NACCHO Aboriginal Health and #Cancer #Smoking : Report from Canada where 400 delegates are meeting at #WICC2019 with theme ‘Respect, Reconciliation and Reciprocity “ discussing cancer and its impact on Indigenous peoples.

“Cancer has been largely overlooked amongst Indigenous populations world-wide and remains the second leading cause of death among Aboriginal and Torres Strait Islander people “

Professor Gail Garvey, who convened the first WICC and is co-chair of WICC 2019 :Pictured above with Professor Tom Calma and Blackfoot Fancy Feather Dancer Kyle Agapi.

“Smoking is the single biggest contributor to early deaths, including cancer deaths, of Aboriginal and Torres Strait Islander people – which is why it is so important that we encourage people not to take up smoking and assist smokers to stop “

Professor Tom Calma AO, National Coordinator, Tackling Indigenous Smoking, and member of the Cancer Australia Aboriginal and Torres Strait Islander Cancer Leadership Group

Read over 80 Aboriginal Health and Cancer articles published by NACCHO in past 7 years

Read over 130 Aboriginal Health and Smoking articles published by NACCHO in past 7 years

Indigenous communities, consumers and health experts from around the world have come together at the opening of the second World Indigenous Cancer Conference (WICC) at the Calgary Telus Convention Centre in Canada.

The conference, which has drawn a large contingent of Australian delegates, follows on from the success of the inaugural WICC held in Brisbane, Australia in 2016.

The WICC 2019 theme is ‘Respect, Reconciliation and Reciprocity,’ with over 400 delegates from across the globe discussing cancer and its impact on Indigenous peoples.

World-wide, Indigenous peoples bear a disproportionately higher cancer burden than non-Indigenous peoples, which makes WICC 2019 so very important.

Hosted by the Canadian Indigenous Research Network Against Cancer (CIRNAC) in partnership with the host sponsor Alberta Health Services, this premier event is supported by the Alberta First Nations Information Governance Centre, Canadian Institutes of Health Research, Canadian Partnership Against Cancer, and the International Agency for Research on Cancer (IARC) which is the specialized cancer agency of the World Health Organization.

 Professor Gail Garvey , Blackfoot Piikani Chief Stan Grier and Professor Tom Calma 

WICC 2019 has drawn expertise of leading cancer researchers, public health practitioners, clinicians, advocacy groups, Indigenous community leaders and consumers.

They are coming together to share knowledge about critical issues across the cancer continuum from prevention and treatment to survivorship and end of life.

Several Aboriginal and Torres Strait Islander delegates with a lived experience of cancer are making an important contribution to the conference.

Des McGrady, an Aboriginal cancer survivor, said “An international meeting is important for the information sharing that we can pass on to community and people working in this space. This will allow us to work in partnership to drive positive change.”

The burden of cancer among Indigenous populations is of major public health importance and forums for collaboration such as this conference will strengthen research and service delivery and help accelerate progress in improving cancer outcomes.

Indigenous leadership, culturally sound service delivery and encouragement of mainstream services to prioritise Indigenous cancer are critical to these efforts and central to WICC 2019.

For more details about the conference, please visit the website: http://wicc2019.com

NACCHO Health and #austph2019 Read full speech HERE : Acting @NACCHOChair Donnella Mills #Humanrights Panel – 48 years of Aboriginal and Torres Strait Islander Community Control’

 ” I believe that the development of collaborative, integrated service models can provide innovative and effective solutions for addressing not only the overrepresentation of Aboriginal and Torres Strait Islander peoples in the justice system, but also the indefensible health gaps between Aboriginal and non-Aboriginal Australians.

Justice health partnerships provide a model of integrated service delivery that goes to the heart of the social determinants of health, key causal factors contributing to Aboriginal and Torres Strait Islander peoples’ over-exposure to the justice and health systems. In this way we are also focussing on the rights of our people.

Address the legal issues, and you will have better health outcomes.

In the health and justice areas the message is simple. Community-control works, cultural safety works and collaborative partnerships work.

With Aboriginal community control at the front and centre of service design, we can deliver both preventive law and preventive health for Aboriginal and Torres Strait Islander peoples. ”

Donnella Mills, Acting Chair NACCHO

Speaking at the Australian Public Health Conference, Adelaide Panel Plenary session titled ‘Human Rights’

I would like to acknowledge that the land on which we are meeting today is the traditional land of the Kaurna Nation. I respect the continuing culture of the Kaurna people and the contribution they make to the life of this important city.

You may wish to say ‘hello, how are you’ in the Kaurna language. If so, say:

“I understand that the traditional greeting in the Kaurna language is ‘Ninna Marni’.”

I am the Acting Chair of NACCHO, which stands for the National Aboriginal Community Controlled Health Organisation. For those of you who don’t know me, I am a Torres Strait Islander woman with ancestral and family links to Masig and Nagir islands.

You may also want to add ‘welcome’ in Meriam Mir. If so, “In the language of Masig Island, ‘Maiem’.”

Thanks are due to the Public Health Association of Australia for welcoming me here to speak today. I am delighted to be able to share ideas with you on a topic that is close to my heart. I am also honoured to be part of a panel with such two inspiring colleagues: Barri Phatarfod (Founder, Doctors for Refugees) and Mohammad Al-Khafaji (CEO, FECCA).

In this presentation I will look at Aboriginal and Torres Strait Islander justice issues and the role of NACCHO’s member organisations: the 144 Aboriginal Community-controlled health organisations (our ‘ACCHOs’).

It is always tempting to focus on problems. I could talk about the fact that our life expectancy is at the level of a Third-World nation: about ten years lower than the non-Aboriginal population.

I could talk about the unconscionably high rates of incarceration for Aboriginal and Torres Strait Islander people and our over-representation in state and territory gaols and institutions across the country. I could ask why nothing has changed since the Royal Commission into Aboriginal Deaths in Custody was initiated in 1988. But most of you are already very familiar with these topics and frustrations.

What I will focus on instead is the ACCHO model of health care, how it started and how it has evolved. Why? Because I think that our model of community control is a way forward. It gives Aboriginal and Torres Strait Islander people control. It gives our people the framework in which we can deliver our own health outcomes and develop our own solutions and are able to form genuine partnerships.

So, before we look forward, let’s look backwards for a moment, so that we can appreciate the context in which this model was forged.

NACCHO and the model of Aboriginal community control

 

The Public Health Association is celebrating 50 years since its foundation in 1969. Two years after that, in 1971, the first Aboriginal medical service was established at Redfern. It was a response to the urgent need to provide decent, accessible health services for the largely medically uninsured Aboriginal population of Redfern.

The mainstream was not working. So it was, that forty-eight years ago, Aboriginal people took control and designed and delivered our own model of health care.

Similar Aboriginal medical services quickly sprung up around the country. In 1974, a national peak organisation was formed to represent them at the national level. All this predated the huge Medibank reforms of 1975.

The ACCHO sector has been growing bigger and stronger every year since 1971. NACCHO – the national peak – now represents 144 ACCHOs across the country. Our members provide about three million episodes of care per year for about 350,000 people – that’s over half the Aboriginal and Torres Strait Islander population.

