NACCHO Aboriginal Health #SocialDeterminants #refreshtheCTGRefresh @KenWyattMP announces 4 year$18.6 million evaluation into Aboriginal and Torres Strait Islander primary healthcare : Designed for faster progress in #Closingthegap in health equality.

” A top priority has been placed on ensuring local communities that are involved in receiving and providing primary healthcare have a strong voice throughout the process,’

Federal Minister for Indigenous Health Ken Wyatt

From Dr Evelyn Lewin RACGP NewsGP 

A four-year $18.6 million evaluation into Aboriginal and Torres Strait Islander primary healthcare aims to produce sustained improvements in service delivery and health outcomes for Aboriginal and Torres Strait Islander peoples.

A main focus of the Federal Government program will be considering how Commonwealth investment in the Indigenous Australians’ Health Programme (IAHP) links with the broader health system.

This is designed to help improve healthcare access and drive faster progress in closing the gap in health equality.

With $3.6 billion being invested in the IAHP across four years (2018–19 to 2021–22), this evaluation will help maximise the value and impact of health funding and guide program design.

The evaluation also aims to learn how well the primary healthcare system is working for Aboriginal and Torres Strait Islander peoples, demonstrate the difference the IAHP makes, and inform efforts to accelerate improvement in health and wellbeing for Aboriginal and Torres Strait Islander peoples.

The evaluation will establish up to 20 location-based studies to collect information from various Aboriginal and Torres Strait Islander health services around the country.

‘The project is another important step in assessing the impact on First Peoples’ health from the provision of effective, high-quality, culturally appropriate healthcare,’ Minister Wyatt said.

According to a report by the Australian Institute of Health and Welfare’s (AIHW), The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples: 2015, 3% of the Australian population (just over 760,000 people) are Aboriginal or Torres Strait Islander peoples.

The report states that one in four (24%) of Aboriginal and Torres Strait Islander peoples aged 15 and over assessed their health as ‘fair or poor’ in 2012–13, making them 2.1 times as likely as non-Indigenous Australians to report such results.

The AIHW report also noted that 39% of the gap between Aboriginal and Torres Strait Islander people and non-Indigenous Australians health outcomes can be explained by social determinants

NACCHO Aboriginal Health #SocialDeterminants and #ClimateChange : How the @Walgett_AMS community members and market garden are at risk from high sodium in water in drought-stricken NSW town

Unfortunately in our community and particularly Aboriginal people, they have a high incidence of chronic disease,

I believe we are going to have an increase in chronic disease here, particularly from the water consumption,

In my life here in Walgett for 40 odd years, it’s the first time I’ve never drank straight from the tap.

I just worry for people who have to drink straight from the tap.”

Chief Executive of the Walgett Aboriginal Medical Service, Christine Corby, said high blood pressure, heart disease, kidney disease and diabetes were common health issues:

The Australian guidelines do state that medical practitioners who are concerned about people with hypertension should advise that people drink water with no more than 20 milligrams of sodium per litre. The Walgett drinking water is about 15 times that amount … so we need to be thinking about action to address that

Salt of the earth see Part 2 below

” It’s part of good health, it’s part of healthy living, it’s part of prevention and treatment of chronic disease.

For now, the garden has an exemption from the town’s level-5 water restrictions, I’m not sure how long that would last. And even with the exemption, the bore water on offer may not be suitable for gardens.

The research that we’ve received from the University of New South Wales has indicated the long-term effects, the quality of the plants, they will deteriorate, the nutrients will be reduced so it doesn’t work,

“In the long term we can’t sustain the garden.”

The Walgett Aboriginal Medical Service runs a community garden which provides fresh produce for its chronic-disease clients.

Christine Corby said the garden was crucial to these people

The Garden was featured recently in our #refreshtheCTGrefresh campaign

Part 1 : Walgett has always been a river town, perched near the junction of the Barwon and the Namoi rivers.

But with the drought biting hard, the water from those rivers isn’t making it to this northern New South Wales town.

See original ABC post here

With nothing to pump from the local weir, Walgett is the latest town forced to go underground for water.

It is now on an emergency supply of bore water, and many locals are worried it is damaging their health.

PHOTO: The Barwon River at Walgett is just a series of stagnant pools at the moment. (ABC: Danielle Bonica)

Dharriwaa Elder, Thomas Morgan, said the water was no good for drinking.

“Too much salt in it,” he said. “The kids, my grandkids, they’re starting to spit it out, they don’t like it.”

Elder Rick Townsend lives near the water treatment plant.

“I get the smell of it every morning and it’s the foulest smell,” he said.

“I don’t drink it, not at all. I drink the water at the hospital, tank water. Or I’ll buy the water in the supermarkets.”

Dharriwaa Elders Clem Dodd, Thomas Morgan, Rick Townsend and Richard Lake are concerned that the town’s emergency bore water isn’t healthy for people to drink.

Another local, Chantelle Kennedy, said most people were avoiding the tap water. “Most of us go to IGA and buy packs of 24 bottles for $20. It’s dear,” she said.

“A lot of people have been buying fizzy drinks because of the water. Some of them come out and buy hot drinks, which is cheaper than buying water.”

Part 2 : Salt of the earth

The bore water is from the Great Artesian Basin, and tests have shown the sodium levels in the water exceeded Australian Drinking Water Guidelines.

Associate Professor Jacqui Webster, from the George Institute for Global Health, said the sodium levels were concerning.

“The sodium levels in the Walgett water supply are at 300 milligrams per litre and the Australian drinking water guidelines are 180 milligrams per litre, so that’s substantially higher,” she said.

Dr Webster said the guidelines for sodium in drinking water were based on taste rather than health.

But she said high sodium levels did pose serious health risks, particularly for people with underlying health problems.

“The Australian guidelines do state that medical practitioners who are concerned about people with hypertension should advise that people drink water with no more than 20 milligrams of sodium per litre,” she said.

“The Walgett drinking water is about 15 times that amount … so we need to be thinking about action to address that.”

Dr Webster said those who avoided salty drinking water by drinking alternatives such as soft drinks were solving one problem and creating another.

“If they are drinking the water it’s potentially a problem but if they are substituting it with other things that is also a cause for concern,” she said.

“Indigenous communities are suffering from greater incidences of diabetes, obesity and hypertension,” she said.

“In general people get a disproportionate amount of salt from processed foods in communities where there is limited access to fresh foods, so compounding that with sodium from the water supply is a problem, and it’s something we need to be looking into.”

PHOTO: Chief Executive of the Walgett Aboriginal Medical Service, Christine Corby, says the community garden may be forced to close if the town’s water situation doesn’t improve.(ABC Western Plains: Jessie Davies)

Part 3 Community veggie garden under threat

The Walgett Aboriginal Medical Service runs a community garden which provides fresh produce for its chronic-disease clients.

Christine Corby said the garden was crucial to these people.

“It’s part of good health, it’s part of healthy living, it’s part of prevention and treatment of chronic disease,” she said.

For now, the garden has an exemption from the town’s level-5 water restrictions, but Ms Corby said she was not sure how long that would last. And even with the exemption, the bore water on offer may not be suitable for gardens.

“The research that we’ve received from the University of New South Wales has indicated the long-term effects, the quality of the plants, they will deteriorate, the nutrients will be reduced so it doesn’t work,” she said.

“In the long term we can’t sustain the garden.”

 

‘It’s going to keep everyone alive’

Walgett’s mayor, Manuel Martinez, said the shire commissioned the town bore to provide water security in the event of shortages just like this one.

“Two years ago, we had the foresight to sink a bore. We’re drought-proofing our whole shire,” Cr Martinez said.

“This is Australia. We’re in a drought and until the drought breaks, that’s the only water supply we’ve got.”

“It’s going to keep everyone alive, and that’s what we’re here to do,” he said.

“The sodium level is a bit high, higher than normal, higher than preferred, but it’s within the guidelines and it’s the same level it is with other bores.

“I’ve lived in Lightning Ridge for the last 32 years with only bore water. Most of outback Queensland is on the Artesian Basin.”

