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

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

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

Download the AIHW Report HERE aihw-cdk-12

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

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

AIHW Website for more info 

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

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

Download Press Release Here : australianchronicdiseasepreventionalliance

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

AIHW Press Release

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

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

Above image NACCHO Library

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

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

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

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

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

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

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

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

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

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

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

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

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

Underlying causes of socioeconomic inequalities in health

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

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

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

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

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

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

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

Summary

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

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

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

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

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

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

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

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

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

Part 2

 

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

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

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

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

This article was originally published HERE 

Part 1 NACCHO Policy

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

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

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

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

Access to healthy and fresh foods in remote Australia

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

From NACCHO Submission Read here 

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

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

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

Read Article HERE

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

Source: ABS and AIHW analysis of 2012–13 AATSIHS

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

What is chronic disease?

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

How is obesity linked to chronic disease?

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

Type 2 diabetes and obesity:

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

Obstructive sleep apnoea and obesity:

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

A woman preparing vegetables for a meal

Cancer and obesity:

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

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

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

1. Eat more fruit and veg

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

2. Limit our alcohol consumption

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

3. Get moving

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

Two women exercising in a park together

4. Buddy up

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

5. Prioritise sleep

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

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

Let’s start today!

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

NACCHO Aboriginal Health @IndigenousPHAA #Prevention : Download @_PHAA_ Report : Saving lives a million at a time: Australia’s #top10publichealth successes over the last 20 years

As we edge closer to the federal election, it’s critical our parties consider what public health successes we must achieve next, and how they can lead on issues such as Aboriginal and Torres Strait Islander health, obesity, nutrition, environmental and ecological issues such as climate change, and advancing health equity.”

PHAA CEO Terry Slevin

Today the Public Health Association Australia (PHAA) launched its new report, the Top 10 Public Health Successes Over the Last 20 Years at Australian Parliament House.

PHAA CEO Terry Slevin stated, “Public health initiatives have prevented an extraordinary amount of ill health and death in our communities – there is a saying in our field that nurses and doctors save lives, and public health professionals also save lives – they just do so a million at a time.”

The report has been compiled by Australia’s leading public health experts, and the top ten achievements are presented in no particular order as they are all considered to have been of equal importance to Australian public health.

The top ten public health successes include:

  • Folate: reduced neural tube defects
  • Immunisation and eliminating infectious disease
  • Containing the spread of HPV and its related cancers
  • Oral health: reduced dental decay
  • Reduced incidence of skin cancer
  • Tobacco control: reduced deaths caused by smoking
  • Reduced the road death and injury toll
  • Gun control: reduced gun deaths in Australia
  • Contained the spread of HIV
  • Prevented deaths from bowel and breast cancer

Download the PHAA report HERE 

PHAA Top 10 Public Health Successes_FINAL

“This report paints a clear picture of exactly which programs and initiatives have had the greatest impact – from cancer screening to vaccines, from road safety to tobacco control. These have all saved thousands of lives and protected the health of millions of Australians.”

“Public health is about preventing or minimising harm – it is always better than cure. We aim to intervene before illness, death or injury occurs, creating safe and healthy environments for all Australians. This is why in public health, we’re for birthdays,” Mr Slevin said.

“We aspire to give Australians more birthdays (five more for each person is our starting goal) and other important celebrations – weddings, births, graduations – all of the significant milestones we value in life. Perhaps most importantly, we want Australians to be healthy enough to really enjoy these extra years and milestones,” Mr Slevin said.

“So the next question we ask is, who will be the policy leaders and decision makers to help us achieve this aspiration? The report acknowledges key decision makers at the federal, state and territory government levels who were instrumental in making the top ten public health successes happen.”

“As we edge closer to the federal election, it’s critical our parties consider what public health successes we must achieve next, and how they can lead on issues such as Aboriginal and Torres Strait Islander health, obesity, nutrition, environmental and ecological issues such as climate change, and advancing health equity.”

The UK has just released a new preventive health vision statement proving that western conservative governments can prioritise prevention. This is key not just because it is the most effective form of public health practice, but also the most economically sound.

“Preventive public health measures are often cheap to implement and more than pay for themselves through reduced health care costs and increased productivity through keeping people out of hospitals.”

“Public health investment in Australia currently amounts to less than 2% of the national health budget, and has been generally declining since at least 2001. It is essential we allocate adequate resources to public health programs and initiatives to build a healthier population, stem the tide of chronic disease that is enveloping the nation, and reduce future health expenditure,” Mr Slevin said.

“We owe it to ourselves and to our children to look back in twenty years’ time and say we did all we could.”

NACCHO Aboriginal Health and #refreshtheCTGRefresh : Download the @AIHW National Key Performance Indicators for Aboriginal and Torres Strait Islander primary health care: results for 2017 showing improvements in 16 out of a possible 23 measures

Between June and December 2017, improvements were seen in 16 out of a possible 23 measures for which comparable data for both periods were available (see Table S1 for details). Results for a further indicator remained stable between reporting periods.

The improvements were seen in 12 of the 15 process-of-care measures with comparable data. Improvements were also seen in 4 of the 8 outcome measures, while 1 outcome measure remained stable. The largest improvements (4 or 5 percentage points) were seen in the recording practices for the measuring of:

  • influenza immunisations for clients with type 2 diabetes, which rose from 31% to 36%
  • influenza immunisations for clients with chronic obstructive pulmonary disease (COPD), which rose from 32% to 37%
  • influenza immunisations for clients aged 50 and over, which rose from 32% to 36%. ” 

 Extract from good news from AIHW Report

 Download full 158 page report HERE

aihw-ihw-200 (1)

Summary

This is the fifth national report on the Indigenous primary health care national Key Performance Indicators (nKPIs) data collection. It presents data on all 24 nKPI indicators for the first time.

Data for this collection are provided to the Australian Institute of Health and Welfare (AIHW) by primary health care organisations that receive funding from the Australian Government Department of Health to provide services to Aboriginal and Torres Strait Islander people. Some primary health care organisations included in the collection receive additional funding from other sources, including state and territory health departments.

As of the June 2017 data collection, changes have been made to the data extraction method, with the Department of Health introducing a new direct load reporting process. This allowed Communicare, Medical Director, and Primary Care Information System (PCIS) clinical information systems (CISs) to generate nKPI data within their clinical system, and transmit directly to the OCHREStreams portal. Best Practice services were provided with an interim tool while MMEx has always had direct load capability.

61.9 % our ACCHO’s

The new process was introduced to provide a greater level of consistency between CISs, but the change in the extraction method means that data from June 2017 onwards are not comparable with earlier collections.

As the June 2017 collection represents a new baseline for the collection, this report only presents data for June and December 2017.

For 2 indicators (Kidney function tests recorded and Kidney function test results) only December 2017 results are presented due to unresolved data quality issues in June 2017.

See Chapter 2 for more information on the change in extraction method, data quality, and the impact  on the collection, and Appendix E for data improvement projects and the nKPI/Online Service Reporting (OSR) review under way.

Improvements were seen for most indicators between June and December 2017. Although data from these 2 reporting periods are not comparable with earlier reporting periods, an overall pattern of improvement is in keeping with the pattern of improvement previously reported for the period June 2012 to May 2015 (see AIHW 2017). This indicates that health organisations continue to show progress in service provision.

Things to work on

For the 3 process-of-care indicators that did not show improvements—glycated haemoglobin (HbA1c) result recorded (6 months), cervical screening, and Medicare Benefits Schedule (MBS) health assessment for those aged 0–4—the changes were very small (0.5, 0.4, and 0.1 percentage points, respectively).

In the case of cervical screening, this might be due to changes to the cervical screening program, which took effect from 1 December 2017 (see Chapter 4 for details).

Three outcome measures that did not show improvements—HbA1c result of 7% or less, low birthweight, and smoking status of women who gave birth in the previous 12 months—saw changes of between 0.8 and 1.8 percentage points.

Contents

  • 1 Introduction
    • The nKPI collection
    • Structure of this report
  • 2 Data quality
    • Data quality issues
    • Additional considerations for interpreting nKPI data
  • 3 Maternal and child health indicators
    • Why are these indicators important?
    • 3.1 First antenatal visit
    • 3.2 Birthweight recorded
    • 3.3 MBS health assessment (item 715) for children aged 0-4
    • 3.4 Child immunisation
    • 3.5 Birthweight result
    • 3.6 Smoking status of females who gave birth within the previous 12 months
  • 4 Preventative health indicators
    • Why are these important?
    • 4.1 Smoking status recorded
    • 4.2 Alcohol consumption recorded
    • 4.3 MBS health assessment (item 715) for adults aged 25 and over
    • 4.4 Risk factors assessed to enable cardiovascular disease (CVD) risk assessment
    • 4.5 Cervical screening
    • 4.6 Immunised against influenza-Indigenous regular clients aged 50 and over
    • 4.7 Smoking status result
    • 4.8 Body mass index classified as overweight or obese
    • 4.9 AUDIT-C result
    • 4.10 Cardiovascular disease risk assessment result
  • 5 Chronic disease management indicators
    • Why are these important?
    • 5.1 General Practitioner Management Plan-clients with type 2 diabetes
    • 5.2 Team Care Arrangement-clients with type 2 diabetes
    • 5.3 Blood pressure result recorded-clients with type 2 diabetes
    • 5.4 HbA1c result recorded-clients with type 2 diabetes
    • 5.5 Kidney function test recorded-clients with type 2 diabetes
    • 5.6 Kidney function test recorded-clients with cardiovascular disease
    • 5.7 Immunised against influenza-clients with type 2 diabetes
    • 5.8 Immunised against influenza-clients with chronic obstructive pulmonary disease
    • 5.9 Blood pressure result-clients with type 2 diabetes
    • 5.10 HbA1c result-clients with type 2 diabetes
    • 5.11 Kidney function test result-clients with type 2 diabetes-eGFR
    • 5.12 Kidney function test result-clients with type 2 diabetes-ACR
    • 5.13 Kidney function test result-clients with cardiovascular disease-eGFR
  • 6 Discussion
    • Data improvements
  • Appendix A: Background to the nKPI collection and indicator technical specifications
  • Appendix B: Data completeness
  • Appendix C: Comparison of nKPI results
  • Appendix D: State and territory and remoteness variation figures
  • Appendix E: Data improvement projects
  • Appendix F: Guide to the figures
  • Glossary
  • References

NACCHO Aboriginal Health #ACCHO Deadly Good News stories #AustPH2018 #UluruStatement : #SA @Nganampa_Health @DeadlyChoices @NunkuYunti #NT @CaaCongress @DanilaDilba #QLD #Goolburri ACCHO @Wuchopperen #NSW @AHMRC #VIC #Treaty #WA @TheAHCWA

1.1 : PM told by his Indigenous advisory council that a proposed “voice” to parliament should be established as a matter of priority

1.2 : NACCHO Executive team meets with Minister Ken Wyatt and AMA President Tony Bartone 

2.SA : Nganampa Health Council ACCHO Tackling Indigenous smoking  at APY Lands school sports day.

