Aboriginal #Rural and #Remote Health #ClosingTheGap #HaveYourSayCTG : New @AIHW Report says the mob living in remote and regional areas are dying preventable deaths from treatable conditions because of a lack of access to health services

 “Australians living in remote and regional areas are dying preventable deaths from treatable conditions because of a lack of access to health services.

The damning assessment is contained in a new Australian Institut­e of Health and Welfare report on rural and remote health, which finds that those in the bush rely heavily on general practitioners to provide primary healthcare services in the absence of specialist doctors.

But patients most in need of GPs often can’t access them, with those in remote areas six times as likely as those in metropolitan centres to report they had no access­ to one.”

From Natasha Robinson The Australian October 24 Continued Part 1 below

Aboriginal and Torres Strait Islander people are more likely to have higher rates of chronic conditions, hospitalisations and poorer health outcomes than non-Indigenous Australians

The differences in health outcomes in Remote and Very remote areas may be due to the characteristics of these populations.

The proportion of the population that is Indigenous, is much higher in more remote areas

However, more Indigenous Australians live in Major cities and Inner regional areas (61% of Indigenous Australians) compared with Remote and Very remote areas (19%) “

From the AIHW Report see Part 2 Below

Download full report HERE

Rural & remote health

Part 1 The Australian media report 

The report comes as The Australian revealed yesterday that the numbers of domestically trained doctors entering GP training had fallen for the third year in a row, with rural areas relying heavily on overseas-trained doctors to fill the workforce shortfall.

The AIHW report finds people in remote areas die five years before­ their city counterparts, with a life expectancy of 76 years.

More than 70 per cent of those living in regional areas are overweight or obese, less than one in 10 eat the recommended number of serves of vegetables per day, and one-quarter have high blood pressure or mental health problems.

Rural Australians are dying of diabetes at much higher rates than city dwellers, and many cancers­ go undetected because of a lack of acces­s to screening programs.

“The rate of potentially avoidable deaths increased as remote­ness increased,” the report says. “These are deaths among people aged 75 and under from conditions considered potentially preventable through individualised care, and/or treatment through existing primary or hospital care.”

The Australian College of Rural and Remote Medicine said the situation was a “tragedy”.

“We have a rural health crisis that extends right across from our Aboriginal and Torres Strait Island­er people to our rural communities,” said college president Ewen McPhee.

“I think it’s a tragedy that rural communities continue to be neglec­ted.”

In many tiny towns across the country, residents rely on the Royal Flying Doctor Service to provide access to a GP.

Yesterday in Stonehenge in remote­ central Queensland, doctor­ Arthur Beggs and nurse Jo Mahony­ flew in to provide the fortnightly mobile GP service for the town and surrounding areas of about 50 people.

“A lot of people don’t want to bother us unless they are really unwell and that’s really typical of the stoic, outback approach,” Dr Beggs said.

The RFDS has introduced a chronic disease management plan to the town, tracking baseline health measurements and flying specialist allied health practitioners in every few weeks to provide extra services.

Dr Beggs knows the challenges of being a rural GP, but says the difficulties are outweighed by the satisfaction of the work.

“I find rural and remote medicine fascinating and much more fulfilling than I do city-based medicine,” he said.

A recent report published by the Medical Deans of Australia found only 15 per cent of medical students in their final year of study said they were interested in becomin­g GPs, the lowest figure in five years.

Dr Beggs said attracting GPs to rural and remote areas was key to improving health outcomes in the bush.

“Modern medicine is all about specialties,” he said.

“The specialties can seem a more lucrative and controlled environm­ent than the realms of general practice, which is unfortun­ate because general practice­ gives you a much better overview of people and their health.”

Part 2

Profile of rural and remote Australians

See AIHW Online version HERE

For more information on Aboriginal and Torres Strait Islander health by remoteness see: The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples: 2015 and the Aboriginal and Torres Strait Islander Health Performance Framework (HPF) report

Overall, more Australians live in Major cities compared with rural and remote areas

. In 2017, the proportion of Australians by area of remoteness was:

72% in Major cities

18% in Inner regional areas 8.2% in Outer regional areas 1.2% in Remote areas

0.8% in Very remote areas (ABS 2019b).

On average, people living in Remote and very remote areas were younger than those living in Major cities ( gures 1a and 1c).

Australians aged 25–44 were more likely to live in Remote and very remote areas and Major cities compared with Inner regional and outer regional areas. However, a higher proportion of people aged 65 and over lived in Inner regional and outer regional areas and Major cities, compared with Remote and very remote areas ( gures 1a, 1b and 1c).

Rural and remote Australia encompasses many diverse locations and communities and people living in these areas face unique challenges due to their geographic isolation.

Those living outside metropolitan areas often have poorer health outcomes compared with those living in metropolitan areas. For example, data show that people living in rural and remote areas have higher rates of hospitalisations, mortality, injury and poorer access to, and use of, primary health care services, compared with those living in metropolitan areas.

Health inequalities in rural and remote areas may be due to factors, including:

  • challenges in accessing health care or health professionals, such as specialists social determinants such as income, education and employment opportunities higher rates of risky behaviours such as tobacco smoking and alcohol use
  • higher rates of occupational and physical risk, for example from farming or mining work and transport-related accidents.

Despite poorer health outcomes for some, the Household, Income and Labour Dynamics in Australia (HILDA) survey found that Australians living in small towns (fewer than 1,000 people) and non-urban areas generally experienced higher levels of life satisfaction compared with those in urban areas (Wilkins 2015).

Rural and remote Australians also report increased community interconnectedness and social cohesion, as well as higher levels of community participation, volunteering and informal support from their communities (Ziersch et al. 2009).

Part 3 National : Closing the Gap / Have your say CTG deadline extended to Friday, 8 November 2019.

 

The engagements are now in full swing across Australia and this is generating more interest than we had anticipated in our survey on Closing the Gap.

The Coalition of Peaks has had requests from a number of organisations across Australia seeking, some Coalition of Peak members and some governments for more time to promote and complete the survey.

We want to make sure everyone has the opportunity to have their say on what should be included in a new agreement on Closing the Gap so it is agreed to extend the deadline for the survey to Friday, 8 November 2019.

This will help build further understanding and support for the new agreement and will not impact our timeframes for negotiating with government as we were advised at the most recent Partnership Working Group meeting that COAG will not meet until early 2020.

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

NACCHO Aboriginal Health and #NATSIHP : Download Report Card on the Implementation Plan for The National Aboriginal and Torres Strait Islander Health Plan 2013 to 2023, showing 12 of the 20 goals named in the Plan are on track to be achieved by 2023.

“A significant number of Indigenous Australian health outcomes are on track to be achieved within four years, an annual Report Card has revealed.

The annual Report Card on the Implementation Plan for The National Aboriginal and Torres Strait Islander Health Plan 2013 to 2023, shows 12 of the 20 goals named in the Plan are on track to be achieved by 2023.

The immunisation target for five-year-old children has been exceeded, with 97 per cent of Indigenous five-year-olds fully immunised, compared to 95 per cent of other children.

All three goals in the maternal health and parenting domain, plus the target for immunisation of two-year-olds, are on track to be achieved by 2023, while all goals related to smoking are expected to be accomplished by the Plan’s completion.

