NACCHO Aboriginal Health and Food security #IndigenousNCDs : Welfare reform is targeting many remote-living Aboriginal people impoverishing them and resulting in the consumption of unhealthy foods that are killing them prematurely from non-communicable diseases

What national and average Closing the Gap figures do not tell us is just how badly the estimated 170,000 Indigenous people in remote and very remote Australia are faring. This region where I focus my work covers 86 per cent of the Australian continent.

In the last decade new race-based instruments have been devised to regulate Indigenous people including their forms of expenditure (via income management), forms of working via the Community Development Programme (CDP) and their places of habitation, where they might access basic citizenship services.

All these measures have implications for consumption of market commodities, including food from shops, and of customary non-market goods, including food from the bush.

Owing to deep poverty, many people can only purchase relatively cheap and unhealthy takeaway foods that are killing them prematurely from non-communicable diseases, like acute heart and kidney disorders, followed by lung cancer from smoking.

With income management Aboriginal people are being coerced to shop at stores according to the government’s rhetoric for their ‘food security’. Before the introduction of this regime many more people were exercising their ‘food sovereignty’ right to harvest far healthier foods from the bush.

Extracts from Jon Altman a research professor in anthropology at the Alfred Deakin Institute for Citizenship and Globalisation at Deakin University, Melbourne.

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A version of this article was first published in the Land Rights News

READ over 5 Articles NACCHO Aboriginal Health and Nutrition 

READ Articles NACCHO Aboriginal Health and Welfare Card 

” NACCHO is strongly opposed to the current cashless debit card trials as well as any proposal to expand. We also note that Aboriginal people are disproportionately affected by the trials and that they are in and proposed for locations where the majority participants are Aboriginal. Whilst it is not the stated intent of the trials, its impact is discriminatory.

NACCHO knows that some Aboriginal people and communities need additional support to better manage their lives and ensure that income support funds are used more effectively.

However, NACCHO is firmly of the view that there are significantly better, more cost efficient, alternative approaches that support improvements in Aboriginal wellbeing and positive decision making.

Aboriginal Community Controlled Health Services would be well placed to develop and implement alternative programs. We firmly believe that addressing the ill health of Aboriginal people, including the impacts of alcohol, drug and gambling related harm, can only be achieved by local Aboriginal people controlling health care delivery.

We know that when Aboriginal and Torres Strait Islander people have a genuine say over our lives, the issues that impact on us and can develop our own responses, there is a corresponding improvement in wellbeing. This point is particularly relevant given that the majority of trial participants are Aboriginal. “

Selected extracts from Submission to the Senate Community Affairs Legislation Committee Inquiry into the Social Services Legislation Amendment (Cashless Debit Card Trial Expansion) Bill 2018 

Download HERE 

NACCHO submission on cashless debit card final

As is the case in many countries, Indigenous people in Australia, New Zealand, United States of America and Canada are disproportionately affected by NCDs.

Diabetes, cardiovascular disease, cancer,  smoking related lung disease and mental health conditions are the five main NCDs identified by the World Health Organisation (WHO), and these are almost uniformly experienced by Indigenous peoples at higher rates than other people.

Indigenous people globally are disproportionately affected by diabetes. In Australia, Aboriginal and Torres Strait Islander peoples are 6 times more likely than the non-Indigenous population to die from diabetes. In Canada, Indigenous peoples are 3-5 times more likely to have diabetes than other citizens.

Indigenous people are also more likely to have Cardiovascular disease. Cardiovascular disease accounts for almost a quarter of the mortality gap between Aboriginal and Torres Strait Islander peoples and other Australians. Maori people are 3-4.2 times more likely to die from cardiovascular disease than other people in New Zealand.

These numbers are not improving, despite national rates of smoking decreasing, and increased social marketing aimed at reducing sugar consumption and increasing physical activity.

Mainstream solutions do little to reduce the burden of NCDs for Indigenous populations. The broader social determinants of health have a huge role to play, and until these are addressed in a meaningful way, Indigenous peoples will continue to experience an inequitable burden.

With colonisation having had a devastating impact on Indigenous peoples, and mainstream solutions unable to significantly reduce the rates of NCDs experienced by Indigenous peoples, a new paradigm is urgently required.

What is required is not more state based solutions but Indigenous led solutions.

Summer May Finlay Croakey 

Welfare reform is targeting many remote-living Aboriginal people impoverishing them and resulting in the consumption of unhealthy foods that are killing them prematurely from non-communicable diseases

Rome (Canberra) continues to fiddle while Black Australia burns. Professor Jon Altman weighs in on the ongoing disasters of government policy that have a tight grip on remote living Indigenous people.

In the last month I participated in two workshops. I used what I observed on my latest visit to Arnhem Land and what people were telling me to inform what I presented at the workshops.

The first workshop explored issues around excessive consumption by industrialised societies globally and how this is harming human health and destroying the planet. Workshop participants asked how such ‘consumptogenic’ systems might be regulated for the global good? My job was to provide a case study from my research on consumption by Indigenous people in remote Australia.

The second workshop looked at welfare reform in the last decade in remote Indigenous Australia. In this workshop I looked at how welfare reform by the Australian state after the NT Intervention was creatively destroying the economy and lifeways of groups in Arnhem Land who are looking to live on their lands and off its natural resources.

Here I want to share some of what I said.

BROADLY speaking Indigenous policy in remote Australia is looking to do two things.

The first is to Close the Gaps so that Indigenous Australians can one future day have the same socio-economic status as other Australians. In remote Australia this goal is linked to the project to ‘Develop the North’ via a combination of opening Aboriginal communities and lands to more market capitalism and extraction, purportedly for the improvement of disadvantaged Indigenous peoples and land owners.

While remote-living Indigenous people have economic and social justice rights to vastly improved wellbeing, in such scenarios of future economic equality based on market capitalism, the downsides of what I think of as ‘consumptomania’ are never mentioned.

The second aim of policy is the extreme regulation of Indigenous people and their behaviour, when deemed unacceptable. In a punitive manifestation of neoliberal governmentality, the Australian state, and its nominated agents, are looking to morally restructure Indigenous people to transform them into model citizens: hard-working, individualistic, highly educated, nationally mobile at least in pursuit of work (not alcohol), and materially acquisitive.

This paternalistic project of improvement makes no concessions whatsoever to cultural difference, colonial history of neglect, connection to country, discrimination, and so on.

In the last decade new race-based instruments have been devised to regulate Indigenous people including their forms of expenditure (via income management), forms of working via the Community Development Programme (CDP) and their places of habitation, where they might access basic citizenship services.

All these measures have implications for consumption of market commodities, including food from shops, and of customary non-market goods, including food from the bush.

We have all heard the bad news, year after year, report after report, that the government-imposed project of improvement, called ‘Closing the Gap’ and introduced by Kevin Rudd in 2008, is failing.

Using the government’s own statistics, after 10 years only one target, year 12 attainment, might be on track. I say ‘might’ because ‘attainment’ is open to multiple interpretations: is attainment just about attendance or about gaining useful life skills?

What national and average Closing the Gap figures do not tell us is just how badly the estimated 170,000 Indigenous people in remote and very remote Australia are faring. This region where I focus my work covers 86 per cent of the Australian continent.

What we are seeing in this massive part of Australia according to the latest census are the very lowest employment/population ratios of about 30 per cent for Indigenous adults (against 80% for non-Indigenous adults) and the deepest poverty, more than 50 per cent of people in Indigenous households currently live below the poverty line.

This is also paradoxically where Indigenous people have most land and native title rights, a recent estimate suggests that 43 per cent of the continent has some form of indigenous title; and is dotted with maybe 1000 small Indigenous communities with a total population of 100,000 at most.

Native title rights and interests give people an unusual and generally unregulated right to use natural resources for domestic consumption.

This form of consumption might include hunting kangaroos or feral animals like the estimated 100,000 wild buffalo in Arnhem Land.

Such hunting is good for health because the meat is lean and fresh; it is also good for the environment because buffalo eat about 30kg of vegetation a day and are environmentally destructive; and it is good for global cooling because each buffalo emits methane with a carbon equivalent value of about two tonnes per annum.

The legal challenge of gaining native title rights and interests is that claimants must demonstrate continuity of customs and traditions and connection to their claimed country. But in remote Australia, culture and tradition have been identified as a key element of the problem that is exacerbating social dysfunction. (That is unless tradition appears as fine art ‘high culture’ which is imagined to be unrelated to the everyday culture and is a favourite item for consumption by metropolitan elites.)

Hence the project of behavioural modification to eradicate Indigenous cultures that exhibit problematic characteristics, like sharing and a focus on kinship and reciprocity, to be replaced by western culture with its high consumption, individualistic and materially acquisitive characteristics.

Connection to country, at least if it involves living on it, is also deemed highly problematic by the Australian state if one wants to produce western educated, home-owning, properly disciplined neoliberal subjects — terra nulliusis now to be replaced by terra vacua, empty land.

Such empty land would be ripe for resource extraction and capitalist accumulation by dispossession Despite all the talk of mining on Aboriginal land, there are currently very few operating mines on the Indigenous estate. This is imagined as one means to Develop the North, but recent history suggests that the long-term benefits to Aboriginal land owners from such development will be limited.

MUCH of what I describe above in general terms resonates with what I have observed in Arnhem Land where I have visited regularly since the Intervention; and what I hear from Aboriginal people and colleagues working elsewhere in remote Indigenous Australia.

From 2007 to 2012 all communities in Arnhem Land were prescribed under NT Intervention laws. Since 2012, under Stronger Futures laws legislated in force until 2022, the Aboriginal population has continued to be subject to a new hyper-regulatory regime: income management, government-licenced stores, modern slavery-like compulsory work for welfare, enhanced policing, unimaginable levels of electronic and police surveillance, school attendance programs and so on.

The limited availability of mainstream work in this region as elsewhere means that most adults of working age receive their income from the new Community Development Program introduced in 2015. Weekly income is limited to Newstart ($260) for which one must meet a work requirement of five hours a day, five days a week if aged 18-49 years and able-bodied.

Of this paltry income, 50 per cent is quarantined for spending at stores where prices are invariably high, owing to remoteness.

The main aim of such paternalism is to reduce expenditure on tobacco and alcohol which cannot be purchased with the BasicsCard.

Shop managers that I have interviewed tell me that despite steep tax-related price rises (a pack of Winfield blue costs nearly $30) tobacco demand is inelastic and sales have not declined.

Since the year 2000, Noel Pearson has popularised his metaphor ‘welfare poison’. Pearson is referring figuratively to what he sees as the negative impacts of long-term welfare dependence. In Arnhem Land welfare is literally a form of poison because in the name of ‘food security’ people are forced to purchase foods they can afford with low nutritional value from ‘licenced’ stores.

However, paternalistic licencing to allow stores to operate the government-imposed BasicsCard is not undertaken equitably by officials from the Department of Prime Minister and Cabinet.

So one sees large, long-standing, community-owned and operated and mainly Indigenous staffed stores being rigorously regulated, managers argue over-regulated. Such stores are highly visible, as are their accounts.

But small private-sector operators (staffed mainly by temporary visa holders and backpackers) that have been established as the regional economy has been prised open to the free market appear under-regulated, even though they are also ‘licenced’ to operate the BasicsCard.

These private sector operators compete very effectively with community-owned enterprises because they only have a focus on commerce: all the profits they make and most of the wages they pay non-local staff leave the region.

Owing to deep poverty, many people can only purchase relatively cheap and unhealthy takeaway foods that are killing them prematurely from non-communicable diseases, like acute heart and kidney disorders, followed by lung cancer from smoking.

With income management Aboriginal people are being coerced to shop at stores according to the government’s rhetoric for their ‘food security’. Before the introduction of this regime many more people were exercising their ‘food sovereignty’ right to harvest far healthier foods from the bush.

This dramatic transformation has occurred as an unusual form of regional economy that involved a high level of customary activity has been effectively destroyed by the dominant government view that only prioritises engagement in market capitalism — that is largely absent in this region.

On one hand, we now see the most able-bodied hunters required to work for the dole every week day with their energies directed from what they do best.

On the other hand, the greatly enhanced police presence is resulting simultaneously in people being deprived of their basic equipment for hunting — guns and trucks — regularly impounded because they are unregistered or their users unlicenced.

People are being increasingly isolated from their ancestral lands and their hunting grounds.

Excessive policing, growing poverty, dependency and anomie are seeing criminality escalate with expensive fines for minor misdemeanours further impoverishing people and reducing their ability to purchase either more expensive healthy foods or the means to acquire bush foods.

A virtuous production cycle that until the Intervention saw much ‘bush food consumption’ has been disastrously reversed. Today, we see a vicious cycle where people regularly report hunger while living in rich Australia; people’s health status is declining.

Welfare reform and Indigeneity is indeed a toxic mix, poison, in remote regions like Arnhem Land.

I WANT to end with some more general conclusions.

On the regulation of Indigenous expenditure, we see a perverse policy intervention: the Australian government is committing what are sometimes referred to as Type 1 and Type 2 errors.