Collectively, we employ about 6,000 staff (the majority of whom are Aboriginal or Torres Strait Islander people), which makes us the single largest employer of Aboriginal or Torres Strait Islander people in the country.

It also shows the flow on effect of what we have been doing. In this case, that our health organisations are doing more to Close the Gap in Aboriginal employment than any government program or scheme.

There is a dangerous myth that Aboriginal and Torres Strait people receive ample funding. The Government’s own numbers show that, in real terms, health expenditure (excluding hospital expenditure) for Aboriginal people fell 2% from $3,840 per person in 2008 to $3,780 per person in 2016.

Over the same period, expenditure on non-Aboriginal people rose by 10%. How can Governments seriously expect to Close the Gap in health if funding is decreasing? The burden of disease for the Aboriginal and Torres Strait Island population is 2.3 times higher than for the rest of the population. The burden of disease can be six-times higher in remote areas.

Despite the funding shortfall, our ACCHOs continue to deliver excellent results.

The primary health care approach developed by Redfern and other early ACCHOs was innovative. It mirrored international aspirations at the time for accessible, effective and comprehensive health care with a focus on prevention and social justice. It even foreshadowed the WHO Alma Ata Declaration on Primary Health Care in 1978.

Just like we did in the 1970s, NACCHO has continued to play a leadership role. Some of you may be aware that, recently, NACCHO and almost 40 other peak Aboriginal and Torres Strait Islander bodies forced the nine Australian governments to get the Closing the Gap process back on track.

This is community control at the national level. It is the first time that Aboriginal and Torres Strait Islander peaks have come together in this way, to work collectively and as full partners with the nine Australian governments.

We need this sort of radical shift to the way governments work with Aboriginal and Torres Strait Islander people at all levels of policy design and implementation. We need a seat at the table and responsibility for making decisions about what governments do in our communities.

Another priority reform area is placing Aboriginal community-controlled services in all sectors – not just health – at the heart of delivering programs and services to our people. When we are in control and lead the design and implementation of services in our communities the outcomes are so much better.

We have also had some staunch allies along the way. ACOSS and the AMA, for example, continue to be a key friends in our sector. For example, the 2018 AMA Report Card was launched in November of last year. It highlighted research showing that the mortality gaps between Aboriginal and Torres Strait Islander people and other Australians are widening. NACCHO called for the immediate adoption of its recommendations.

Closing the gap on justice outcomes

Now that I have referred back to the history of the community-controlled model and where it is today, let me now switch the focus onto human rights and justice outcomes.

The World Health Organisation (WHO) sees the “highest attainable standard of health as a fundamental human right”. I agree with this statement.

Most of you here today know the shocking statistics. I have already mentioned that Aboriginal and Torres Strait Islanders have ten-years less in life expectancy than other Australians.

We must take a rights-based approach in addressing health inequities, if we are ever going to close the gap. This means that we need to address the social determinants of health, such as: education, housing, and other social and economic factors. This, of course, is a huge topic, so let’s just focus on justice outcomes.

Earlier this year it was reported that Aboriginal and Torres Strait Islander men are imprisoned at a rate almost 15-times greater than non-Aboriginal men, and for women the rate is even higher, 21-times worse than non-Aboriginal women.

Our women represent the fastest growing population group in prisons; their imprisonment rate is up 148% since 1991. Locking up our women affects the whole community. Children may be removed and placed in out-of-home care. Research has found there are links between detainees’ children being placed into out-of-home care and their subsequent progression into youth detention centres and adult correctional facilities. Communities suffer, and the cycle of intergenerational trauma and disadvantage is perpetuated.

Figures on the incarceration of our children and young people in detention facilities also reveal alarmingly high trends of overrepresentation. Our young people aged 10–17 are 26-times as likely as non-Aboriginal young people to be in detention on any given night. How can this be justified?

Governments’ inertia and lack of commitment to genuinely addressing the issues have contributed to a worsening situation. The National Indigenous Law and Justice Framework 2009-2015 was never funded, attracted no buy in from state and territory governments, and the review findings of the Framework were never made public.

It is encouraging to note that in its 2016 report of the inquiry into Aboriginal and Torres Strait Islander experience of law enforcement and justice services, the Senate committee recommended that the Commonwealth Government support Aboriginal-led justice reinvestment projects. In December 2017, the Australian Law Reform Commission recommended that Commonwealth, state and territory governments should provide support for:

  • the establishment of an independent justice reinvestment body; and
  • justice reinvestment trials initiated in partnership with Aboriginal and Torres Strait Islander communities.

Emerging out of these inquiries is a growing understanding that an improvement in justice outcomes must begin with a commitment to self-determination, community control, and cultural safety. These are three of the most critical elements of the community-controlled model itself.

Appropriately resourced community controlled services are essential for addressing these barriers. Best-practice solutions to preventable problems of our peoples’ exposure to the justice system must begin with enabling their access to trusted services that are governed by these three principles.

But let’s see some traction on the ground with these statements. The intentions are there, but now is the time to act.

Case study – Law Yarn

As a lawyer myself and the ex-Chair of the Cairns-based Wuchopperen Health Service, I have become aware of the need to provide better legal supports for my community. In conversations with local Elders and LawRight, Wuchopperen entered into a justice health partnership in 2016.

LawRight is an independent, not-for-profit, community-based legal organisation which coordinates the provision of pro bono legal services for individuals and community groups. The aim of the partnership was to improve health outcomes by enhancing access to legal rights and early intervention. Initially, it was decided that, as community member and lawyer employed by LawRight, I would provide the free legal services at Wuchopperen’s premises.

One of the challenges of health justice partnerships is ongoing funding, and in 2017 we were forced to close our doors for several months. We knew the partnership was addressing a real need in our community, so we submitted a funding proposal to the Queensland Government, and received funding of $55,000 to trial ‘Law Yarn’.

Law Yarn is a unique resource that supports good health outcomes in Aboriginal and Torres Strait Islander communities. It helps health workers to yarn with members of remote, regional and urban communities about their legal problems and connect them to legal help.

Representatives from LawRight, Wuchopperen Health Service, Queensland Indigenous Family Violence Legal Service and the Aboriginal Torres Strait Islander Legal Services came together and created a range of culturally safe resources based on LawRight’s successful Legal Health Check resources. A handy how-to guide includes conversation prompts and advice on how to capture the person’s family, financial, tenancy or criminal law legal needs as well as discussing and recording their progress.

Legal and health services throughout Australia have expressed interest in this holistic approach to the health and wellbeing of Aboriginal and Torres Strait Islander peoples. And we are hopeful that the evaluation findings will support the rollout of our model to ACCHOs across Australia.

Conclusion

In conclusion, I believe that the development of collaborative, integrated service models can provide innovative and effective solutions for addressing not only the overrepresentation of Aboriginal and Torres Strait Islander peoples in the justice system, but also the indefensible health gaps between Aboriginal and non-Aboriginal Australians.

Justice health partnerships provide a model of integrated service delivery that goes to the heart of the social determinants of health, key causal factors contributing to Aboriginal and Torres Strait Islander peoples’ over-exposure to the justice and health systems. In this way we are also focussing on the rights of our people. Address the legal issues, and you will have better health outcomes.