2.2 SA : Nunkuwarrin Yunti ACCHO and the Tackling Tobacco Team at the CATSINaM conference at the Hilton Hotel Adelaide.

3.1 NT : Congress ACCHO Alice Springs : The NT is putting a minimum floor price on alcohol, because evidence shows this works to reduce harm

3.2 : NT Danila Dilba ACCHO Darwin staff out at Palmerston Indigenous Village doing Men’s Health Screenings.

4 .1 QLD : Wuchopperen ACCHO Cairns Supports Next Generation of Doctors

4.2 QLD : Ministers & Director General visit Goolburri Aboriginal Health Advancement

5 NSW : AHMRC Message Stick Newsletter launched 

6. VIC :  Keeping The Victorian Aboriginal Community At The Heart Of Treaty

7. WA : AHCWA For dialysis in remote communities, kidney disease patients can now be treated closer to Country.

MORE INFO AND REGISTER FOR NACCHO AGM

How to submit a NACCHO Affiliate  or Members Good News Story ?

Email to Colin Cowell NACCHO Media 

Mobile 0401 331 251

Wednesday by 4.30 pm for publication each Thursday /Friday

1.1 : PM told by his Indigenous advisory council that a proposed “voice” to parliament should be established as a matter of priority

 “Scott Morrison has been told by his Indigenous advisory council that a proposed “voice” to parliament should be established as a matter of priority, that it must be free from the whims of the political cycle and should ­draw on existing governance structures such as land councils and the ­national ­Aboriginal health ­network (NACCHO) .” 

From the Australian 27 September

The council’s co-chairs, ­Andrea Mason and Roy Ah-See, have told the Prime Minister of “an urgent need to future-proof our place in this nation” — a reference to establishing the advisory body by referendum in the Con­stitution so that it cannot be ­summarily disbanded by the ­government of the day.

The submission to the parliamentary committee highlights the ­discredited Aboriginal and Torres Strait Islander Commission, which was ­disbanded by the ­Howard government in 2005.

The submission suggests that the ATSIC, along with the current National Congress for Australia’s First Peoples, could be used as the basis for structuring a new body.

It says while ATSIC “developed, supported and empowered the emergence of a critical mass of … public administrators, equipped to navigate the machinery of government”, its demise could “largely be attributed to personalities ­rather than principles or the intent of the organisation”.

It accuses politicians of having “generated confusion within the Australian public” on the role of a voice when it took centre place in last year’s Uluru Statement ­from the Heart as the only form of ­constitutional recognition that would satisfy indigenous ­Australians.

The submission cites Mark Leibler — who ­­co-chaired the Referendum Council — and constitutional law experts Anne Twomey and ­George Williams as having ­“rejected the suggestion that a voice would intrude on ­parliamentary sovereignty”.

Mr Morrison said on ABC radio yesterday morning that the voice would constitute a “third ­chamber” of parliament — a characterisation that has been dismissed by experts, ­including the lawyers cited in the submission.

The joint parliamentary ­committee is due to ­report in ­November.

1.2 NACCHO Executive team meets with Minister Ken Wyatt and AMA President Tony Bartone 

2.SA : Nganampa Health Council ACCHO Tackling Indigenous smoking  at APY Lands school sports day.

It was a great day and the display was visited by children from Pipalyatjatjara, Murputja, Amata, Pukatja, Fregon, Mimili, Indulkana and Yalata.

The kids loved the big cigarette and learning about all the poisons that are in cigarettes and went away with Tjikita Nyuntu Ngayuku Malpa Wiya wristbands and drink bottles.

We also did smokelysers to check carbon monoxide levels on some of the older kids and adults. We will be following up any high readings.

Zibeon organised a colour 3 km run at the end of the sports day and the kids ran with joy and enthusiasm despite the fact that it was the last event of the day.

The day was topped off by the dance competition at Pukatja school that night where there was some great dancing.

The Deadly Choices team were also out on the APY lands supporting partners the Port Power Aboriginal Program

The guys have been visiting communities all over delivering the WillPower Program and supporting this Ernabella Sports & Dance festival

2.2 SA : Nunkuwarrin Yunti ACCHO and the Tackling Tobacco Team at the CATSINaM conference at the Hilton Hotel Adelaide.

3.1 NT : Congress ACCHO Alice Springs : The NT is putting a minimum floor price on alcohol, because evidence shows this works to reduce harm

From October 1, 2018, one standard drink in the Northern Territory will cost a minimum of A$1.30. This is known as floor price, which is used to calculate the minimum cost at which a product can be sold, depending on how many standard drinks the product contains.

People in the Northern Territory consume alcohol at much higher levels and have the highest rate of risky alcohol consumption in Australia. In 2014, around 44% of people in the NT were drinking alcohol at a level that put them at risk of injury or other harms at least once in the past month. This was compared to 26% of people nationally.

The implementation of the minimum floor price is the result of legislation, recently passed to minimise alcohol-related harms in the NT. From October, the NT will become one of the first places in the world to introduce a minimum price for alcohol.

Published in Croakey and The Conversation 

This article was co-authored by Donna Ah Chee, CEO of the Central Australian Aboriginal Congress and Mr Edward Tilton, Health Policy Consultant at the Central Australian Aboriginal Congress.The Conversation

John Boffa is Adjunct Associate Professor at Curtin University

A history of alcohol restrictions

The NT government introducted trial restrictions on the availability of alcohol in Alice Springs in 2002. This came after many years of campaigning for restrictions on alcohol sales by Aboriginal community organisations and the People’s Alcohol Action Coalition (an Alice Springs-based alcohol reform group).

The trial restrictions limited the hours during which take-away alcohol could be sold on weekdays to 2-9pm. They also attempted to address the sale of cheap 4L or 5L casks of wine by prohibiting the sale of take-away alcohol in containers larger than 2L. This super cheap alcohol was most implicated in the town’s social and health problems.

The trial had some positive effects but was substantially undermined by drinkers switching from cask-wine to other cheap forms of alcohol – in particular fortified wine sold in flagons and casks.

This led to renewed advocacy for more effective approaches to alcohol–related harm. In 2006, the NT government implemented the Alice Springs Liquor Supply Plan (LSP). This continued the earlier restrictions on the hours of sale for take-away alcohol. But it also extended the ban on the sale of cheap alcohol to include both wine in containers larger than two litres and fortified wine in containers larger than one litre.

What the liquor supply plan achieved

A 2011 government commissioned study found removing the two cheapest forms of alcohol (cask wine and fortified wine in casks and large bottles) from the market increased the price of alcohol in Central Australia. Before the introduction of the liquor supply plan, the average wholesale price per standard drink was around A$0.80. Under the plan, this increased to about A$1.10 per standard drink.

This increase was primarily achieved by the bans on cheap alcohol, effectively doubling the minimum unit price from about A$0.25 per standard drink to A$0.50 per standard drink. As the figure below shows, the introduction of the liquor supply plan in Alice Springs led to a significant decrease in alcohol consumption (estimated by using wholesale sales data) – from around 24 standard drinks per week for every person aged 15 years and over to around 20 standard drinks per week.


https://public.flourish.studio/visualisation/111877/embed

Made with Flourish

As expected, the ban on cheap cask and fortified wine led some drinkers to turn to other types of alcohol. But while there was a 70% increase in the consumption of more expensive full-strength beer, the decline in the consumption of cheap alcohol more than offset this. This led to the overall 20% decline in consumption.

The reductions in alcohol consumption were accompanied by a significant decrease in social harms and adverse health impacts. Treatments for alcohol-related harms at Alice Springs Hospital, which had been rising steeply, levelled off. Though they continued to rise, they did so at a much reduced rate.

This included reductions in those who were admitted to hospital because of assaults. In particular, the liquor supply plan led to around 120 fewer than projected Aboriginal women being hospitalised per year for assault. A similar pattern was seen for emergency department presentations, with a significant decrease in people presenting as a result of assault.

The LSP also saw significant reductions in the proportion of alcohol-related anti-social behaviour incidents recorded in Alice Springs.

A minimum floor price works

It’s clear restrictions on the sale of cheap alcohol are effective in reducing alcohol-related harm. And while the causes of family and community violence are complex, bans on cheap alcohol are especially effective in reducing the number of Aboriginal women subjected to assault.

Some have argued Aboriginal drinking is not affected by price as these drinkers will simply increase their expenditure on alcohol to maintain their consumption. But the liquor supply plan provides powerful evidence this assumption is incorrect. The reduction in assaults of Aboriginal women strongly suggests the increases in price were accompanied by a reduction in consumption.

The implementation of the minimum floor price shows the importance of local advocacy by Aboriginal organisations and community groups in moving policy and practice in alcohol control forward.

3.2 NT Danila Dilba ACCHO Darwin staff out at Palmerston Indigenous Village doing Men’s Health Screenings.

Picture above : Ray Chula and Maria Burrenjuck with Crystal Burrenjuck, Tidora Burrenjuck, Patrick Burrenjuck, Sebastian Burrenjuck, and Maggie Madigan

The team also put on a cooked breakfast and BBQ for the community. Thanks to everyone who came down and great to see men taking control of their health.

Left to right: Timothy Thomson, Brian Long, Lyle Braun, Ray Chula, Joseph Fitz and Darryl Tambling

4 .1 QLD : Wuchopperen ACCHO Cairns Supports Next Generation of Doctors

Dr Ben Schussler, who is spending a year at Wuchopperen, has worked in a range of clinics including Chronic and Complex and Men and Male Youth since beginning his placement in February.

Wuchopperen Health Service Limited proudly supports the next generation of doctors through its medical student and registrar placement programs.

GP Registrars Dr Alex and Dr Schussler are on placement while third year medical student Josh Preece completed his in August.

Josh, a University of Sydney medical student, has a close personal connection with Wuchopperen.

‘My nanna, Louisa Preece, (who I stayed with while I was up in Cairns) worked at Wuchopperen from 1993 to 2005 as Registered Nurse,’ he explained.

‘My auntie Julie Boneham was a Registered Nurse at Wuchopperen and has previously served as the Chairperson of and is currently a director on Wuchopperen’s Board, my auntie Cilla Preece was a dental assistant at Wuchopperen and later served on Wuchopperen’s  Board, and my cousin, Dania Ahwang is currently the CEO.’

Josh, a third year medical student, chose Wuchopperen for his GP placement in order to gain a greater understanding of the community controlled health sector.

‘I have been lucky enough to sit in with Wuchopperen’s Chronic and Complex Health GPs and really get a feel for what the working life of a GP is like,’ he said.

