‘ACCHOs have a strong history in doing this effectively and appropriately for their communities,
Specifically, ACCHO-embedded non-dispensing pharmacists and community pharmacies have a role in identifying risk factors and encouraging heart health checks within the ACCHO communities.’
Deputy NACCHO CEO Dr Dawn Casey
With new research showing current cardiovascular disease screening guidelines are missing younger at-risk Aboriginal people, a leading Aboriginal health specialist has highlighted the role pharmacists can play in preventative cardiac care.
The statement Dr Dawn Casey comes following research finding up to half of older Australian Aboriginal and Torres Strait Islander people are at high risk of cardiovascular disease (CVD), and that significant numbers of those in their 20s were also at risk.¹
Australian National University researchers found 1.1% of Aboriginal and Torres Strait Islander 18-24 year olds and 4.7% of 25-34 year olds were at high absolute primary risk of CVD. This is around the same as the proportion of non-Indigenous Australians aged 45-54 who are at high risk.¹
The study of 2820 people from a 2012-13 health survey² revealed many Aboriginal and Torres Strait Islander people are not aware of their risk and most not receiving currently recommended therapy to lower their cholesterol, and are hospitalised for coronary heart disease at a rate up to eight times higher than that of other Australians.¹
Australia’s national guidelines recommend all Aboriginal and Torres Strait Islander peoples aged 35-74 have a heart check. But this new research found the high-risk category starts much earlier than this, and indicates the affected group needs to start receiving CVD checks earlier in life, the study authors said.
Dr Casey echoed the positive results of the study, allowing the entire ACCHS sector to better deliver preventative and holistic care.
‘ACCHOs have a strong history in doing this effectively and appropriately for their communities,’ she told Australian Pharmacist.
‘Specifically, ACCHO-embedded non-dispensing pharmacists and community pharmacies have a role in identifying risk factors and encouraging heart health checks within the ACCHO communities.’
‘Embedded ACCHO pharmacists can use their skills and knowledge work with a range of clinicians in the ACCHO to conduct holistic risk screening and overall management strategy.
NACCHO is currently actively advocating for enhanced integration of pharmacists into ACCHOs models of care.’
NACCHO and PSA are currently working as part of a broader team on two projects to enhance the broader roles that pharmacists’ skills and training can deliver – Integrating Pharmacists within Aboriginal Community Controlled Health Services to improve Chronic Disease Management (IPAC) and Indigenous Medication Review Service (IMeRSe).
‘Pharmacists have a broad range of clinical skills and are often very suitable additions to multidisciplinary clinical teams, especially where chronic disease is prevalent and many medicines required,’ Dr Casey said.
‘Community pharmacists may identify risks within normal client care, for example through a pharmacy-based MedsCheck or an HMR. Where team-based care is working effectively, pharmacies and ACCHOs will liaise and work together to ensure care is optimised across these settings.
‘Pharmacists’ understanding of medicines also involves understanding how medical conditions and risk factors for these conditions apply. Unfortunately there is still sometimes a misconception across Australia that pharmacists really just supply medicines and manage retail businesses. Enhancing professional and clinical services is a key trend across the whole pharmacy sector and NACCHO is an active participant in these developments.’
PSA and NACCHO have collaboratively produced guidelines to support pharmacists caring for Aboriginal and Torres Strait Islander people available at:
1 Calabria B, Korda RJ, Lovett RW, Fernando P, Martin T, Malamoo L, Welsh J, Banks, E. Absolute cardiovascular disease risk and lipid-lowering therapy among Aboriginal and Torres Strait Islander Australians. Med J Aust 2018; 209 (1): 35-41. DOI: 10.5694/mja17.00897
” Heart-related conditions, such as coronary heart disease, heart failure, and rheumatic heart disease (RHD), contribute substantially to poor health and reduced life expectancy among Aboriginal and Torres Strait Islander people.
Cardiac conditions are more common among Indigenous than non-Indigenous Australians, and there are many interconnected reasons for this, including higher rates of risk factors for cardiac conditions (such as smoking, low levels of physical activity, overweight or obesity, diabetes, and high blood pressure), and poorer access to preventative health services “
The Better Cardiac Care for Aboriginal and Torres Strait Islander People project is an initiative that was developed at the Better Cardiac Care for Aboriginal and Torres Strait Islander People Forum, held in March 2014 (BCCF 2014).
Representatives from various Indigenous and other organisations, as well as Australian Government and jurisdictional health departments attended the forum.
The project aims to reduce mortality and morbidity from cardiac conditions among Indigenous Australians, by increasing access to services, better managing risk factors and treatment, and improving coordination of care.
The forum established 5 priority areas of interventions that health services should undertake to improve cardiac care for Indigenous Australians, which:
are aligned with national and international best-practice guidelines for cardiac care and chronic disease
were informed by the Essential Service Standards for Equitable National Cardiovascular Care
focus on providing sustainable models of care built around partnerships between all health service providers.
primary preventive care—early cardiovascular risk assessment and management
clinical suspicion of disease—timely diagnosis of heart disease and heart failure
acute episode—guideline-based therapy for acute coronary syndrome
ongoing care—optimisation of health status and provision of ongoing preventive care
rheumatic heart disease—strengthening the diagnosis, notification, and follow-up of RHD.
A set of 21 Better Cardiac Care measures (Table 1.1) were also developed to track the implementation and monitoring of the priority areas and associated actions
Priority area 1: Early cardiovascular risk assessment and management
Priority area 1 of the Better Cardiac Care project is early cardiovascular risk assessment and management. This is based on the premise that all Aboriginal and Torres Strait Islander people with no known cardiac disease should receive:
an annual cardiovascular risk assessment
appropriate management and follow-up for identified cardiac disease risk factors
lifestyle modification advice appropriate to their cardiovascular risk level, as per current guidelines (NACCHO & RACGP 2012).
Primary prevention in the form of early and consistent risk factor identification and management will improve long-term outcomes for Indigenous Australians, reduce the population burden of chronic cardiac disease, and improve the appropriate delivery of care by the health-care system (BCCF 2014).
Three measures were agreed upon within this priority area, and updated data are available for measure 1.1 on health assessments.
The data for measure 1.2 are expected to become available for the next report, which will be provided based on the AIHW data collection on the national key performance indicators for Aboriginal and Torres Strait Islander primary health care.
Measure 1.1: Annual health assessments
This measure reports on the number and proportion of Indigenous Australians who had a Medicare Benefits Schedule (MBS) health assessment in the previous 12 months (Table B.2 in Appendix B contains the list of relevant MBS item numbers included in the measure).