Cr Martinez said that as soon as there was water in the rivers again, Walgett would be back on river water — or at least on a mixture of river and bore water.

He said the bore water was a short-term emergency supply.

“I’m not doubting what they say, long-term effects of anything can be harmful, especially sodium or salt in the water system,” he said.

Part 4 The upstream imbalance

PHOTO: Elders in Walgett say locals are sad and sorry that pastimes like fishing and swimming in the river are no longer possible. They’re concerned the river is dry not just because of drought but because of mismanagement and water use upstream. (ABC: Danielle Bonica)

Many residents in Walgett believe it is not just the drought that is to blame for the dry rivers.

They say the waterways have not being managed properly and that too much water is being taken out upstream.

Chairman of the Walgett Aboriginal Medical Service, Bill Kennedy, said it was hard when people saw so much water in the rivers not far up the road.

“We’ve lived through droughts before but there was always some water, and some running water,” he said.

“I guess progress has changed all that with irrigators, farming, and especially cotton further up the river.

“I was driving to Tamworth, Newcastle last week and there’s water in the rivers further up at Gunnedah, Narrabri, Wee Waa.

PHOTO: Chairperson of Walgett Aboriginal Medical Service Bill Kennedy. (ABC Western Plains: Jessie Davies )

The mayor agreed, and said it was frustrating to see so much water upstream in both rivers.

“Even in this present time now you’ll see irrigators spraying all their crops,” Cr Martinez said.

“You’ve got a town with no water supply and you go 30kms up the road and irrigators are pumping”

Cr Martinez said the last two water releases from Lake Keepit were supposed to flow down as far as Walgett but they never made it.

“It’s beyond council’s control … we can only apply to push, to get another release, and try and get water to make it down to us.”

He said there was another water release from Lake Keepit on its way and hopefully this one will make it all the way to Walgett.

Spirits at low ebb

Many people in this community were deeply saddened by the state of the two rivers here.

Elder Rick Townsend says it was the worst dry spell anyone could remember.

“It’s a pretty bad state of affairs,” he said.

“It’s the worst I’ve ever seen it in all my life that I’ve lived here.”

For countless generations, the rivers have been a place to meet, fish and swim. But locals said at the moment that was simply not possible.

“There’s no fish or anything in the river any more,” says another Elder, Thomas Morgan.

“People used to come down here and fish every day, catch heaps of fish and crayfish. [They would] come with their kids and spend a good day here with them and be happy, and now they can’t do that.”

PHOTO: Dharriwaa Elders Group chairperson Clem Dodd. (ABC Western Plains: Jessie Davies )

For Clem Dodd, a spokesman for the Dharriwaa Elders Group, the implications for the community were dire.

“This place will be a ghost town before long,” he said.

“If there’s no water, everything’s going to die. There’ll be nothing here for people — they’ll all be moving out.”

 

NACCHO Aboriginal Health #refreshtheCTGRefresh @jackietrad Queensland Minister for Aboriginal and Torres Strait Islander Partnerships : How Queensland reform will #ClosetheGAP

 ” We asked the Queensland Productivity Commission to examine how res­ources devoted to service delivery in remote Aboriginal and Torres Strait Islander communities could be best used to meet their needs. It was clear from those findings, delivered in June, that we must reform and reframe the way we work with the state’s 19 remote communities.

They have given us a clear message: “Stop consulting us. Stop engaging us. Stop doing things to us and start doing things with us. Start to hear what we’re saying, and make us equal partners and key enablers in turning around the disadvantage our people face.”

Jackie Trad is Queensland Deputy Premier, Treasurer and Minister for Aboriginal and Torres Strait Islander Partnerships. see extracts from Health Report here

Download all reports HERE

Or Download Health report here

Chapter-17-Health-and-wellbeing

This year marked 10 years since the release of the landmark report Closing the Gap, which for the first time held governments accountable for addressing the endemic inequality that exists between indigenous and non-indigenous Australians. There has been significant progress in areas such as Year 12 completion, employment and reducing infant mortality, but in some areas the gap has widened.

Does that mean we have been too ambitious? Of course not. It is incumbent on this generation to be ambitious in pursuing a better future for First Nations people and to right the wrongs of the past by tackling injustice, poverty and disadvantage. We cannot hope to achieve this unless we learn from mistakes, build on good work and acknowledge what doesn’t work.

In 2016, the Productivity Commission was scathing in its assessment of 1000 government programs to tackle indigenous disadvantage, finding that just 34 of them had been properly evaluated. It recommended more robust evaluation and publication of results.

These requests are central to achieving real change. We must stop punishing people and start empowering them. I am steadfast in my desire to make this happen. I want the Palaszczuk government’s response to be more than just a shopping list of things we are providing communities. We must throw away the bureaucratic playbook that has hampered change, and must work together to give real meaning to local authority, local decision-making and self-determin­ation.

I have tasked my director-general, Chris Sarra, to work with communities to test and work through the QPC recommendations and to put in place a framework that will enable commun­ities to thrive. It’s an agenda not devised and proselytised from Brisbane but shaped by the people who live in the unique communities across our state — communities such as Cherbourg, Yarrabah, Doomadgee and Thursday Island.

Thriving Communities will build on past successes and acknowledge failures. There is a clear place for the policy agenda advanced by Noel Pearson’s welfare reform trial and the Families Responsibilities Commission. For 10 years the FRC has been fac­ilitating behavioural change through conditional access to welfare payments in five communities in Cape York. Like Closing the Gap, the program has had mixed success.

Despite its protestations, the federal government knows this too. In June 2015, Indigenous Affairs Minister Nigel Scullion wrote to the Queensland government seeking support for a new “lower cost approach” to the FRC, citing the current model as expensive and with limitations. Consequently, for two years, all parties have been engaged in a review of the model — a fact notice­ably absent from Scullion and special envoy Tony Abbott’s recent commentary. There also has been no mention of their failure to allocate funds to the program beyond this month.

While the federal government remains distracted by internal turbulence, we are committed to working with communities to give them the self-determination they need.

About the Inquiry

In September 2016, the Queensland Government announced the Queensland Productivity Commission (QPC) would inquire into service delivery in remote and discrete Aboriginal and Torres Strait Islander communities. The Inquiry was announced in response to concerns expressed by Indigenous leaders that the level of investment in all services (federal, State and non-government) was not delivering higher outcomes for members of their communities.

The QPC was asked to consider investment in remote and discrete Indigenous communities and what works well, and why, with a view to improving outcomes for Aboriginal and Torres Strait Islander people.

The QPC has released its final report which is available on the QPC website.

The QPC Inquiry Recommendations

The QPC Inquiry final report and recommendations are based on extensive consultation with more than 500 stakeholders and remote and discrete Indigenous communities in Queensland.

The QPC Inquiry final report shows examples of good service delivery that can be built upon but most stakeholders agree that there are opportunities to improve how services are designed, funded and delivered that will work towards better outcomes for Aboriginal and Torres Strait Islander Queenslanders.

The QPC Inquiry final report provides 22 recommendations and proposes a substantial reform agenda for policy and service delivery that includes structural reform, service delivery reform and economic reform, to be supported by capacity and capability building of all stakeholders, and timely and transparent transfer of data to measure performance and evaluation.

The Queensland Government Response to the QPC Inquiry

The Queensland Government makes a long-term commitment to work with the 19 remote and discrete Aboriginal and Torres Strait Islander communities, their leaders and Mayors and other stakeholders to implement the intent of the reform agenda proposed by the QPC.

The Queensland Government has provided its response to the final report (PDF, 521 KB).

Key points Health Delivery (text added by NACCHO ) 

􀁸 Indigenous people in remote Queensland experience a burden of disease and injury 2.4 times the non-Indigenous rate—mainly chronic disease, mental disorders, cancers and intentional injuries.

􀁸 Socioeconomic determinants (education, income, overcrowding), racism and discrimination play a significant role in the health gap, along with behavioural and environmental risk factors.

