NACCHO Our Members #Aboriginal Health Deadly Good News Stories : Features #WNTD2019 @TISprogramme Photos from @NACCHOChair #NSW @ahmrc @ReadyMob @Galambila #Redfern ACCHO @awabakalltd #VIC @VACCHO_org #QLD @Apunipima @DeadlyChoices #SA @AHCSA_ #WA @TheAHCWA #NT @CAACongress @Kwhb_OneShield

For World No Tobacco Day 31 May NACCHO celebrates and highlights examples of the great work many of our Aboriginal Community Controlled Health Services throughout Australia are doing in tobacco control.

1.National

2.New South Wales

3.Victoria

4.Queensland

5.Western Australia

6.South Australia

7.Tasmania

8.Northern Territory

9.ACT

10. Sista Quit

How to submit in 2019 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 Thursday /Friday

1.National

On World No Tobacco Day NACCHO participated in the National #CommunityControl Twitter Festival that spotlighted the work of Aboriginal Community Controlled Health Services in tobacco control.

The Festival was sponsored by the Aboriginal Health and Medical Research Council of NSW (AH&MRC) and hosted by Croakey Professional Services.

For full Croakey coverage of the event

Read the first one here

The second one here

And the third here

During the period when Croakey was publishing about the Twitter Festival (13 May-3 June 2019), 299 Twitter accounts sent more than 2,000 tweets using the #CommunityControl hashtag, creating more than 17 million Twitter impressions.

See the Symplur Analytics here, and the Twitter transcript here.

Read all NACCHO Smoking articles HERE 

2.New South Wales

2.1 AHMRC

 

It’s vital that brief tobacco interventions are embedded into routine health care and checks. Our staff love to yarn with community to help them quit. You can read about the #ATRACYarning Tool here: https://buff.ly/2JLvWaF 

We have developed the #ATRAC Yarning Tool which has been incorporated into smoking cessation programs across the country. The tool has assisted many health workers to initiate meaningful smoking cessation discussions with clients.

2.2 Redfern ACCHO

2.3 Ready Mob Coffs Harbour to Port Macquarie

The Tackling Indigenous Smoking program team Ready Mob is a federally funded program based out of Galambila Aboriginal Health Service in Coffs Harbour, covering the Mid North Coast region from Coffs Harbour through to Port Macquarie.

My name is Kristy Pursch and my ancestral ties are to the Butchulla people of Fraser Island in Queensland. I have lived in NSW for the past 20 years and brought my children up in beautiful Gumbaynggirr country for the past 14 years.

Ready Mob is an acronym for Really Evaluate and Decide Yourself, Make Ourselves Better which is all about self determination, we don’t tell our mob what to do we just provide the tools and education so that people can make their own informed decisions.

Our strategy to work in and with our local communities is to use local places and local faces. Our relationships in communities are paramount to our effectiveness as a health promotion program.

There are 8 people in our team and all are Aboriginal people with the majority working within their own ancestral lands. This connection and investment in our own local people is integral at ensuring our approach is both determined by and effective for our local mob.

Second and third hand smoke causes just as much damage to small lungs as smoking resulting in more acute respiratory infections, severe asthma attacks and can cause middle infections.

Encouraging our smokers to ‘take a look around and see, who are you sharing your smoke with?’ A non shame based campaign encouraging introspection and positive decision making especially around the impacts smoking causes to those around you.

As with all our campaigns the call to action is to seek quit support by calling the Quitline or visiting your GP and local Aboriginal Medical Service

2.4 Tharawal ACCHO Dr Tim Senior

And working in #communitycontrol means they know the service is set up for them, and they have friends and relatives employed there and on the board! And we have staff and programs that will help.

So for example, I have access to free nicotine replacement, as well as the medicines on the PBS. And especially important are our health workers and our mums and bubs and social and emotional wellebeing programs. And dentists.

Fundamentally, my goal as a GP in #CommunityControl is to enable people to make decisions about their life, NOT tell people what to do. (We’ve tried that for >200 yrs. It doesn’t work!)

And having a relationship with a patient, means the discussion we have can be very practical.