‘I was able to get involved with patient’s healthcare, and hear their stories. I chose Wuchopperen for my placement because I really wanted to get some exposure to frontline Indigenous health at an Aboriginal Community Controlled Health Organisation.

‘A patient being able to have all their healthcare needs met in a culturally appropriate setting, and having “Aboriginal health in Aboriginal hands” was really inspiring. It shows that self-determination, autonomy, and self-governance works!’

Josh said he learned that health is more than the problem presented at an appointment.

‘I learned that you have to think about the whole person in front of you, especially in Indigenous healthcare,’ he said.

‘You can’t just solve “high blood pressure”, you need to be thinking holistically about a person’s lifestyle and goals, the social context in which they live, and respect their autonomy. I was lucky enough to sit in with Wuchopperen’s diabetes educators, nursing team, physio, dietitian, and Aboriginal health workers, as well as spending some time at the Raintrees pharmacy. It was great to see the whole range of allied health services and how we can all work together to drive patient outcomes.’

Wuchopperen’s new GP Registrars, Dr Jerry Alex and Dr Ben Schussler have also been on learning curves.

Dr Jerry, who is spending six months doing an extended skills placement in Aboriginal and Torres Strait Islander health, said the ‘learning is constant.’

‘I wanted to do my placement here because I am interested in Aboriginal and Torres Strait Islander health.  The learning process is constant and I gaining a better understanding of the multiple impacts on Aboriginal and Torres Strait Islander health.’

‘I am planning to do a Fellowship in Indigenous health next year.’

Dr Ben Schussler, who is spending a year at Wuchopperen, has worked in a range of clinics including Chronic and Complex and Men and Male Youth since beginning his placement in February.

His decision to do his placement at Wuchopperen was inspired by a wish to find out more about Indigenous health, and to increase his skills in caring for Aboriginal and Torres Strait Islander people.

‘I wanted to increase my knowledge of Indigenous health issues and culture as well as improve my skills in providing medical care to this population,’ Dr Ben explained.

Like Josh and Dr Jerry, Dr Ben said he has learned an enormous amount since starting his placement.

‘It has been, and is, such a great experience working here,’ he said.

‘I have learned about medical problems such as rheumatic heart disease that I likely never would have seen had I not worked with this group of patients.  I have learned more about the Indigenous culture and history in Australia and have a better understanding of the barriers to care for Indigenous Australians.’

‘I am very impressed with the services available at Wuchopperen. The resources available to optimise patient care are superb.  The opportunity to access allied health services for my patients far exceeds what is typically available in general practice.’

4.2 QLD : Ministers & Director General visit Goolburri Aboriginal Health Advancement

Ministers & Director General visit Goolburri Aboriginal Health Advancement Company Limited to learn about there integrated model of health, human and social services in Toowoomba & South Western Queensland

5 NSW : AHMRC Message Stick Newsletter launched 

Read HERE 

6. VIC :  Keeping The Victorian Aboriginal Community At The Heart Of Treaty

IMAGE: MEMBERS OF THE ABORIGINAL TREATY WORKING GROUP AND VICTORIAN TREATY ADVANCEMENT COMMISSIONER IN PARLIAMENT DURING THE TABLING OF THE ADVANCING THE TREATY PROCESS WITH ABORIGINAL VICTORIANS BILL 2018 (L TO R): VICKI CLARK, PAUL BRIGGS, MICK HARDING (CHAIR), JILL GALLAGHER (COMMISSIONER), JANINE COOMBS, GERALDINE ATKINSON. (SUPPLIED)

The Andrews Labor Government is engaging even more Aboriginal Victorians in the state’s historic Treaty process with a second round of Treaty grants.

Minister for Aboriginal Affairs Natalie Hutchins today announced almost $1.3 million for 19 Aboriginal organisations as part of the second round of the Treaty Community Engagement Program.

The successful organisations include the First Nations Legal and Research Services, Winda-Mara Aboriginal Corporation, Aldara Yanera, Victorian Aboriginal Child Care Agency, the Victorian Traditional Owner Land Justice Group, Yorta Yorta, Koorie Youth Council.

Wantanda Consulting, Mangrook Footy Show, Eastern Maar Aboriginal Corporation,  Gunaikurnai Land and Waters Aboriginal Corporation, the Willum Warrain Gathering Place, Yingadi Aboriginal Corportaion, Spark Health and Bunjilwarra were also successful.

The Program will support Traditional Owners groups and other organisations and businesses to engage with Victorian Aboriginal communities as well as non-Aboriginal Victorians on Treaty. This will provide further insight on how self-determination and treaty can strengthen Victorian Aboriginal communities.

The Program will also help ensure the treaty process continues to be guided by Aboriginal voices and prepare the Aboriginal community for the establishment of the Aboriginal Representative Body and eventual Treaty negotiations.

Insights obtained through the Program will be used by the Victorian Treaty Advancement Commission as it works to establish the Aboriginal Representative Body as part of the next phase of the treaty process.

The Program offers two kinds of grants: Treaty Circle Grants and Treaty Engagement Grants.

Treaty Circle Grant will support small, community-led consultations on key issues related to treaty.

Treaty Engagement Grants will support in-depth, ongoing engagement with Victorian Aboriginal communities, as well as research on key issues relating to treaty and self-determination.

Today’s funding builds on the $370,000 in grants provided to Aboriginal organisations in the first round of the Program. Further rounds of Treaty grant funding will be open soon.

The Labor Government has provided more than $37.5 million to support the treaty process and promote self-determination among Victorian Aboriginal communities.

Quotes attributable to Minister for Aboriginal Affairs Natalie Hutchins

“The voices of Aboriginal Victorians will always be at the centre of the Treaty process. This goes to the heart of self-determination.”

“These exceptional Aboriginal organisations know their community best and that’s why we’re supporting them to consult and engage on Victoria’s historic Treaty process.”

7. WA : AHCWA For dialysis in remote communities, kidney disease patients can now be treated closer to Country.

With Aboriginal communities receiving Medicare funding for dialysis in remote communities, kidney disease patients can now be treated closer to Country.

Instead of being stuck in a hospital 800km away, Barbara Reid can now receive her dialysis only an hour’s drive away from her family.

Read full story HERE 

NACCHO Aboriginal Health and #Cancer Policies , Strategies and Future directions : Latest @HealthInfoNet review shows many cancers are preventable among Aboriginal and Torres Strait Islander people

‘The review shows that cultural safety in service provision, increased participation in breast, bowel and cervical screening and reduction in risk factors will improve outcomes for cancer among Aboriginal and Torres Strait Islander people.

The good news is that many cancers are considered to be preventable. Lung cancer is the most commonly diagnosed cancer among Aboriginal and Torres Strait Islander people, followed by breast cancer, bowel cancer and prostate cancer.

Tobacco smoking is still seen as the greatest risk factor for cancer’.

HealthInfoNet Director, Professor Neil Drew

Read over 75 Aboriginal Health and Cancer articles published by NACCHO last 6 years

“Aboriginal and Torres Strait Islander Community Controlled Health Services

Aboriginal and Torres Strait Islander Community Controlled Health Services are located in all jurisdictions and are funded by the federal,state and territory governments and other sources [91].

They are planned and governed by local Aboriginal and Torres Strait and Torres
Strait Islander communities and aim to deliver holistic and culturally appropriate health and health-related services.

Services vary in the primary health care activities they offer. Possible activities include: diagnosis and treatment of illness or disease; management of chronic illness; transportation to medical appointments; outreach clinic services; immunisations; dental services; and dialysis services.

Aboriginal and Torres Strait Islander cancer support groups have been identified as important for improving cancer awareness and increasing participation in cancer screening services [92].

Aboriginal women attending these support groups have reported an increased
understanding of screening and reported less fear and concern over cultural appropriateness, with increases in screening rates [19].

Support groups have also been found to help in follow up and ongoing care for cancer survivors [19, 93], particularly where they are shaped to meet the needs of Aboriginal and Torres Strait Islander people [73, 94].”

See Page 12 of Review

Download Review+of+cancer+among+Aboriginal+and+Torres+Strait+Islander+people

The Australian Indigenous HealthInfoNet (HealthInfoNet) at Edith Cowan University has published a new Review of cancer among Aboriginal and Torres Strait Islander people.

The review, written by University of Western Australia staff (Margaret Haigh, Sandra Thompson and Emma Taylor), in conjunction with HealthInfoNet staff (Jane Burns, Christine Potter, Michelle Elwell, Mikayla Hollows, Juliette Mundy), provides general information on factors that contribute to cancer among Aboriginal and Torres Strait Islander people.

It provides detailed information on the extent of cancer including incidence, prevalence and survival, mortality, burden of disease and health service utilisation.

This review discusses the issues of prevention and management of cancer, and provides information on relevant programs, services, policies and strategies that address cancer among Aboriginal and Torres Strait Islander people.

The review provides:

  • general information on factors (historical/protective/risk) that contribute to cancer among Aboriginal and Torres Strait Islander people
  • detailed information on the extent of cancer among Aboriginal and Torres Strait Islander people, including: incidence, prevalence and survival data; mortality and burden of disease and health service utilisation
  • a discussion of the issues of prevention and management of cancer
  • information on relevant programs, services, policies and strategies that address cancer among Aboriginal and Torres Strait Islander people
  • a conclusion on the possible future directions for combating cancer in Australia

Selected Extracts

Policies and strategies

There are very few national policies and strategies that focus specifically on cancer in the Aboriginal and Torres Strait Islander population. The National Aboriginal and Torres Strait Islander Cancer Framework is therefore significant as the first national approach to addressing the gap in cancer outcomes that currently exists between Aboriginal and Torres Strait Islander people and the non-Indigenous population [132]. However, over the past 30 years, there have been a number of relevant strategies and frameworks developed addressing cancer in the general population, and broader aspects of Aboriginal and Torres Strait Islander health. A selection of national policy developments relevant to addressing cancer among Aboriginal and Torres Strait Islander people are described briefly below.

Selected national policy developments relevant to addressing cancer among Aboriginal and Torres Strait Islander people

2018 Lung Cancer Framework: Principles for Best Practice Lung Cancer Care in Australia is released
2016 National Framework for Gynaecological Cancer Control is released
2015 First National Aboriginal and Torres Strait Islander Cancer Framework is released
2015 Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan is released
2014 Second Cancer Australia Strategic Plan 2014–2019 is published
2013 First National Aboriginal and Torres Strait Islander Health Plan 2013–2023 is published
2011 First Cancer Australia Strategic Plan 2011–2014 is published
2008 National Cancer Data Strategy for Australia is released
2003 Report Optimising Cancer Care in Australia is published
1998 First National health priority areas cancer control report is published
1996 Cancer becomes one of four National health priority areas (NHPA)
1988 Health for all Australians report is released
1987 First National Cancer Prevention Policy for Australia is published

 

It was not until the late 1980s that national cancer control strategies and policies began to be developed [133]. In 1987, the first National Cancer Prevention Policy for Australia, was published by the Australian Cancer Society (ACS) (now the Cancer Council Australia) based on a series of expert workshops [134].