􀁸 The health system is a multifaceted network of services and settings, involving a variety of public and non-government providers, funding arrangements, participants and regulatory mechanisms.

System issues

􀁸 The ‘silo’ approach to service delivery is problematic for communities. It is difficult to ensure services are adequate, appropriate, coordinated and not unnecessarily duplicated, and meet community priorities and user needs.

􀁸 Mainstream mental health services do not meet the cultural needs of Indigenous people, who view social and emotional wellbeing as incorporating individuals, their families and communities.

􀁸 Service providers and institutions are not well-equipped to respond effectively to the distress Stolen

Generations can experience when using those services—distress that arises from the role of those institutions in past injustices.

􀁸 Anecdotally, Foetal Alcohol Spectrum Disorder is prevalent, and access to diagnosis limited.

􀁸 Access to healthcare can be problematic—issues include ineffective, nil or confusing referral pathways, lower screening rates and limited access to renal care and rehabilitation centres. There are significant gaps in the Indigenous health workforce.

What is working

􀁸 Aboriginal and Torres Strait Islander community-controlled health services provide effective, culturally appropriate and multidisciplinary models of comprehensive primary healthcare.

􀁸 Family Wellbeing is an example of a cultural healing program that has been found to increase the capacity of participants to exert greater control over their health and wellbeing.

The reforms proposed by this inquiry can provide an enabling environment for stakeholders to develop collaborative and flexible solutions to these challenges.

 

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

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

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

See SMH Article Part 1 below

Download PDF copy of report

Senate Obesity report

Extract from Report Programs in Aboriginal and Torres Strait Islander communities

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

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

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

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

Access to healthy and fresh foods in remote Australia

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

From NACCHO Submission Read here 

Recommendation 21 see all Recommendations Part 2

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

Recommendation 22

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

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

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

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

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

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

Part 1 SMH Article 

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Part 2 ALL 22 Recommendations

Recommendation 1

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

Recommendation 2

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

Recommendation 3

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

Recommendation 3.1

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

Recommendation 3.2

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

Recommendation 6

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

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

Recommendation 7

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

Recommendation 8

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

Recommendation 9

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

Recommendation 10

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

Recommendation 11

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

Recommendation 12

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

Recommendation 13

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

Recommendation 14

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

Recommendation 15

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

Recommendation 16

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

Recommendation 17

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

Recommendation 18

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

Recommendation 19

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

Recommendation 20

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

Recommendation 21

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

Recommendation 22

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

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

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

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

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

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

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

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

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

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

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

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

Part 4

Sugary drink levy among 22 recommendations

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

BACKGROUND:

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

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

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

NACCHO Aboriginal Health we need to #refreshtheCTGRefresh to #closethegap : At COAG on December 12 : Which states and territories will support a formal partnership with Aboriginal and Torres Strait Islander peoples ?

“ We understand that at this stage it is intended that new Closing the Gap targets will be settled at COAG’s December meeting,

We are calling on COAG to hold off doing this and instead put in place a proper partnership mechanism with us. The new targets haven’t been published and Indigenous peaks are uncertain what the targets will be and therefore we cannot provide our support.

NACCHO and the peak bodies engaged with the process, took time to submit written submissions and attend workshops to discuss refreshing the Closing the Gap strategy earlier this year. But we can’t see how our input has been taken into account,

As a first step we propose a meeting with COAG representatives and the peak bodies to discuss a way forward that includes a genuine partnership approach.

Aboriginal people need to be at the centre of the Closing the Gap Refresh policy; the gap won’t close without our full engagement and involvement.

Having Aboriginal people involved in the design of the Refresh and proposed revised targets will lead to Aboriginal people taking greater responsibility for the outcomes. It’s been proven that Aboriginal community control is vital and delivers better outcomes for our people.” 

NACCHO Chief Executive Pat Turner AM see interview Part 3 below 

Download the NACCHO Press Release Here

NACCHO media release Refresh The CTG Refresh

Part 1 NACCHO Press Release continued 

The National Aboriginal Community Controlled Health Organisation (NACCHO) and other Aboriginal peak bodies across Australia have written to COAG First Ministers seeking a full partnership approach between Indigenous people and governments in refreshing the Closing the Gap Strategy, scheduled to be put to COAG for consideration in Adelaide on 12 December.

The letter, signed by 13 peak bodies, proposes an urgent meeting of Aboriginal and Torres Strait Islander peak bodies to meet with COAG representatives to determine a framework for reaching agreement on a refreshed Closing the Gap strategy.

It’s the second letter the group has written to COAG after failing to receive a response to their initial letter in early October from any government except the Northern Territory.

Part 2 Letter to Council of Australian Government First Ministers

Dear Council of Australian Government First Ministers 16/11/2018

We write again, further to our letter of 4 October 2018, concerning the Closing the Gap Refresh, a joint initiative of the Council of Australian Governments (COAG), to seek a formal partnership mechanism between Aboriginal and Torres Strait Islander peoples and governments in the Closing the Gap Refresh policy. We have only received a response from the Northern Territory Government.

As stated in our original letter, all of us believe it is essential that agreement is reached on the Closing the Gap Refresh policy between Indigenous organisations, on behalf of communities across Australia and Australian governments. What we propose is entirely consistent with the commitment made by COAG to set a new relationship with our communities based on a partnership.

If governments alone, continue to make decisions about the Closing the Gap, without an opportunity for us to be at the table, it will not be possible to advocate with any confidence or motivate our communities to support Closing the Gap and to take joint responsibility with governments for achieving the targets.

 

Pictures above and below from our #refreshtheCTGRefresh Campaign

The evidence is strong that when Indigenous people are included and have a real say in the design and delivery of services that impact on them, the outcomes are far better. We are certain that Indigenous peoples need to be at the centre of the Closing the Gap Refresh policy: the gap won’t close without our full involvement and COAG First Ministers, who are responsible for the Closing the Gap framework, cannot expect us to take responsibility and work constructively with them to improve outcomes if we are excluded from the decision making.

We have proposed a reasonable way forward to Australian Governments in our original letter without making it public to give everyone a reasonable opportunity to consider it. However, we understand that it is the intention of Australian Governments to still settle on targets at the forthcoming meeting of COAG on 12 December 2018.

We also understand that implementation arrangements are to be left over for COAG to agree in 2019. We make the points that neither ourselves nor anyone else outside government have seen the proposed targets which we think is way short of being partners and transparent and we cannot see how the targets can be agreed without considering at the same time how they are to be achieved.

 

We assume that Australian Governments will justify agreeing to targets by referring to the consultations earlier this year. Those consultations were demonstrably inadequate. They were conducted at a very superficial level without an opportunity for Indigenous interests to be prepared for the workshops held across Australia.

They were based on a discussion paper produced by the Department of the Prime Minister and Cabinet in December 2017 and which stated that only one of the seven targets was on track which two months later was contradicted by the former Prime Minister who said that three targets were on track. Critical elements of the original Closing the Gap framework, particularly COAG’s National Indigenous Reform Agreement, were not referred to at all in the consultations and the focus was on new targets instead of how we could make sure that this time around they were achieved.

There was no independent report prepared on the outcomes of the consultations and there is no way of telling if what was said in the consultations is reflected in the proposed Refresh policy including the targets.

The consultations started far too late which has left us with 4 targets having expired in June 2018. We do not accept that we have been properly consulted let alone given the opportunity to negotiate a mechanism that allows a proper partnership to be put in place in relation to the design, delivery and monitoring of Closing the Gap.

 

There is a now a significant opportunity to put this disappointing process back on track and in particular to establish a robust Closing the Gap framework founded on a genuine partnership between Indigenous people and governments.

It is open to governments on 12 December 2018, to endorse a partnership approach and establish a mechanism to initiate negotiations between representatives of COAG and Peak organisations with a view to developing a genuine partnership as part of the Closing the Gap Refresh. This would be endorsed by the Peak Organisations across Australia.

Subject to COAG endorsing a partnership approach, we propose a meeting of Aboriginal and Torres Strait Islander Peak bodies to meet with COAG representatives to determine a framework for reaching agreement on a refreshed closing the gap strategy.