I’ve never met anyone who doesn’t know that smoking is bad for them. But stress, poverty, boredom, habit, socialising underscored by addiction are all reasons people continue to smoke.

We can offer practical advice for all of these things, in complete confidence, with onward referral as appropriate

FYI, these are the smoking cessation guidelines.

2.5 Awabakal ACCHO

2.6 Yerin ACCHO Gosford 

3.Victoria

3.1 VACCHO

3.2 Goolum Goolum Aboriginal Co-Operative

World No Tobacco Day @ Goolum. Great day, great feed and celebrating #smokefreemob champions.

4.Queensland

4.1 Apunipima ACCHO Cape York

Last week TIS Health Workers Brett and Clara celebrated WNTD in Kowanyama with a morning tea and an educational stall

4.2 Deadly Choices 

5.Western Australia

5.1 AHCWA 

5.2 Join the TIS team now at Wirraka Maya for World no Tobacco Day.

Have your Smoke reading taken, along with Quit Smoking support and information.

 

6.South Australia

6.1 AHCSA

AHCSA Staff came together to raise awareness about World No Tobacco Day today and joined the mob by taking the 2019 Puyu Blasters Pledge.

Are you interested in taking the pledge? Follow the link to find out how..

6.2 Tackling Tobacco Team – Nunkuwarrin Yunti

The Tackling Tobacco Team helped the team and kids of Playford and was given the chance to have a hit of tennis with the Deadly and Legendary Evonne Goolagong-Cawley. The ‘Come and Try’ clinics are for 5 to 15 year old boys and girls, with an emphasis on having fun and being healthy!

6.3 AHCSA Puyu Blaster

Today the Puyu Blaster and the Aboriginal Dental Program visited Berri Primary School to celebrate World No Tobacco Day this week. We look forward to coming back. Thanks for having us!

Who are the Puyu Blasters?

We all are!

Puyu Blasters is a community based approach to addressing the issue of smoking within our communities.

The Puyu Blasters Team is hosted by the Aboriginal Health Council of South Australia and it’s Tackling Indigenous Smoking (TIS) Program.

The AHCSA TIS Program has been funded to support regional approaches to reducing the gap in prevalence of smoking among Aboriginal and Torres Strait Islander People compared to that among non-Indigenous, through;

  • Reducing uptake of smoking
  • Increasing smoking cessation and
  • Reduced exposure to environmental tobacco smoke

7.Tasmania ( TBC )

8.Northern Territory

8.1  Congress Alice Springs

Our Health Promotions team would like to thank everyone who came down to Araluen Park on Saturday to participate in the World No Tobacco Day Colour Smash Fun Run/Walk.

To View all Facebook Photos 

We had a massive turn out and all had a lot of fun!

#filltheskywithcolournotsmoke #smokefreethewaytobe

8.2 Katherine West Health Board

The Quitskills Team would like to acknowledge the traditional people of the Katherine region for welcoming the Quitskills educators onto their country to deliver smoking cessation training.

We would also like to acknowledge the hard work of the team from Katherine West Health Board whose aim is to provide a holistic clinical, preventative and public health service to clients in the Katherine West Region of the Northern Territory of Australia.

We wish you the greatest success in achieving your aim.

Smoke breath 🤢
Keep your breath fresh by staying smoke free!

Yarn with your local Health Centre about how to quit smoking
What’s Your Smoke Free Story?

8.3 Danila Dilba ACCHO

On May 31 Danila Dilba Community Services and Northern Territory Government AOD teams set up information stalls around Darwin and Palmerston for World No Tobacco Day. Thank you to everyone who popped in for a yarn! If you are ready to start your quit journey or thinking about quitting smoking, contact your local Danila Dilba Clinic and book an appointment with a GP, Aboriginal Health Practitioner or Tobacco support team.