The IHRF is the first national research program led by Indigenous people at all levels, and conducted with close engagement with Indigenous communities,“We have set other clear goals to end avoidable Indigenous blindness by 2025, end avoidable Indigenous deafness, and eliminate rheumatic heart disease over the course of this decade.

These are top priorities within the Morrison Government’s new $160 million, 10-year Indigenous Health Research Fund (IHRF), funded through the Medical Research Future Fund.”

Minister for Health, Greg Hunt, thanked the members of the Implementation Plan Advisory Group, the National Health Leadership Forum and other Aboriginal and Torres Strait Islander leaders, communities and stakeholders, for their involvement in the development of the Report Card.

The Report Card outlines the progress made to date against the Implementation Plan, with improvements across a range of health and social outcomes for Aboriginal and Torres Strait Islander peoples. Some key achievements include:

  • all three goals in the maternal health and parenting domain are on track to be achieved by 2023;
  • the 88 percent immunisation target for Aboriginal and Torres Strait Islander 1-year-olds is on track to be met by 2023;
  • as at 31 December 2018 nationally, 97 per cent of Aboriginal and Torres Strait Islander children aged 5 years were fully immunised, compared with 95 per cent of other children; and
  • all goals relating to smoking are on track to be achieved by 2023, and this is expected to have an impact on the burden of disease over time.

The Report Card acknowledges that while many health outcomes are improving for Aboriginal and Torres Strait Islander peoples, there is more work needed to close the gap in health inequality.

The Department of Health would like to thank members of the Implementation Plan Advisory Group for their ongoing expertise and contributions to finalising the Report Card, as well as guiding progress towards the next Implementation Plan.

PDF version: Report Card for the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013-2023 – PDF 3228 KB
Word version: Report Card for the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013-2023 – Word 11758 KB

Minister for Indigenous Australians, Ken Wyatt, welcomed the announcement, saying the progress was a result of “strong collaboration between the Government and Australia’s Indigenous community.”

“Our focus is on practical outcomes and empowering local communities to have their say when it comes to the decision-making of Government,” Minister Wyatt said.

“That’s why we’re working with Indigenous communities and governments throughout Australia to improve health outcomes and help close the gap through co-design.”

The Morrison Government is committed to improving the eight goals currently unmeasurable or behind predicted figures.

Over four years from 2019-20, the Government will invest $4.1 billion in dedicated health programs for Indigenous Australians.

These investments are only possible because of our strong economic management

 

NACCHO Aboriginal Kidney Health #NIKTT #NIDTC2019 #ClosingTheGap #HaveYourSayCTG : Our CEO Pat Turner pays tribute to her Uncle Charlie Perkins in speech to the National Indigenous Dialysis and Transplantation Conference

 ” Every which way you look at renal disease in Aboriginal people, the only solutions that will work in the long term are those that are Aboriginal–led, culturally responsive, located in Aboriginal organisations and evaluated through an Aboriginal lens.

As I have described below, Danila Dilba and KAMS show you the proven capacity of community control to deliver results and accelerate outcomes for people with chronic renal disease.  

Both services have people sharing their experiences at this conference.  Keep an eye out for their presentations.

To our non-Indigenous supporters in the audience today, I believe these examples about HOW we want to work together will be inspiring. Please expand your discussions during the conference with a positive acknowledgement of community control, and the rights we have as Aboriginal and Torres Strait Islander peoples to shape our own destiny, to partner with you as equals in service delivery, and to be accountable. ” 

Pat Turner NACCHO CEO

Read all Aboriginal Kidney Health articles published by NACCHO

Read all 160 Aboriginal Health and Diabetes articles published by NACCHO 

Before I begin, I acknowledge the Arrernte people and their country on which we meet today.  As many of you may know, I am back home where I was born and feeling very much re-energised by the country that knows me so well, my family and friends.

This conference brings together both community and health care sectors.  A hugely diverse audience!   Your efforts at this conference will help shape a five-year National Indigenous Kidney Transplantation Strategy to be provided to the Commonwealth in 2020.

With this conference mandate, I hope you will permit me to reflect on the WHY, the HOW and the WHEN of what we are all trying to achieve together.

The WHY is both personal and professional for me.

At the time of his death in 2000 from renal complications, one of my uncles had been the longest living Australian kidney transplant recipient.

And my uncle had been many other ‘firsts’ in his life.  For example:

  • The first Aboriginal person to graduate with a university degree
  • The first Aboriginal person to play soccer at elite level

and

  • The first Aboriginal person to be the permanent head of an Australian government department.

My uncle’s name?  Charlie Perkins.

His transplant in 1972 – the year he arrived in Canberra for the Tent Embassy  – gave my uncle another 28 years of life.

Instead of dying at 36 years of age, he died nearly three decades later at 64.

Imagine if his life had been cut short at 36, which is what would have happened without his renal transplant.

In the words of then Senator Aiden Ridgeway in the Senate chamber in October 2000  about my uncle: “we would not have had his contribution to the life of the nation”.

Dying in his mid-thirties would have been a tragic loss for the country.  BUT, it would ALSO have been a tragic personal loss for uncle’s family, including me, and his communities.   It would have robbed us of someone we loved far too soon.

Every Aboriginal and Torres Strait Islander person whose life you save is just as important  to their family and community as my uncle was to me and mine.

While each one may not have the same national profile as Charlie Perkins, each person has a life with meaning and importance.

The old man you treated last week could be a respected cultural boss, a law man, an esteemed knowledge holder in his own community.

The young woman you treat next week could be on her own journey to become a healer, an artist or elder in her own right, as her community ordains.

The next 20 year-old your efforts engage in renal health could be Australia’s first Aboriginal Prime Minister, or the Chancellor of Australia’s first Indigenous university or our 1000th Aboriginal doctor.

You never know.  You must take the long view.

Every premature death from preventable renal disease inflicts a shortfall in community capacity and resilience: now and in the future.

Every funeral adds to our intergenerational trauma, our collective loss and our … exhaustion!  We have plenty of reserves  — history shows my people always manage to bounce back.  BUT the preventable toll of chronic renal disease must stop.

So there it is.  The WHY is huge!

Because of this WHY, let me now share a few ideas about HOW.

My first example comes from Danila Dilba Health Service in Darwin. 

Data points taken over a ten-year period provided Danila Dilba with unique insights about the management and disease trajectory of people with chronic renal disease before and after the appointment of a Renal Case Manager to their team.   Creating this Renal Case Manager position specifically aimed to delay progression of their clients to end-stage kidney disease.

Danila Dilba recruited this new position in early 2008.   With this new role, all members of the primary healthcare team were to be supported through the provision of systematic patient monitoring, and access to the latest advice about evidence-based practice for very complex clinical challenges.  As a learning organization, Danila Dilba also committed to an independent evaluation of these service changes.

Before this new role, there were clear gaps in care that needed improving.  For example:

  • Documentation in the electronic clinical record system.  Only 60% of patients were identified with their diagnosis.
  • Screening of ‘at risk’ patients was very low. Although there were over 500 patients with diabetes for example, few of these had been screened for chronic renal disease.
  • There was underuse of the GP management plan.  Only 63% of patients had a current plan. Only 14% of these contained self-management goals.  Only 26% contained clinical goals.