We stand ready to do this quickly and would work with COAG on having a partnership framework in place in early 2019 with a revised approach agreed by the middle of the year.

Ms Pat Turner AM, the CEO of the National Aboriginal Community Controlled Health Organisation, is our contact for the purpose of responding to this vital matter and we ask that you contact her.

We look forward to working with you on the Closing the Gap Refresh through an established partnership mechanism.

Yours sincerely,

 

Part 3 Going backwards’: Aboriginal bodies take aim at Closing the Gap

Aboriginal peak organisations have slammed federal, state and territory governments for failing to give Indigenous leaders an effective role in re-energising the faltering Closing the Gap process.

In a letter written jointly to Prime Minister Scott Morrison, chief ministers and premiers, the leaders of the 13 peak bodies say they have been shut out of meaningful consultation about refreshed targets to overcome Aboriginal disadvantage.

By Deborah Snow SMH 19 November

Pat Turner, chief executive of the National Aboriginal Community Controlled Health Organisation, said "it's all gone backwards".
Pat Turner, chief executive of the National Aboriginal Community Controlled Health Organisation, said “it’s all gone backwards”. CREDIT:GLENN CAMPBELL

And they want the Coalition of Australian Governments – due to consider an update to Closing the Gap next month – to defer setting new targets until a fresh pact is hammered out giving “full partnership” to Aboriginal bodies.

“I think it’s all gone backwards,” the chief executive of the National Aboriginal Community Controlled Health Organisation (NACCHO), Pat Turner,  told the Herald.

“In the last few years, governments seem to have dropped the ball a lot. I hope they are giving serious consideration to our letter. They can’t go on having two bob each-way. They are there to lead and they have to have a bit of backbone. [The state of] Aboriginal affairs is a national shame, it is something that they should be wanting to get fixed.”

Ms Turner said only one government – the Northern Territory – had bothered replying to the group when they first wrote a letter a month ago seeking better consultation over new targets and implementation strategies.

“NACCHO and the peak [Indigenous] bodies engaged with the process took time to submit written submissions and attend workshops to discuss refreshing the Closing the Gap strategy earlier this year” she said. “But we can’t see how our input has been taken into account.”

The peak bodies decided on Sunday to release a second letter they wrote to all governments at the end of last week.

The letter says the “disappointing” Closing the Gap process has to be put “back on track” with Indigenous people taking part in the design and delivery of services on the basis of “genuine partnership”.

“As a first step we propose a meeting with COAG representatives and the peak bodies to discuss [such an] approach” Ms Turner said.

The Herald sought a response from Aboriginal Affairs minister Nigel Scullion but was unable to contact his office on Sunday.

Closing the Gap was first conceived of a decade ago as a way to measure Aboriginal disadvantage and set clear targets to redress it.

Earlier this year a report from the Department of Prime Minister and Cabinet said three of seven targets were “on track”: to halve the gap in year 12 attainment and halve the gap in child mortality by 2018, and to have 95 per cent of Indigenous four-year-olds enrolled in early childhood education by 2025.

However it said that other targets, including halving the gap in reading and numeracy, and halving the gap in employment, as well as closing the gap on life expectancy, were not on track.

NACCHO Aboriginal Health #RefreshtheCTGRefresh #ClosingTheGap : @ABSStats Release : #Aboriginal and Torres Strait Islander life expectancy lowest in remote and very remote areas

“Today’s figures show that life expectancy estimates for Aboriginal and Torres Strait Islander Australians remain lower than for the non- Indigenous population.

The life expectancy at birth of Aboriginal and Torres Strait Islander men in 2015-2017 was 8.6 years lower than for non-Indigenous men, while that of Aboriginal and Torres Strait Islander women was 7.8 years lower than that of non-Indigenous women”

The life expectancy at birth for Aboriginal and Torres Strait Islander Australians in 2015-2017 was 71.6 years for men and 75.6 years for women, according to figures released today by the Australian Bureau of Statistics (ABS).

See ABS Website 

“However, life expectancy within the Aboriginal and Torres Strait Islander population varied considerably, with the lowest life expectancy experienced by those living in the more remote parts of the country” said Anthony Grubb, Director of Demography at the ABS.

“Life expectancy at birth for Aboriginal and Torres Strait Islander people living in remote and very remote areas was 65.9 years for men and 69.6 years for women, while those living in major cities had the highest life expectancy (72.1 years and 76.5 years for men and women respectively).”

“Today’s figures show that life expectancy estimates for Aboriginal and Torres Strait Islander Australians remain lower than for the non- Indigenous population. The life expectancy at birth of Aboriginal and Torres Strait Islander men in 2015-2017 was 8.6 years lower than for non-Indigenous men, while that of Aboriginal and Torres Strait Islander women was 7.8 years lower than that of non-Indigenous women”.

These differences were more marked in remote and very remote areas, where the difference in life expectancy at birth for the Aboriginal and Torres Strait Islander population compared with the non-Indigenous population was 13.8 years for men and 14.0 years for women.

Aboriginal and Torres Strait Islander people living in the Northern Territory and Western Australia had the lowest life expectancy estimates.

Today’s release suggests the differences in life expectancy between Aboriginal and Torres Strait Islander and non-Indigenous Australians narrowed slightly over the five-year period since 2010-2012.

LIFE EXPECTANCY AT BIRTH, Remoteness Areas – 2015-2017(a)

Aboriginal and Torres Strait Islander
Non-Indigenous
Difference between non-Indigenous and Aboriginal and 
Torres Strait Islander life expectancy at birth(b)

MALES


Major Cities
72.1
80.7
8.6
Inner and Outer Regional
70.0
79.1
9.1
Remote and Very Remote
65.9
79.7
13.8

FEMALES


Major Cities
76.5
83.7
7.2
Inner and Outer Regional
74.8
82.8
8.0
Remote and Very Remote
69.6
83.6
14.0

DIFFERENCE BETWEEN MALES AND FEMALES


Major Cities
-4.4
-3.0
. .
Inner and Outer Regional
-4.8
-3.7
. .
Remote and Very Remote
-3.8
-3.9
. .

.. not applicable.
(a) Based on the average number of Aboriginal and Torres Strait Islander deaths registered in 2015-2017 adjusted for under/over identification of Indigenous Status in registrations, and final Aboriginal and Torres Strait Islander population estimates for 30 June 2016 based on the 2016 Census.
(b) Differences are based on unrounded estimates. 

LIFE EXPECTANCY AT BIRTH, States and Territory – 2015-2017(a)

LIFE EXPECTANCY AT BIRTH
Aboriginal and Torres Strait Islander
Non-Indigenous
Difference between non-Indigenous and Aboriginal and
Torres Strait Islander life expectancy at birth(b)
years
years
years

MALES


NSW
70.9
80.2
9.4
Qld
72.0
79.8
7.8
WA
66.9
80.3
13.4
NT
66.6
78.1
11.5
Aust.(c)
71.6
80.2
8.6

FEMALES


NSW
75.9
83.5
7.6
Qld
76.4
83.2
6.7
WA
71.8
83.8
12.0
NT
69.9
82.7
12.8
Aust.(c)
75.6
83.4
7.8

(a) Based on the average number of Aboriginal and Torres Strait Islander deaths registered in 2015-2017 adjusted for under/over identification of Indigenous Status in registrations, and final Aboriginal and Torres Strait Islander population estimates for 30 June 2016 based on the 2016 Census.
(b) Differences are based on unrounded estimates.
(c) These life expectancy estimates are calculated taking age-specific identification rates into account. 

Further details are available in Life Tables for Aboriginal and Torres Strait Islander Australians, 2015-2017 (cat. no. 3302.0.55.003).

 

NACCHO Aboriginal Children’s Health #refreshtheCTGRefresh #HOSW8 @fam_matters_au Download the #FamilyMatters Report 2018: The report 2018 urges that investment in #prevention is critical to stopping our national child removals crisis

 ” We call on all Australian Governments
 to work with Aboriginal and Torres Strait Islander communities and their representatives over the
 coming year and beyond to implement the evidence based strategies for change that this report shows are desperately needed. We hope that, as a result, next year’s report will show a changing story.