Why is it important?
Health assessments aim to increase preventative health opportunities, detect chronic disease risk factors, manage existing chronic disease, and reduce inequities in access to primary care for Indigenous Australians. Early detection and management of risk factors for cardiac disease (such as smoking, physical inactivity, high blood pressure) can reduce the incidence of cardiac disease and lessen its severity.
All Indigenous Australians are eligible for an annual health assessment, which is listed as item 715 on the MBS.This comprehensive health asessement covers a wide variety of risk factors related to cardiac disease and other chronic diseases, including medical history, nutrition, physical activity, smoking and alcohol intake, living conditions, and body mass index, although it is not a specific cardiovascular risk assessment. People within specified target groups may also be eligible for other types of MBS health assessments (Department of Health 2014), which are referred to as ‘general’ health assessments in this report.
In 2015–16, more than one-quarter of Indigenous Australians (27%, or an estimated 199,400 people) received a health assessment—about 26% received an MBS item 715 health assessment, and about 1% received a general health assessment (Figure 1.1a).
Between 2004–05 and 2015–16, the age-standardised proportion of Indigenous Australians who had an MBS health assessment rose from 2% to 27% for females, and from 2% to 24% for males (Figure 1.1b).
From 2014–15 to 2015–16, the overall proportion rose by 3 percentage points.
A marked increase occurred from 2010–11, coinciding with the introduction of the Australian Government’s Indigenous Chronic Disease Package.
Sex and age:
more Indigenous females than males had an MBS health assessment (Figure 1.1b)
about one-quarter (25%) of Indigenous children aged under 15 had an MBS health assessment. Among Indigenous Australians aged 15 and over, the proportion rose from 21% among those aged 15–24 to 38% among those aged 65 and over (Figure 1.1c).
State/territory and remoteness area:
In 2015–16, the proportion of Indigenous Australians who had an MBS health assessment was:
highest in Queensland (33%), and lowest in Tasmania (9%) (Figure 1.1d)
highest in Inner/Outer regional areas combined (29%), and lowest in Major cities (21%)
Priority area 2: Timely diagnosis of heart disease and heart failure
Priority area 2 of the Better Cardiac Care project is timely diagnosis of heart disease and heart failure.
This is based on the premise that all Aboriginal and Torres Strait Islander people suspected of having heart disease or heart failure should receive appropriate initial diagnostic services (such as stress testing or coronary angiography for ischaemic heart disease, or echocardiography for heart failure and rheumatic heart disease) as close to the patient’s home as possible, within acceptable timeframes according to the level of risk and the patient’s condition (BCCF 2014).
Of the 3 measures recommended for this priority area, data are available for:
measure 2.1 for Medicare-listed diagnostic items
measure 2.3 for cardiologist review of suspected/confirmed cardiac disease
Measure 2.1: Cardiac-related diagnosis
This measure reports on the number and proportion of Indigenous Australians who had 1 or more relevant cardiac-related MBS diagnostic item claims in the previous 12 months, compared with non-Indigenous Australians (Table B.2 in Appendix B contains the list of relevant MBS item numbers included in the measure).The current report includes additional MBS items within measure 2.1, compared with the second national report (AIHW 2016); as such the results are not comparable. Additional MBS items were used to more accurately capture the status of cardiac-related diagnoses, and were obtained from the Cardiac Services Clinical Committee of the Medical Benefit Schedule Review Taskforce (Department of Health 2017).
Why is it important?
People suspected of having cardiac disease should receive appropriate and timely diagnostic services. Categories of diagnostic tests captured by this measure include:
diagnostic procedures and investigations—19 items that include various kinds of electrocardiography, and pacemaker and defibrillator testing
diagnostic imaging services—25 items that include various kinds of echocardiography, computed tomography scans and angiography (Department of Health 2018).
64,909 MBS claims for cardiac-related diagnostic items were made for Indigenous patients (age-standardised proportion of 13.2%), compared with 3,178,327 claims for non-Indigenous patients (proportion of 12.1%).
45,932 claims for diagnostic procedures and investigations (age-standardised proportion of 9.3%), and 18,977 claims for diagnostic imaging services (age-standardised proportion of 3.9%) were made for Indigenous patients—both proportions were slightly higher than for non-Indigenous Australians (Figure 2.1a).
Between 2004–05 and 2015–16, the age-standardised proportion of Indigenous Australians who had cardiac-related diagnostic items MBS claims rose from 6.8% to 10.4%, with a similar pattern for non-Indigenous Australians (rising from 6.9% to 9.1%) (Figure 2.1b).
Sex and age:
In 2015–16, the proportion of Indigenous Australians who had MBS claims for cardiac-related diagnostic items:
rose with increasing age, with the lowest proportion among those aged under 25. It was slightly higher than that of non-Indigenous Australians in all age groups, except for those aged 65 and over, where proportions were higher among non-Indigenous Australians (Figure 2.1c)
was lower overall than that of non-Indigenous Australians, for men and women, with Indigenous women having slightly higher proportions than Indigenous men (Figure 2.1d).
Better Cardiac Care measures for Aboriginal and Torres Strait Islander people 2017 11
State/territory and remoteness area:
In 2015–16, the proportions of MBS claims for cardiac-related diagnostic items:
ranged from 3% to 13% across states and territories, and from 7% to 8% across remoteness areas among Indigenous Australians (figures 2.1e and 2.1f)
were lower among Indigenous Australians living in Major cities and Inner/Outer regional areas combined than their non-Indigenous counterparts (Figure 2.1f).
Priority area 4: Optimisation of health status and provision of ongoing preventive care
Priority area 4 is optimisation of health status and provision of ongoing preventive care. This is based on the premise that all Aboriginal and Torres Strait Islander people with cardiac conditions should receive ongoing multidisciplinary primary health care and specialist physician follow-up as required, to prevent further illness, and to optimise health status (BCCF 2014).
Of the 4 measures recommended for this priority area, MBS data are available for:
measure 4.2 for follow-up after receiving a cardiovascular therapeutic procedure
measure 4.3 for specialist physician review after a cardiovascular therapeutic procedure
Priority area 5: Strengthening the diagnosis, notification and follow-up of rheumatic heart disease
Priority area 5 of the Better Cardiac Care project is strengthening the diagnosis, notification and follow-up of rheumatic heart disease (RHD) (BCCF 2014). This is based on the premise that:
all Aboriginal and Torres Strait Islander people suspected to have acute rheumatic fever (ARF) or RHD should receive an echocardiogram as early as possible
new cases should be automatically reported to a central register to help track patients, and ensure ongoing care.