Make every day World No Tobacco Day! #Notobacco #WorldNoTobaccoDay#KickinTobacco #LiveLongLiveStrong

9.ACT _TBC 

10. Sista Quit

Our new centre in Coffs Harbour will support excellence in we are seeking three full-time researchers (as many as possible to be Indigenous) and offering Indigenous PhD scholarship – get in touch

See details here on NACCHO Communique 

Aboriginal Health and Smoking #WNTD2019 31 May News Alerts #CommunityControl #YourHealthYourFuture: Over 7 years 130 Plus articles Including 20 myths about smoking that will not die

“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 on World No Tobacco Day, AMA President, Dr Tony Bartone

NACCHO and Croakey followers are invited to join Aboriginal Community Controlled Health Services in New South Wales in a Twitter Festival focused on tobacco control initiatives and successes across Australia.

NACCHO will be posting 8.45 to 9.00 AM Follow NACCHO

Follow the discussions on Twitter and contribute your views by using the hashtags #CommunityControl and #YourHealthYourFuture.

Please encourage your networks and organisations to support the event by following the discussion and retweeting as much as possible.

See full program 8.00 to 1.00 Pm HERE

Our special thanks to Tom Calma who has been our NO 1 promoter of our alerts 

Read or subscribe to NACCHO Daily Aboriginal Health News Alerts

“Across forty years I’ve come to recognise many factoid-driven myths about smoking that just won’t die. If I asked for a dollar each time I had to refute these statements, I’d have accumulated a small fortune.

Their persistence owes much to their being a vehicle for those who utter them to express unvoiced but clear sub-texts that reflect deeply held beliefs about women, the disadvantaged, mental illness, government health campaigns and the “natural”.

Let’s drive a stake through the heart of ten of the most common myths.”

Simon Chapman  Emeritus Professor in Public Health, University of Sydney

Originally published in The Conversation 

1. Women and girls smoke more than men and boys

Women have never smoked more than men. Occasionally, a survey will show one age band where it’s the other way around, but from the earliest mass uptake of smoking in the first decades of last century, men streaked out way ahead of women.

In 1945 in Australia, 72% of men and 26% of women smoked. By 1976, men had fallen to 43% and women had risen to 33%.

As a result, men’s tobacco-caused death rates have always been much higher than those of women. Women’s lung cancer rates, for example, seem unlikely to reach even half the peak rates that we saw among men in the 1970s.

Currently in Australia, 15% of men and 12% of women smoke daily.

But what about all the “young girls” you can see smoking, I’m always being told. In 2014, 13% of 17-year-old male high school students and 11% of females smoked. In two younger age bands, girls smoked more (by a single percentage point).

Those who keep on insisting girls smoke more are probably just letting their sexist outrage show about noticing girls’ smoking than their ignorance about the data.

2. Quit campaigns don’t work on low socioeconomic smokers

In Australia, 11% of those in the highest quintile of economic advantage smoke, compared with 27.6% in the lowest quintile. More than double.

So does this mean that our quit campaigns “don’t work” on the least well-off?

Smoking prevalence data reflect two things: the proportion of people who ever smoked, and the proportion who quit.

If we look at the most disadvantaged group, we find that a far higher proportion take up smoking than in their more well-to-do counterparts. Only 39.5% have never smoked compared with 50.4% of the most advantaged – see table 9.2.6).

When it comes to quitting, 46% of the most disadvantaged have quit compared to 66% of the least disadvantaged (see table 9.2.9).

There is a higher percentage of the disadvantaged who smoke mainly because more take it up, not because disadvantaged smokers can’t or won’t quit. With 27.6% of the most disadvantaged smoking today, the good news is that nearly three-quarters don’t. Smoking and disadvantage are hardly inseparable.

3. Scare campaigns ‘don’t work’

Countless studies have asked ex-smokers why they stopped and current smokers about why they are trying to stop. I have never seen such a study when there was not daylight between the first reason cited (worry about health consequences) and the second most nominated reason (usually cost).

For example, this national US study covering 13 years showed “concern for your own current or future health” was nominated by 91.6% of ex-smokers as the main reason they quit, compared with 58.7% naming expense and 55.7% being concerned about the impact of their smoking on others.

If information and warnings about the dire consequences of smoking “don’t work”, then from where do all these ex-smokers ever get these top-of-mind concerns? They don’t pop into their heads by magic. They encounter them via anti-smoking campaigns, pack warnings, news stories about research and personal experiences with dying family and friends. The scare campaigns work.

