and improve nutrition literacy and behaviours around diet, physical activity and well-being.

Recommendation 15

The committee recommends that the National Obesity Taskforce, when established, form a sub-committee directly responsible for the development and management of a National Childhood Obesity Strategy.

Recommendation 16

The committee recommends the Medical Services Advisory Committee (MSAC) consider adding obesity to the list of medical conditions eligible for the Chronic Disease Management scheme.

Recommendation 17

The committee recommends the Australian Medical Association, the Royal Australian College of General Practitioners and other college of professional bodies educate their members about the benefits of bariatric surgical interventions for some patients.

Recommendation 18

The committee recommends the proposed National Obesity Taskforce commission evaluations informed by multiple methods of past and current multistrategy prevention programs with the view of designing future programs.

Recommendation 19

The committee recommends the proposed National Obesity Taskforce is funded to develop and oversee the implementation of multi-strategy, community based prevention programs in partnership with communities.

Recommendation 20

The committee recommends the proposed National Obesity Taskforce develop a National Physical Activity Strategy.

Recommendation 21

The committee recommends the proposed National Obesity Taskforce is funded to develop and oversee culturally appropriate prevention and intervention programs for Aboriginal and Torres Strait Islander communities.

Recommendation 22

The committee recommends the Commonwealth develop additional initiatives and incentives aimed at increasing access, affordability and consumption of fresh foods in remote Aboriginal and Torres Strait Islanders

Part 3 Protect our children chronic disease groups support calls to restrict junk food advertising

Junk food advertising to children urgently needs to be better regulated.

That’s a recommendation from the Senate report on obesity, released last night, and a message that the Australian Chronic Disease Prevention Alliance strongly supports.

Chair of the Australian Chronic Disease Prevention Alliance Sharon McGowan said limiting unhealthy food marketing would reduce children’s exposure to unhealthy food and its subsequent consumption.

“Unhealthy weight is a major risk factor for cancer, diabetes, heart disease, stroke and kidney disease. Preventing obesity in children is particularly important, as it is difficult to reverse weight gain once established,” Ms McGowan said.

Ms McGowan said one in four children are already overweight or obese, and more likely to grow into adults who are overweight or obese with greater risk of chronic disease.

“While there are multiple factors influencing unhealthy weight gain, this is not an excuse for inaction,” she said. “Food companies are spending big money targeting our kids, unhealthy food advertising fills our television screens, our smartphones and digital media channels.

“Currently, self-regulation by industry is limited and there are almost no restrictions for advertising unhealthy foods online – this has to stop.

“We need to act now to stem this tide of obesity and preventable chronic disease, or we risk being the first generation to leave our children with a shorter life expectancy than our own.”

The Australian Chronic Disease Prevention Alliance also welcomed the Report’s recommendations for the establishment of a National Obesity Taskforce, improvements to the Health Star Rating food labelling system, development a National Physical Activity Strategy and introduction of a sugary drinks levy.

“We support the recent Government commitment to develop a national approach to obesity and urge the government to incorporate the recommendations from the Senate report for a well-rounded approach to tackle obesity in Australia,” Ms McGowan said.

Part 4

Sugary drink levy among 22 recommendations

The Obesity Policy Coalition (OPC) has welcomed a Senate Inquiry report into the Obesity Epidemic in Australia as an important step toward saving Australians from a lifetime of chronic disease and even premature death.

Jane Martin, Executive Manager of the Obesity Policy Coalition, said that when two thirds of Australians are overweight or obese, the Inquiry’s comprehensive report provides an acknowledgement of the scale of the problem and a blueprint for tackling it.

“Obesity in this country has reached epidemic proportions, but it is not a problem without a solution. Today’s report demonstrates a willingness from representatives across all political parties to investigate the systemic causes of obesity and develop a way forward.”

A key recommendation from the Inquiry’s report is the introduction of a tax on sugary drinks; something the OPC has led calls for, and which has been supported by around 40 public health, community and academic groups in the Tipping the Scales report.