If the Government really wants to help vulnerable populations, don’t punish them with cashless welfare cards, with robo-debts or by sending them off to meaningless Work for the Dole activities. Work with us, not against us.

In the health and justice areas the message is simple. Community-control works, cultural safety works and collaborative partnerships work.

With Aboriginal community control at the front and centre of service design, we can deliver both preventive law and preventive health for Aboriginal and Torres Strait Islander peoples.

Thank you.

 

NACCHO Aboriginal #SexualHealth News : New PBS Doctors Bag listing for benzathine penicillin to address syphilis outbreak Plus new clinician resource STI and BBV control in remote communities: clinical practice and resource manual

  “ STI and BBV control in remote communities: clinical practice and resource manual was developed by the South Australian Health and Medical Research Institute for clinicians practising in remote communities.

It’s for doctors, nurses and Aboriginal Health Workers and is designed as an induction tool for new recruits as well as a resource manual for more experienced practitioners. ”

See Part 2 SAHMRI Press Release below for download link 

Read over 50 Aboriginal Sexual Health articles published recently by NACCHO

Part 1 New PBS Doctors Bag listing for benzathine penicillin to address Syphilis outbreak

Starting September 1st 2019, benzathine benzlypenicillin (Bicillin L-A) is listed on the Emergency Drug Supply Schedule (also known as Prescribers Bag or Doctors Bag).

The listing can be found here.

NACCHO worked in consultation with ACCHO members services, expert clinicians and the Royal Australian College of Physicians (RACP) to co-author a submission to the Pharmaceutical Benefits Advisory Committee (PBAC) in early 2019 to improve syphilis treatment options for health services.

This was supported by the PBAC and now this item can be prescribed through the Doctors Bag scheme.

The listing of benzathine benzlypenicillin (Bicillin L-A) will support the timely treatment of syphilis for Aboriginal and Torres Strait Islander communities by providing a mechanism for health services to have stock on site, and/or obtain supply for patients in advance of a consultation.

Part 2 New clinician resource STI and BBV control in remote communities: clinical practice and resource manual

SAHMRI consulted widely with remote clinicians in developing this resource.

Many highlighted the same main challenges regarding STI and BBV control in remote communities:

  • difficulty navigating health systems and models of care
  • limited exposure to and knowledge with some of the STIs and BBVs endemic in many remote communities
  • accessing and navigating relevant STI and BBV clinical guidelines
  • limited cultural orientation, and or guidance on how to best engage young people in the clinic and community settings.

This feedback informed the development of the manual, which includes links to useful online induction resources, training modules and remote practice manuals from across Queensland, Northern Territory, Western Australia and South Australia.

View the full manual here.

Or Download the PDF Copy HERE

STI-BBV-control-clinical-practice-manual-31072019

 

The manual also collates national, jurisdictional and regional STI and BBV clinical guidelines as well as highlighting national guidelines for addressing the current syphilis outbreak affecting much of remote Australia.

It’s important to note that the information contained within this manual does not constitute clinical advice or guidance and should not be relied on by health practitioners in providing clinical care.

SAMRI sends a huge thank you to the many doctors, nurses and Aboriginal and Torres Strait Islander Health Workers and Practitioners who generously provided feedback and advice in developing this manual.

We also acknowledge the young people, Elders, community leaders – and whole communities – who graciously and enthusiastically offered their time to developing the Young Deadly Free health promotion resources catalogued in the manual.

View the full manual here.

 

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 News : Minister @GregHuntMP launches Australia’s Long Term National Health Plan that charts the way forward over the next 3 and 10 years : Download HERE

Delivering the world’s best mental health system – stigma-free and focused on prevention, starting with children under 12 – is the major focus of the Australian Government’s Long Term National Health Plan, outlined today.

Under this Plan, we will build a mentally and physically healthy Australia. For the first time, mental health will be rated equally alongside physical health.

The Long Term National Health Plan recognises that depression, anxiety, bipolar disorder and psychosis are health problems to be treated just like diabetes, asthma and broken bones.

It charts the way forward over the next three and 10 years in the key areas of mental health, primary care, hospitals, preventive health and medical research.

The Long Term National Health Plan includes:

  • The 2030 mental health vision, including a new strategy specifically for children under 12 years
  • The 10-year Primary Health Care Plan
  • Continued improvement of private health insurance
  • The 10-year National Preventive Health Strategy
  • The 10-year Medical Research Future Fund (MRFF) investment plan.

To help inform the Plan, the Government is commissioning a multi-year study of more than 60,000 Australians to provide the most complete picture ever of our physical and mental health.

The Intergenerational Health and Mental Health Study will cover mental health, general health, nutrition and physical activity.

Health Minister Greg Hunt launching The Long Term National Health Plan at the National Press Club August 14

Download Read full 30 minute speech HERE

Transcript Minister Greg Hunt Launch Health Plan

Improving the health of Aboriginal and Torres Strait Islander people is a top priority for the Government.

Over four years from 2019-20, we will invest $4.1 billion in dedicated health programs for Indigenous
Australians.

This represents an annual increase of around four per cent. This will improve access to culturally sensitive comprehensive primary health care, and target areas of critical need to accelerate progress
towards the Closing the Gap targets.

Our focus is on working with Indigenous communities and other governments to ensure programs are working effectively to improve health outcomes, by tackling the social factors which impact heavily on health.

All Aboriginal Community Controlled Health Services now report against national key performance
indicators, which are critical for measuring progress towards the Government’s Closing the Gap targets.

We are also funding research and innovation in cooperation with Australia’s First Nations’ people,
including $160 million for a 10-year national Indigenous Health Research Fund.

Up to $25 million will be directed to communities and stakeholder groups to implement proposals at
a local level to improve Aboriginal and Torres Strait Islander Health “

Australia’s Long Term National Health Plan charts the way forward over the next 3 and 10 years in the key areas of mental health, primary care, hospitals, preventive health and medical research

Download the Plan HERE

australia-s-long-term-national-health-plan_0

Mental health

The Government will build a mental health system that is integrated, simplified, trusted and comprehensive.

The new Children’s Mental Health Strategy focuses on the 0–12 age group, and aims to maintain mental wellbeing and prevent mental ill health. It will improve delivery of supports for early childhood, parenting and early education.

We know that half of all symptoms of mental illness begin before the age of 14, and that neuropsychiatric conditions are the leading cause of disability in young people. If untreated, these conditions severely influence how children develop, and how they do at school and in life.

The Children’s Mental Health Strategy will provide a framework to embed protective skills in early childhood, create mentally healthy home environments, support parents, and prevent or treat early childhood trauma.

The expert working group developing the Strategy will be co-chaired by Professor Frank Oberklaid and Professor Christel Middeldorp. Two internationally recognised leaders in child mental health.

Professor Oberklaid, Director of the Centre for Community Child Health at The Royal Children’s Hospital, and Professor Middeldorp, conjoint Professor of Child and Youth Psychiatry at the Child Health Research Centre and Children’s Health Queensland Hospital and Health Service, are two of Australia’s leading child mental health experts.