It outlined what prevention activities were currently being undertaken, what should be undertaken and suggested a number of goals, targets and strategies in the areas of cancer prevention and early detection and screening. This policy has been updated many times over the years [133] and is still in publication as the National cancer control policy [135].

The following year, in 1988, the Health for all Australians report, commissioned by the Australian Health Ministers’ Advisory council (AHMAC), recognised that cancers could be influenced by primary or secondary prevention strategies [136]. The report recommended nine goals and 15 targets related to cancers, based on those put forward by the National Cancer Prevention Policy for Australia. Cancer prevention and strategies relating to breast, cervical and skin cancer and tobacco smoking were recommended as initial priorities under the National Program for Better Health. These were then endorsed at the Australian Health Ministers Conference and funding was provided.

In 1996, cancer control was identified as one of four National health priority areas (NHPA). This led, the following year, to the publication of the First report on national health priority areas 1996, which outlined 26 indicators spanning the continuum of cancer care, and included outcome indicators, indicators relating to patient satisfaction and the creation of hospital based cancer registries [137].

In 1998, the first NHPA cancer control report was produced [138]. It identified a number of opportunities for improvements in cancer control, including within ‘special populations such as Indigenous people’ [138].

In 2003, the report Optimising cancer care in Australia was jointly developed by The Cancer Council Australia, the Clinical Oncological Society of Australia (COSA) and the National Cancer Control Initiative (NCCI), with strong consumer input [139]. This report made 12 key recommendations, including that the needs of Aboriginal and Torres Strait Islander people be the focus of efforts to bridge gaps in access to and utilisation of culturally sensitive cancer services.

In 2008, the National Cancer Data Strategy for Australia aimed to provide direction for collaborative efforts to increase data availability, consistency and quality [140]. It reported that although Indigenous status is recorded by cancer registries, data quality is poor, and recommended that the quality of Indigenous markers in hospital and death statistics collections needs to improve if cancer registries are to have better data.

In 2011, Cancer Australia published the first Cancer Australia strategic plan 2011–2014, which aimed to identify future trends in national cancer control and to outline strategies for the organisation to improve outcomes for all Australians diagnosed with cancer [141]. It was followed in 2014, by the Cancer Australia Strategic Plan 2014–2019, which had an increased focus on improving quality of cancer care and outcomes for Aboriginal and Torres Strait Islander people [142].

In 2013, the National Aboriginal and Torres Strait Islander Health Plan 2013–2023 (the Health plan) was developed to provide a long-term, evidence-based policy framework approach to closing the gap in disadvantage experienced by Aboriginal and Torres Strait Islander people [143].

The Health plan emphasises the importance of culture in the health of Aboriginal and Torres Strait Islander people and the rights of individuals to a safe, healthy and empowered life. Its vision is for the Australian health system to be free of racism and inequity and all Aboriginal and Torres Strait Islander people to have access to health services that are effective, high quality, appropriate and affordable. This led to the publication of the Implementation plan for the National Aboriginal and Torres Strait Islander Health Plan 2013–2023 in 2015 [90], which outlines the strategies, actions and deliverables required for the Australian Government and other key stakeholders to implement the Health plan.

The first National Aboriginal and Torres Strait Islander Cancer Framework (the Framework­) was released in 2015, to address disparities and improve cancer outcomes for Aboriginal and Torres Strait Islander people [56]. It provides strategic direction by setting out seven priority areas for action and suggests enablers that may help in planning or reviewing strategies to address each of the priority areas. The Framework aims to improve cancer outcomes for Aboriginal and Torres Strait Islander people by ensuring timely access to good quality and appropriate cancer related services across the cancer continuum.

In 2016, Cancer Australia released the National Framework for Gynaecological Cancer Control to guide future directions in national gynaecological cancer control to improve outcomes for women affected, as well as their families and carers [144]. It aims to ensure the provision of best practice and culturally appropriate care to women across Australia by offering strategies across six priority areas, of which one pertains specifically to improving outcomes for Aboriginal and Torres Strait Islander women.

In 2018, Cancer Australia released the Lung Cancer Framework: Principles for Best Practice Lung Cancer Care in Australia [145]. It aims to improve the outcomes and experiences of people affected by lung cancer by supporting the uptake of five principles: patient-centred care; multidisciplinary care; timely access to evidence-based care; coordination, communication and continuity of care and data-driven improvements.

Future directions

The National Aboriginal and Torres Strait Islander Cancer Framework (the Framework­) provides guidance for individuals, communities, organisations and governments [56]. The Framework was developed in partnership with Menzies School of Health Research, and was informed by a systematic review of the evidence and extensive national consultations. The parties involved in these consultations included Aboriginal and Torres Strait Islander people affected by cancer, health professionals working with Aboriginal and Torres Strait Islander people and experts in Indigenous cancer control. The Framework outlined seven evidence-based priority areas for action as follows:

  • improving knowledge and attitudes about cancer
  • focusing prevention activities
  • increasing participation in screening and immunisation
  • ensuring early diagnosis
  • delivering optimal and culturally appropriate treatment and care
  • involving, informing and supporting families and carers
  • strengthening the capacity of cancer-related services to meet the needs of Aboriginal and Torres Strait Islander people.

Each of these priorities was accompanied by a number of enablers to assist in planning or reviewing strategies to address that priority. The enablers provide flexible approaches to meeting the priorities that allow for local context and needs.

The development of the Framework has been responsible for gathering national support and agreement on the priorities and for creating a high level of expectation around the ability to address the growing cancer disparity [146]. Cancer Australia has since commenced a number of projects and initiatives that focus on one or more of the priorities identified by the Framework. One project aims to identify critical success factors and effective approaches to increasing mammographic screening participation for Aboriginal and Torres Strait Islander women [147]. A leadership group on Aboriginal and Torres Strait Islander cancer control tasked with driving a shared agenda to improve cancer outcomes has also been established [148]. In addition, the development of a monitoring and reporting plan for the Framework is underway.

Quality data are critical to understanding the variations in cancer care and outcomes of Aboriginal and Torres Strait Islander people, and to inform policy, service provision and clinical practice initiatives to improve those outcomes. However, it has been repeatedly reported in the literature and by the Framework, that current data are inadequate or incomplete, and there is a significant need for improved local, jurisdictional and national data on Aboriginal and Torres Strait Islander people with cancer [56149-151]. In particular, the need for primary healthcare services to address the under identification of Aboriginal and Torres Strait Islander status in data registries. A project currently underway in SA, which is likely to have relevance to other regions, aims to develop an integrated comprehensive, cancer monitoring and surveillance system for Aboriginal people, while also incorporating their experiences with cancer services [149].

Both the Framework and the literature have identified a need for a more supportive and culturally appropriate approach across the cancer care continuum for Aboriginal and Torres Strait Islander people [5677151152]. The Wellbeing Framework for Aboriginal and Torres Strait Islander Peoples Living with Chronic Disease, (Wellbeing framework), aims to assist healthcare services to improve the quality of life and quality of care, as well as health outcomes, for Aboriginal and Torres Strait Islander people living with chronic disease [153]. This addresses the identified need for more supportive and culturally appropriate care as it attempts to incorporate the social, emotional, cultural and spiritual aspects of health and wellbeing, as well as the physical aspects.

The Wellbeing framework is underpinned by two core values, which are considered fundamental to the care of Aboriginal and Torres Strait Islander people [153154]. These core values highlight that wellbeing is supported by:

  • upholding people’s identities in connection to culture, spirituality, families, communities and country and
  • having culturally safe primary healthcare services in place.

The Wellbeing framework consists of four essential elements for supporting the wellbeing of Aboriginal and Torres Strait Islander people living with chronic disease [153154]. These show the importance of having:

  • locally defined, culturally safe primary health care services
  • appropriately skilled and culturally competent health care teams
  • holistic care throughout the lifespan
  • best practice care that addresses the particular needs of a community.

The Wellbeing framework suggests a number of practical and measurable applications for applying or achieving the underlying principles of each element. It has the capacity to be adapted by primary healthcare services, in consultation with the communities they serve, to more effectively meet the chronic and cancer care needs of their communities [153154].

 

The Leadership Group on Aboriginal and Torres Strait Islander Cancer Control was established in 2016-17 to:

  • provide strategic advice and specialist expertise in Indigenous cancer control
  • encourage cross-sector collaboration in addressing the priorities in the National Aboriginal and Torres Strait Islander Cancer Framework
  • share knowledge across the sector to leverage opportunities.

Concluding comments

Despite considerable improvements in cancer detection and treatment over recent decades, Aboriginal and Torres Strait Islander people diagnosed with cancer generally experience poorer outcomes than non-Indigenous people for an equivalent stage of disease [2797]. This is highlighted by statistics which showed that, despite lower rates of prevalence and hospitalisation for all cancers combined for Aboriginal and Torres Strait Islander people compared with non-Indigenous people, between 1998 and 2015, the age-standardised mortality rate ranged from 195 to 246 per 100,000 while the rate for non-Indigenous people decreased from 194 to 164 per 100,000 [2].

Furthermore for 2007–2014, while 65% of non-Indigenous people had a chance of surviving five years after receiving a cancer diagnosis, only 50% of Aboriginal and Torres Strait Islander people did [2].

The disparities are particularly pronounced for some specific cancers – for lung cancer the age-standardised incidence rate for Aboriginal and Torres Strait Islander people was twice that for non-Indigenous people, while for cervical cancer the rate was 2.5 times the rate for non-Indigenous people for 2009–2013 [2].

The factors contributing to these poorer outcomes among Aboriginal and Torres Strait Islander people are complex. They reflect a broad range of historical, social and cultural determinants and the contribution of lifestyle and other health risk factors [6], combined with lower participation in screening programs, later diagnosis, lower uptake and completion of cancer treatment, and the presence of other chronic diseases [2798155]. Addressing the various factors that contribute to the development of cancer among Aboriginal and Torres Strait Islander people is important, but improvements in some of these areas, particularly in reducing lifestyle and behavioural risk factors, are likely to take some time to be reflected in better outcomes.

Current deficiencies in the prevention and management of cancer suggest there is considerable scope for better services that should lead to improvements in the short to medium term. Effective cancer prevention and management programs that are tailored to community needs and are culturally appropriate are vital for the current and future health of Aboriginal and Torres Strait Islander people [5657]. Providing effective cancer prevention and management also requires improved access to both high quality primary health care services and tertiary specialist services. Effective and innovative programs for the prevention and management of cancer among Aboriginal and Torres Strait Islander people do exist on an individual basis and, in some cases, the efforts made to engage Aboriginal and Torres Strait Islander people in screening programs, in particular, are impressive. However, a more coordinated, cohesive national approach is also required.

