NACCHO Aboriginal #AusVotesHealth #VoteACCHO Will preventative health be on the #Election2019 agenda today at the @PressClubAust debate between health ministers @CatherineKingMP and @GregHuntMP? #npc #auspol @_PHAA_ @amapresident @CHFofAustralia @Prevention1stAU

” Labor has vowed to ramp up the Australian government’s efforts to prevent people from becoming unwell if it wins the upcoming federal election.

The pledge comes as Health Minister Greg Hunt will have the opportunity to spruik the coalition’s record on improving people’s health in a debate with Labor’s health spokeswoman Catherine King.

The pair will go head-to-head at the National Press Club today ;

You can watch the debate from 12.30 pm on ABC TV

See media report Part 1 Below

” The health of Australians is far more likely to be advanced by spending money on preventing disease than it is curing or treating illnesses.

With an aging population and chronic disease snowballing, the current focus on health through the prism of hospitals and drugs is unsustainable.

Many Australians would be shocked to learn that less than 2% of the health budget is spent on prevention. We are calling for that to change.

Most OECD countries commit around 5% of health spending to prevention. On this Australia is lagging behind.”

We have shown what can be done by driving down smoking rates. While more needs to be done on tobacco, there is an urgent and growing need to apply that lesson to obesity, physical activity and alcohol consumption. “

PHAA CEO, Terry Slevin from the Public Health Association of Australia (PHAA) who recently launched its election manifesto at its Justice Health conference in Sydney in an attempt to pivot the health conversation towards prevention. See Part 2 Below

Download the PHAA Election Priorities Here

PHAA Policy Priorities 2019

“ The AMA is calling on Health Minister, Greg Hunt, and Shadow Health Minister, Catherine King, to use today’s Health Policy Debate at the National Press Club to fill the gaps in their respective overarching visions for the future health system in Australia.

The Australian health system is one of the best in the world, if not the best. But it will take strong leadership, hard work, good policy with long-term strategic vision, and significant well-targeted funding to keep it working efficiently to meet growing community demand.

“The health system has many parts, and they are all linked. Governments cannot concentrate on a few, and neglect the others. Otherwise, patients will be the ultimate losers. Whole patient care cannot be done in silos, in parts, or in isolation.

“Health is the best investment that any government can make. We expect to hear more detail on their intended investment from the major parties at the National Press Club today,”

Dr Tony  Bartone AMA President See Part 3 Below

” We don’t need more reviews. Experience has shown stopgap health policies won’t pay in the long run. The evidence here and internationally tells us that the best overall returns for the health dollar will come from nationally co-ordinated preventive health measures to counter modern malaises of obesity and chronic illness.

Closely linked to the prevention drive should be better resourced primary health services — GP-led team care for the growing number of chronically ill and older patients. People want affordable, convenient and reliable care close to home “

Update

AMA President, Dr Tony Bartone, said today that Labor has announced a comprehensive framework to re-energise a coordinated national preventive health strategy to keep Australians fitter and healthier and out of hospital.

Dr Bartone said the broad range of initiatives is welcome, but will ultimately require significantly greater funding to be truly effective for the long term. “Investing in preventive health saves hundreds of millions of dollars in health costs and improves lives,”

See Press Release HERE

AMA Prevention

Leanne Wells is chief executive of the Consumers Health Forum of Australia. See Part 4

‘We urge Health Minister Greg Hunt and Shadow Minister Catherine King to outline how they are going to get better bang for the health buck at today’s National Press Club debate’, says Australian Healthcare and Hospitals Association (AHHA) Chief Executive Alison Verhoeven.

‘The Coalition, Labor, and the Greens are all promising welcome extra health dollars and reduced out-of-pocket costs for electors should they win government—but public commitment to getting better value for those dollars has been muted.

See AHHA Press Release Part 5

NACCHO has developed a set of policy #Election2019 recommendations that if adopted, fully funded and implemented by the incoming Federal Government, will provide a pathway forward for improvements in our health outcomes.

We are calling on all political parties to include these recommendations in their election platforms and make a real commitment to improving the health of Aboriginal and Torres Strait Islander peoples and help us Close the Gap.

With your action and support of our #VoteACCHO campaign we can make the incoming Federal Government accountable.

See NACCHO Election 2019 Website

NACCHO Recommendation 6.Allocate Indigenous specific health funding to Aboriginal Community Controlled Health Organisations

  • Transfer the funding for Indigenous specific programs from Primary Health Networks to ACCHOs.
  • Primary Health Networks assign ACCHOs as preferred providers for other Australian Government funded services for Aboriginal and Torres Strait Islander peoples unless it can be shown that alternative arrangements can produce better outcomes in quality of care and access to services

Part 1 Media Coverage 

Health has been a key battleground for the election campaign so far, with both major parties spending weeks trying to convince Australians they will be best placed to look after them when they’re sick.

Labor has vowed to spend $2.3 billion over four years on improving the coverage of cancer services on Medicare and wants to spend an extra $2.8 billion on public hospitals.

But the coalition says it has funded hospitals at record levels, because its strong economic management has given it the cash to do so.

Mr Hunt has also argued his government has made far more medicines affordable by listing them on the Pharmaceutical Benefits Scheme, which means they are subsidised by the government.

Improving the mental health of young and indigenous Australians is also in the coalition’s sights, with the party promising an extra $42 million for services that would do as much if it wins the national poll.

Labor has now turned its attention to stopping people from becoming ill in the first place, pledging $115.6 million worth of initiatives to promote health and prevent disease.

The prevention package includes implementing Australia’s first National Obesity Strategy.

That will involve spending $39 million over three years to roll out a national anti-obesity marketing campaign.

Smokers would be targeted by a separate $40 million anti-smoking campaign over four years to reduce cancer rates.

Money would also go toward a sun protection awareness campaign and initiatives to drive up early detection of bowel cancer.

Labor also wants to reduce harmful drinking, vowing $10 million worth of targeted campaigns, delivering warning labels on alcohol packaging and doing more to limit alcohol advertising to children.

Ms King stressed that almost a third of Australia’s burden of disease is preventable.

Every dollar spent on preventing people from becoming sick through lifestyle factors delivers almost $6 in health and productivity benefits, she said.

“Prevention is better than cure – both for our own health and the country’s.”

Part 2 PHAA

Australia invests a meagre 1.7% of the health system spending on preventative health – one of the lowest levels of the OECD economies. says we must match the world’s best practice of 5% to advance the health of Australians.

Download the PHAA Election Priorities Here

PHAA Policy Priorities 2019

The recent launch of the PHAA Immediate Priorities 5-point plan called for:

  • Setting the target of 5% of Australia’s health budget to focus on prevention
  • Protecting kids from marketing of tobacco, alcohol, junk food
  • Investing in sustained and effective community education programs on tobacco, healthy eating, alcohol and being physically active
  • Focusing on improved health for Aboriginal and Torres Strait Islander adolescents, and
  • Curbing climate change with clear and effective action to ensure a healthy planet.