“Sugar is a problem in our diets and sugary drinks are the largest contributor of added sugar for Australians. Consumption of these beverages is associated with chronic health conditions including type 2 diabetes, heart disease, some cancers and tooth decay,” Ms Martin said.

“We have been calling for a 20% health levy on sugary drinks for a number of years, but Australia continues to lag behind 45 other jurisdictions around the world that have introduced levies. When sugary drinks are often cheaper than water, it’s time to take action.”

The report also calls for a review of the current rules around junk food advertising to children.

Ms Martin insisted any review should prioritise an end to the advertising industry’s selfregulated codes.

“We know industry marketing is having a negative effect; it directly impacts what children eat and what they pester their parents for. It’s wallpaper in their lives, bombarding them during their favourite TV shows, infiltrating their social media feeds and plastering their sports grounds and uniforms when they play sport,” Ms Martin said.

“With more than one in four Australian children overweight or obese, it’s time for the Government to acknowledge that leaving food and beverage companies to make their own sham rules allows them to continue to prioritise profits over kids’ health.”

While the Inquiry’s report calls for a National Obesity Strategy, a commitment announced by the COAG Health Ministers earlier this year, Ms Martin stressed that this must be developed independently, without the involvement of the ultra-processed food industry, which has already hampered progress to date.

“The OPC, along with 40 leading community and public health groups, have set out clear actions on how best to tackle obesity in our consensus report, Tipping the Scales. These actions came through strongly from many of the groups who participated in the inquiry and we are pleased to see them reflected in the recommendations.

“The evidence is clear on what works to prevent and reduce obesity, but for real impact we need leadership from policy makers. We need to stop placing the blame on individuals. The Federal and State governments must now work together to push those levers under their control to stem the tide of obesity.”

The senate inquiry report contains 22 recommendations which address the causes, control of obesity, including:

  • The establishment of a National Obesity Taskforce, with a view to develop a National Obesity Strategy
  • Introduction of a tax on sugar-sweetened beverages
  • The Health Star Rating system be made mandatory by 2020
  • Adoption of mandatory labelling of added sugar
  • Restrictions on discretionary food and drink advertising on free-to-air television until 9pm
  • Implementation of a National Education Campaign aimed at improving nutrition literacy and behaviours around diet and physical activity
  • Form a sub-committee from the National Obesity Taskforce around the development and management of a National Childhood Obesity Strategy

BACKGROUND:

On 10 May 2018, the Senate voted to establish an inquiry to examine the impacts of Australia’s obesity epidemic.

The Select Committee into the obesity epidemic was established on 16 May 2018 to look at the causes of rising levels of obese and overweight people in Australia and how the issue affects children. It also considered the economic burden of the health concern and the effectiveness of existing programs to improve diets and tackle childhood obesity. The inquiry has received 145 submissions and has published its full report today.

The Committee held public hearings from public health, industry and community groups. The OPC provided a submission and Jane Martin gave evidence at one of these sessions.

NACCHO Aboriginal Health and #rethinksugarydrink : A new campaign asking people to reduce their sugar intake highlights the link between obesity and 13 different types of cancer

 ” Obesity is now a leading preventable cause of cancer , but less than half of all Australians are aware of the link . A new campaign launched today by Cancer Council Victoria is aiming to change this.

In a ground-breaking new public awareness campaign, Cancer Council Victoria will expose the link between obesity and 13 types of cancer by depicting the toxic fat around internal organs.

As many as 98% of Australians are aware that obesity is a risk factor for type 2 diabetes and heart disease, but as little as 40% of Australians know about its link with cancer . ”

Being above a healthy weight is now a leading preventable cause of cancer. Our new campaign urges people to avoid to reduce their risk

You wouldn’t put this much sugar in a tea or coffee? But if you’re drinking one soft drink a day, over 20 years – that’s 73,000 teaspoons.”