Reducing the impact of cancer among Aboriginal and Torres Strait Islander people is a crucial aspect in ‘closing the gap’ in health outcomes. The National Aboriginal and Torres Strait Islander cancer framework [56] may be an important first step in addressing the current disparity in cancer outcomes and raises the probability of real progress being made. Cancer Australia has recently released the Optimal Care pathway for Aboriginal and Torres Strait Islander people which recommends new approaches to cancer care and with the aim of reducing disparities and improving outcomes and experiences for Aboriginal and Torres Strait Islander people with cancer [156]. As encouraging as these developments are, substantial improvements will also depend upon the effective implementation of comprehensive strategies and policies that address the complexity of the factors underlying the disadvantages experienced by Aboriginal and Torres Strait Islander people.

Action beyond the health service sector that addresses the broader historical, social and cultural determinants of health are also required if real progress is to be made [6].

NACCHO Aboriginal Health NEWS : @AIHW report : The consumption of #alcohol, #tobacco and other #drugs is a major cause of preventable disease and illness in our communities

The consumption of alcohol, tobacco and other drugs is a major cause of preventable disease and illness in our comminities

There are a wide range of data sources available that contribute to our understanding of alcohol, tobacco and other drug use.

This web report from AIHW is intended to be a general reference for contemporary data on alcohol, tobacco and other drugs in Australia.

SEE Full Report 

This report consolidates the most recently available information regarding the use of tobacco, alcohol, cannabis, meth/amphetamines and other stimulants, the non-medical use of pharmaceutical drugs, illicit opioids (heroin) and new (and emerging) psychoactive substances (NPS).

Key trends in the availability, consumption, harms and treatment are identified and detailed data are presented for vulnerable populations.

These population groups include Aboriginal and Torres Strait Islander people, homeless people, older people, people from culturally and linguistically diverse backgrounds, people identifying as lesbian, gay, bisexual, transgender, intersex or queer (LGBTIQ), people in contact with the criminal justice system, people with mental health conditions, young people and people who inject drugs

Key findings Aboriginal and Torres Strait Islander people 

  • There has been significant declines in the proportion of Aboriginal and Torres Strait Islander people smoking and consume alcohol that exceeds lifetime risk guidelines (consuming more than two standard drinks per day on average).
  • The prevalence of smoking by Indigenous people has declined from 55% in 1994 to 45% in 2014–15.
  • The proportion of Indigenous people that consume alcohol as levels that exceed lifetime risk guidelines has reduced from 19% in 2008 to 15% in 2014–15.
  • In 2011, tobacco use accounted for 12% of the burden of disease for Indigenous Australians. This accounts for 23.3% of the health gap between Indigenous and non-Indigenous Australians.
  • In 2016, more than 1 in 4 (27%) Indigenous Australians used an illicit drug in the last 12 months. This was 1.8 times higher than for non-Indigenous Australians (15.3%).
  • The most commonly used illicit drug by Indigenous Australians is cannabis (16.7%), followed by the non-medical use of pharmaceutical drugs (11.0%).
  • Of clients of alcohol and other drug, treatment services, 15% were Indigenous Australians aged 10 and over, which is an overrepresentation relative to their population size.

Currently there are almost 800,000 Aboriginal or Torres Strait Islander people (see Box ATSI1) living in Australia, accounting for 2.8% of the Australian population [1]. There are substantial differences in measures of health and welfare between Aboriginal or Torres Strait Islander people and non-Indigenous Australians.

Box ATSI1: Aboriginal and Torres Strait Islander people

The terms ‘Aboriginal and Torres Strait Islander people’ is preferred in Australian Institute of Health and Welfare (AIHW) publications when referring to the separate Indigenous peoples of Australia. However, the term ‘Indigenous’ Australians is used interchangeably with ‘Aboriginal and Torres Strait Islander’ in order to assist readability.

The Australian Burden of Disease Study identified that Aboriginal or Torres Strait Islander people experience a burden of disease that is 2.3 times the rate of non-Indigenous Australians [2]. The gap in the disease burden is due to a range of factors including disconnection to culture, traditions and country, social exclusion, discrimination and isolation, trauma, poverty, and lack of adequate access to services [3]. Tobacco, alcohol, and other drugs are key risk factors contributing to the health gap between Indigenous and non-Indigenous Australians [2].

Box ATSI2. Data sources examining tobacco, alcohol and other drug use by Aboriginal and Torres Strait Islander people

There are a number of data sources that provide information about tobacco, alcohol and other drug use by Aboriginal and Torres Strait Islander people.

The National Aboriginal and Torres Strait Islander Social Survey (NATSISS) [4] and the Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS) [5] collected by the ABS are designed to obtain a representative sample of Indigenous Australians. In relation specifically to tobacco smoking, the ABS has consolidated data from six large, national, multistage random household surveys to identify trends between 1994 and 2014–15 [6].

The AIHW’s National Drug Strategy Household Survey (NDSHS) uses a self-completion questionnaire to capture information about drug and alcohol use among the general Australian population; however it is not specifically designed to obtain reliable national estimates for Indigenous people. In 2016, 2.4% of the NDSHS (unweighted) sample aged 12 and over (or 568 respondents) identified as being of Aboriginal or Torres Strait Islander origin. The estimates produced by the NDSHS should be interpreted with caution due to the low sample size [7].

There are also other data sources that provide information relevant to Aboriginal and Torres Strait Islander people.

  • Australia’s Burden of Disease study analyses the impact of nearly 200 diseases and injuries in terms of living with illness (non-fatal burden) and premature death (fatal burden). In 2015, a report was released that provides estimates of burden of disease between Indigenous and non-Indigenous Australians [8].
  • The National Perinatal Data Collection covers each birth in Australia and includes information on Indigenous mothers and their babies [6].
  • The Alcohol and Other Drug Treatment Services National Minimum Dataset (AODTS-NMDS) contains information on treatment provided to clients by publicly funded alcohol and other drug services including Indigenous clients [9].
  • The Online Services Report (OSR) contains information on the majority of Australian Government-funded Aboriginal and Torres Strait Islander substance use services [6].

Tobacco smoking

While tobacco smoking is declining in Australia, it remains disproportionately high among Indigenous Australians. Data from the Australian Bureau of Statistics (ABS) has shown:

  • In 1994, the Indigenous Australian survey data showed that 55% of Indigenous Australians aged 18 and over were smokers; 20 years later, in 2014–15, this had declined to 45% (Table S3.4).
  • Over a similar 20-year period, the National Health Survey (NHS) the proportion of non-Indigenous smokers aged 18 and over declined, from 24% in 1995 to 16% in 2014–15 (Table S3.5).
  • There appears to have been no change to the gap in smoking prevalence between the Indigenous Australian adult population and the non-Indigenous Australian adult population from 1994 to 2014–15. Even though the Indigenous Australian smoking rates are declining, the non-Indigenous rate is declining at a similar rate, therefore the gap remained constant [6] (Figure ATSI1).

Most of the decline in smoking occurred in non-remote areas. Over the 20-year period, the proportion of Indigenous Australians aged 18 and over in non-remote areas who were smokers declined from 55% to 42%, while the proportion in remote areas remained relatively stable at between 54% and 56% (Table S3.4).

In 2014–15, Indigenous males were more likely than Indigenous females to be smokers (47% compared with 42%) [1].

Geographic trends

The 2014–15 NATSISS provides estimates of tobacco smoking for Indigenous Australians by jurisdiction. According to the 2014–15 NATSISS, 39% of Indigenous Australians aged 15 and over smoked daily. Those from the Northern Territory (45%) and Western Australia (42%) surpassed this national average, while Indigenous Australians from South Australia (35%) were the least likely to be a current daily smoker [4] (Table S3.3).

Tobacco smoking in pregnancy

Indigenous Australians are at an elevated risk of smoking during pregnancy compared with non-Indigenous Australians. The National Perinatal Data Collection showed that:

  • Indigenous mothers accounted for 19% of mothers who smoked tobacco at any time during pregnancy in 2015, despite accounting for only around 4% of mothers.
  • The age-standardised rate of Indigenous mothers smoking during pregnancy has decreased from 50% in 2009 to 45% in 2015.
  • Almost 1 in 2 (45%) Indigenous mothers reported smoking during pregnancy—compared with 12% of non-Indigenous mothers (age-standardised).
  • The age-standardised rate of Indigenous mothers quitting smoking during pregnancy (14%) is about half that of non-Indigenous mothers (25%) (based on mothers who reported smoking in the first 20 weeks of pregnancy and not smoking after 20 weeks of pregnancy) [10].

Alcohol consumption

Abstinence (non-drinkers)

  • The 2016 NDSHS found that Indigenous Australians aged 14 and over were more likely to abstain from drinking alcohol than non-Indigenous Australians (31% compared with 23%, respectively) and abstinence among Indigenous Australians has been increasing since 2010 when it was 25% [7] (Table S3.1).
  • This pattern is consistent with data from the 2012–13 AATSIHS, where 28% of Indigenous Australians reported abstaining from drinking compared with 18% of non-Indigenous Australians [5].

Lifetime risk

  • The 2014–15 NATSISS found that the proportion of Indigenous Australians aged 15 years and over who exceeded the NHMRC lifetime risk guidelines for alcohol consumption (consuming more than 2 standard drinks per day on average) decreased between 2008 and 2014–15 (19% compared with 15%; non age-standardised proportions). The overall change is largely due to a decline in non-remote areas (19% in 2008 to 14% in 2014–15) [4] (Table S3.6).
  • Comparisons between Indigenous and non-Indigenous Australians are only available using age-standardised data from the 2012–13 AATSIHS and is not comparable to the 2014–15 NATSISS. The findings showed that lifetime risky drinking of Indigenous Australians aged 15 and over was similar to that of non-Indigenous Australians (9.8% compared with 9.7%; age-standardised) [5] (Table S3.7).

Single occasion risk

  • According to the 2014–15 NATSISS, 30% of Indigenous Australians aged 15 and over exceeded the single occasion risk guidelines for alcohol consumption (non age-standardised proportions), which is a decline since 2002 (35%).
  • Comparisons between Indigenous and non-Indigenous Australians are only available using age-standardised data from the 2012–13 AATSIHS and is not comparable to the 2014–15 NATSISS. The 2012–13 AATSIHS reported that 1 in 2 (50%) Indigenous Australians exceed the single occasion risky drinking guidelines (more than 4 standard drinks on a single occasion in past year). This was 1.1 times the rate that non-Indigenous Australians (44%) that exceeded these guidelines [5] (Table S3.7).