This plan was launched at our Justice Health conference to emphasise the importance of focusing on the people of greatest need.

“Those who come in contact with the justice system are often the most vulnerable. People with mental health issues, drug and alcohol problems, Aboriginal and Torres Strait Islander people are all overrepresented in our jails. If we aim for a fair go for all Australians, that requires us to focus our attentions on those with the greatest need.”

“If we get this right, we can add at least five more good years to people’s lives so they can enjoy the fruits of their labour, the celebrations and successes of our families and the people we love for longer. Surely this is a goal we all must share and pursue.”

“Health experts have the solutions; parliamentarians simply need to act. ”

Part 3 AMA

The AMA is calling on Health Minister, Greg Hunt, and Shadow Health Minister, Catherine King, to use today’s Health Policy Debate at the National Press Club to fill the gaps in their respective overarching visions for the future health system in Australia.

AMA President, Dr Tony Bartone, said that the AMA has welcomed announcements from the major parties of new funding and strategies for public hospitals, cancer care, primary care, dental care for pensioners and seniors, Indigenous health, the lifting of the Medicare rebate freeze, and the Pharmaceutical Benefits Scheme (PBS), among others.

“The AMA will compare and contrast these policies and publicly rate them accordingly before election day,” Dr Bartone said.

“But we need to see the major parties announcing the missing pieces from their health care vision over the next two-and-a-half weeks, starting today.

“As the population ages and more people are living longer with multiple complex and chronic conditions, it is vital that Australia has a robust, connected, and holistic strategy to ensure improved health outcomes for patients throughout life.

“The big gaps include aged care, broad mental health strategies, comprehensive primary care and general practice investment, the private health sector, and prevention.

“The Australian health system is one of the best in the world, if not the best. But it will take strong leadership, hard work, good policy with long-term strategic vision, and significant well-targeted funding to keep it working efficiently to meet growing community demand.

“The health system has many parts, and they are all linked. Governments cannot concentrate on a few, and neglect the others. Otherwise, patients will be the ultimate losers. Whole patient care cannot be done in silos, in parts, or in isolation.

“Health is the best investment that any government can make. We expect to hear more detail on their intended investment from the major parties at the National Press Club today,” Dr Bartone said.

The AMA’s health policy wish list – Key Health Issues for the 2019 Federal Election – is available at https://ama.com.au/article/key-health-issues-2019-federal-election

The AMA will issue a health policy scorecard in the final week of the campaign.

Public Release. View in full here.

Part 4 Preventive measures the most effective health policy prescription

Health is once again a target for billions of taxpayer dollars in election promises that may soothe but never heal community concerns.

There has been no shortage of diagnoses about what ails the health system. A feature of Australia’s health policy in the past decade has been the preponderance of probes into various elements of the health sector, ranging from system-wide inquiries to more focused reviews of troubled areas.

The Coalition government, since coming to power in 2013, has instituted a clutch of reviews into key problem zones: primary care for the chronically ill, mental health, private health insurance, out-of-pocket medical costs, regulation and remuneration of pharmacies, and the efficacy of high-cost Medicare benefits.

These reviews produced various ideas for change and improvement, but community unease about health still creates a spike in public opinion surveys.

There were two recurring concerns raised by respondents to a recent survey conducted by the Consumers Health Forum. The issues were cost and uncertainty. These are worry points often reflected in the focus of the health policies announced so far in this federal election campaign.

The out-of-pocket costs dilemma confronting so many patients in Australia also is often connected to a widespread sense of uncertainty about healthcare and its co-ordination — what care is needed, its cost and where to go for appropriate treatment.

Our survey found most people were satisfied with the quality of the healthcare they received. However, a third encountered difficulties at every stage of the healthcare process, such as finding the right place to get care, deciding which provider to see and getting to see the provider they needed.

The unease about care costs and uncertain access to co-ordinated care have prompted a variety of responses from the political parties.

Labor has proposed a plan to reduce out-of-pocket costs for cancer patients; the Coalition is pledging support for streamlined access to integrated care for the over-70s and a new website detailing medical specialists’ fees. And both sides promise more hospital funding and a continuing stream of new drugs on the Pharmaceutical Benefits Scheme.

But there remains the reality that we are getting piecemeal measures when what is needed is a holistic approach with overarching strategies reflecting all of the modern world’s knowledge about the causes of ill health and our capacity to avoid ill health.

We are proposing that the next federal government give priority to three areas: childhood obesity, public dental services and primary healthcare. We don’t need more reviews. Experience has shown stopgap health policies won’t pay in the long run. The evidence here and internationally tells us that the best overall returns for the health dollar will come from nationally co-ordinated preventive health measures to counter modern malaises of obesity and chronic illness.

Closely linked to the prevention drive should be better resourced primary health services — GP-led team care for the growing number of chronically ill and older patients. People want affordable, convenient and reliable care close to home,

The political default on health is to offer more and bigger hospitals. We need to rebalance the investment to give more focus on comprehensive care in the community that reduces our dependence on hospitals.

Obesity is a dominant factor in chronic illness yet as a nation we have no coherent, effective strategy to counter poor diet and promotion to children of unhealthy food and drink, and to take other more practical measures, such as overcoming urban planning and transport obstacles to routine activities such as walking.

Modern economies and digital technology have brought new levels of consumer control and understanding to most corners of society. Yet health, despite the expertise of its practitioners and reliance on precision record-keeping elsewhere in healthcare, lags behind 21st-century potential when it comes to communications with patients. Instead, we as a wealthy country have hundreds of thousands of people each year putting off having scripts filled, seeing a specialist or living with the misery of toothache because they can’t ­afford a dentist.

Australia’s health system remains less efficient than it should be and federal-state divisions in health funding and the resistance of practitioners to change, or lack of support for practitioners to change, are significant impediments. We have seen in recent years welcome strides towards a more transparent and accountable health system. Consumers must be empowered with more government support for the development of consumer leadership and patient-centred care to improve not only health outcomes but also the working experience of clinicians.

Transforming services by encouraging consumer-influenced health services and patient engagement in healthcare can bring long-term benefits to Australia’s physical and fiscal health.

Leanne Wells is chief executive of the Consumers Health Forum of Australia.

Part 5

‘We urge Health Minister Greg Hunt and Shadow Minister Catherine King to outline how they are going to get better bang for the health buck at today’s National Press Club debate’, says Australian Healthcare and Hospitals Association (AHHA) Chief Executive Alison Verhoeven.

‘The Coalition, Labor, and the Greens are all promising welcome extra health dollars and reduced out-of-pocket costs for electors should they win government—but public commitment to getting better value for those dollars has been muted.