There is no diagnostic pathology test for ARF; instead, its diagnosis is based on a clinical decision (RHD Australia et al. 2012). The clinical manifestation of ARF is non-specific and can be atypical, with delays in both presentation and referral of patients. As a result, ARF can often go undetected in the acute stage, leading to ongoing complications and lifelong morbidity.
Of the 4 measures recommended for this priority area, data are available from RHD registers in Queensland, Western Australia, South Australia, and the Northern Territory for:
measure 5.1 for the annual incidence of ARF and RHD
measure 5.2 for recurrent ARF
measure 5.3 for treatment with benzathine penicillin G doses
measure 5.4 for echocardiograms among patients with severe or moderate RHD.
” Programs aimed at prevention should also be co-designed with Aboriginal and Torres Strait Islander peoples, taking into account social and cultural barriers that impact access and ongoing treatment.
The good news is, we know heart attacks and strokes can be prevented and we have effective treatments to achieve this. Within Aboriginal and Torres Strait Islander communities there is huge potential to prevent heart attacks and stroke.
Many people don’t receive a heart check and could be at high risk without knowing it. Prevention starts with getting a heart check and continuing to use any medications prescribed to you by your doctor to lower your risk ‘
Professor of Epidemiology and Public Health, National Centre for Epidemiology and Population Health, Australian National University, Canberra
Associate Professor Ray Lovett
Head of Aboriginal and Torres Strait Islander Health Program, National Centre for Epidemiology and Population Health, Australian National University, Canberra
Most heart attacks and strokes can be prevented with appropriate treatment. Yet heart disease, including heart attacks, causes 13% of deaths among Australia’s Aboriginal and Torres Strait Islander peoples and is a major contributor to the gap in life expectancy with non-Indigenous Australians.
New findings from a study published today in the Medical Journal of Australia show vast room for improvement in heart health among Aboriginal and Torres Strait Islander peoples.
Who is at risk?
This new research found 10% of Aboriginal and Torres Strait Islander people aged 35-74 years old have heart disease (compared to 9% aged 45-74 in the general population). Another 16% are at high risk of getting heart disease (compared to 11% aged 45-74 in the general population), defined in Australia as a greater than 15% chance of getting heart disease in the next five years.
A heart check involves calculating how likely a person is to develop heart disease over a specific time period (five years in Australia). This involves gathering information from multiple factors including a person’s age, sex, smoking status, whether they have diabetes and their blood pressure and cholesterol levels.
Around 1.1% of Aboriginal and Torres Strait Islander 18-24 year olds and 4.7% of 25-34 year olds were at high risk of heart disease. This is around the same as the proportion of non-Indigenous Australians aged 45-54 who are at high risk.
Potential to prevent events through medication
Heart disease risk can be lowered through lifestyle changes, including giving up smoking, losing weight and exercising more, as well as using medications that lower blood pressure and cholesterol levels. Generally, all people who have heart disease and those at high risk should be prescribed preventative medications.
Yet this latest evidence shows only 53% of Aboriginal and Torres Strait Islander peoples with existing heart disease and 42% of those at high risk were using cholesterol-lowering medications. We don’t know the exact reasons for this. It could be due to a number of things including people not getting a heart check in the first place, and not continuing to use medications when they have been prescribed.
We don’t know the exact number of Aboriginal and Torres Strait Islander people receiving a heart check, but we do know overall numbers are low and it varies by region. Estimates among Aboriginal and Torres Strait Islander people with diabetes found rates of heart checks ranged from about 3% of people in participating health centres in Queensland, South Australia and Western Australia to around 56% in the Northern Territory.
This highlights the huge potential to prevent future heart attack and stroke in these communities by improving treatment in people at high risk.
What can we do?
These findings highlight multiple actions that can be taken to improve heart disease prevention. First, this new evidence suggests the age to start doing heart checks should be lowered in Australian guidelines. This decision would need to be jointly undertaken with Aboriginal and Torres Strait Islander communities.
GPs and nurses should be proactive in identifying Aboriginal and Torres Strait Islander patients, providing heart and overall health checks, and following up with patients.
The Northern Territory is a good example. There, the number of Aboriginal and Torres Strait Islander peoples receiving a heart check more than doubled after improvements in reporting, monitoring and follow-up. Improving the rate of health checks for adolescents and young adults is particularly important so discussions and treatment decisions can take place early.
Programs aimed at prevention should also be co-designed with Aboriginal and Torres Strait Islander peoples, taking into account social and cultural barriers that impact access and ongoing treatment.
The good news is, we know heart attacks and strokes can be prevented and we have effective treatments to achieve this. Within Aboriginal and Torres Strait Islander communities there is huge potential to prevent heart attacks and stroke.
Many people don’t receive a heart check and could be at high risk without knowing it. Prevention starts with getting a heart check and continuing to use any medications prescribed to you by your doctor to lower your risk.
Part 2 Stroke Foundation Press Release
Stroke Foundation has backed a call for urgent action to prevent stroke in Australia’s Aboriginal and Torres Strait Islander community.
This follows today’s release of a world-first study by the Australian National University (ANU), highlighting the harrowing reality of stroke and heart attack risk in Aboriginal and Torres Strait Islander people.
The research found around one-third to a half of Aboriginal and Torres Strait Islander people in their 40s, 50s and 60s were at high risk of future heart attack or stroke. It also found risk increased substantially with age and starts earlier than previously thought.
Stroke Foundation Chief Executive Officer Sharon McGowan said the research results were frightening.
“We knew the Aboriginal and Torres Strait Islander community had a greater risk of stroke and cardiovascular disease, but the rate was well above the non-indigenous population,” Ms McGowan said.
“Alarmingly, the study also found high levels of risk were occurring in people younger than 35.
“Steps must be taken immediately to increase stroke awareness and access to health checks through targeted action. Federal and state government must come together to address this issue.”
National guidelines currently recommend heart health and stroke risk screening be provided to Aboriginal and Torres Strait Islander people 35 and over. This study highlights the need for screening in much younger people.
Ms McGowan said there was one stroke every nine minutes in Australia and Aboriginal and Torres Strait Islander people were overrepresented in stroke statistics.
Aboriginal and Torres Strait Islander people were twice as likely to be hospitalised with stroke and 1.4 times as likely to die from stroke than non-indigenous Australians.
“Stroke can be prevented, it can be treated and it can be beaten. We must act now to stem the tide of this devastating disease,’’ she said.