The former sees the government looking to regulate Indigenous consumption using the expensive instrument of income management that has cost over $1.2 billion to date, despite no evidence that it makes a difference.

The latter sees an absence of the proper regulation of supply in licences stores evident when stores with names like ‘The Good Food Kitchen’ sell cheap unhealthy take-aways.

In my view the racially-targeted and crude attempts to regulate Indigenous expenditure are unacceptable on social justice grounds.

Two principles as articulated by Guy Standing stand out.

‘The security difference principle’ suggests that a policy is only socially just if it improves the [food]security of the most insecure in society. Income management and work for the dole do not do this.

And ‘the paternalism test’ suggests that a policy like income management would only be socially just if it does not impose controls on some groups that are not imposed on the most-free groups in society.

Paternalistic governmentality in remote Australia is imposing tight regulatory frameworks on some people, even though the justifying ideology suggests that markets should be free and unregulated.

Sociologist Loic Wacquant in  Punishing the Poor shows how the carceral state in the USA punishes the poor with criminalisation and imprisonment; the poor there happen to be mainly black.

In Australia, punitive neoliberalism punishes those remote living Aboriginal people who happen to be poor and dependent on the state.

Once again there is a perversity in policy implementation.

Hence in Arnhem Land, people maintain strong vestiges of a hunter-gatherer subjectivity that when combined with deep poverty makes them avid consumers of western commodities that are bad for health (like tobacco that is expensive and fatty, sugary takeaway food that is relatively cheap).

At the same time commodities that might be useful to improve health, like access to guns and trucks essential for modern hunting, are rendered unavailable by a combination of poverty and excessive policing.

Australian democracy that is founded on notions of liberalism needs to be held to account for such travesties.

Long ago in 1859, John Stuart Mill, the doyen of liberals, wrote in  On Liberty: “…despotism is a legitimate form of government in dealing with barbarians, providing the end be their improvement and the means justified by actually effecting that end”.

In illiberal Australia today, authoritarian controls over remote living Indigenous people and their behaviour are again viewed as legitimate by the powerful now neoliberal state, even though there is growing evidence from remote Australia that things are getting worse.

I want to end with some suggested antidotes to the toxic mix that has resulted from welfare reform that is targeting many remote-living Aboriginal people and impoverishing them.

First, in my view despotism for some is never legitimate, so people should be treated equally irrespective of their ethnicity or structural circumstances.

Second, the Community Development Programme is a coercive disaster that is far more effective at breaching and penalising the jobless for not complying with excessive requirements than in creating jobs. CDP is further impoverishing people and should be replaced, especially in places where there are no jobs, with unconditional basic income support.

Third, people need to be empowered to find their own solutions to the complex challenges of appropriate development that accord with their aspirations, norms, values, and lifeways. Devolutionary principles of self-government and community control, not big government and centralised control, are needed.

Fourth, the native title of remote living people should be protected to ensure that they benefit from all their rights and interests. There is no point in legally allocating property rights in natural resources valuable for self-provisioning if people are effectively excluded from access to their ancestral lands and the enjoyment of these resources.

Finally, governments should support what has worked in the past to improve people’s diverse culturally-informed views about wellbeing and sense of worth.

While such an approach might not close some imposed ‘closing the gap’ targets, like employment as measured by standard western metrics, it will likely improve other important goals like reducing child mortality and enhancing life expectancy and overall quality of life.



NACCHO Aboriginal Health : Download @CSIROnews #FutureofHealth Report that provides a new path for national healthcare delivery, setting a way forward to shift the system from illness treatment, to #prevention.

Australians rank amongst the healthiest in the world with our health system one of the most efficient and equitable. However, the nation’s strong health outcomes hide a few alarming facts: 

  • There is a 10-year life expectancy gap between the health of non-Indigenous Australians and Aboriginal and Torres Strait Islander people
  • Australians spend on average 11 years in ill health – the highest among OECD countries
  • 63% (over 11 million) of adult Australians are considered overweight or obese
  • 60% of the adult population have low levels of literacy 
  • The majority of Australians do not consume the recommended number of serves from any of the five food groups.

From CSIRO Future of Health report

Download HERE full 60 Page Report NACCHO INFO FutureofHealthReport_WEB_180910

The CSIRO Future of Health report provides a list of recommendations for improving the health of Australians over the next 15 years, focussed around five central themes: empowering people, addressing health inequity, unlocking the value of digitised data, supporting integrated and precision health solutions, and integrating with the global sector.

CSIRO Chief Executive Dr Larry Marshall said collaboration and coordination were key to securing the health of current and future generations in Australia, and across the globe.

“It’s hard to find an Australian who hasn’t personally benefitted from something we created, including some world’s first health innovations like atomic absorption spectroscopy for diagnostics; greyscale imaging for ultrasound, the flu vaccine (Relenza); the Hendra vaccine protecting both people and animals; even the world’s first extended-wear contact lenses,” Dr Marshall said.

“As the world is changing faster than ever before, we’re looking to get ahead of these changes by bringing together Team Australia’s world-class expertise, from all sectors, and the life experiences of all Australians to set a bold direction towards a brighter future.”

The report highlighted that despite ranking among the healthiest people in the world, Australians spent on average of 11 years in ill health – the highest among OECD countries.

Clinical care was reported to influence only 20 per cent of a person’s life expectancy and quality of life, with the remaining 80 per cent relying on external factors such as behaviour, social and economic support, and the physical environment.

“As pressure on our healthcare system increases, costs escalate, and healthy choices compete with busier lives, a new approach is needed to ensure the health and wellbeing of Australians,” CSIRO Director of Health & Biosecurity Dr Rob Grenfell said.

The report stated that the cost of managing mental health related illness to be $60 billion annually, with a further $5 billion being spent on managing costs associated with obesity.

Health inequities across a range of social, economic, and cultural measures were found to cost Australia almost $230 billion a year.

“Unless we shift our approach to healthcare, a rising population and increases in chronic illnesses such as obesity and mental illness, will add further strain to the system,” Dr Grenfell said.

“By shifting to a system focussed on proactive health management and prevention, we have an exciting opportunity to provide quality healthcare that leaves no-one behind.

“How Australia navigates this shift over the next 15 years will significantly impact the health of the population and the success of Australian healthcare organisations both domestically and abroad.”

CSIRO has been continuing to grow its expertise within the health domain and is focussed on research that will help Australians live healthier, longer lives.

The Future of Health report was developed by CSIRO Futures, the strategic advisory arm of CSIRO.

More than 30 organisations across the health sector were engaged in its development, including government, health insurers, educators, researchers, and professional bodies.

Australia’s health challenges:

  • Australians spend on average 11 years in ill health – the highest among OECD countries.
  • 63 per cent (over 11 million) of adult Australians are considered overweight or obese.
  • There is a 10-year life expectancy gap between the health of non-Indigenous Australians and Aboriginal and Torres Strait Islander peoples.
  • 60 per cent of the adult population have low levels of health literacy.
  • The majority of Australians do not consume the recommended number of serves from any of the five food groups.

The benefits of shifting the system from treatment to prevention:

  • Improved health outcomes and equity for all Australians.
  • Greater system efficiencies that flatten the cost curve of health financing.
  • More impactful and profitable business models.
  • Creation of new industries based on precision and preventative health.
  • More sustainable and environmentally friendly healthcare practices.
  • More productive workers leading to increased job satisfaction and improved work-life balance.

More info :

NACCHO Aboriginal Children’s Health : Dr @SandroDemaio presents a five-point policy plan using a lifeSPANS approach to address child obesity in Australia: #NCDs #EnoughNCDs @FAREAustralia @AHPA_AU @SaxInstitute


” The answer to obesity will never be in telling people what to do, guilting them for making unhealthier choices in a confusing consumption landscape, or by simply banning things. We also know that education and knowledge will get us only so far.

The real answers lie not even in inspiring populations to make hundreds of healthier decisions each and every day in the face of a seductively obesogenic, social milieu.

If we are to drive long‐term, sustained and scalable change, we must tweak the system to ensure those healthier choices become the path of least resistance—and eventually preferred. And I believe we must focus, initially, on our kids.

It is time for a lifeSPANS approach to addressing obesity in Australia.”

Dr Alessandro Demaio ” A $100 Million question ” see Bio in full Part 2

Download this Paper HERE : Demaio-2018-Health_Promotion_Journal_of_Australia

Listen to Dr Sandro’s childhood obesity Podcast HERE 

  ” The 2012-13 Health Survey identified that Indigenous adults were 1.6 times as likely to be obese as non-Indigenous Australians, with the prevalence increasing more rapidly in Aboriginal school-aged children.

Overweight and obesity in childhood are important predictors of adult adiposity, increasing the risk of developing a range of medical conditions, each of which is a major cause of morbidity, mortality and health expenditure.

While it is surprisingly clear what needs to be done to improve the health of Indigenous children, recent cuts to Indigenous preventative workforce and nutrition programs throughout Australia have severely reduced the capacity to respond.

Comprehensive primary health care is a key strategy for improving the health of Indigenous Australians and is an important platform from which to address complex health and social issues associated with obesity.

Closing the Gap, including the gap attributable to obesity, requires ensuring the ACCHS sector is resourced to deliver the full range of core services required under a comprehensive and culturally safe model of primary health care.

The effectiveness of ACCHSs has long been recognised, with many able to document better health outcomes than mainstream services for the communities they serve. “

Extract from NACCHO Network Submission to the Select Committee’s Obesity Epidemic in Australia Inquiry. 

Download the full 15 Page submission HERE

Obesity Epidemic in Australia – Network Submission – 6.7.18

Compelling populations, individuals or even ourselves to act pre‐emptively on the urgent and massive challenges of tomorrow is notoriously difficult.

The concept is called temporal or future discounting, and it is well documented.1 It is the idea that we prioritise our current comfort and happiness over our future and seemingly distant safety or wellbeing.

This psychological shortcoming plays out in many ways. At the micro level, we may defer until next week what we should do today—that run, drinking more water or the dentist check‐up—as it may not reap benefits for months, or ever. Eventually, we may act on some of these but whether delayed, deferred or denied, it can reap serious health consequences.

At the macro level, it becomes even more problematic. When we combine this “delay what’s beyond tomorrow” phenomenon with short‐term political cycles in the context of systems‐based, slowly evolving and largely invisible future threats, important but not yet imminent issues are not just postponed, but ignored.

Few challenges are a greater threat to the health of Australians, nor better define future discounting, than obesity. At the individual level and in our modern, obesogenic societies, weight gain has become the norm—the biological and social path of least resistance.

Food systems have shifted from a focus on seasonal, fresh and relatively calorie‐poor staples with minimal processing or meat, to an environment where junk foods and processed foods are ubiquitous, heavily advertised, hugely profitable and, for many communities, the only feasible “choice”.

Poor nutrition is now the leading risk factor for disease in our country.2City living has come with benefits, but along with an increasingly automated and digitalised lifestyle, has seen physical activity become something we must seek out, rather than an unavoidable component of our daily lives. Factors such as these have made individual action difficult for most of us and combined with our biology, have contributed to obesity rates more than doubling in Australia since 1980 alone.3

At the policy level, a dangerous, pernicious and unhealthy status quo has evolved over decades. One which sees a population increasingly affected by preventable, chronic disease. One which can only be solved through difficult decisions from politicians and the public to make the short‐term, passive but unhealthy comfort harder; and the long‐term promise of wellbeing more attractive.

One which must see sustained public demand and political commitment for a distant goal and best scenario of nil‐effect, in the face of constant, coordinated and powerful pushback, threats and careful intimidation from largely unprecedented policy counter‐currents.

But opportunities do exist; levers throughout this gridlocked policy landscape that can be utilised to move the obesity agenda forward.

One of those is our kids.

We know that if we cannot prevent obesity in our children, those young Australians will likely never achieve wellbeing.

We know that one in four of our children is overweight or obese and that while 5% of healthy weight kids become obese adults, up to 79% obese children will never realise a healthy weight.45 We know that the school years are a time when major weight gain occurs in our lifecourse and almost no one loses weight as they age.6

Recent evidence suggests early, simple interventions not only reduce weight and improve the health for our youngest kids, but also reduce weight in their parents.78 An important network of effective implementation platforms and primed partners already exist in our schools and teachers around the nation.

Finally, a large (but likely overstated) proportion of Australians may call “nanny state” at even the whiff of effective policies against obesity, but less so if those policies are aimed at our children.

With this in mind, I was recently invited to Canberra to present on how I would spend an extra $100 million each year on preventive health for the nation.

This is the five‐point policy plan I proposed; a lifeSPANS approach to addressing child obesity—and with it, equipping a new generation of Australians to act on tomorrow’s risks, today. This is an evidence‐based package to reduce the major sources of premature deaths, starting early.