‘For example, do you really need that extra appointment with the doctor to renew a script or have a specialist referral updated? Do you really need to pay a GP to carry out a treatment or give an injection when a trained nurse can do it just as effectively? Why are some treatments still subsidised by Medicare when more effective evidence-based treatments are available? Why get that injury treated in hospital when it could be done just as well at your local primary care clinic for a fraction of the cost?

‘We need to shift the whole system to value-based healthcare—that is, better outcomes for patients relative to costs—or the right care in the right place at the right time by the right provider.

‘This will often involve teams of health professionals providing ongoing care for chronic conditions—this has been proven internationally to be more effective, more timely and better value than traditional care systems.

‘Integrated or “joined up” care driven by results is better for the patient than care driven by number of consultations attended and/or the size of the patient’s wallet.

‘To their credit, during its current term the Government initiated a review of all Medicare item numbers for relevance and effectiveness. Progress has been limited to date, but the review is ongoing.

‘The Government also initiated an inquiry into out-of-pocket costs—but included only one consumer representative in a sea of medical and private health interests. One proposed outcome of the inquiry—compelling specialists to publish their fees on a government website—while laudable, is yet to see the light of day.

‘The Government introduced the Health Care Home model of integrated care, which is a move toward value-based healthcare. But it failed to attract enough ‘buy-in’ from medical practitioners or consumers—in part because of insufficient funding and poor planning. The Coalition’s recently announced policy of rewarding GP practices for people over 70 signing up or registering with the practice for chronic disease care is a renewed step in the right direction. So is the commitment of both major parties to Primary Health Networks tasked with introducing innovative and value-based primary healthcare regimes tailored to local circumstances.

‘The $2.3 billion investment pledged by Labor to address out-of-pocket costs for people with cancer is a much-needed response to the significant and unexpected costs faced by many people with cancer. But, apart from a suggested oncology Medicare item number available only through bulk-billing of patients, there is little detail as yet on how the initiative will ensure real value for patients while sidestepping unnecessary low value care.

‘Labor’s proposed Health Reform Commission, and the Greens’ similar proposed single funding agency are encouraging signs of political will to achieve better value and less waste by ending the “blame game” between various levels of government—but we would like to see more concrete actions detailed in their policies.

‘As a nation we also need to invest in appropriate Australian research into best value care—AHHA has recently launched the Australian Centre for Value-Based Health Care to support this work.

‘We call on all parties and candidates to commit to better bang for the health buck—a revamped value-for-money health system focused on what matters to patients’, Ms Verhoeven said.

Visit the Australian Centre for Value-Based Health Care here. To follow AHHA commentary throughout the election campaign, visit www.ahha.asn.au/election. This release is also available online.

NACCHO Aboriginal Youth Health : ‘Dark days of old Don Dale’: John Paterson CEO @AMSANTaus and Human rights groups condemn #NT Government and Minister Dale Wakefield’s new youth justice laws

“ The NT government talks proudly about its commitment to Aboriginal-led solutions, to co-design and to collaboration,

So why was this bill kept from those who are part of those solutions and collaborations until the moment it was introduced into the parliament?

The bill went “far beyond” clarifying technical matters,

It does not reflect the royal commission recommendations or the government’s previous policy position to accept and implement those recommendations.

These amendments bring back the draconian treatment of young people and will see children restrained and isolated at the discretion of detention staff.

Far from reducing ambiguity as the minister claims, the amendments reintroduce ambiguity with subjective definitions and powers.

The Chief Executive Officer of AMSANT, John Paterson The Aboriginal Medical Services Alliance of the Northern Territory (AMSANT) today condemned the Labor Government and Minister Wakefield in the strongest possible terms for its behaviour in avoiding debate and scrutiny in order to ram through retrograde changes to the Youth Justice Act for the operation of youth detention.

Read The Guardian Amnesty coverage 

Read full AMSANT Press Releases Part 1 Below

Read over 60 NACCHO Aboriginal Health and Don Dale detention articles 

“The Territory Labor Government is creating generational change and safer communities by overhauling the Youth Justice system and putting at-risk young people back on track.

“The safety of youth detention staff and detainees is absolutely paramount. These amendments will help to better manage security risks that puts lives in danger.

“Last year we amended the Youth Justice Act to ensure that force, restraints and isolation could not be used for the purpose of disciplining a young person in detention.

“The new amendments provide clarity by removing ambiguities in the Act to ensure that youth detention staff can better respond to serious and dangerous incidents. Laws often need adjusting to reflect operational realities

Minister for Territory Families, Dale Wakefield Read Full Press release Part 2 Below 

Part 1

Mr Paterson, said “The Minister has been misleading and disingenuous in her speeches and answers to the limited questioning that was allowed in the Legislative Assembly. Despite the Minister’s assertions, these amendments are not mere technical clarifications.

They are substantive changes that erode the small improvements that were made in 2018 in response to the Royal Commission.

They will allow harsh treatment of young people in detention to continue unopposed and unscrutinised.”

WATCH TV NEWS COVERAGE

Mr Paterson said that the Bill passed this afternoon with no scrutiny, is clearly intended to retrospectively make lawful, actions that were unlawful under the law as it existed until today. “We must ask ourselves whether this unseemly and undemocratic haste is intended to defeat legal actions currently on foot by young people who believe their treatment in detention has been unlawful.

Does the government know that unlawful treatment occurred and is now seeking to avoid accountability? It is difficult to draw any other conclusion despite the Minister’s obfuscation in the Assembly” said Mr Paterson.

AMSANT believes that the harsh treatment of young people now permitted under the law will lead to increased tensions and incidents in detention. When the next major incident occurs, the government, not the young people, must be held to account. “Let’s not forget” said Mr Paterson “that a large proportion of young people in detention have significant cognitive disabilities.

The government is condoning the use of restraint, isolation and physical force against young people with disabilities because they do not have the capacity to comply with the demands of the detention environment.

Right now, young people are being restrained in handcuffs and waist shackles to simply walk from one part of Don Dale to another under the control of a guard.”

“AMSANT is disgusted by this behaviour by a government and calls on the Chief Minister to withdraw this legislation prior to it receiving the assent of the Administrator. To do otherwise is to walk away from the Royal Commission recommendations.” said Mr Paterson. Mr Paterson seeks to remind the Chief Minister of his words and apparent distress when he responded to the Royal Commission.

The Chief Minister said in November 2017, “Our youth justice and child protection systems are supposed to make our kids better, not break them, they are supposed to teach them to be part of society, not withdraw”. “This legislation is not consistent with that statement”, Mr Paterson concluded

Protestor at Alice Springs Market yesterday 

1.2 Youth Justice Amendment Bill a return to the bad old days!

Aboriginal Medical Services Alliance of the Northern Territory (AMSANT) Chief Executive Officer, John Paterson, today called on the Chief Minister to halt the progress of the Youth Justice Amendment Bill 2019 through the Legislative Assembly until Aboriginal people and organisations have the chance to have a say.