“Federal and State Government must do more to empower our Aboriginal and Torres Strait Islander communities to take control of their health and prevent stroke and heart disease – we must deliver targeted education on what stroke is, how to prevent it and the importance of accessing treatment at the first sign of stroke.”
Ms McGowan said stroke could be prevented by managing your blood pressure and cholesterol, eating healthily, exercising, not smoking and limiting alcohol consumption
” One in every two Australians suffer from chronic disease but experts say Commonwealth and State Governments appear blind to the country’s greatest health challenge.
The latest assessment of the country’s chronic disease prevention policy has found that while our health measures in tobacco policy are world leading, Australia has fallen well short in its preventive health efforts in the key areas of alcohol consumption, nutrition, and physical activity.”
A scorecard released today by Prevention 1st found that while government anti-smoking policies are ‘good’, efforts to address alcohol consumption, physical activity and nutrition all rate poorly.
Prevention 1st invited experts in tobacco, alcohol, nutrition and physical activity to rate Commonwealth and state government action against the World Health Organization’s (WHO) ‘Best Buys’ and Other Recommended Interventions for the Prevention and Control of Noncommunicable Diseases.i
Chronic disease, which is responsible for 83 per cent of all premature deaths in Australia, accounts for 66 per cent of the burden of disease, and costs our economy an estimated $27 billion annually.
According to the Australian Institute of Health and Welfare, one-third of chronic disease cases are preventable and can be traced to four modifiable risk factors: tobacco use, alcohol consumption, poor diet, and physical inactivity.
FARE Chief Executive Michael Thorn says that while Australia has been a world leader in preventive health, past glories count for little, when the Prevention 1st Scorecard released today makes clear that our governments are not presently doing enough.
Mr Thorn says a framework already exists around evidence-based, short-term wins and that those World Health Organization recommendations, if implemented, would immediately improve Australians’ health.
“Effective policies are essential and we have those, but those solutions become worthless if government is not prepared to translate those policies into action,” Mr Thorn said
The Prevention 1st Scorecard recommends the implementation of four simple evidence-based measures to address tobacco use, alcohol consumption, nutrition and physical activity.
• The renewal of mass media anti-smoking campaigns that are population-wide and engage effectively with disadvantaged groups.
• The abolition of the Wine Equalisation Tax (WET) and introduction of a volumetric tax for wine and cider.
• Legislated time-based restrictions on exposure of children (under 16 years of age) to unhealthy food and drink marketing on free-to-air television until 9.30pm.
• The implementation of a whole-of-school program that includes mandatory daily physical activity.
Prevention 1st is a campaign led by the Foundation for Alcohol Research and Education (FARE), the Public Health Association of Australia (PHAA), Consumers Health Forum of Australia (CHF Australia), and Dementia Australia.
‘Patients have the right to respectful care that promotes their dignity, privacy and safety.
Equipped with greater cultural awareness and the ability to ensure cultural safety, GPs will provide better quality and more appropriate care to all of their patients. It will also ensure they are well-rounded and more effective doctors.’
Associate Professor Peter O’Mara, Chair of RACGP Aboriginal and Torres Strait Islander Health, believes GPs can make important contributions towards creating a safe and culturally welcoming environment for Aboriginal and Torres Strait Islander peoples.
He views National Reconciliation Week (27 May – 3 June) as an opportunity to improve the relationships between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians.
To mark National Reconciliation Week, Morgan Liotta from newsGP looks at the importance of cultural safety in general practice and highlights some useful resources for GPs and practice teams.
See Full RACGP Press Release Part 2 Below
‘The inequitable situation whereby Aboriginal and Torres Strait Islanders are 30% less likely to receive appropriate care after a heart attack demands action.
Working in partnership with Aboriginal and Torres Strait Islander peoples and health organisations is the most effective tool for building cultural safety in our public hospitals, reducing discharge against medical advice and improving care pathways after discharge.
Understanding the true history of Australia allows non-Indigenous clinicians and health administrators to be aware of the background to our current situation, learn about their stereotypes, reflect on practices and build trust with Aboriginal and Torres Strait Islander people.’
Dr Chris Bourke, a Gamillaroi man and Director of Strategic Programs at the AHHA, said the five dimensions of reconciliation—race relations, equality and equity, institutional integrity, unity and historical acceptance—directly relate to the Lighthouse goal of achieving better outcomes for Aboriginal and Torres Strait Islander patients who go to hospital after a heart attack.
Hospitals are developing stronger links with ACCHO’s / Aboriginal Medical Services; this means discharges are better planned, so patients are more likely to access follow up appointments, take ongoing medication and use cardiac rehabilitation services.
See Full Press Release Part 2 Below
Part 1 The RACGP The importance of culturally appropriate healthcare spaces
Given GPs are considered the first point of contact for most Australians when accessing healthcare, a culturally responsive general practice environment can play a significant part in improving that access, and can be crucial to closing the gap in health outcomes.
Ada Parry is a community representative on the RACGP Aboriginal and Torres Strait Islander Health Board. She agrees that cultural awareness benefits all aspects of a healthcare relationship – from a patient’s greeting as they enter a practice to fostering an ongoing connection throughout the care.
‘A really simple step is to have a friendly face at reception. Many Aboriginal and Torres Strait Islander people go to mainstream health services and want to be treated like everyone else,’ Ms Parry told newsGP.
‘It is important to understand that some Aboriginal and Torres Strait Islander patients may have a different culture or cultural practices to non-Indigenous Australians.
‘If [healthcare professionals] don’t show that they care about those differences, this can really affect their patients.’
Ms Parry strongly believes that taking the time to get to know patients, to hear their story and help them understand their illness and treatments can make a big difference.
‘People need to get past stereotypes and stop making assumptions,’ she said.
‘The approaches that work for most of your patients may not always work for Aboriginal and Torres Strait Islander patients.
‘Treat patients the way you would like to be treated.’
Associate Professor O’Mara agrees, emphasising that the strength of culturally responsive care is not only for patients.
‘The role healthcare professionals, organisations, medical colleges and governments have in providing safe and appropriate spaces for Aboriginal and Torres Strait Islander patients could not only benefit the patients, but also the healthcare providers themselves,’ he said.
NACCHO & @RACGP will be running free half day workshops to support practice teams to maximise the opportunity for prevention of disease for Indigenous clients . For busy GPs, @NATSIHWA members , practice nurses @CATSINaM or ACCHO practice managers
Standards for general practices (5th edition), ‘Criterion C2.1 – Respectful and culturally appropriate care’ – includes explanations that are meaningful for Aboriginal Community Controlled Health Services by taking into account their context, culture and service delivery models
Part 2 AHHA Recognising the historic experience of Indigenous patients is key to reconciliation
Understanding the history behind why Aboriginal and Torres Strait Islander patients are five times more likely to leave hospital against medical advice is key to achieving reconciliation in the hospital system, the Australian Healthcare and Hospitals Association (AHHA) and the Heart Foundation said this week.