The choices that we make now go to the very heart of our shared obligation to heal our nation’s fractured past and secure our children’s future.”

– Natalie Lewis, Chair of Family Matters

At the launch of this Family Matters Report 2018, the campaign is calling upon the Council of Australian Governments to work in partnership with Aboriginal and Torres Strait Islander leaders and organisations across the country, to develop a generational Aboriginal and Torres Strait Islander children’s strategy to eliminate over-representation in out-of-home care and address the causes of child removals.

Download the Report

Family-Matters-Report-2018

The rate at which Aboriginal and Torres Strait Islander children are being removed from their families is an escalating national crisis.

The Family Matters Report 2018, which was released at the Healing Our Spirit Worldwide Conference in Sydney today, finds that Aboriginal and Torres Strait Islander children are now 10.1 times more likely to be removed from their families than non-Indigenous children. And the rate is projected to triple in the next twenty years if urgent action is not taken.

Fewer than half of Aboriginal and Torres Strait Islander children are placed with Aboriginal and Torres Strait Islander carers, following a steep decline over the last 10 years. This places Aboriginal and Torres Strait Islander children who are removed from their families at serious risk of being permanently disconnected from their families, communities and cultures.

The Family Matters Report 2018 points to a number of issues as the drivers of over-representation of Aboriginal and Torres Strait Islander children in the child protection system. Poverty is one – it was found that 25 per cent of clients accessing homelessness services were Aboriginal and/or Torres Strait Islander people, and most disturbingly, of those clients, one in four was a child under the age of 10.

Family violence was also highlighted in the report, where in 2016-17, emotional abuse, which can include exposure to family violence, was the most common child protection concern for Aboriginal and Torres Strait Islander children.

Another driver of over-representation is intergenerational trauma. Direct descendants of the Stolen Generations are 30 per cent more likely to have poor mental health than other Aboriginal and Torres Strait Islander people. All of these factors put our children at greater risk of entering the child protection system.

The report also notes with concern the strong trends in policy and legislative reform to increase the focus on permanent care and adoption. The recently released report from the Senate Inquiry into Local Adoption recommends pathways to open adoption for all children in out-of-home care, which will disproportionately impact Aboriginal and Torres Strait Islander children.

As recognised in the ALP’s dissenting report this “willfully ignores the weight of evidence from submitters, it also flies in the face of human rights conventions”. Safety for Aboriginal and Torres Strait Islander children is always the priority and this includes ensuring their connection to culture, community and kin, as recognised in the Family Matters Report.

This year’s report is solutions-focussed, highlighting the way forward for positive change. We must shift from being reactive to being proactive, invest heavily in solutions, and involve Aboriginal and Torres Strait Islander people in decision-making about their own children.

Governments are only investing 17% of child protection funding in support services for children and their families, which are critical to preventing the situations that lead to child removals. The majority of child protection funding (83%) is spent on child protection services and out-of-home care – reacting to problems once they’ve already occurred.

There must be a significant boost in funding of culturally safe preventative and early intervention measures to urgently put a stop to these high rates of Aboriginal and Torres Strait Islander child removals.

But, the pace of investment and action in prevention and early intervention is slow. Efforts to address broader community and social issues that contribute to risk for our children across areas such as housing, justice, violence and poverty, remain vastly inadequate and lack coordination… This year’s Family Matters Report puts a spotlight on primary prevention measures in the early years of children’s lives – the years that matter most to changing the storyline for our families.”

– Natalie Lewis, Chair of Family Matters

Another way forward is putting greater focus on early years services to ensure that our children have the best possible start in life. Aboriginal and Torres Strait Islander five-year-olds are 2.5 times more likely to be developmentally delayed than non-Indigenous children. And yet they are accessing early childhood education and care at half the rate of non-Indigenous children. We must facilitate greater access for Aboriginal and Torres Strait Islander children and their families to early years services.

The Family Matters Report 2018 also highlights the importance of Aboriginal and Torres Strait Islander decision-making in child protection. So far only Victoria and Queensland have a statewide program to support Aboriginal families to participate in child protection decisions. Only the same two states have agreed on a comprehensive strategy to improve outcomes for children that is overseen by Aboriginal and Torres Strait Islander representatives. Aboriginal and Torres Strait Islander family-led decision-making in child protection must be rolled out nation-wide to ensure the best outcomes for our children.

Family Matters is Australia’s national campaign to ensure Aboriginal and Torres Strait Islander children and young people grow up safe and cared for in family, community and culture. The campaign is led by SNAICC – National Voice for our Children – the national peak body for Aboriginal and Torres Strait Islander children. Our goal is to eliminate the over-representation of Aboriginal and Torres Strait Islander children in out-of-home care by 2040.

 

NACCHO Aboriginal Health #refreshtheCTGRefresh : @NACCHOchair Welcomes the release of the @AMAPresident 2018 Report Card on Indigenous Health and joins its call for rebuilding the #ClosingtheGap health strategy from the ground up

It’s been a decade since the Council of Australian Governments (COAG) launched the Closing the Gap Strategy, with a target of achieving life expectancy equality by 2031

But 10 years on, progress is limited, mixed, and disappointing. If anything, the gap is widening as Aboriginal and Torres Strait Islander health gains are outpaced by improvement in non-Indigenous health outcomes.

The Strategy has all but unravelled, and efforts underway now to refresh the Strategy run the risk of simply perpetuating the current implementation failures.

The Strategy needs to be rebuilt from the ground up, not simply refreshed without adequate funding and commitment from all governments to a national approach.”

The Closing the Gap Strategy is unravelling, and must be rebuilt from the ground up to have any chance of closing the life expectancy gap between Indigenous and non-Indigenous Australians, AMA President, Dr Tony Bartone said today at the launch of the AMA report at the ATSICHS ACCHO in Brisbane : Interview with The Guardian Part 3 Below 

Download the 24 Page AMA Report 

AMA Indigenous Health Report Card 2018 (2)

Dr Tony Bartone (left ) and Ms Donnella Mills ( Second left ) on tour of ATSICHS

We congratulate the AMA on their work to support closing the gap and endorse the recommendations in the report.”

The report highlights research which indicates the mortality gaps between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians are widening, not narrowing.

Urgent and systematic action is needed to reverse these failures and to have any prospect of meeting the Council of Australian Governments’ goal to Close the Gap in life expectancy by 2031

NACCHO calls for the immediate adoption of the Report Card’s recommendations.

We are seeking a formal partnership between Aboriginal and Torres Strait Islander peoples and governments to be included in the Closing the Gap Refresh policy , Aboriginal people need to be at the centre of Closing the Gap strategies; the gap won’t close without our full engagement and involvement.

The Chairperson of the peak body for Aboriginal controlled health services Ms Donnella Mills today welcomed the release of the AMA’s 2018 Report Card on Indigenous Health and joined its call for rebuilding the Closing the Gap from the ground up. See full NACCHO Press Release HERE 

It doesn’t mean that things aren’t improving, because health outcomes for our people are improving

The challenge is that we’re trying to actually improve the pace of that improvement faster than some of the healthiest people in the world, which is what Australians enjoy – one of the healthiest countries on the globe.

So you’re trying to actually close the gap between some of the sickest people in the world to some of the healthiest people in the world – it was always an ambitious target.”

Adrian Carson, CEO of the Urban Institute of Indigenous Health, said while national outcomes lagged behind, he had seen “significant” health improvements at a local level in south-east Queensland. see Part 3 below or in full here 

Busting the myth that Indigenous-led organisations ‘don’t deliver’

Dr Bartone today launched the AMA Indigenous Health Report Card 2018, the AMA’s annual analysis of an area of Aboriginal and Torres Strait Islander health across the nation.

This year’s Report Card scrutinises the 10-year-old Closing the Gap Strategy, and recent efforts to “refresh” the Strategy.