Using the ten-year data, this independent evaluation documented convincing improvements. The evaluation showed that Danila Dilba increased screening and monitoring of people under their care with Stage 3 to 5 chronic renal disease.

Prompt access to expert knowledge at the tertiary level also increased the organisation’s competence to recognise and effectively manage patients with chronic renal disease and associated complex comorbidities.

BUT the risk of tertiary renal services taking over the management of people to the exclusion of their other health priorities was avoided.

There was a significant increase in the timely identification of people in Stage 3 rather than the later, more difficult stages of chronic renal disease.  In fact, the patient numbers with Stage 3 grew from fifteen to 101 patients. The growth in the number of people in Stages 4 and 5 was less dramatic in absolute numbers, but a positive improvement was shown.  There was an increase in clinic visits for people with more advanced disease and, overall, improved management of risk factors.

As a result of this initiative, those patients with both renal disease and diabetes were better managed in terms of meeting agreed evidence-based targets for diabetes control.

At Danila Dilba, the proportion of patients meeting specific clinical targets for their care has sat above 90% consistently since 2012. Indeed, management of patients with diabetes has been above average since these data audits commenced.  There was a very welcome stabilization of diabetes control for those with Stage 5 renal disease.  This is fantastic for the patient’s wellbeing.

Of course, you’ll also be asking whether this increased service output delayed progression of chronic renal disease!

Before the program, 50% of patients ended up with Stage 5 within two and half years of identification.  After the program, progression had slowed down dramatically.  Rather than two and half years, the time it took to progress had extended out to four years.  This represents a significant delay in disease progression.  I find these results very positive.  In my mind, the rate of progression seems to have been nearly halved.  My congratulations to the team.

Overall, this experience has helped shift Danila Dilba to a ‘systems approach’. Their new service design, which also takes services close to home, has increased client access and increased client numbers.  This is what community-controlled primary health care is all about.  Screening for chronic renal disease is embedded in annual health checks.   Anyone with acute kidney injury is managed with clinical precision, until their kidney function returns to usual.  Since 2014, there has also been a doubling of people with diabetes, so Danila Dilba staff are managing much more complexity.

As a result of these initiatives, those patients with both renal disease and diabetes are better managed in terms of meeting agreed evidence-based targets for diabetes control.  The evidence is convincing.  Danila Dilba’s national KPIs are either AT or VERY CLOSE to their 2023 targets.

At Danila Dilba, there is a careful balance between ‘siloed’ technical expertise held by those with super-speciality knowledge about chronic kidney disease, and the need for care that looks at the whole person.  As Dr Sarah Giles has said “We’re not managing numbers, we are caring for people”.  Danila Dilba is preventing disease onset through effective risk factor management AND preparing people with serious renal disease and their families for choices, for a planned transition to dialysis.

I learned from the Transplant Society’s Performance Report that Aboriginal Australians are less likely than other Australians to receive a kidney transplant primarily because they are less likely to be put on the waiting list.  The need for culturally competent pre-transplant education is indisputable.  What Danila Dilba shows is that this education cannot happen out-of-the-blue without an existing relationship between the person, their family AND a health service they trust.  Expanding that waiting list is a clear role for community-controlled primary health care in concert with their tertiary service colleagues.

The second community-controlled example I’d like to share with you today is from the Kimberley region.

There, the Kimberley Aboriginal Medical Services known as KAMS has taken a pioneering step in becoming the first aboriginal community controlled renal healthcare service in Australia.  And quite possibly in the world.  This service is known as Kimberley Renal Services, or KRS, a wholly owned subsidiary of KAMS.  By running KRS itself, KAMS ensures a culturally appropriate renal healthcare service is available for Aboriginal people with chronic renal disease close to home.

There are 124 people currently receiving lifesaving haemodialysis treatment cared for by KRS. KRS provides renal healthcare services within four renal health centres.  These are located in the towns of Broome, Derby, Fitzroy Crossing and Kununurra.  Another 18 patients have chosen Home Therapy.   But there is a very large number of Kimberley people waiting in Perth to be able to come back home for dialysis.  Perth is a long way from country.

After many years frustrated by a model that wasn’t working for communities, KAMS secured significant funding for this service innovation which they have designed with absolute attention to cultural safety and clinical outcomes.

KRS has ensured a multi-disciplinary team approach is available to support people throughout their renal healthcare journey.  Access to the renal health centres is provided 6 days a week Monday to Saturday all year round.  The only days that the service is not available are Sunday’s and Christmas Day.

In designing their own solution, our colleagues in KAMS thought it was important to emphasise health as a priority, not disease.  So the decision was made to change from the previous term ‘dialysis units’ to the new term, ‘renal health centres’.   Anyone can engage with their renal health centre for advice, information and understanding.

There is a focus on local staff in each of these sites, learning and doing and caring for their families and communities in jobs vital for the community.  These local KRS staff include Aboriginal Health Workers, Patient Care Assistants, Aboriginal care co-ordinators and Aboriginal nurses.   KAMS is committed to Aboriginal employment.  Currently, 36% of the staff employed in KRS is Aboriginal.   There is an affirmative Aboriginal employment policy and, because KRS is managed by KAMS, cultural values permeate the entire service.  No patient is seen without an Aboriginal staff member.  All non-Indigenous staff recognise that Aboriginal staff guide their practice.

As a matter of necessity, there are three “renal GPs” in the team.  These are qualified GPs credentialed for independent practice who have also gained specific expertise in the nuanced management of chronic renal disease and other medical conditions affecting kidney function.  In a region the size of Germany, this works in a shared care model.

KRS has also been designed to conduct scheduled outreach to communities.  In doing so, this KRS multidisciplinary team does not cut across primary health care. Indeed, KRS has a shared care model that requires a strong foundation in primary health care to work.  This partnership is best when there are common values, clear team arrangements and community control.  Clinical medical records are shared. The renal team offers in-service training, both formal and informal, any time they are visiting a location for regular community outreach visits.  There can be telephone enquiries about patients at any time.

Another part of this service addresses community engagement and life-saving prevention. There are approximately 2,800 people known to KRS who are in Stages 1 to 3 of chronic renal disease across the region.  It is this commitment to prevention that will stem the tide of future incidence.

KAMS is looking outwards and wants to ensure none of these people in Stages 1, 2 or 3 progress to the more critical Stages 4 or 5.  Currently, there are 138 people progressing to End Stage Kidney Disease.  These patients will require haemodialysis within the next 12 to 18 months.  This will more than double the caseload.  With this projection, people are asking why the region does not yet have at least one full-time residential nephrologist.  Addressing this unresolved aspect of medical workforce planning and distribution nationally is critical to successful chronic disease management, and achieving equity of access to renal replacement therapy that our people deserve.

Having visited the Kimberley last week, I was most impressed by the commitment to evidence-based renal disease management through Australia’s first community-controlled renal healthcare service. Speaking with staff and community, the best outcomes are coming through with community-controlled primary health care.  Indeed, this KAMS model can’t work unless there is a strong foundation of community-controlled primary health care.

I learned last week that some of the greatest frustrations occur when primary health care is understaffed, especially when members of the primary health care team are pulled off chronic disease management for a different priority, OR when locum staff don’t handover properly and neglect to check critical pathology results.  These “stop-start” dynamics in primary health care are seen in all settings across the country.  They compromise shared care models.  They are also unsafe for patient care.