  • $3 million to support the revision and implementation of clear, mandatory guidelines on healthy food in school canteens
  • $3 million to coordinate and support the removal of sales of sugary drinks
  • $13 million to expand food and nutrition programs to remaining primary schools
  • $40 million as $5000‐10 000 means‐tested grants for infrastructure that supports healthy eating and drinking in primary schools
  • $130 million to cover 1.7 million daily school breakfasts for every child at the 6300 primary schools nationally910
  • $140 million left from sugary drink tax revenue for school staffing and programs for nutrition and physical activity

Schools alone cannot solve the child obesity epidemic; however, it is unlikely that child obesity rates can be reversed without strong school‐based policies to support healthy eating and physical activity. Children and adolescents consume 19%‐50% of daily calories at school and spend more time there than in any other environment away from home.11 Evidence suggests that “incentives” are unlikely to result in behaviour change but peer pressure might.12 Therefore, learning among friends offers a unique opportunity to positively influence healthy habits.

Trials have demonstrated both the educational and health benefits of providing free school meals, including increased fruit and vegetable consumption, knowledge of a healthy diet, healthier eating at home and improved school performance. Providing meals to all children supports low‐income families and works to address health inequalities and stigma.10

School vending machines or canteens selling sugary drinks and junk foods further fuel an obesogenic, modern food environment. Sugary drinks are the leading source of added sugar in our diet in Australia and are considered a major individual risk factor for non‐communicable diseases, such as type 2 diabetes.13 Removing unhealthy foods and drinks from schools would support children, teachers and parents and send a powerful message to communities about the health harms of these products.

Finally, it is not only about taking things away but also supporting locally driven programs and the school infrastructure to support healthier habits. Drinking fountains, play equipment and canteen hardware could all be supported through small grants aimed at further empowering schools as decisions makers and agents for healthier kids.


  • 20% increase in sugary drinks pricing with phased expansion to fast foods over three years, unlocking approximately $400 million in annual revenue to add to existing $100 million for prevention
  • More than $600 million in annual health savings expected from sugary drinks price increase of 20%
  • $10 million for social marketing campaigns to explain the new policy measures, and benefits to community
  • Compensation package for farmers and small retailers producing and selling sugary drinks (cost unknown but likely small)
  • Such legislation would also support industry to reformulate or reshape product portfolios for long‐term market planning

Today’s food environment sees increased availability of lower cost, processed foods high in salt, fats and added sugars.14 People have less time to prepare meals and are influenced by aggressive food marketing. This leads to food inequality with those from low socioeconomic backgrounds at greater risk from obesity. Obesity increases the risks of cardiovascular disease, type 2 diabetes, stroke, cancer, mental health issues and premature death.15 There are also wider societal and economic costs amounting to an estimated $8.6 billion spent in the health sector alone annually.16

Food prices should be adjusted in relation to nutritional content. Policy makers must shift their pricing focus to integrate the true societal cost of products associated with fiscally burdensome disease. In 2016, a WHO report highlighted that a 20% increase in retail price of sugary drinks lowers consumption as well as obesity, type 2 diabetes and tooth decay.17

The landmark peso per litre sugar tax from Mexico highlighted the behaviour change potential such policies possess. Sales of higher priced beverages decreased substantially in subsequent years. Importantly, the most significant decreases occurred among the poorest households.18 For Australia, a similar approach is estimated to lead to $609 million in annual health savings and raise $400 million in direct revenue.16

These legislative approaches should be framed as an expansion of our existing GST and would encourage industry to reformulate products, positively influencing the food environment.131517

This is not a sin tax or ban, it is an effective policy and pricing that is fair to families. It is also backed by evidence and supported by the public.19


  • End all junk food marketing to children, and between 6 am and 10 pm on television
  • End the use of cartoons on any food or drink packaging
  • $30 million to replace junk food sponsorship of sport and arts events with healthy messaging and explanation of lifeSPANS policy approach
  • Phased expansion of advertising ban over three years to all non‐essential foods (GST language)

The food industry knows that marketing works, otherwise they would not spend almost $400 million annually on advertisements in Australia alone.20

Three of four commercial food advertisements are for unhealthy products and evidence suggests that food advertising triggers cognitive processes that influence our food choices, similar to those seen in addiction. Studies also demonstrate that food commercials including the use of cartoons influence the amount of calories that children consume and the findings are particularly pronounced in overweight children.21

Fast food advertising at sporting and arts events further reinforces a dangerous and confusing notion that sees the direct association between societal heroes or elite athleticism and the unhealthiest of foods.

Ending junk food advertising to children, including any use of cartoons in the advertisement of food and drinks, is an important step to support our kids.


  • Further strengthen existing labelling approaches, including mandatory systems

Nutritional information can be confusing for parents, let alone children. Food packaging often lists nutritional information in relation to portion size meaning a product with a higher figure may simply be larger rather than less healthy. While the Health Star Rating system, implemented in 2014, has made substantive progress, it remains voluntary.22

Efforts should be made to strengthen the usability of existing efforts and make consistent, evidence‐based and effective labelling mandatory. Such developments would also provide stronger incentives for manufacturers to reformulate products, reducing sugar, fat and salt content.

Clearer and consistent information would help create a more enabling food environment for families to make informed choices about their food.


  • Utilise procurement and supply chains of schools and public institutions to drive demand for healthier foods
  • Leverage the purchasing power of large organisations to reduce the costs of healthy foods for partner organisations and communities

Coordinated strategies are needed to support the availability of lower cost, healthy foods for all communities. Cities and large organisations such as schools and hospitals could collaborate to purchase food as collectives, thus driving demand, building market size and improving economies of scale.23

By leveraging collective purchasing power, institutions can catalyse the availability of sustainable and healthy foods to also support wider, positive food environment change.

Part 2

Dr Alessandro Demaio, or Sandro, trained and worked as a medical doctor at The Alfred Hospital in Australia.

While practicing as a doctor he completed a Master in Public Health including fieldwork to prevent diabetes through Buddhist Wats in Cambodia. In 2010, he relocated to Denmark where he completed a PhD with the University of Copenhagen, focusing on non-communicable diseases. His doctoral research was based in Mongolia, working with the Ministry of Health.

He designed, led and reported a national epidemiological survey, sampling more than 3500 households. Sandro held a Postdoctoral Fellowship at Harvard Medical School from 2013 to 2015, and was assistant professor and course director in global health at the Copenhagen School of Global Health, in Denmark.

He established and led the PLOS blog Global Health, and served on the founding Advisory Board of the EAT Foundation: the global, multi-stakeholder platform for food, health and environmental sustainability.

To date, he has authored over 23 scientific publications and more than 85 articles and blogs. In his pro bono work, Dr Demaio co-founded NCDFREE, a global social movement against noncommunicable diseases using social media, short film and leadership events – crowdfunded, it reached more than 2.5 million people in its first 18 months.

Then, in 2015, he founded festival21, assembling and leading a team of knowledge leaders in staging a massive and unprecedented, free celebration of community, food, culture and future in his hometown Melbourne. In November 2015, Sandro joined the Department of Nutrition for Health and Development at the World Health Organization’s global headquarters, as Medical Officer for noncommunicable conditions and nutrition.

From 2017, he is also co-host of the ABC television show Ask the Doctor – an innovative and exploratory factual medical series broadcasting weekly across Australia. Sandro is currently fascinated by systems-innovation and leadership; impact in a post-democracy; and the commercial determinants of disease. He also loves to cook.

NACCHO Aboriginal Health and @PSA_National ‏#Pharmacy News : New @jcu research shows the potentially life-saving #Closingthegap benefits of integrating pharmacists within Aboriginal Community Controlled Health Services

” There’s good evidence that pharmacists in our ACCHO health services improve patient health,”

NACCHO Director, Medicines Policy and Programs, Mike Stephens (Pictured above ) says the pharmacists would also educate staff and liaise with external stakeholders, including hospitals, to develop strategic plans for more effective medicine use.

Read all articles and or SUBSCRIBE to NACCHO Aboriginal and Pharmacy ALERTS

James Cook University, the Pharmaceutical Society of Australia and the National Aboriginal Community Controlled Health Organisation (NACCHO) have joined forces to explore this potential by way of a project which will aim to embed pharmacists in 22 Aboriginal community-controlled health services in Queensland, Victoria and the Northern Territory.

Funded by the Australian Government under the 6th Community Pharmacy Agreement, the pioneering project will see culturally trained pharmacists working with clinical staff and patients to improve medication use. The first project pharmacists commenced in July this year.

Research by JCU Associate Professor, General Practice and Rural Medicine, Sophia Couzos, says the project is vital because the inability of many Aboriginal and Torres Strait Islander people with chronic diseases to access pharmacist support may be placing lives at risk.

Dr Couzos said these patients often struggle with medication regimes – including treatment for life-threatening conditions like diabetes and cardio-vascular disease.

“There is a higher burden of chronic disease in the Aboriginal community, and these patients are likely to be prescribed multiple medicines, which also place them at greater risk of drug-related complications,” she says.

“Yet they have limited access to appropriate pharmacist advice across Australia, particularly in remote areas. We know that ‘drugs don’t work if patients don’t taken them’, so finding ways to optimise this is a vital health system improvement.”

The project pharmacists, located within the primary healthcare teams of Aboriginal health services, will assist individual patients to overcome obstacles, and prescribers to optimise medication choices.

“These pharmacists will be providing advice in a culturally safe environment for the patient, where they can feel at ease,” Dr Couzos says.

But the practice only occurs on an ad hoc basis in Australia. Despite this, there is no shortage of pharmacists keen to play frontline roles within Aboriginal health services, he maintained.

PSA manager, Health Sector Engagement, Shelley Crowther, says the peak body has been advocating for a number of years that pharmacists play an active role in improving medication management for Aboriginal and Torres Strait Islander people.

“There is a lot of evidence to support that medication misadventure results in cost to the health system,” she says.

“The Australian Commission on Safety and Quality in Healthcare estimates medication-related admissions to hospitals Australia-wide cost $1.2 billion annually.

“The discrepancies in health outcomes for Aboriginal and Torres Strait Islander people give even greater weight to the importance of embedding pharmacists to reduce medication misadventure and improve medication management to try to achieve better health outcomes.”

Hannah Mann, a community pharmacist speaking on behalf of the Pharmacy Guild of Australia says that “There are many community pharmacists who already have experience working with Aboriginal community controlled health services, who have excellent relationships with them, and who are looking to further strengthen these ties between community pharmacy and health services to better the health outcomes of patients.”

The project is scheduled to run until early 2020 and JCU will measure the healthcare improvements in chronic disease sufferers supported by project pharmacists.

“If the quality of care improves, that will lead to health dollar savings down the track because we know that access to quality primary health care can prevent unnecessary hospitalisations,” Dr Couzos says.

“This project will give impetus to the Australian Government to explore how healthcare workforce innovation may enhance access to quality healthcare for Aboriginal and Torres Strait Islander people.”

Associate Professor Couzos is presenting a paper about the project at the Community Pharmacy Stakeholder Forum in Sydney on the 7th September 2018.

NACCHO Aboriginal Health and #Closingthegap : Reconciling a policy mess : But research shows ACCHO’s significantly more effective at improving Indigenous health outcomes than the mainstream system.

 ” The present National Aboriginal Community Controlled Health Organisation (NACCHO )network provides a different working model for governments devolving decision-making power to the people directly affected. Research shows the network is significantly more effective at improving indigenous health outcomes than the mainstream system.

In its submission to a parliamentary committee considering options for indigenous constitutional recognition, the peak health body says: “We know that governments, of all persuasions and at all levels, struggle to … ensure full participation from ­Aboriginal and Torres Strait ­Islander peoples to have a genuine say over matters that impact on us. This can be seen now in the poorly conceived and led consultations on the Closing the Gap Refresh.”

From The Australian 5 September Stephen Fitzpatrick Indigenous affairs editor 

To get to the bottom of why the decade-old Closing the Gap program designed to reduce Aboriginal and Torres Strait Islander disadvantage has been such an underwhelming enterprise, it helps to trawl through the confused muddle of a half-century of indigenous affairs policy in Australia.

The Council of Australian Governments scheme, with its range of targets tracking outcomes across health, education and employment based on rigorous data sets, emerged in Kevin Rudd’s hands from the formal reconciliation era to become an annual showpiece addressing the state of the First Nations within the broader nation.

That this concept was even possible dates to 1967, when a referendum gave the commonwealth powers to join with state and territory governments to create a national system of indigenous affairs. For the first time, indigenous Australians could be treated — in theory — the same as everyone.

But theory and practice often don’t align. The fact Closing the Gap now is undergoing a root-and-branch review, labelled a “refresh”, shows this. So does the Turnbull government’s malign rejection last year of the Uluru Statement from the Heart’s proposal for indigenous constitutional recognition, which would have put indigenous Australians at the heart of policy made about them.

Now the latest top-down spasm in indigenous affairs policy, the appointment of Tony Abbott to an ill-defined role as “special envoy” in the field, is being seen in many quarters as yet another abrogation of repeated government promises to do things “with, not to” Aborigines and Torres Strait Islanders.