“The government talks proudly about its commitment to Aboriginal led solutions, to co-design and to collaboration” said Mr Paterson.

“So why was this Bill kept from those who are part of those solutions and collaborations until the moment it was introduced into the Parliament?”

“The Minister has said the Bill simply clarifies technical matters and keeps faith with 2018 amendments.” Mr Paterson said.

“The Bill goes far beyond that. It undoes the positive progress in the 2018 changes which were a start in implementing the Royal Commission recommendations. The government consulted with Aboriginal organisations and other youth advocates and we supported the 2018 amendments.”

Mr Paterson said that this Bill is a u-turn on the progress in 2018. It does not reflect the Royal Commission recommendations or the Government’s previous policy position to accept and implement those recommendations.

“These amendments bring back the draconian treatment of young people and will see children restrained and isolated at the discretion of detention staff. Far from reducing ambiguity as the Minister claims, the amendments reintroduce ambiguity with subjective definitions and powers.”

Mr Paterson also questioned the need for retrospective effect of these amendments. “The only reason for retrospective effect is to legalise actions that were illegal when they were taken.” AMSANT said that the safety of both staff and young people is important and called on the government to work with Aboriginal organisations and other experts to explore the safety concerns and solutions. The government needs to think more carefully about the way forward. “

If the workforce cannot safely deliver a detention system under current laws which give quite considerable powers over the young people, the government needs to look at the skills, training and support of the workforce to ensure that they can. Attacking the human rights of young people is not the solution” Mr Paterson emphasised.

Mr Paterson noted that under the Diagrama Foundation which runs 70% of youth detention in Spain, for example, highly qualified staff with expertise in youth development, trauma and de-escalation work with young people in a therapeutic way that does not involve restraint, force and isolation. “Diagrama facilities rarely experience incidents of the kind seen last year at Don Dale.

Mr McGuire from Diagrama told audiences in Darwin last year that it is at least 10 years since there was a significant incident at a Diagrama facility. And Diagrama experiences a reoffending rate of only 20% across all its residents compared to 80% in the NT.”

Part 2

Passage of Youth Justice Act Amendments to Manage Security

Risks in the Territory’s Youth Detention Centres

March 2019

Today the Territory Labor Government passed amendments to the Youth Justice Act which will clarify and tighten the existing framework for managing safety and security risks within the youth detention centres.

The amendments will provide youth detention centre staff with a clear and unambiguous framework for exercising their powers, and will enable them to have a very clear guideline in their decision making when responding to dangerous and challenging situations.

The amendments include:

  • Clarify the circumstances in which force and restraints may be used, to account for situations where detainees mayact in a way that threatens the safety or security of a detention centre, but not in a way that presents an imminent risk
  • Create a consistent test to determine what is a reasonable use of force and restraints
  • Clarify the meaning of an emergency situation, which is relevant to the general application of all uses of force • Clarify the definition of separation
  • Enable screening and pat down searches of detainees in a broader range of circumstances
  • Include an express power to transfer a detainee from one detention centre to another

The amendments will remove any uncertainty around the operation of existing powers in the legislation, for both youth detention centre staff and detainees.

The amendments will apply retrospectively to the date in which the original provisions of the Act commenced (May 2018). This will remove any doubt about the original intention of these key provisions in the legislation.

NACCHO Aboriginal Health and #SuicidePrevention News Alerts : #Closethegap : #NACCHO and @TheRACP Peak Health bodies call for Prime Minister and state and territory leaders to declare Aboriginal youth #suicide crisis an urgent national health priority

The recent Aboriginal youth suicides represent a national emergency that demands immediate attention.

Aboriginal community controlled health services need to be properly resourced to ensure our children are having regular health checks and to develop community led solutions.’

NACCHO CEO, Ms Patricia Turner : See NACCHO RACP press release : see Part 1 below

See all 130 + NACCHO Aboriginal Health and Suicide Prevention articles published over last 7 years 

“Funded programs are not required to demonstrate a measurable reduction in suicide and mental health risk factors, which is staggering,

We just aren’t demanding that basic level of accountability

The first priority must be analyses of suicide mortality data to identify the causal pathways,  

Suicide risk is the most complex thing to assess and monitor … communities are crying out for specialist assistance and just not getting it. “Children as young as 10 are dying by suicide … this is no longer an Aboriginal issue, it’s a national one,

Indigenous psychologist Adjunct Professor Tracy Westerman said Australia had failed to collect crucial evidence to determine what intervention strategies work. See Part 2 below 

 ” Community driven action plans to prevent suicide are extending across the Kimberley, with four more communities implementing plans to save lives and improve health and well-being.

As part of the Kimberley Aboriginal Suicide Prevention Trial, Kununurra, Balgo, Wyndham and Halls Creek now have local plans, joining Broome, Derby and Bidyadanga.

Each community receives up to $130,000 to help roll out its action plan which reflects and responds to local issues

See Minister Ken Wyatt Press Release and Communique Part 3 and 4 Below

Part 1 RACP and NACCHO Press Release

JOINT STATEMENT

HEALTH BODIES DECLARE ABORIGINAL YOUTH SUICIDE AN URGENT NATIONAL PRIORITY

  • Health bodies call for Prime Minister and state and territory leaders to declare urgent national health priority
  • Immediate investment in Aboriginal-led mental health and wellbeing services needed to stop child deaths
  • Long-term solution of Aboriginal and Torres Strait Islander self-determination requires commitment to Uluru Statement from the Heart

The Royal Australasian College of Physicians (RACP), the Royal Australian and New Zealand College of Psychiatrists (RANZCP) and the National Aboriginal Community Controlled Health Organisation (NACCHO) are calling on the Prime Minister to make tackling Aboriginal and Torres Strait Islander youth suicides a national health priority.

Suicide was once unknown to Aboriginal and Torres Strait Islander peoples but now every community has been affected by suicide.

In response to the recent Aboriginal youth suicides and the release of the WA Coroner’s report on the inquest into the deaths of thirteen children and young persons in the Kimberley Region, we are calling on the Prime Minister and state and territory leaders to put the issue at the top of the COAG agenda and to implement a coordinated crisis response to urgently scale up Aboriginal led mental health services before more young lives are tragically lost.

An urgent boost to Aboriginal community controlled health services is required to build on the existing range of initiatives that are being rolled out. We also call on the Government to expand upon evidence-based resilience and cultural connection programs to be adapted and attuned to local needs.