Dr Gihan Jayaweera

A third of Victorians admit to drinking more than a litre of sugary drink each week 7, that’s more than 5.5kgs of sugar a year. We want people to realise that they could be drinking their way towards weight gain, obesity and toxic fat, increasing their risk of 13 types of cancer,”

Dr Ahmad Aly

 ” 69% of Aboriginal and Torres Strait Islander people are considered overweight (29%) or obese (40%); among children this is 30% (20% overweight, 10% obese) “

Read over 60 NACCHO Aboriginal Health and Obesity articles

Or see Statistics part 2 Below 

SEE NEWS COVERAGE

https://www.9news.com.au/7f9400a3-9f9d-4e39-9eb2-eef88a7291ce

Cancer Council Victoria CEO, Todd Harper, acknowledged that the campaign’s portrayal of toxic fat could be confronting but said so was the fact that nearly two-thirds of Australians were overweight or obese 4.

“While talking about weight is a sensitive issue, we can’t shy away from the risk being above a healthy weight poses to our health.” Mr Harper said.

“With around 3,900 cancers in Australia each year linked to being above a healthy weight, it’s vital that we work hard to help people understand the link and encourage them to take steps to reduce their risk 5.”

Sugary drinks contribute the most added sugar to Australians’ diets 6, so Cancer Council Victoria is focusing on how these beverages can lead to unhealthy weight gain, which can increase the risk of certain cancers. The campaign will communicate that one way of reducing the risk is to cut sugary drinks from your diet.

The ad features Melbourne surgeon Dr Ahmad Aly exposing in graphic detail what sugary drinks could be doing to your health, as his laparoscopic camera delves inside a patient’s body to expose the dangerous toxic fat around internal organs.

Watch Video 

Dr Aly has seen first-hand the impact toxic fat has on people’s health and hopes the campaign will make people think again before reaching for sugary drinks.

Jane Martin, Executive Manager of the Obesity Policy Coalition, said that while the campaign aims to get people thinking about their own habits, Cancer Council Victoria and partner organisations are also working to encourage governments, the food industry, and communities to make changes.

“It’s virtually impossible to escape the enormous amount of marketing for sugary drinks surrounding us on TV, social media and public transport. It’s also easier to get a sugary drink than it is to find a water fountain in many public places, and that’s got to change. We need to take sugary drinks out of schools, recreation and healthcare settings to make it easier for Victorians to make healthy choices.”

“The need for a healthy weight strategy in Victoria, as well as nationally, is overdue. In the same way tobacco reforms have saved lives, we now need to apply the same approach to improving diets”, Ms Martin said.

Case study: Fiona Humphreys

Since giving up the sweet stuff, Fiona Humphreys has more energy and has managed to shed the kilos and keep them off.

“I used to drink at least two sugary drinks every day as a pick me up, one in the morning and one in the afternoon. I was addicted to the sugar rush and thought I needed them to get through my busy day.”

“After giving up sugary drinks I saw an immediate change in both my mood and my waistline. I lost 7 kilos just by making that one simple change and I haven’t looked back.”

“I decided to go cold turkey and switched to soda or mineral water with a slice of lime or lemon. I tricked my mind to enjoy the bubbles and put it into a beautiful glass. I feel healthier and my mind is clearer as a result.”

The campaign will run for five weeks and be shown on TV and radio and will feature across social media channels as well as outdoors across the state.

A dedicated campaign website cancervic.org.au/healthyweight will provide factsheets for health professionals and consumers and digital elements about how to make small lifestyle changes to improve people’s health.