Academic Marcia Langton has called the appointment a “punch in the guts to indigenous Australia”, and it has been described by others as being more about solving Scott Morrison’s political problems than black Australia’s lived ones. The Prime Minister’s indigenous advisory council was not even consulted, co-chairman Roy Ah See revealed to The Australian.

There are just three Closing the Gap targets still formally being considered, only two of them on track: halving the gap on Year 12 attainment and getting 95 per cent of four-year-olds enrolled in early childhood education. The third, closing the gap on life expectancy by 2031, remains derailed.

Four more targets expired recently. Just one — halving the child mortality rate — is trending to be met, although data experts query whether the underlying figures used to demonstrate this are accurate. The other three still off course when their timelines ran out were on reading, writing and numeracy; school attendance; and employment.

The Australian Institute of Health and Welfare charts a life expectancy gap of 10 years and says that between one-third and one-half of the health gaps between indigenous and non-indigenous Australians are associated with differences in socio-economic position such as education, employment and income.

Linked to this, it recently released a report documenting the ongoing impact of trauma suffered by the Stolen Generations, of whom it calculates there are 17,150 survivors.

Many of the detailed written submissions to the official government “refresh” point out that structural reform is the only thing capable of overcoming the inequity born of more than two centuries of dispossession and trauma. Not a blind adherence to meeting targets — or, as expressed in ­Abbott’s acceptance of his new role, the rather hollow platitude that improved school attendance rates “is the absolute key to a better future for indigenous kids and this is the key to reconciliation”.

The overwhelming conclusion is that long-term failure has been the result of a lack of consistent indigenous voices in policymaking — and although peak groups and individuals are being consulted on the “refresh”, there is not much expectation of ongoing co-design.

After a series of workshops involving peak groups and individuals, there are 23 revised targets on the table. Several continue on the original themes, ­although the reliance on a mix of state and territory data and policies, as well as those at the commonwealth level, is a reminder that the 1967 referendum’s unanticipated result was an overall indigenous affairs policy incoherence.

Measures on health, education and employment take up the first nine proposed targets, with existing data on each of these assessed to be largely adequate for integrating into a revised scheme.

A new category of entrepreneurship acknowledges that getting out of poverty is crucial to escaping disadvantage, but analyst Charles Jacobs, from the Centre for Independent Studies, warns that its reliance wholly on government procurement spending increases could mask the need for also boosting indigenous business participation in the private sector.

“Small enterprises, for instance tourism businesses, are part of this, so the measure should perhaps be achieving a certain percentage of self-employment in the whole sector,” Jacobs says. “You’ve got to include businesses in the free market because the government procurement approach is limited.”

Areas such as housing, child protection, justice and family violence also are categorised as having sufficient data streams to create realistic targets, but the worry is that measuring inequitable rates of out-of-home care and imprisonment could be meaningless at the commonwealth level if the state and territory jurisdictions that determine them do not also introduce actual policy change.

Among the Uluru Statement’s most powerful lines is a direct reference to this dilemma: “Proportionally, we are the most incar­cerated people on the planet. We are not an innately criminal people. Our children are alienated from their families at unprecedented rates. This cannot be because we have no love for them. And our youth languish in detention in obscene numbers. They should be our hope for the future.”

The remaining areas being considered in the current blueprint cover targets that may address some of the root causes of this, but for which the review’s briefing notes admit there is no useful data being collected.

This raises the question of whether measurability on these should even be the key goal or whether the voice to parliament proposed at Uluru might be a better lever because it could have a direct influence on policymaking. They include disability and social inclusion, culture and language, racism and systemic discrimination, healing and trauma: issues that inquiry after inquiry has acknowledged are influencers of overall poor indigenous outcomes.

The First Peoples Disability Network submission to the review describes the flaws as being built in to the system.

“Once a year the Prime Minister delivers his report on outcomes to parliament, but after the report is delivered there is no systematic process that involves Aboriginal and Torres Strait Islander expertise on how to respond to the outcomes and issues,” it says. “The process needs to be transformed from a retrospective, static and non-participatory process into a dynamic and responsive process.”

There is even speculation that the 11th report, due in February, simply will be an announcement of a new measurement regime for the revised series of targets, thereby avoiding the dismal recitation in recent years of failure.

There is a further fly in the ointment, though: an Australian National Audit Office inquiry also is under way, investigating whether appropriate data governance arrange­ments are in place for estab­lishing progress in the official program and whether there is effec­tive evaluation of what impact indigenous programs are having. That audit is due in February, right when the annual Prime Minister’s report lobs. The outcome could be a jarring crossover, as the Auditor-General, a statutory official, is under no pressure to make the government look good.

Richard Weston, chief executive of the Healing Foundation, which came into being after the 1997 Bringing Them Home report identified unresolved trauma as a key driver of continuing indigenous family and community dysfunction, says the “huge economic cost to the Australian taxpayer of only addressing symptoms of trauma” is just one of the issues at stake in whether Closing the Gap works.

“There’s no simple fix; it’s complex,” Weston tells The Australian. “We don’t have a vision for Aboriginal and Torres Strait Islander policy or people. We’re trying to fix a complex problem with simple solutions, which become like a flavour-of-the-month approach, just throwing a bit of money first at one thing and then another.”

His foundation’s submission to the government review is damning. “Empirical evaluation designs that seek to prove a statistically significant impact on Aboriginal and Torres Strait Islander wellbeing are failing to shed light on what elements of the program failed, why they failed or how they could have succeeded, and have not given recognition to those considered effective in the eyes of the people who deliver or engage with the services,” it reads.

“While there is a place for quantitative evaluation of programs, evaluation needs to go beyond the finding of ‘nothing works’ to consider whether the program has actually failed, whether the evaluation methodology has failed, or if both the program and evaluation have disregarded key underlying factors associated with poor outcomes for Aboriginal and Torres Strait Islander people.”

Which is where going back to the 1967 referendum outcome is helpful. A Productivity Commission report last year said 44 per cent of the $33.4 billion allocated to indigenous spending annually came via the commonwealth, a direct result of that vote.

Of this total, $27.4bn (or 88 per cent) was channelled through mainstream services available to all Australians, such as health, ­policing and education.

The remaining $6bn came through indigenous-specific programs and, of this, the Department of Prime Minister and Cabinet administered almost $2bn, but the whole often is delivered via a spaghetti bowl of overlapping service and program providers, with ­inade­quate evaluation of effici­ency or results and frequent shifts in policy.

One example of this was the implementation in 2014 of an overarching Indigenous Advancement Strategy federal funding model, an approach broadly canned by a later Senate inquiry for its poor design and implementation and that stripped $500 million from the field.

This all raises the question of whether the commonwealth should be providing programs at all or, as University of Queensland professor Mark Moran puts it, deciding to “fix a failing public ­administration system”.

“This could include innovations in new funding methods, with collaboration and accountability measures that wrap and build around the discrete place or dispersed urban population, instead of targeting individual recipients with more grants,” Moran says. “Mainstream services — such as education, school, health, police and child protection — are essential and must remain.

“But if the funds for all of the ‘additional’ programs were pooled and channelled into a small number of ­locally based organisations, or into all-encompassing community development program(s), it could create a more effective and enabling environment for innovation and locally led reform to occur.”

It’s what the Uluru Statement’s framers say the voice to parliament is designed to address, with very likely a regional, traditional owner-based network feeding up to a national body but directing it towards locally determined needs.

So, too, is the Empowered Communities model, being trialled in nine discrete indigenous communities nationwide including in Sydney’s Redfern and La Perouse, or Cape York’s Pama Futures approach, a collaboration between local people and governments that its advocates describe as “the best chance we have to close the gap on indigenous disparity in our region”.

There has not been a national approach to inviting representative indigenous input to policy since the Howard government dissolved the Aboriginal and Torres Strait Islander Commission in 2004, and even Amanda Vanstone, the minister at the time, said recently that “in hindsight (it) might have been a mistake” to abolish that body in its entirety.

Law professor Megan Davis, pro vice-chancellor indigenous at the University of NSW (and one of the authors, with Cape York lawyer Noel Pearson, of the Uluru Statement), says a key feature of ATSIC was its impact on regional policymaking, in particular the provision of remote infrastructure and the importance of this to closing the gap on indigenous disadvantage.

Before ATSIC, bodies such as the National Aboriginal Conference, established by the Fraser government in 1977, exploited what then minister Fred Chaney has recently described as a “loud and often critical voice” that was nonetheless “useful and effective” in determining the needs of indigenous Australia.

Post-ATSIC, the National Congress of Australia’s First Peoples was an attempt at providing a representative voice but it lost all funding with the introduction of the Indigenous Advancement Strategy.

But perhaps Gumatj clan leader Djawa Yunupingu put it best when he asked in a fiery and, as it turns out, prescient speech recently at the annual Garma festival in Arnhem Land, the same forum Abbott used in 2013 to declare he would be a “prime minister for indigenous affairs” should he win office.

“How long do we have to wait to get this right?” Yunupingu said. “Another committee? Another meeting? Another prime minister?

NACCHO Aboriginal Children’s Health #Nutrition #Obesity : @IndigenousPHAA The #AFL ladder of sponsorships such as soft drinks @CocaColaAU and junk food @McDonalds_AU endangers the health of our children

 “Aboriginal and Non- Aboriginal kids are being inundated with the advertising of alcohol, junk food and gambling through AFL sponsorship deals according to a new study.

With obesity and excessive drinking remaining a significant problem in our communities, it’s time for the AFL ladder of unhealthy sponsorship (see below) to end,

Children under the age of eight are particularly vulnerable to advertising because they lack the maturity and mental skills to evaluate the messages. Therefore, in the case of the AFL, they begin to associate unhealthy products with their favourite sport and players

We need to ask ourselves why Australia’s most popular winter sport is serving as a major advertising platform for soft drink, beer, wine, burgers and meat pies. It’s sending the wrong message to Australians that somehow these unhealthy foods and drinks are linked to the healthy activity of sport,”

Says the Public Health Association of Australia (PHAA).

Read all NACCHO Aboriginal Health Nutrition / Obestity articles over 6 years HERE 

In the study published this week in the Australian and New Zealand Journal of Public Health, Australian researchers looked at the prevalence of sponsorship by alcohol, junk food and gambling companies on AFL club websites and on AFL player uniforms.

The findings were used to make an ‘AFL Sponsorship Ladder’, a ranking of AFL clubs in terms of their level of unhealthy sponsorships, with those at the top of the ladder having the highest level of unhealthy sponsors.

The study clearly demonstrated that Australia’s most popular spectator sport is saturated with unhealthy advertising.

Download PDF Copy of report NACCHO Unhealthy sponsors of sport

Ainslie Sartori, one of the authors involved in the research confirmed, “After reviewing the sponsorship deals of AFL clubs, we found that 88% of clubs are sponsored by unhealthy food and beverage companies. A third of AFL clubs are also involved in business partnerships with gambling companies.”


Sponsorship offers companies an avenue to expose children and young people to their brand, encouraging a connection with that brand.

The AFL could reinforce healthy lifestyle choices by shifting the focus away from the visual presence of unhealthy sponsorship, while taking steps to ensure that clubs remain commercially viable.

Policy makers are encouraged to consider innovative health promotion strategies and work
with sporting clubs and codes to ensure healthy messages are prominent


The study noted that children are often the targets of AFL advertising. This is despite World Health Organization recommendations that children’s settings should be free of unhealthy food promotions and branding (including through sport) due to the known risk it poses to their diet and chances of developing obesity.

PHAA CEO Terry Slevin commented, “When Australian kids see their sports heroes wearing a uniform plastered with certain brands, they inevitably start to associate these brands with the player they look up to and with the positive and healthy experience of the sport.”

He added, “The AFL is in a unique position to positively influence the health of Australian kids through banning sponsorship by alcohol, junk food and gambling companies. It could instead reinforce the importance of a healthy lifestyle for them.”

“Australian health policy makers need to consider innovative health promotion strategies and work together with sport clubs and codes to ensure that unhealthy advertising is not a feature. We successfully removed tobacco advertising from sport and we can do it with junk food and gambling too,” Mr Slevin said.

The recently released Sport 2030 plan rightly identifies sport as a positive vehicle to promote good health. But elite “corporate sport” plays a role of bypassing restrictions aimed at reducing exposure of children to unhealthy product marketing.

“The evidence is clear – it’s time for Australia to phase out all unhealthy sponsorship of sport,” Mr Slevin conclude

NACCHO Aboriginal Male Health : History of #OchreDay2018 How one @Apunipima man’s drive to make a change can make a difference

“ I was fortunate enough to attend the first White Ochre Day in Mossman Gorge, after seeing the potential affect this type of event could make, I took the opportunity to share the concept with Mark Saunders from NACCHO and who then adopted the concept and developed it into the national event it is today.

Without the development through Mark and now NACCHO chair, John singer, this event wouldn’t have been possible.”