4. Roll-your-own tobacco is more ‘natural’ than factory made

People who smoke rollies often look you in the eye and tell you that factory made cigarettes are full of chemical additives, while roll-your-own tobacco is “natural” – it’s just tobacco. The reasoning here that we are supposed to understand is that it’s these chemicals that are the problem, while the tobacco, being “natural”, is somehow OK.

This myth was first turned very unceremoniously on its head when New Zealand authorities ordered the tobacco companies to provide them with data on the total weight of additives in factory made cigarettes, roll-your-own and pipe tobacco.

For example, data from 1991 supplied by WD & HO Wills showed that in 879,219kg of cigarettes, there was 1,803kg of additives (0.2%). While in 366,036kg of roll-your-own tobacco, there was 82,456kg of additives (22.5%)!

Roll-your-own tobacco is pickled in flavouring and humectant chemicals, the latter being used to keep the tobacco from drying out when smokers expose the tobacco to the air 20 or more times a day when they remove tobacco to roll up a cigarette.

5. Nearly all people with schizophrenia smoke

It’s true that people with mental health problems are much more likely to smoke than those without diagnosed mental health conditions. A meta-analysis of 42 studies on tobacco smoking by those with schizophrenia found an average 62% smoking prevalence (range 14%-88%). But guess which study in these 42 gets cited and quoted far more than any of the others?

If you said the one reporting 88% smoking prevalence you’d be correct. This small 1986 US study of just 277 outpatients with schizophrenia has today been cited a remarkable 1,135 times. With colleagues, I investigated this flagrant example of citation bias (where startling but atypical results stand out in literature searches and get high citations – “wow! This one’s got a high number, let’s quote that one!”).

By googling “How many schizophrenics smoke”, we showed how this percolates into the community via media reports where figures are rounded up in statements such as, “As many as 90% of schizophrenic patients smoke.”

Endlessly repeating that “90%” of those with schizophrenia smoke does these people a real disservice. We would not tolerate such inaccuracy about any other group.

6. Everyone knows the risks of smoking

Knowledge about the risks of smoking can exist at four levels:

  • Level 1: having heard that smoking increases health risks.
  • Level 2: being aware that specific diseases are caused by smoking.
  • Level 3: accurately appreciating the meaning, severity, and probabilities of developing tobacco related diseases.

Level 4: personally accepting that the risks inherent in levels 1–3 apply to one’s own risk of contracting such diseases.

Level 1 knowledge is very high, but as you move up the levels, knowledge and understanding greatly diminish. Very few people, for example, are likely to know that two in three long term smokers will die of a smoking caused disease, nor the average number of years that smokers lose off normal life expectancy.

7. You can reduce the health risks of smoking by just cutting down

It’s true that if you smoke five cigarettes a day rather than 20, your lifetime risk of early death is less (although check the risks for one to four cigarettes a day here).

But trying to “reverse engineer” the risk by just cutting down rather than quitting has been shown in at least four large cohort studies such as this one to confer no harm reduction.

If you want to reduce risk, quitting altogether should be your goal.

8. Air pollution is the real cause of lung cancer

Air pollution is unequivocally a major health risk. By “pollution”, those who make this argument don’t mean natural particulate matter such as pollen and soil dusts, they mean nasty industrial and vehicle pollution.

The most polluted areas of Australia are cities where pollution from industry and motor vehicle emissions are most concentrated. Remote regions of the country are the least polluted, so if we wanted to consider the relative contributions of air pollution and smoking to smoking-caused diseases, an obvious question to ask would be “does the incidence of lung cancer differ between heavily polluted cities and very unpolluted remote areas?”

Yes it does. Lung cancer incidence is highest in Australia in (wait for this …) in the least polluted very remote regions of the country, where smoking prevalence happens also to be highest.

9. Smokers should not try to quit without professional help or drugs

If you ask 100 ex-smokers how they quit, between two-thirds and three-quarters will tell you they quit unaided: on their final successful quit attempt, they did not use nicotine replacement therapy, prescribed drugs, or go to some dedicated smoking cessation clinic or experience the laying on of hands from some alternative medicine therapist. They quit unaided.