“It’s been a decade since the Council of Australian Governments (COAG) launched the Closing the Gap Strategy, with a target of achieving life expectancy equality by 2031,” Dr Bartone said.

“But 10 years on, progress is limited, mixed, and disappointing. If anything, the gap is widening as Aboriginal and Torres Strait Islander health gains are outpaced by improvement in non-Indigenous health outcomes.

“The Strategy has all but unravelled, and efforts underway now to refresh the Strategy run the risk of simply perpetuating the current implementation failures.

“The Strategy needs to be rebuilt from the ground up, not simply refreshed without adequate funding and commitment from all governments to a national approach.”

The Report Card outlines six targets to rebuild the Strategy:

  • committing to equitable, needs-based expenditure;
  • systematically costing, funding, and implementing the Closing the Gap health and mental health plans;
  • identifying and filling primary health care service gaps;
  • addressing environmental health and housing;
  • addressing the social determinants of health inequality; and
  • placing Aboriginal health in Aboriginal hands.

“It is time to address the myth that it is some form of special treatment to provide additional health funding to address additional health needs in the Aboriginal and Torres Strait Islander population,” Dr Bartone said.

“Government spend proportionally more on the health of older Australians when compared to young Australians, simply because elderly people’s health needs are proportionally greater.

“The same principle should be applied when assessing what equitable Indigenous health spending is, relative to non-Indigenous health expenditure.

“The Australian Institute of Health and Welfare estimates that the Aboriginal and Torres Strait Islander burden of disease is 2.3 times greater than the non-Indigenous burden, meaning that the Indigenous population has 2.3 times the health needs of the non-Indigenous population.

“This means that for every $1 spent on health care for a non-Indigenous person, $2.30 should be spent on care for an Indigenous person.

“But this is not the case. For every $1 spent by the Commonwealth on primary health care, including Medicare, for a non-Indigenous person, only 90 cents is spent on an Indigenous person – a 61 per cent shortfall.

“For the Pharmaceutical Benefits Scheme, the gap is even greater – 63 cents for every dollar, or a 73 per cent shortfall from the equitable spend.

“Spending less per capita on those with worse health, and particularly on their primary health care services, is dysfunctional national policy. It leads to us spending six times more on hospital care for Indigenous Australians than we do on prevention-oriented care from GPs and other doctors.

“We will not close the gap until we provide equitable levels of health funding. We need our political leaders and commentators to tackle the irresponsible equating of equitable expenditure with ‘special treatment’ that has hindered efforts to secure the level of funding needed to close the health and life expectancy gap.”

AMA Media Coverage 

The AMA 2018 Indigenous Health Report Card is at https://ama.com.au/article/2018-ama-report-card-indigenous-health-rebuilding-closing-gap-health-strategy-and-review

Part 2 : The Chairperson of the peak body for Aboriginal controlled health services Ms Donnella Mills today welcomed the release of the AMA’s 2018 Report Card on Indigenous Health and joined its call for rebuilding the Closing the Gap from the ground up.

Download the full NACCHO Press Release HERE

National Aboriginal Community Controlled Health Organisation (NACCHO) Chairperson, Ms Donnella Mills said, “We congratulate the AMA on their work to support closing the gap and endorse the recommendations in the report.”

The report highlights research which indicates the mortality gaps between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians are widening, not narrowing.

The AMA estimate that the Commonwealth government spend on Aboriginal and Torres Strait Islander health is only 53% of needs-based requirements. Aboriginal and Torres Strait Islander peoples have at least twice the per capita need of the rest of the population because of much higher levels of illness and burden of disease.

“This underspend represents a significant failure” Ms Mills said. “Genuine commitment by Australian governments to Closing the Gap requires equitable funding.”

The funding shortfall is particularly important for primary health care services where big gains could be made in improving health, keeping people out of hospital and preventing premature deaths. Funding for Aboriginal Community Controlled Health Services, which deliver accessible, culturally safe, comprehensive primary health care across Australia, is not keeping up with need.

Alongside the increased funding for Aboriginal Community Controlled Health Service there is an urgent need for government to address the environmental health, housing and other social determinants of health inequality.

NACCHO, its Affiliates and members will continue to work with the AMA to urge the adoption of the Report Card’s recommendations by Australian governments.

Part 3 Busting the myth that Indigenous-led organisations ‘don’t deliver’

From NITV

Adrian Carson, CEO of the Urban Institute of Indigenous Health, said while national outcomes lagged behind, he had seen “significant” health improvements at a local level in south-east Queensland.

He urged governments to place more trust in Indigenous-led organisations to deliver services.

“This country’s still got a crisis in terms of its relationship with the First People,” Mr Carson told NITV News.

“The narrative’s a negative one, it’s always deficit-based, but we turn around and look at what parts of our sector are doing… we’re actually coming up with improved health outcomes within our community – they’re actually solutions that could benefit the whole country.

So this whole idea that somehow our communities can’t be trusted, or that we don’t have the capacity to deliver, is a myth.”

Mr Carson said while he welcomed the AMA’s report, it was important to take a proactive approach rather than dwelling on negative statistics.

“It doesn’t mean that things aren’t improving, because health outcomes for our people are improving,” he said.

“The challenge is that we’re trying to actually improve the pace of that improvement faster than some of the healthiest people in the world, which is what Australians enjoy – one of the healthiest countries on the globe.

“So you’re trying to actually close the gap between some of the sickest people in the world to some of the healthiest people in the world – it was always an ambitious target.”

Part 4 The Guardian Interview

The Australian Medical Association says the Closing the Gap strategy has “all but unravelled” and insists that the policy needs to be rebuilt from the ground up, starting with boosting health expenditure on Indigenous Australians and putting Aboriginal healthcare in Aboriginal hands.

A refresh of the program is expected to be considered at the December meeting of the Council of Australian Governments, but the AMA president, Tony Bartone, says Closing the Gap needs root-and-branch reform, not changes “without adequate funding and commitment from all governments to a national approach”.

Read in full 

 

 

NACCHO Aboriginal Health and #refreshtheCTGRefresh Campaign : 13 peak Aboriginal and Torres Strait Islander bodies propose meeting  with COAG reps to determine a framework for reaching agreement on a refreshed #ClosingtheGap strategy

We understand that at this stage it is intended that new Closing the Gap targets will be settled at COAG’s December meeting,

We are calling on COAG to hold off doing this and instead put in place a proper partnership mechanism with us. The new targets haven’t been published and Indigenous peaks are uncertain what the targets will be and therefore we cannot provide our support.

NACCHO and the peak bodies engaged with the process, took time to submit written submissions and attend workshops to discuss refreshing the Closing the Gap strategy earlier this year. But we can’t see how our input has been taken into account,

As a first step we propose a meeting with COAG representatives and the peak bodies to discuss a way forward that includes a genuine partnership approach.

Aboriginal people need to be at the centre of the Closing the Gap Refresh policy; the gap won’t close without our full engagement and involvement.

Having Aboriginal people involved in the design of the Refresh and proposed revised targets will lead to Aboriginal people taking greater responsibility for the outcomes. It’s been proven that Aboriginal community control is vital and delivers better outcomes for our people.” 

NACCHO Chief Executive Pat Turner AM see interview Part 3 below 

Download the NACCHO Press Release Here

NACCHO media release Refresh The CTG Refresh

Part 1 NACCHO Press Release continued 

The National Aboriginal Community Controlled Health Organisation (NACCHO) and other Aboriginal peak bodies across Australia have written to COAG First Ministers seeking a full partnership approach between Indigenous people and governments in refreshing the Closing the Gap Strategy, scheduled to be put to COAG for consideration in Adelaide on 12 December.

The letter, signed by 13 peak bodies, proposes an urgent meeting of Aboriginal and Torres Strait Islander peak bodies to meet with COAG representatives to determine a framework for reaching agreement on a refreshed Closing the Gap strategy.

It’s the second letter the group has written to COAG after failing to receive a response to their initial letter in early October from any government except the Northern Territory.