The name has changed from White Ochre to simply Ochre Day, because of the different meaning that Ochre plays in communities and culture across Australia. Dan should be incredibly proud that he started something as significant as this for Aboriginal Men’s Health “

Dr Mark Wenitong, the Public Health Medical Advisor at Apunipima ACCHO Cape York

Read over 360 Aboriginal Male Health articles published by NACCHO over 6 years

View NACCHO TV Interview with Dr Mark

Ochre Day is celebrated each year on 27th August; Ochre Day recognises the importance of Aboriginal Men’s Health and Social and Emotional Wellbeing and forms an integral of NACCHO’s Aboriginal Men’s Health initiative.

Download the Plan Here a-blueprint-for-aboriginal-male-healthy-futures 

In 2012, Dan Fischer, an Indigenous Male Health Worker at Apunipima Cape York Health Council in Mossman Gorge wanted to share with the men of his community, the support and guidance that his much loved grandfather had shown him. Dan saw that many of the programs and support services that were offered to the men in his community were developed to solve a problem, not to prevent them.

Dan wanted to help the men and boys of his community in a positive way that celebrates and upholds the traditional values of respect for Aboriginal laws, respect for elders, cultures and traditions. He also saw that there was a need to encourage the men of his community to become leaders and role models.

“My Grandfather, Peter Fischer, was a great role model for me. I was lucky.” Said Dan.

From the humble beginnings, of a group of men sharing and supporting each other, in a remote community in Far North Queensland, Ochre Day was celebrated.

Ochre Day was adopted the following year, by NACCHO (National Aboriginal Community Controlled Health Organisation) at an event held in Canberra, where Dan’s passion and commitment to Close the Gap and help the men in his community was recognised.

VIEW Minister Ken Wyatt Video HERE 

Ochre Day is now celebrated right across Australia. It is an opportunity for Aboriginal males of all ages to share knowledge and explore ways to engage with their local communities, as an essential and positive part of family and community life.

“My grandfather told me that I would do good things for the health of my people and all these years later, here I am,” Dan said.

Dan believes that the success of Ochre Day from these humble beginnings is because of the great role models he has had in his life, both personally and professionally. White Ochre Day in Mossman Gorge is Dan’s way of paying forward his good fortune.

Ochre Day is evidence that one person can make a difference.

NACCHO Aboriginal Health NEWS : @AIHW report : The consumption of #alcohol, #tobacco and other #drugs is a major cause of preventable disease and illness in our communities

The consumption of alcohol, tobacco and other drugs is a major cause of preventable disease and illness in our comminities

There are a wide range of data sources available that contribute to our understanding of alcohol, tobacco and other drug use.

This web report from AIHW is intended to be a general reference for contemporary data on alcohol, tobacco and other drugs in Australia.

SEE Full Report 

This report consolidates the most recently available information regarding the use of tobacco, alcohol, cannabis, meth/amphetamines and other stimulants, the non-medical use of pharmaceutical drugs, illicit opioids (heroin) and new (and emerging) psychoactive substances (NPS).

Key trends in the availability, consumption, harms and treatment are identified and detailed data are presented for vulnerable populations.

These population groups include Aboriginal and Torres Strait Islander people, homeless people, older people, people from culturally and linguistically diverse backgrounds, people identifying as lesbian, gay, bisexual, transgender, intersex or queer (LGBTIQ), people in contact with the criminal justice system, people with mental health conditions, young people and people who inject drugs

Key findings Aboriginal and Torres Strait Islander people 

  • There has been significant declines in the proportion of Aboriginal and Torres Strait Islander people smoking and consume alcohol that exceeds lifetime risk guidelines (consuming more than two standard drinks per day on average).
  • The prevalence of smoking by Indigenous people has declined from 55% in 1994 to 45% in 2014–15.
  • The proportion of Indigenous people that consume alcohol as levels that exceed lifetime risk guidelines has reduced from 19% in 2008 to 15% in 2014–15.
  • In 2011, tobacco use accounted for 12% of the burden of disease for Indigenous Australians. This accounts for 23.3% of the health gap between Indigenous and non-Indigenous Australians.
  • In 2016, more than 1 in 4 (27%) Indigenous Australians used an illicit drug in the last 12 months. This was 1.8 times higher than for non-Indigenous Australians (15.3%).
  • The most commonly used illicit drug by Indigenous Australians is cannabis (16.7%), followed by the non-medical use of pharmaceutical drugs (11.0%).
  • Of clients of alcohol and other drug, treatment services, 15% were Indigenous Australians aged 10 and over, which is an overrepresentation relative to their population size.

Currently there are almost 800,000 Aboriginal or Torres Strait Islander people (see Box ATSI1) living in Australia, accounting for 2.8% of the Australian population [1]. There are substantial differences in measures of health and welfare between Aboriginal or Torres Strait Islander people and non-Indigenous Australians.

Box ATSI1: Aboriginal and Torres Strait Islander people

The terms ‘Aboriginal and Torres Strait Islander people’ is preferred in Australian Institute of Health and Welfare (AIHW) publications when referring to the separate Indigenous peoples of Australia. However, the term ‘Indigenous’ Australians is used interchangeably with ‘Aboriginal and Torres Strait Islander’ in order to assist readability.

The Australian Burden of Disease Study identified that Aboriginal or Torres Strait Islander people experience a burden of disease that is 2.3 times the rate of non-Indigenous Australians [2]. The gap in the disease burden is due to a range of factors including disconnection to culture, traditions and country, social exclusion, discrimination and isolation, trauma, poverty, and lack of adequate access to services [3]. Tobacco, alcohol, and other drugs are key risk factors contributing to the health gap between Indigenous and non-Indigenous Australians [2].

Box ATSI2. Data sources examining tobacco, alcohol and other drug use by Aboriginal and Torres Strait Islander people

There are a number of data sources that provide information about tobacco, alcohol and other drug use by Aboriginal and Torres Strait Islander people.

The National Aboriginal and Torres Strait Islander Social Survey (NATSISS) [4] and the Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS) [5] collected by the ABS are designed to obtain a representative sample of Indigenous Australians. In relation specifically to tobacco smoking, the ABS has consolidated data from six large, national, multistage random household surveys to identify trends between 1994 and 2014–15 [6].

The AIHW’s National Drug Strategy Household Survey (NDSHS) uses a self-completion questionnaire to capture information about drug and alcohol use among the general Australian population; however it is not specifically designed to obtain reliable national estimates for Indigenous people. In 2016, 2.4% of the NDSHS (unweighted) sample aged 12 and over (or 568 respondents) identified as being of Aboriginal or Torres Strait Islander origin. The estimates produced by the NDSHS should be interpreted with caution due to the low sample size [7].

There are also other data sources that provide information relevant to Aboriginal and Torres Strait Islander people.

  • Australia’s Burden of Disease study analyses the impact of nearly 200 diseases and injuries in terms of living with illness (non-fatal burden) and premature death (fatal burden). In 2015, a report was released that provides estimates of burden of disease between Indigenous and non-Indigenous Australians [8].
  • The National Perinatal Data Collection covers each birth in Australia and includes information on Indigenous mothers and their babies [6].
  • The Alcohol and Other Drug Treatment Services National Minimum Dataset (AODTS-NMDS) contains information on treatment provided to clients by publicly funded alcohol and other drug services including Indigenous clients [9].
  • The Online Services Report (OSR) contains information on the majority of Australian Government-funded Aboriginal and Torres Strait Islander substance use services [6].

Tobacco smoking

While tobacco smoking is declining in Australia, it remains disproportionately high among Indigenous Australians. Data from the Australian Bureau of Statistics (ABS) has shown:

  • In 1994, the Indigenous Australian survey data showed that 55% of Indigenous Australians aged 18 and over were smokers; 20 years later, in 2014–15, this had declined to 45% (Table S3.4).
  • Over a similar 20-year period, the National Health Survey (NHS) the proportion of non-Indigenous smokers aged 18 and over declined, from 24% in 1995 to 16% in 2014–15 (Table S3.5).
  • There appears to have been no change to the gap in smoking prevalence between the Indigenous Australian adult population and the non-Indigenous Australian adult population from 1994 to 2014–15. Even though the Indigenous Australian smoking rates are declining, the non-Indigenous rate is declining at a similar rate, therefore the gap remained constant [6] (Figure ATSI1).

Most of the decline in smoking occurred in non-remote areas. Over the 20-year period, the proportion of Indigenous Australians aged 18 and over in non-remote areas who were smokers declined from 55% to 42%, while the proportion in remote areas remained relatively stable at between 54% and 56% (Table S3.4).

In 2014–15, Indigenous males were more likely than Indigenous females to be smokers (47% compared with 42%) [1].

Geographic trends

The 2014–15 NATSISS provides estimates of tobacco smoking for Indigenous Australians by jurisdiction. According to the 2014–15 NATSISS, 39% of Indigenous Australians aged 15 and over smoked daily. Those from the Northern Territory (45%) and Western Australia (42%) surpassed this national average, while Indigenous Australians from South Australia (35%) were the least likely to be a current daily smoker [4] (Table S3.3).

Tobacco smoking in pregnancy

Indigenous Australians are at an elevated risk of smoking during pregnancy compared with non-Indigenous Australians. The National Perinatal Data Collection showed that:

  • Indigenous mothers accounted for 19% of mothers who smoked tobacco at any time during pregnancy in 2015, despite accounting for only around 4% of mothers.
  • The age-standardised rate of Indigenous mothers smoking during pregnancy has decreased from 50% in 2009 to 45% in 2015.
  • Almost 1 in 2 (45%) Indigenous mothers reported smoking during pregnancy—compared with 12% of non-Indigenous mothers (age-standardised).
  • The age-standardised rate of Indigenous mothers quitting smoking during pregnancy (14%) is about half that of non-Indigenous mothers (25%) (based on mothers who reported smoking in the first 20 weeks of pregnancy and not smoking after 20 weeks of pregnancy) [10].

Alcohol consumption

Abstinence (non-drinkers)

  • The 2016 NDSHS found that Indigenous Australians aged 14 and over were more likely to abstain from drinking alcohol than non-Indigenous Australians (31% compared with 23%, respectively) and abstinence among Indigenous Australians has been increasing since 2010 when it was 25% [7] (Table S3.1).
  • This pattern is consistent with data from the 2012–13 AATSIHS, where 28% of Indigenous Australians reported abstaining from drinking compared with 18% of non-Indigenous Australians [5].

Lifetime risk

  • The 2014–15 NATSISS found that the proportion of Indigenous Australians aged 15 years and over who exceeded the NHMRC lifetime risk guidelines for alcohol consumption (consuming more than 2 standard drinks per day on average) decreased between 2008 and 2014–15 (19% compared with 15%; non age-standardised proportions). The overall change is largely due to a decline in non-remote areas (19% in 2008 to 14% in 2014–15) [4] (Table S3.6).
  • Comparisons between Indigenous and non-Indigenous Australians are only available using age-standardised data from the 2012–13 AATSIHS and is not comparable to the 2014–15 NATSISS. The findings showed that lifetime risky drinking of Indigenous Australians aged 15 and over was similar to that of non-Indigenous Australians (9.8% compared with 9.7%; age-standardised) [5] (Table S3.7).

Single occasion risk

  • According to the 2014–15 NATSISS, 30% of Indigenous Australians aged 15 and over exceeded the single occasion risk guidelines for alcohol consumption (non age-standardised proportions), which is a decline since 2002 (35%).
  • Comparisons between Indigenous and non-Indigenous Australians are only available using age-standardised data from the 2012–13 AATSIHS and is not comparable to the 2014–15 NATSISS. The 2012–13 AATSIHS reported that 1 in 2 (50%) Indigenous Australians exceed the single occasion risky drinking guidelines (more than 4 standard drinks on a single occasion in past year). This was 1.1 times the rate that non-Indigenous Australians (44%) that exceeded these guidelines [5] (Table S3.7).

Risky alcohol consumption

  • According to the 2016 NDSHS, almost 1 in 5 Indigenous Australians (18.8%) consumed 11 or more standard drinks at least once a month. This was 2.8 times the rate that non-Indigenous Australians (6.8%) consumed this amount of alcohol [7] (Table S3.1).

Geographic trends

Between 2002 and 2014–15 there was a decline in the proportion of Indigenous Australians that resided in New South Wales Victoria, Queensland, South Australia, Western Australia and the Australian Capital Territory that exceeded the lifetime and single occasion risk guidelines (Figure ATSI2). Indigenous Australians residing in Tasmania (36%), the Australian Capital Territory (ACT) (35%), Queensland (33%) and Western Australia (33%) had higher rates of exceeding the single occasion drinking guidelines than the national average [4] (Table S3.8).

Indigenous Australians residing in Western Australia (16%), New South Wales (16%) and Queensland (15%) surpassed the national average for exceeding lifetime risk guidelines [4] (Table S3.9).