We are calling on the Federal Government to:

  • Provide secure and long-term funding to Aboriginal community controlled health services to expand their mental health, social and emotional wellbeing, suicide prevention, and alcohol and other drugs services, using best-practice traumainformed approaches
  • Increase funding for ACCHSs to employ staff to deliver mental health and social and emotional wellbeing services, including psychologists, psychiatrists, speech pathologists, mental health workers and other professionals and workers;
  • Increase the delivery of training to Aboriginal health practitioners to establish and/or consolidate skills development in mental health care and support, including suicide prevention
  • Commit to developing a comprehensive strategy to build resilience and facilitate healing from intergenerational trauma, designed and delivered in collaboration with Aboriginal and Torres Strait Islander communities

RACP spokesperson Dr Mick Creati, said: “The unspeakable child suicide tragedy that has been unfolding requires a national response and the attention of the Prime Minister. Unless we see urgent boost to investment in Aboriginal-led mental health services then the deaths will continue.”

RANZCP President Dr Kym Jenkins, said: ‘We must address the factors underlying suicidality in Aboriginal and Torres Strait Islander communities, including intergenerational trauma, disadvantage and distress. For this, we urgently need an increased capacity of mental health and wellbeing services to help people and communities recover from trauma and build resilience for the future.’

Part 2 Leaders urged to declare Aboriginal child suicides a ‘national crisis’

 Kate Aubusson From the Brisbane Times 20 March 

Prime Minister Scott Morrison must declare Indigenous child suicides a national emergency and overhaul current strategies, peak medical and health bodies have demanded.

The call comes in the wake of harrowing Aboriginal and Torres Strait Islander child suicide rates, and the WA coroner’s inquest into the deaths of 13 young people, five aged between 10 and 13 years in the Kimberley region.

A joint statement from the Royal Australasian College of Physicians (RACP), the Royal Australian and New Zealand College of Psychiatrists (RANZCP) and the National Aboriginal Community Controlled Health Organisation (NACCHO) has urged Mr Morrison and all state and territory leaders to make Indigenous youth suicides an “urgent national health priority”.

The organisations called on the leaders to launch a “coordinated crisis response” and invest in Aboriginal-led strategies “before more young lives are tragically lost”.

In January, five Aboriginal girls aged between 12 and 15 years took their own lives.

The latest ABS data shows Indigenous children aged 10 to 14 die of suicide at 8.4 times the rate of non-Indigenous children. One in four aged under 18 who suicided were Aboriginal.

None of the 13 children who died by suicide had a mental health assessment, according to the coroner’s report.

The international journal The Lancet Child and Adolescent Health recently called Australia’s Indigenous youth suicide rate an “unmitigated crisis”.

NACCHO CEO Pat Turner said the recent Aboriginal youth suicides was “a national emergency that demands immediate attention”.

The joint statement called for Indigenous community-led solutions, long-term funding boosts to Aboriginal Community Controlled Health Services (ACCHS) for best-practice and trauma-informed mental health, suicide prevention, and drug and alcohol programs.

The organisations also pushed for more ACCHS funding to employ more psychologists, psychiatrists, speech pathologists and mental health workers, increase training for Aboriginal health practitioners to develop a comprehensive strategy focused on resilience and intergenerational trauma healing.

In September the Morrison government announced $36 million in national suicide prevention projects.

Paediatrician with Victorian Aboriginal Health Service Dr Mick Creati said Indigenous suicides could not be prevented by a “white bread psychiatry model”.

Aboriginal suicides were often radically different from those among the general population, research shows. They were more likely to be impulsive, potentially triggered by some kind of interpersonal conflict.

The crisis demanded a “different, culturally appropriate model”, Dr Creati said.

“We don’t know exactly what the right model is yet … but Aboriginal people need to be included [in their development] to make sure they are appropriate for Aboriginal populations.”

But Indigenous psychologist Adjunct Professor Tracy Westerman said Australia had failed to collect crucial evidence to determine what intervention strategies work.

“Funded programs are not required to demonstrate a measurable reduction in suicide and mental health risk factors, which is staggering,” Professor Westerman said.

“We just aren’t demanding that basic level of accountability”.

The first priority must be analyses of suicide mortality data to identify the causal pathways,  Professor Westerman said.

“Suicide risk is the most complex thing to assess and monitor … communities are crying out for specialist assistance and just not getting it. “Children as young as 10 are dying by suicide … this is no longer an Aboriginal issue, it’s a national one,” she said.

Part 3 The eighth meeting of the Kimberley Suicide Prevention Trial Working Group was held on 14 March in Broome communique

The Working Group discussed the findings of WA Coroner’s Report into suicide deaths in the Kimberley and continued its consideration of resources and strategies to support activity as part of the suicide Prevention trial.

The meeting today was chaired by the Hon Ken Wyatt, Minister for Indigenous Health (Commonwealth) and attended by the Hon Roger Cook, Deputy Premier and Minister for Health (WA State Government), Senator the Hon Patrick Dodson (Commonwealth) and Member for the Kimberley, the Hon Josie Farrer MLC (WA State Government). Apologies were received from the Hon Ben Wyatt, Minister for Indigenous Affairs (WA State Government).

The meeting was also attended by over 40 representatives from communities, organisations and government agencies.

Key messages from today’s discussion included:

  • A shared commitment to work together at all levels of government to develop place-based, and Aboriginal-led and designed responses.
  • A commitment to ongoing collaboration.
  • Acknowledgement of the good work achieved thus far – but noting more needs to be done.
  • The role of the community liaison officers on the ground across Kimberley communities was highlighted as an example of good progress – connecting services and projects with what people want.
  • The need to continue mapping services was agreed.
  • The need for holistic approaches was highlighted.
  • Community organisations are keen to work with the State and Commonwealth Governments on solutions that address the recommendations in relation to the report of the WA Coronial Inquest and all other referenced reports.

Part 4 Minister Wyatt Press release

Community driven action plans to prevent suicide are extending across the Kimberley, with four more communities implementing plans to save lives and improve health and well-being.

As part of the Kimberley Aboriginal Suicide Prevention Trial, Kununurra, Balgo, Wyndham and Halls Creek now have local plans, joining Broome, Derby and Bidyadanga.

Each community receives up to $130,000 to help roll out its action plan which reflects and responds to local issues.

However, the four new plans have a common thread – they are centred on people working and walking together on country, with a series of camps involving high-risk groups.

The camps are planned to provide a range of supports around suicide including healing and sharing and respecting cultural knowledge and traditions. They will also support close engagement with Elders.

A strong cultural framework underpins all the Trial’s activities and all the projects identified by the communities fit within the systems-based approach, guided by the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project (ATSISPEP).

Nine communities are involved in the Kimberley Aboriginal Suicide Prevention Trial, with Community Liaison Officers playing a critical role.

The outcomes will contribute to a national evaluation which aims to find the most effective approaches to suicide prevention for at-risk populations and share this knowledge across Australia.

The Morrison Government is supporting the Kimberley Aboriginal Suicide Prevention Trial with $4 million over four years, from 2016-2020.