The Government will continue to tackle stigma around mental illness and encourage people to seek help – and seek it early.

Enormous progress has been made on destigmatisation, but self-stigma – people’s self-consciousness about their own mental health concerns remains high. It is the main barrier to people seeking help.

As a Government, and through the nation’s leaders, organisations, schools and the community, we will work to ensure there will be no shame – in particular, no shame in our own mental health challenges – when we reach out for help.

The Government is undertaking unprecedented action to reduce the rates of suicide, particularly for our young people and Indigenous Australians. More than 3,120 recorded suicides in 2017 – part of an upward trend over the past decade – is a national tragedy.

The Government will establish a ‘towards zero’ suicide target and culture through a whole-of-government approach driven by Australia’s first National Suicide Prevention Adviser, Christine Morgan.

One of the specific priority areas for the next round of the Government’s Million Minds mental health research mission will be research on suicide prevention. Funding of $8 million will be made available to support this research with a round to be opened for competitive application in November 2019.

We will continue to improve service delivery. Funding of $111 million will establish 30 more headspace centres in this term, taking the total to 145 around Australia.

Funding of $110 million is allocated for the Early Psychosis Youth Services Program; $114.5 million to establish eight adult mental health centres; $63 million for residential eating disorder centres in each state and territory; and $36.7 million to expand Way Back services in selected regions, to support people after attempting suicide.

Between now and 2030, we will establish a network of adult mental health centres.

Australia’s mental health system needs to be better integrated. The Government will work towards a New National Mental Health Partnership with states and territories. This Partnership will be informed by the National Mental Health Commission and the Productivity Commission, which are currently working together on Vision 2030: Blueprint for the Future.

The Partnership will identify individual and shared responsibilities for states and territories, and the Commonwealth.

The goal of national partnerships with each of the states and territories is for a simplified mental health system from prevention to treatment to recovery.

Primary care

The Government will implement the 10-year Primary Health Care Plan.

A key reform is support for GPs to provide more flexible care for patients over 70 with chronic and complex conditions, through a new patient enrolment payment model rather than fee-for-service MBS items.

We will develop genomics testing as the new standard of care. Genomics will transform prevention, prediction, diagnosis and treatment by providing precision medical care, targeting the unique genetic makeup of individuals.

We will progressively roll out universal telehealth, modernising general practice, improving continuity and convenience, and particularly benefiting rural and remote Australia.

We will encourage more nurses to enter the primary care workforce.

We will make pharmacy an even more essential part of primary care. The Government is committed to early and inclusive negotiations for a new Community Pharmacy Agreement.

Through our Stronger Rural Health Strategy, we will better distribute the health workforce, with 3,000 new doctors and nurses and hundreds of allied health professionals to be located in areas of need, especially in regional and rural Australia.

Indigenous health is a key priority. We will complete the next iteration of the National Aboriginal and Torres Strait Islander Health Plan by mid-2020.

Through Medicare and the Pharmaceutical Benefits Scheme (PBS), we will continue to ensure Australians have guaranteed access to subsidised health care and medicines. We have provisioned $40 billion for PBS medicines over the next four years. Of this, more than $10 billion is for cancer medicines. We are also looking at ways to improve subsidised access, including streamlining processes for medicines that offer a real therapeutic advance.

Hospitals and private health insurance

We have begun the next wave of private health insurance reforms. We are working collaboratively with insurers, hospitals and doctors to deliver a better outcome for consumers. Our first round of reforms delivered the lowest premium changes in 18 years.

With $131 billion in record public hospitals funding on the table for the next five years under the National Health Reform Agreement, we will work with states and territories to better coordinate care for complex and chronic conditions, keep people out of hospital, and improve management, including self-management, of people with chronic and complex conditions.

Under our landmark $1.25 billion Community Health and Hospitals Program, we will continue to allocate funds for important health and hospital projects. So far, $100 million in signed bilateral agreements with states and territories has been released for 65 projects, including the Peter MacCallum Cancer Centre to bring CAR T – cell treatment to Australia ($80 million), Sydney Children’s Comprehensive Cancer Care Centre ($100 million), the Repat Brain and Spinal Centre, South Australia ($20 million), and the Logan Urgent and Specialist Care Centre, Queensland ($33.4 million).

Preventive health

The Government will develop and implement a 10-year National Preventive Health Strategy. This strategy will provide a better balance between treatment and prevention. It will be designed to keep people healthier and out of hospital.

We will continue to lift cancer screening rates across the three current population-based cancer screening programs – bowel, breast, and cervical – and have requested Cancer Australia to investigate the potential for a national lung cancer screening program.

Australia is set to be the first country in the world to eliminate cervical cancer through vaccination and screening.

We will continue to invest in the National Immunisation Program – $400 million for this year. We will develop a national obesity strategy with states and territories. A $20 million National Tobacco Campaign over four years will continue to reduce tobacco use. Our goal is to reduce smoking rates to below 10 per cent by 2025.

The National Preventive Health Strategy includes an Indigenous Preventive Health Plan. Under this plan, targets for improved health outcomes include:

  • Ending avoidable blindness by 2025
  • Ending avoidable deafness by 2025
  • Eradicating rheumatic heart disease by 2030
  • A 10 per cent annual increase in the number of people having at least one health check a year
  • 60 per cent of pregnant women to have at least one health check in the first trimester
  • Stopping the growth in type 2 diabetes among children and young people within five years.

Medical research

The 10-year, $5 billion MRFF investment plan and the $500 million Biomedical Translation Fund are giving funding certainty to our best and brightest researchers and start-ups. They are reaffirming Australia’s reputation as a world leader in the health and medical research.

A total of 54 clinical trials are now being funded through the MRFF. Within 10 years, we will have established Australia as a global centre for clinical trials.

Eight research missions covering brain cancer ($124.7 million), mental health ($125 million), genomics $500 million), ageing, aged care and dementia ($185 million), Indigenous ($160 million), stem cell ($150 million), cardiovascular ($220 million) and traumatic brain injury ($50 million) are funded through the MRFF. Over time, they will transform health care.

Work on breakthrough treatments includes the $20 million Mackenzie’s Mission to research rare genetic conditions like spinal muscular atrophy and fragile X syndrome, and the $50 million Genomic Cancer Medicine Program.

NACCHO Aboriginal Health #amafdw19 #Prevention #Smoking : At #NPC @AMApresident says the Federal Government must commit adequate resources to its proposed long-term national preventive health strategy :

“ Preventive health measures reduce the rate of chronic ill health and improve the health and wellbeing of all Australians, leading to better and healthier lives.

As a nation, we spend woefully too little on preventive health – around two per cent of the overall health budget.

A properly resourced preventive health strategy, including national public education campaigns on issues such as smoking and obesity, is vital to helping Australians improve their lifestyles and quality of life.

The Australian Government must commit adequate resources to its proposed long-term national preventive health strategy, and work with GPs to help improve the health of all Australians.

AMA President, Dr Tony Bartone, who addressed the National Press Club as part of Family Doctor Week, said the AMA is looking forward to working on the strategy, which Health Minister, Greg Hunt, first announced in a video message to the AMA National Conference in May.