Illicit drug use

In the 2014–15 NATSISS, Aboriginal and Torres Strait Islander people aged 15 and over were asked whether they had used illicit substances in the last 12 months, and the types of illicit substances they had used during that period [4]. The data showed that:

  • Almost one-third (30%) of Indigenous Australians aged 15 and over reported having used illicit substances in the last 12 months, up from 22% in 2008.
  • Males were significantly more likely than females to have used illicit substances (34% compared with 27%), as were people in non-remote areas compared with those in remote areas (33% compared with 21%).
  • Cannabis was the most commonly reported illicit drug used by Aboriginal and Torres Strait Islander people in the last 12 months at 19% (25% of males compared with 14% of females).
  • The non-medical use of analgesics and sedatives (such as painkillers, sleeping pills and tranquilisers) was also relatively common (13%), with females (15%) being more likely than males (11%) to have used analgesics and sedatives.
  • One in twenty (5%) Indigenous Australians aged 15 and over reported having used amphetamines or speed in the last 12 months (6% of males compared with 3% of females) [4] (Figure ATSI3).

The 2016 NDSHS data showed that (other than ecstasy and cocaine), Indigenous Australians aged 14 and over recent used of illicit drugs was at a higher rate than non-Indigenous Australians (Table S3.1). Rates of illicit drug use in 2016 for Indigenous Australians aged 14 and older were:

  • Over one in four (27%) used any illicit drug in the last 12 months—1.8 times higher than non-Indigenous Australians (15.3%)
  • One in five (19.4%) used cannabis in the last 12 months—1.9 times higher than non-Indigenous Australians (10.2%)
  • Around one in 10 (10.6%) used a pharmaceutical for non-medical use—2.3 times higher than non-Indigenous Australians (4.6%) [7] (Table S3.1)
  • 3.1% used meth/amphetamines in the last 12 months—2.2 times higher than non-Indigenous Australians (1.4%).

The differences between Indigenous and non-Indigenous Australians were still apparent even after adjusting for differences in age structure (Figure ATSI4). There were no significant changes in illicit use of drugs among Indigenous Australians between 2013 and 2016, however due to the small sample sizes for Indigenous Australians, the estimates of the NDSHS should be interpreted with caution.

Geographic trends

Indigenous Australians aged 15 and over residing in the Northern Territory (22%) were the least likely to report substance use, while those from the Australian Capital Territory (41%) and Victoria (40%) were the most likely to report using substances.

Indigenous Australians from the Northern Territory (22%) and Queensland (29%) were the only jurisdictions below the national average (30%) [4] (Table S3.3).

Health and harms

The health status of Aboriginal and Torres Strait Islander people are considerably lower than for non-Indigenous Australians. For instance:

  • 35.1% of Aboriginal or Torres Strait Islander people compared with 58.3% of non-Indigenous Australia self-assessed their health as ‘excellent’ or ‘very good’ (age-standardised per cent).
  • 32.5% of Indigenous Australians compared with 12.3% of non-Indigenous Australians reported high/very high psychological distress (age-standardised per cent).
  • 71.0% of Aboriginal or Torres Strait Islander people reported having a long-term health condition compared with 55.3% of non-Indigenous Australians (age-standardised per cent) [4] (Table S3.6).

Almost 1 in 2 Indigenous Australians with a mental health condition were a daily smoker (46%) and about 2 in 5 (39%) to have used substances in the last 12 months. This was higher than for Indigenous  Australians with other long-term health conditions (33% and 24%, respectively) or those with no long term health condition (39% and 29% respectively) [4] (Table S3.11).

The Australian Burden of Disease Study provides an indication of the risk factors that contribute to the health gap between Indigenous and non-Indigenous Australians. In 2011, tobacco use accounted for 23.3% of the gap, and alcohol and drug use contributed to 8.1% and 4.1% of the gap, respectively [8] (Table S3.12).


Indigenous Australians are also overrepresented in drug and alcohol treatment services. In 2016–17, the Alcohol and Other Drug Treatment Services National Minimum Dataset (AODTS-NMDS) showed that 15% of clients were Indigenous Australians aged 10 and over (Table S3.13). Indigenous Australians (3,313 per 100,000 population) were 7 times more likely to receive AOD treatment services than non-Indigenous Australians (430 per 100,000 population) were. Specifically where:

  • Amphetamines was the principal drug of concern, Indigenous Australians (1,204 per 100,000 population) were 8 times more likely than non-Indigenous Australians (155 per 100,000 population).
  • Heroin was the principal drug of concern Indigenous Australians (911 per 100,000 population) were 7 times more likely than non-Indigenous Australians (123 per 100,000 population) were.
  • Cannabis was the principal drug of concern Indigenous Australians (867 per 100,000 population) were 7 times more likely than non-Indigenous Australians (126 per 100,000 population) were.
  • Alcohol was the principal drug of concern Indigenous Australians (136 per 100,000 population) were 7 times more likely than non-Indigenous Australians (26 per 100,000 population) [9] (Table S3.14).

Dependence on opioid drugs (including codeine, heroin and oxycodone) can be treated with pharmacotherapy therapy using substitute drugs such as methadone or buprenorphine. The National Opioid Pharmacotherapy Statistics Annual Data collection (NOPSAD) provides information on clients receiving opioid pharmacotherapy treatment on a snapshot day each year. For jurisdictions where data was provided, in 2017:

  • Around 1 in 10 clients (9%) were Indigenous, an overrepresentation relative to their population size.
  • Indigenous Australians were almost 3 times as likely (70 clients per 10,000 population) to receive pharmacotherapy treatment as non-Indigenous Australians (26 clients per 10,000 population) [11] (Table S3.15).

Data from the OSR shows that 2015–16, there were 80 organisations around Australia that provided alcohol and other drug treatment services to around 32,700 Aboriginal and Torres Strait Islander clients [6]. The OSR data also shows that:

  • All 80 organisations reported that alcohol was one of the top five common substance-use issue, followed by cannabis (94%) and amphetamines (70%)
  • Treatment episodes were more likely to be to occur in non-residential settings (87%)
  • One third of all treatment episodes were in Very remote areas (32%) and the highest proportion of clients were located in Major cities (35%).

Policy context

The Aboriginal and Torres Strait Islander Health Performance Framework 2017

The Aboriginal and Torres Strait Islander Health Performance Framework 2017 includes a suite of products that give the latest information on how Aboriginal and Torres Strait Islander people in Australia are faring according to a range of 68 performance measures across 3 tiers: Tier 1—health status and outcomes, Tier 2—determinants of health, and Tier 3—health system performance. The measures are based on the Aboriginal and Torres Strait Islander Health Performance Framework and cover data that has been collected on the entire health system, including Indigenous-specific services and programs, and mainstream services [12].

National Aboriginal Torres Strait Islander Peoples Drug Strategy 2014–2019

The National Aboriginal and Torres Strait Islander Peoples’ Drug Strategy 2014–2019 was a sub-strategy of the National Drug Strategy 2010–2015 and remains a sub-strategy under the National Drug Strategy 2017–2025. The overarching goal of this sub-strategy is to improve the health and wellbeing of Aboriginal and Torres Strait Islander people by preventing and reducing the harmful effects of alcohol and other drugs (AOD) on individuals, families and their communities [13].

NACCHO Aboriginal Health and #COAG Alice Springs 5 of 5 Posts : 1. Download or Read COAG Communique includes #Indigenous Health Roundtable #MyHealthRecord #Cancer #Hearing #Dental funding #Obesity #MentalHealth #Womens #Mens Health Strategies 2020 -2030 2.Download or Read Press Conference Transcript Ministers @GregHuntMP @KenWyattMP

 ” The Federal, State and Territory Health Ministers met in Alice Springs yesterday (2 August ) at the COAG Health Council to discuss a range of national health issues. 

The meeting was hosted by the Hon Natasha Fyles, the Northern Territory Minister for Health. The meeting was chaired by the Ms Meegan Fitzharris MLA, Australian Capital Territory Minister for Health and Wellbeing.

On Wednesday 1 August Health Ministers held a Roundtable with Indigenous leaders to listen to what is important to Indigenous people and to talk about how we can work together to improve health and healthcare for Aboriginal and Torres Strait Islander people to achieve equity in health outcomes.

A separate communique has been prepared for the Indigenous Roundtable.

Following the meeting the Australian Commission for Safety and Quality in Health Care launched the National Safety and Quality Health Service Standards – User Guide for Aboriginal and Torres Strait Islander Health.

See full COAG Health Miinisters Communique Part 1 Below or Download HERE 

CHC Communique 020818_1

On Wednesday 1 August, COAG Health Council (CHC) members met with Indigenous health leaders for an Aboriginal and Torres Strait Islander Health Roundtable.

All Ministers welcomed and valued this momentous opportunity to hear collectively from Indigenous health leaders. 

The COAG Health Council welcomed Minister Ken Wyatt, the Federal Minister for Indigenous Health to the meeting and expressed its deepest thanks to those Indigenous Leaders from across Australia who participated.” 

See full COAG Health Miinisters Indigenous Health Rundtable Communique Part 1 Below or Download HERE

CHC Indigenous Roundtable Communique_010818

 ” So there’s work that we’ve centred our attention on, working very closely with the community-controlled health sector across the nation, because these are two very significant illnesses that prevail within Aboriginal communities – avoidable blindness, avoidable deafness.

But we also want to look at some of those other underlying issues that impact on a child in their early years – crusted on scabies, we’ve just committed a substantial piece of work around to tackle that issue and look at solutions.

But the underlying social determinants are absolutely critical. But with the state and territory health ministers meeting here in Alice Springs, it means we will have a very serious discussion around the way in which the Commonwealth and state and territories work in partnership with Aboriginal people, not for us to deliver programs to them.

Because often change will only come when families have the ownership, when communities are those who determine the priorities that are needed, that then are given the level of support and resourcing that is important in the way that we’ve done with Purple House.

Ken Wyatt Greg Hunt Press Conference Alice Springs see Part 2 Below or Download Transcripts of both 

Before meeting

Press Conference 1 . pdf

 ” The best health comes from the community.

The best health comes when Indigenous communities and Indigenous leaders are able to take control, and that’s what they want to do.

They are saying – particularly through the ACCHOs – that we are able to help our own people if you give us the support and the tools, and that’s why the workforce plan is fundamental, coupled with additional support for research by and into Indigenous health.” 

Minister Greg Hunt after the COAG meeting

Greg Hunt Ken Wyatt Alice Springs Indigenous Health Press Conference


1 of 5 NACCHO Aboriginal Health : Download @GrattanInst #MappingPrimaryCare ‏Report : Reform primary care to improve health care for all Australians says @stephenjduckett

2 of 5 NACCHO Aboriginal Health #COAG meeting Alice Springs : Time for COAG Health Council to address the Indigenous funding myth & ‘market failure’ says Ian Ring

3 of 5 NACCHO Aboriginal Health #COAG : Indigenous Health Leadership , Ministers @GregHuntMP @KenWyattMP and Australia’s Health Ministers gather in #AliceSprings to shine a spotlight on #Indigenous health

4 of 5 NACCHO Aboriginal Health #ACCHO Deadly Good News stories : Features #NT @DanilaDilba @EvonneGoolagong @DeadlyChoices #QLD @IUIH_ #SA @Nganampa_Health #WA @TheAHCWA #VIC @VAHS1972


Major items discussed by COAG Health Ministers today included:

1.National collaboration to improve health outcomes for Aboriginal and Torres Strait Islander Australians 

Health Ministers held a strategic discussion on national collaboration to improve health outcomes for Aboriginal and Torres Strait Islander Australians. The wide-ranging discussion covered the impacts of potentially preventable rates of eye disease, ear disease, kidney disease, crusted scabies, Rheumatic Heart Disease, Human T-Lymphotropic Virus Type 1 (HTLV-1) and mental health in Aboriginal and Torres Strait Islander communities. Ministers identified opportunities for collaborative action to improve Aboriginal and Torres Strait Islander health outcomes that builds on the work already underway across Australia.

Roundtable Report

Ministers acknowledged the breadth and depth of Indigenous health knowledge, experience and leadership represented at the Roundtable, as well as the proven record of Aboriginal controlled health organisations in improving the health and wellbeing of indigenous Australians.

Indigenous leaders spoke of the importance of mutual trust and respect, the need to increase cultural capability and eliminate racism in all health settings and services, and the importance of cultural safety in improving the health and wellbeing of indigenous Australians.

Ministers welcomed this message and agreed that cultural safety in providing healthcare to indigenous Australians was essential.

Ministers agreed to progress cultural safety training within their own jurisdiction and committed to explore the requirement for cultural safety training in health professionals registration.

Ministers agreed to progress initiatives to implement a Safe Patient Journey through the health care system within their own jurisdiction and committed to explore the requirement for cultural safety training in health professionals and tasked the Australian Health Practitioner Regulation Agency to develop options  for the next CHC meeting in consultation with national bodies and indigenous health workforce representatives.

Indigenous leaders clearly outlined the importance of a workforce plan to guide action and inspire Aboriginal and Torres Strait Islander people to a successful career in health.

Ministers agreed to develop a National Aboriginal and Torres Strait Islander Health Workforce Plan with a first draft to be considered at the CHC’s next meeting, to be followed by consultation.

Ministers agreed to work with Indigenous leaders to develop a National Aboriginal and Torres Strait Islander Health and Medical Workforce Plan.