Top tips to avoid sugary drinks 

  • Avoid going down the soft drink aisle at the supermarket and beware of the specials at the checkout and service stations.
  • If you’re eating out, don’t go with the default soft drink – see what other options there are, or just ask for water.
  • Carry a water bottle, so you don’t have to buy a drink if you’re thirsty.
  • Herbal teas, sparkling water, home-made smoothies or fruit infused water are simple alternatives that still taste great.
  • For inspiration and recipe ideas visit cancervic.org.au/healthyweight

How is sugar linked to weight gain

Sugar is a type of carbohydrate which provides energy to the body. However, eating too much sugar over time can lead to weight gain. Strong evidence shows that being above a healthy weight increases the risk of developing 13 different types of cancer and chronic diseases including cardiovascular disease and type 2 diabetes.

Let’s unpack what happens when our body receives more energy than it needs, how this can lead to weight gain and what you can do to decrease your risk of cancer.

Where do we find sugar?

In terms of health risks, we need to be concerned about ‘added sugar’. That is, sugar that has been added to food or drink.

Natural sugars in foods

  • Fruit and milk products
  • High in nutrients – vitamins, minerals, fibre or calcium.
  • We should eat these foods every day.

Sugar added to food

  • Processed foods
  • These foods are unhealthy and high in energy (kJ).
  • They don’t have other nutrients we need such as fibre, vitamins and minerals.
  • We should limit these foods.

Aboriginal and Torres Strait Islander Communities

Aboriginal and Torres Strait Islander communities tend to have higher rates of obesity and sugary drink consumption and experience poorer health outcomes as a result.

We know that more than half of the Aboriginal and Torres Strait Islander community drink sugary drinks almost every day.

The Overview also examined factors contributing to health, including nutrition and body weight. Some statistics of note include:

  • dietary risks contribute 9.7% to the total burden of disease for Aboriginal people
  • 69% of Aboriginal and Torres Strait Islander people are considered overweight (29%) or obese (40%); among children this is 30% (20% overweight, 10% obese)
  • 54% of Indigenous Australians meet the daily recommended serves of fruit; only 8% meet the daily recommended serves of vegetables
  • both measures are lower in remote communities compared with urban areas and intake is far more likely to be inadequate among the unemployed and those who did not finish school
  • on average, Aboriginal and Torres Strait Islander people consume 41% of their daily energy in the form of discretionary foods — 8.8% as cereal-based products (cakes, biscuits & pastries) and 6.9% as non-alcoholic beverages (soft drinks)
  • average daily sugar consumption is 111g — two-thirds (or the equivalent of 18tsp of white sugar) of which are free sugars from discretionary foods and beverages
  • 22% of Aboriginal people reported running out of food and being unable to afford more in the past 12 months; 7% said they had run out and gone hungry — both were more prevalent in remote areas

In the latest issue of JournalWatch, Dr Melissa Stoneham takes a look at obesity in Australia’s remote Indigenous communities and the struggle to eat well against the odds

Read in full at Croakey

Yorta Yorta woman Michelle Crilly gave up her sugary drink habit and hasn’t looked back. Watch her story.

Video: Rethink Sugary Drink - Michelle Crilly

Read more about the ‘Our Stories’ campaign and hear from more inspiring Victorian Aboriginal community members who have cut back on sugary drinks on our partner site Rethink Sugary Drink.

NACCHO Aboriginal Health and #BreastCancerAwarenessMonth : Download @AIHW BreastScreen Australia monitoring report :Download #Indigenous Resources from @CancerAustralia 

 

” Around 55% of women in the targeted age group of 50–74 participated in the BreastScreen Australia in 2015–2016 with more than 1.7 million screening. Breast cancer mortality has decreased since BreastScreen Australia began from 74 deaths per 100,000 women aged 50–74 in 1991 to 44 deaths per 100,000 women in 2015.

While Indigenous women experience a lower age-standardised incidence rate of breast cancer than non-Indigenous women (rate ratio of 0.9; AIHW 2017c), breast cancer is still the most common cancer diagnosed in Indigenous women. “

Download the full AIHW Report aihw-can-116

NACCHO Aboriginal Women’s Health #BreastCancerAwareness #getChecked : 1.Download #Indigenous Resources from @CancerAustralia 

Participation in BreastScreen Australia and breast cancer outcomes in Indigenous women

Aboriginal and Torres Strait Islander women of Australia, hereafter respectfully referred to as Indigenous women, experience a high burden from breast cancer.