It is one of 12 Suicide Prevention Trials being conducted across the nation, with total funding of $48 million.

NACCHO Aboriginal Health and Alcohol @FAREAustralia : Overcoming #Indigenous #FamilyViolence. Download new study from @marcialangton #unimelb where experts find success in Alcohol Management Plans but fear government failure to understand the magnitude of the alcohol problem

Our research found that average annual hospital admissions for assault fell from 32.25 per 1,000 people to 5.7 over 11 years, in line with tightening alcohol supply restriction,

We’ve identified propositions for better AMP outcomes long-term, through realistic financial support and stronger community-led governance “

The Associate Provost and Chair of Australian Indigenous Studies, Professor Marcia Langton, who co-authored the paper, says since the AMP was introduced there has been a reduction in violent assaults and the severity of family violence across the traditional lands of the Thaayorre and Mungkan peoples on the western coast of Cape York Peninsula

Paper Title: The Alcohol Management Plan at Pormpuraaw, Queensland, Australia: An ethnographic community-based study

Download Alcohol Management Plan Melbourne Uni

Authors: Kristen Smith, Marcia Langton, Richard Chenhall, Penelope Smith & Shane Bawden

Read over 200 NACCHO Aboriginal Health Alcohol and Other Drug articles published over pst 7 years 

Alcohol Management Plans (AMPs), including one that has helped dramatically reduce violent assault rates in the remote Indigenous community of Pormpuraaw in far north Queensland, are under threat.

Coinciding today with the 5th Annual Overcoming Indigenous Family Violence Forum in Melbourne, University of Melbourne researchers have released a new study on the successes and challenges of the Pormpuraaw AMP.

While the dramatic drop in hospital admissions showed the AMP was working extremely well, Foundation for Alcohol Research and Education (FARE) Chief Executive Michael Thorn is concerned that AMPs are under threat and riddled with problems stemming from government inertia.

Mr Thorn said the Pormpuraaw AMP study highlighted the need for genuine government investment overseen by a strong national alcohol strategy for protecting children, women, families and communities from alcohol harms.

“The good news is that an AMP can be an effective tool to significantly reduce alcohol harm, including family violence. But there’s a gulf between the well-intended rhetoric of governments to address harms in Indigenous communities and the unrealistic, unsustainable government action on the ground,” Mr Thorn said.

The University of Melbourne in-depth, community-based study investigated how AMP controls, restrictions and responses are understood and managed with Australian Aboriginal communities.

Research Fellow and lead author of the paper, Dr Kristen Smith, says most community members in

Pormpuraaw welcomed the reduced violence and community disharmony.

“There is strong community commitment to ‘place-based’ programs, but there are many issues that are being experienced in the community which are not being addressed,” Dr Smith said.

Dr Smith said the biggest concern was government failure to understand the magnitude of the alcohol problem and therefore underestimate resourcing.

“Underfunding is compounded over time through erratic political and policy decisions that fail to reliably meet the community’s needs for treatment services or address issues such as ‘sly-grogging’, gambling and criminalisation,” she said.

Professor Langton said the AMPs were too vulnerable to political and policy instabilities to ensure their long-term success. “We’ve identified propositions for better AMP outcomes long-term, through realistic financial support and stronger community-led governance,” she said.

NACCHO Aboriginal Children’s Health : #SaltAwarenessWeek #UnpackTheSalt #EatLessSalt @georgeinstitute Report : Which fast #junkfood giants packs the most amount of salt in your kids’ meal?

New research has revealed the hidden toll that fast food kids’ meals can have on young children’s health. Some meals aimed at kids contain more than an entire day’s maximum recommended salt intake.

Most disturbing, the salt content of fast foods like chicken nuggets in Australia can be more than twice as salty as similar meals in the UK.

A new report from The George Institute for Global Health, VicHealth and the Heart Foundation analysed the salt content in kids’ meals from four major fast food outlets (Hungry Jack’s, KFC, McDonald’s and Subway) as part of a global push to reduce the salt content in children’s food during World Salt Awareness Week.

Originally Published HERE 

The report found high levels and a huge variation in the salt content of children’s meals across the four chains. A kids’ chicken nuggets meal from Hungry Jack’s contained more than an entire day’s worth of salt for a 4-8 year old child, a McDonald’s Cheeseburger Happy Meal with fries contained almost two thirds of a day’s worth of salt, and a KFC Kids Meal Snack Popcorn contained almost half a days’ worth of salt.

Subway Kids’ Paks were the least salty meal options, providing mini subs and purees rather than burgers with chips. All of their meals were found to be in the top five lowest salt kids’ meal options and contained one gram of salt or less per meal.

Meals with fries were among the saltiest options. McDonalds was the only chain that provided apple slices, yoghurt and cherry tomatoes as an option, instead of fries.

Heart Foundation dietitian Sian Armstrong said while none of the popular meals are healthy options, it was concerning to see some kids’ meals containing more than an entire day’s worth of salt.

“An alarming 80 per cent of Aussie kids are eating too much salt with most of it coming from processed food and fast food takeaways,” Ms Armstrong said.

“Consuming excess salt can lead to high blood pressure, a major risk for heart attack, stroke and kidney disease. Studies suggest that children with elevated blood pressure may go onto suffer it as adults.

“Most parents know that fast food isn’t a healthy option for their kids, however they may not realise that a single kids’ meal could blow out an entire day’s salt intake.

“This research shows fast food doesn’t have to be this salty. There is no reason why chicken nuggets at KFC and Hungry Jack’s should be almost twice as salty as the chicken nuggets from McDonald’s. The same goes for fries. Fast food outlets can and must reduce the salt content of their meals.”

Read over 100 NACCHO Aboriginal Health and Nutrition articles HERE 

Key findings:

  • The average salt content of children’s meals across the four outlets was 1.57g of salt or 45% of a child’s recommended daily salt intake.
  • The highest salt children’s meal was the Hungry Jack’s 6 Chicken Nugget Kids’ pack (includes a dipping sauce and small chips), which contained 3.78g salt or 108% of a 4-8-year-old child’s recommended daily salt intake.
  • The lowest salt children’s meal was the Subway Kids’ Pak Veggie Delite Mini Sub, (includes a mini-sub and SPC puree snack), which contained 0.44g salt or 13% of a 4-8-year-old child’s daily recommended salt intake.
  • McDonald’s is the only fast-food outlet offering fresh fruit (apple slices) and vegetables (grape tomatoes) with the Kids Meal packs.
  • Within the retailers, there was a range in salt levels for children’s meals. For example, a McDonald’s Happy Meal containing 3 chicken nuggets, apple slices and water contains 16% of a 4-8-year-old child’s salt intake, whereas the saltier option of a cheeseburger, fries and water contains 66% of a 4-8-year-old child’s salt intake.
  • There are huge variations in the same product at the different outlets; a 6 pack of chicken nuggets from KFC and Hungry Jack’s contained twice as much salt as 6 pack of chicken nuggets from McDonald’s
  • The UK set salt targets for takeaway kids’ meals of less than 1.8 grams of salt per meal. Thirty per cent of the meals analysed in this report exceeded this target. All Subway products met this target.