Download full speech HERE

AMA President Press Club Address

” The Northern Territory Government has been judged to have been the worst-performing Australian government on tobacco control measures over the last 12 months, and shamed with the Dirty Ashtray Award for 2019.

This year is the 25th anniversary of the National Tobacco Control Scoreboard – run by the AMA and the Australian Council on Smoking and Health (ACOSH) – and the Northern Territory has managed to collect the dubious Dirty Ashtray Award 13 times.”

SEE Part 2 below NATIONAL TOBACCO CONTROL SCOREBOARD 2019

Read over 130 Aboriginal Health and Smoking articles published by NACCHO in the last 7 years 

Part 1 AMA President, Dr Tony Bartone Prevention Press Release

“Family doctors – GPs – are best placed to manage preventive health, and can assist their patients in managing issues such as weight, alcohol consumption, physical activity, stress, substance use, and quitting smoking.

“Managing weight is a vital part of preventive health. Carrying excess weight contributes to cancers, high blood pressure, and musculoskeletal disorders like bad backs and neck pain. It also affects general health and wellbeing.

“Too many Australians drink at harmful levels, and this is dangerous to their health. Drinking in moderation, and within the guidelines, is a message all Australians should be aware of, and if you are worried about alcohol consumption, talk to your GP.

“Tobacco kills. There is no way to sugar coat the dangers of smoking. If you smoke, you increase your risk of coronary heart disease and cancer.

“Smoking can cause cancer of the lung, oesophagus, mouth, throat, kidney, bladder, liver, pancreas, stomach, cervix, colon, and rectum.

“If you want to quit smoking, start by seeing your family doctor.”

Dr Bartone will also announced the recipient of the 2019 Dirty Ashtray Award, which is presented to the government – Federal, State, or Territory – that has done the least over the past year to combat smoking.

AMA Family Doctor Week runs from 21 to 27 July 2019.

Background

  • In 2017-18, two-thirds of Australian adults and almost one-quarter of Australian children were overweight or obese.
  • Coronary heart disease is the nation’s leading single cause of death.
  • It is estimated that more than 1.2 million Australians have diabetes. The majority (85 per cent) have type 2 diabetes, which is largely preventable.
  • In 2013, diabetes contributed to 10 per cent of all deaths in Australia.
  • Tobacco is the leading cause of cancer in Australia.
  • In 2014-15, more than 1.6 million Australian males aged 15 years and over smoked, 90 per cent of whom smoked daily.
  • More than 1.2 million Australian females aged 15 years and over smoked, 91 per cent of whom smoked daily.
  • About one in 10 mothers smoked in the first 20 weeks of pregnancy.
  • In 2016, 57 per cent of daily smokers were aged over 40, and 20 per cent of daily smokers lived in remote and very remote areas of Australia.
  • Daily tobacco smoking has been trending downward since 1991, from 24 per cent to 12 per cent in 2016.
  • The proportion of people choosing never to take up smoking has increased to 62 per cent in 2016, from 51 per cent in 2001.
  • In 2016, almost one in three (31 per cent) current smokers aged 14 and over have used e-cigarettes.
  • Of current smokers in secondary school aged 16-17, more than one-quarter (26 per cent) smoked daily.

Sources: Australian Bureau of Statistics’ National Health Survey, Australian Institute of Health and Welfare, Heart Foundation.

 

Part 2 NATIONAL TOBACCO CONTROL SCOREBOARD 2019

To read all the states an Territories scores CLICK HERE

The Northern Territory Government has been judged to have been the worst-performing Australian government on tobacco control measures over the last 12 months, and shamed with the Dirty Ashtray Award for 2019.

This year is the 25th anniversary of the National Tobacco Control Scoreboard – run by the AMA and the Australian Council on Smoking and Health (ACOSH) – and the Northern Territory has managed to collect the dubious Dirty Ashtray Award 13 times.

In contrast, the Queensland Government has achieved a remarkable hat trick by topping the scoring to win the coveted National Tobacco Control Scoreboard Achievement Award for leading the nation in tobacco control measures.

AMA President, Dr Tony Bartone, today released the results of the AMA/Australian Council on Smoking and Health (ACOSH) National Tobacco Control Scoreboard 2019 at the National Press Club in Canberra.

Dr Bartone congratulated Queensland on its strong consistent record in stopping people from smoking, and urged the Northern Territory to build momentum with its efforts on tobacco control, while noting the NT Government had amended and strengthened its tobacco control legislation earlier this year.

“The Queensland Government has continued to protect its community from second-hand smoke in a range of outdoor public areas including public transport, outdoor shopping malls, and sports and recreation facilities,” Dr Bartone said.

“Queensland Health is well ahead of other health services in recording smoking status, delivering brief intervention, and referring patients to evidence-based smoking cessation support such as Quitline.

“The Making Tracks – toward closing the gap in health outcomes for Indigenous Queenslanders by 2033 – Policy and Accountability Framework indicates a commitment to reducing smoking among Indigenous communities.

“Funding continues for the B.Strong Brief Intervention training program to strengthen primary healthcare services for Indigenous smokers by increasing the brief intervention skills of health professionals, access to culturally effective resources, and referral to Quitline.

“A dedicated smoking cessation website – QuitHQ – has been developed for the Queensland community, which includes quit support, information for health professionals, and smoking laws. Promotion of QuitHQ includes on-line messages and billboards.”

Dr Bartone said that the Northern Territory is showing signs of moving ahead with stronger tobacco control programs, but we are yet to see solid action and proper funding.

“The NT Government has  published a new Tobacco Action Plan 2019-2023 stressing the need for  media campaigns, smoke-free spaces, sustaining quit attempts and preventing relapse, and identifying priority populations,” Dr Bartone said.

“But these good intentions are yet to be backed with the necessary funding.”

Dr Bartone said the AMA would like to see the Federal Government take on a greater leadership role to drive stronger nationally coordinated tobacco control to stop people smoking and stop people taking up the killer habit.

“The Federal Government has not run a major, national media campaign against smoking since 2012-13, when plain packaging was introduced,” Dr Bartone said.

“Nor has it implemented any further product regulation or constraints on tobacco marketing in that time.

“We would like to see the National Tobacco Campaign reinstated with additional and sustained funding.

“The $20 million announced during the Federal election health debate is a welcome start, but falls well short of the $40 million a year that is needed for a sustained public education program.

“That is a mere 0.24 per cent of the $17 billion the Government expects to reap from tobacco taxes in 2019-20.

“The Government should also implement a systemic approach to providing support for all smokers to quit when they come into contact with health services.

“These key ingredients should be part of the Minister’s commitment, first announced at the AMA National Conference in May, to develop a National Preventive Health Strategy in consultation with the AMA and other health and medical bodies.

“Smoking remains the leading cause of preventable death and disease in Australia, causing 19,000 premature deaths each year.

“Two-thirds of all current Australian smokers are likely to be killed by their smoking. That is a staggering 1.8 million people.

“While Australia is a world leader in tobacco control, more needs to be done to help people quit smoking, or not take it up in the first place.

“Big Tobacco is attempting to distract attention from evidence-based measures that will reduce smoking, while promoting itself as being concerned about health.