National Reconciliation Week is this week, and the theme ‘Don’t Keep History a Mystery’ highlights the importance of all Australians exploring our past, learning more about Aboriginal and Torres Strait Islander histories and cultures, and developing a deeper understanding of our national story.
Reitai Minogue, national manager for the Lighthouse Hospital Project, said, ‘Closing the heart health gap between Indigenous and non-Indigenous Australians requires understanding why many Aboriginal and Torres Strait Islander patients have a distrust of hospitals.
‘Historic experiences such as racism, miscommunication and mistreatment have influenced the level of distrust, which is reflected in the fact that Aboriginal and Torres Strait Islander patients are five times more likely to leave hospital against medical advice.’
The Lighthouse Hospital Project, a federally funded joint program by the AHHA and the Heart Foundation, is working with 18 hospitals around the nation to transform the experience of healthcare for Indigenous patients by trying to make their environments more culturally safe.
Examples of positive changes include improving the hospital environment with local artwork, bush gardens and cultural spaces for family, and expanding and better supporting the Aboriginal workforce. Hospitals are developing stronger links with Aboriginal Medical Services; this means discharges are better planned, so patients are more likely to access follow up appointments, take ongoing medication and use cardiac rehabilitation services.
About the Lighthouse Hospitals Project
The Lighthouse Hospitals Project is a joint initiative of AHHA and the Heart Foundation. The $10 million third phase of the Lighthouse Hospitals Project is funded by the Commonwealth Department of Health through the Indigenous Australians’ Health Program.
NSW: Coffs Harbour Health Campus, John Hunter Hospital, Liverpool Hospital, Orange Health Service and Tamworth Rural Referral Hospital.
NT: Royal Darwin Hospital.
Qld: Cairns and Hinterland Hospital and Health Service, Mount Isa Base Hospital, Princess Alexandra Hospital, Prince Charles Hospital and Townsville Hospital and Health Service.
SA: Flinders Medical Centre. Vic: Bairnsdale Regional Health Service.
WA: Broome Regional Health Campus, Fiona Stanley Hospital, Kalgoorlie Health Campus, Royal Perth Hospital and Sir Charles Gairdner Hospital.
“ The World Health Organisation resolution for global action to tackle rheumatic heart disease (RHD) will have significant implications for Australia, which has some of the highest rates of the disease in the world
This disease disproportionately affects some of the most vulnerable communities around the world, including our Aboriginal and Torres Strait Islander communities in Australia.
It’s the most common acquired cardiovascular disease in children and young adults in low resource settings.
More than any other condition, RHD is emblematic of the health gap between Indigenous and non-Indigenous Australians”
Institute Director Professor Jonathan Carapetis said the resolution, passed late Friday May 25 , will give RHD the attention required to eliminate what is mostly a preventable disease
Rheumatic fever is caused by an abnormal immune reaction to Strep A infection of the skin and throat and, when left untreated, can lead to rheumatic heart disease – in turn causing disability and premature death. It affects 30 million people worldwide.
The resolution was passed at the 71st World Health Assembly in Geneva, attended by delegates from 194 WHO Member States. The commitment aims to consolidate efforts worldwide towards the prevention, control and elimination of RHD.
“This resolution puts RHD front and centre on the global agenda, meaning governments will be compelled to act,” Professor Carapetis said.
“Countries with a high burden of the disease will be required to prioritise the implementation of strategies aimed at prevention and treatment, with countries with a low burden providing support and funding.”
This film will give health messages and information for women with severe rheumatic heart disease. A film about Aboriginal women and the relationship between culture and health and how this influences care
Professor Carapetis applauded the Australian Government for playing a leading role in drafting the resolution.
“We look forward to working closely with all relevant ministers and departments on the implementation of a comprehensive, research-backed strategy to end the disease in Australia.
“With more than 30 years of research behind us, combined with Indigenous leadership and growing political will at home and internationally, we’ve never been in a stronger position to make ending RHD a reality in Australia.”
” Naomi and Rukmani’s stroke rap runs through vital stroke awareness messages, such as lifestyle advice, learning the signs of stroke, and crucially the need to seek medical advice when stroke strikes.
“Music is a powerful tool for change and we hope that people will listen to the song and remember the FAST message – it could save their life,”
Stroke Foundation Queensland Executive Officer Libby Dunstan
The major concern with high blood pressure is many people don’t realise they have it. It has no immediate symptoms, but over time, it damages blood vessels and increases the risk of stroke and heart disease.
I am urging you – no matter what age you are – to have a blood pressure check regularly with your ACCHO GP (General Practitioner), pharmacist or via a digital health check machine.
Stroke strikes in an instant, attacking the brain. It kills more women than breast cancer and more men than prostate cancer and leaves thousands with an ongoing disability, but stroke is largely preventable by managing blood pressure and living a healthy lifestyle.
Stroke Foundation and SiSU Wellness conducted more than 520,000 digital health checks throughout 2017, finding 16 percent of participants had high blood pressure putting them at risk of stroke
Given there will be 56,000 strokes in Australia this year alone, if we can reduce high blood pressure we will have a direct and lasting impact on the rate of stroke in this country.Yours sincerely,
Chief Executive Officer
On Monday night Four Corners investigates the power of Big Sugar and its influence on public policy.
“How did the entire world get this fat, this fast? Did everyone just become a bunch of gluttons and sloths?” Doctor
The figures are startling. Today, 60% of Australian adults are classified as overweight or obese. By 2025 that figure is expected to rise to 80%.
“It’s the stuff of despair. Personally, when I see some of these young people, it’s almost hard to imagine that we’ve got to this point.” Surgeon
Many point the finger at sugar – which we’re consuming in enormous amounts – and the food and drink industry that makes and sells the products fuelled by it.
Tipping the scales, reported by Michael Brissenden and presented by Sarah Ferguson, goes to air on Monday 30th of April at 8.30pm. It is replayed on Tuesday 1st of May at 1.00pm and Wednesday 2nd at 11.20pm.
It can also be seen on ABC NEWS channel on Saturday at 8.10pm AEST, ABC iview and at abc.net.au/4corners.