For this reason, NACCHO is leading national projects to ensure that core services are fully funded in primary health care and deliver the outcomes our people deserve.

NACCHO supports statements by various governments to transition Aboriginal primary health care to community control.   Successful transition of one local primary health care service in East Arnhem from government management to community control achieved a 400% (yes, FOUR hundred percent) increase in episodes of care within five years.  This community engaged with an Aboriginal community-controlled primary health care service in a way that increased health checks beyond the national average.  More babies were born with healthy weights.  You, in the audience, know better than me the importance of healthy human development right from the beginning of conception to ensure healthy kidneys for life!

Every which way    you look at renal disease    in Aboriginal people, the only solutions that will work in the long term are those that are Aboriginal–led, culturally responsive, located in Aboriginal organisations and evaluated through an Aboriginal lens.

As I have described, Danila Dilba and KAMS show you the proven capacity of community control to deliver results and accelerate outcomes for people with chronic renal disease.  Both services have people sharing their experiences at this conference.  Keep an eye out for their presentations.

To our non-Indigenous supporters in the audience today, I believe these examples about HOW we want to work together will be inspiring. Please expand your discussions during the conference with a positive acknowledgement of community control, and the rights we have as Aboriginal and Torres Strait Islander peoples to shape our own destiny, to partner with you as equals in service delivery, and to be accountable.

So that covers the WHY and the HOW.

I want to talk about WHEN.

WHEN should we start working differently together? 

The answer is right now.

An historic Partnership Agreement on Closing the Gap has been signed between COAG and the national Coalition of Peak Aboriginal and Torres Strait Islander Organisations.  Now, for the first time, Aboriginal and Torres Strait Islander people through their peak representatives will share decision making with governments on Closing the Gap.

This Partnership Agreement has created a high-level COAG Joint Council for Indigenous Affairs.

This Joint Council is made up of 22 members.  That means a Minister from the Commonwealth Government, a Minister from each State and Territory Governments, and a representative from local government. This makes up ten members.

What about the other twelve?

The Coalition of Aboriginal Peak Bodies has ensured that the majority of members on this Joint Council are Aboriginal or Torres Strait Islander representatives.  Chosen by us, in the majority, working for our mobs.

The Joint Council has three reform priorities.  These are:

  1. Establishing shared formal decision making between Australian governments and Aboriginal and Torres Strait Islander people at the State/Territory, regional and local level to embed ownership, responsibility and expertise on Closing the Gap.
  2. Building and strengthening Aboriginal and Torres Strait Islander community-controlled organisations to deliver services and programs in priority areas.
  3. Ensuring all mainstream government agencies and institutions undertake systemic and structural transformation to contribute to Closing the Gap.

This commitment to equal partnership through COAG has brought us to the table.  There’s no going back.

The Joint Council also agreed to the Coalition of Peaks leading engagements with Aboriginal and Torres Strait Islander people to ensure others can have a say on the National Agreement on Closing the Gap.  Surveys are out now and can be submitted anytime by Friday 25 October.

So to close my presentation to you today, a final reflection.

I am mindful that the Bulletin of the World Health Organization recently carried an article stating that kidney disease is ‘THE most neglected chronic disease’.

….. but neglected by whom?

Certainly NOT by anyone in THIS audience!

I applaud your dedication and your hard work.  By being here in Alice Springs, your commitment to better health for Aboriginal and Torres Strait Islander peoples in Australia is visible and much appreciated.

I know this issue is complex and no doubt frustrating.  Occasionally, you must feel completely demoralized in your work.  The Society’s Performance Report recognizes there is ‘no easy fix’.

But please be strengthened by the WHY, the HOW and the WHEN I have described today.

Working together, we can achieve even more than my uncle ever imagined.

National : Closing the Gap / Have your say CTG deadline extended to Friday, 8 November 2019.

 

The engagements are now in full swing across Australia and this is generating more interest than we had anticipated in our survey on Closing the Gap.

The Coalition of Peaks has had requests from a number of organisations across Australia seeking, some Coalition of Peak members and some governments for more time to promote and complete the survey.

We want to make sure everyone has the opportunity to have their say on what should be included in a new agreement on Closing the Gap so it is agreed to extend the deadline for the survey to Friday, 8 November 2019.

This will help build further understanding and support for the new agreement and will not impact our timeframes for negotiating with government as we were advised at the most recent Partnership Working Group meeting that COAG will not meet until early 2020.

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

NACCHO Aboriginal Health and #FamilyMatters Report 2019 Download : The crisis of Aboriginal and Torres Strait Islander children being over-represented in the child protection systems continues to escalate at an alarming rate.

“If we do not change our course of action the number of Aboriginal and Torres Strait Islander children in care will more than double in the next 10 years.

Aboriginal and Torres Strait Islander children are seven times more likely to be on a permanent care order until 18 years. They are at serious risk of permanent separation from their families, cultures and communities.

The trauma associated with child removal is intergenerational.

It affects a person’s functioning in the world, has an adverse impact on family relationships and creates vulnerability in families.

Healing is an important part of reclaiming the resilience we need to deal with life’s challenges and address the burden of trauma in our communities,”

Family Matters Co-Chair Richard Weston.

The crisis of Aboriginal and Torres Strait Islander children being over-represented in the child protection systems continues to escalate at an alarming rate, reveals The Family Matters Report 2019

The report also shows a growing trend towards permanent placement away from their families and that Aboriginal and Torres Strait Islander children continue to experience high levels of disadvantage.

Aboriginal and Torres Strait Islander children are 37.3% of the total out-of-home care population, including foster care, but only 5.5% of the total population of children.

Aboriginal and Torres Strait Islander children are now 10.2 times more likely to be removed from their families than non-Indigenous children.

The decreasing rate of placement of Aboriginal and Torres Strait Islander children with Indigenous carers dropped from 49.4% to 45% in a year and has declined from 65.3% in 2006.

The Family Matters Report 2019 also reveals poverty and homelessness has a profound impact on children being removed from their home.

Nearly one in three Aboriginal and Torres Strait Islander people are living below the poverty line. Aboriginal and Torres Strait Islander householders are almost twice as likely to experience rental stress.

“Household income and access to safe and healthy housing have a substantial impact on the capacity of families to provide safe and supportive care for children,” says Family Matters Co-Chair Natalie Lewis.

“Aboriginal and Torres Strait Islander children experience disadvantage across a range of early childhood areas, are more likely to be developmentally delayed at the age of five and attend childcare services at half the rate of non-Indigenous children.

“We stress the need for an increased investment in prevention and early intervention to redress the over-representation of Aboriginal and Torres Strait Islander children in out-of- home care. Consistently, more funding is invested in child protection services than support services,” says Ms Lewis.

The Family Matters Report 2019 calls for:

  1. A national comprehensive Aboriginal and Torres Strait Islander children’s strategy that includes generational targets to eliminate over-representation and address the causes of Aboriginal and Torres Strait Islander child
  2. Investment in quality Aboriginal and Torres Strait Islander community-controlled integrated early years services through a specific program with targets to increase coverage in areas of high Aboriginal and Torres Strait Islander population and high levels of
  3. Establishing state-based and national Aboriginal and Torres Strait Islander children’s commissioners to enable improved government accountability and oversight.
  4. An end to legal orders for permanent care and adoption for Aboriginal and Torres Strait Islander children, replaced by a focus on supporting their connections to kin, culture and

Family Matters is Australia’s national campaign to ensure Aboriginal and Torres Strait Islander children and young people grow up safe and cared for in family, community and culture. It aims to eliminate the over-representation of Aboriginal and Torres Strait Islander children in out-of-home care by 2040.