Ministers acknowledged the many successes and achievements in Indigenous health outlined during the Roundtable and welcomed the expressions of hope for the future. Equally, Ministers acknowledged the challenges faced by indigenous people across urban, rural and remote communities.

Ministers acknowledged the experience of Indigenous people in health settings and noted the importance of a safe clinical and cultural health journey for Indigenous people.

Recognising the importance of Aboriginal and Torres Strait Islander  health and medical research and researchers, Commonwealth, states and territory Health Ministers commit to working together to strengthen Indigenous led health and medical research. This should include an enhanced focus on specific Aboriginal and Torres Strait Islander health and medical research to improve outcomes for the community.

In recognition of the significant value of continuing to build mutual trust, respect and understanding, Ministers committed to an annual dialogue with Indigenous health leaders with the next Roundtable to occur in 12 months’ time. Further, Aboriginal and Torres Strait Islander Health has been established as a standing item on every COAG Health Council meeting.

Ministers further strengthened the accountability for Aboriginal and Torres Strait Islander health by agreeing to invite the Commonwealth Minister for Indigenous Health to every COAG Health Council meeting thus embedding consideration of these matters in all health discussions.

Ministers acknowledged the strong contribution by Aboriginal and Torres Strait Islander leaders in advancing improvements in Indigenous Health and the achievements of the Commonwealth, states and territories.

Ministers concluded a strategic discussion in the CHC meeting on Thursday 2 August by reaffirming their commitment to addressing gaps in Indigenous health outcomes.

The summary themes from the discussion are listed below:

  • Develop a National Indigenous Health and Medical Workforce Plan that provides a career path, national scope of practice and builds more balance of indigenous and non-indigenous people across all health professions, make health an aspirational career for Aboriginal people. This should include a specific focus on a national scope of practice for Aboriginal Health Workers and Practitioners.
  • Trust, hope, faith and strong relationships important to ensure services meet needs.
  • Need for deep listening at all levels.
  • Important to recognise and share the good things that are already happening and some of the recent positive announcements.
  • Tap into the centres of excellence that are already operating and build on success.
  • Aboriginal and Torres Strait Islander people are invested in success and seek same investment from non-indigenous partners.
  • Need to have different approaches for urban, regional and remote communities to reflect the diversity of local needs, resources and capability across all settings.
  • Primary health care services critical to wellbeing to prevent the need for subsequent acute services, tackling chronic disease essential.
  • Make sure cultural capability and cultural safety are within legislation and policy frameworks.
  • It is important that there is collaborative, needs based planning and implementation rather than vertical disconnected programs, and funding needs to be long term to support sustainability.
  • Need a range of measures: personal health interventions as well as community strategies such as supply reduction of hazards.
  • It is important that other determinants such as housing, electricity and water are addressed.
  • In recognition of the importance of connection to country, services should also be on country where safe and appropriate.
  • Aboriginal and Torres Strait community leadership is critical to success

2.Mandatory reporting requirements by treating practitioners

Health Ministers approved a targeted consultation process for amendments to mandatory reporting requirements by treating practitioners. The targeted consultation process will seek feedback on proposed legislation that strikes a balance between ensuring health practitioners can seek help when needed, while also protecting the public from harm. The consultation process will involve professional bodies representing each registered health profession, consumer groups, National Boards and professional indemnity insurers. The

results of the targeted consultation process will inform a Bill to be presented to the Queensland Parliament as soon as possible.

Western Australia is not included in this process as its current arrangements will continue.

3.Australian Health Practitioner Regulation Agency

Health Ministers welcomed advice that all 15 health practitioner National Boards, their Accreditation Councils and AHPRA have partnered with Aboriginal and Torres Strait Islander health sector leaders and organisations to sign a National Registration and Accreditation Scheme Statement of Intent to achieve equity in health outcomes.

This joint commitment aims to ensure a culturally safe health workforce, increasing participation of Aboriginal and Torres Strait Islander Peoples in the registered health professions along with greater access to culturally safe health services.

This work will reach over 700,000 registered health practitioners, over 150,000 registered students and the 740 plus programs of study accredited through the National Scheme. The launch was held on traditional lands of the Wurundjeri Peoples of the Kulin Nation in Melbourne, Victoria with a Welcome to Country and a traditional smoking ceremony.

4.Update on 2016-17 determination of national health reform funding

Health Ministers received an update from the Commonwealth Health Minister on the process and timing of the 2016-17 determination, and of the importance of rapidly setting the 2016-17 determination of the national health reform funding to provide certainty for hospital services into the future. Health Ministers also noted the work on improvements to the reconciliation process for inclusion in the next National Health Reform Agreement.

Ministers welcomed the appointment of Michael Lambert as the Administrator of the National Health Funding Pool.

5.Private patients in public hospitals.

Ministers agreed to commission an independent review of a range of factors regarding utilisation of private health insurance in public hospitals to report as soon as possible but no later than 31 December 2018.

6.Progress update on the National Health Reform Agreement

The Commonwealth Minister for Health provided an update on drafting of the National Health Reform Agreement. The Council noted the importance of a dispute resolution process.

7.National approach to hearing health

Minsters recognised that 3.6 million Australians currently experience hearing loss and that the prevalence of hearing loss is expected to more than double by 2060. Ministers discussed the economic, social and health impacts of hearing loss, particularly for the 90 per cent of

Aboriginal and Torres Strait Islander children in some remote communities who experience otitis media infections at any time. Ministers agreed to further consider a national approach to hearing health, following the Commonwealth’s response to the House of Representatives Inquiry Report ‘Still Waiting to be Heard’ expected later this year.

8.Public dental funding arrangements 

Ministers noted that the current National Partnership Agreement on Public Dental Services for Adults will end on 30 June 2019, and that the State and Territory public provider access to the Child Dental Benefits Schedule will end on 31 December 2019.

Ministers agreed that securing sustainable and fair future funding arrangements is critical to providing timely access to public dental care. Ministers agreed to commence formal negotiations to achieve fair, long-term public dental funding arrangements, including extension of access to the Child Dental Benefits Schedule.

9.Mutual recognition of mental health orders 

Ministers discussed the important issue of ensuring continuity of care for mental health consumers moving between jurisdictions with different legislation. Ministers agreed that work to ensure interoperability of mental health legislation between states and territories, as part of the 5th National Mental Health and Suicide Prevention Plan is prioritised.

10.Recognising Continuity of Care for Consumers of Mental Health Services

The Council discussed and agreed to South Australia’s proposal that the COAG Health Council monitor the ongoing transition to the NDIS of mental health clients and to identify any emerging services gaps that need to be addressed in order to ensure continuity of support.

Ministers agreed that the Australian Health Ministers’ Advisory Council work with the Disability Reform Council Senior Officials Working Group and provide advice at the next COAG Health Council on actions to resolve interface issues between health and disability services.

11.Obesity – limiting the impact of unhealthy food and drinks on children

The Queensland Minister led a discussion on a suite of actions to improve children’s diets and prevent child obesity with a focus on health care settings, schools, children’s sport and recreation, food promotion and food regulation.

The development of cross-sectoral initiatives with education and sport and recreation sectors was noted. Health departments were tasked with developing national minimum nutrition standards for food and drink supply in public health care facilities. The Queensland Minister presented a national interim guide for reducing children’s exposure to unhealthy food and drink marketing. This guide was endorsed by Ministers, noting that the guide is for voluntary use by governments.

Health Ministers noted the voluntary pledge made by the Australian Beverages Council Limited to reduce sugar across their portfolio of products by 20% on average by 2025.

12. Implementation of National Cancer Work Plan – Additional Optimal Cancer Care Pathway

Health Ministers endorsed the Optimal Cancer Care Pathway (OCP) for Aboriginal and Torres Strait Islander peoples, which is the first OCP under the National Cancer Work Plan that specifically addresses the needs of a cultural group. It is critical that cancer service systems are culturally responsive and competent to address the current and growing disparities in health outcomes for Aboriginal and Torres Strait Islander Australians relative to non-Indigenous Australians. This OCP is designed to provide culturally safe and responsive healthcare, including acknowledging how social determinants can impact health outcomes. This OCP is to be used in conjunction with the 15 tumour-specific OCPs.

The OCP for Aboriginal and Torres Strait Islander peoples was developed collaboratively by Cancer Australia in partnership with the Victorian Department of Health and Human Services and Cancer Council Victoria. Ministers also gratefully acknowledge Aboriginal leadership in development of this pathway with input from an Expert Working Group and from Cancer Australia’s Leadership Group on Aboriginal and Torres Strait Islander Cancer Control, as well as feedback from many Aboriginal Controlled Community Organisations and peak groups during the public consultation phase.

13. Public disclosure to support hospital and clinical comparisons

Ministers agreed to commit to create a data and reporting environment that increases patient choice through greater public disclosure of hospital and clinician performance and information.

Ministers noted it is the Australian Institute of Health and Welfare’s (AIHW) role to facilitate consistent and timely reporting of health and welfare statistics and performance information, including the publication of the MyHospitals and MyHealthy Communities websites following the cessation of the National Health Performance Authority.

All jurisdictions agreed to work with the Commonwealth’s Chief Medical Officer in his investigation of the issue around a number of women being diagnosed with cancer, which may be linked to breast implants. This includes the role all jurisdictions play in reporting information to track the use of implants.

14.National Action Plan for Endometriosis

Ministers noted that the National Action Plan for Endometriosis has been finalised and was launched on 26 July 2018. All states and territories will be working with the Commonwealth toward implementation of the plan.

15.National Women’s Health Strategy 2020-2030 and National Men’s Health Strategy 2020-2030

Ministers noted that the Commonwealth is developing a National Women’s Health Strategy 2020-2030 and a National Men’s Health Strategy 2020-2030. Both Strategies are expected to be finalised and launched in early 2019.

16. Ministerial Advisory Committee on Out-of-Pocket Costs

Ministers noted the work being undertaken by the Ministerial Advisory Committee on Out-of-Pocket Costs. It was agreed that the Commonwealth release a detailed report of the activity of the Ministerial Advisory Committee on Out-of-Pocket Costs including specific fee transparency options before the next COAG Health Council meeting so that decisive actions can be agreed.

17. Digital health

Jurisdictions reaffirmed their support of a national opt out approach to the My Health Record. Jurisdictions noted clinical advice about the benefits of My Health Record and expressed their strong support for My Health Record to support patient’s health.

Ministers acknowledged some concerns in the community and noted actions proposed to provide community confidence, including strengthening privacy and security provisions of My Health Record.

Part 2Press Conference Alice Springs

It’s a real honour to be here at Purple House with Ken Wyatt, Indigenous Health Minister, but of course the first Indigenous Minister in the history of the Commonwealth of Australia.

And then Sarah and her team, all of the members of Purple House. Purple House is about saving lives and protecting lives.

It’s about closing the gap so as in Indigenous Australians have a better shot at better kidney health. As the Chief Medical Officer was just explaining, dialysis means that the machines do the work of the kidneys where the kidneys have been damaged, and that means that people can help expel the toxins, can have a healthier life and deal with some of the challenges and they can be on dialysis and manage their lives for literally two decades or more in some cases, as Brendan was setting out.

Today, I am delighted to announce that the Australian Government will under the National Health and Medical Research Council. These projects will cover things such as lung function, reducing smoking during pregnancy, improving the health of blood and Ken will talk to you in particular about point-of-care testing in dialysis.

It’s about ensuring that whilst we clearly have not closed the gap yet, which is why we asked together – the Council of Australian Governments – to come to Alice Springs and to focus on Indigenous Australia. Whilst we haven’t closed that gap, we are making progress, important steps, but a whole lot more to go.

This funding builds on what we’ve done in supporting Purple House and builds on what we’ve done in supporting additional remote dialysis. I’ll ask Ken to talk about those, but today is a critically important day for investment in Indigenous health, research and training and improved outcomes. Each one of these projects, each one of these 28 projects has the potential to save lives and improve lives. Ken?


It’s great to be here. I was in Darwin and I heard an elder from Tiwi Island talk about living life and enjoying it fully, until he had to go to Darwin, and he said when he went to a Royal Darwin Hospital he thought he was going for a prescription and tablets that would allow him to go home.

He said he never realised he would be married to a machine and never return to country. And what’s great is Purple House now provides that opportunity for elders and senior people within the community and younger ones who experience renal failure to go back to the point of where they grew up. Point-of-care testing makes it easier now to identify where we have renal problems and start to address the needs of individuals.

The $23 million that the Australian Government, the Turnbull Government have provided to Purple House means that the purple bus will reach further out into remote and isolated communities, but more importantly an increase in the number of dialysis point of access that enables both the use of chairs and other support programs that are important.

Over a period of time we’ve seen senior Aboriginal people make a decision to disengage from dialysis in regional hospitals, go back to country and die on country. This now changes that. This gives an incredible opportunity for people to spend time with their family, for culture and law to be passed on through those who have that task.