” In 2012-13, Aboriginal and Torres Strait Islander people 2 years and over consumed an average of 75 grams of free sugars per day (equivalent to 18 teaspoons of white sugar)1. Added sugars made up the majority of free sugar intakes with an average of 68 grams (or 16 teaspoons) consumed and an additional 7 grams of free sugars came from honey and fruit juice. “
“Amata was an alcohol-free community, but some years earlier its population of just under 400 people had been consuming 40,000 litres of soft drink annually.
The thing that I say in community meetings all the time is that, the reason we’re doing this is so that the young children now do not end up going down the same track of diabetes, kidney failure, dialysis machines and early death, which is the track that many, many people out here are on now,”
NACCHO Post : Mai Wiru, meaning good health, and managed by long-time community consultant John Tregenza.
“This isn’t about, as the food industry put it, people making their own choices and therefore determining what their weight will be. It is not as simple as that, and the science is very clear.” Surgeon
Despite doctors’ calls for urgent action, there’s been fierce resistance by the industry to measures aimed at changing what we eat and drink, like the proposed introduction of a sugar tax.
“We know about the health impact, but there’s something that’s restricting us, and it’s industry.” Public health advocate
On Monday night Four Corners investigates the power of Big Sugar and its influence on public policy.
“The reality is that industry is, by and large, making most of the policy. Public health is brought in, so that we can have the least worse solution.” Public health advocate
From its role in shutting down debate about a possible sugar tax to its involvement in the controversial health star rating system, the industry has been remarkably successful in getting its way.
“We are encouraged by the government here in Australia, and indeed the opposition here in Australia, who continue to look to the evidence base and continue to reject this type of tax as some sort of silver bullet or whatnot tosolve what is a really complex problem, and that is our nation’s collective expanding waistline.” Industry spokesperson
We reveal the tactics employed by the industry and the access it enjoys at a time when health professionals say we are in a national obesity crisis.
“We cannot leave it up to the food industry to solve this. They have an imperative to make a profit for their shareholders. They don’t have an imperative to create a healthy, active Australia.” Health advocate
NACCHO post – Sixty-three per cent of Australian adults and 27 per cent of our children are overweight or obese.
“This is not surprising when you look at our environment – our kids are bombarded with advertising for junk food, high-sugar drinks are cheaper than water, and sugar and saturated fat are hiding in so-called ‘healthy’ foods. Making a healthy choice has never been more difficult.
The annual cost of overweight and obesity in Australia in 2011-12 was estimated to be $8.6 billion in direct and indirect costs such as GP services, hospital care, absenteeism and government subsidies.1 “
OPC Executive Manager Jane Martin
” This campaign is straightforward – sugary drinks are no good for our health. It’s calling on people to drink water instead of sugary drinks.’
Aboriginal and Torres Strait Islander people in Cape York experience a disproportionate burden of chronic disease compared to other Australians.’
‘Regular consumption of sugary drinks is associated with increased energy intake and in turn, weight gain and obesity. It is well established that obesity is a leading risk factor for diabetes, kidney disease, heart disease and some cancers. Consumption of sugary drinks is also associated with poor dental health.
Water is the best drink for everyone – it doesn’t have any sugar and keeps our bodies healthy.’
Apunipima Public Health Advisor Dr Mark Wenitong
Read over 48 NACCHO articles Health and Nutrition HERE
“All of our 6000 staff in 145 member services in 305 health settings across Australia will have access to this new and update edition of the National Guide. It’s a comprehensive edition for our clinicians and support staff that updates them all with current medical practice.
“NACCHO is committed to quality healthcare for Aboriginal and Torres Strait Islander patients, and will work with all levels of government to ensure accessibility for all.”
NACCHO Chair John Singer said the updated National Guide would help governments improve health policy and lead initiatives that support Aboriginal and Torres Strait Islander people.
A/Prof Peter O’Mara, NACCHO Chair John Singer Minister Ken Wyatt & RACGP President Dr Bastian Seidel launch the National guide at Parliament house this morning
“Prevention is always better than cure. Already one of the most widely used clinical guidelines in Australia, this new edition includes critical information on lung cancer, Foetal Alcohol Spectrum Disorder and preventing child and family abuse and violence.
The National Guide maximises the opportunities at every clinic visit to prevent disease and to find it early.It will help increase vigilance over previously undiagnosed conditions, by promoting early intervention and by supporting broader social change to help individuals and families improve their wellbeing.”
Minister Ken Wyatt highlights what is new to the 3rd Edition of the National Guide-including FASD, lung cancer, young people lifecycle, family abuse & violence and supporting families to optimise child safety & wellbeing : Pic Lisa WhopSEE Full Press Release Part 2 Below
The Royal Australian College of General Practitioners (RACGP) and the National Aboriginal Community Controlled Health Organisation (NACCHO) have joined forces to produce a guide that aims to improve the level of healthcare currently being delivered to Aboriginal and Torres Strait Islander patients and close the gap.
Chair of RACGP Aboriginal and Torres Strait Islander Health Associate Professor Peter O’Mara said the third edition of the National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people (the National Guide) is an important resource for all health professionals to deliver best practice healthcare to Aboriginal and Torres Strait Islander patients.
“The National Guide will support all healthcare providers, not just GPs, across Australia to improve prevention and early detection of disease and illness,” A/Prof O’Mara said.
“The prevention and early detection of disease and illness can improve people’s lives and increase their lifespans.
“The National Guide will support healthcare providers to feel more confident that they are looking for health issues in the right way.”
RACGP President Dr Bastian Seidel said the RACGP is committed to tackling the health disparities between Indigenous and non-Indigenous Australians.
“The National Guide plays a vital role in closing the gap in Aboriginal and Torres Strait Islander health disparity,” Dr Seidel said.
“Aboriginal and Torres Strait Islander people should have equal access to quality healthcare across Australia and the National guide is an essential part of ensuring these services are provided.
“GPs and other healthcare providers who implement the recommendations within the National Guide will play an integral role in reducing health disparity between Indigenous and non-Indigenous Australians, and ensuring culturally responsive and appropriate healthcare is always available.”
The updated third edition of the National Guide can be found on the RACGP website and the NACCHO website.
Free to download on the RACGP website and the NACCHO website:
Part 2 Prevention and Early Diagnosis Focus for a Healthier Future
The critical role of preventive care and tackling the precursors of chronic disease is being boosted in the latest guide for health professionals working to close the gap in health equality for Indigenous Australians
The critical role of preventive care and tackling the precursors of chronic disease is being boosted in the latest guide for health professionals working to close the gap in health equality for Indigenous Australians.