The George Institute’s Public Health Nutritionist and the report’s lead author Clare Farrand said it was clear there needed to be more regulation on fast food outlets to make their products healthier.

“It is unacceptable that some children’s meals in Australia are significantly saltier than similar meals purchased in the UK,” Ms Farrand said.

“Hungry Jack’s 6 pack nugget meal was 1.5 times saltier in Australia than in the UK and McDonald’s 6 pack nugget meal was a whopping 1.7 times saltier.”

“The fact that some companies produce the same foods with a lot less salt in the UK demonstrates that they can, and should for all countries.”

“We know that some companies are doing better than others – all of the Subway kids’ meals meet the UK targets – but clearly more needs to be done to reduce the salt content across the board.”

VicHealth dietitian Jenny Reimers said when it comes to kids’ meals it was time for fast food outlets to make the default choice the healthier option.

“Kids aren’t born craving salty food – we develop this taste preference based on exposure so it’s really important parents limit the amount of salty food their kids eat,” Ms Reimers said.

“Fast food really should be occasional treats, yet the average family has takeaway almost once a week. If you’re going to have takeaway foods, try less salty options with fresh fruit and vegetables included.

“While it’s encouraging that some fast food outlets are including fresh fruit and vegies as options in their kids’ meals this should be the default and it should be offered at all restaurants.”

Tips for consumers:

  • Limit fast food – these discretionary foods should only be eaten in small amounts as a treat every now and again
  • If you are eating fast food, try to choose options with fruit and vegetables as these are likely to be lower in salt
  • Parents looking to lower their family’s salt intake can sign up to the Unpack Your Lunch 10-Day Salt Challengewhere they will receive tips to reduce salt, blogs and low salt recipes.

About the Victorian Salt Reduction Partnership

The Victorian Salt Reduction Partnership was established in 2014 in response to alarming high levels of salt consumption by the Victorian public.

The partnership comprises of peak public health organisations: VicHealth, Heart Foundation, The George Institute for Global Health, Deakin University Institute for Physical Activity and Nutrition (IPAN), National Stroke Foundation, Kidney Health Australia, The Victorian Department for Health and Human Services, Baker Heart and Diabetes Institute, Food Innovation Australia Ltd, CSIRO and the High Blood Pressure Research Council.

Australia is committed to meeting the World Health Organization’s target of 30 percent reduction in average population salt intake by 2025. To achieve this, the partnership has developed a comprehensive set of actions aimed at gaining consensus and commitment for salt reduction action from governments, public and industry in Victoria.

NACCHO and @RACGP Aboriginal Women’s Health and #FamilyViolence : How to identify and provide early intervention for victims and perpetrators.

About four in 10 women who were physically injured [as a result of family violence] visited a health professional for their injuries
 
This information [from the report] offers important insights for those involved in family and domestic violence policy, as well as organisations which provide services for Aboriginal and Torres Strait Islander peoples, aimed at preventing violence and supporting those affected by violence.’

ABS Director of the Centre of Excellence for Aboriginal and Torres Strait Islander Statistics, Debbie Goodwin said.

 ” Chapter 16 of the RACGP NACCHO National Guide : ‘Family abuse and violence’, provides key recommendations on prevention interventions – screening, behavioural and environmental.

These recommendations aim to support healthcare professionals to develop a high level of awareness of the risks of family abuse and violence, and how to identify and provide early intervention for victims and perpetrators.”

National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people (

Published by NewsGP Morgan Liotta

The report forms part of the Australian Bureau of Statistics’ (ABS) publication National Aboriginal and Torres Strait Islander Social Survey, 2014–15 and compares sociodemographic factors of Aboriginal and Torres Strait Islander women who experienced family violence with those who did not in the year prior to the 2014–15 survey.

Key findings show that, among Aboriginal and Torres Strait Islander populations, around two in three women (72%) compared with one in three men (35%) were likely to identify an intimate partner or family member as at least one of the perpetrators in their most recent experience of physical violence.

Approximately one in 10 Aboriginal and Torres Strait Islander women experienced family violence based on their most recent experience of physical violence.

Almost seven in 10 (68%) women who had experienced family violence reported that alcohol and/or other substances contributed to the incident:

  • More than half of women (53%) who had experienced family violence reported alcohol (by itself or with other substances) was a contributing factor
  • More than one in 10 (13%) reported that other substances alone were a contributing factor

When compared with Aboriginal and Torres Strait Islander women who had not experienced any physical violence, those who had were:

  • more likely to report high or very high levels of psychological distress (69% compared with 34%)
  • more likely to have a mental health condition (53% compared with 31%)
  • more likely to report they had experienced homelessness at some time in their life (55% compared with 26%)
  • less likely to trust police in their local area (44% compared with 62%)
  • just as likely to trust their own doctor (77% compared with 83%)

The report underlines the role of GPs’ support for such people.

GP resources

  • The RACGP and the National Aboriginal Community Controlled Health Organisation (NACCHO)’s National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people (National Guide), Chapter 16: ‘Family abuse and violence’, provides key recommendations on prevention interventions – screening, behavioural and environmental. These recommendations aim to support healthcare professionals to develop a high level of awareness of the risks of family abuse and violence, and how to identify and provide early intervention for victims and perpetrators.
  • The RACGP’s Abuse and violence: Working with our partners in general practice (White book), Chapter 11: ‘Aboriginal and Torres Strait Islander violence’, outlines statistics and recommendations for healthcare professionals to show leadership at a community level through local organisations by advocating for provision of services that meet the needs of Aboriginal and Torres Strait Islander peoples experiencing family violence.

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 #MentalHealth and #JunkFood : Increasing how much exercise we get and switching to a healthy diet can also play an important role in treating – and even preventing – depression

” The review found that across 41 studies, people who stuck to a healthy diet had a 24-35% lower risk of depressive symptoms than those who ate more unhealthy foods.

These findings suggest improving your diet could be a cost-effective complementary treatment for depression and could reduce your risk of developing a mental illness.

From the Conversation / Megan Lee

 ” NACCHO Campaign 2013 : Our ‘Aboriginal communities should take health advice from the fast food industry’ a campaign that eventually went global, reaching more than  20 million Twitter followers.”

See over 60 NACCHO Healthy Foods Articles HERE

See over 200 NACCHO Mental Health articles HERE 

Worldwide, more than 300 million people live with depression. Without effective treatment, the condition can make it difficult to work and maintain relationships with family and friends.

Depression can cause sleep problems, difficulty concentrating, and a lack of interest in activities that are usually pleasurable. At its most extreme, it can lead to suicide.