Family Matters – Strong communities. Strong culture. Stronger children. is led by SNAICC

– National Voice for our Children and a group of eminent Aboriginal and Torres Strait Islander leaders from across the country. The campaign is supported by a Strategic Alliance of over 150 Aboriginal and Torres Strait Islander and non-Indigenous organisations.

Since 2016, the campaign has released an annual Family Matters report that examines how Australia is faring in improving the safety and wellbeing of Aboriginal and Torres Strait Islander children.

Have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander children  #HaveYourSay about #closingthegapCTG

Aboriginal and Torres Strait Islander people know what works best for us.

We need to make sure Aboriginal and Torres Strait Islander youth voices are reflected and expertise is recognised in every way at every step on efforts to close the gap in life outcomes between Aboriginal and Torres Strait Islander people and other Australians.’

‘The Coalition of Peaks is leading the face to face discussions, not governments.

The Peaks are asking Aboriginal and Torres Strait Islander youth to tell us what should be included in a new Closing the Gap agreement and we will take this to the negotiating table.’

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

 

 

NACCHO Aboriginal Health Research #ourculturescount #HaveYourSayCTG : Download @Mayi_Kuwayu and @LowitjaInstitut Defining the Indefinable: Descriptors of Aboriginal and Torres Strait Islander peoples’ culture and their links to health and wellbeing

“In recent years, interest in understanding the relationship between Aboriginal and Torres Strait Islander peoples’ cultures and how culture relates to health and wellbeing has been growing. The first step in understanding this relationship is to identify what is described in the literature as ‘culture’ and then to describe how the literature reports the relationship between culture and health and wellbeing.

Some people argue that culture is not definable or that it is intangible. However, all people are born into and grow, work and live within a culture or cultures. Cultures are maintained or modified when they are passed on and are reinforced and practised in both specific and general situations.

The many definitions encompass culture- specific knowledge, attitudes, beliefs and behaviours (including within cultural variations according to rules), and all human life is culturally bound.

Much work in epidemiology and public health focuses on the presence (or absence) of disease and not on the culture within which illness and wellbeing manifest.

We need to understand both wellbeing and culture to have effective public health. “

From the publication Mayi_Kuwayu and Lowitja Institute Defining the Indefinable : Continued Part 1

Download HERE

Defining_Indefinable_report_FINAL_WEB

In Australia, limited data establish or define the relationship between health, wellbeing and culture and the mechanisms through which Aboriginal and Torres Strait Islander cultural determinants impact health and wellbeing.

There is increasing attention on the relationship between culture, health and wellbeing in this population.

The authors conducted this literature review as preliminary work for the Mayi Kuwayu Study—Mayi Kuwayu broadly means “to follow Aboriginal people over a long time” in Ngiyampaa language (language of the Wongaibon people of New South Wales, Australia).

Survey Website 

The aim was to help us understand the cultural factors that are important to Aboriginal and Torres Strait Islander peoples and how these factors relate to health and wellbeing.

The authors examined the Australian literature, as well as literature from countries that have experienced colonisation events similar to those of Australia— primarily Aotearoa (New Zealand), Canada and the United States.

 Part 1 Introduction continued from opening 

This work stems from the desire of many Aboriginal and Torres Strait Islander people to achieve that understanding in order to improve our health. Culture (the maintenance, revitalising, embracing, nurturing and growth of it) is important to our happiness and wellbeing and for improving health outcomes.

This review provides insights into what Indigenous peoples across the world describe as culture. However, much more knowledge is likely to be held by cultural leaders and others who have not engaged in what is often non-

Indigenous-led research. This also means that what is described as culture is largely viewed through the lens of people from non-Indigenous cultures. The content of this review is not intended to be a tool to measure indigeneity or cultural proficiency for individuals or groups and should not be read or interpreted as such.

The Lowitja Institute Aboriginal and Torres Strait Islander Health CRC funded this review under project 16- SDH-0503. Our aims were to identify from the literature the broad domains (and additional sub-domains) of Indigenous peoples’ cultures and describe how these relate to health and, more broadly, wellbeing.

We mainly restricted our review to literature published between 1990 and 2017 and used an iterative search process that initially returned many thousands of results from five online databases and through hand searching. We included grey literature to ensure as much material as possible was included.

We identified six broad, frequently cited cultural domains or themes, each with a number of sub-domains (see ‘Summary of cultural indicators’ at the end of Chapter 3). The broad domains were:

  • Connection to Country
  • Indigenous beliefs and knowledge
  • Indigenous language
  • Family, kinship and community
  • Cultural expression and continuity
  • Self-determination and

This revised edition of the literature review has been published by the Lowitja Institute as part of the project completion process.

Part 2 : The Conclusion

We have highlighted the often complex and overlapping factors that affect Aboriginal and Torres Strait Islander culture and wellbeing.

These factors can operate at the individual or community level. Importantly, we have identified that, while some practices, processes and beliefs are different in the context of Aboriginal and Torres Strait Islander culture, there are some universal elements across Australia and internationally.

We have highlighted in this review that health and more broadly wellbeing appear to be enhanced when cultural elements and culture more broadly is learnt, practiced and incorporated into people’s lives.

While we have likely not produced a succinct definition of culture, as a result of this review we have a better understanding of what things constitute the varying parts of culture for Aboriginal and Torres Strait Islander peoples and how these relate to health and wellbeing.

The authors acknowledge that this review may not include some elements of Indigenous peoples culture however this paper, has for the first time, put in one place the range of factors describing Aboriginal and Torres Strait Islander culture from an Australian and international perspective.

As a result of the extensive search we have been able to list broad domains of culture and a range of sub themes under each broad cultural domain. This is the first time to our knowledge this has been done.

Through the review we have been able to identify quantitative cultural measures that did not currently exist and this enabled the research team identify areas for data development – the creation of new measures for Mayi Kuwayu, the National Study of Aboriginal and Torres Strait Islander Wellbeing.

This review also assisted in informing the modification of existing measures for inclusion in the Study. The Mayi Kuwayu Study commenced data collection in October 2018.

The report was prepared by Minette Salmon, Kate Doery, Phyll Dance, Jan Chapman, Ruth Gilbert, Rob Williams & Ray Lovett

 Part 3 Have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander people  #HaveYourSay about #closingthegapCTG

Aboriginal and Torres Strait Islander people know what works best for us.

We need to make sure Aboriginal and Torres Strait Islander youth voices are reflected and expertise is recognised in every way at every step on efforts to close the gap in life outcomes between Aboriginal and Torres Strait Islander people and other Australians.’

‘The Coalition of Peaks is leading the face to face discussions, not governments.

The Peaks are asking Aboriginal and Torres Strait Islander youth to tell us what should be included in a new Closing the Gap agreement and we will take this to the negotiating table.’