Minister for Indigenous Health, Ken Wyatt AM, today launched the updated third edition of the National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people.
“Prevention is always better than cure,” said Minister Wyatt. “Already one of the most widely used clinical guidelines in Australia, this new edition includes critical information on lung cancer, Foetal Alcohol Spectrum Disorder and preventing child and family abuse and violence.
“The National Guide maximises the opportunities at every clinic visit to prevent disease and to find it early.
“It will help increase vigilance over previously undiagnosed conditions, by promoting early intervention and by supporting broader social change to help individuals and families improve their wellbeing.”
The guide, which was first published in 2005, is a joint project between the National Aboriginal Community Controlled Health Organisation (NACCHO) and the Royal Australian College of General Practitioners RACGP).
“To give you some idea of the high regard in which it is held, the last edition was downloaded 645,000 times since its release in 2012,” said Minister Wyatt.
“The latest edition highlights the importance of individual, patient-centred care and has been developed to reflect local and regional needs.
“Integrating resources like the national guide across the whole health system plays a pivotal role in helping us meet our Closing the Gap targets.
“The Turnbull Government is committed to accelerating positive change and is investing in targeted activities that have delivered significant reductions in the burden of disease.
“Rates of heart disease, smoking and binge drinking are down. We are on track to achieve the child mortality target for 2018 and deaths associated with kidney and respiratory diseases have also reduced.”
The National Guide is funded under the Indigenous Australian’s Health Programme as part of a record $3.6 billion investment across four financial years.
The RACGP received $429,000 to review, update, publish and distribute the third edition, in hard copy and electronic formats.
” This review describes how, prior to European settlement in Australia, Aboriginal and Torres Strait Islander peoples were generally healthy and enjoyed a varied traditional diet low in energy density and rich in nutrients.
Now, evidence shows that five of the seven leading risk factors contributing to the health gap between Aboriginal and Torres Strait Islander and non-Indigenous Australians relate to poor diet.
The review also highlights that sustained and effective interventions to improve nutrition will require: an adequately trained workforce; adequate and sustained resourcing; intersectoral partnerships; a practical monitoring, research and evaluation framework; and effective dissemination.”
” At a local level, most mainstream and Community Controlled Primary Health Care Services (ACCHO’s) in Australia could play a critical role in the delivery of nutrition and dietetic services.
To meet the needs of Aboriginal and Torres Strait Islander people, primary health care services need to deliver both competent and culturally appropriate chronic disease care [215, 216].
The involvement of Aboriginal and Torres Strait Islander Health Workers has been identified by health professionals and patientsas an important factor in the delivery of effective clinical care to Aboriginal and Torres Strait Islander people, including nutrition education [215, 217].
Press Release : The Australian Indigenous HealthInfoNet (HealthInfoNet) at Edith Cowan University has published a new Review of nutrition among Aboriginal and Torres Strait Islander people.
It provides detailed information on food, diet and nutritional health among Aboriginal and Torres Strait Islander people, and includes data for diet-related conditions; morbidity, mortality and burden of disease.
This review highlights the importance of nutrition promotion and the prevention of diet-related disease, and provides information on relevant programs, services, policies and strategies that help improve food supply, diet and nutritional health among Aboriginal and Torres Strait Islander people.
Lead author Professor Amanda Lee is a Senior Advisor at the Australian Prevention Partnership Centre at the Sax Institute and has more than 35 years’ experience as a practitioner and academic in nutrition, obesity and chronic disease prevention, Aboriginal and Torres Strait Islander health and public health policy.
HealthInfoNet Director, Professor Neil Drew says ‘This review written by Professor Amanda Lee and Kathy Ride (HealthInfoNet Research Team Leader) shows the important role nutrition plays in health. As we see in many areas of Aboriginal and Torres Strait Islander health, community control has been shown to be critical for the success of nutrition programs.’
This review describes how, prior to European settlement in Australia, Aboriginal and Torres Strait Islander peoples were generally healthy and enjoyed a varied traditional diet low in energy density and rich in nutrients. Now, evidence shows that five of the seven leading risk factors contributing to the health gap between Aboriginal and Torres Strait Islander and non-Indigenous Australians relate to poor diet.
The review also highlights that sustained and effective interventions to improve nutrition will require: an adequately trained workforce; adequate and sustained resourcing; intersectoral partnerships; a practical monitoring, research and evaluation framework; and effective dissemination
The United Nations General Assembly has proclaimed a Decade of Action on Nutrition from 2016 to 2025 in recognition of the need to eradicate hunger and prevent all forms of malnutrition, including under-nutrition and over-nutrition, worldwide . The Global nutrition report provides context for nutrition issues internationally and in Australia, including those of Aboriginal and Torres Strait Islanders .
Aboriginal and Torres Strait Islander people continue to suffer the worst health of all population groups in Australia, with a high burden of disease and low life expectancy [6-9]. The latest available estimates of life expectancy, released in 2013, show that the gap between Aboriginal and Torres Strait Islander and non- Indigenous Australians remains high at 10.6 years for men and 9.5 years for women . A relatively large proportion of Aboriginal and Torres Strait Islander deaths are premature; during the 5-year period 2009–2013, around 81% of deaths among Aboriginal and Torres Strait Islander people occurred before the age of 75 years, compared with 34% of deaths for non-Indigenous people .
Poor nutrition is an important factor contributing to overweight and obesity, malnutrition, cardiovascular disease, type 2 diabetes, and tooth decay [11, 12]. Chronic diseases – such as cardiovascular disease, type 2 diabetes, chronic kidney disease and some cancers- are responsible for at least 75% of the mortality gap between Aboriginal and Torres Strait Islander and other Australians .
For example, Aboriginal and Torres Strait Islander people are 1.6 times more likely to die from cardiovascular disease and 3-4 times more likely to die from type 2 diabetes than other Australians.
Yet these diseases are potentially preventable by modifying risk factors such as being overweight and obese, cigarette smoking, physical inactivity and poor nutrition [6, 10, 13]. Five of the seven leading risk factors contributing to the health gap between Aboriginal and Torres Strait Islander and non-Indigenous Australians – obesity, high blood cholesterol, alcohol, high blood pressure, and low fruit and vegetable intake – relate to poor diet . Combined dietary factors contribute the greatest proportion (27.4%) of all risk factors assessed .
Poor diet and nutritional status of Aboriginal and Torres Strait Islander people are influenced by many factors, such as socio- economic disadvantage, and geographical, environmental, and social factors [11, 12].