Risky alcohol consumption

  • According to the 2016 NDSHS, almost 1 in 5 Indigenous Australians (18.8%) consumed 11 or more standard drinks at least once a month. This was 2.8 times the rate that non-Indigenous Australians (6.8%) consumed this amount of alcohol [7] (Table S3.1).

Geographic trends

Between 2002 and 2014–15 there was a decline in the proportion of Indigenous Australians that resided in New South Wales Victoria, Queensland, South Australia, Western Australia and the Australian Capital Territory that exceeded the lifetime and single occasion risk guidelines (Figure ATSI2). Indigenous Australians residing in Tasmania (36%), the Australian Capital Territory (ACT) (35%), Queensland (33%) and Western Australia (33%) had higher rates of exceeding the single occasion drinking guidelines than the national average [4] (Table S3.8).

Indigenous Australians residing in Western Australia (16%), New South Wales (16%) and Queensland (15%) surpassed the national average for exceeding lifetime risk guidelines [4] (Table S3.9).

Illicit drug use

In the 2014–15 NATSISS, Aboriginal and Torres Strait Islander people aged 15 and over were asked whether they had used illicit substances in the last 12 months, and the types of illicit substances they had used during that period [4]. The data showed that:

  • Almost one-third (30%) of Indigenous Australians aged 15 and over reported having used illicit substances in the last 12 months, up from 22% in 2008.
  • Males were significantly more likely than females to have used illicit substances (34% compared with 27%), as were people in non-remote areas compared with those in remote areas (33% compared with 21%).
  • Cannabis was the most commonly reported illicit drug used by Aboriginal and Torres Strait Islander people in the last 12 months at 19% (25% of males compared with 14% of females).
  • The non-medical use of analgesics and sedatives (such as painkillers, sleeping pills and tranquilisers) was also relatively common (13%), with females (15%) being more likely than males (11%) to have used analgesics and sedatives.
  • One in twenty (5%) Indigenous Australians aged 15 and over reported having used amphetamines or speed in the last 12 months (6% of males compared with 3% of females) [4] (Figure ATSI3).

The 2016 NDSHS data showed that (other than ecstasy and cocaine), Indigenous Australians aged 14 and over recent used of illicit drugs was at a higher rate than non-Indigenous Australians (Table S3.1). Rates of illicit drug use in 2016 for Indigenous Australians aged 14 and older were:

  • Over one in four (27%) used any illicit drug in the last 12 months—1.8 times higher than non-Indigenous Australians (15.3%)
  • One in five (19.4%) used cannabis in the last 12 months—1.9 times higher than non-Indigenous Australians (10.2%)
  • Around one in 10 (10.6%) used a pharmaceutical for non-medical use—2.3 times higher than non-Indigenous Australians (4.6%) [7] (Table S3.1)
  • 3.1% used meth/amphetamines in the last 12 months—2.2 times higher than non-Indigenous Australians (1.4%).

The differences between Indigenous and non-Indigenous Australians were still apparent even after adjusting for differences in age structure (Figure ATSI4). There were no significant changes in illicit use of drugs among Indigenous Australians between 2013 and 2016, however due to the small sample sizes for Indigenous Australians, the estimates of the NDSHS should be interpreted with caution.

Geographic trends

Indigenous Australians aged 15 and over residing in the Northern Territory (22%) were the least likely to report substance use, while those from the Australian Capital Territory (41%) and Victoria (40%) were the most likely to report using substances.

Indigenous Australians from the Northern Territory (22%) and Queensland (29%) were the only jurisdictions below the national average (30%) [4] (Table S3.3).

Health and harms

The health status of Aboriginal and Torres Strait Islander people are considerably lower than for non-Indigenous Australians. For instance:

  • 35.1% of Aboriginal or Torres Strait Islander people compared with 58.3% of non-Indigenous Australia self-assessed their health as ‘excellent’ or ‘very good’ (age-standardised per cent).
  • 32.5% of Indigenous Australians compared with 12.3% of non-Indigenous Australians reported high/very high psychological distress (age-standardised per cent).
  • 71.0% of Aboriginal or Torres Strait Islander people reported having a long-term health condition compared with 55.3% of non-Indigenous Australians (age-standardised per cent) [4] (Table S3.6).

Almost 1 in 2 Indigenous Australians with a mental health condition were a daily smoker (46%) and about 2 in 5 (39%) to have used substances in the last 12 months. This was higher than for Indigenous  Australians with other long-term health conditions (33% and 24%, respectively) or those with no long term health condition (39% and 29% respectively) [4] (Table S3.11).

The Australian Burden of Disease Study provides an indication of the risk factors that contribute to the health gap between Indigenous and non-Indigenous Australians. In 2011, tobacco use accounted for 23.3% of the gap, and alcohol and drug use contributed to 8.1% and 4.1% of the gap, respectively [8] (Table S3.12).

Treatment

Indigenous Australians are also overrepresented in drug and alcohol treatment services. In 2016–17, the Alcohol and Other Drug Treatment Services National Minimum Dataset (AODTS-NMDS) showed that 15% of clients were Indigenous Australians aged 10 and over (Table S3.13). Indigenous Australians (3,313 per 100,000 population) were 7 times more likely to receive AOD treatment services than non-Indigenous Australians (430 per 100,000 population) were. Specifically where:

  • Amphetamines was the principal drug of concern, Indigenous Australians (1,204 per 100,000 population) were 8 times more likely than non-Indigenous Australians (155 per 100,000 population).
  • Heroin was the principal drug of concern Indigenous Australians (911 per 100,000 population) were 7 times more likely than non-Indigenous Australians (123 per 100,000 population) were.
  • Cannabis was the principal drug of concern Indigenous Australians (867 per 100,000 population) were 7 times more likely than non-Indigenous Australians (126 per 100,000 population) were.
  • Alcohol was the principal drug of concern Indigenous Australians (136 per 100,000 population) were 7 times more likely than non-Indigenous Australians (26 per 100,000 population) [9] (Table S3.14).

Dependence on opioid drugs (including codeine, heroin and oxycodone) can be treated with pharmacotherapy therapy using substitute drugs such as methadone or buprenorphine. The National Opioid Pharmacotherapy Statistics Annual Data collection (NOPSAD) provides information on clients receiving opioid pharmacotherapy treatment on a snapshot day each year. For jurisdictions where data was provided, in 2017:

  • Around 1 in 10 clients (9%) were Indigenous, an overrepresentation relative to their population size.
  • Indigenous Australians were almost 3 times as likely (70 clients per 10,000 population) to receive pharmacotherapy treatment as non-Indigenous Australians (26 clients per 10,000 population) [11] (Table S3.15).

Data from the OSR shows that 2015–16, there were 80 organisations around Australia that provided alcohol and other drug treatment services to around 32,700 Aboriginal and Torres Strait Islander clients [6]. The OSR data also shows that:

  • All 80 organisations reported that alcohol was one of the top five common substance-use issue, followed by cannabis (94%) and amphetamines (70%)
  • Treatment episodes were more likely to be to occur in non-residential settings (87%)
  • One third of all treatment episodes were in Very remote areas (32%) and the highest proportion of clients were located in Major cities (35%).

Policy context

The Aboriginal and Torres Strait Islander Health Performance Framework 2017

The Aboriginal and Torres Strait Islander Health Performance Framework 2017 includes a suite of products that give the latest information on how Aboriginal and Torres Strait Islander people in Australia are faring according to a range of 68 performance measures across 3 tiers: Tier 1—health status and outcomes, Tier 2—determinants of health, and Tier 3—health system performance. The measures are based on the Aboriginal and Torres Strait Islander Health Performance Framework and cover data that has been collected on the entire health system, including Indigenous-specific services and programs, and mainstream services [12].

National Aboriginal Torres Strait Islander Peoples Drug Strategy 2014–2019

The National Aboriginal and Torres Strait Islander Peoples’ Drug Strategy 2014–2019 was a sub-strategy of the National Drug Strategy 2010–2015 and remains a sub-strategy under the National Drug Strategy 2017–2025. The overarching goal of this sub-strategy is to improve the health and wellbeing of Aboriginal and Torres Strait Islander people by preventing and reducing the harmful effects of alcohol and other drugs (AOD) on individuals, families and their communities [13].

NACCHO Aboriginal Health and the #UluruStatement promoted during #NRW18 and @TheLongWalkOz Thanks to @AMAPresident @EssendonFC @VAHS1972 @quitvic @DeadlyChoices

” What you (Victorian Premier Daniel Andrews ) said about Aboriginal and Torres Strait Islander advancement being led by Aboriginal and Torres Strait Islander people is absolutely right,

The great Australian Chris Sarra said very wisely … governments have got to stop doing things to Aboriginal people and start doing things with them and that is my commitment.”

Prime Minister Malcolm Turnbull has told a Reconciliation event The Long Walk he is committed to following the lead of Indigenous people, less than a year after rejecting their call for an enshrined voice in parliament.

After Premier Daniel Andrews spoke of his government’s efforts to create a state Treaty at the Long Walk event at Melbourne’s Federation Square, Mr Turnbull said the two leaders were “starting to agree on more things all the time”.

During a summit at Uluru in May 2017, Indigenous leaders rejected symbolic constitutional recognition in favour of an elected parliamentary advisory body and a treaty.

But in October, Mr Turnbull said a new representative body was not desirable or capable of winning acceptance at a referendum

NACCHO Aboriginal Health #treaty : #Uluru Summit calls for the establishment of a First Nations Voice enshrined in the Constitution

Australian Medical Association has thrown its support behind last year’s Uluru Statement from the Heart: It was a fairly clear-cut decision for us to make.

We recognise the issue regarding the will to want to have the right to self-determination. We recognise the health inequities, the social justice inequities, the wellness inequities that confront our Indigenous population.

And this Statement is just another way of trying to ensure that we can continue to work and get all governments, both State, Federal, and Territory, to work towards closing the gap, improving the social determinants of health, and recognising the need and the required improvements that are necessary to address the gap that currently exists.

The ACCHOs, or Aboriginal Community Controlled Health Organisations, are a very important part of the health delivery process. It recognises that the usual relationships, when it comes to health facilities in a different way, it’s a different connectivity. “

The recently elected Australian Medical Association’s President, Tony Bartone, who participated in the Long Walk spoke with ABC Radio reporter, Dan Conifer . See full interview and AMA press release Part 1 and 2 below

 

 ” Politicians, footballers and campaigners have joined thousands of Australians in the Long Walk event to support moves to improve Indigenous health and celebrate Aboriginal and Torres Strait Islander culture.

It has been 14 years since AFL champion Michael Long’s momentous journey from his home in Melbourne to the Prime Minister to get the lives of Aboriginal and Torres Strait Islander people back on the national agenda.

