NACCHO Aboriginal News: A free COVID-19 vaccine will be available throughout 2021, if promising trials prove successful

Prime Minister’s announcement on COVID-19 vaccines

Last week the Prime Minister announced Australia has secured onshore manufacturing agreements for two COVID-19 vaccines. This could mean a free vaccine for all Australians as early as January 2021 if proven safe and effective for use.

Advising the Australian Government on potential vaccines is the Australian Technical Advisory Group on Immunisation and the COVID-19 Vaccine and Treatments for Australia – Science and Industry Technical Advisory Group.

Remember to keep up to date with changing state, territory and border restrictions.

There are now 147 GP led respiratory clinics in operation across Australia, providing assessment of people with fever and respiratory symptoms and COVID-19 testing. You can find testing locations on the Health Direct website.

Cancer patients to be ‘wrapped in culture’ as they undergo treatment

Yorta Yorta woman Leah Lindrea-Morrison knows all too well the experience of undergoing cancer treatment, both as a patient and as someone watching a loved one go through it.

As a survivor of breast cancer, Ms Lindrea-Morrison counts herself lucky, and she has started a project to revive a local Aboriginal tradition to bring comfort to other patients.

  • The project will create a possum skin cloak to be used by Indigenous cancer patients
  • It will be made during a workshop bringing together local people touched by cancer
  • A film will also be made to show the value of adding a cultural healing element to the medical process.

Read the full story here.

Image source: ABC

Victoria continues to move towards a Treaty with First Nations people

The Victorian Government is helping Traditional Owners build stronger nations and to ensure every voice is heard on the path to Treaty. Minister for Aboriginal Affairs Gabrielle Williams today announced more than $4.3 million will be made available as part of the Traditional Owner Nation-Building Support Package to make communities stronger.

Funding will be used to support specific outcomes, such as improving governance arrangements, boosting youth engagement or building projects that will deliver economic and cultural benefits. Under the principles of the Nation-Building fund, it’s important Traditional Owners are engaged with their communities and are self-determining with strong identities, governance and knowledge, as well as economically sustainable and independent.

For further information click here.

Image source: Shutterstock

Government announces $13 million in funding for community nursing

Nurses are set to be recognised for their immense contributions in keeping Australians safe as a part of Nursing in the Community Week.

Starting on Monday, the week is about recognising the important role nurses have played during the pandemic and ensuring the most vulnerable are kept safe and healthy.

The federal government is planning to highlight the important role nurses have played for remote and regional communities, particularly in Indigenous and Defence Force health services.

Read the full story here.

Recent updates to Australian Immunisation Register

Improving the health of Aboriginal and Torres Strait Islander peoples is a national priority. The National Immunisation Program (NIP) for all Aboriginal and Torres Strait Islander people provides additional vaccines to help improve the health of Indigenous people, and close the gap between Indigenous and non- Indigenous people in health and life expectancy.

Until recently, the AIR used information from Medicare to record whether a person identified as Aboriginal or Torres Strait Islander.

Read the full article here.

Aboriginal child receiving an injection.vaccination

Image source: Deadly Vibe website.

Winnunga Nimmityjah Aboriginal Health Service August Newsletter

Winnunga AHCS August Newsletter is out! To read the newsletter click here.

New COVID-19 mental health clinics in Victoria

Minster for Health, Greg Hunt, says from Monday 14 September 2020, Victorians will have access to additional mental health support with 15 new dedicated mental health clinics opening to the public.

“The clinics, announced on 17 August as part of a $31.9 million federal government mental health package to support Victorians during the COVID-19 pandemic, have been rapidly rolled out across the state at a cost of $26.9 million.

Image Source: Department of Health

“There will be nine HeadtoHelp clinics located in Greater Melbourne and six in regional Victoria. The locations are: Greater Melbourne: Berwick, Frankston, Officer, Hawthorn, Yarra Junction, West Heidelberg, Broadmeadows, Wyndham Vale, Brunswick East and Regional Victoria: Warragul, Sale, Bendigo, Wodonga, Sebastopol and Norlane.”

To read the full press release click here.

Image source: Department of Health

Adverse Childhood Experience Coordinator – Yerin, NSW Central Coast

Yerin is seeking an experienced Aboriginal or Torres Strait Islander Case Coordinator to work with children, young people and their families on the NSW Central Coast, Darkinjung country wo are experiencing multiple vulnerabilities and whose children are at risk or have experienced an adverse childhood trauma. Through screening children and families, you will provide appropriate intervention care by arranging the required services to address the Adverse Childhood Trauma.

Read the full position description here.

To apply and know about other job vacancies at Yerin click here.

2021 National Aboriginal and Torres Strait Islander Eye Health Conference

Indigenous Eye Health has announced the dates for the 2021 National Aboriginal and Torres Strait Islander Eye Health Conference (previously the ‘Close the Gap for Vision by 2020 National Conference’). The conference will take place virtually from 20 April – 22 April 2021.

The full conference announcement can be read on the IEH website, here.

NACCHO Aboriginal News: Input Required to Renew Indigenous Suicide Prevention Strategy

 

Input required to renew Aboriginal and Torres Strait Islander Suicide Prevention Strategy

Marking World Suicide Prevention Day, Gayaa Dhuwi (Proud Spirit) Australia (GDPSA) announced the renewal of the 2013 National Aboriginal and Torres Strait Islander Suicide Prevention Strategy (NATSISPS) and called for stakeholders to make sure their voices are heard during the process.

GDPSA CEO Mr Tom Brideson explained, “The NATSISPS was released in May 2013. It was developed by Indigenous experts and leaders in mental health and suicide prevention and remains a sound evidence-based strategic response to Indigenous suicide. However, it also responded to a set of circumstances that have changed since 2013 and that require it to be renewed.

“GDPSA would like to hear from you to inform the NATSISPS renewal process. To that end, between now and the end of 2020, we will be hosting a number of targeted subject matter roundtables and Zoom consultations with particular groups, but there is also the opportunity to participate through our website and to make submissions against a Discussion Paper we have developed.”

Professor Pat Dudgeon, GDPSA director and National Director of the Centre of Best Practice in Indigenous Suicide Prevention (CBPATSISP) continued, Australian governments announced the renewal of the NATSISPS, alongside the development of a new mainstream national suicide prevention plan, in the 2017 Fifth National Mental Health and Suicide Prevention Plan. GDPDSA has been asked by the Australian Government to renew the NATSISPS and will work closely with CBPATSISP and the Prime Minister’s National Suicide Prevention Taskforce to that end. We also want to hear from a range of stakeholders and – on behalf of both GDPSA and CBPATSISP – I strongly encourage you to participate – including Indigenous and non-Indigenous stakeholders.”

GDPSA Chair Professor Helen Milroy said, “Preliminary advice we have provided to the Taskforce are that there are two priority areas for consideration in NATSISPS renewal. The first is establishing Indigenous governance of Indigenous suicide prevention including at the national, regional and community levels. The second is establishing what is important to include in integrated approaches to Indigenous suicide prevention in our communities. In particular, with reference to ATSISPEP’s Solutions That Work report, and the to-be-released learnings from the Indigenous-specific suicide prevention trial sites. This includes consideration of clinical and cultural support elements of mental health and suicide prevention service provision.

To find out more or to make a submission please visit: https://www.gayaadhuwi.org.au/sp-strategy-renewal/

NACCHO highlights ACCHO work on World Suicide Prevention Day

National Indigenous Times (NIT) feature:

Currently, suicide is the fifth leading cause of death for Indigenous people in Australia, with rates twice as high as that for non-Indigenous Australians. ACCHOs are delivering place-based, community-led strategies and solutions to decrease suicide rates.

“For NACCHO and our communities, reducing suicide rates and improving the mental health of Aboriginal and Torres Strait Islander people has always been a priority,” said NACCHO Chair, Donnella Mills.

“We know our Aboriginal Community Controlled Health Organisations are best placed to deliver these essential services because they understand the issues our people go through.”

Kimberley Aboriginal Medical Services (KAMS) in WA are working tirelessly to ensure suicide prevention is a top priority in their region.

“Every loss of life due to suicide is tragic because it is preventable. What we are trying to do in the Kimberley is trying to better understand the reasons why the rates are so much higher, they are twice that of other Aboriginal people in Australia and three times the rate of non-Aboriginal Australians,” said Rob McPhee, KAMS Chief Operating Officer.

“It is really about getting to the root cause of that over representation and being able to work with communities to be able to address the issues associated with them.”

KAMS has been heavily involved with the Kimberley Aboriginal Suicide Prevention Trial which is currently in its fifth and final year.

To read the full article click here.

Empowered Young Leaders Forum 2019’ in Broome WA

Health and safety for Aboriginal and Torres Strait Islander people

Three recent reports and a new book share some critical messages for addressing systemic failures that are harming Aboriginal and Torres Strait Islander people, reports Associate Professor Megan Williams, a Wiradjuri scholar from the University of Sydney.

Her article is published on what would have been the 58th birthday of Tanya Day, whose death in custody in December 2017 is the subject of one of these reports. Across social media today, supporters shared photographs of themselves wearing pink to pay their respects, using the hashtag #PinkforTanya, in response to a request by her family.

Commission recommendations, Inquest findings and Ombudsman reports about Aboriginal and Torres Strait Islander people’s health and wellbeing are frequently quoted in attempts to improve systems and prevent further harms and deaths occurring. Their pages often include recommendations for mainstream, non-Indigenous workforce development, ranging from disciplinary actions to supervision and training.

To read the full story published in Croakey click here.

 

Stronger Together, There’s More to Say After #RUOK? 

Steven Satour, Stronger Together Campaign Manager, R U OK? says looking out for your mob is more important than ever in 2020, as it has been a challenging year for everyone and circumstances have made it even more important for us to stay connected.

“We know as a community we are Stronger Together. We know knowledge is culture and emotional wellness can be learned from our family members, so sharing resources, educating each other and providing guidance on what to say if someone answers they are not okay amongst our families is vital,” says Mr Satour.

Learn what to say next at www.ruok.org.au

Johnathan Thurston opens doors for Logan youth with ‘deadly’ new program

A new Deadly Choices jersey will be launched at Marsden State High School on September 11 by JT Academy Managing Director Johnathan Thurston – a key part of the JTConnect program that encourages the youth of Logan to believe in yourself and have the courage and confidence and pursue employment.

The JTConnect program is an initiative of the Johnathan Thurston Academy, sponsored by the Deadly Choices’ Indigenous health campaign, and is designed to empower young people to believe in themselves and be the difference. Students who complete the JTConnect program and are up to date with their 715 Health Check through their participating community controlled health service will receive a JTConnect Deadly Choices jersey.

“I’m excited about the new Deadly Choices jersey collaboration with the JT Academy and JTConnect – the program has already visited a number of high schools around Cairns and Logan,” Thurston said.  “We truly believe that by instilling a strong sense of self belief, confidence and courage will empower young people to pursue a career or a job for a better life.

“In everything we do, we aim to inspire our youth to feel proud and strong with their identity and who they are as individuals and this program will go a long way towards this goal.”

IAHA call for the long-term retention of temporary MBS telehealth items

Indigenous Allied Health Australia (IAHA), the peak organisation for the Aboriginal and Torres Strait Islander allied health workforce, calls on the government to extend access to Medicare Benefits Schedule (MBS) telehealth items for allied health professionals.

Introduced in March 2020 in response to the impacts of COVID-19 on the ability of people to access in person care, 36 new telehealth allied health items were included on the MBS, replicating existing MBS allied health items traditionally provided face-to-face. Scheduled to expire at the end of September 2020, IAHA joins calls from other stakeholders for the longerterm retention of these telehealth items on the MBS.

Read the full IAHA press release here.

Feature Image tile - Aboriginal Health News Coalition of Peaks Close the Gap Interview Save the Date NITV The Point

NACCHO Aboriginal News: Coalition of Peaks Housing Interview on NITV

Tune in this Sunday 16 August at 7pm for the FINAL exclusive installment of interviews with Coalition of Peaks members working to Close the Gap. This week Jamie Lowe, National Native Title Council and Josie Douglas, Central Land Council, join John Paul Janke from NITV’s The Point to discuss housing, a really important issue that impacts all areas of Aboriginal and Torres Strait Islander people’s lives.

Australian Medical Students’ Association declare climate health emergency

The Australian Medical Students’ Association has joined Australia’s peak medical groups, representing around 90,000 or 75% of the nation’s doctors, in calling on Prime Minister Scott Morrison to commit to a climate-focused health recovery from COVID-19. A joint letter has been coordinated by Doctors for the Environment Australia (DEA), an independent organisation of medical doctors protecting health through care of the environment.

For further information about DEA and to view the joint letter to PM Scott Morrison click here.

Australian peak medical bodies, 10 in total

CHF calls for mandatory supply of health worker face masks

The Consumers Health Forum of Australia (CHF) has warned an inadequate supply of face masks in some hospitals and widespread confusion about when and what masks are needed represents a serious public health hazard that endangers many Australians.

CHF CEO, Leanne Wells said “The ongoing problems with the supply of masks generally, and particularly of hospital-grade masks, highlight the need for mandatory measures to ensure all health settings are adequately supplied.”

To view CHF’s 11 August 2020 Media Release click here.

Two health workers with PPE

Image source: AAP: David Mariuz – ABC News.

Boots for All charity sports store

Located in Melbourne, Boots for All is the only charity sports store in Australia. BFA was created in 2006 to provide high-quality recycled and new sports equipment at low prices to enable as many Australians as possible — no matter where they live or their economic circumstances — to participate in sport and physical activity.

Relying on donations from individuals, sporting clubs and sports apparel companies, Boots for All provides a valuable service for families in the local community, as well as distributing sports equipment across Australia, including many Indigenous communities and organisations.

Funds generated by Boots for All are used to provide training and employment opportunities for young people in the Melbourne area.

Boots for All has a broad range of new and high-quality used sports equipment: the main items are football boots (and footballs), running shoes, basketball gear, tennis and cricket gear, and team uniforms. All at bargain prices!

The Boots for All sports store has been closed for the past several months due to COVID-19, but purchases can be made online or by calling the CEO (and founder) Joanne Rockwell on (0408) 102 918.

Boots for All is currently running an online promotion on the sale of football boots — good quality footy boots are available for as little as $10.

For more information or to purchase apparel please visit here.

Aboriginal kids legs with boots, Boots for All logo

Image source: Boots for All website.

Lack of Australia-wide preventative program investment

A successful remote cattle station youth-at-risk program, that has been operating for the past 30 years without any public funding, has received $4.5 million from the NT government to run intensive youth camps for the next five years.

Meagan Krakouer, Director at the National Suicide Prevention and Trauma Recovery Project, said the funding is a “step in the right direction” however “small steps, even if in the right direction, are not enough”- there is a lack of Australia-wide investment in preventative programs and funding to date has been insufficient to make a real difference in people’s lives.

To read the full National Indigenous Times article click here.

Photo of Seven Emu Stattion owner Frank Shadforth standing in front of bush vehicle in outback

Seven Emu Station owner Frank Shadforth works with at risk kids to develop life skills and cultural connection. Photo supplied by Office of the NT Chief Minister.

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

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

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

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

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

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

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

Here are the key facts

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

Key facts

Population

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

Births and pregnancy outcomes

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

Mortality

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

Hospitalisation

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

Selected health conditions

Cardiovascular health

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

Cancer

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

Diabetes

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

Social and emotional wellbeing

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

Kidney health

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

Injury, including family violence

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

Respiratory health

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

Eye health

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

Ear health and hearing

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

Oral health

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

Disability

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

Communicable diseases

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

NACCHO Aboriginal #CoronaVirus News Alert No 39 : April 16 #KeepOurMobSafe : #OurJobProtectOurMob : Anyinginyi ACCHO partners in new report “Fix housing and you’ll reduce risks of coronavirus and other disease in remote Indigenous communities “

” Remote Indigenous communities have taken swift and effective action to quarantine residents against the risks of COVID-19.

Under a plan developed by the Aboriginal and Torres Strait Islander Advisory Group, entry to communities is restricted to essential visitors only.

This is important, because crowded and malfunctioning housing in remote Indigenous communities heightens the risk of COVID-19 transmission.

High rates of chronic disease mean COVID-19 outbreaks in Indigenous communities may cause high death rates. ” 

Originally published in the Conversation

 ” Rapid-testing machines that detect COVID-19 in 45 minutes are being sent to 83 indigenous communities where remote health clinics are currently waiting up to 10 days to find out whether an Aboriginal resident has coronavirus.

Health Minister Greg Hunt has announced the Australian government was investing $3.3m to establish the rapid coronavirus testing program for remote and rural ­Aboriginal and Torres Strait Islander communities.

The commonwealth is choosing the sites in most need and most at risk with help from state and territory governments and health services, and aims to have 83 ­machines in place by mid-May.”

See full story Part 2 below :  Coronavirus: Rapid tests on way to remote Indigenous communities.

Read full release Here

The “old story” of housing, crowding and health continues to be overlooked. A partnership between the University of Queensland and Anyinginyi Health Aboriginal Corporation, in the Northern Territory’s (NT) Tennant Creek and Barkly region, re-opens this story. A new report from our work together is titled in Warumungu language as Piliyi Papulu Purrukaj-ji – “Good Housing to Prevent Sickness”. It reveals the simplicity of the solution: new housing and budgets for repairs and maintenance can improve human health.

Infection risks rise in crowded housing

Rates of crowded households are much higher in remote communities (34%) than in urban areas (8%). Our research in the Barkly region, 500km north of Alice Springs, found up to 22 residents in some three-bedroom houses. In one crowded house, a kidney dialysis patient and seven family members had slept in the yard for over a year in order to access clinical care.

Many Indigenous Australians lease social housing because of barriers to individual land ownership in remote Australia. Repairs and maintenance are more expensive in remote areas and our research found waiting periods are long. One resident told us:

Houses [are] inspected two times a year by Department of Housing, but no repairs or maintenance. They inspect and write down faults but don’t fix. They say people will return, but it doesn’t happen.

Better ‘health hardware’ can prevent infections

The growing populations in communities are not matched by increased housing. Crowding is the inevitable result.

Crowded households place extra pressure on “health hardware”, the infrastructure that enables washing of bodies and clothing and other hygiene practices.


Read more: Homelessness and overcrowding expose us all to coronavirus. Here’s what we can do to stop the spread


We interviewed residents who told us they lacked functioning bathrooms and washing machines and that toilets were blocked. One resident said:

Scabies has come up a lot this year because of lack of water. We’ve been running out of water in the tanks. There’s no electric pump … [so] we are bathing less …

[Also] sewerage is a problem at this house. It’s blocked … The toilet bubbles up and the water goes black and leaks out. We try to keep the kids away.

A lack of health hardware increases the transmission risk of preventable, hygiene-related infectious diseases like COVID-19. Anyinginyi clinicians report skin infections are more common than in urban areas, respiratory infections affect whole families in crowded houses, and they see daily cases of eye infections.

Data that we accessed from the clinic confirmed this situation. The highest infection diagnoses were skin infections (including boils, scabies and school sores), respiratory infections, and ear, nose and throat infections (especially middle ear infection).

These infections can have long-term consequences. Repeated skin sores and throat infections from Group A streptococcal bacteria can contribute to chronic life-threatening conditions such as kidney disease and rheumatic heart disease (RHD). Indigenous NT residents have among the highest rates of RHD in the world, and Indigenous children in Central Australia have the highest rates of post-infection kidney disease (APSGN).


Read more: The answer to Indigenous vulnerability to coronavirus: a more equitable public health agenda


Reviving a vision of healthy housing and people

Crowded and unrepaired housing persists, despite the National Indigenous Reform Agreement stating over ten years ago: “Children need to live in accommodation with adequate infrastructure conducive to good hygiene … and free of overcrowding.”

Indigenous housing programs, such as the National Partnership Agreement for Remote Indigenous Housing, have had varied success and sustainability in overcoming crowding and poor housing quality.

It is calculated about 5,500 new houses are required by 2028 to reduce the health impacts of crowding in remote communities. Earlier models still provide guidance for today’s efforts. For example, Whitlam-era efforts supported culturally appropriate housing design, while the ATSIC period of the 1990s introduced Indigenous-led housing management and culturally-specific adaptation of tenancy agreements.

Our report reasserts the call to action for both new housing and regular repairs and maintenance (with adequate budgets) of existing housing in remote communities. The lack of effective treatment or a vaccine for COVID-19 make hygiene and social distancing critical. Yet crowding and faulty home infrastructure make these measures difficult if not impossible.

Indigenous Australians living on remote country urgently need additional and functional housing. This may begin to provide the long-term gains described to us by an experienced Aboriginal health worker:

When … [decades ago] houses were built, I noticed immediately a drop in the scabies … You could see the mental change, could see the difference in families. Kids are healthier and happier. I’ve seen this repeated in other communities once housing was given – the change.


Trisha Narurla Frank contributed to the writing of this article, and other staff from Anyinginyi Health Aboriginal Corporation provided their input and consent for the sharing of these findings.

Part 2 :  Coronavirus: Rapid tests on way to remote Indigenous communities

Rapid-testing machines that detect COVID-19 in 45 minutes are being sent to 83 indigenous communities where remote health clinics are currently waiting up to 10 days to find out whether an Aboriginal resident has coronavirus.

There are no known cases of COVID-19 in indigenous communities but health authorities are on high alert for a breakout, particularly in Western Australia, where 11 health workers in the far north Kimberley region tested positive. After a doctor in the Kimberley town of Halls Creek saw Aboriginal patients while he was potentially infectious, those ­patients have been deemed not to be close contacts.

Health Minister Greg Hunt has announced the Australian government was investing $3.3m to establish the rapid coronavirus testing program for remote and rural ­Aboriginal and Torres Strait Islander communities.

The commonwealth is choosing the sites in most need and most at risk with help from state and territory governments and health services, and aims to have 83 ­machines in place by mid-May.

The test, called the Xpert SARS-CoV-2 test, uses rapid ­technology to detect COVID-19 infections by using a nasal swab polymerase chain reaction test in the early phases of the illness.

“It’s vital we do all we can to protect our rural and remote ­Aboriginal and Torres Strait ­Islander communities,” Mr Hunt said.

“This world-first testing response means that we can continue to stay ahead of the curve when it comes to fighting this virus.

“If an outbreak is detected, local health services can move quickly to protect the community and activate established evacuation procedures.”

Indigenous Australians Minister Ken Wyatt said indigenous people were more vulnerable if they contracted coronavirus.

“There are higher rates of chronic conditions and other health issues in these communities and it can be hard to access healthcare,” Mr Wyatt said

“This means that an outbreak of COVID-19 in an Aboriginal or Torres Strait Islander community has the potential to be very serious.

“This testing program will help protect indigenous Australians against the virus.”

The program is an initiative of the Kirby Institute, in partnership with Flinders University.

NACCHO Aboriginal Health and #SocialDeterminants : #MovetoTown Housing bureaucrats are in talks with Aboriginal organisations to convert all town camps into proper suburbs with metered water and electricity

” The suspension of services comes as part of a slow but significant change.

The McGowan government is investing heavily in 10 of the state’s largest remote communities, including by installing sewerage and water systems that residents will for the first time be billed for.

It is also helping Aboriginal families move off dilapidated town camps into new or refurbished homes in the suburbs in a program called Move To Town.

The changes could mean the end of town camps that have been marred by violence and anti-­social behaviour.

Housing bureaucrats are in talks with Aboriginal organisations to convert all town camps into proper suburbs with metered water and electricity.” 

From the Australian 9 March 2020

Read all NACCHO Aboriginal Health and Housing Articles HERE

Read all NACCHO Aboriginal Health and Social Determinant Articles HERE

The West Australian Labor government has quietly suspended essential services at 25 remote Aboriginal communities five years after their Liberal predecessors suffered a political backlash for proposing the closure of most of the settlements.

The Australian has obtained a list of 25 settlements across the far north Kimberley where ­essential services such as maintaining bores and generators are “suspended” because the communities were considered abandoned or inhabited too infreq­uently to justify the cost to the taxpayer.

The West Australian Department of Communities, which is responsible for remote housing, said the suspensions followed consultation with Aboriginal people. It is part of a policy of ­investing in larger remote settlements while razing town camps and moving residents to suburbs in larger communities.

Former Liberal premier Colin Barnett sparked mass protests, a rebuke from the UN and was criticised by the state Labor ­opposition when he announced in November 2014 that most of Western Australia’s 274 remote communities would close.

Read NITV Article HERE

Opposition Treasury and ­Aboriginal affairs spokesman Ben Wyatt asked the state’s lower house to condemn Mr Barnett for “ongoing uncertainty, confusion and fear that he has created in remote Aboriginal communities”. The policy crisis was largely a result of a federal ­decision that states and the Northern Territory would bear the full cost of remote housing, ending an arrangement in which the federal government paid half.

Mr Barnett said there was no way Western Australia could carry that cost. While WA Labor wanted the federal government to reverse or delay its decision, Mr Barnett became the target of anger when he linked community closures to child-sex abuse. “They cannot look anyone in the eye and guarantee the safety of little boys and girls,” he told parliament.

Prime minister Tony Abbott was also criticised when he ­described the decision to live in remote settlements as a lifestyle choice.

The list of communities that have had services suspended by the McGowan Labor government includes Osmond Valley at the foot of the Bungle Bungles where flood then fire drove residents away several years ago.

The Australian understands Warmun Community Incorporated uses its own budget to carry out basic maintenance at ­Osmond Valley amid hopes it can one day become a tourist destination that generates income for Aboriginal people.

Other communities on the state government’s “suspended” list include Kurlku in the Great Sandy Desert, which was established by the late artist Jimmy Pike in the 1980s. It has no permanent residents though rangers had in recent years camped there when carrying out work. Some other remote communities on the list are outstations that had previously been recorded as having small permanent populations or were seasonally occupied.

The suspension of services comes as part of a slow but significant change. The McGowan government is investing heavily in 10 of the state’s largest remote communities, including by installing sewerage and water systems that residents will for the first time be billed for. It is also helping Aboriginal families move off dilapidated town camps into new or refurbished homes in the suburbs in a program called Move To Town.

The changes could mean the end of town camps that have been marred by violence and anti-­social behaviour. Housing bureaucrats are in talks with Aboriginal organisations to convert all town camps into proper suburbs with metered water and electricity.

But the department has shown it is prepared to raze those town camps if that is what traditional owners want. So far, one camp called One Mile on the outskirts of Broome has been bulldozed and all residents of the Kennedy Hill town camp in the centre of Broome have opted to move to better housing elsewhere in the town. One boarded-up house ­remains at Kennedy Hill and will be demolished within a week.

Paul Isaachsen, assistant ­director of general strategy and transformation at the Department of Communities, said the West Australian government was maintaining services in remote places where people lived.

“When the state government establishes that a remote community it supports is no longer ­occupied, which can be the case with very small outstations, the maintenance of essential and ­municipal service assets is suspended pending any return of residents,” he said. “For example, the regular inspection (and, if necessary, ­repair) of generators and bores does not occur during the suspension period. Currently, ­services are suspended in 25 remote communities following ­numerous visits to the communities and consultation with community members, service providers and other relevant stakeholders.”

WA Housing Minister Peter Tinley said he hoped the Labor government’s collaborative approach could succeed where the former Liberal government failed. “Aboriginal people are the most marginalised and vulnerable in Australia — even more so when they live in remote communities, out of sight and generally out of mind to the vast majority of us,” he said.

“The McGowan government does not believe that people should be denied access to basic services based on where they live.

“Everyone has the right to ­expect running water, proper sewerage systems, power supplies, education and health services and suitable housing.

“The challenge to providing such services arose when the state government’s long-term funding partner in the joint arrangement that used to deliver those same services — the commonwealth government — walked away from its responsibilities, axed its funding contribution and laid the entire financial burden on the state government.

“The result is an ongoing ­annual $100m hole in the state’s budget.”

NACCHO Aboriginal Health and #SocialDeterminants “Poor housing is not an issue of indigeneity; it is an issue of poverty” – Dr Paul Torzillo

Aboriginal health, more specifically, is often characterised as wicked.

But when it comes to the link between housing and Indigenous health at least, Dr Paul Torzillo says emphatically,

“This is not some issue about cultural dissonance. This is not a wicked problem.”

Dr Paul Torzillo is a founding director of Healthabitat. A non-profit company that has been working for more than three decades to identify a quantifiable link between housing and health in remote Aboriginal communities, and to offer solutions to clearly articulated, fixable problems.

Drawing above showing Healthabitat’s nine Healthy Living Practice

This article by Habititat and Tracey Clement

“It’s going to get too hard for ngurraritja to live in the desert soon. I might shift somewhere when the desert dries up – up north, down south.”

Without action to stop climate change, people may be forced to leave their country,”

Climate change is a clear and present threat to the survival of our people and their culture,”

Living in “unbearable concrete hot boxes” doesn’t help.

People resort to sleeping outside, or cramming everybody into the coolest room, with all the well-known consequences for the spread of diseases.

It’s also common for people to sleep in shifts, with young people roaming the streets at night where they get into trouble, and sleeping during the day when they should beat school.

You can sometimes see people in communities hosing the outside of their Besser brick walls with garden hoses to keep cool despite the water shortages – that’s how desperate they are.”

” Too hot for our mob ” From Central Land Council’s Head of Policy, Josie Douglas

Download Land Rights News 

Land-Rights-News-March-2020_(2)

Read all NACCHO Aboriginal Health and Housing Articles HERE

Read all NACCHO Aboriginal Health and Social Determinant Articles HERE

Drawing above showing Healthabitat’s nine Healthy Living Practice

The company applies a scientific approach to what some have seen as a social and cultural problem.

Some problems are so complex we label them ‘wicked.’ As the Australian Public Service Commission (APS) explains, “The term ‘wicked’ in this context is used, not in the sense of evil, but rather as an issue highly resistant to resolution.”

In a document titled, ‘Tackling wicked problems: A public policy perspective,’ the APS, a policy unit within the Department of the Prime Minister and Cabinet, cites climate change, obesity, land degradation and Indigenous disadvantage as examples.

In 1985, Torzillo was working as a medical officer for the Nganampa Health Council at the Pukatja (Ernabella) health clinic in the Anangu Pitjantjatjara Yankunytjatjara (APY) Lands in South Australia. There he met architect Paul Pholeros (1953–2016) and anthropologist Stephan Rainow.

They began working together at the invitation of elder Yami Lester, who could see that people in the community were still getting sick, despite improved health services. In 1987, the trio released a report known as the Uwankara Palyanku Kanyintjaku (UPK) – a plan to “stop people getting sick”, in the local Pitjantjatjara language.

In the UPK, Torzillo, Pholeros and Rainow – who would become the founding directors of Healthabitat – identified a clear link between deficiencies in the built environment and the poor health of community members.

The report outlined nine Healthy Living Practices: washing people, washing clothes and bedding, removing wastewater safely, improving nutrition through the ability to store prepare and cook food, reducing the negative impact of over-crowding; reducing the negative effects of animals, insects and vermin; reducing the impact of dust; controlling temperature in the living environment; and reducing hazards that cause physical trauma.

These practices are still at the core of what Healthabitat does today.

Healthabitat primarily works on projects that focus on improving health by fixing what Dr Fred Hollows (1929–1993) called “health hardware,” in this case the physical infrastructure in a home that enables occupants to undertake the nine Healthy Living Practices. Since 1985, licensed contractors overseen by Healthabitat have completed some 287,919 repair jobs, mostly in remote Indigenous communities. But recently they also conducted projects in densely populated urban areas in both Australia and the USA. “And those projects have provided data to support the important thesis that poor housing is not an issue of indigeneity,” Torzillo says, “it is an issue of poverty.”

While a common misconception persists that occupants in remote Aboriginal communities have destroyed their own homes, Healthabitat’s extensive collection of data has demonstrated that vandalism (or even unsuccessful repair work) accounts for only seven percent of damaged health hardware.

Overwhelmingly, poor design, poor material choices, shoddy or incomplete initial construction (19%), and lack of routine maintenance (74%) are the factors that lead to substandard infrastructure in the homes that they have worked on.

As Torzillo puts it, “We have found that you can improve health hardware in these communities for an affordable cost. And we have also shown that the key reasons that these houses aren’t performing are not reasons which are philosophical, or race related, or even occupant dependent. They are issues that are fixable.”

Small teams of local people undertake Survey-Fix work as part of Healthabitat’s “yellow caps” house repair program.

This all seems fairly straightforward. After all, the link between sanitation and health has been widely accepted since at least the Victorian era. A functioning toilet, kitchen and shower should be standard in all homes, and yet the problem of healthy housing in Indigenous communities is ongoing.

Which is not to say that Healthabitat has not had some success. “I think what we have done is we have unequivocally changed the language and the rhetoric around housing in Australia. So at every housing conference somebody talks about the nine Healthy Living Practices, and at every conference people talk about housing for health, and most bureaucratic statements include language that would suggest that they are adopting the principles,” Torzillo explains. “The difficulty is in the implementation.”

Despite clearly defined solutions and quantifiable evidence that its projects work, Healthabitat’s methodology has yet to be meaningfully translated into Federal and State government policy within Australia. When asked why, Torzillo admits that there is no easy answer. For him, “the hard question”, as he puts it, is why do those in authority insist on labelling the problem as ‘wicked’?

Tackling this question is one of the reasons Healthabitat became an industry partner on a Housing for Health Incubator, led by Professor Tess Lea and facilitated by the Henry Halloran Trust. Beyond the big, complex ‘why’ questions, Lea and her team are also examining the interactions between politics and bureaucracy and probing the ‘how.’

They are asking questions, Torzillo says, such as: “How is it that we are still building houses that don’t perform? How is it that we are losing housing stock because we don’t have sustainable maintenance systems? How does that happen?” Their research, which will conclude later this year, also addresses another apparently wicked problem: climate change.

As Torzillo explains, “Our work started with me thinking predominantly about child health, predominantly about infectious disease and the impact of washing and waste disposal in the 1980s. Most of that still stands, but now there is a whole other set of issues.” Climate change is perhaps the issue of our times, and it is already hitting hard in the communities Healthabitat works with. “Lots of remote communities now have temperatures in the high 40s and low 50s centigrade. And they are not going to have the money to afford the energy to control temperature. So communities are going to be threatened by that,” Torzillo says. “This is a big issue right now. So we want to bring that into the centre of what we’re doing.”

With this in mind, the Henry Halloran Trust Incubator is looking at updating, modernising, and refocusing Healthabitat’s work with an emphasis on the impact of the climate crisis on housing for poor people.

As Torzillo points out. “It’s not a future issue, it’s a here-and-now issue.”

Tracey Clement is an artist and writer based in Sydney, Australia.

NACCHO Aboriginal #Environmental Health ClosingtheGap #HaveYourSay : Our CEO Pat Turner’s speech to the National Aboriginal and Torres Strait Islander Environmental Health Conference in Perth this week

” In mainstream settings, there is no battle for recognition or resources for environmental health from finance departments. There is nothing more to prove and a fully resourced framework is in place. 

But Aboriginal environmental health is something else again.

Aboriginal environmental health combines deep cultural knowledge of how things work in Aboriginal communities with these hard scientific facts about disease.

Aboriginal environmental health must forge high-trust partnerships with community. 

Aboriginal environmental health is a community asset.

And Aboriginal environmental health is needed now more than ever.   Why is this so?

Public housing and public utilities have largely been taken out of Aboriginal control. In some locations, funding for the Aboriginal Environmental Health workforce has evaporated.\

Sometimes, the power to make the simplest decision on the ground has been ripped away from local communities. 

Instead, this power is with someone far away who doesn’t even know us.

This is nowhere more manifest than in Aboriginal housing. 

Effective Aboriginal environmental health programs must be in Aboriginal hands. 

Community controlled organisations must drive the necessary knowledge exchange between those who hold technical expertise and those who have been denied it.

The very nature of this work means that Aboriginal communities must retain the reins – and retain the knowledge

Selected extracts NACCHO CEO Pat Turner addressing the National Aboriginal and Torres Strait Islander Environmental Health Conference in Perth this week

As an Aboriginal woman of Gudanji-Arrernte heritage, I wish to acknowledge the Whadjuk people of the Noongar nation as traditional owners of the land where we meet today.

I also acknowledge our continuing and vibrant First Nations cultures.  I am grateful for the contributions of our past, present and emerging leaders.

Our cultures, our leaders and our country give us collective strength and resilience as Aboriginal and Torres Strait Islander peoples.

Just a note for about language conventions in Western Australia. I tend to use the term Aboriginal in recognition that Aboriginal people are the original inhabitants here. This is not out of any disrespect to Torres Strait Islander colleagues and communities.

I have discovered that the first NATSIEH conference was held in 1998. Every second year or so since, the aim of these national conferences is to increase the understanding and awareness of environmental health issues in our communities.

This year, your theme is ONE GOAL: MANY PATHS.  There must be a huge diversity of backgrounds, professions and experiences in the room.   I am delighted to be here.  I hope I have something for everyone in my address to you today.

I will begin with recent CHANGES in the way governments must now work with Aboriginal and Torres Strait Islander people.

Then I’ll cover some CHALLENGES that we can no longer ignore.

And finally, I’ll explain how Aboriginal LEADERSHIP will show the right path that we must take together.

How has our political landscape changed?

Please cast your minds back to 2008 when the original Closing the Gap policy was agreed by the Council of Australian Governments – known as COAG.

There was never full ownership of Closing the Gap from Aboriginal and Torres Strait Islander peoples. CLOSING the Gap was always considered to be an initiative of Governments.  Frankly, it was governments talking to other governments ABOUT us.  WITHOUT us.

Many Aboriginal and Torres Strait Islander Peak bodies supported Closing the Gap in good faith, particularly with new funding given to specific issues including housing, health and education.

But was Closing the Gap ever going to work with its genesis in the bureaucratic backrooms of Canberra?

Our people were always going to be configured as ‘the problem’.  Not as allies, not as experts, not as partners, not as equals.  It was not surprising to Aboriginal people to see that progress was patchy.

As Prof Marcia Langton, a leading Aboriginal academic of Yiman and Bidjara heritage, said in February this year at the Australian and New Zealand School of Government Indigenous conference:

“You can’t have administration of very complex matters from the Canberra bubble. It’s not working and lives are being lost. 

… We must push for policies that give formal powers to the Indigenous sector and remove incompetent, bureaucratic bungling.”

Marcia made a specific request of those who were listening:

“Please do not feel personally offended by what I have to say to you” she said.

I also ask this of you today.  And as Marcia continued to say:

‘… we must all take responsibility and be courageous enough to take action, to put an end to the policies and programs that disempower Aboriginal and Torres Strait Islander people, not just causing a decline in their living standards, but accelerating them into permanent poverty.

Especially the vulnerable. The children and youth are victims of a failed view of the Indigenous world and Indigenous people. This is a dystopian nightmare. We must imagine a future in which Indigenous people thrive and we must do whatever it takes to reach that future. This is urgent.”

It is not surprising then, that after 10 years, not much progress against the Closing the Gap targets had been made.

As the Closing the Gap targets were expiring, COAG announced a “Refresh” of Closing the Gap.  This “refresh” kicked in during 2017.  As various conversations took place however, it became clear that governments were still not listening properly or engaging in a genuine way, and they only wanted to talk about new targets.

Many Aboriginal Peak bodies wanted more time to test the options being put before us in these conversations. Most importantly, Peak bodies needed to be sure that THEIR voices were truly being heard. There was a real concern – AGAIN – that governments had already decided what they wanted to do. That governments were now negotiating behind closed doors to decide new priorities and targets without our input.

As Aboriginal peak bodies, we had to call this out before the country made another momentous mistake. We were very insistent.  We formed a Coalition.  The Prime Minister and his COAG colleagues had to adopt a better way of working.  Without a radical change in approach, the next ten years would be more of the same lack luster approach.

To his credit, Prime Minister Morrison listened.

He opened the door to a new way of working, giving his personal authority to change.

An historic Partnership Agreement on Closing the Gap was signed this year in March between COAG and the Coalition of Peaks.  This means that now, for the first time, Aboriginal and Torres Strait Islander people, through their peak body representatives, will share decision making with governments on Closing the Gap.

How is this to be done?

This Partnership Agreement has created a high-level COAG Joint Council.  This Joint Council is made up of 22 members.  That means a Minister from the Commonwealth Government, a Minister from each State and Territory Governments, and a representative for local government. This makes up ten members.

But significant success was realized when the Coalition of Aboriginal Peak Bodies ensured TWELVE Aboriginal or Torres Strait Islander representatives were on the Joint Council.  Chosen by us, in the majority, working for our mobs.

The Joint Council is co-chaired by the current Commonwealth Minister for Indigenous Australians and a representative of the Coalition of Peaks chosen by the Peaks. Currently, that representative is me.

The Partnership Agreement embodies the belief of all signatories that:

  • When Aboriginal and Torres Strait Islander peoples are included and have a real say in the design and delivery of services that impact on them, the outcomes are far better;
  • Aboriginal and Torres Strait Islander peoples need to be at the centre of Closing the Gap policy: the gap won’t close without our full involvement; and
  • COAG cannot expect us to take responsibility and work constructively with them to improve outcomes if we are excluded from the decision making.

So to those public servants in the audience, whether you work in Commonwealth, state, territory or local government institutions, I say this.

If the Director-General, Secretary or CEO of your department or agency is not enabling you to do your work differently and act in accordance with the Partnership Agreement, Principles, then you need to join the movement and shake the tree.

I encourage you to:

  • Initiate co-design that looks entirely different to the way your department worked two years ago.
  • Give power of veto to communities on priorities. Listen to what THEY say.
  • Double the number of Indigenous people on your committees.
  • Forget ‘one size fits all’ … because it doesn’t.
  • Immerse yourself in this unprecedented opportunity for true equity in our country.

Trust me, your change of practice will be noticed, commended and supported.

Within the Joint Council, we will continue to lead the structural reform that will make your change of practice easier.  At our recent meeting in Adelaide, the Joint Council significantly agreed to develop a new National Agreement on Closing the Gap centred on three reform priorities.

The reform priorities seek to change the way Australian Governments work with Aboriginal and Torres Strait Islander peoples and organisations, and accelerate life outcomes for Aboriginal and Torres Strait Islander peoples, these are:

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

The Joint Council also agreed to the Coalition of Peaks leading engagements with Aboriginal and Torres Strait Islander people over the next two months to ensure others can have a say on the new National Agreement on Closing the Gap.

The Coalition of Peaks want to hear views from across the country on what is needed to make the reform priorities a success.

 

I encourage you all to contribute and have your say.

You can find out more on the NACCHO website. Step up and join in!

I know these priorities, especially the first two, are critical to our success as Aboriginal  people. And I know this from a lifetime of advocacy and service for my people, including my current role as CEO of NACCHO.

NACCHO is the living embodiment of the aspirations of Aboriginal and Torres Strait Islander communities and our struggle for self-determination.  NACCHO is the national peak body representing 143 Aboriginal Community Controlled Health Services or “ACCHOs” across the country.   NACCHO has a history stretching back to a meeting in Albury in 1974 in country New South Wales.

For those who don’t know, 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.

As a sector, we are especially proud that ACCHOs are the largest employer of Aboriginal and Torres Strait Islanders in the country.  Not even the mining sector compares. We also have evidence that ACCHOs are demonstrably better than mainstream in providing culturally responsive, clinically effective primary health care.

At this year’s AMSANT conference, Donna Ah Chee, a Bundgalung woman from NSW and CEO of Central Australian Aboriginal Congress, said precisely what community control means in this context.

Read full speech HERE

It means:

  • The right to set the agenda and determine what the issues are
  • The right to determine which programs or approaches are best suited to tackle the problems in the community
  • The right to determine how a program is run, its size and resources
  • The right to determine when a program operates, its pace and timing
  • The right to say where a program will operate, its geographic coverage and its target groups
  • The right to determine who will deliver the program its staff and advisers.

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

I’d now like to cover some CHALLENGES in environmental health. 

Environmental health is a science-based, technical practice.  Environmental health takes scientific knowledge to people. It focuses on disease risk and finds the way to limit disease in modern society. Environmental Health Practitioners draw the connection between environmental factors and health outcomes.

Environmental health practitioners take this science and fix environmental hazards to prevent risk. They nip outbreaks in the bud.

They influence and draft legislation, and monitor compliance with public health laws and the regulations to protect people’s health.

Of course, in mainstream Australia, hardly anyone recognizes the role that environmental health plays.  For the majority of the population, environmental health is silently present. Water, sanitation, rubbish, housing standards, food safety, everything … it is all taken for granted.

In mainstream settings, there is no battle for recognition or resources for environmental health from finance departments. There is nothing more to prove and a fully resourced framework is in place.

But ABORIGINAL environmental health is something else again.

Aboriginal environmental health combines deep cultural knowledge of how things work in Aboriginal communities with these hard scientific facts about disease. Aboriginal environmental health must forge high-trust partnerships with community.

Aboriginal environmental health is a community asset.

And Aboriginal environmental health is needed now more than ever.   Why is this so?

Public housing and public utilities have largely been taken out of Aboriginal control. In some locations, funding for the Aboriginal Environmental Health workforce has evaporated. Sometimes, the power to make the simplest decision on the ground has been ripped away from local communities.  Instead, this power is with someone far away who doesn’t even know us.

This is nowhere more manifest than in Aboriginal housing.

First, the evidence.  A recent systematic review of the scientific literature has summarized the known causal links between the home environment and health.  Here are some examples:

  • Skin-related diseases are associated with crowding
  • Viral conditions such as influenza are also associated with crowding.
  • Ear infections are associated with crowding, lack of functioning facilities for washing people, bedding and sewerage outflow.
  • Gastro infections are associated with poorly maintained housing and the state of food preparation and storage.

These are not hypothetical claims yet to be proved.  These have academic weight and the verdict is in.

In mainstream Australia, these causal links between the housing and health have been actioned.  In mainstream Australia, sustained progress in the social and environmental determinants of health has permanently reduced the rates of preventable infectious diseases.  One look at the disease burden tells us that.

BUT … because of the state of OUR environmental conditions, Aboriginal people are denied the health outcomes that non-Indigenous people now enjoy.

The challenge is huge.

  • Let’s consider clinic presentations for Aboriginal children for their first year of life. Did you know that research has found that the median number of clinic presentations per child in the first year of life was 21.  Twenty-one! Per child!   Children in this NT study would typically have six clinic presentations for diarrhea in any one year!  SIX! An infectious ear disease known as Otitis Media and skin infections were also high on the list of most frequent reasons for Aboriginal children coming to the clinic in their first year of life. These infectious diseases are NOT caused by bad parents.  They are caused by poor living conditions, overcrowding and poverty imposed on our people.
  • In the Fitzroy Valley in the Kimberley here in Western Australia, 70% of Aboriginal children have been admitted to hospital at least once before they turn seven years of age. A closer look at the reasons why is shocking.  The researchers concluded that most of these admissions would not have happened at all if household disadvantage, poor quality housing and access to primary health care had been addressed.
  • Another example comes from the Western Desert region here in Western Australia. This looked at clinic presentations of all children aged 0 to 5 years of age.  These children had on average more than 30 clinic visits each per year to their clinic. ………  Think about what that means to the morale of the parents, the attitudes of the clinicians, the health budget bottom line. Infectious diseases explained half of these presentations:
    • Ear infections were 15%
    • Upper respiratory tract infections, 13%
    • Skin sores were 12% of the total.
    • And 25% needed treatment for scabies.
  • These statistics aren’t just confined to remote communities. Aboriginal children in Western Sydney in homes with 3 or more housing problems were two and a half times more likely than others to have recurrent gastro-enteritis. For every additional housing problem, the odds of infectious disease significantly increased.

But is this all NEWS?  What about the year of your first NATSIEH conference in 1998?

1998 was the year a study was published showing that admissions to hospital for skin disease of Aboriginal children under five years of age was ten times higher than that of their non-Indigenous counterparts.

It was also the year that deaths among Aboriginal men from infectious diseases were calculated to be some 15 times higher than deaths among non-Indigenous men.

1998 was also the year a study measured the precise “wear and tear” on washing machines installed in seven remote communities.

1998 was a year AFTER a study had already been published showing that over one-third of Aboriginal remote communities had water supply or sanitation problems. Seventy percent had housing problems.  In the words of the researchers, overcrowding and substandard housing were “commonplace”.

So there we have it.   Even this brief snapshot shows we have a disconnect between data and decisions.

From your first conference in 1998 to this one in 2019 …

….  Aboriginal people, their children and now their children’s children have NOT been afforded their DUE HUMAN RIGHTS in response to these “repeat plays” of research data.

Should we have mobilised a more strategic response at the time these research studies were published?

Perhaps data sovereignty is another challenge we need to face.

I regret thinking of the number of children growing up since 1998 who should have been safe from preventable infections IF THERE HAD BEEN ACTION.  I think of how many children need not have gone to hospital.  Who should NOT have ended up with permanent damage for life from rheumatic heart disease or deafness …

… and would NOT have ended up with these conditions if their houses had been safe, healthy and affordable.

I have been told even mental health problems – including suicide – get worse in overcrowded houses not fit for social purpose.

And please don’t tell me we can’t find the money.  My colleagues in the Kimberley estimate that one third of the entire cost of hospital admissions of Aboriginal children is DIRECTLY due to the environmental conditions in which these children live.  Let me repeat that. One third of the entire cost.

In one year alone, $16.9 million is the estimated cost for hospitalisations of Aboriginal people directly due to the environment. And that was just the Kimberley.

Maybe all those departments of housing really don’t have the money BUT their colleagues in health departments are spending it hand over fist.

The Australian Indigenous Governance Institute affirms that Aboriginal people have the right to:

  • Exercise control of the data “ecosystem” including creation, development, stewardship, analysis, dissemination and infrastructure.

We also have the right to:

  • Data structures that are accountable to Aboriginal and Torres Strait Islander peoples and their governance structures.

And the right to

  • Data that is protective and respects our individual and collective interests.

AND

  • Data that is relevant and empowers sustainable self-determination and effective self-governance.

In my view, Aboriginal people must more clearly set the agenda for the health data story.

As Aboriginal people, WE are vested in the outcomes.  WE are accountable to each other, our families and communities.  These research studies represent OUR families, OUR loved ones, OUR LOST ones.

I believe the character and foresight of Aboriginal leadership will show the right path. 

Should you need convincing, I can think of no better example in environmental health than Yami Lester and the Nganampa Health Council in the APY lands.

Decades ago, these leaders knew that health improvement required medical services AND a healthy living environment.  In 1986, they initiated a collaborative project between local Anangu people and technical experts to ‘stop people getting sick’. Some of you may recognise this as the UKP project.

These Aboriginal leaders engaged Paul Pholeros and Dr Paul Torzillo to work together to develop a codified schedule for home assessments and repairs.  When assessments were finished, simple repairs to health hardware that could be fixed, WERE fixed.  Immediately, over 75% of these assessment and repair teams were local Aboriginal and Torres Strait Islander people trained and assisted by skilled managers and team leaders.

Any requirements for major repairs that were the responsibility of the landlord were submitted, logged and monitored. As this program expanded, data from different locations showed that the reasons for poor housing conditions were shoddy building materials in the first place (22%); inadequate maintenance schedules by the landlord (70%) and less than 8% was due to damage by occupants.

As relevant today, Yami Lester and his Council knew the importance of sharing with their people knowledge about disease transmission and supporting households to adopt new habits to sustain health in circumstances none of us would find easy.

And they succeeded.

Their legacy is the framework of nine Healthy Living Practices about washing, clothes, wastewater, nutrition, crowding, animals, dust, temperature and safety against injury.

Today, housing audits and home hardware assessments conceived by Aboriginal leaders in this UKP project MUST be permanently funded everywhere and combined with culturally responsive support directed by communities to re-build THEIR knowledge about disease transmission.

Every home is different.  Every environmental risk assessment is unique.  In one, there might be an issue with food-borne diseases. In another, passive smoking that affects the children’s ears, lungs and eyes.  In another, it could be …

– a blocked toilet,

– a shower dislodged from a poorly laid wet floor, or

– a washing machine that has collapsed under the pressure from multiple loads and hard water every single day.

Resources enable Aboriginal environmental health workers and families to work together over time to build the household’s confidence and knowledge.  The shared goal is self-management in healthy habits ….. AND an assertiveness as tenants to report poor quality building materials, housing problems and urgent repairs to the respective housing landlord.

Effective Aboriginal environmental health programs must be in Aboriginal hands.  Community controlled organisations must drive the necessary knowledge exchange between those who hold technical expertise and those who have been denied it. The very nature of this work means that Aboriginal communities must retain the reins – and retain the knowledge.

What Yami Lester envisaged is our unrealized obligation.

Housing programmes will have limited impact UNLESS they are controlled in their design and delivery by Aboriginal organisations with sustained visibility, authority and relationships in the community.  Communities have ideas on how to manage overcrowding, maintain housing stock and build new housing through local entrepreneurship. It is time once again for Aboriginal leaders to be heard.

You may know about extensive consultations conducted across the country in 2017 known as “My Life My Lead”.

The purpose of these consultations was to provide an opportunity to shape the next update of the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan released originally in 2013.

At these consultations, Aboriginal people spoke up about the fundamental significance of social, economic and environmental determinants affecting their health and wellbeing.

Environmental health was identified as one of seven top priorities for the next Implementation Plan.

I quote:

Addressing the underlying environmental health conditions that contribute to poor health outcomes in many Aboriginal and Torres Strait islander communities will lead to long-term improved health, education and employment outcomes. 

This is why I hope my message to you today is clear. We will get better health by improving housing and environmental health programs. Regaining control over decisions about housing will also lead to better health.  Returning authority for decision-making to communities about resources and program design reinvigorates empowerment, autonomy and more equitable power arrangements.  Self-determination promotes health.

With a decent investment in Aboriginal housing alongside genuine shifts in who makes decisions about resource allocation, I am prepared to guarantee to you today that the impact on Aboriginal health outcomes will be large, positive and permanent.

If those estimates of the costs from hospital admissions hold true nationally, I am also prepared to guarantee a significant reduction in healthcare budgets.

Our Prime Minister is inclined to miracles … so I think this would be the next miracle he’d very much like to see!

If we believe in public health and preventing the preventable …

If we believe in equity and social justice …

If we believe in community control …

… then we have everything we need to turn this around.

To governments I say let Aboriginal leaders sit down with you and – together in partnership – analyse the current state of environmental health and housing in your jurisdictions.

Let’s establish the level of investment that will reduce the cost of hospitalisations of Aboriginal children, adults and elders due to poor housing and living conditions.

Let’s develop national standards for a safe house. Let’s agree to strict criteria for urgent and priority housing repairs.  Let’s audit repair performance.  Let’s publish the data.

Let’s get more accountability from public housing for proactive home maintenance schedules and repairs.

Let’s invest in environmental and building programs that will cut the demand in primary health care clinics by a quarter and let these busy staff focus on other priorities.

Let’s grow knowledge in our communities as experts in healthy living.

Let’s train, credential and employ young Aboriginal people as environmental health workers, plumbers, electricians and carpenters to keep houses safe, healthy and ready for climate change ahead.

Let’s ensure a sustainable on-the-ground workforce for effective environmental health employed by Aboriginal organisations.

Here at this conference, let’s create the cross-sectoral approach involving communities, environmental health, primary health care and governments IN PARTNERSHIP to get this moving.

In closing, I’d like to quote Senator Patrick Dodson, a Yawuru man from Broome who, in February this year, asked a very important question:

“Who actually closes the gap?”

He answered this by saying:

“It’s the people working at the grassroots, led by First Nations peoples, with a deep understanding and lived experience of the needs of their communities.”

It is in that spirit that I thank each and every Aboriginal Environmental Health Practitioner at this conference whether it is your 1st or your 12th.

I know you work hard. I know you care deeply about your communities.  I know you lead by example.

I respect your hard-earned skills and your expertise to provide a huge scope of professional services ranging from dog control to vector management.

I admire your precise and up-to-date knowledge of disease transmission routes, hazardous chemicals, sanitation and practical engineering.

I am sincerely impressed by the care you take to work with families whose circumstances are complex … and that you find THEIR strengths and work with their capacities.

You respect cultural protocols.  You deliver with few resources, a lot of ingenuity and teamwork.

It is enabling YOU to do an even better job for YOUR communities that motivates me to do mine.  And I will keep on working just as hard as you do.

It’s been a pleasure sharing my reflections with you all.

Thank you for this opportunity to kick off the second day of your 12th NATSIEH conference here in Perth.

 

NACCHO Aboriginal Health #ClosingtheGap Download @AIHW Australia’s Welfare Report 2019 : Our mobs welfare is closely linked to health and is influenced by #socialdeterminants such as education, employment, housing, access to services, and community safety.

Indigenous wellbeing is shaped by the wellbeing of the community. In recent years there have been improvements in a range of areas of wellbeing for Aboriginal and Torres Strait Islander Australians.

Indigenous home ownership has risen over the past decade, from 34% in 2006 to 38% in 2016, household overcrowding has decreased, and fewer Indigenous Australians rely on government payments.

Education remains important in helping to overcome Indigenous disadvantage.

The employment gap between Indigenous and non-Indigenous Australians narrows as education levels increase.

There is no gap in the employment rates between Indigenous and non-Indigenous Australians with a university degree.

Despite these improvements, some Indigenous Australians experience widespread social and economic disadvantage.

One in 5 Indigenous Australians live in remote areas and fare worse than those in non-remote areas. They had lower rates of school attendance and employment, and were more likely to live in overcrowded conditions and in social housing.

Members of the Stolen Generations are another particularly disadvantaged group.

They were more likely than other Indigenous Australians to have been incarcerated, receive government payments as their main source of income, experience actual or threatened physical violence or experience homelessness.”

AIHW spokesperson Mr. Dinesh Indraharan.

” Many factors contribute to the welfare of Aboriginal and Torres Strait Islander Australians.

Welfare is closely linked to health and is influenced by social determinants such as education, employment, housing, access to services, and community safety. Contextual and historical factors are particularly important for understanding the welfare of Indigenous Australians.”

” Home ownership has an opportunity to formulate the next wave of transformative success for indigenous people.

Home ownership is a key pillar on the journey to economic independence for indigenous Australians, providing not only stable housing but also an anchor from which to build an asset base for current and future generations and equity for other investment and business opportunities.”

Dagoman-Wardaman man and chairman of Indigenous Business Australia Eddie Fry oversees a home loan program that is helping increasing numbers of Aboriginal and Torres Strait Islander people into home ownership. See Part 2 Below

The latest two-yearly snapshot of national wellbeing uses high-quality data to show how Australians are faring in key areas, including housing, education and skills, employment, social support and justice and safety.

The Australian Institute of Health and Welfare report Australia’s welfare 2019 was launched today in Canberra by Senator the Hon. Anne Ruston, Minister for Families and Social Services.

The report shows that record employment and an increase in education levels are contributing to Australia’s wellbeing but challenges facing the nation include housing stress among low-income earners.

Download the Report and Snapshot

aihw-aus-227

Australias-welfare-snapshots-2019

‘Australia’s welfare 2019 demonstrates the value in continuing to build an evidence base that supports the community, policy makers and services providers to better understand the varying and diverse needs of Australians,’ said AIHW spokesperson Mr. Dinesh Indraharan.

‘Australia is in the top third of Organisation for Economic Co-operation and Development (OECD) countries for a range of measures, including life satisfaction and social connectedness.

‘In 2018, 74% of people aged 15–64 were employed—the highest annual employment rate recorded in Australia. In July 2019 the female and total employment rates remain at record levels.’

The proportion of Australians working very long hours (50 or more per week) declined from 16% to 14% and more Australians are using part-time work to balance work with other activities including caring responsibilities.

However, in December 2018, about 9% of workers were underemployed, or unable to find as many hours of work as they would like. One in 9 families with children had no one in the family who was employed.

Generally, the higher a person’s level of education, the more opportunities they have in their working life.

‘Between 2008 and 2018 the proportion of students staying in school until Year 12 rose from 69% to 81% for males and from 80% to 89% for females,’ Mr Indraharan said.

‘In 2018, 65% of Australians aged 25–64 had a non-school qualification at Certificate III level or above. This is up from 55% in 2009.’

Australia has high levels of civic engagement with 97% of eligible people enrolled to vote in 2019—up from 90% in 2010 and strong rates of volunteering (contributing 743 million hours a year). But an estimated 1 in 4 Australians are currently experiencing an episode of loneliness – with people who live alone, young adults, males and people with children more likely to feel lonely.

Finding affordable housing remains a challenge for many Australians, with more people spending a higher proportion of their incomes on housing than in the past and fewer younger people owning their own homes.

‘More than 1 million low-income households were in housing stress in 2017-18, where they spent more than 30% of their income on rent or mortgage repayments,’ Mr Indraharan said.

There has been little change in income inequality since the mid-2000s—though it is higher now than it was in the 1980s—and wealth is more unequally distributed than income.

Most crime rates have fallen in recent years but Australia ranked in the bottom third of countries for people feeling safe walking alone at night.

‘Survey data shows rates of partner and sexual violence have remained relatively stable since 2005, while rates of total violence have fallen. However, the number and rate of sexual assault victims recorded by police has risen each year since 2011,’ Mr. Indraharan said.

Welfare services and support for people in need

Australian governments spent nearly $161 billion on welfare services and support in 2017-18, including $102 billion on cash payments to specific populations, $48 billion on welfare services and $10 billion on unemployment benefits. Per person spending on welfare increased an average of 1.3% a year—from $5,287 per person in 2001–02 to $6,482 in 2017–18.

Over the past 2 decades, there has been a notable fall in the number of people aged 18–64 receiving income support—down from 2.6 million in 1999 to 2.3 million in 2018. Put another way, in 1999, 22% of Australians aged 18–64 received income support, but this fell to 15% in 2018.

In 2017-18:

  • 1.2 million people (or 3 in 10 older people) received aged care services
  • 803,900 people were in social housing
  • 288,800 people were supported by Specialist Homeless Services
  • 280,000 people used specialist disability support services under the National Disability Agreement
  • 172,000 people were active participants in the National Disability Insurance Scheme (at June 2018)
  • 159,000 (or 1 in 35) children aged 0–17 received child protection services.

incarcerated, receive government payments as their main source of income, experience actual or threatened physical violence or experience homelessness.

Aboriginal and Torres Strait Islander Survey #HaveYourSay :

Pat Turner Lead Convener of the Coalition of Peaks invites community to share their voice on #ClosingtheGap

Part 2 From today’s Australian

More indigenous Australians than ever are homeowners, fewer live in overcrowded accommodation and Aboriginal and Torres Strait Islander people who rent are slowly shifting away from social housing in favour of private properties.

Figures to be published on Wednesday by the Australian Institute of Health and Welfare show almost two in five indigenous Australians were homeowners at the last census — of those, 12 per cent owned their home outright and 26 per cent had a mortgage. The number of indigenous households where the home is paid off or mortgaged has reached an estimated 263,000.

The rate of home ownership among indigenous Australians has gradually increased since 2006, while the home ownership rate among non-indigenous Australians has decreased slightly over the same period.

In 2006, 34 per cent of indigenous Australians owned their home or were paying it off.

By 2011 that figure had climbed to 36 per cent and at the 2016 census, 38 per cent of indigenous Australians either owned their homes outright or were paying off a mortgage.

In contrast, the percentage of non-indigenous Australians who either owned their home or were paying it off declined from 68 per cent in 2006 to 66 per cent in 2016.

Dagoman-Wardaman man and chairman of Indigenous Business Australia Eddie Fry oversees a home loan program that is helping increasing numbers of Aboriginal and Torres Strait Islander people into home ownership.

IBA approved more than $1bn in home loans to indigenous Australians over the past five years.

In 2014-15, IBA approved 517 home loans to Aboriginal and Torres Strait Islander people. In 2017-18, the number of home loans approved by IBA was a record 917.

“Home ownership has an opportunity to formulate the next wave of transformative success for indigenous people,” Mr Fry said.

“Home ownership is a key pillar on the journey to economic independence for indigenous Australians, providing not only stable housing but also an anchor from which to build an asset base for current and future generations and equity for other investment and business opportunities.”

The Australian Institute of Health and Welfare report used census data to show that, between 2006 and 2016, the proportion of indigenous households living in social housing fell from 29 per cent to 21 per cent.

The proportion of indigenous Australians renting privately increased from 27 per cent to 32 per ce

NACCHO Aboriginal Health News : Read Barb Shaw AMSANT Chair keynote speeches at the inaugural Indigenous Health Justice Conference #NILCIHJC2019 Darwin 13 Aug and #AMSANT25Conf Alice Springs 7 Aug

” The conference represents the coming together of two strands of community endeavour—health and justice—that I think naturally belong together, and about which I have had a close association with, and passion for, since I was young.

From my sector’s perspective—the primary health care sector—you simply cannot talk about health without invoking the principles of justice.

It’s in our DNA as health professionals.

Even more so when we are talking about Aboriginal community controlled primary health care services.

For our services are—first and foremost—acts of self-determination. There is no stronger expression of our community’s desire and hunger for justice than the pursuit of our rights as First Nations peoples to be self-determining.

To have our people making the decisions about what we need and how we should do things.

And to have our people governing and being employed in the organisations that deliver programs and services to our communities.

And yet we have never accepted, and we will never accept, this imposed status quo.

Aboriginal community controlled health services embody this determination and resolve.” 

Barb Shaw keynote address delivered 13 August to the inaugural Indigenous Health Justice Conference held in Darwin in conjunction with the National Indigenous Legal Conference.

Read in full Part 1 Below

” AMSANT provides a strong and respected voice nationally, which is evidenced by the high regard that we are afforded by the politicians we seek to influence, the bureaucrats we spar with on a daily basis, and by our peers who we work with at the national level, including our national peak body, NACCHO. AMSANT has been a consistent and significant contributor to NACCHO.

I will finish by sounding a note of concern that we can’t take our achievements or position for granted. We need to be forever vigilant, for despite all our efforts, the system has not fundamentally changed and is still configured to marginalise and disempower Aboriginal people. We have to work harder and smarter.

And we know we can because AMSANT is all of us. When we work together, when we combine our voices, and when we share a vision, then nothing is going to stop us.

May the next 25 years of AMSANT be as wonderful as the first.

AMSANT Chair Barb Shaw Keynote address for AMSANT 25th Anniversary Conference
Alice Springs Convention Centre, 7th August 2019 

At the #AMSANT25Conf Dinner 25 years of Aboriginal health leadership cutting the 25 year celebratory cake Our Barb Shaw Chair and John Paterson CEO , Pat Anderson , June Oscar and Donna Ah Chee 

Read and or download 25 Anniversary address here 

Barb Shaw – Keynote address for AMSANT 25th Anniversary Conference_FINAL (2)

Good morning everyone.

I’d like to begin by acknowledging the Traditional Owners of the land on which we’re meeting, the Larrakia people, and particularly their elders, past, present and emerging, and to thank James Parfitt for his warm welcome to country.

My name is Barb Shaw.

I am the Chairperson of the Aboriginal Medical Services Alliance of the NT—or AMSANT—and also the Chief Executive Officer of Anyinginyi Health Service.

I would like especially thank David Woodroffe for his insightful words of introduction, and particularly his highlighting of the importance of the words hope, optimism and resilience. These are qualities that have always been strong in our communities.

I am very grateful to the Winkiku [Win-kee-koo] Rrumbangi NT Indigenous Lawyers Association for their invitation to AMSANT to partner with them in holding the inaugural Indigenous Health Justice Conference, being held in parallel with this year’s National Indigenous Legal Conference.

The conference represents the coming together of two strands of community endeavour—health and justice—that I think naturally belong together, and about which I have had a close association with, and passion for, since I was young.

From my sector’s perspective—the primary health care sector—you simply cannot talk about health without invoking the principles of justice.

It’s in our DNA as health professionals.

Even more so when we are talking about Aboriginal community controlled primary health care services.

For our services are—first and foremost—acts of self-determination. There is no stronger expression of our community’s desire and hunger for justice than the pursuit of our rights as First Nations peoples to be self-determining.

To have our people making the decisions about what we need and how we should do things.

And to have our people governing and being employed in the organisations that deliver programs and services to our communities.

When we take a long, hard look at the many, many injustices our people face today, we can trace the path of injustice back to the persistent and variously callous, arrogant, or ignorant denials of our rights to self-determination that is our lived experience as First Nations peoples in this country.

And yet we have never accepted, and we will never accept, this imposed status quo.

Aboriginal community controlled health services embody this determination and resolve.

In the NT, we have been around more than 45 years, since Congress was first established in Alice Springs in 1974.

It was a time when one out of every four of our babies died before their first birthday! Just think about that.

It was a time when the life expectancy for Aboriginal males was just 52 years and for Aboriginal females, 54 years.

The community rallied—literally. It was a turning point and a movement was born.

Other communities followed and new community controlled services emerged—Urapuntja in 1977, Wurli Wurlinjang in the early 1980s, Pintupi and Anyinginyi in 1984, with more joining over the years.

As a sector, we didn’t sit back and wait for the government to do to us—we actively drove the agenda, took a leadership role, and did the hard work to advocate and lobby—and importantly—to provide the evidence and substance to what we were asking for.

Last week AMSANT held our 25th Anniversary celebrations in Alice Springs. One of our strong and amazing leaders, Pat Anderson, reminded us of our sector’s leadership in the early years, including in the international arena.

When primary health care leaders from around the world met in Russia in 1978, to set out a vision for primary health care, resulting in the historic Alma Ata Declaration—we were there—making our contribution to the Declaration’s drafting.

And in 1996, when the United Nations Working Group on Indigenous Populations was drafting the UN Declaration on the Rights of Indigenous Peoples—UNDRIP—we were there, advocating for community control.

Back in Australia, we led the campaign to remove health from ATSIC’s responsibilities—where it was chronically underfunded—and transfer it to the Commonwealth Department of Health, where Commonwealth bureaucrats were made accountable for our people’s health.

Importantly, this meant we were finally able to begin to access the mainstream resources and services due to us, that we were not receiving.

This brought significantly increased funding to our sector and transformed the Aboriginal health landscape.

Today, our services provide over 60% of all primary health care to our people in the Northern Territory.

And we do it better. In 2010, a major study concluded that when ACCHSs deliver health programs there is fifty percent more health gain or benefit than if those programs were delivered by mainstream primary care services.

The important point here is that this didn’t come from government. It came from us.

This history also illustrates two fundamental principles that our two disciplines, justice and health, also hold in common—Truth and Evidence.

For our sector, our truth existed in the history of disadvantage, neglect, exclusion and institutional racism that our communities were facing.

But in order to get action from government we needed to provide the evidence to support our case.

The battles we were fighting were, in fact, situated within a much longer history of struggle to establish and protect human rights.

Advances in public health achieved during the 19th century laid the foundations for a set of rights as citizens and communities that we now regard as standard entitlements and the responsibility of good government—if not to provide—then at least to regulate.

These advances depended on evidence.

For example, discovery of the causes of infectious diseases, such as cholera, provided crucial evidence for the need for public infrastructure for clean water supply and sewage disposal.

Evidence of the impacts on health caused by poor and overcrowded housing contributed to establishing a role for government in the provision of public housing and building standards—the concept of shelter as a basic human right.

Such advances in our knowledge of health determinants underpin the rights and laws that have developed around these issues, which we largely take for granted.

In stating this, it is also apparent to all of us here that these rights have not become automatic and universally available, and that those who most often lack them, come from the poorest and most marginalised sections of our society.

Here in the Northern Territory, particularly in remote communities, the lack of adequate housing, water and sewerage are major issues of concern.

For our people, connection to country and the ability to live on our ancestral lands are fundamental to our identity, to our cultural and spiritual wellbeing, and to our right to maintain our relationships and communities.

However, we cannot achieve this without basic infrastructure and services that are routinely provided in cities and towns, but which in many of our communities, are either inadequately provided or don’t exist.

Poor quality and inadequate sources of potable water have become issues of public health concern which in some cases are threatening community viability.

The significant shortfall in housing and high levels of overcrowding and homelessness experienced in Aboriginal communities are unacceptable in themselves, but all the more so, because the evidence tells us that inadequate housing and homelessness are determinants of poor health and wellbeing.

This includes transmitted diseases such as rheumatic heart disease, communicable diseases, effects on stress and wellbeing, family violence and even school attendance.

Whichever way you look at it, Indigenous housing is an area of significant government failure.

In a large part this is because government made a series of ill-considered decisions to cut us out of any significant or meaningful governance and decision-making role in housing.

Our Indigenous Community Housing Organisations were abolished.

The Commonwealth’s Strategic Indigenous Housing and Infrastructure Program or SIHIP, and National Partnership on Remote Indigenous Housing or NPARIH, burned through some $1.7 billion over 10 years without much troubling to get our input.

And the NT Intervention saw the Commonwealth take over responsibility for remote community leases and housing, with housing transferred to the NT Government.

The latter has been its own disaster, with evidence of incompetent management of residential tenancy leases and rents and an inadequate system for responding to repairs and maintenance, leading to significant hardship for residents.

Despite evidence of its own failures, it is perhaps unsurprising that the government is not happy that communities have recently exercised their rights to adequate housing by launching a class action against the NT Government in relation to rents and repairs.

This is a good example of a health justice partnership—the community partnering with a group of lawyers who provided the expertise to document and launch an action at the direction of the community.

It is hard to look at this example as anything other than a spectacular own goal by government.

They should have listened to us, perhaps!

In saying this, it needs to be acknowledged that there are encouraging developments in government policy on housing at both the NT and Commonwealth levels.

The NT Government’s Local Decision Making policy extends to Aboriginal housing and the new National Partnership Agreement on Indigenous housing struck between the NT and the Commonwealth, includes the four Northern Territory Land Councils in a significant role.

However, this falls well short of self-determination in Aboriginal housing.

Here, the leadership has once again come from the Aboriginal community. Four years’ work—supported by the Aboriginal Peak Organisations NT, or APO NT—has resulted in the development of a new Northern Territory Aboriginal peak housing body, Aboriginal Housing NT, or AHNT.

This was our initiative and our hard work—not government’s.

With in-principle agreement to support the new body, it is now a matter of negotiation about what formal role the new peak body will be afforded.

Occasionally an issue emerges that cuts like a knife through the national consciousness, requiring immediate and strong action.

Such was the situation when the 4-Corners program revealed the appalling abuse that was occurring inside the Don Dale youth detention centre. The revelations prompted the immediate establishment of the Royal Commission into the protection and detention of children in the Northern Territory.

This issue blew wide open the systemic failures that exist in the treatment of our young people, mostly Indigenous children, and provided a huge opportunity for reform.

Our sector’s response, alongside our APO NT partners, provided leadership to ensure an evidence-based, therapeutic, public health response was considered by the Royal Commission.

We also advocated for a new Tripartite Forum with an oversight role in relation to reforms in child protection and youth justice. AMSANT is represented on the Forum as one of three APO NT representatives.

The NT Government’s acceptance of the recommendations of the Royal Commission is commendable, however progress on the reforms is concerning and the lack of a commitment of funding from the Commonwealth is disappointing.

It is also disappointing to see the Northern Territory Government waver in the face of a recent campaign to water down the reforms.

We know only too well the politics that have long played out in the Northern Territory to scapegoat and demonise our people as problems to be managed, and punished.

We have seen the law and order and mandatory sentencing campaigns that have directly contributed to outcomes such as Don Dale.  We have suffered under the NT Intervention.

The low road of political opportunism dressed up as community concern.

Anything but focus on the neglect and structural racism that are key underlying determinants of the situation.

We can and must do better as a community.

This brings me to two other moments of national consciousness pricking that bring us—I believe—to a watershed moment in this nation’s history.

The first is Closing the Gap—a policy that was well-intentioned but also typically forged without our consent or input and delivered as a top-down initiative.

What could possibly go wrong?

Burdened with annual, very public demonstrations of its failure according to its own indices—only two of 10 targets achieving reasonable improvement—the Prime Minister sensibly called for a re-fresh of the policy.

Perhaps not so sensibly, the re-fresh consultations were centrally controlled and once again failed to engage us meaningfully.

However, this time, faced with concern expressed by a national Coalition of Peak Indigenous organisations, the Prime Minister asked for our solution.

The result is a formal Partnership Agreement on Closing the Gap with the Coalition of Peaks, and the establishment of a Joint Council on Closing the Gap with the Coalition of Peaks represented as a member—the first time that a non-governmental body has been represented within a COAG structure.

APO NT is a member of the Coalition of Peaks and the NACCHO CEO, our very own Pat Turner, is leading the Coalition.

Importantly, the central ask of the Coalition of Peaks, is not around the new indicators—although these are important tools to get right—but for a fundamental change in the way governments work with our people and the full involvement of our people in shared decision-making at all levels.

This includes the need for a commitment to building, strengthening and expanding the formal Aboriginal and Torres Strait Islander community controlled sector to deliver Closing the Gap services and programs.

The second watershed moment was the release of the Uluru Statement from the Heart.

That this considered and heart-felt gesture from our communities was summarily dismissed by the Prime Minister of the day—and that it continues to be undermined by baseless scaremongering—represents a moment of national shame.

But we have taken great heart from the many, many non-Indigenous organisations and individuals who have taken the Statement to their hearts.

This includes the AMA and the Australian Law Society.

And what did we ask for? We asked for:

  • a process of treaty-making to lay a firm basis for the future relationship of First Nations and those who came to this country later;
  • a process of truth telling about our shared past; and
  • a constitutionally enshrined voice to Parliament to ensure ongoing structures for our input into policy making and the life of the nation.

If we were to try to pinpoint the essence of what justice for our people means and what it will take to address the health disadvantage we face, then we would probably find it contained within the pregnant potential of these two initiatives—Closing the Gap and the Uluru Statement.

We are not going anywhere.

And we will not give up on our dreams.

All we ask is to be afforded the responsibility to make our own decisions about our own lives.

To have the opportunity to participate in decision-making over the policies that affect us; and to have our organisations and our people serve our communities.

To be afforded respect as equals, side-by-side, safe and secure in our cultures and identity.

To have the courage and the decency to face the truth of this nation.

Over the next two days, these and many other issues will be discussed and I know it will be done with passion and with goodwill.

I commend this conference to you.

Thank you.