Very few Aboriginal and Torres Strait Islander people meet dietary recommendations for intake of healthy foods [11, 14]. Also, 41% of their daily energy intake is derived from unhealthy ‘discretionary’ foods and drinks that are high in saturated fat, added sugar, salt and/or alcohol (‘junk’ foods), compared to 35% among non- Indigenous Australians [14-16].
The current poor nutritional health of Aboriginal and Torres Strait Islander people is in marked contrast to the situation prior to European settlement in Australia, when Aboriginal and Torres Strait Islander peoples were generally healthy and enjoyed a varied traditional diet low in energy density and rich in nutrients [12, 17].
Aboriginal and Torres Strait Islander people continue to suffer the worst diet-related health of all population groups in Australia.
Diet-related chronic diseases – such as cardiovascular disease, type 2 diabetes, chronic kidney disease and some cancers – are responsible for at least 75% of the mortality gap between Aboriginal and Torres Strait Islanders and other Australians.
In 2011, 13 dietary factors were identified as being risk factors for the Australian population (out of 29 risk factors). When combined, the joint effect of all dietary risks combined contributed 9.7% to the burden of disease for Aboriginal and Torres Strait Islander people.
The nutrition burden among Aboriginal and Torres Strait Islander adults is underscored by malnutrition, which includes both over-nutrition (particularly over-consumption of unhealthy ‘discretionary’ foods) and under-nutrition (dietary deficiencies related to inadequate intake of healthy foods).
In 2012-13, very few Aboriginal and Torres Strait Islander adults or children consumed adequate amounts of healthy foods consistent with recommendations of the Australian Dietary Guidelines. Furthermore, over two-fifths (41%) of total daily energy reported by Aboriginal and Torres Strait Islander people came from unhealthy foods and drinks classified as ‘discretionary’.
The current situation is in marked contrast to the situation prior to European settlement of Australia. All available evidence suggests that Aboriginal and Torres Strait Islander Australians were traditionally healthy; enjoying varied dietary patterns of fresh plant and animal foods, low in energy density and rich in nutrients.
Many historical, socioeconomic, environmental and geographic factors contribute to the current poor diet, nutrition and food security experienced by Aboriginal and Torres Strait Islander people.
In 2012-13, 66% of Aboriginal and Torres Strait Islander people aged 15 years or older were classified as overweight (29%) or obese (37%); a further 30% were normal weight and 4% were underweight. In addition, 30% of Aboriginal and Torres Strait Islander children aged 2-14 years were overweight (20%) or obese (10%); 62% were in the normal weight range and 8% were underweight.
Prevalence of poor pregnancy outcomes and infant malnutrition remains high in many areas. Low birthweight, failure to thrive and poor child growth are still serious concerns in many Aboriginal and Torres Strait Islander communities.
In 2012-13, 83% of Aboriginal and Torres Strait Islander children aged 0-3 years had been breastfed, compared with 93% of non-Indigenous children. Of those who were breastfed, Aboriginal and Torres Strait Islander infants were less likely than non-Indigenous infants to have been breastfed for 12 months or more (12% compared with 21%).
Based on self-reported usual serves of vegetables eaten per day, only 8% of Aboriginal and Torres Strait Islander people met the vegetable intake recommended in the Australian Dietary Guidelines. Mean reported vegetable intake was less than a third of the recommended amount.
Based on self-reported usual serves of fruit eaten per day, 54% of Aboriginal and Torres Strait Islander people met the fruit intake recommended in the Australian Dietary Guidelines. Mean reported fruit intake was around half the recommended amount.
One-quarter (25%) of grain (cereal) foods consumed by Aboriginal and Torres Strait Islander people were from wholegrain and/or high fibre varieties, compared to the recommended 50% or more.
The average daily consumption of milk, yoghurt, cheese and alternatives for each age-sex group of Aboriginal and Torres Strait Islander people, with the exception of children aged 2-3 years and girls 4-8 years, was considerably lower than the respective recommend number of serves.
The average daily consumption of lean meats and meat alternatives for each age-sex group of Aboriginal and Torres Strait Islander people, with the exception of girls 2-3 years, was less than the respective recommendations; intake was relatively high in remote areas.
On average, Aboriginal and Torres Strait Islander people 2 years and over reported consuming an average of 75g (18 teaspoons) of free sugars per day, which equates to an average of 14% of dietary energy, nearly 50% more than World Health Organization (WHO) recommendations. Two-thirds of Aboriginal and Torres Strait Islander people’s free sugar intake came from sugary drinks.
In 2011-2013, 22% of survey respondents said they had run out of food and couldn’t afford to buy more in the last 12 months. Aboriginal and Torres Strait Islander people in remote areas were more likely to run out of food than those in non- remote areas (31% and 20% respectively).
The underlying causes of food insecurity in Aboriginal and Torres Strait Islander communities include factors such as low income and unemployment, inadequate housing, over- crowding, lack of educational opportunities, transport, high food costs, cultural food values, food and nutrition literacy, knowledge and skills.
A range of general Australian Government Department of Health programs contribute to the prevention and management of diet-related disorders among Aboriginal and Torres Strait Islanders at a national level. However, since the expiry of the National Aboriginal and Torres Strait Islander nutrition strategy and action plan 2002-2010, there has been no national coordination of nutrition efforts in Australia.
Several community-based nutrition programs have demonstrated positive outcomes in the past. The most effective programs have adopted a multi-strategy approach, addressing both food supply (availability, accessibility and affordability of foods) and demand for healthy foods. A major success factor is community involvement in (and, ideally, control of) all stages of program initiation, development, implementation and evaluation, to ensure the intervention is culturally appropriate and tailored to community needs.
Programs to improve food supply have included a focus on: food retail outlets; local food production, such as school or community gardens; food provided by Aboriginal and Torres Strait Islander and community organisations; and food aid. Community store nutrition policies have been shown to be important influences on the food supply and dietary intake in remote areas.
While nutrition education alone will not improve food security or dietary intake, it can be effective when combined with a range of other strategies to help people access healthy food, such as cooking programs, peer education, budgeting advice, and group-based lifestyle modification programs.
A well-supported, resourced and educated Aboriginal and Torres Strait Islander nutrition workforce is essential for the success of nutrition interventions.
There is a long history of effort to improve nutrition and food security among Aboriginal and Torres Strait Islander people, however there is no current national nutrition policy or strategy in place.
Improving food supply and security to better prevent and manage poor nutrition and diet-related disease is vital to the current and future health of Aboriginal and Torres Strait Islander Australians. Food and nutrition programs play an important role in the holistic approach to improving health outcomes for Aboriginal and Torres Strait Islander people.