While Indigenous women experience a lower age-standardised incidence rate of breast cancer than non-Indigenous women (rate ratio of 0.9; AIHW 2017c), breast cancer is still the most common cancer diagnosed in Indigenous women.

Aspects of breast cancer and breast screening in Indigenous women are reported by the AIHW and others in various reports and publications, but considering these data individually is not as valuable as considering all available data collectively.

This chapter therefore brings together the BreastScreen Australia participation, incidence and mortality data that previously appeared in several places in this report, and supplements these with additional analyses on incidence, survival and mortality, as well as incorporating data and findings from other published sources.

5.1 Participation in BreastScreen Australia in Indigenous women

Indigenous status of women who participate in BreastScreen Australia is self-reported by women at the time of their screen.

In 2015–2016, participation of Indigenous women aged 50–74 in BreastScreen Australia was 39.1%, compared with the non-Indigenous rate of 54.3% (age-standardised).

Participation trends for Indigenous and non-Indigenous women are shown in Figure 5.1. Historical Indigenous participation rates have been recalculated using new Indigenous population estimates so that meaningful comparisons between reporting periods can be made (see Box 5.1).

Trend data show that the participation rates in Indigenous women aged 50–69 have increased, from around 32%–33% for all reporting periods between 2001–2002 and 2011–2012 to 38% in 2014–2015 and 39% in 2015–2016—although Indigenous women have always had a lower participation rate than non-Indigenous women (Figure 5.2).

Lower participation of Indigenous women may reflect a decreased opportunity to screen, compared with non-Indigenous women, and/or different screening behaviour of Indigenous women (that is, being less likely to screen even with the same opportunity to do so). There may also be a level of under-reporting of Indigenous status in BreastScreen data (as Indigenous status is self-reported by women at the time of their screen), which would also have the effect of lowering the apparent participation rate. This is because under-identification of Indigenous women in BreastScreen data would reduce the size of the numerator without affecting the denominator.

 

Figure 5.1: Participation of women aged 50–74 in BreastScreen Australia, by Indigenous status, 2015–2016 

Source: AIHW analysis of BreastScreen Australia data. Data for this figure are available in Table A1.8.

Figure 5.2: Participation of women aged 50–69 in BreastScreen Australia, by Indigenous status, 1996–1997 to 2015–2016

42 BreastScreen Australia monitoring report 2018

Box 5.1: Indigenous populations

This report uses Indigenous population estimates based on the 2011 Census, which were the most recent estimates available at the time of preparation of this report.

New Indigenous population estimates were released by the ABS in 2014 based on the 2011 Census. These estimates included backcasts of the Indigenous population, as well as population projections to 2026. The backcast estimates of the Indigenous population were considerably larger than those previously published based on the 2006 Census.

This is in part due to improvements in Census coverage and enumeration of Indigenous Australians in the 2011 Census, and an increased likelihood that individuals identified themselves and their children as Indigenous. Historical Indigenous participation rates have been recalculated using these new Indigenous population estimates so that meaningful comparisons between reporting periods can be made over time. Rates presented in this report should not be compared with previously published rates that used population estimates based on the 2006 Census.

Results of a recent Queensland project, ‘Closing the Gap in Breast Cancer Screening’, suggest that different screening behaviour of Indigenous women may play a significant role in their lower participation rates. This project aimed to address barriers to screening for Indigenous women through culturally appropriate messages, art shows and partnerships with local Indigenous groups, in order to build trust, educate and support Indigenous women to attend BreastScreen Australia. The project reported an increase in Indigenous participation from 49% to 56% in 2 years.