Indigenous health is focal point of this year’s walk, with the Victorian Aboriginal Health Service Australian Medical Association (AMA) and Quit Victoria both throwing their support behind the event.

Ill health forced Essendon great Michael Long to miss this year’s Long Walk.

Part 1 : Australian Medical Association has thrown its support behind last year’s Uluru Statement from the Heart

The AMA Federal Council has endorsed the Uluru Statement from the Heart, which calls for a First Nations’ voice in the Australian Constitution.

AMA President, Dr Tony Bartone, said today that the AMA has for many years supported Indigenous recognition in the Australian Constitution, and that the Uluru Statement is another significant step in making that recognition a reality.

“The Uluru Statement expresses the aspirations of Aboriginal and Torres Strait Islander people in regard to self-determination and status in their own country,” Dr Bartone said.

“The AMA is committed to improving the health and wellbeing of Aboriginal and Torres Strait Islander peoples.

“Closing the gap in health services and outcomes requires a multi-faceted approach.

“Cooperation and unity of purpose from all Australian governments is needed if we are to achieve meaningful and lasting improvements.

“This will involve addressing the social determinants of health – the conditions in which people are born, grow, live, work, and age.

“Constitutional recognition can underpin all these endeavours, as we work to improve the physical and mental health of Indigenous Australians.”

Dr Bartone said the AMA was proud to announce its endorsement of the Uluru Statement during National Reconciliation Week.

Part 2 :The recently elected Australian Medical Association’s President, Tony Bartone, who participated in the Long Walk spoke with ABC Radio reporter, Dan Conifer

ELIZABETH JACKSON: Within the next couple of years, your local doctor’s surgery could be adorned with posters supporting Indigenous Constitutional change. The highly influential

Australian Medical Association has thrown its support behind last year’s Uluru Statement from the Heart. The peak body says including Aboriginal and Torres Strait Islander people in the nation’s founding document could help make Indigenous patients healthier. The AMA’s President Tony Bartone has told our political reporter Dan Conifer the organisation is unequivocal in its support.

TONY BARTONE: It was a fairly clear-cut decision for us to make. We recognise the issue regarding the will to want to have the right to self-determination. We recognise the health inequities, the social justice inequities, the wellness inequities that confront our Indigenous population. And this Statement is just another way of trying to ensure that we can continue to work and get all governments, both State, Federal, and Territory, to work towards closing the gap, improving the social determinants of health, and recognising the need and the required improvements that are necessary to address the gap that currently exists.

DAN CONIFER: Can you just explain for us how something like the Uluru Statement from the Heart, and the changes that it calls for, would support health outcomes, would improve life expectancy and so on?

TONY BARTONE: They’re fairly fundamental aspirations that are part of the Uluru Statement, and those aspirations and recognitions really speak to a number of emotional, physical, and broader social, environmental issues that really will address, as we say, the social determinants of health. We can’t really seek to close the gap when it comes to health outcomes until we address the fundamental building blocks.

DAN CONIFER: Now, one of the key elements of the Uluru Statement is about involving Aboriginal and Torres Strait Islander Australians in decision-making processes. In the medical profession, how has involving Indigenous Australians driven improvements?

TONY BARTONE: The ACCHOs, or Aboriginal Community Controlled Health Organisations, are a very important part of the health delivery process. It recognises that the usual relationships, when it comes to health facilities in a different way, it’s a different connectivity. Put another way, it recognises the inherent qualities and behavioural patterns of our Indigenous population, and that is different from a traditional Western-type setting which we’ve become experienced with.

DAN CONIFER: And if a referendum were to be held on any of the elements of the Uluru Statement, how would the AMA, individual doctors and specialists around the country, take part or be involved in that campaign?

TONY BARTONE: We would use all avenues open to us, both in terms of our advocacy and communication with our members, to ensure that the information and the sharing of that information, in terms of the wider community, patients who come to our surgery, the access points that we do have, are used to the fullest in terms of ensuring a proper address of the Statement’s initiatives.

DAN CONIFER: So we could see Vote Yes posters or pamphlets or badges in GP surgeries when this, or if this comes to a vote?

TONY BARTONE: What we’d see is the Association taking a front foot in our communication and advocacy on behalf of members. Of course, each individual member is free and would be wanting to participate to perhaps even a fuller extent, which would lead to putting up of posters and sharing that material in a surgery environment. But we would take a front foot more at an Association level to ensure that we communicate with our stakeholders, with our leaders in Parliament, and with the community in general through our media connectivity to communicate that wish and desire.

Part 3 The Long Walk ,VAHS and Quit Victoria promotes Indigenous health

Smoking rates among Aboriginal and Torres Strait Islander people are almost three times the national average of non-Indigenous people, although the prevalence in Indigenous communities is falling steadily.

In Victoria, 41 per cent of the Aboriginal and Torres Strait Islander population are smokers.

Quit Victoria’s Aboriginal Tobacco Control Program Coordinator Jethro Pumirri Calma-Holt told SBS News the health of Indigenous Australians should be kept at the top of the agenda.

“Indigenous health is something that needs to be invested in by everyone and that’s part of national reconciliation week.”

“What Michael Long did all those years ago has created a really big legacy for everyone to follow in his footsteps,” he said

Check it out the legend himself Anthony McDonald-Tipungwuti wearing the VAHS Deadly Choices Shirt out during the warm up for Dream Time at the G. The other players also wore the shirts as well… What a moment !

If you want your very own VAHS Deadly Choices Shirt just like Tippa the only way you can get one is to complete a health check at VAHS. So call us and book your health check on 03 9419 3000

 

 

 

NACCHO Aboriginal Health #IHMayDay18 #ACCHO Deadly Good News stories : Features #WorldNoTobaccoDay events from #NSW @ReadyMob @Galambila #QLD @Apunipima #VIC @VAHS1972 #SA #WA #NT @DanilaDilba

1.1 National :The Northern Territory Government, a serial offender, has again received the Dirty Ashtray Award, for putting in the least effort to reduce smoking over the past 12 months.

1.2 RACGP and NACCHO presents Smoking podcast

2 .NSW : Galambila ACCHO – READY MOB Tackling Smoking and Healthy Lifestyles team host #IHMayday18

3.1 VACCHO Quit the smokes today 

3.VIC : VAHS Healthy Lifestyle Team launch new Deadly Dan movie and education package on World No Tobacco Day

4.QLD : Apunipima ACCHO Cape York launches 3 great videos on World No Tobacco Day

 

5.WA : Listen in, as Jodi from the TIS team at Wirraka Maya ACCHO , offers a few key messages to help you protect those around you from harmful second-hand smoke.

6 .SA : Zena Wingfield is the Tackling Indigenous Smoking Project Officer at Nunyara Aboriginal Health Service

7.1 NT : Danila Dilba ACCHO Darwin launches community campaign

7.2 NT Congress Alice Springs World No Tobacco Day Event  

8. ACT : Deadly Choices World No Tobacco Day

Video From Congress Alice Springs

 

 View hundreds of ACCHO Deadly Good News Stories over past 6 years

How to submit a NACCHO Affiliate  or Members Good News Story ?

 Email to Colin Cowell NACCHO Media    

Mobile 0401 331 251

Wednesday by 4.30 pm for publication each Thursday /Friday

 

1.National : The Northern Territory Government, a serial offender, has again received the Dirty Ashtray Award, for putting in the least effort to reduce smoking over the past 12 months.

“Smoking kills. Smoking robs people, including young people, of their health.

“Governments must do more to help people to stop smoking, or to not take up the deadly habit in the first place.

“Strong government actions, including making packaging unappealing, keeping tobacco products out of view, and keeping tobacco prices high, have helped to encourage people to quit, or young people not to start.

“The Minister for Indigenous Health, Ken Wyatt, is to be commended for continuing funding of $183.7 million over four years for the Tackling Indigenous Smoking program.

Releasing the AMA/ACOSH National Tobacco Control Scoreboard 2018 on World No Tobacco Day, AMA President, Dr Tony Bartone, said it is the third year in a row that the NT has earned the dubious honour.

“The NT scored an E this year, and continues to fail miserably when it comes to protecting Territorians from the harms from smoking,” Dr Bartone said.

“This completes a ‘dirty dozen’ for the Territory – its 12th ‘win’ since the Award was first presented in 1994.

“The Queensland Government has won the Achievement Award for the second year in a row, but it still only scored a C – a C for complacency.”

Queensland was narrowly the best of the C-graders, scoring highest in the provision of smoke-free environments. It was just ahead of the Australian Government for its appropriate, evidence-based decisions about liquid nicotine and e-cigarettes.

Dr Bartone said that all Australian governments must urgently step up their efforts to combat smoking, including reintroducing education campaigns, and banning shop assistants and employees under the age of 18 from selling tobacco products.

“While Australia has made remarkable progress in tackling tobacco, we are in danger of losing momentum in the face of constant efforts by the tobacco industry to promote smoking,” Dr Bartone said.

“Tobacco is unique among consumer products in that it causes disease and premature death when it is used exactly as intended. Two out of three smokers will die from their habit.

“We know that public education and awareness campaigns can have a powerful effect on people’s decisions, yet there has been no national media campaign on tobacco since 2012.

“It is especially disappointing that, yet again, the latest Federal Budget provides no new funding, despite expecting to raise more than $11 billion a year from tobacco taxes.

“It is important that we stay vigilant against any attempts to normalise smoking, or make it appealing to young people.

Above : Katherine West Health Board NT

“This includes regulating e-cigarettes in exactly the same manner as tobacco cigarettes, and not allowing them to be marketed as quit smoking aids until such time as there is scientific evidence that they work as cessation aids, and do not cause further harm

“But no one government is excelling.

“Tobacco control is still a public health priority, here and around the world.

“Australia has to reclaim its reputation as the world leader in tobacco control.”

The AMA/ACOSH National Tobacco Control Scoreboard is compiled annually to mark World No Tobacco Day on 31 May.

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

The judges called on all jurisdictions to allocate consistent funding for strong media campaigns, and to ban all remaining forms of tobacco marketing and promotion.

They also called on all States and Territories to strengthen controls on the sale of tobacco by banning employees under 18 from selling tobacco products.

1.2 RACGP and NACCHO presents Smoking podcast

‘Do you smoke?’ A simple preventive activity for clinicians to engage with every patient. Listen to Episode one:

Smoking & Smoking Cessation with Prof David Thomas on The National Guide Podcast

2 .NSW : READY MOB ACCHO’s Tackling Smoking and Healthy Lifestyles team host #IHMayday18

Kristy Pursch and David ReidStepping into a smoke free future

Pursch and Reid are members of the READY MOB Tackling Smoking and Healthy Lifestyles team, and are passionate about raising the awareness of the health impacts of tobacco smoking and chronic disease in Aboriginal communities and promoting positive lifestyle changes.