But more importantly, to keep families together and I think that the combination of the work that the Turnbull Government, and in particular Minister Hunt in his strong commitment to looking at the research that is required to close those gaps, has made an incredible difference. And it’s great having you here as well because you have also been an advocate and I’d like to invite you to make a couple of comments as well.

Okay. We’re happy to take any questions.

Well, if I may kick it off. Minister Hunt, we’ve heard a lot of concerns about privacy issues regarding My Health. What benefits though are there in digitising health records?

Well, enormous benefits, and I have to say that the Northern Territory is one of the nation’s leaders on that front and I’ve been discussing this with the Northern Territory Minister, who’s been a great advocate and it crosses party lines.

But when you have a mobile population and they may not have their own records as most people don’t, they don’t carry their records with them, if they’re a mobile population, or if the medical community is moving, then what this does is it marries up your history and your chronic conditions and your medicines across the different points of care.

So this gives every Australian the capacity to have their health care system with them, if they want it. And in Indigenous Australia, and in particular in the Northern Territory, we see that this area is leading the nation in terms of engagement with the population on digital health. So for Indigenous Australia it’s going to be a real game-changer.

Are you confident, Minister, that the changes you’ve made address the privacy concerns?

Yes, these are changes which come directly from the advice, request and sensible proposals put forward by the AMA and the College of GPs and really we’re doing two things, one, we are lifting Labor’s 2012 legislation to the same level as the practise of the last six years, which is an ironclad legislative guarantee that no health records will be released without a court order.

Secondly, once somebody seeks to have their record deleted, it will now be cancelled and fully deleted forever from the record so. If you seek to have it cancelled, if you seek to opt-out after a record’s been created, it’s gone forever, rather than the 130 years which was put in under Labor’s legislation.

Labor says the opt-out period should be put on hold. Will you do that?

That’s not the advice of the medical authorities who are very clear that they want this done this year, so we’ve extended by a month and we’ve worked with the medical authorities. I understand that Labor at the moment is being, shall we say, a little bit curious because only a few weeks ago they were welcoming this as a long-overdue step and when the legislation went through, unanimously, through the Parliament they praised this as an important and vital step forward.

The Women’s Legal Service in Queensland says you haven’t done enough to address new concerns around My Health Record and that it may risk the safety of women fleeing abusing partners. Have you heard of those concerns and are you doing anything on that front?

Yes, I’ve asked the head of the Digital Health Agency to talk with them and meet with them as a matter of priority. The advice I have is that there are very, very strong protections, but we’re always working with different groups and these have been raised and so the head of the Digital Health Agency will meet with and talk with those groups and take their concerns very, very seriously.

Minister, what else is the federal government doing to help ensure that Indigenous people can live a healthy life in remote communities?

Well, there’s a comprehensive program and I’ll ask Ken to address this in more detail. But you have of course the health treatment, and these 28 new projects are each about improving health in different areas, whether, as I say, it’s in relation to smoking rates for pregnant women, point of care for dialysis, whether it’s improving outcomes in relation to lung function.

But we’re also working through the education system on activity, on diet, and then of course there’s economic development, because you cannot escape the social determinants of health, they are a reality. That’s why Indigenous Australia has worse outcomes, because there are challenges that are unique to that community and we have to have a comprehensive program.

Now, Ken has, as much as any person in Australian history, helped drive that forward and he’s being supported on the ground. I have to say, Jacinta was one of the motivating sources for the COAG meeting to be here in Alice Springs. Ken?

Some of the priorities that we’re working on are premised on rheumatic heart disease and the impact that that has from birth through to later adult life. The increasing number of people living with renal failure and certainly our research is showing that the onset might be as early as 19 years in males.

So there’s work that we’ve centred our attention on, working very closely with the community-controlled health sector across the nation, because these are two very significant illnesses that prevail within Aboriginal communities – avoidable blindness, avoidable deafness. But we also want to look at some of those other underlying issues that impact on a child in their early years – crusted on scabies, we’ve just committed a substantial piece of work around to tackle that issue and look at solutions.

But the underlying social determinants are absolutely critical. But with the state and territory health ministers meeting here in Alice Springs, it means we will have a very serious discussion around the way in which the Commonwealth and state and territories work in partnership with Aboriginal people, not for us to deliver programs to them. Because often change will only come when families have the ownership, when communities are those who determine the priorities that are needed, that then are given the level of support and resourcing that is important in the way that we’ve done with Purple House.

On the ground approaches work far better than if we try and tackle them from capital cities, and so this whole focus means that we bring health and health thinking and design and planning much closer. Our roundtable this afternoon with the Indigenous leaders is a reflection of us seeking their advice to look at what are the directions that we need to seriously consider, given the geographic diversity of our nation.

Minister Wyatt, do you think there’s been enough done to explain, I guess, My Health? I mean, you’re here at Purple House where many languages are spoken other than English. Are you confident that the message is getting out there to those regional communities where English is perhaps third or fourth languages?

Look, I think our Aboriginal health workers who are employed by many organisations, including state and territory health systems, provide that front line interaction. Because I once made a comment to a group of Aboriginal health workers in New South Wales that power doesn’t sit with the director or with the minister, the power of change and impact sits with the Aboriginal health workers who understand the families, understand the communities, that can speak language and understand the nuances of the relationships within a community. I think that’s where our best opportunity lies.

Minister Wyatt, I think everybody would agree the syphilis epidemic is very high, too high, in Indigenous populations. What’s your plan to bring down those numbers?

Well when that was first raised with us there were two steps we took. One is the Chief Medical Officer undertook a piece of work with the Australian Health Minsters’ Council because the predominance of that work in terms of surveillance, treatment, and the provision of treatment, really reside with state and territories. But also, Aboriginal community-controlled health organisations play a key role. James Ward has also developed community awareness materials that are pragmatic and practical and kids can relate to the messages in the materials that he has produced.

But also having the community-controlled health services now turn their attention to point of care testing, but more importantly around some of the messages of why it’s important to practice safe sex. The other avenue we use which is a great one is through some of the big sporting events – Adrian Carson in Brisbane will be holding a rugby knock out carnival in Townsville. Now, at that they’re anticipating somewhere between 10,000 and 16,000 people will turn up along with all of those playing, so it gives a great opportunity for the community-controlled health sector to get some of those messages into the community.

But our strategic approach is working with the jurisdictions and with the Aboriginal communities in making sure that we entrench a practice of identification of STIs, including HIV and blood-borne viruses where they may prevail, but then providing the level of treatment that is important in eradicating the challenge that we’ve had. We’ve seen this outbreak across the top end of Australia and certainly the level of commitment that we’ve had from states and territories has been tremendous.

Is that going to be a similar approach for HLTV-1 virus?

Yes, we’ve set aside through the AHMAC process $8 million, which will be part of a process of a round of discussions involving Aboriginal community-controlled health services, key researchers, but also the jurisdictions in identifying the priorities. We have to ascertain the extent of the spread of the virus and not only consider that, but consider research that’s been done overseas.

I’ve certainly read some of the research out of Japan in terms of transmission points, but we need to have a look at what is the challenge here in Australia. I know it was something that was identified in the Fitzroy Valley in the 80s and 90s and certainly I want to compliment my own department and Minister Hunt’s department on the work that they’ve been doing with our state and territory colleagues and the community-controlled health sector.

Thank you very much.

NACCHO Aboriginal Health #COAG : Indigenous Health Leadership , Ministers @GregHuntMP @KenWyattMP and Australia’s Health Ministers gather in #AliceSprings to shine a spotlight on #Indigenous health


“Australia’s Health Ministers have gathered in Alice Spring to shine a spotlight on Indigenous health, almost 10 years after the Council of Australian Governments (COAG) approved Closing the Gap targets to achieve health equality for First Nations peoples.

While we can reflect on progress – our people, on average, are living longer with fewer dying from chronic conditions – it is equally important to focus on our failure to close the gap in life expectancy, which remains about 10 years.

For sustainable change, however, local family warriors must step up, be respected, acknowledged and encouraged.

The Hon Ken Wyatt Indigenous Health Minister see Part 1 Below

Investigation and investment where it is needed is critical to delivering better health outcomes for First Nations Peoples, to protect lives and save lives

Today we visited the Purple House Renal Clinic in Alice Springs and have seen first-hand the debilitating effects of poor kidney health.

Kidney disease disproportionately affects Indigenous Australians — research has shown that almost one in five (18 per cent) Aboriginal and Torres Strait Islander people aged over 18 had indicators of chronic kidney disease.

I am delighted that we can announce $327,192 for Monash University to develop a point-of-care test for the diagnosis and management of chronic kidney disease.

Social and emotional well-being was another critical matter for Aboriginal and Torres Strait Islander Australians, especially youth.

The Australian Institute of Health and Welfare has found that the single largest contributor to ill health amongst Aboriginal and Torres Strait Islander Australians is mental health and substance use disorders,” said Minister Hunt.

Five projects across five different states will examine social and emotional well-being issues affecting Aboriginal and Torres Strait Islander infants, children, adolescents and young adults.

They will undertake culturally-informed research looking at the influencing factors, mental health and life-coaching, and fostering wellness.”

Health Minister Greg Hunt see full Press release Part 2

Part 1 Continued from opening quote

For over 65,000 years, First Nations people thrived without a plethora of organisations. We were child, family and community-centred.

Responsibility and authority revolved around a woman, with her key roles as the mother and protector, and equally, around a man, the father and family shield.

This year, I am focusing on five areas – renal health, rheumatic heart disease (RHD), avoidable blindness, avoidable deafness and crusted scabies.

First Nations people experience 7.3 times the burden of chronic kidney disease than other Australians. In the Northern Territory, RHD is 37 times more prevalent and, overall, we endure three times the rate of vision impairment.

Our children suffer, on average, 32 months of hearing loss compared with three months for other Australian children, while remote northern communities have the world’s highest rates of crusted scabies.

We are losing too many lives and not realising the potential of too many more.

In many remote locations, doctors and health workers are joined by fly-in fly-out health practitioners, providing specialist services.

However, we must ensure a local army of individuals on the ground is empowered to monitor for signs of illness.

We need home-based heroes, family warriors, as they were in times past – and still are in functional families.

They need to understand that infections such as skin sores can be precursors to RHD, kidney failure and crusted scabies.

We are not going to fully transform the health of those who are struggling, until they understand with pride and responsibility, the culture that perpetuated healthy lives for thousands of years.

Our mothers and fathers, uncles, aunts and grandparents are the first protectors of our children.

Now extended to 136 communities, the Better Start to Life program is proving the power of engaging with and supporting young parents to understand their responsibilities.

The Turnbull government has invested significantly in these areas but the record $3.9 billion committed to Indigenous health over the next four years will only ever be part of the currency of change.

It’s now time to highlight the heroes within our families, to move from disempowerment to empowerment, away from a deficit model.

I encourage every mother, father, uncle, aunt and Elder to become a warrior for health, joining in and taking responsibility for their own health and the health of their families.

Today we visited the Purple House Renal Clinic in Alice Springs and have seen first-hand the debilitating effects of poor kidney health.

The Government has committed $23.2 million through the National Health and Medical Research Council (NHMRC) to 28 new projects, and has launched a NHMRC Road Map 3 to help chart the direction for Indigenous health and medical research investment over the next ten years.

New research investment will include targeted renal, cancer and social and emotional wellbeing projects aimed at improving Aboriginal and Torres Strait Islander health outcomes.

The five projects together form the first of a series of targeted calls for research by the NHMRC to address Indigenous health priorities. Other calls will include healthy ageing and nutrition.

Minister for Indigenous Health, Ken Wyatt AM, said the new research projects would help to strengthen work already underway to curb chronic disease.

“The renal point-of-care test will complement the Renal Health Road Map that is currently being compiled,” Minister Wyatt said.

“This exciting new research is focused on making a difference on the ground, from reducing smoking during pregnancy and boosting cancer care, to combating diabetic blindness and improving diets.”

“The five social and emotional wellbeing projects are especially welcome, as we continue working with local communities to reduce the rate of suicide.”

Other key research projects announced today include point-of-care testing for blood-borne diseases and sexually transmitted infections, reducing incarceration rates of young women, improving prisoner mental health, burns care, lung health, scabies testing and reducing unborn baby deaths.

The direction of future First Nations research will be informed by the NHMRC’s Road Map 3, which will include a yearly report card and a commitment to spend at least 5% of annual NHMRC funding on Aboriginal and Torres Strait Islander health and medical research.

“Most importantly, the NHMRC Road Map 3 was developed in consultation with communities, First Nations researchers and the broader health and medical research sector to address Indigenous health issues and encourage and strengthen the capacity of Indigenous researchers, now and into the future,” said Minister Wyatt.

The NHMRC has today also released the Ethical conduct in research with Aboriginal and Torres Strait Islander Peoples and communities: Guidelines for researchers and stakeholders as well as Keeping Research on Track II.

The Guidelines provide a set of principles to ensure that research is safe, respectful, responsible, high-quality and of benefit to Aboriginal and Torres Strait Islander people and communities.