Initiatives such as these are common to state and territory BreastScreen programs. These strategies and initiatives are designed to be culturally sensitive and appropriate to the knowledge, attitudes and beliefs of Aboriginal and Torres Strait Islander women. They include dedicated and appropriate communication resources, group bookings for Indigenous women who would prefer to attend as a group, and the use of Indigenous artwork. BreastScreen workers liaise closely with Aboriginal Health Workers and Aboriginal and Torres Strait Islander community groups to increase acceptance of screening.

In the last quarter of 2014–15, the Australian Government ran the National BreastScreen Australia Campaign to support the expansion of the program to women aged 50–74. The campaign included additional communication activities for Aboriginal and Torres Strait Islander consumers, with materials developed in consultation with Aboriginal and Torres Strait Islander women.

Access to BreastScreen services for Indigenous women is a national policy feature of BreastScreen Australia, which has developed National Accreditation Standards (NAS) Measures to ensure that this policy feature is met by services accredited through BreastScreen Australia (see Box 3.3 for more information on NAS Measures and accreditation). These NAS Measures, along with other NAS Measures related to access and participation in BreastScreen Australia, underpin BreastScreen Australia’s aim to maximise the proportion of women in the target population who are screened every 2 years. Table 3.1 shows the NAS Measures related to participation.

5.2 Breast cancer outcomes in Indigenous women

The source of national cancer incidence data in Australia is the Australian Cancer Database (ACD), which is compiled from data supplied by state and territory cancer registries. The cancer registers rely on pathology forms as their primary source of information—which do not include Indigenous status in all states and territories. However, the cancer registers collect

BreastScreen Australia monitoring report 2018 43

information from additional sources, such as hospital records and death records, which allows for information on Indigenous status to be collected where possible.

The level of identification of Indigenous status in the ACD for the period 2009–2013 is considered sufficient to enable analysis in 5 jurisdictions, with data from New South Wales, Victoria, Queensland, Western Australia and the Northern Territory. While the majority (89.9%) of Australian Indigenous people live in these 5 jurisdictions, the degree to which data for these jurisdictions are representative of data for all Indigenous people is unknown (ABS 2012).

Analysis of data from these jurisdictions showed that, in 2009–2013, Indigenous women aged 50–74 had a lower incidence rate of breast cancer, at 251 new cases per 100,000 women, compared with 285 new cases for non-Indigenous women (Figure 5.3)—with a similar trend for all ages (99 compared with 111 per 100,00 women).

Note: Rates age-standardised to the Australian population as at 30 June 2001; ‘Total’ rate includes women with a ‘not stated’ Indigenous status and is therefore greater than the ‘Non-Indigenous’ rate.

Source: AIHW Australian Cancer Database 2014. Data for this figure are available in Table A7.8.

Figure 5.3: Incidence of breast cancer in women aged 50–74 (New South West, Victoria, Queensland, Western Australia and the Northern Territory), by Indigenous status, 2009–2013

Survival

Crude survival was also calculated, and found to be lower for Indigenous women, compared with non-Indigenous women—crude survival was 73.7% for Indigenous women of all ages, compared with 84.3% for non-Indigenous women of all ages during the period 2009–2013. Similarly, crude survival was lower in Indigenous women when restricted to women aged 50–74 (75.4% compared with 89.0% for non-Indigenous women).

Mortality

The source of mortality data is the AIHW National Mortality Database, in which information on Indigenous status is considered to be adequate for reporting for 5 jurisdictions: New South Wales, Queensland, Western Australia, South Australia and the Northern Territory.

In 2011–2015, the mortality rate from breast cancer was higher in Indigenous women aged 50–74, at 55 deaths per 100,000 women, compared with 46 deaths for non-Indigenous women (Figure 5.4). While participation in BreastScreen Australia has a direct effect on the incidence of breast cancer, additional factors come into play for mortality from breast cancer, such as the stage of cancer at diagnosis, and access to treatment.