“This is particularly outrageous from an industry whose products kill more than seven million people each year.

“It is crucial that Australia maintains its strong evidence-based policies and avoids being diverted by Big Tobacco’s new distraction strategies, particularly following disturbing evidence from the US and Canada about the epidemic of youth e-cigarette use.

“We must remain vigilant against any attempts to normalise smoking, or make it appealing to young people.

“This includes following the advice of the National Health and Medical Research Council and the Therapeutic Goods Administration in regulating e-cigarettes, and not allowing them to be marketed as quit smoking aids until such time as there is scientific evidence that they are safe and effective.”

The AMA/ACOSH National Tobacco Control Scoreboard is compiled annually to measure performance in combating smoking.

Judges from the Australian Council on Smoking and Health (ACOSH), the Cancer Councils, and the National Heart Foundation allocate points to the State, Territory, and Australian Governments in various categories, including legislation, to track how effective each has been at combating smoking in the previous 12 months.

No jurisdiction received an A or B rating this year or last year.

AMA/ACOSH Award – Judges’ Comments

This year is the Silver Anniversary of the AMA/ACOSH National Tobacco Control Scoreboard. 

Since the introduction of the Award in 1994, daily smoking in Australia has halved from 26.1% in 1993 to 12.8% in 2016.

Importantly, the proportion of 12 to 17-year-old school students who have never smoked in their life has increased significantly from 33% in 1984 to 82% in 2017.

Australia has led the world in its implementation of a comprehensive approach to reduce smoking.

Since the early 1990s, Australia has implemented the following strategies to reduce smoking, many of which have been duplicated in other countries around the globe:

We call on the Australian, State and Territory Governments to implement the following recommendations:

  • allocate adequate funding from tobacco revenue (predicted to be $17 billion in 2019/2020) to ensure strong media campaigns at evidence-based levels;
  • ban all remaining forms of tobacco marketing and promotion and legislate to keep up with innovative tobacco industry strategies;
  • implement tobacco product regulation to decrease the palatability and appeal of tobacco products;
  • implement comprehensive action, including legislation, in line with Article 5.3 of the Framework Convention on Tobacco Control (FCTC) to protect public health policy from direct and indirect tobacco industry interference, and ban tobacco industry political donations;
  • implement positive retail licensing schemes for all jurisdictions;
  • implement best practice support for smoking cessation across all health care settings;
  • ensure consistent funding for programs that will decrease smoking among Aboriginal and Torres Strait Islanders and other groups with a high prevalence of smoking; and
  • ensure further protection for the community from the harms of second-hand smoke.

Results

NACCHO Aboriginal Research Health News : New @NHMRC project to implement and evaluate 715 annual health checks interventions designed to help Close the Gap

 “The prevalence of most chronic diseases increases with age and affects not only physical health, but also the broader contributors to the well-being of older Aboriginal people, including participation in family, community and cultural leadership roles and connection with community networks.

Aboriginal people often receive a diagnosis at a more advanced stage of chronic disease, which means there’s less opportunity to prevent their condition and health deteriorating “

Professor Sanson-Fisher said chronic diseases continue to be a major contributor to unhealthy ageing among Aboriginal and Torres Strait Islander people. Timely diagnosis and appropriate management was vital to improving health outcomes for Aboriginal and Torres Strait Islander people. See Website

Consider these facts

  • In 2016-2017 just 27 per cent of Indigenous adults aged 15 to 24 had an annual health assessment.
  • Only 30 per cent of 25-to 54-year-olds, and 41 per cent of Indigenous adults over 55 had one.
  • Around 37 per cent of the burden of disease in Aboriginal people could be prevented by reducing risk factors

Read previous NACCHO 715 Health Check Articles

Download resources to boost the rates of the 715 health check. Information available for patients and health professionals!

An intervention designed to help Close the Gap, by increasing the number of Aboriginal and Torres Strait Islander people who receive an annual health check by their GP, will be implemented and evaluated by a new National Health and Medical Research Council (NHMRC) project.

Renowned population health researcher, Laureate Professor Rob Sanson-Fisher of the University of Newcastle and Hunter Medical Research Institute, will lead a team of expert Aboriginal and non-Aboriginal researchers in the five-year research project – which was awarded $745,056 following a Targeted Call for Research** for Healthy Ageing of Aboriginal and Torres Strait Islander People.

Indigenous people die about eight years earlier than non-Indigenous Australians. For Aboriginal and Torres Strait Islander Australians born in 2015-17, the life expectancy is 71.6 years for men and 75.6 years for women – about 8.6 and 7.8 years less than non-Aboriginal men and women respectively.

Twenty-two mainstream general practice clinics within the central Coast and New England regions will participate in the research project.

The intervention package will comprise strategies such as continuing medical education, recall and reminder systems, and mailed invitations to patients.

The project will also test whether the intervention increases doctors’ adherence to best practice care and improves patient outcomes.

More than 60 per cent of Indigenous people regularly visit mainstream general practice services – a key opportunity to deliver an annual ‘715’ health assessment, which forms an integral part of the Australian Government’s Closing the Gap commitment.

The aim of the Aboriginal and Torres Strait Islander Health Assessment (Medicare Benefits Schedule item 715) is to help ensure Indigenous Australians receive primary health care matched to their needs, by encouraging early detection, diagnosis and intervention for common and treatable conditions that cause morbidity and early death.

The health assessment is an annual service and covers the full age spectrum..

Key contributing chronic conditions include cardiovascular diseases (19 per cent of the chronic disease prevalence gap), mental and substance use disorders (14 per cent), cancer (9 per cent), chronic kidney disease, diabetes, vision loss, hearing loss and respiratory, musculoskeletal, neurological and congenital disorders.

Around 37 per cent of the burden of disease in Aboriginal people could be prevented by reducing risk factors.

The risk factors causing the most burden are tobacco use (12 per cent of the total burden), alcohol use (8 per cent), high body mass (8 per cent), physical inactivity (6 per cent), high blood pressure (5 per cent) and high blood glucose levels (5 per cent).

“Mainstream general practice is a crucial setting to impact on prevention, timely diagnosis and appropriate management of chronic disease for Aboriginal people, which is imperative to help Close the Gap,” Professor Sanson-Fisher said.

 

NACCHO Aboriginal #MentalHealth @georgeinstitute Download new screening tool to help Aboriginal and Torres Strait Islander people combat depression

“ This tool, which was developed in conjunction with Aboriginal communities and researchers, will help us address easily treated problems that often go undiagnosed. It will also help us to assess the scale of mental health problems in communities.

Up until now, we couldn’t reliably ascertain this in a culturally appropriate way, which has remained a huge concern.

We need better resources and funding for mental health across Australia, but particularly for Aboriginal and Torres Strait Islander people and within under-resourced health services. We hope this tool will be a turning point.”

Lead researcher Professor Maree Hackett, of The George Institute for Global Health, said mental health problems experienced by Aboriginal and Torres Strait Islander peoples have been overlooked, dismissed and marginalised for too long. 

A culturally-appropriate depression screening tool for Aboriginal and Torres Strait Islander peoples not only works, it should be rolled out across the country, according to a new study.