Depression has long been treated with medication and talking therapies – and they’re not going anywhere just yet. But we’re beginning to understand that increasing how much exercise we get and switching to a healthy diet can also play an important role in treating – and even preventing – depression.

So what should you eat more of, and avoid, for the sake of your mood?

Ditch junk food

Research suggests that while healthy diets can reduce the risk or severity of depression, unhealthy diets may increase the risk.

Of course, we all indulge from time to time but unhealthy diets are those that contain lots of foods that are high in energy (kilojoules) and low on nutrition. This means too much of the foods we should limit:

  • processed and takeaway foods
  • processed meats
  • fried food
  • butter
  • salt
  • potatoes
  • refined grains, such as those in white bread, pasta, cakes and pastries
  • sugary drinks and snacks.

The average Australian consumes 19 serves of junk food a week, and far fewer serves of fibre-rich fresh food and wholegrains than recommended. This leaves us overfed, undernourished and mentally worse off.

Here’s what to eat instead

Mix it up. Anna Pelzer

Having a healthy diet means consuming a wide variety of nutritious foods every day, including:

  • fruit (two serves per day)
  • vegetables (five serves)
  • wholegrains
  • nuts
  • legumes
  • oily fish
  • dairy products
  • small quantities of meat
  • small quantities of olive oil
  • water.

This way of eating is common in Mediterranean countries, where people have been identified as having lower rates of cognitive decline, depression and dementia.

In Japan, a diet low in processed foods and high in fresh fruit, vegetables, green tea and soy products is recognised for its protective role in mental health.

How does healthy food help?

A healthy diet is naturally high in five food types that boost our mental health in different ways:

Complex carbohydrates found in fruits, vegetables and wholegrains help fuel our brain cells. Complex carbohydrates release glucose slowly into our system, unlike simple carbohydrates (found in sugary snacks and drinks), which create energy highs and lows throughout the day. These peaks and troughs decrease feelings of happiness and negatively affect our psychological well-being.

Antioxidants in brightly coloured fruit and vegetables scavenge free radicals, eliminate oxidative stress and decrease inflammation in the brain. This in turn increases the feelgood chemicals in the brain that elevate our mood.

Omega 3 found in oily fish and B vitamins found in some vegetables increase the production of the brain’s happiness chemicals and have been known to protect against both dementia and depression.

Salmon is an excellent source of omega 3. Caroline Attwood

Pro and prebiotics found in yoghurt, cheese and fermented products boost the millions of bacteria living in our gut. These bacteria produce chemical messengers from the gut to the brain that influence our emotions and reactions to stressful situations.

Research suggests pro- and prebiotics could work on the same neurological pathways that antidepressants do, thereby decreasing depressed and anxious states and elevating happy emotions.

What happens when you switch to a healthy diet?

An Australian research team recently undertook the first randomised control trial studying 56 individuals with depression.

Over a 12-week period, 31 participants were given nutritional consulting sessions and asked to change from their unhealthy diets to a healthy diet. The other 25 attended social support sessions and continued their usual eating patterns.

The participants continued their existing antidepressant and talking therapies during the trial.

At the end of the trial, the depressive symptoms of the group that maintained a healthier diet significantly improved. Some 32% of participants had scores so low they no longer met the criteria for depression, compared with 8% of the control group.

The trial was replicated by another research team, which found similar results, and supported by a recent review of all studies on dietary patterns and depression. The review found that across 41 studies, people who stuck to a healthy diet had a 24-35% lower risk of depressive symptoms than those who ate more unhealthy foods.

These findings suggest improving your diet could be a cost-effective complementary treatment for depression and could reduce your risk of developing a mental illness.

 

NACCHO Aboriginal Children’s Health : Aboriginal and Torres Strait Islander children are almost twice as likely to be hospitalised for unintentional injuries such as falls, burns and poisoning than non-Aboriginal children, a new study has shown.

“Aboriginal Community Controlled Organisations have an important role in helping reduce the risk of Aboriginal child injury because they engage with Aboriginal people within local community contexts and deliver holistic programs that address underlying health and social issues.

There also needs to be much stronger leadership and coordination of child injury prevention from government and other agencies.”

Co-author Professor Kathleen Clapham, Murrawarri, Professor (Indigenous Health), Australian Health Services Research Institute (AHSRI), University of Wollongong, pointed out that at the present time very few culturally acceptable injury prevention programs have been developed or evaluated.

Download Report 

Full Study Childhood Injury (1)

Read over 350 Aboriginal Children’s Health articles published by NACCHO over past 7 years 

Aboriginal and Torres Strait Islander children are almost twice as likely to be hospitalised for unintentional injuries such as falls, burns and poisoning than non-Aboriginal children, a new study has shown.

The analysis also revealed that there had been no overall improvement in injury rates since 2003 and that the gap between Aboriginal and non- Aboriginal children remained significant.

Researchers from The George Institute for Global Health, UNSW and the University of Wollongong said the findings highlighted the need for Aboriginal-led intervention programs.

The study published in the Australian and New Zealand Journal of Public Health analysed the records of almost one million children born in NSW hospitals between 2003-2007 and 2008-2012, of which around three per cent identified as Aboriginal.

View Research Paper HERE

Lead researcher Dr Holger Möller said:

“If you are an Aboriginal child you are much more likely to suffer an unintentional injury such as a burn, and this is despite nationwide safety campaigns and legislation. Children should not be turning up at our hospitals with preventable injuries and we need to recognise this inequality and put in place strategies that will start reducing this startling difference.”

Key Findings

  • Researchers found Aboriginal children were around 2.5 times more likely to have been treated for transport-related injuries and burns and have a three times greater risk of poisonings than non-Aboriginal children. However, rates for these three types of injury did drop for both Aboriginal and non-Aboriginal children.
  • The records of 915,525 children born in NSW hospitals 2003-2007 and 2008-2012 were analysed, of which 31,290 were Aboriginal.
  • Aboriginal children had 1.7 times higher rates of unintentional injuries.
  • Falls were the leading cause of injury in Aboriginal children – making up one third of all injuries.
  • Rates of burns, poisonings and transport injuries did fall for Aboriginal children from 2003 to 2012 – by 30%, 23% and 30% respectively.
  • The rates of Aboriginal children being struck (for example by a falling object) rose by 29%.

Professor Rebecca Ivers, Head, School of Public Health and Community Medicine, UNSW Sydney, added:

“There were some positives in our findings, but the fact is the gap between Aboriginal and non-Aboriginal children remains the same. This demonstrates we need programs which are designed with, and led by, Aboriginal people and supported by governments.

“We need to create a society where all children have a safe environment to thrive in, so we need strategies that will address the wider social determinants of health and ensure Aboriginal families can access services and programs that could really make a difference.”

 

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