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

NACCHO Aboriginal Health #HaveYourSayCTG #ClosingTheGap New @OxfamAustralia report shows #self-determined First Peoples like our ACCHO’s are In Good Hands : Download HERE

“ Not only will this give First Peoples a sense of empowerment, control and indeed sovereignty, as the case studies in this report show, this approach will also help to address the systemic disadvantage that is a consequence of Australian history.

Sadly, Australia’s current approach lags well behind similar countries in closing the health and well-being gaps endured by First Peoples around the world.

Oxfam Australia is calling on State and Federal governments to empower and fund local Aboriginal and Torres Strait Islander communities and organisations to allow them to build on traditional knowledge and culture when delivering services,” 

National Manager for Oxfam’s First Peoples’ Program, Ngarra Murray, said preferencing Aboriginal organisations was essential in working towards a future underpinned by the principles of self-determination, community-control and effective service delivery to the First Peoples of Australia.

Download the Report HERE 

2019-AP-001-IN_GOOD_HANDS_FINAL_FA_WEB

“We walk and work in two worlds . We have a far better grasp of the issues faced by these communities. We shouldn’t be overlooked because we are an Aboriginal medical service.”

Acting Chief Executive Jo Grant says in the report that Katungul ACCHO staff had a much deeper understanding of the issues facing the Aboriginal people of the region

Government policies that empower local Aboriginal communities and build on traditional knowledge and culture to deliver services generally produce better results and should become the policy norm in Australia, according to a landmark report released today by Oxfam Australia.

The report, In Good Hands, shows how programs that embrace the principle of self-determination have been rolled out extensively in the United States and other countries with similar historical settings, with better outcomes for Indigenous people than those achieved in Australia.

However, the report also demonstrates that successive Australian governments have instead taken a top- down approach and ignored advice from their own experts on how to effectively tackle the systemic disadvantage and poverty that afflicts too many Aboriginal and Torres Strait Islander Australians.

The Oxfam report captures numerous case studies that demonstrate why community-based services are best placed to respond to the complex needs of First Peoples.

The unique network of more than 145 Aboriginal medical services is a prime example of how trusted organisations that are grounded in community and culture deliver results that improve health outcomes – and at the same time can reduce the demand on the hospital system.

The report cites new data showing an impressive 30 per cent reduction in preventable hospitalisations in the region where Katungul Aboriginal Medical Service operates on New South Wales’ south coast in the six years to 2016-17, compared with a rise of 20 per cent for the entire NSW population.

In Western Australia, the Ngalla Maya employment service has placed more than 300 ex-prisoners into jobs by taking an approach that is grounded in traditional culture.

Former prisoner and now Chief Executive Mervyn Eades explained: “The cultural stuff, mentoring, that is the heart of our project.

We talk a lot about culture. A lot of the young ones don’t have identity in heritage and the self-worth in being part of the oldest culture in the world; they haven’t been taught and told, the stories haven’t been handed down to empower them.”

The report highlights that despite these results, many Aboriginal organisations are forced to navigate a never- ending treadmill of grant applications and changing funding streams to keep their lights on and staff paid.

“Oxfam Australia is calling on State and Federal governments to empower and fund local Aboriginal and Torres Strait Islander communities and organisations to allow them to build on traditional knowledge and culture when delivering services,” Ms Murray said.

Have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander mob #HaveYourSay about #closingthegapCTG

Aboriginal and Torres Strait Islander people know what works best for us.

We need to make sure Aboriginal and Torres Strait Islander youth voices are reflected and expertise is recognised in every way at every step on efforts to close the gap in life outcomes between Aboriginal and Torres Strait Islander people and other Australians.’

‘The Coalition of Peaks is leading the face to face discussions, not governments.

The Peaks are asking Aboriginal and Torres Strait Islander youth to tell us what should be included in a new Closing the Gap agreement and we will take this to the negotiating table.’

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

NACCHO #HaveYourSayCTG about #closingthegap on Aboriginal and Torres Strait Islander youth health : #NACCHOYouth19 Registrations Close Oct 20 @RACGP Doctor :Routine health assessments co-created with young Aboriginal and Torres Strait Islander people may soon be adopted by general practice.

Part 1 : Research project ‘Developing, implementing, and testing a co-created health assessment for Aboriginal and Torres Strait Islander young people in primary care’

Part 2 : Registrations close 20 October for the NACCHO Youth Conference Darwin 4 November 

Part 3 : If you cannot get to Darwin  you can still have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander youth

‘General practice needs to think more carefully about the issues facing young people as a distinct group. Better understanding has to start with asking Aboriginal and Torres Strait Islander people about important health priorities, and then listening carefully to the responses.

Once we have listened to community voices on health priorities and co-created the young person’s health assessment, we intend to conduct a pilot randomised trial of the new health assessment looking at outcomes including social and emotional wellbeing, detection of psychological distress and appropriate management and referrals.” 

Dr Geoffrey Spurling first had the idea for his research project ‘Developing, implementing, and testing a co-created health assessment for Aboriginal and Torres Strait Islander young people in primary care’ during a moving experience not so long ago, when he attended the funeral of a young Aboriginal woman who had committed suicide. See Part 1

The project was originally published in the RACGP News GP

Read all NACCHO Youth Articles HERE 

Part 1 ‘Developing, implementing, and testing a co-created health assessment for Aboriginal and Torres Strait Islander young people in primary care’. Continued from intro above

‘It was a profoundly sad experience,’ Dr Spurling told newsGP.

‘At the same time, community members were telling me that social and emotional wellbeing, especially for young people, was a health priority.

‘I wanted to do what I could with my medical and research skills to understand and help address the social and emotional wellbeing issues facing the community.’

It was here that his research project began to take shape.

Dr Spurling, a GP at Inala Indigenous Health Service and senior lecturer at the University of Queensland, was recently granted funds from the National Health and Medical Research Council (NHMRC) to develop his project, ‘Developing, implementing, and testing a co-created health assessment for Aboriginal and Torres Strait Islander young people in primary care’.

Through collaboration with Aboriginal and Torres Strait Islander community members, this research aims to develop and implement a health check especially tailored for young people in these communities.

Current Aboriginal and Torres Strait Islander Medicare health assessments involving adolescents are constructed for 5–14-year-olds and 15–54-year-olds. Dr Spurling believes more focus is needed on the health of young people within the second age group, and a specific health assessment should be implemented.

Following development of the tailored health assessments, Dr Spurling and his team intend to conduct a trial comparing the new health check with the current one available in clinical software, aiming to show better detection and management of social and emotional wellbeing concerns.

‘By creating a youth health assessment together with both young people and clinicians, I hope we can have more relevant conversations about health in general practice within both the specific context of the newly developed young person’s Aboriginal and Torres Strait Islander health assessment, and more broadly in general practice.’

The National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people recommends the Social Emotional Wellbeing (SEW) and HEEADSSS screening tools as part of health assessments for young people.

Investigator Grants is the NHMRC’s largest funding scheme, with a 40% allocation from the Medical Research Endowment Account. The scheme’s objective is to support the research of outstanding investigators at all career stages, providing five-year funding security for high-performing researchers through its salary and research support packages. The 2019 Investigator Grants funding totals $365.8 million.

Part 2 NACCHO Youth Conference Darwin 4 November 

 ” Culturally-appropriate care and safety has a vast role to play in improving the health and wellbeing of our people.