Researchers at The George Institute for Global Health, in partnership with key Aboriginal and Torres Strait primary care providers conducted the validation study in 10 urban, rural and remote primary health services across Australia.

The screening tool is an adapted version of the existing 9-item patient health questionnaire (PHQ-9) used across Australia and globally accepted as an effective screening method for depression. The adapted tool (aPHQ-9) contains culturally-appropriate questions asking about mood, appetite, sleep patterns, energy and concentration levels. It is hoped the adapted questionnaire will lead to improved diagnosis and treatment of depression in Aboriginal communities.

The results of the validation study were published in the Medical Journal of Australia 1 July 2019

Download the 7 page study  mja250212

The aPHQ-9 is freely available in a culturally-appropriate English version, and can be readily used by translators when working with First Nation communities where English is not the patients first language.

It is estimated up to 20 per cent of Australia’s general population with chronic disease will have a diagnosis of comorbid major depression. [1]

Approximately similar proportions will meet criteria for moderate or minor depression. Mental illness and depression are also considered to be key contributors in the development of chronic disease.

Across the nation, chronic disease (cardiovascular disease, cerebrovascular disease, diabetes, chronic kidney disease and chronic obstructive pulmonary disease) accounts for 80 per cent of the life expectancy gap experienced by Aboriginal people [2]  

How the tool works

The adapted tool, which was evaluated with 500 Aboriginal and Torres Strait Islander peoples, contains culturally-appropriate questions.

For example, the original (PHQ-9) questionnaire asks:

  • Over the last two weeks, how often have you been bothered by any of the following problems: Little interest or pleasure in doing things?
  • Feeling down, depressed or hopeless

The adapted (aPHQ-9) tool instead asks:

  • Over the last two weeks have you been feeling slack, not wanted to do anything?
  • Have you been feeling unhappy, depressed, really no good, that your spirit was sad?

Download: Adapted Patient Questionnaire with scoring (PDF 117 KB)

Download: Adapted Patient Questionnaire without scoring(PDF 114 KB)

Professor Alex Brown, of the South Australian Health and Medical Research Institute, who was co-investigator on the study, said the importance of using culturally appropriate language with First Nations people cannot be underestimated.

“In Australia, as with many countries around the world, everything is framed around Western understandings, language and methods. Our research recognises the importance of an Aboriginal voice and giving that a privileged position in how we respond to matters of most importance to Aboriginal people themselves.

“What we found during this study was that many questions were being lost in translation. Instead of a person scoring highly for being at risk of depression, they were actually scoring themselves much lower and missing out on potential opportunities for treatment.

“It was essential that we got this right and that we took our time speaking with Aboriginal people and ascertaining how the wording needed to be changed so we can begin to tackle the burden of depression.”

Aboriginal psychologist Dr Graham Gee, of the Murdoch Children’s Research Institute, saidAboriginal communities have unacceptably high rates of suicide which need to be addressed. “Identifying and treating depression is an important part of responding to this major challenge. It’s clear this tool is much needed.”

The new tool will be available for use at primary health centres across Australia and will be available to download here from Monday July 1.

The George Institute for Global Health

The George Institute for Global Health conducts clinical, population and health system research aimed at changing health practice and policy worldwide.

Established in Australia and affiliated with UNSW Sydney, it also has offices in China, India and the UK, and is affiliated with the University of Oxford.  Facebook at thegeorgeinstitute  Twitter @georgeinstitute Web georgeinstitute.org.au

[1] https://www.aihw.gov.au/reports/mentalhealthservices/mentalhealthservicesinaustralia/reportcontents/summary/prevalenceandpolicies

[2] https://www.aihw.gov.au/reports/indigenousaustralians/contributionofchronicdiseasetothegapinmort/contents/summary

Additional Media 

Doctors can now use the new tool

Extract from the Conversation 1 July 2019

In 2014-15, more than half (53.4%) of Aboriginal and Torres Strait Islander peoples aged 15 years and over reported their overall life satisfaction was eight out of ten or more. Almost one in six (17%) said they were completely satisfied with their life. These positive data are testament to Aboriginal and Torres Strait Islander peoples’ ongoing endurance.

But over the years, events like colonisation, racism, relocation of people away from their lands, and the forced removal of children from family and community have disrupted the resilience, cultural beliefs and practices of many Aboriginal and Torres Strait Islander Australians. In turn, these factors have impacted their social and emotional well-being.

This may explain why Aboriginal and Torres Strait Islander peoples are twice as likely to be hospitalised for mental health disorders and die from suicide than their non-Aboriginal counterparts.

Teenagers aged 15 to 19 are five times more likely than non-Indigenous teenagers to die by suicide.

The importance of being able to more accurately identify those at risk can’t be understated.

While screening all Aboriginal and Torres Strait Islander peoples who present to general practice for depression is not recommended, the new questionnaire is a free, easy to administer, culturally acceptable tool for screening Aboriginal and Torres Strait Islander peoples at high risk of depression.

People who might be at heightened risk of depression include those with chronic disease, a history of depression and those who have been exposed to abuse and other adverse events.

Without a culturally appropriate tool, Aboriginal and Torres Strait Islander people with depression and suicidal thoughts might fly under the radar. This questionnaire will pave the way for important discussions and the provision of treatment and services to those most in need.

If this article has raised issues for you or you’re concerned about someone you know, call Lifeline on 13 11 14. Visit the Beyond Blue website to access specific resources for Aboriginal and Torres Strait Islander people.

Maree Hackett, Professor, Faculty of Medicine, UNSW and Geoffrey Spurling, Senior lecturer, Discipline of General Practice, The University of Queensland

This article is republished from The Conversation under a Creative Commons license. Read the original article.

NACCHO Aboriginal Health and #715HealthCheck 3 of 3 : @healthgovau Your Health is in Your Hands – Download resources to boost the rates of the #715healthcheck. Information available for patients and health professionals!

” A 715 it’s a health check that Aboriginal and Torres Strait on the people’s can have done on an annual timetable.

But it should be comprehensive in nature, and offer you not just the usual, hi, how are you?

What’s your name? Where do you live?

But take full consideration of your social background and social histories, ask you about your family history.

Is there anything important not just in your own personal medical background, but that of your family, so we can take that into consideration?

We know that we have many families with long backgrounds of chronic disease, for example, diabetes, cardiovascular risk, and they’re super important we’re considering how we tailor our history, our examination, our investigations, and then a treatment plan for you.

 It goes through the steps of that history and they’ll ask you questions about, you got a job at the moment, where are you working?

What are you exposed to? What are your interest? Do you play sport?

Are you involved in any other sort of social activities, cultural activities, for example, which I think is really important.

They’ll then make determinations around the kinds of examination if they need to tailor that at all, depending upon your age, and where you live and your access to services and what your history brought up, for example, male, female, young or old.

And then the investigations and X-ray, for example, or some bloods taken, and referrals as appropriate.

For allied health professionals, pediatrists, nutritionists, diabetes educators, but also perhaps you might need to see a cardiologist or a diabetes and endocrinologist as a specialist.

And then we wrap that all up in a specific and individualised kind of plan for you, that we discuss and we negotiate and we try to educate so that you then are able to play a part in your own health and take responsibility for some of those aspects.