Part 2 Letter to Council of Australian Government First Ministers

Dear Council of Australian Government First Ministers 16/11/2018

We write again, further to our letter of 4 October 2018, concerning the Closing the Gap Refresh, a joint initiative of the Council of Australian Governments (COAG), to seek a formal partnership mechanism between Aboriginal and Torres Strait Islander peoples and governments in the Closing the Gap Refresh policy. We have only received a response from the Northern Territory Government.

As stated in our original letter, all of us believe it is essential that agreement is reached on the Closing the Gap Refresh policy between Indigenous organisations, on behalf of communities across Australia and Australian governments. What we propose is entirely consistent with the commitment made by COAG to set a new relationship with our communities based on a partnership.

If governments alone, continue to make decisions about the Closing the Gap, without an opportunity for us to be at the table, it will not be possible to advocate with any confidence or motivate our communities to support Closing the Gap and to take joint responsibility with governments for achieving the targets.

Pictures above and below from our #refreshtheCTGRefresh Campaign

The evidence is strong that when Indigenous people are included and have a real say in the design and delivery of services that impact on them, the outcomes are far better. We are certain that Indigenous peoples need to be at the centre of the Closing the Gap Refresh policy: the gap won’t close without our full involvement and COAG First Ministers, who are responsible for the Closing the Gap framework, cannot expect us to take responsibility and work constructively with them to improve outcomes if we are excluded from the decision making.

We have proposed a reasonable way forward to Australian Governments in our original letter without making it public to give everyone a reasonable opportunity to consider it. However, we understand that it is the intention of Australian Governments to still settle on targets at the forthcoming meeting of COAG on 12 December 2018.

We also understand that implementation arrangements are to be left over for COAG to agree in 2019. We make the points that neither ourselves nor anyone else outside government have seen the proposed targets which we think is way short of being partners and transparent and we cannot see how the targets can be agreed without considering at the same time how they are to be achieved.

We assume that Australian Governments will justify agreeing to targets by referring to the consultations earlier this year. Those consultations were demonstrably inadequate. They were conducted at a very superficial level without an opportunity for Indigenous interests to be prepared for the workshops held across Australia.

They were based on a discussion paper produced by the Department of the Prime Minister and Cabinet in December 2017 and which stated that only one of the seven targets was on track which two months later was contradicted by the former Prime Minister who said that three targets were on track. Critical elements of the original Closing the Gap framework, particularly COAG’s National Indigenous Reform Agreement, were not referred to at all in the consultations and the focus was on new targets instead of how we could make sure that this time around they were achieved.

There was no independent report prepared on the outcomes of the consultations and there is no way of telling if what was said in the consultations is reflected in the proposed Refresh policy including the targets.

The consultations started far too late which has left us with 4 targets having expired in June 2018. We do not accept that we have been properly consulted let alone given the opportunity to negotiate a mechanism that allows a proper partnership to be put in place in relation to the design, delivery and monitoring of Closing the Gap.

There is a now a significant opportunity to put this disappointing process back on track and in particular to establish a robust Closing the Gap framework founded on a genuine partnership between Indigenous people and governments.

It is open to governments on 12 December 2018, to endorse a partnership approach and establish a mechanism to initiate negotiations between representatives of COAG and Peak organisations with a view to developing a genuine partnership as part of the Closing the Gap Refresh. This would be endorsed by the Peak Organisations across Australia.

Subject to COAG endorsing a partnership approach, we propose a meeting of Aboriginal and Torres Strait Islander Peak bodies to meet with COAG representatives to determine a framework for reaching agreement on a refreshed closing the gap strategy.

We stand ready to do this quickly and would work with COAG on having a partnership framework in place in early 2019 with a revised approach agreed by the middle of the year.

Ms Pat Turner AM, the CEO of the National Aboriginal Community Controlled Health Organisation, is our contact for the purpose of responding to this vital matter and we ask that you contact her.

We look forward to working with you on the Closing the Gap Refresh through an established partnership mechanism.

Yours sincerely,

 

Part 3 Going backwards’: Aboriginal bodies take aim at Closing the Gap

Aboriginal peak organisations have slammed federal, state and territory governments for failing to give Indigenous leaders an effective role in re-energising the faltering Closing the Gap process.

In a letter written jointly to Prime Minister Scott Morrison, chief ministers and premiers, the leaders of the 13 peak bodies say they have been shut out of meaningful consultation about refreshed targets to overcome Aboriginal disadvantage.

By Deborah Snow SMH 19 November

Pat Turner, chief executive of the National Aboriginal Community Controlled Health Organisation, said "it's all gone backwards".
Pat Turner, chief executive of the National Aboriginal Community Controlled Health Organisation, said “it’s all gone backwards”. CREDIT:GLENN CAMPBELL

And they want the Coalition of Australian Governments – due to consider an update to Closing the Gap next month – to defer setting new targets until a fresh pact is hammered out giving “full partnership” to Aboriginal bodies.

“I think it’s all gone backwards,” the chief executive of the National Aboriginal Community Controlled Health Organisation (NACCHO), Pat Turner,  told the Herald.

“In the last few years, governments seem to have dropped the ball a lot. I hope they are giving serious consideration to our letter. They can’t go on having two bob each-way. They are there to lead and they have to have a bit of backbone. [The state of] Aboriginal affairs is a national shame, it is something that they should be wanting to get fixed.”

Ms Turner said only one government – the Northern Territory – had bothered replying to the group when they first wrote a letter a month ago seeking better consultation over new targets and implementation strategies.

“NACCHO and the peak [Indigenous] bodies engaged with the process took time to submit written submissions and attend workshops to discuss refreshing the Closing the Gap strategy earlier this year” she said. “But we can’t see how our input has been taken into account.”

The peak bodies decided on Sunday to release a second letter they wrote to all governments at the end of last week.

The letter says the “disappointing” Closing the Gap process has to be put “back on track” with Indigenous people taking part in the design and delivery of services on the basis of “genuine partnership”.

“As a first step we propose a meeting with COAG representatives and the peak bodies to discuss [such an] approach” Ms Turner said.

The Herald sought a response from Aboriginal Affairs minister Nigel Scullion but was unable to contact his office on Sunday.

Closing the Gap was first conceived of a decade ago as a way to measure Aboriginal disadvantage and set clear targets to redress it.

Earlier this year a report from the Department of Prime Minister and Cabinet said three of seven targets were “on track”: to halve the gap in year 12 attainment and halve the gap in child mortality by 2018, and to have 95 per cent of Indigenous four-year-olds enrolled in early childhood education by 2025.

However it said that other targets, including halving the gap in reading and numeracy, and halving the gap in employment, as well as closing the gap on life expectancy, were not on track.

 

 

 

NACCHO Aboriginal Women’s Health #SistersInside #imaginingabolition : Our CEO Pat Turner address to @SistersInside 9th International Conference Decolonisation is not a metaphor’: Abolition for First Nations women

NACCHO supports the abolition of prisons for First Nations women. The incarceration of Aboriginal and Torres Strait Island women should be a last resort measure.

It is time to consider a radical restructuring of the relationship between Aboriginal people and the state.

Aboriginal and Torres Strait Islander people and their communities must be part of the design, decision-making and implementation of government funded policies, programs and services that aim to reduce – or abolish –the imprisonment of our women.

Increased government investment is needed in community-led prevention and early intervention programs designed to reduce violence against women and provide therapeutic services for vulnerable women and girls. Programs and services that are holistic and culturally safe, delivered by Aboriginal and Torres Strait Islander organisations.

NACCHO calls for a full partnership approach in the Closing the Gap Refresh, so that Aboriginal people are at the centre of decision-making, design and delivery of policies that impact on them.