In this respect, I want to make special mention of the proven record of the Aboriginal Community Health Organisations in increasing the health and wellbeing of First Peoples by delivering culturally competent care.

I’m pleased to be here at this conference, which aims to make a difference with a simple but sentinel theme of investing in what works, surely a guiding principle for all that we do

Providing strong pointers for this is a new youth report from the Australian Institute of Health and Welfare.

Equipped with this information, we can connect the dots – what is working well and where we need to focus our energies, invest our expertise, so our young people can reap the benefits of better health and wellbeing “

Minister Ken Wyatt launching AIHW Aboriginal and Torres Strait Islander Adolescent and Youth Health and Wellbeing 2018 report at NACCHO Conference 31 October attended by over 500 ACCHO delegates including 75 ACCHO Youth delegates Pictured above 

Read Download Report HERE

The central focus of the NACCHO Youth Conference Healthy youth, healthy future is on building resilience. For thousands of years our Ancestors have shown great resolve thriving on this vast continent.

Young Aboriginal and Torres Strait Islander people, who make up 54% of our population, now look to the example set by generations past and present to navigate ever-changing and complex social and health issues.

Healthy youth, healthy future provides us with opportunities to explore and discuss issues of importance to us, our families and communities, and to take further steps toward becoming tomorrow’s leaders.

We hope to see you there!

Registrations CLOSE 20 October 

Registrations are now open for the 2019 NACCHO Youth Conference, which will be held November 4th in Darwin at the Darwin Convention Centre

REGISTER HERE

Part 3 Have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander youth #HaveYourSay about #closingthegapCTG

Aboriginal and Torres Strait Islander people know what works best for us.

We need to make sure Aboriginal and Torres Strait Islander youth voices are reflected and expertise is recognised in every way at every step on efforts to close the gap in life outcomes between Aboriginal and Torres Strait Islander people and other Australians.’

‘The Coalition of Peaks is leading the face to face discussions, not governments.

The Peaks are asking Aboriginal and Torres Strait Islander youth to tell us what should be included in a new Closing the Gap agreement and we will take this to the negotiating table.’

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

Aboriginal and Torres Strait Islander Health #WorldMentalHealthDay 2019: NACCHO recognises the foundations are in place to Closing the #MentalHealth Gap, but the work lies ahead. @cbpatsisp @MenziesResearch #ClosingtheGap #HaveyourSayCTG

“Our people experience very high levels of psychological stress at almost three times the rate of other Australians and are twice as likely to commit suicide.

At the heart of suicide is a sense of helplessness and powerlessness, which Aboriginal and Torres Strait Islander people experience across multiple domains in direct response to their intractable circumstances.

Almost all of our people who die of suicide are living below the poverty line.

Our children are four times more likely to kill themselves in comparison with other Australian children.

In 2018, suicide was the leading cause of death for Aboriginal and Torres Strait Islander children, accounting for more than a quarter of all Aboriginal and Torres Strait Islander child deaths.”

NACCHO CEO Pat Turner AM highlighting the most vulnerable victims of this mental health crisis

Read over 230 Aboriginal Mental Health articles published by NACCHO over past 7 years 

Read over 150 Aboriginal Health and Suicide articles published by NACCHO over past 7 years

” Aboriginal and Torres Strait Islander communities will have greater support for their wellbeing with the release of a video in nine Aboriginal languages and in Aboriginal English during Mental Health Week.

Led by Menzies School of Health Research (Menzies) and in collaboration with Indigenous communities, “Yarning About Mental Health:

Becoming Better, Becoming Stronger” aims to support the wellbeing of Indigenous communities by drawing on the strength and resilience of communities to promote mental health and wellbeing

See Menzies Press Release and English video version Part 2 below

Download this NACCHO Press Release in PDF HERE

NACCHO is marking World Mental Health Day by emphasising the importance of the 2019 theme and focus, suicide prevention.

In Australia, the rate of suicide in Aboriginal and Torres Strait Islander communities continues to grow.

NACCHO believes that suicide prevention initiatives must incorporate culturally safe, holistic approaches that are co-designed with communities, and which consider the physical, emotional, spiritual and cultural wellbeing of individuals and families.

Professor Pat Dudgeon, Director of the Centre of Best Practice in Aboriginal and Torres Strait Islander Suicide Prevention Director, said, “The evidence shows that Indigenous cultural strengths already provide an overarching foundation for the national effort ahead. These strengths contribute to what we call our ‘social and emotional wellbeing’. Strong families, strong communities and strong cultures and cultural identity support Aboriginal and Torres Strait Islander mental (and indeed physical) health.”

There is a range of evidence which demonstrates that community-led initiatives, exemplified by the values, beliefs and services of Aboriginal Community Controlled Health Organisations (ACCHOs), are critical for designing programs that strengthen Social and Emotional Wellbeing and promote healing.

Ms Turner stated, “Our ACCHOs deliver culturally safe, trauma-informed services in communities dealing with the extreme social and economic disadvantage that are affected by intergenerational trauma, but they need more support. Our services know what’s happening on the ground, and the help that our communities need and that is why government funding is so vital.”

NACCHO understands harnessing the global momentum on World Mental Health Day is critical to ensure productive and culturally meaningful solutions are resourced and delivered to drive suicide rates down within Aboriginal and Torres Strait communities.

“NACCHO urges the Commonwealth Government to continue providing support for the national suicide prevention trials in 12 communities by looking at the learnings and how they can transition the successful elements into ongoing funding and programs,” Ms Turner stated.

Part 2 : Media Release Menzies School of Health Research : New resource to promote mental health and wellbeing in Indigenous communities featured during Mental Health Week

Aboriginal and Torres Strait Islander communities will have greater support for their wellbeing with the release of a video in nine Aboriginal languages and in Aboriginal English during Mental Health Week.

Led by Menzies School of Health Research (Menzies) and in collaboration with Indigenous communities, “Yarning About Mental Health: Becoming Better, Becoming Stronger” aims to support the wellbeing of Indigenous communities by drawing on the strength and resilience of communities to promote mental health and wellbeing.

The short video provides information about common mental illnesses and delivers strength- based messages about staying strong and seeking help.

According to project lead, Associate Professor Tricia Nagel, releasing the video during Mental Health Week where the focus is on ‘Do you see what I see’, is very appropriate.

“People tell us that story telling in a way that shares strengths and cultural values, and includes local people and language, is the best way to share wellbeing messages – and that is what this video is all about,” A/Prof Nagel said.

“The video describes key mental health concepts and uses imagery designed to resonate with Indigenous people, drawing on connections to country and kin.”

Menzies Indigenous researcher, Jahdai Vigona says the video has been designed for use by wellbeing service providers and within communities to talk about wellbeing and ways to stay strong.

“It makes talking about mental health more accessible and the discussion more relevant to community members,” Mr Vigona said.
The video is now available on YouTube in nine Aboriginal languages and in Aboriginal English here.

The project was supported by funding from the Australian Government through the Primary Health Network Program.