But also you then get to choose what you share with family and the other providers.

It’s supposed to be a relationship and partnership for your health, that you understand, that you agree to and then together, you can move forward on how to be healthy and stay healthy.

From interview with Dr Ngaire Brown 

Download resources below or from HERE

Podcasts

Annual health checks for Aboriginal and Torres Strait Islander Australians

Aboriginal and Torres Strait Islander people can access a health check annually, with a minimum claim period of 9 months. 715 health checks are free at Aboriginal Medical Services and bulk bulling clinics to help people stay healthy and strong.

We acknowledge that many individuals refer to themselves by their clan, mob, and/or country. For the purposes of the health check, we respectfully refer to Aboriginal and Torres Strait Islander people as Aboriginal and Torres Strait Islander throughout.

Your Health is in Your Hands

Having a health check provides important health information for you and your doctor.

Staying on top of your health is important. It helps to identify potential illnesses or chronic diseases before they occur. It is much easier to look at ways to prevent these things from occurring, rather than treatment.

The 715 Health Check is designed to support the physical, social and emotional wellbeing of Aboriginal and Torres Strait Islander patients of all ages. It is free at Aboriginal Medical Services and bulk billing clinics.

What happens at the health check?

Having the health check can take up to an hour. A Practice Nurse, Aboriginal Health Worker or Aboriginal and Torres Starlit Islander Health Practitioner may assist the doctor to perform this health check. They will record information about your health, such as your blood pressure, blood sugar levels, height and weight. You might also have a blood test or urine test. It is also an opportunity to talk about the health of your family.

Depending on the information you’ve provided, you might have some other tests too. You’ll then have a yarn with the doctor or health practitioner about the tests and any follow up you might need. It’s also good to tell them about your family medical history or any worries you have about your health.

Information for patients

Only about 30 per cent of Aboriginal and Torres Strait Islander people are accessing the 715 health check. Resources have been developed to help improve the uptake of 715 health checks in the community.

These are available for patients, community organisations, PHNs and GP clinics to download or order

Read all NACCHO 715 Health Check articles Here

Frequently Asked Questions

What happens at the health check?

Health checks might be different depending on your age.

Having the health check should take between 40-60 minutes. A health practitioner might check your:

  • blood pressure
  • blood sugar levels
  • height and weight

You might also a have blood test and urine test.

It’s also good to tell your health practitioner about your family medical history or any worries you have about your health.

Follow up care

Once you finish the check, the Practice Nurse, Aboriginal Health Worker or Doctor might tell you about other ways to help look after your health. They might suggest services to help you with your:

  • heart
  • vision
  • hearing
  • movement
  • mental health

You may also get help with free or discounted medicines you might need. Your Doctor can give you information about Closing the Gap scripts if you have or at risk of having a chronic disease.

Where can you access a 715 health check?

You can choose where you get your 715 health check. If you can, try to go to the same Doctor or clinic.

This helps make sure you are being cared for by people who know about your health needs.

Do I need to pay for the 715 health check?

The health check is free at your local Aboriginal Medical Service. It is also free at bulk billing health clinics. If you are unsure whether it will be free at your local Doctor, give them a call to ask about the 715 health check before you book.

Why Should I Identify?

It’s important to tell the Doctor if you are Aboriginal and/or Torres Strait Islander so that they can make sure you get access to health care you might need. Medicare can help record this for you, and their staff are culturally trained to help.

Call the Aboriginal and Torres Strait Islander Access line on 1800 556 955.

Information for Health Professionals

For more information about for health professionals and medical practitioners delivering the 715 health checks please go to Supporting Aboriginal and Torres Strait Islander patients.

Video Case Studies

Social Media Tiles

2 boys stand with a woman in a school basketball court. They look happy and healthy/
An Aboriginal Health worker measures the weight of a child was part of the 715 health check.
A doctor takes a man’s pulse as part of the 715 health check.

NACCHO Aboriginal Health and #CancerAwareness : @JacintaElston @KelvinKongENT Hey you mob It’s ok to talk about #cancer – For assistance download #YarnforLife resources

“Yarn for Life aims to reduce feelings of shame and fear associated with cancer and highlights the importance of normalising conversation around cancer and encouraging early detection of the disease.

It also emphasises the value of support along the patient journey.”

Professor Jacinta Elston, Pro Vice-Chancellor (Indigenous), Monash University, said that finding cancer early gave people the best chance of surviving and living well.

“Yarn for Life seeks to empower Aboriginal and Torres Strait Islander people to participate in screening programs, discuss cancer with their doctor or health care worker openly, and if cancer is diagnosed, complete their cancer treatment.”

Australia’s first Australian Aboriginal surgeon Associate Professor Kelvin Kong, University of Newcastle : continued below 

Download Yarn for Life Resources HERE

Read over 80 Aboriginal and Torres Strait Islander Cancer Awareness articles published by NACCHO over past 7 years 

In a national first, Cancer Australia has launched Yarn for Life, a new initiative to reduce the impact of cancer within Aboriginal and Torres Strait Islander communities by encouraging and normalising discussion about the disease.

Cancer is a growing health problem and the second leading cause of death among Indigenous Australians who are, on average, 40 percent more likely to die from cancer than non-indigenous Australians.

The multi-faceted health promotion Yarn for Life has been developed by and with Indigenous Australians, and weaves the central message that it is okay to talk about cancer by sharing personal stories of courage and survivorship from Aboriginal and Torres Strait Islander people.

Yarn for Life features 3 individual experiences of cancer which are also stories of hope.

“While significant gains have been made with regard to cancer overall, Aboriginal and Torres Strait Islander people continue to experience disparities in cancer incidence and outcomes. Cancer affects not only those diagnosed with the disease but also their families, carers, Elders and community,” said Dr Helen Zorbas, CEO, Cancer Australia.

Associate Professor Kong said it was also important for health services to support better outcomes for Indigenous patients by being culturally aware.

“For Aboriginal and Torres Strait Islander people, health and connection to land, culture community and identity are intrinsically linked. Optimal care that is respectful of, and responsive to, the cultural preferences, sensitivities, needs and values of patients, is critical to good health care outcomes.”

The Yarn for Life initiative is supported by two consumer resources which outline what patients should expect at all points on the cancer pathway.

Yarn for Life will feature television, radio and social media resources designed to be shared with friends, family and the community, to carry on the Yarn for Life conversation online.

SEEING YOUR DOCTOR OR HEALTH WORKER

Finding cancer early gives you the best chance of getting better and living well. The good news is there are things you can do to find cancer early. If there are any changes in your body that could be due to cancer, it’s really important to have them checked out. Speak to your health worker about:

  • any new or unusual changes in your body
  • how you are feeling
  • whether you are in any pain
  • whether anyone in your family has or had cancer
  • any other problems that are worrying you.

Free screening programs

It’s also important that you and your family participate in screening programs for breast, bowel and cervical cancers.

You can find out more about these free programs including how old you need to be to participate at cancerscreening.gov.au. Remember most of us will need to go to a check-up or screening at some point in our lives—so there’s no shame in talking to family or friends about it as well as your health care worker.