We are seeking a voice to the Commonwealth Parliament, so we have a say over the laws that affect us. “

Pat Turner NACCHO CEO Speaking at  Sisters Inside 9th International Conference 15 Nov

See Pats full speaking notes below

Theme of the day: ‘Decolonisation is not a metaphor’: Abolition for First Nations women

About Sisters Inside

  • Sisters Inside responds to criminalised women and girls’ needs holistically and justly. We work alongside women and girls to build them up and to give them power over their own lives. We support women and girls to address their priorities and needs. We also advocate on behalf of women with governments and within the legal system to try to achieve fairer outcomes for criminalised women, girls and their children.
  • At Sisters Inside, we call this ‘walking the journey together’. We are a community and we invite you to be part of a brighter future for Queensland’s most disadvantaged and marginalised women and children.

Sisters Inside Website Website 

In Picture above Dr Jackie Huggins, Pat Turner, Jacqui Katona, Dr Chelsea Bond and June Oscar, Aunty Debbie Sandy and chaired by Melissa Lucashenko.

Panel: Why abolition for First Nations Women?

Panel members:

  • Dr Jackie Huggins AM FAHA (Co-Chair, National Congress of Australia’s First Peoples)
  • Pat Turner AM (CEO, National Aboriginal Community Controlled Health Organisation)
  • Dr Chelsea Bond (Senior Lecturer, University of Queensland)
  • Jacqui Katona (Activist & Sessional Lecturer (Moondani Balluk), Victoria University)
  1. Imprisonment, colonialism, and statistics
  • The Australian justice system was founded on a white colonial model that consistently fails and seeks to control and supress Aboriginal and Torres Strait Islander peoples.
  • Indigenous peoples are overrepresented in the prison system:
    • Aboriginal and Torres Strait Islander adults are 12.5 times more likely to be imprisoned than non-Indigenous Australians.[i]
    • Our women represent the fastest growing group within prison populations and are 21 times more likely to be imprisoned than non-Indigenous women.[ii]
  • Imprisonment is another dimension to the historical and contemporary Aboriginal experience of colonial removal, institutionalisation and punishment.[iii]
  • Our experiences of incarceration are not only dehumanising. They contribute to our ongoing disempowerment, intergenerational trauma, social disadvantage, and burden of disease at an individual as well as community level.
  1. Aboriginal and Torres Strait Islander women’s experiences of imprisonment
  • The Change the Record report found that most Aboriginal and Torres Strait Islander women who enter prison systems:
    • are survivors of physical and sexual violence, and that these experiences are most likely to have contributed to their imprisonment; and
    • struggle with housing insecurity, poverty, mental illness, disability and the effects of trauma.
  • Family violence must be understood as both a cause and an effect of social disadvantage and intergenerational trauma.
  • Risk factors for family violence include poor housing and overcrowding, substance misuse, financial difficulties and unemployment, poor physical and mental health, and disability.[iv]
  • Imprisoning women affects the whole community. Children are left without their mothers. The whole community suffers.
  1. Kimberley Suicide Prevention Trial
  • The Kimberley Suicide Prevention Trial, of which NACCHO is a member, provides a grim example of the link between trauma, suicide, incarceration and the social determinants of health.
  • The rate of suicide in the Kimberley is seven times that of other Australian regions.
  • Nine out of ten suicides involve Aboriginal people.
  • Risk factors include imprisonment, poverty, homelessness and family violence.
  • Western Australia has the highest rate of Aboriginal and Torres Strait Islander imprisonment.
  1. Imprisonment and institutional racism
  • The overrepresentation of Aboriginal peoples in prison systems is not simply a law-and-order issue.[v] The trends of over-policing and imprisoning of Indigenous peoples are examples of institutional racism inherent in the justice system. [vi]
  • Institutional racism affects our everyday encounters with housing, health, employment and justice systems.
  • Institutional racism is not only discriminatory; it entrenches intergenerational trauma and socioeconomic disadvantage.[vii]
  • Exposure to racism is associated with psychological distress, depression, poor quality of life, and substance misuse, all of which contribute significantly to the overall ill-health experienced by Indigenous people. We are twice as likely to die by suicide or be hospitalised for mental health or behavioural reasons.
  1. Ways forward see opening quote Pat Turner 
  2. The role of ACCHSs in supporting Indigenous women

Increasing access to the health care that people need

  • Racism is a key driver of ill-health for Indigenous people, impacting not only on our access to health services but our treatment and outcomes when in the health system.
  • Institutional racism in mainstream services means that Indigenous people do not always receive the care that we need from Australia’s hospital and health system.
  • It has been our experience that many Indigenous people are uncomfortable seeking help from mainstream services for cultural, geographical, and language disparities as well as financial costs associated with accessing services.
  • The combination of these issues with racism means that we are less likely to access services for physical and mental health conditions, and many of our people have undetected health issues like poor hearing, eyesight and chronic conditions.

Early detection of health issues that are risk factors for incarceration

  • The Aboriginal Community Controlled Health model provides answers for addressing the social determinants of health, that is, the causal factors contributing to the overrepresentation of Indigenous women’s experiences of family violence and imprisonment.
  • Aboriginal Community Controlled Health organisations should be funded to undertake comprehensive, regular health check of Aboriginal women so that risk factors are identified and addressed early.

Taking a holistic approach to health needs and social determinants of health and incarceration

  • Overall, the Aboriginal Community Controlled Health model recognises that Aboriginal and Torres Strait Islander people require a greater level of holistic healthcare due to the trauma and dispossession of colonisation which is linked with our poor health outcomes.
  • Aboriginal Community Controlled Health is more sensitive to the needs of the whole individual, spiritually, socially, emotionally and physically.
  • The Aboriginal Community Controlled Model is responsive to the changing health needs of a community because it of its small, localised and agile nature. This is unlike large-scale hospitals or private practices which can become dehumanised, institutionalised and rigid in their systems.
  • Aboriginal Community Controlled Health is scalable to the needs of the community, as it is inextricably linked with the wellbeing and growth of the community.
  • The evidence shows that Aboriginal Community Controlled organisations are best placed to deliver holistic, culturally safe prevention and early intervention services to Indigenous women.
  1. About NACCHO
  • NACCHO is the national peak body representing 145 ACCHOs across the country on Aboriginal health and wellbeing issues. In 1997, the Federal Government funded NACCHO to establish a Secretariat in Canberra, greatly increasing the capacity of Aboriginal peoples involved in ACCHOs to participate in national health policy development.
  • Aboriginal Community Controlled Health first arose in the early 1970s in response to the failure of the mainstream health system to meet the needs of Aboriginal and Torres Strait Islander people and the aspirations of Aboriginal peoples for self-determination.
  • An ACCHO is a primary health care service initiated and operated by the local Aboriginal community to deliver holistic, comprehensive, and culturally appropriate health care to the community which controls it, through a locally elected Board of Management. ACCHOs form a critical part of the Indigenous health infrastructure, providing culturally safe care with an emphasis on the importance of a family, community, culture and long-term relationships.
  • Our members provide about three million episodes of care per year for about 350,000 people. In very remote areas, our services provided about one million episodes of care in a twelve-month period. Collectively, we employ about 6,000 staff (most of whom are Indigenous), which makes us the single largest employer of Indigenous people in the country.

[i] https://www.alrc.gov.au/publications/over-representation

[ii] Human Rights Law Centre and Change the Record Coalition, 2017, Over-represented and overlooked: the crisis of Aboriginal and Torres Strait Islander women’s growing over-imprisonment: NB: The foreword is written by Vicki Roach, a presenter in the next session of the Abolition conference

[iii] file://nfs001/Home$/doris.kordes/Downloads/748-Article%20Text-1596-5-10-20180912.pdf – John Rynne and Peter Cassematis, 2015, Crime Justice Journal, Assessing the Prison Experience for Australian First Peoples: A prospective Research Approach, Vol 4, No 1:96-112.

[iv] Australian Institute of Health and Welfare. 2018. Family, domestic and sexual violence in Australia. Canberra.

[v] https://www.theguardian.com/australia-news/2017/feb/20/indigenous-incarceration-turning-the-tide-on-colonisations-cruel-third-act

[vi] ‘A culture of disrespect: Indigenous peoples and Australian public institutions’.

[vii] https://www.theguardian.com/australia-news/2018/jul/12/indigenous-women-caught-in-a-broken-system-commissioner-says