 

READY MOB is: Really Evaluate And Decide Yourself Make Ourselves Better.

We couldn’t do what we do without great relationships and collaboration. Working together for community

The name also signifies that the team is READY to work with the community to promote healthy lifestyles. They are based at the Galambila Aboriginal Health Service on the mid north coast of NSW.

Follow – @KristyPursch

 

2.2 NSW  : Tamworth says no to smokes

How young minds are getting blown away from  smokes

http://www.northerndailyleader.com.au/story/5440414/how-young-minds-are-getting-blown-away-from-smokes/?cs=159 via @The_NDL

3.1 VACCHO Quit the smokes today 

Quit the smokes today on to improve your health and reduce your risk of heart disease and stroke.

Contact your local ACCO or the Aboriginal Quitline today for support

 

3.VIC : VAHS Healthy Lifestyle Team launch new Deadly Dan movie and education package on World No Tobacco Day

 WATCH HERE

 

The VAHS Healthy Lifestyle Team and Darebin City Council launched the Deadly Dan Education Suite to teachers within the Darebin area. The new resource will include the book, our new film and 2 lesson plans with heaps of resources!

Thank you to Darebin Mayor Kim Le Cerf for attending and supporting this resource!

We’re excited to continue spreading Deadly Dan’s healthy lifestyle messages to early years and primary schools across Darebin.

If you couldn’t make it to the education launch or want more info about Deadly Dan’s education suite pleas contact Lena at 9403 3300 or message

4.QLD : Apunipima ACCHO Cape York launches 3 great videos on World No Tobacco Day

Today is #WNTD #WorldNoTobaccoDay is a day to raise awareness about the devastating health effects that tobacco use and exposure to second-hand tobacco smoke has on an individual, their family and the community

The Team in Coen

This we have launched 3 more of our campaign videos, we are showcasing some locals in Hope Vale’s real stories. Check out why Desmond stopped smoking

WATCH HERE

“My brother had emphysema, he would be still here if he didn’t smoke.” Lex from Hope Vale.

View Lex’s inspiring video here

Watch Here

Giving up is not as hard as what everyone predicted it to be” What’s your story Cape York?

Don’t make smokes your story!

5.WA : Listen in, as Jodi from the TIS team at Wirraka Maya ACCHO , offers a few key messages to help you protect those around you from harmful second-hand smoke.

Are you aware of the dangers of passive smoking?

Listen in, as Jodi from the TIS team at Wirraka Maya, offers a few key messages to help you protect those around you from harmful second-hand smoke.
If you need help quitting smoking, give us a call on 08 9172 0444#WMHSAC #BeAtYourBest #WirrakaMaya


VIEW HERE

6 .SA : Zena Wingfield is the Tackling Indigenous Smoking Project Officer at Nunyara Aboriginal Health Service

chatting on Community Soapbox today about , next Wednesday, 31st May.

Listen up: 

7.NT : Danila Dilba ACCHO Darwin launches community campaign\

Thanks to Larrakia TV (Aboriginal TV) for sharing this video showing Danila Dilba’s Tackling Indigenous Smoking team out and about promoting World No Tobacco day all this week in the community.

Great work by our team in spreading the message about the dangers of smoking.

Watch Here

 

7.2 NT Congress Alice Springs World No Tobacco Day Event  

 

 

8. ACT : Deadly Choices World No Tobacco Day

Did you know that pack-a-day smoking can cost more than just your health? Give it up for a year, and you could save $10,000!

Contact our clinics to have a yarn about quitting the smokes

8. Tasmania Aboriginal Centre not available at publication date

 

 

 

NACCHO Aboriginal Health #AFL @AlcoholDrugFdn #NRW2018 #WorldNoTobaccoDay : Senator Bridget McKenzie Minister for Sport and Rural Health supports Redtails Pinktails #SayNoMore Drugs, #Smoking and #FamilyViolence #SayYesTo #Education #Employment #Family #Community

 

 ” Over the weekend Senator Bridget McKenzie had a chat pregame to local Central Australia Redtails before they took on Darwin’s TopEnd Storm curtain raiser to AFL Sir Doug Nicholls Indigenous round , a 6 hour broadcast on Channel 7 nationally : The Redtails and PinkTails Right Tracks Program is funded by the Local Drug Action Teams Program ”

See Part 1 Below

Part 2 Say No more to Family Violence all players link up

Part 3 #WorldNoTobaccoDay May 31 launched in the Alice

 ” Tobacco smoking is the largest preventable cause of death and disease in Australia and the Coalition Government is further committing to reduce the burden on communities.

In the lead up World No Tobacco Day on 31 May, today I am pleased to launch the next phase of the Coalition Government’s highly successful campaign Don’t Make Smokes Your Story,”

Watch video launch in the

The Minister for Rural Health, Senator Bridget McKenzie was also is in Alice Springs to launch the next phase of the National Tobacco Campaign and said that smoking related illness devastates individuals, families and the wider community : see Part 3 below

PART 1

Arrernte Males AFL Opening Ceremony

Arrernte women AFL Opening Ceremony

Part 1 The Australian Government and the ADF are excited to welcome an additional 92 Local Drug Action Teams, in to the LDAT program

The Senator with Alcohol and Drug Foundation CEO Dr Erin Lalor and  General Manager of Congress’ Alice Springs Health Services, Tracey Brand in Alice Springs talking about the inspirational Central Australian Local Drug Action Team at Congress and announcing 92 Local Drug Action Teams across Australia building partnerships to prevent and minimise harm of ice alcohol & illicit drugs use by our youth with local action plans

WATCH VIDEO of Launch

The Local Drug Action Team Program supports community organisations to work in partnership to develop and deliver programs that prevent or minimise harm from alcohol and other drugs (AOD).

Local Drug Action Teams work together, and with the community, to identify the issue they want to tackle, and to develop and implement a plan for action.

The Alcohol and Drug Foundation provides practical resources to assist Local Drug Action Teams to deliver evidence-informed projects and activities. The community grants component of the Local Drug Action Team Program may provide funding to support this work.

Each team will receive an initial $10,000 to develop and finalise a Community Action Plan and then to implement approved projects in your community. Grant funding of up to a maximum of $30k in the first year and up to a maximum of $40k in subsequent years is also available to help deliver approved projects in Community Action Plans. LDAT funding is intended to complement existing funding and in kind support from local partners.

LDATs typically apply for grants of between $10k and $15k to support their projects

 

See ADF website for Interactive locations of all sites

The power of community action

Community-based action is powerful in preventing and minimising harm from alcohol and other drugs.

Alcohol and other drugs harms are mediated by a number of factors – those that protect against risk, and those that increase risk. For example, factors that protect against alcohol and other drug harms include social connection, education, safe and secure housing, and a sense of belonging to a community. Factors that increase risks of alcohol and other drug harms include high availability of drugs, low levels of social cohesion, unstable housing, and socioeconomic disadvantage. Most of these factors are found at the community level, and must be targeted at this level for change.

Alcohol and other drugs are a community issue, not just an individual issue.

Community action to prevent alcohol and other drug harms is effective because:

  • the solutions and barriers (protective/risk factors) for addressing alcohol and other drugs harm are community-based
  • it creates change that is responsive to local needs
  • it increases community ownership and leads to more sustainable change

Part 2 Say No more to Family Violence all players link up

Such a powerful message told here in Alice Springs today as the Redtails Football Club, Top End Storm football club, link arms with the Melbourne Football Club, Adelaide Football Club for the NO MORE Campaign AU before the AFL Indigenous Round started.

WEBSITE Link up and say ‘No More’

 

 Watch Channel 7 Coverage of this special statement from all players

Part 3 #WorldNoTobaccoDay May 31 launched in the Alice

Tobacco smoking is the largest preventable cause of death and disease in Australia and the Coalition Government is further committing to reduce the burden on communities.

In the lead up World No Tobacco Day on 31 May, today I am pleased to launch the next phase of the Coalition Government’s highly successful campaign Don’t Make Smokes Your Story,”

Watch the ABC TV Interview HERE

Watch video of launch in the Alice

Successful Tobacco Campaign Continues

Tobacco smoking is the largest preventable cause of death and disease in Australia and the Coalition Government is further committing to reduce the burden on communities.

The Minister for Rural Health, Senator Bridget McKenzie was in Alice Springs to launch the next phase of the National Tobacco Campaign and said that smoking related illness devastates individuals, families and the wider community.

“In the lead up World No Tobacco Day on 31 May, today I am pleased to launch the next phase of the Coalition Government’s highly successful campaign Don’t Make Smokes Your Story,” Minister McKenzie said.

“The latest phase of Don’t Make Smokes Your Story continues to focus on Indigenous Australians aged 18–40 years who smoke and those who have recently quit. The campaign also concentrates on pregnant women and their partners with Quit for You, Quit for Two.

“An evaluation of the first two phases of the campaign revealed they had successfully helped to reduce smoking rates.

“More than half of the Aboriginal and Torres Strait Islander participants who saw the campaign took some action towards quitting smoking — and 8 per cent actually quit.

“These are very promising stats, however, we must continue to support and encourage those Australians who want to quit, but need help.”

The launch of the next phase of the campaign aligns with World No Tobacco Day and this year’s theme is Tobacco and heart disease.

“Cardiovascular disease is one of the leading causes of death in Australia, killing one person every 12 minutes,” Minister McKenzie said.

“There is a clear link between tobacco and heart and other cardiovascular diseases, including stroke — a staggering 45,392 deaths in Australia can be attributed to cardiovascular disease in 20151.

“Latest estimates show that tobacco use and exposure to second-hand tobacco smoke not only costs the lives of loved ones, but it costs the Australian community $31.5 billion in social — including health — and economic costs.”

“The Coalition Government, along with all states and territories, has made significant efforts to reduce tobacco consumption across the board.

“For example, we know that tobacco is the leading cause of preventable disease for Aboriginal and Torres Strait Islander people accounting for more than 12 per cent of the overall burden of illness.

“The Coalition Government has recently invested $183.7 million continuing to boost the Tackling Indigenous Smoking program to cut smoking and save lives.

“This comprehensive program has helped to cut the rates of Aboriginal and Torres Strait Islander people smoking and we want to build on this success.

“The Government’s investment in this program highlights our long-term commitment to Closing the Gap in health inequality.”

The ABS report Aboriginal and Torres Strait Islander People: Smoking Trends, Australia, 1994 to 2014-15, reported a decrease in current (daily and non-daily) smoking rate in those aged 18 years and older from 55 per cent in 1994 to 45 per cent in 2014-15, which shows Indigenous tobacco control is working.

For help to quit smoking, phone the Quitline on 13 7848, visit the Department of Health’s Quitnow website or download the free My Quitbuddy app.

Your doctor or healthcare provider can also help with information and support you may need to quit.