Menzies’ full suite of mental health resources dedicated to Indigenous wellbeing can be found at www.menzies.edu.au/mentalhealthresources

Part 3 : Have your say about mental health / suicide prevention and what is needed to make real change in the lives of Aboriginal and Torres Strait Islander people #HaveYourSay about #closingthegap

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

NACCHO Aboriginal Health @AIDAAustralia News : The @AMAPresident Dr Tony Bartone speech opening #AIDAConf2019 : We must use collective wisdom and advocacy to ensure that #ClosingtheGap is not just words, but a meaningful and deliverable target. #HaveYourSayCTG

 

 “ The basic principles of successful Indigenous healthcare models should be better promoted as exemplars and replicated across the country.

This will support Aboriginal and Torres Strait Islander people to translate their knowledge into innovative practices that will help solve intractable health problems in their communities.

Governments at all levels must ensure that policy frameworks move towards harmonisation with norms recognising the autonomy of Aboriginal and Torres Strait Islander people.

Governments must ensure that these frameworks are bolstered with adequate funding and workforce strategies to enable Indigenous communities to succeed in their pursuit of the right to health and wellbeing.

With the right support, Aboriginal and Torres Strait Islander people stand to address health inequities by transforming services under their purview, as well as health services provided to Indigenous people by the mainstream.

As President of the AMA, I will continue to ensure that Aboriginal and Torres Strait Islander health is a key priority.”

President of the AMA Dr Tony Bartone opening speech

Photo above : Opening of #AIDAConf2019 a Welcome to Country from Larrakia Dr Jessica King. MC Jeff McMullen, keynotes  AIDA President Dr Kris Rallah-Baker, NLC CEO Marion Scrymgour, Danila Dilba ACCHO Olga Havnen, Dr Tony Bartone

I would like to begin by acknowledging the traditional owners and custodians of the land on which we meet today, and I pay my respects to their elders, past and present.

Thank you to the Australian Indigenous Doctors’ Association (AIDA) for inviting me to speak at your annual conference. This is my third year attending, and I feel very privileged to be here.

The theme for this year’s Conference is ‘Disruptive Innovations in Health Care’.

As a General Practitioner who has been practising medicine for over 30 years, I well and truly understand that innovative health care is needed to achieve improved outcomes for patients.

Indeed, innovation will be crucial as we deal with a health system that is so under strain.

This is especially true for Indigenous health, given the much higher burden of disease and mortality rates among Aboriginal and Torres Strait Islander people, and the need for care to be delivered in a manner that is culturally safe.

We all know that Indigenous health statistics paint a bleak picture.

And we all know that Aboriginal and Torres Strait Islander people have poorer health than other Australians.

Medical science is constantly evolving and we have, only in recent times, recognised the innovations and practices of Indigenous people here and overseas.

There are some parallels and similarities in the way Australia and Canada – both former British colonies – are trying to improve health care for First Nations peoples.

In both countries, we are trying to address a legacy of harm from the imposition of policies that resulted in poor health today.

Sadly, investments in Indigenous health are often inadequate, and they are implemented without proper engagement with, and direction by, Aboriginal and Torres Strait Islander people.

We all know that this approach does not work.

However, I know that there are many innovative health services that are delivering high quality health care for their communities, driven by local leadership.

There are models of health care that are delivering proved health outcomes for Aboriginal and Torres Strait Islander people, and these should be supported in terms of funding and workforce.

I was fortunate to visit one such model last year and see first-hand just one example of quality health services and witness the important work that they do.

There are others all underpinned by community oversight and direction. This sense of community leadership is a key feature.

I am sure you will hear of many more positive and innovative healthcare models throughout this Conference.

The problem with such models is that they are not being sufficiently resourced and funded to continue and further their development.

The basic principles of successful Indigenous healthcare models should be better promoted as exemplars and replicated across the country.

This will support Aboriginal and Torres Strait Islander people to translate their knowledge into innovative practices that will help solve intractable health problems in their communities.

Governments at all levels must ensure that policy frameworks move towards harmonisation with norms recognising the autonomy of Aboriginal and Torres Strait Islander people.

Governments must ensure that these frameworks are bolstered with adequate funding and workforce strategies to enable Indigenous communities to succeed in their pursuit of the right to health and wellbeing.

With the right support, Aboriginal and Torres Strait Islander people stand to address health inequities by transforming services under their purview, as well as health services provided to Indigenous people by the mainstream.

As President of the AMA, I will continue to ensure that Aboriginal and Torres Strait Islander health is a key priority.

I am very proud to lead an organisation that champions Aboriginal and Torres Strait health care.

This is demonstrated through:

  • the AMA’s Taskforce on Indigenous Health, which I am honoured to Chair;
  • having AIDA represented on the AMA’s Federal Council;
  • producing an annual Report Card on Indigenous Health;
  • supporting more Aboriginal and Torres Strait Islander people to become doctors through our Indigenous Medical Scholarship initiative;
  • participation in the Close the Gap Steering Committee; and
  • participation in the END Rheumatic Heart Disease Coalition, among many other things.

 See all NACCHO and AMA Articles HERE 

The AMA also supports the Uluru Statement from the Heart, and is encouraging the Australian Parliament to make this a national priority.

I firmly believe that giving Aboriginal and Torres Strait Islander people a say in the decisions that affect their lives will allow for healing through recognition of past and current injustices.

The AMA believes respecting the decisions and directions of Aboriginal and Torres Strait Islander people should underpin all Government endeavours to close the health and life expectancy gap.

The AMA is pleased to see the agreement between the Council of Australian Governments and a Coalition of Peak Aboriginal and Torres Strait Islander organisations – an historic partnership to oversee the refresh of the Closing the Gap strategy.

See Coalition of Peaks Press Release this week

But this is not enough.

We must use this collective wisdom and advocacy to ensure that Closing the Gap is not just words, but a meaningful and deliverable target.

This is certainly an innovative approach to improving health and life outcomes for Indigenous Australians.

Since the beginning of the Closing the Gap strategy, progress has been mixed, limited, and, overall, disappointing.

This must change. It has to change.

It is simply unacceptable that year in, year out, we see the same gaps and the same shortfalls in funding and resources.

I hope that the partnership between COAG and the Coalition of Peaks will result in some real, meaningful change. It must.

Governments cannot keep promising to improve health and other services and not deliver on their commitments.

The AMA welcomed the stated intent of the Minister for Indigenous Australians, Ken Wyatt, to hold a referendum on Constitutional recognition for Indigenous peoples.

And I was disappointed by his recent announcement that an Indigenous voice to Parliament enshrined in the Constitution would not be included as part of this process.

Ken Wyatt has achieved a tremendous amount in his time as Minister, and I hope that Constitutional recognition is part of his legacy.

Let me conclude by saying that it is our responsibility as doctors to ensure that Aboriginal and Torres Strait Islander people can enjoy the same level of good health as their non-Indigenous peers – that they are able to live their lives to the fullest.

The AMA recognises that Indigenous doctors are critical to making real change in Indigenous health, as they have the unique ability to align their clinical and cultural expertise to improve access to services and provide culturally safe care.

The Indigenous medical workforce is steadily growing, but we need more Indigenous doctors. And dentists, nurses, social workers, and all other allied health specialists.

The AMA remains committed to working in partnership with Aboriginal and Torres Strait Islander people to advocate for better Government investment and cohesive, coordinated strategies to improve health outcomes.

Thank you, and I wish you the very best for your Conference.

 Part 2  Have your say about what is needed to make real change in the lives of Aboriginal and Torres Strait Islander people #HaveYourSay about #closingthegap

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

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: