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

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

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

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

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

Pat Turner NACCHO CEO

Read all Aboriginal Kidney Health articles published by NACCHO

Read all 160 Aboriginal Health and Diabetes articles published by NACCHO 

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

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

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

The WHY is both personal and professional for me.

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

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

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

and

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

My uncle’s name?  Charlie Perkins.

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

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

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

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

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

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

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

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

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

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

You never know.  You must take the long view.

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

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

So there it is.  The WHY is huge!

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

So that covers the WHY and the HOW.

I want to talk about WHEN.

WHEN should we start working differently together? 

The answer is right now.

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

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

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

What about the other twelve?

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

The Joint Council has three reform priorities.  These are:

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

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

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

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

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

….. but neglected by whom?

Certainly NOT by anyone in THIS audience!

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

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

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

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

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

 

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

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

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

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

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

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

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

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

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

NACCHO Aboriginal Health and #ChronicDisease #Prevention News : @ACDPAlliance Health groups welcome action on added sugars labelling and further consider 10 recommendations to improve the Health Star Rating system

 

“Industry spends vast amounts of money advertising unhealthy foods, so it is essential that nutrition information is readily available to help people understand what they are eating and drinking.

Two in three Australian adults are overweight or obese and unhealthy foods, including those high in added sugars, contribute greatly to excess energy intake and unhealthy weight gain”

Chair of the Australian Chronic Disease Prevention Alliance Sharon McGowan said food labelling is an important part of understanding more about the products we consume every day

Read previous 70 NACCHO Aboriginal Health and Nutrition Healthy foods articles

The five year review of the HSR system (the Review) has now been completed. See Part 2 Below

Five Year Review of the Health Star Rating System – PDF 3211 KB

The Australian Chronic Disease Prevention Alliance welcomes the recent decisions to improve food labelling and provide clear and simple health information on food and drinks.

The Australia and New Zealand Ministerial Forum on Food Regulation announced yesterday it would progress added sugars labelling and further consider 10 recommendations to improve the Health Star Rating system.

Decisions were also made to provide a nationally consistent approach to energy labelling on fast food menu boards and consider the contribution of alcohol to daily energy intake.

Current Health Star Rating system.

Ms McGowan said overweight and obesity is a key risk factor for many chronic diseases.

“We welcome improvements to existing labelling systems to increase consumer understanding and provide an incentive for industry to create healthier products.”

The Ministerial Forum also released the independent review of the Health Star Rating system with 10 recommendations for strengthening the system, including changes to how the ratings are calculated, and setting targets and timeframes for industry uptake.

The Australian Chronic Disease Prevention Alliance has been advocating to improve the Health Star Rating system for years. While the Alliance supports stronger changes to the ratings calculator, Ms McGowan said it was promising to see recommendations enhancing consistency of labels and proposing a mandatory response if voluntary targets are not met.

“Under the current voluntary system, only around 30 percent of eligible products display the health star rating on the label and some manufacturers are applying ratings to the highest scoring products only,” Ms McGowan said.

SMH Editorial The epidemic of childhood obesity and chronic health conditions linked to bad diet has turned supermarket aisles into the front line of one of the hardest debates in politics.

“To truly achieve its purpose and help people compare products, the rating needs to be visible and consistently applied to all foods and drinks.”

The recommendations to improve the Health Star Rating system will be considered by Ministers later this year.

Ms McGowan added “We know that unhealthy food and drinks are a major contributor to overweight and obesity, and that food labelling should be part of an overall approach to creating healthier food environments.”

Read the Health Star Rating report here and the Ministerial Forum communique here.

The five year review of the HSR system (the Review) has now been completed.

Five Year Review of the Health Star Rating System – PDF 3211 KB
Five Year Review of the Health Star Rating System – Word 16257 KB

The five year review of the HSR system considered if and how well the objectives of the system have been met and has identified several options for improvements to the system, including communication, monitoring, governance and system/calculator enhancements.

The Review found that the HSR system has been performing well. Whilst there is a broad range of stakeholders with diverse opinions, there is also strong support for the system to continue.

The recommendations contained in the Review Report are designed to address some of the key criticisms of the current system. The key recommendations from the report are that:

  • the HSR system continue as a voluntary system with the addition of some specific industry uptake targets and that the Australian, state and territory and New Zealand governments support the system with funding for a further four years;
  • that changes are made to the way the HSR is calculated to better align with Dietary Guidelines, and including fruit and vegetables into the system; and
  • that some minor changes are made to the governance of the system, including transfer of the HSR calculator to Food Standards Australia New Zealand.

The next steps will be for members of the Australia and New Zealand Ministerial Forum on Food Regulation to respond to the Review Report, and the recommendations contained within. It is anticipated that Forum will respond before the end of 2019.
Five Year Review – Draft Report

A draft of the review report was made available for public comment on the Australian Department of Health’s Consultation Hub from Monday 25 February 2019 until midnight Monday 25 March 2019. Following consideration of comments received, the report will be finalised and provided to the Australia and New Zealand Ministerial Forum on Food Regulation (through the HSRAC and the Food Regulation Standing Committee) in mid-2019. mpconsulting sought targeted feedback on the draft recommendations – in particular, any comments on inaccuracies, factual errors and additional considerations or evidence that hadn’t previously been identified.

Draft Five Year Review Report – PDF 2928 KB
Draft Five Year Review Report – Word 21107 KB

A list of submissions for which confidentiality was not requested is below; submissions are available on request from the Front-of-Pack Labelling Secretariat via frontofpack@health.gov.au.

List of submissions: draft five year review report – PDF 110 KB
List of submissions: draft five year review report – Excel 13 KB
Five Year Review – Consultation

Detail on previous opportunities to provide feedback during and on the review are available on the Stakeholder Consultation page.

public submission process for the five year review was conducted between June and August 2017. mpconsulting prepared a report on these submissions and proposed a future consultation strategy. A list of submissions made is also available.

Submissions to the five year review of the HSR system – PDF 446 KB
Submissions to the five year review of the HSR system – Excel 23 KB

Report on Submissions to the Five Year Review of the Health Star Rating System – PDF 736 KB
Report on Submissions to the Five Year Review of the Health Star Rating System – Word 217 KB

5 Year Review of the Health Star Rating system – Future Consultation Opportunities – PDF 477 KB
5 Year Review of the Health Star Rating system – Future Consultation Opportunities – Word 28 KB

mpconsulting also prepared a Navigation Paper to guide Stage 2 (Wider Consultations Feb-Apr 2018) of their consultation strategy.

Navigation Paper – PDF 355 KB
Navigation Paper – Word 252 KB

Drawing on the early submissions and public workshops conducted across Australia and New Zealand in February- April 2018, mpconsulting identified 10 key issues relating to the products on which the HSR appears and the way that stars are calculated. A range of options for addressing identified issues were identified and, where possible, mpconsulting specified its preferred option. These issues are described in the Five Year Review of the Health Star Rating System – Consultation Paper: Options for System Enhancement.

Five Year Review of the Health Star Rating System – Consultation Paper: Options for System Enhancement – PDF 944 KB
Five Year Review of the Health Star Rating System – Consultation Paper: Options for System Enhancement – Word 430 KB

This Consultation Paper is informed by the TAG’s in-depth review of the technical components of the system. The TAG developed a range of technical papers on various issues identified by stakeholders, available on the mpconsulting website.

From October to December 2018, mpconsulting sought stakeholder views on the issues and the options, input on the impacts of the various options, and any suggestions for alternative options to address the identified issues. Written submissions could be made via the Australian Department of Health’s Consultation Hub.

mpconsulting held three further stakeholder workshops in Melbourne, Auckland and Sydney in November 2018 to enable stakeholders to continue to provide input on key issues for the review, including on options for system enhancements.
Five Year Review – Process

In April 2016, the Health Star Rating (HSR) Advisory Committee (HSRAC) commenced planning for the five year review of the HSR system.

Terms of Reference for the five year review follow:
Terms of Reference for the five year review of the Health Star Rating system – PDF 23 KB
Terms of Reference for the five year review of the Health Star Rating system – Word 29 KB

In September 2016, the HSRAC established a Technical Advisory Group (TAG) to analyse the performance of the HSR Calculator and respond to technical issues and related matters referred to it by the HSRAC.

HSRAC Members agreed that, in order to achieve a degree of independence, consultant(s) should be engaged to complete the review. In July 2017, following an Approach to Market process, Matthews Pegg Consulting (mpconsulting) was engaged as the independent reviewer.

The timeline for the five year review.
Five year review timeline – PDF 371 KB
Five year review timeline – Excel 14 KB

NACCHO Aboriginal Health #SaveADate @KidneyHealth April 8 -14 #KidneyHealthWeek #iKidneyCheck Plus @AusHealthReform Defining #culturalsafety – a public consultation. The consultation ends 15 May 2019

This weeks featured NACCHO SAVE A DATE events

15 May Cultural Safety Consultation closes

Download the 2019 Health Awareness Days Calendar 

8- 14 April Kidney Health Week

9 April Webinar : What will #Budget2019 mean for health consumers?

20 -24 May 2019 World Indigenous Housing Conference. Gold Coast

18 -20 June Lowitja Health Conference Darwin

2019 Dr Tracey Westerman’s Workshops 

7 -14 July 2019 National NAIDOC Grant funding round opens

23 -25 September IAHA Conference Darwin

24 -26 September 2019 CATSINaM National Professional Development Conference

9-10 October 2019 NATSIHWA 10 Year Anniversary Conference

16 October Melbourne Uni: Aboriginal and Torres Strait Islander Health and Wellbeing Conference

5-8 November The Lime Network Conference New Zealand 

Featured Save a dates date

15 May Cultural Safety Consultation closes 

This engagement process is important to ensure the definition is co-designed with Aboriginal and Torres Strait Islander people, health professionals and organisations across Australia.

Cultural safety is essential to improving health and wellbeing outcomes for Aboriginal and Torres Strait Islander Peoples and we are committed to a genuine partnership approach to develop a clear definition “

NHLF Chair, Pat Turner said the forum’s partnership with the Strategy Group meant that the definition is being led by Aboriginal and Torres Strait Islander health experts, which is an important value when developing policies or definitions that affect Aboriginal and Torres Strait Islander Peoples.

The NHLF has been operating since 2011 and is national representative committee for Aboriginal and Torres Strait Islander health peak bodies who provide advice on all aspects of health and well-being.

Help define this important term for the scheme that regulates health practitioners across Australia.

AHPRA, the National Boards and Accreditation Authorities in the National Registration and Accreditation Scheme which regulates registered health practitioners in Australia have partnered with Aboriginal and Torres Strait Islander health leaders and the National Health Leadership Forum (NHLF) to release a public consultation.

Together, they are seeking feedback on a proposed definition of ‘cultural safety’ to develop an agreed, national baseline definition that can be used as a foundation for embedding cultural safety across all functions in the National Registration and Accreditation Scheme and for use by the National Health Leadership Forum.

In total, there are 44 organisations represented in this consultation, which is being coordinated by the Aboriginal and Torres Strait Islander Health Strategy Group (Strategy Group), which is convened by AHPRA, and the NHLF (a list of representatives is available below).

Strategy Group Co-Chair, Professor Gregory Phillips said the consultation is a vital step for achieving health equity for Aboriginal and Torres Strait Islander Peoples. (see Picture below )

‘Patient safety for Aboriginal and Torres Strait Islander Peoples is inextricably linked with cultural safety. We need a baseline definition of ‘cultural safety’ that can be used across the National Scheme so that we can help registered health practitioners understand what cultural safety is and how it can help achieve health equity for all Australians’, said Prof Phillips.

The NHLF has been operating since 2011 and is national representative committee for Aboriginal and Torres Strait Islander health peak bodies who provide advice on all aspects of health and well-being.

The consultation is a continuation of the work by the National Scheme’s Strategy Group that has achieving health equity for Aboriginal and Torres Strait Islander Peoples as its overall goal. Members of the Group include Aboriginal and Torres Strait Islander health leaders and members from AHPRA, National Boards, Accreditation Authorities and NSW Councils.

AHPRA’s Agency Management Committee Chair, Mr Michael Gorton AM, said the far reach of this work is outlined in the Strategy Group’s Statement of intent, which was published last year.

‘The approach to this consultation is embodied in the Strategy Group’s Statement of intent, which has commitment, accountability, shared priorities, collaboration and high-level participation as its values. As a scheme, we are learning from our engagement with Aboriginal and Torres Strait Islander leaders, who are the appropriate leaders in this work. I thank these leaders, and the experts who have shared their knowledge and expertise with us, for their generosity and leadership which will lead to better health outcomes’, said Mr Gorton.

The six-week consultation is open to the public. Everyone interested in helping to shape the definition of ‘cultural safety’ that will be used in the National Scheme and by NHLF members is warmly invited to share their views.

The consultation is open until 5:00pm, Wednesday 15 May 2019.

For more information:

Download the NACCHO 2019 Calendar Health Awareness Days

For many years ACCHO organisations have said they wished they had a list of the many Indigenous “ Days “ and Aboriginal health or awareness days/weeks/events.

With thanks to our friends at ZockMelon here they both are!

It even has a handy list of the hashtags for the event.

Download the 53 Page 2019 Health days and events calendar HERE

naccho zockmelon 2019 health days and events calendar

We hope that this document helps you with your planning for the year ahead.

Every Tuesday we will update these listings with new events and What’s on for the week ahead

To submit your events or update your info

Contact: Colin Cowell www.nacchocommunique.com

NACCHO Social Media Editor Tel 0401 331 251

Email : nacchonews@naccho.org.au

Kidney Health Week: 8 – 14 April, 2019

” I’m Alice, I’m 31, and I have chronic kidney disease. When I found out my kidneys were failing, I didn’t understand what it meant or what my kidneys do, but now I do. The kidneys are one of the main organs in your body and if they aren’t well, you can get really sick, and end up in hospital on dialysis.

Before my health issues, I remember running around with my brother and cousins and doing everything kids are allowed to do. But when I turned 10, I couldn’t anymore. I felt like my freedom had been taken away from me. I asked all the time ‘why does this have to happen to me?’

Starting dialysis was terrifying. I didn’t know anything about it until I had been on it myself. It’s annoying knowing the fact that I’m going to be on it dialysis for the rest of my life. My advice is to go get your kidneys checked every 6 months. Having kidney disease is just as bad as having cancer but nobody knows about it until they get it.”

See Alice’s Webpage to donate 

This Kidney Health Week, Kidney Health Australia is asking Aboriginal and Torres Strait Islander
communities to visit their local Indigenous Health Centre to complete simple tests – blood, urine and blood pressure – to see if they are at risk of developing chronic kidney disease.

Download Kidney Health Week Supporter Kit with all the tools and resources you need to assist Kidney Health Australia to raise awareness of kidney disease. This includes social media text and images, newsletter copy, and key messages for your staff, affiliates, supporters as appropriate.

Kidney Health Week 2019 Supporter Kit – Alliances

Kidney Health Australia CEO, Chris Forbes, explained that while Aboriginal and Torres Strait Islander people represent less than 2.5 percent of the national population, they account for approximately eleven percent of people commencing kidney replacement therapy each year and the incidence of end-stage kidney disease for Indigenous peoples in remote areas of Australia is 18 to 20 times higher than that of comparable non-Indigenous peoples.

TAKE THE TEST HERE 

9 April What will #Budget2019 mean for health consumers?

What will  mean for health consumers? Join us next Tuesday for our webinar to learn more.

Register here 

20 -24 May 2019 World Indigenous Housing Conference. Gold Coast

Thank you for your interest in the 2019 World Indigenous Housing Conference.

The 2019 World Indigenous Housing Conference will bring together Indigenous leaders, government, industry and academia representing Housing, health, and education from around the world including:

  • National and International Indigenous Organisation leadership
  • Senior housing, health, and education government officials Industry CEOs, executives and senior managers from public and private sectors
  • Housing, Healthcare, and Education professionals and regulators
  • Consumer associations
  • Academics in Housing, Healthcare, and Education.

The 2019 World Indigenous Housing Conference #2019WIHC is the principal conference to provide a platform for leaders in housing, health, education and related services from around the world to come together. Up to 2000 delegates will share experiences, explore opportunities and innovative solutions, work to improve access to adequate housing and related services for the world’s Indigenous people.

Event Information:

Key event details as follows:
Venue: Gold Coast Convention and Exhibition Centre
Address: 2684-2690 Gold Coast Hwy, Broadbeach QLD 4218
Dates: Monday 20th – Thursday 23rd May, 2019 (24th May)

Registration Costs

  • EARLY BIRD – FULL CONFERENCE & TRADE EXHIBITION REGISTRATION: $1950 AUD plus booking fees
  • After 1 February FULL CONFERENCE & TRADE EXHIBITION REGISTRATION $2245 AUD plus booking fees

PLEASE NOTE: The Trade Exhibition is open Tuesday 21st May – Thursday 23rd May 2019

Please visit www.2019wihc.com for further information on transport and accommodation options, conference, exhibition and speaker updates.

Methods of Payment:

2019WIHC online registrations accept all major credit cards, by Invoice and direct debit.
PLEASE NOTE: Invoices must be paid in full and monies received by COB Monday 20 May 2019.

Please note: The 2019 WIHC organisers reserve the right of admission. Speakers, programs and topics are subject to change. Please visit http://www.2019wihc.comfor up to date information.

Conference Cancellation Policy

If a registrant is unable to attend 2019 WIHC for any reason they may substitute, by arrangement with the registrar, someone else to attend in their place and must attend any session that has been previously selected by the original registrant.

Where the registrant is unable to attend and is not in a position to transfer his/her place to another person, or to another event, then the following refund arrangements apply:

    • Registrations cancelled less than 60 days, but more than 30 days before the event are eligible for a 50% refund of the registration fees paid.
    • Registrations cancelled less than 30 days before the event are no longer eligible for a refund.

Refunds will be made in the following ways:

  1. For payments received by credit or debit cards, the same credit/debit card will be refunded.
  2. For all other payments, a bank transfer will be made to the payee’s nominated account.

Important: For payments received from outside Australia by bank transfer, the refund will be made by bank transfer and all bank charges will be for the registrant’s account. The Cancellation Policy as stated on this page is valid from 1 October 2018.

Terms & Conditions

please visit www.2019wihc.com

Privacy Policy

please visit www.2019wihc.com

18 -20 June Lowitja Health Conference Darwin


At the Lowitja Institute International Indigenous Health and Wellbeing Conference 2019 delegates from around the world will discuss the role of First Nations in leading change and will showcase Indigenous solutions.

The conference program will highlight ways of thinking, speaking and being for the benefit of Indigenous peoples everywhere.

Join Indigenous leaders, researchers, health professionals, decision makers, community representatives, and our non-Indigenous colleagues in this important conversation.

More Info 

2019 Dr Tracey Westerman’s Workshops 

More info and dates

7 -14 July 2019 National NAIDOC Grant funding round opens 

The opening of the 2019 National NAIDOC Grant funding round has been moved forward! The National NAIDOC Grants will now officially open on Thursday 24 January 2019.

Head to www.naidoc.org.au to join the National NAIDOC Mailing List and keep up with all things grants or check out the below links for more information now!

https://www.finance.gov.au/resource-management/grants/grantconnect/

https://www.pmc.gov.au/indigenous-affairs/grants-and-funding/naidoc-week-funding

23 -25 September IAHA Conference Darwin

24 September

A night of celebrating excellence and action – the Gala Dinner is the premier national networking event in Aboriginal and Torres Strait Islander allied health.

The purpose of the IAHA National Indigenous Allied Health Awards is to recognise the contribution of IAHA members to their profession and/or improving the health and wellbeing of Aboriginal and Torres Strait Islander peoples.

The IAHA National Indigenous Allied Health Awards showcase the outstanding achievements in Aboriginal and Torres Strait Islander allied health and provides identifiable allied health role models to inspire all Aboriginal and Torres Strait Islander people to consider and pursue a career in allied health.

The awards this year will be known as “10 for 10” to honour the 10 Year Anniversary of IAHA. We will be announcing 4 new awards in addition to the 6 existing below.

Read about the categories HERE.

24 -26 September 2019 CATSINaM National Professional Development Conference

 

 

The 2019 CATSINaM National Professional Development Conference will be held in Sydney, 24th – 26th September 2019. Make sure you save the dates in your calendar.

Further information to follow soon.

Date: Tuesday the 24th to Thursday the 26th September 2019

Location: Sydney, Australia

Organiser: Chloe Peters

Phone: 02 6262 5761

Email: admin@catsinam.org.au

9-10 October 2019 NATSIHWA 10 Year Anniversary Conference

SAVE THE DATE for the 2019 NATSIHWA 10 Year Anniversary Conference!!!

We’re so excited to announce the date of our 10 Year Anniversary Conference –
A Decade of Footprints, Driving Recognition!!! 

NATSIHWA recognises that importance of members sharing and learning from each other, and our key partners within the Health Sector. We hold a biennial conference for all NATSIHWA members to attend. The conference content focusses on the professional support and development of the Health Workers and Health Practitioners, with key side events to support networking among attendees.  We seek feedback from our Membership to make the conferences relevant to their professional needs and expectations and ensure that they are offered in accessible formats and/or locations.The conference is a time to celebrate the important contribution of Health Workers and Health Practitioners, and the Services that support this important profession.

We hold the NATSIHWA Legends Award night at the conference Gala Dinner. Award categories include: Young Warrior, Health Worker Legend, Health Service Legend and Individual Champion.

Watch this space for the release of more dates for registrations, award nominations etc.

16 October Melbourne Uni: Aboriginal and Torres Strait Islander Health and Wellbeing Conference

The University of Melbourne, Department of Rural Health are pleased to advise that abstract
submissions are now being invited that address Aboriginal and Torres Strait Islander health and
wellbeing.

The Aboriginal & Torres Strait Islander Health Conference is an opportunity for sharing information and connecting people that are committed to reforming the practice and research of Aboriginal & Torres Strait Islander health and celebrates Aboriginal knowledge systems and strength-based approaches to improving the health outcomes of Aboriginal communities.

This is an opportunity to present evidence-based approaches, Aboriginal methods and models of
practice, Aboriginal perspectives and contribution to health or community led solutions, underpinned by cultural theories to Aboriginal and Torres Strait Islander health and wellbeing.
In 2018 the Aboriginal & Torres Strait Islander Health Conference attracted over 180 delegates from across the community and state.

We welcome submissions from collaborators whose expertise and interests are embedded in Aboriginal health and wellbeing, and particularly presented or co-presented by Aboriginal and Torres Strait Islander people and community members.

If you are interested in presenting, please complete the speaker registration link

closing date for abstract submission is Friday 3 rd May 2019.
As per speaker registration link request please email your professional photo for our program or any conference enquiries to E. aboriginal-health@unimelb.edu.au.

Kind regards
Leah Lindrea-Morrison
Aboriginal Partnerships and Community Engagement Officer
Department of Rural Health, University of Melbourne T. 03 5823 4554 E. leah.lindrea@unimelb.edu.au

5-8 November The Lime Network Conference New Zealand 

This years  whakatauki (theme for the conference) was developed by the Scientific Committee, along with Māori elder, Te Marino Lenihan & Tania Huria from .

To read about the conference & theme, check out the  website. 

NACCHO Aboriginal Health #WorldKidneyDay #Organdonation :  Minister @KenWyattMP announces $2.3mill for @TSANZ_txsoc proposal to address inequity and launches report Improving Kidney Transplant Outcomes for our mob

 

” I have the pleasure of launching a significant report in improving access to organ and tissue donation, but also the establishment of a national task force that will undertake work to look at, what the obstacles are, what are the challenges and considerations we need to make in the way in which people access the transplant list, but also the operations that follow”.

Federal Minister for Indigenous Health Ken Wyatt announced the national project on Tuesday, saying it aimed to combat the low rates of Aboriginal and Torres Strait Islander Australians receiving donor kidneys and has announced it will provide $2.3 million towards increasing the number of Indigenous Australians receiving donor kidneys. see full speech part 2 Below

PHOTO: Darwin dialysis patient Jacqueline Amagula would like to be waitlisted for a kidney transplant. (ABC News: Bridget Brennan)

Download copy of report

Kidney Transplantation Report

World Kidney Day – Thursday 14 March 2019

World Kidney Day is an annual global campaign to raise awareness of the importance of kidney health.

Chronic kidney disease affects approximately 195 million women worldwide and it is currently the 8th leading cause of death in women, with close to 600,000 deaths each year.

On its 14th anniversary, World Kidney Day promotes affordable and equitable access to health education, healthcare and prevention for kidney diseases for all.

Find out more at www.worldkidneyday.org

” Australians should be “saddened, angry and flabbergasted” that Indigenous patients are up to 10 times less likely to be added to the kidney donation waitlist than non-Indigenous patients, a leading renal specialist has said.

Background Key points 2017

  • Indigenous dialysis patients 10 times less likely to be put on a waitlist for kidney transplant
  • Dr Paul Lawton says non-Indigenous doctors are biased towards non-Indigenous dialysis patients
  • Professor Steve Chadban says racism is not to blame

Dr Paul Lawton, a specialist at the Menzies School of Health Research, said Australian kidney specialists were “well meaning” but that structural racism had led to unacceptably low transplant rates for Aboriginal patients.

He said Australia’s system was tipped towards waitlisting non-Indigenous patients over Aboriginal and Torres Strait Islander people.

“Currently, our system is structured so that us non-Indigenous, often male, middle-aged white kidney specialists offer kidney transplants to people like ourselves,

Dr Lawton told 7.30.

The report was commissioned in June 2018, partly in response to figures that suggested Indigenous patients are 10 times less likely than non-Indigenous patients to be added to the waiting list for a kidney donation transplant :Picture Below 2017

FROM SBS / NITV 

Despite those figures, 13 per cent of patients receiving dialysis treatment in Australia are Indigenous.

The report was compiled by the Transplantation Society of Australia and New Zealand and prioritises three of its 35 recommendations, including the establishment of a National Indigenous Kidney Transplantation taskforce.

Professor Stephen McDonald, a nephrologist at the Royal Adelaide Hospital and one of the report’s authors, said the funding announcement is an important step.

“This is a very clear next step, and a change in focus from identifying with the problem, to actually doing something about the problem in a coordinated fashion. There have been a variety of bodies who have had input in this area in the past, but this is the first time there’s been a coordinated and focused approach.”

Indigenous people, especially those who live in remote communities, have a much greater risk of developing end-stage kidney disease, which initially requires dialysis treatment.

However, once Indigenous people make it on to the transplant waiting list, they receive transplants at around the same rate as non-Indigenous people.

Part 2 :Minister for Senior Australians and Aged Care and Minister for Indigenous Health, Ken Wyatt AM, MP speech at the 2019 Donation and Transplantation Conference – Indigenous Health Roundtable

Good morning everyone – in West Australian Noongar language, I say “kaya wangju” – hello and welcome.

I acknowledge the traditional owners of the land on which we meet, the Gadigal people of the Eora Nation, and pay my respects to their Elders past, present and future.

I also acknowledge:

  • Lucinda Barry (CEO of Australia’s Organ and Tissue Authority)
  • Chairman of the OTA Board, Dr Mal Washer and Board members:
    • Professor Carol Pollock (deputy Chair)
    • Dr Marisa Herson
    • Margaret Kruger
    • Oren Klemich
    • Prof Stephen Lynch

I welcome our special international guests:

  • Howard Nathan (President and CEO of the Gift of Life Donor Program in Philadelphia, United States)
  • Chris Callaghan (Consultant kidney and pancreas transplant surgeon at Guy’s Hospital, Great Ormond Street Hospital and Evelina London Children’s Hospital, London, UK)
  • Dr Nick Cross (nephrologist at Christchurch Hospital, New Zealand)
  • And all the distinguished attendees here today.

On behalf of the Morrison Government and the Organ and Tissue Authority, I thank you for joining us for this important conference.

Organ and tissue donation and transplantation is an area I am very passionate about, and one that is critical to our nations’ health systems.

We are celebrating 10 years of the Australian Government’s national program to improve organ and tissue donation for transplantation in Australia.

At this significant anniversary, I think it is an important opportunity to reflect on how far we have come.

Since 2009, the national program has seen the number of deceased organ donors more than double – to 554 in 2018.

This has resulted in more than 11,000 people receiving a lifesaving transplant.

There has also been more than 16,000 Australians receiving the gift of sight since 2009.

And last year, we achieved our highest ever consent rate of 64 per cent due to more Australians saying ‘yes’ to donation.

The data gives us essential facts but what has made this real for me has been talking to those families who have said yes to donation and those that have had their lives transformed by a transplant.

I heard from a teenage boy who talked about his Dad becoming a donor, and the comfort it gave him knowing his father had given someone else the chance to live.

He spoke with pride about his Dad and pondered whether whoever had received his organs would also develop the same passions for life and sport that his father had.

And in January this year I was at St Vincent’s Hospital, here in Sydney.

There I met Jayden Cummins – a single Dad who in 2017 was living a normal life, caring for his teenage son, when he contracted the flu.

His life was turned upside down when he was told he needed a heart transplant.

He showed me his black little bag with his Ventricular Assist Device that he was permanently attached to – keeping him alive.

He had been waiting about 18 months, however he remained positive and totally focused on being there for his son.

Today, I was informed that Jayden has had his transplant and is on the road to recovery. I wish Jayden all the best and thank the generosity of his donor and their family for giving him the gift of life.

This is just one story that shows the importance of your work and the significant impact is has on people’s lives.

Like everyone attending this conference, our Government’s focus is on continuing to enhance clinical programs in hospitals, and the systems which support donation and transplantation services.

But what if we find a group of people within our communities who are not receiving their fair share of increasing organ donation and transplantation?

Last year, I saw figures showing that, among Aboriginal and Torres Strait Islander people registered for Renal Replacement Therapy, only 13 per cent received transplants, compared with 51 per cent of non-Indigenous Australians.

So, in June I announced funding for the Transplantation Society of Australia and New Zealand to lead an expert panel, to investigate and identify transplantation barriers facing our people.

The expert panel, convened by Prof Stephen McDonald, has produced an outstanding report: Improving Access to and Outcomes of Kidney Transplantation for Aboriginal and Torres Strait Islander People in Australia.

I want to thank all members of the panel for their contribution to this comprehensive document, which I am releasing – and endorsing – today.

Furthermore, I am proud to announce that the Morrison Government will provide $2.3 million to drive a national project to lift the low rates of Aboriginal and Torres Strait Islander Australians receiving donor organs, as recommended in the report.

NACCHO Aboriginal Health #Obesity #Diabetes News: 1. @senbmckenzie report #ObesitySummit19 and 2. @MenziesResearch are calling for immediate action to reduce risk the of #obesity and #diabetes in #Indigenous children and young people.

Type 2 Diabetes is a particular concern as there is a global trend of increasing numbers of young people being diagnosed, there is limited data available in Australia but anecdotally numbers are rising rapidly amongst young Indigenous Australians.

Childhood obesity and Type 2 diabetes leads to other serious health issues such as kidney disease which then puts a huge burden on families, communities and health facilities. When it occurs at a young age, it is a much more aggressive disease than in older people.

It is critical that we act now to prevent this emerging public health issue, with engagement of Indigenous communities in the design of interventions being crucial.

“A suite of interventions across the life course are required, targeting children and young people before they develop disease, particularly childhood obesity, as well as targeting their parents to prevent intergenerational transmission of metabolic risk” 

Dr Angela Titmuss, paediatric endocrinologist at Royal Darwin Hospital and Menzies School of Health Research (Menzies) PhD student : See Press Release Part 1

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

Read over 70 Aboriginal Health and Obesity articles published by NACCHO over past 7 years

” The latest Australian Bureau of Statistics National Health Survey shows that previous efforts to combat obesity have had limited success.

Two-thirds of adults and a quarter of children aged from five to 17 years are now overweight or obese.

While the rate for children has been stable for 10 years, the proportion of adults who are not just overweight but obese has risen from 27.9 per cent to 31.3 per cent.

Overweight and obesity not only compromise quality of life, they are strongly linked to preventable chronic diseases—heart disease, diabetes, lung disease, certain cancers, depression and arthritis, among others.

Senator McKenzie #ObesitySummit19 See Press Release Part 2 Below

Researchers are calling for immediate action to reduce risk the of obesity and diabetes in Indigenous children and young people.

A suite of interventions across the life course are required, targeting children and young people before they develop disease, particularly childhood obesity, as well as targeting their parents to prevent intergenerational transmission of metabolic risk.

The in utero period and first 5 years of life are influential in terms of the long term risk of chronic disease, and we propose that identifying and improving childhood metabolic health be a targeted priority of health services.

In an article published in the Medical Journal of Australia (MJA) today, researchers have identified childhood obesity and the increasing numbers of young people being diagnosed with Type 2 diabetes as emerging public health issues.

Lead author Dr Angela Titmuss, paediatric endocrinologist at Royal Darwin Hospital and Menzies School of Health Research (Menzies) PhD student, says in the MJA Perspective article that collaboration between communities, clinicians and researchers across Australia is needed to get an accurate picture of the numbers involved.

In Indigenous Australian young people with type 2 diabetes, there are also higher rates of comorbidities, with 59% also having hypertension, 24% having dyslipidaemia and 61% having obesity.

These comorbidities will have a significant impact on the future burden of disease, and may lead to renal, cardiac, neurological and ophthalmological complications. Canadian data demonstrated that 45% of patients with youth onset type 2 diabetes had reached end‐stage renal failure, requiring renal replacement therapy, 20 years after diagnosis, compared with zero people with type 1 diabetes.

Youth onset type 2 diabetes was associated with a 23 times higher risk of kidney failure and 39 times higher risk of need for dialysis, compared with young people without diabetes.

This implies that many young people who are being diagnosed with diabetes now will be on dialysis by 30 years of age, with significant effects on Aboriginal and Torres Strait Islander families and communities.

Menzies HOT NORTH project is supporting this research through the Diabetes in Youth collaboration, a Northern Australia Tropical Disease Collaborative Research Program, funded by the NHMRC.

The MJA Article is available here

https://www.mja.com.au/journal/2019/210/3/emerging-diabetes-and-metabolic-conditions-among-aboriginal-and-torres-strait

 Comprehensive strategies, action plans and both funding and better communication across sectors (health, education, infrastructure and local government) and departments are required to address obesity, diabetes and metabolic risk among Indigenous young people in Australia.

It requires a radical rethinking of our current approach which is failing Aboriginal and Torres Strait Islander young people and communities, and a commitment to reconsider the paradigm, to be open to innovative approaches and the involvement of multiple sectors

Part 2

I again apologise for any offence taken by the unfortunate photo taken out of context at the Obesity Summit on Friday, and I am happy if my ridicule leads to action on the complex issue of obesity in this country.

The Senator has apologised.

The issue of obesity is a matter I take very seriously and would never triavisie it- or to add in any way to stigmatisation. I sincerely apologise for this very unfortunate photo taken as I demonstrated how my stomach felt after scrambled eggs reacted w yogurt I had just eaten.

That is exactly the reason I called international and Australian experts together for the National Obesity Summit last week

Last October, the Council of Australian Governments’ (COAG) Health Council— comprising federal, state and territory ministers—agreed to develop a national strategy on obesity.

Friday’s National Obesity Summit in Canberra represented an important first step towards a new nationally cohesive strategy on obesity prevention and control.

The Summit focussed on the role of physical activity, primary health care clinicians, educators and governments to work collaboratively rather than in silos.

At the Summit we heard from national and global experts because obesity is an international issue and we need to understand how other jurisdictions are tackling the problem.  We also heard that stigma surrounding obesity can be a barrier to help being accessed.

The latest Australian Bureau of Statistics National Health Survey shows that previous efforts to combat obesity have had limited success.

Two-thirds of adults and a quarter of children aged from five to 17 years are now overweight or obese.

While the rate for children has been stable for 10 years, the proportion of adults who are not just overweight but obese has risen from 27.9 per cent to 31.3 per cent.

Overweight and obesity not only compromise quality of life, they are strongly linked to preventable chronic diseases—heart disease, diabetes, lung disease, certain cancers, depression and arthritis, among others.

We know that there is not one simple solution to tackling the problem so we need to examine all options and develop a multi-faceted approach.

The Obesity Summit represented an important moment for Australians’ health and recognised that there is no magic fat-busting policy pill.

NACCHO Aboriginal Health and #SocialDeterminants : Download @AIHW Report : Indicators of socioeconomic inequalities in #cardiovascular disease #heartattack #stroke, #diabetes and chronic #kidney disease @ACDPAlliance

 ” Most apparent are inequalities in chronic disease among Aboriginal and Torres Strait Islander people and non-Indigenous Australians. Social and economic factors are estimated to account for slightly more than one-third (34%) of the ‘good health’ gap between the 2 groups, with health risk factors such as high blood pressure, smoking and risky alcohol consumption explaining another 19%, and 47% due to other, unexplained factors.

 An estimated 11% of the total health gap can be attributed to the overlap, or interactions between the social determinants and health risk factors (AIHW 2018a).

Download the AIHW Report HERE aihw-cdk-12

‘By better understanding the role social inequality plays in chronic disease, governments at all levels can develop stronger, evidence based policies and programs aimed at preventing and managing these diseases, leading to better health outcomes across our community,’

AIHW spokesperson Dr Lynelle Moonn noted that these three diseases are common in Australia and, in addition to the personal costs to an individual’s health and quality of life, they have a significant economic burden in terms of healthcare costs and lost productivity

AIHW Website for more info 

Government investment is essential to encourage health checks, improve understanding of the risk factors for chronic disease, and implement policies and programs to reduce chronic disease risk, particularly in areas of socioeconomic disadvantage,

Chair of the Australian Chronic Disease Prevention Alliance Sharon McGowan said that the data revealed stark inequities in health status amongst Australians.

Download Press Release Here : australianchronicdiseasepreventionalliance

The Australian Chronic Disease Prevention Alliance is calling on the Government to target these health disparities by increasing the focus on prevention and supporting targeted health checks to proactively manage risk.

AIHW Press Release

Social factors play an important role in a person’s likelihood of developing and dying from certain chronic diseases, according to a new report from the Australian Institute of Health and Welfare (AIHW).

The report, Indicators of socioeconomic inequalities in cardiovascular disease, diabetes and chronic kidney disease, examines the relationship between socioeconomic position, income, housing and education and the likelihood of developing and dying from several common chronic diseases—cardiovascular disease (which includes heart attack and stroke), diabetes and chronic kidney disease.

Above image NACCHO Library

The report reveals that social disadvantage in these areas is linked to higher rates of disease, as well as poorer outcomes, including a greater likelihood of dying.

‘Across the three chronic diseases we looked at—cardiovascular disease, diabetes and chronic kidney disease— we saw that people in the lowest of the 5 socioeconomic groups had, on average, higher rates of these diseases than those in the highest socioeconomic groups,’ said AIHW spokesperson Dr Lynelle Moon.

‘And unfortunately, we also found higher death rates from these diseases among people in the lowest socioeconomic groups.’

The greatest difference in death rates between socioeconomic groups was among people with diabetes.

‘For women in the lowest socioeconomic group, the rate of deaths in 2016 where diabetes was an underlying or associated cause of death was about 2.4 times as high as the rate for those in the highest socioeconomic group. For men, the death rate was 2.2 times as high,’ Dr Moon said.

‘Put another way, if everyone had the same chance of dying from these diseases as people in the highest socioeconomic group, in a one year period there would be 8,600 fewer deaths from cardiovascular disease, 6,900 fewer deaths from diabetes, and 4,800 fewer deaths from chronic kidney disease.’

Importantly, the report also suggests that in many instances the gap between those in the highest and lowest socioeconomic groups is growing.

‘For example, while the rate of death from cardiovascular disease has been falling across all socioeconomic groups, the rate has been falling more dramatically for men in the highest socioeconomic group—effectively widening the gap between groups,’ Dr Moon said.

The report also highlights the relationship between education and health, with higher levels of education linked to lower rates of disease and death.

‘If all Australians had the same rates of disease as those with a Bachelor’s degree or higher, there would have been 7,800 fewer deaths due to cardiovascular disease, 3,700 fewer deaths due to diabetes, and 2,000 fewer deaths due to chronic kidney disease in 2011–12,’ Dr Moon said.

Housing is another social factor where large inequalities are apparent. Data from 2011–12 shows that for women aged 25 and over, the rate of death from chronic kidney disease was 1.5 times as high for those living in rental properties compared with women living in properties they owned. For men, the rate was 1.4 times as high for those in rental properties.

Dr Moon noted that these three diseases are common in Australia and, in addition to the personal costs to an individual’s health and quality of life, they have a significant economic burden in terms of healthcare costs and lost productivity.

‘By better understanding the role social inequality plays in chronic disease, governments at all levels can develop stronger, evidence based policies and programs aimed at preventing and managing these diseases, leading to better health outcomes across our community,’ she said

Underlying causes of socioeconomic inequalities in health

There are various reasons why socioeconomically disadvantaged people experience poorer health. Evidence points to the close relationship between people’s health and the living and working conditions which form their social environment.

Factors such as socioeconomic position, early life, social exclusion, social capital, employment and work, housing and the residential environment— known collectively as the ‘social determinants of health’—can act to either strengthen or to undermine the health of individuals and communities (Wilkinson & Marmot 2003).

These social determinants play a key role in the incidence, treatment and outcomes of chronic diseases. Social determinants can be seen as ‘causes of the causes’—that is, as the foundational determinants which influence other health determinants such as individual lifestyles and exposure to behavioural and biological risk factors.

Socioeconomic factors influence chronic disease through multiple mechanisms. Socioeconomic disadvantage may adversely affect chronic disease risk through its impact on mental health, and in particular, on depression. Socioeconomic gradients exist for multiple health behaviours over the life course, including for smoking, overweight and obesity, and poor diet.

When combined, these unhealthy behaviours help explain much of the socioeconomic health gap. Current research also seeks to link social factors and biological processes which affect chronic disease. In CVD, for example, socioeconomic determinants of health have been associated with high blood pressure, high cholesterol, chronic stress responses and inflammation (Havranek et al. 2015).

The direction of causality of social determinants on health is not always one-way (Berkman et al. 2014). To illustrate, people with chronic conditions may have a reduced ability to earn an income; family members may reduce or cease employment to provide care for those who are ill; and people or families whose income is reduced may move to disadvantaged areas to access low-cost housing.

Action on social determinants is often seen as the most appropriate way to tackle unfair and avoidable socioeconomic inequalities. There are significant opportunities for reducing death and disability from CVD, diabetes and CKD through addressing their social determinants.

Summary

Australians as a whole enjoy good health, but the benefits are not shared equally by all. People who are socioeconomically disadvantaged have, on average, greater levels of cardiovascular disease (CVD), diabetes and chronic kidney disease (CKD).

This report uses latest available data to measure socioeconomic inequalities in the incidence, prevalence and mortality from these 3 diseases, and where possible, assess whether these inequalities are growing. Findings include that, in 2016:

  • males aged 25 and over living in the lowest socioeconomic areas of Australia had a heart attack rate 1.55 times as high as males in the highest socioeconomic areas. For females, the disparity was even greater, at 1.76 times as high
  • type 2 diabetes prevalence for females in the lowest socioeconomic areas was 2.07 times as high as for females in the highest socioeconomic areas. The prevalence for males was 1.70 times as high
  • the rate of treated end-stage kidney disease for males in the lowest socioeconomic areas was 1.52 times as high as for males in the highest socioeconomic areas. The rate for females was 1.75 times as high
  • the CVD death rate for males in the lowest socioeconomic areas was 1.52 times as high as for males in the highest socioeconomic areas. For females, the disparity was slightly less, at 1.33 times as high
  • if all Australians had the same CVD death rate as people in the highest socioeconomic areas in 2016, the total CVD death rate would have declined by 25%, and there would have been 8,600 fewer deaths.

CVD death rates have declined for both males and females in all socioeconomic areas since 2001— however there have been greater falls for males in higher socioeconomic areas, and as a result, inequalities in male CVD death rates have grown.

  • Both absolute and relative inequality in male CVD death rates increased—the rate difference increasing from 62 per 100,000 in 2001 to 78 per 100,000 in 2011, and the relative index of inequality (RII) from 0.25 in 2001 to 0.53 in 2016.

Often, the health outcomes affected by socioeconomic inequalities are greater when assessed by individual characteristics (such as income level or highest educational attainment), than by area.

  • Inequalities in CVD death rates by highest education level in 2011–12 (RII = 1.05 for males and 1.05 for females) were greater than by socioeconomic area in 2011 (0.50 for males and 0.41 for females).

The impact on death rates of socioeconomic inequality was generally greater for diabetes and CKD than for CVD.

  • In 2016, the diabetes death rate for females in the lowest socioeconomic areas was 2.39 times as high as for females in the highest socioeconomic areas. This compares to a ratio 1.75 times as high for CKD, and 1.33 for CVD. For males, the equivalent rate ratios were 2.18 (diabetes), 1.64 (CKD) and 1.52 (CVD).viii

Part 2

 

NACCHO Aboriginal Health and #chronicdisease @SandroDemaio How #obesity ups your chronic disease risk and what to do about it

” Almost two in every three Australian adults are now overweight or obese, as are one in four of our children.

This rising obesity burden is the outcome of a host of factors, many of which are beyond our individual control – and obesity is linked to a number of chronic diseases.”

Dr Sandro Demaio is an Aussie medical doctor and global expert on non-communicable diseases. Co-host of the ABC TV series ‘Ask the Doctor’, author of 30 scientific papers and ‘The Doctor’s Diet’ (a cookbook based on science) see Part 2 below 

This article was originally published HERE 

Part 1 NACCHO Policy

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

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

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

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

Access to healthy and fresh foods in remote Australia

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

From NACCHO Submission Read here 

” Many community members in the NT who suffer from chronic illnesses would benefit immensely from using Health Care Homes.

Unfortunately, with limited English, this meant an increased risk of them being inadvertently excluded from the initiative.

First, Italk Alice Springs produced the English version of the story. Then using qualified interpreters, they produced Aboriginal language versions in eight languages: Anmatyerre, Alyawarr, Arrernte, East Side Kriol, West Side Kriol, Pitjatjantjara, Warlpiri and Yolngu Matha

Read Article HERE

Figure 2.22-1 Proportion of persons 15 years and over (age-standardised) by BMI category and Indigenous status, 2012–13
Proportion of persons 15 years and over (age-standardised)

Source: ABS and AIHW analysis of 2012–13 AATSIHS

Read over 60 Aboriginal Health and Obesity articles published by NACCHO over past 7 Years

What is chronic disease?

Chronic disease is a broad term, which includes type 2 diabetes, heart disease, cancers, certain lung conditions, mental illness and genetic disorders. They are often defined by having complex and multiple causes, and are long-term or persistent (‘chronic’ actually means long-term).

How is obesity linked to chronic disease?

Obesity increases the risk of developing certain chronic diseases, including cardiovascular diseases (heart disease and stroke), sleep disorders, type 2 diabetes and at least 13 types of cancer.

Type 2 diabetes and obesity:

Obesity is the leading risk factor for type 2 diabetes, and even being slightly overweight increases this risk. Type 2 diabetes is characterised physiologically by decreased insulin secretion as well as increased insulin resistance due to a combination of genetic and environmental factors. Left uncontrolled, this can lead to a host of nasty outcomes like blindness, kidney problems, heart disease and even loss of feeling in our hands and feet.

Obstructive sleep apnoea and obesity:

This is another chronic disease often linked to obesity. Sleep apnoea is caused when our large air passage is partially or fully blocked by a combination of factors, including the weight of fat tissue sitting on our neck. It can cause us to jolt awake, gasping for oxygen. It leads to poor sleep, which adds physiological pressure to critical organs.

A woman preparing vegetables for a meal

Cancer and obesity:

This is a disease of altered gene expression. It originates from changes to the cell’s DNA caused by a range of factors, including inherited mutations, inflammation, hormones, and external factors including tobacco use, radiation from the sun, and carcinogenic agents in food. Strong evidence also links obesity to a number of cancers including throat cancer, bowel cancer, cancer of the liver, gallbladder and bile ducts, pancreatic cancer, breast cancer, endometrial cancer and kidney cancer.

Obesity is also associated with high blood pressure and increased risk of heart attack and stroke.

This might sound overwhelming, but it’s not all bad news. Here are a few things we can all start to do today to reduce our risk of obesity and associated chronic disease:

1. Eat more fruit and veg

Most dietary advice revolves around eating less. But if we can replace an unhealthy diet with an abundance of fresh, whole fruits and vegetables – at least two servings of fruit per day and five servings of vegetables – we can reduce our risk of obesity whilst still embracing our love for good food.

2. Limit our alcohol consumption

Forgo that glass of wine or beer after a long hard day at work and opt instead for something else that helps us relax. Pure alcohol is inherently full of energy – containing twice the energy per gram as sugar. This energy is surplus and non-essential to our nutritional needs, so contributes to our widening waistlines. And whether we’re out for drinks with mates or at a function, we can reduce our consumption by spacing out our drinks and holding off before reaching for another glass.

3. Get moving

While not everyone loves a morning sprint, there are many enjoyable ways to maintain a sufficient level of physical activity. Doing some form of exercise for at least 30 minutes each day is an effective way of keeping our waistlines in check. So, take a break to stretch out the muscles a few times during the workday, spend an afternoon at the local pool, get out into the garden or take some extra time to ride or walk to work. If none of these appeal, do some research to find the right exercise that will be fun and achievable.

Two women exercising in a park together

4. Buddy up

There’s nothing like a bit of peer pressure to get us healthy and active. Pick a friend who has the same goals and encourage each other to keep going. Sign up for exercise classes together, meet for a walk, have them over for a healthy meal, share tips and seek out support when feeling uninspired.

5. Prioritise sleep

Some argue that sleep is the healthy icing on the longevity cake. The benefits of a good night’s sleep are endless, with recent research suggesting it can even benefit our decision-making and self-discipline, making it easier to resist that ‘between-meal’ treat. Furthermore, lack of sleep can increase our appetite and see us lose the enthusiasm to stay active.

Above all, we need to foster patience and perseverance when it comes to achieving a healthy weight. It might not happen overnight, but it is within reach.

Let’s start today!

Co-host of the ABC TV series ‘Ask the Doctor’, author of 30 scientific papers and ‘The Doctor’s Diet’ (a cookbook based on science), Dr Sandro Demaio is an Aussie medical doctor and global expert on non-communicable diseases.

NACCHO Aboriginal Health and #Sugarydrinks : @BakerResearchAu Study reveals the damaging effects for inactive, young, obese people who consume soft drink regularly : What’s going on inside your veins ?

“ With lifestyle-related diseases such as obesity rising rapidly and sugar sweetened beverages the largest source of added sugars in Western diets, understanding the ‘real world’ health impact is critical in determining ‘real world’ prevention and intervention strategies,”

Professor Bronwyn Kingwell, the study’s senior author : See Baker Institute Press Release Part 1

If you did this day in, day out, your pancreas would be under considerable stress – and this is how diabetes can develop.

Having a little can of soft drink in the morning is going to have lasting effects throughout the day.”

If your diet has too much sugar in it, forcing your body to keep your insulin high all the time, eventually your cells will grow insulin-resistant. That forces the pancreas to make even more insulin, adding to its workload. Eventually, it will burn out

Professor Bronwyn Kingwell. See SMH Article Part 2 What’s going on inside your veins after you drink a soft drink

See NACCHO Nutrition ,Obesity , Sugar Tax,, Health Promotion 200 + articles published over 6 years and see our policy below

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

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

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

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

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

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

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

Download the full 15 Page submission HERE

Obesity Epidemic in Australia – Network Submission – 6.7.18

Press Release : Study reveals the damaging metabolic effects for inactive, young, obese people who consume soft drink regularly

We know drinking soft drink is bad for the waistline, now a study by Baker Heart and Diabetes Institute researchers provides evidence of the damaging metabolic effects on overweight and obese people who regularly consume soft drink and sit for long periods.

Researchers have quantified the detrimental effects on glucose and lipid metabolism by studying young, obese adults in a ‘real-world’ setting where up to 750ml of soft drink is consumed between meals daily and where prolonged sitting with no activity is the norm.

The results, outlined by PhD candidate Pia Varsamis in the Clinical Nutrition journal, show how habitual soft drink consumption and large periods of sedentary behaviour may set these young adults on the path to serious cardiometabolic diseases such as fatty liver disease, type 2 diabetes and heart disease.

Whilst most studies to date have focused on the relationship between soft drink consumption and obesity, the large amount of added sugars contained in these drinks has additional implications beyond weight control.

Watch TV Interview

Senior author, Professor Bronwyn Kingwell, who heads up the Institute’s Metabolic and Vascular Physiology laboratory, says the acute metabolic effects of soft drink consumption and prolonged sitting identified in this latest study are cause for concern.

“With lifestyle-related diseases such as obesity rising rapidly and sugar sweetened beverages the largest source of added sugars in Western diets, understanding the ‘real world’ health impact is critical in determining ‘real world’ prevention and intervention strategies,” Professor Kingwell says.

She says this study quantified the effects of soft drink consumption compared to water on glucose and lipid metabolism in a context that was reflective of typical daily consumption levels, meal patterns and activity behaviours such as sitting for long periods.

The study, involved 28 overweight or obese adults aged 19–30 years who were habitual soft drink consumers. They participated in two separate experiments on different days drinking soft drink on one and water on the other both mid-morning and mid-afternoon during a 7-hour day of uninterrupted sitting.

Professor Kingwell says the combination of soft drink and prolonged sitting significantly elevated plasma glucose and plasma insulin, while reducing circulating triglycerides and fatty acids which indicates significant suppression of lipid metabolism, particularly in males.

She says the metabolic effects of a regular diet of soft drink combined with extended periods of sitting may contribute to the development of metabolic disease in young people who are overweight or obese, including predisposing men to an elevated risk of fatty liver disease.

“The acute metabolic effects outlined in this study are very worrying and suggest that young, overweight people who engage in this type of lifestyle are setting themselves on a path toward chronic cardiometabolic disease,” Professor Kingwell says. “This highlights significant health implications both for individuals and our healthcare system.”

Part 2 : Here’s what’s going on inside your veins after you drink a soft drink

Orginally published Here

Half an hour after finishing a can of soft drink, your blood sugar has spiked.

So you’re probably feeling pretty good. Your cells have plenty of energy, more than they need.

Maybe that soft drink had some caffeine as well, giving your central nervous system a kick, making you feel excitable, suppressing any tiredness you might have.

But a clever new study, published this week, nicely illustrates that while you’re feeling good, strange things are going on inside your blood vessels – and in the long run they are not good for you.

For this study, 28 obese or overweight young adults agreed to sit in a lab for a whole day while having their blood continuously sampled.

The volunteers ate a normal breakfast, lunch and dinner. At morning tea and afternoon tea, researchers from Melbourne’s Baker Heart and Diabetes Institute gave them a can of soft drink.

Their blood samples revealed exactly what happened next.

Sugar from, say, a chocolate bar is released slowly, as your digestive system breaks it down.

With a can of soft drink, almost no break-down time is needed. The drink’s sugar starts to hit your bloodstream within about 30 minutes. That’s why you get such a big spike.

Your body responds to high levels of blood sugar by producing a hormone called insulin.

Insulin pumps through the bloodstream and tells your cells to suck in as much sugar as they can. The cells then start burning it, and storing what they can’t burn.

That quickly reduces the amount of sugar in the blood, and gives you a burst of energy. So far so good.

But the sugar keeps coming. High levels of blood sugar will quickly damage your blood vessels, so the body keeps making insulin.

In fact, just having two cans of soft drink meant the volunteers’ insulin stayed significantly higher than usual – all day.

After lunch, and another soft drink for afternoon tea, their sugar and insulin levels spiked again.

And, once again, over the next few hours blood sugar dropped but insulin levels stayed stubbornly high – right through to late afternoon, when the study finished.

The study demonstrates that two cans of soft drink is all it takes to give your pancreas – the crucial organ that produces insulin – a serious workout, says Professor Bronwyn Kingwell, the study’s senior author.

Watch Video 

We get more sugar each year from beverages than all the sweet treats you can think of combined.

“If you did this day in, day out, your pancreas would be under considerable stress – and this is how diabetes can develop,” says Professor Kingwell. “Having a little can of soft drink in the morning is going to have lasting effects throughout the day.”

If your diet has too much sugar in it, forcing your body to keep your insulin high all the time, eventually your cells will grow insulin-resistant. That forces the pancreas to make even more insulin, adding to its workload. Eventually, it will burn out.

But something else interesting is happening inside your body as well.

Insulin tells your body to burn sugar. But it also tells it to stop burning fat.

Normally, the body burns a little bit of both at once. But after a soft drink, your insulin stays high all day – so you won’t burn much fat, whether you’re on a diet or not.

One of the study’s participants, Michelle Kneipp, is now trying as hard as she can to kick her soft-drink habit.

She’s switched soft drinks for flavoured sparkling water. “It still tastes like soft drink, and it’s still got the fizz,” she says.

“But it’s hard, because sugar’s a very addictive substance.”

 

NACCHO Commentary ” So, lets reset the Aboriginal Health agenda now! Plus two major launches at the #IndigenousHealthSummit 1. @KenWyattMP Helping reduce kidney transplant barriers 2. Aboriginal Kids – a healthy start to life: Report of the Chief Health Officer 2018

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Launch 1 Ken Wyatt and Kidney transplants

We know our First Nations people have substantially higher rates of end-stage kidney disease but are much less likely to receive a kidney transplant.

By identifying the barriers and developing a national framework to address them, this panel can advise on an integrated model of care to change and save lives.

People with kidney failure have two kidney replacement therapy options – dialysis or a kidney transplant.”

Indigenous Health Minister Ken Wyatt AM said Turnbull Government funding of $250,000 would allow the Transplantation Society of Australia and New Zealand (TSANZ) to lead a comprehensive review into the hurdles, service gaps and practical challenges faced by Aboriginal and Torres Strait Islander patients receiving treatment for renal disease.

See full press release Part 3 below

Launch 2 Aboriginal Kids – a healthy start to life: Report of the NSW Chief Health Officer 2018

The Report of the Chief Health Officer 2018 Aboriginal Kids – a healthy start to life was released on 21 June 2018. The Report was developed in collaboration with the Aboriginal Health and Medical Research Council and focuses on key improvements in the health of Aboriginal children in NSW in the first five years of life.

The Report emphasises the importance of services and programs being carried out in partnership with Aboriginal people, their communities, the Aboriginal Community Controlled Health Sector and across government.

Services and programs that have helped to achieve improvements in Aboriginal child health are highlighted throughout the Report.

Further information on the health of Aboriginal children and the NSW population can be found on HealthStats NSW​​.

Download chief-health-officers-report-2018

Part 2 So why do we need to reset? Contribution from NACCHO CEO Pat Turner

It is important to acknowledge how far we have all come together over the last 100 years. The new medical technology now saves countless lives, the testing regimens are first rate, surgical care has been enhanced and our people now have pathways to a multitude of careers and thrive in the health workforce.

Some are even in positions of ‘real power’ to advocate for reforms.

So let’s be clear that Australia has a world-class health system,  but not for all of us! So, let’s focus today on the fact that health outcomes for Aboriginal and Torres Strait Islander people in Australia are still a long way from those of non-Indigenous people.

That is why we need to reset and do it now!

NACCHO is the national peak body representing 144 Aboriginal Community Controlled Health Services in over 304 clinics and health settings. We provide about three million episodes of care each year for about 350,000 people which is provided by almost 6,000 staff. In very remote areas, our services provided about one million episodes of care.

Over 50 per cent of the workforce is Aboriginal and we are working at increasing that.

So, our ACCHOs are universally acknowledged as effective in primary health care despite endless amounts of red tape, data manipulation, dealing with inconsistent funding models, constantly reacting to the medical crisis ‘du jour’ – what is it today Minister? -oh that’s right- STI outbreaks in Northern Australia due to various state government departmental health budget cuts.

Our Aboriginal leadership matrix works in health but is yet to be fully funded or accepted by government in other public service sectors!

Why are the Aboriginal self-determination concepts accepted only by parts of our machinery of federal government rather than as a whole of government planning principle? The Feds pick and choose what they like, what they fund and how they access our Indigenous data!

That’s not to mention the usual buck-passing between commonwealth and state entities which drive us all mad with inconsistent and arbitrary decisions made on behalf of our people. The system is actually designed to work against our best interests.

We don’t need more goodwill and the best of intentions from the government. We require more commitment to the concept of Aboriginal self-determination through meaningful engagement.

This week the PM told the Local Government Association Dinner in Canberra that they are all agreeing on what (they) wanted to achieve and then committing our respective resources to work in coordination to achieve it.

Why can’t they offer that same deal to us? working collaboratively with our local communities is especially vital when you realise that our Aboriginal population will increase to one million people by 2030.

And why is it that our governments are at such a disadvantage when modelling economic or health data for such a small segment of the overall population? I’m as mystified as you to that answer after almost 50 years in Indigenous affairs!

I have lost count of the number of speeches I have given over the years on this subject regarding Aboriginal people’s health to numerous gatherings, meetings, conferences, forums, roundtables and symposiums. I don’t need to refresh my memory like the government needs to do ever election cycle of what is wrong NACCHO just wants to reset the agenda to the solutions we Aboriginal people have developed over the years!

NACCHO wants to help our people live healthier, longer lives, supported by better, more targeted health services across the nation.

Now we are funded by the Australian Government to support improvements in Indigenous health through the Aboriginal Community Controlled Health Services network and to bring the voices of those services into health policy decisions in Canberra. So they need to listen to us when we say we want to reset the agenda and draw on our collective experience.

NACCHO is independent of, trusted by and offers a strong voice to the federal government for the provision of specific community sector health care needs for Aboriginal people that is controlled by Aboriginal people. This ensures a strong voice in policy work and participation in policy development and legislation advocating and dealing with the issues as they arise or as reforms are discussed.

I coordinate 25 staff who sit on some 80 national committees and bodies. Historically NACCHO has a proud tradition and has developed over the last 20 years a strong coalition of support with other NGO’s already across a diverse range of areas.

We offer an alternative point of view enhanced by years of dedicated experience. Aboriginal perspectives from our governing bodies and staff about culturally appropriate healthcare needs are admired and respected by government.

According to the AIHW Aboriginal and Torres Strait Islander peoples represented 3.3 per cent of the population or 787,000 people.

The median age of an Aboriginal is 23 years and only one in ten reported speaking one of the 150 Australian Indigenous languages at home.

As many of you would know, the state of Aboriginal health continues to be cause for both national shame and requires national action.

I’m still as frustrated as some of you are that we have not Closed the gap for Indigenous people or had meaningful reconciliation in this nation.

I believe there is no agenda more critical to Australia than enabling Aboriginal people to live good quality lives while enjoying all their rights and fulfilling their responsibilities to themselves, their families and communities.

Aboriginal people should feel safe in their strong cultural knowledge being freely practiced and acknowledged across the country. This should include the daily use of our languages, in connection with our lands and with ready access to resources.

Aboriginal people should feel free from racism, empowered as individuals and have educational opportunities, careers, and health services to meet their needs and overcome inequality, poverty and increase life expectancy.

Now the Australian Government’s 2007 commitment to Close the Gap between Indigenous and non-Indigenous life expectancy within a generation was welcome. But the Close the Gap agenda did not deliver on a fundamental change to the way governments work with Aboriginal people or effect real change to the social determinants of health for our people.

I want to be very clear why we need to reset the agenda as meaningful progress against the closing the gap targets is now stalling and,  in many cases, is going backwards.

I am also concerned that the Government is now shifting the focus to ‘prosperity’ targets, when we don’t even have the basic targets on track.

The figures paint a staggering reality. The Australian Institute of Health and Welfare tells us that the mortality gaps are still not closing quickly enough.

No government can preside over widening mortality gaps and maintain goals to improve life expectancy and child mortality rates. On average Indigenous men and women die 15 years earlier than other Australians. Indigenous people suffer chronic diseases that are entirely preventable and have virtually been eliminated in the non-Indigenous population: trachoma, rheumatic heart disease and congenital deaths as a direct result of the current Syphilis outbreak across Australia, are but three examples.

But of course, it’s not all bad news, NACCHO, its Affiliates and our hardworking Member services have had recent success with various national health programs. As you know Alcohol consumption during pregnancy can result in birth defects and behavioural and neurodevelopmental abnormalities including Fetal Alcohol Spectrum Disorder (FASD). Smoking rates are declining and NACCHO is working to stop any increase in STI rates arcoss the nation.

Aboriginal culture has many strengths that can provide a positive influence, such as supportive extended family networks, connection to country and language. It is imperative that a person’s health be considered in the context of their social, emotional, spiritual and cultural wellbeing, and that of their community. We know that being able to better manage and control your own affairs is directly linked to improved wellbeing and mental health.

This is where the community-controlled health sector and Aboriginal Health Workers are uniquely placed.

Our Member services build ongoing relationships to give continuity of care so that chronic conditions are managed and preventative health care can be effectively targeted.

So, for any reset to be successful Aboriginal communities need to be properly resourced, and Aboriginal people need to be in control. NACCHO continues to call on the Australian Government to invest in the expansion of the Aboriginal Community Controlled Health Services, especially to reach more people living in remote isolated areas.

So, lets reset the agenda now!

Part 3


An expert panel will investigate and identify any barriers faced by First Nations people in need of kidney donations, to help ensure equity of access to lifesaving and life changing transplants.

Minister Wyatt said that, in December 2016, there were 1,987 Aboriginal and Torres Strait Islander Australians receiving such therapy.

“Of these, 13 per cent had received a kidney transplant, compared with 50 per cent of other Australians, revealing that First Nations people were nine times as likely to be reliant on dialysis,” said Minister Wyatt.

“While the Turnbull Government is funding improvements to dialysis services and renal disease prevention measures in regional and remote communities, our commitment to transplant access is absolute.”

The panel will comprise people with expertise in working in community, clinical settings, research and public policy and will consult widely across First Nations communities and the health and transplantation sectors.

“I have heard many moving stories of the trauma and heartache caused by renal disease, including in my own family,” Minister Wyatt said.

“This review aims to increase Aboriginal and Torres Strait Islander transplant rates, reduce the burden of regular dialysis and give more First Nations people the chance to live fulfilling lives on country and in their communities.”

The panel’s work will help inform development of a long-term strategy for organ donation, retrieval and transplantation being undertaken by the Commonwealth, as agreed by the COAG Health Council. It is hoped the strategy will be ready for consideration by COAG in 2019.

Funding for TSANZ for the project is provided under the Indigenous Australians’ Health Programme (IAHP).

The Turnbull Government is investing $3.9 billion in Aboriginal and Torres Strait Islander health over the next four years, with the IAHP providing comprehensive, high-quality and culturally appropriate primary health care services across the nation.

NACCHO Media Alerts : Top 10 Current Aboriginal Health News Stories to keep you up to date

1. Aboriginal sexual health: The Australian : Was the syphilis epidemic preventable ? NACCHO responds

2.Royal Flying Doctors Service extra 4-year funding $84 million Mental Health and Dental Services

3.Nurses PAQ continues political membership campaign spreading false and misleading information about our cultural safety

4.AMSANT has called for re-doubled efforts to implement the recommendations of the Royal Commission into the care and protection of children in partnership with NT Aboriginal leaders

5.Dialysis facilities worth $17 million are sitting padlocked, empty and unused in WA’s north

6.ALRC Report into Incarceration of Aboriginal and Torres Strait Islander People.

7. Minister Ken Wyatt : Listening to Indigenous Needs: Healthy Ears Program Extended with $29.4 commitment

8.Tangentyere Alice Springs Women’s Family Safety Group visits Canberra

9.Minister Ken Wyatt launches our NACCHO RACGP National Guide to a preventative health assessment for Aboriginal and Torres Strait Islander people

10. Your guide to a healthy Easter : #Eggs-actly  

 

1.Aboriginal sexual health: The Australian : Was the syphilis epidemic preventable ? NACCHO responds

“These (STIs) are preventable diseases and we need increased testing, treatment plans and a ­culturally appropriate health ­education campaign that focuses resources on promoting safe-sex messages delivered to at-risk ­communities by our trained Aboriginal workforce,”

Pat Turner, chief executive of peak body the National Aboriginal Community Controlled Health Organisation, is adamant about this.

Read full article in Easter Monday The Australian or Part B below

2.Royal Flying Doctors Service extra 4-year funding $84 million Mental Health and Dental Services

Read full press release here

 

3.Nurses PAQ continues political membership campaign spreading false and misleading information about cultural safety

SEE NACCHO Response

SEE an Indigenous Patients Response

See Nurses PAQ Misleading and false campaign

4. AMSANT  has called for re-doubled efforts to implement the recommendations of the Royal Commission into the care and protection of children in partnership with NT Aboriginal leaders

Read full AMSANT press Release

Listen to interview with Donna Ah Chee

Press Release @NACCHOChair calls on the Federal Government to work with us to keep our children safe

#WeHaveTheSolutions Plus comments from CEO’s @Anyinginyi @DanilaDilba

4.Dialysis facilities worth $17 million are sitting padlocked, empty and unused in WA’s north

Read full Story HERE

6.ALRC Report into Incarceration of Aboriginal and Torres Strait Islander People;

Read Download Full Transcript

Senator Patrick Dodson

Download the report from HERE

Community Groups Call For Action on Indigenous Incarceration Rates

7. Minister Ken Wyatt : Listening to Indigenous Needs: Healthy Ears Program Extended with $29.4 commitment

The Australian Government has committed $29.4 million to extend the Healthy Ears – Better Hearing, Better Listening Program, to help ensure tens of thousands more Indigenous children and young adults grow up with good hearing and the opportunities it brings.

Read Press Release HEAR

8.Tangentyere Alice Springs Women’s Family Safety Group visits Canberra

This week the Tangentyere Women’s Family Safety Group from Alice Springs were in Canberra. They shared with politicians, their own solutions for their own communities, and they are making an enormous difference.
Big thanks to all the Tangentyere women who made it to Canberra.

Read Download the Press Release

TANGENTYERE WOMEN’S FAMILY SAFETY GROUP (FED

9. Minister Ken Wyatt launches our NACCHO RACGP National Guide to a preventative health assessment for Aboriginal and Torres Strait Islander people

Read press releases and link to Download the National Guide

10. Your guide to a  healthy Easter : #Eggs-actly  

And finally hope you had a Happy Easter all you mob ! After you have enjoyed your chocolate eggs and hot cross buns , this is how much exercise you will require to work of those Easter treats .

For medical and nutrition advice please check with your ACCHO Doctor , Health Promotion / Lifestyle teams or one of our ACCHO nutritionists

 

Part B Full Text The Australian Article Easter Monday

There is no reason it should have happened, especially not in a first-world country like Australia, but it has: indigenous communities in the country’s north are in the grip of wholly treatable sexually transmitted diseases.

In the case of syphilis, it is an epidemic — West Australian Labor senator Patrick Dodson ­described it as such, in a fury, when health department bureaucrats mumbled during Senate estimates about having held a few “meetings” on the matter.

There have been about 2000 syphilis notifications — with at least 13 congenital cases, six of them fatal — since the outbreak began in northern Queensland in 2011, before spreading to the Northern Territory, Western Australia and, finally, South Australia.

What’s worse, it could have been stopped. James Ward, of the South Australian Health and Medical Research Institute, wrote in mid-2011 that there had been a “downward trend” over several years and it was likely at that point that the “elimination of syphilis is achievable within indigenous ­remote communities”.

But governments were slow to react, and Ward is now assisting in the design of an $8.8 million emergency “surge” treatment approach on the cusp of being rolled out in Cairns and Darwin, with sites in the two remaining affected states yet to be identified.

It will be an aggressive strategy — under previous guidelines, you had to have been identified during a health check as an active carrier of syphilis to be treated. Now, anyone who registers antibodies for the pathogen during a blood prick test, whether actively carrying syphilis or not, will receive an ­immediate penicillin injection in an attempt to halt the infection’s geographical spread.

This is key: the high mobility of indigenous people in northern and central Australia means pathogens cross jurisdictions with ­impunity. Australian Medical ­Association president Michael Gannon calls syphilis a “clever bacterium that will never go away”, warning that “bugs don’t respect state borders”.

Olga Havnen, one of the Northern Territory’s most respected public health experts, points out that many people “will have connections and relations from the Torres Strait through to the Kimberley and on to Broome — and it’s only a matter of seven or eight kilometres between PNG and the northernmost islands there in the Torres Strait”.

“This is probably something that’s not really understood by the broader Australian community,” Havnen says. “I suspect once you get a major outbreak of something like encephalitis or Dengue fever, any of those mosquito-borne diseases, and that starts to encroach onto the mainland, then people will start to get a bit worried.”

Olga Havnen, CEO of the Danila Dilba Health Service, says transmission is complex issue in Australia’s indigenous communities.
Olga Havnen, CEO of the Danila Dilba Health Service, says transmission is complex issue in Australia’s indigenous communities.

But it is not just syphilis — ­indeed, not even just STIs — that have infectious disease authorities concerned and the network of Aboriginal Community Controlled Health Organisations stretched.

Chlamydia, the nation’s most frequently diagnosed STI in 2016 based on figures from the Kirby Institute at the University of NSW, is three times more likely to be contracted by an indigenous Australian than a non-­indigenous one.

The rate was highest in the NT, at 1689.1 notifications per 100,000 indigenous people, compared with 607.9 per 100,000 non-indigenous Territorians. If you’re indigenous, you’re seven times more likely to contract gonorrhoea, spiking to 15 times more likely if only women are considered. Syphilis, five times more likely.

As the syphilis response gets under way, health services such as the one Havnen leads, the Darwin-based Danila Dilba, will be given extra resources to tackle it. “With proper resourcing, if you want to be doing outreach with those people who might be visitors to town living in the long grass, then we’re probably best placed to be able to do that,” she says.

But the extra focus comes with a warning. A spate of alleged sexual assaults on Aboriginal children, beginning with a two-year-old in Tennant Creek last month and followed by three more alleged ­attacks, has raised speculation of a link between high STI rates and evidence of child sexual assault.

After the first case, former NT children’s commissioner Howard Bath told this newspaper that STI rates were “a better indicator of background levels of abuse than reporting because so many of those cases don’t get reported to anyone, whereas kids with serious infections do tend to go to a ­doctor”. Others, including Alice Springs town councillor Jacinta Price and Aboriginal businessman Warren Mundine, raised the ­spectre of the need for removing more at-risk indigenous children from dangerous environments.

Children play AFL in Yeundumu. Picture: Jason Edwards
Children play AFL in Yeundumu. Picture: Jason Edwards

However, Sarah Giles, Danila Dilba’s clinical director and a medical practitioner of 20 years’ standing in northern Australia, warns this kind of response only exacerbates the problem. She is one of a range of public health authorities who, like Havnen, say connecting high STI figures to the very real scourge of child sex abuse simply makes no sense. They do not carry correlated data sets, the experts say.

“One of the things that’s really unhelpful about trying to manage STIs at a population level is to link it with child abuse and mandatory reporting, and for people to be fearful of STIs,” Giles says. “The problem is that when they’re conflated and when communities feel that they can’t get help ­because things might be misinterpreted or things might be reported, they’re less likely to present with symptoms. The majority of STIs are in adults and they’re sexually transmitted.”

Havnen says there is evidence of STIs being transmitted non-sexually, including to children, such as through poor hand ­hygiene, although Giles says that is “reasonably rare”. And while NT data shows five children under 12 contracted either chlamydia or gonorrhoea in 2016 (none had syphilis), and there were another five under 12 last year, Havnen points to the fact that over the past decade there has been no increasing trend in under 12s being affected. Where there has been a rise in the NT is in people aged between 13 and 19, with annual gonorrhoea notifications increasing from 64 cases in the 14-15-year-old ­female cohort in 2006 to 94 notifications in 2016.

In the 16-17-year-old female ­cohort the same figures were 96 and 141 and in the 12-13-year-old group it rose from 20 in 2006 to 33 in 2016. Overall, for both boys and girls under 16, annual gonorrhoea notifications rose from 109 in 2006 to 186 in 2016, according to figures provided to the royal ­commission into child detention by NT Health. Havnen describes the rise as “concerning but not, on its own, evidence of increasing ­levels of sexual abuse”.

Ward is more direct. Not all STIs are the result of sexual abuse, he warns, and not all sexual abuse results in an STI. If you’re a health professional trying to deal with an epidemiological wildfire, the distinction matters — the data and its correct interpretations can literally be a matter of life and death.

Indeed, in its own written cav­eats to the material it provided to the royal commission, the department warns that sexual health data is “very much subject to variations in testing” and warns against making “misleading assumptions about trends”. Ward says: “Most STIs notified in remote indigenous communities are ­assumed to be the result of sex ­between consenting adults — that is, 16 to 30-year-olds. Of the under 16s, the majority are 14 and 15-year-olds.” He says a historically high background prevalence of STIs in remote indigenous communities — along with a range of other ­infectious diseases long eradicated elsewhere — is to blame for their ongoing presence. Poor education, health services and hygiene contribute, and where drug and ­alcohol problems exist, sexually risky behaviour is more likely too. The lingering impact of colonisation and arrival of diseases then still common in broader ­society cannot be underestimated.

But Ward claims that an apparently high territory police figure of about 700 cases of “suspected child sexual offences” in the NT over the past five years may be misleading. He says a large number of these are likely to be the result of mandatory reporting, where someone under 16 is known to have a partner with an age gap of more than two years, or someone under 14 is known to be engaging in sexual activity. Ward points out that 15 is the nationwide ­median sexual debut age, an age he suggests is dropping. At any rate, he argues, child sex abuse is unlikely to be the main reason for that high rate of mandatory ­reporting in the NT.

Areyonga is a small Aboriginal community a few hours drive from Alice Springs.
Areyonga is a small Aboriginal community a few hours drive from Alice Springs.

Data matters, and so does how it is used. Chipping away at the perception of child sexual abuse in indigenous communities are the latest figures from the Australian Institute of Health and Welfare showing the rate of removals for that crime is actually higher in non-indigenous Australia.

According to a report this month from the AIHW, removals based on substantiated sex abuse cases in 2016-17 were starkly different for each cohort: 8.3 per cent for indigenous children, from a total of 13,749 removals, and 13.4 per cent for non-indigenous children, from 34,915 removals.

Havnen concedes there is a need for better reporting of child abuse and has called for a confidential helpline that would be free of charge and staffed around the clock by health professionals.

It’s based on a model already in use in Europe that she says deals with millions of calls a year — but it would require a comprehensive education and publicity campaign if it were to gain traction in remote Australia. And that means starting with the adults.

“If you’re going to do sex ­education in schools and you start to move into the area about sexual abuse and violence and so on, it’s really important that adults are ­educated first about what to do with that information,” she says. “Because too often if you just ­educate kids, and they come home and make a disclosure, they end up being told they’re liars.”

These challenges exist against the backdrop of a community already beset by a range of infectious diseases barely present elsewhere in the country, including the STIs that should be so easily treatable. It is, as Havnen is the first to admit, a complex matter.

Cheryl Jones, president of the Australasian Society for Infectious Diseases, says the answer is better primary treatment solutions and education, rather than trying to solve the problem after it has ­occurred. “For any of these public health infectious disease problems in ­remote and rural areas, we need to support basic infrastructure at the point of care and work alongside communities to come up with ­solutions,” she says.

Sisters play in the mud after a rare rain at Hoppy's 'town camp' on the outskirts of Alice Springs.
Sisters play in the mud after a rare rain at Hoppy’s ‘town camp’ on the outskirts of Alice Springs.

Pat Turner, chief executive of peak body the National Aboriginal Community Controlled Health Organisation, is adamant about this. “These (STIs) are preventable diseases and we need increased testing, treatment plans and a ­culturally appropriate health ­education campaign that focuses resources on promoting safe-sex messages delivered to at-risk ­communities by our trained Aboriginal workforce,” Turner says.

The Australian Medical ­Association has called for the formation of a national Centre for Disease Control, focusing on global surveillance and most likely based in the north, as being “urgently needed to provide national leadership and to co-ordinate rapid and effective public health responses to manage communicable diseases and outbreaks”.

“The current approach to disease threats, and control of infectious diseases, relies on disjointed state and commonwealth formal structures, informal networks, collaborations, and the goodwill of public health and infectious disease physicians,” the association warned in a submission to the Turnbull government last year.

However, the federal health ­department has rebuffed the CDC argument, telling the association that “our current arrangements are effective” and warning the suggestion could introduce “considerable overlap and duplication with existing functions”.

“I think it (the CDC) might have some merit, if it helps to ­advocate with government about what needs to happen,” Havnen says, “but if these things are going to be targeted at Aboriginal bodies, it needs to be a genuine partnership. It’s got to be informed by the realities on the ground and what we know. That information has to be fed up into the planning process.”