So if you ask the question: “What method is used by most successful quitters when they quit?” The answer is cold turkey.

Fine print on this English National Health Service poster states a bald-faced lie by saying that “There are some people who can go cold turkey and stop. But there aren’t many of them.” In the years before nicotine-replacement threapy and other drugs were available, many millions – including heavy smokers – quit smoking without any assistance. That’s a message that the pharmaceutical industry was rather not megaphoned

10. Many smokers live into very old age: so it can’t be that harmful

In just the way that five out of six participants in a round of deadly Russian roulette might proclaim that putting a loaded gun to their head and pulling the trigger caused no harm, those who use this argument are just ignorant of risks and probability.

Many probably buy lottery tickets with the same deep knowing that they have a good chance of winning.

11. Today’s smokers are all hard core, addicted smokers who can’t or won’t give up

This claim is the essence of what is known as the “hardening hypothesis”: the idea that decades of effort to motivate smokers to quit has seen all the low-hanging fruit fall from the tree, leaving only deeply addicted, heavy smokers today.

The key index of addicted smoking is the number of cigarettes smoked per day. This creates a small problem for the hardening hypothesis: in nations and states where smoking has reduced most, the average number of cigarettes smoked daily by continuing smokers has gone down, not up. This is exactly the opposite of what the hardening hypothesis would predict if remaining smokers were mostly hard core.

12. Smoking is pleasurable

Repeated studies have found that around 90% of smokers regret having started, and some 40% make an attempt to quit each year. There’s no other product with even a fraction of such customer disloyalty.

But I’m always amused at some die-hard smokers’ efforts explain that they smoke for pleasure and so efforts to persuade them to stop are essentially just anti-hedonistic tirades. Many studies have documented that the “pleasure” of smoking centres around the relief smokers get when they have not smoked for a while. The next nicotine hit takes away the discomfort and craving they have been experiencing.

This argument is a bit like saying that being beaten up every day is something you want to continue with, because hey, it feels so good when the beating stops for a while.

13. Light and mild cigarettes deliver far less tar and nicotine to the smoker than standard varieties

Several nations have outlawed cigarette descriptors such as “light” and “mild” because of evidence that such products do not deliver lower amounts of tar and nicotine to smokers, and so are deceptive.

The allegedly lower yields from cigarettes labelled this way resulted from a massive consumer fraud.

Cigarette manufacturers obtained these low readings by laboratory smoking machine protocols which took a standardized number of puffs, at a standardized puff velocity. The smoke inhaled by the machine was then collected in glass “lungs” behind the machine and the tar and nicotine weighed to give the readings per cigarette.

But the companies didn’t tell smokers two things. So-called light or mild cigarettes had tiny, near-invisible pin-prick perforations just on the filter (see picture). These holes are not covered by the “lips” or “fingers” of the laboratory smoking machine, allowing extra air to be inhaled and thus diluting the dose of tar and nicotine being collected.

But when smokers use these products, two things happen. Their lips and fingers partially occlude the tiny ventilation holes, thus allowing more smoke to be inhaled. Smokers unconsciously “titrate” their smoking to obtain the dose of nicotine that their brain’s addiction centres demand: they can take more puffs, inhale more deeply, leave shorter butt lengths or smoke more cigarettes.

Today, where use of these descriptors has been stopped, the consumer deception continues with the companies using pack colours to loudly hint to smokers about which varieties are “safer”.

Magnification and location of filter ventilation holes. Author collection

14. Filters on cigarettes remove most of the nasty stuff from cigarettes

We’ve all seen the brown stain in a discarded cigarette butt. But what few have seen is how much of that same muck enters the lungs and how much stays there.

This utterly compelling video demonstration shows how ineffective filters are in removing this deadly sludge. A smoker demonstrates holding the smoke in his mouth and then exhales it through a tissue paper, leaving a tell-tale brown stain. He then inhales a drag deep into his lungs, and exhales it into a tissue. The residue is still there, but in a much reduced amount. So where has the remainder gone? It’s still in the lungs!

15. Governments don’t want smoking to fall because they are addicted to tobacco tax and don’t want to kill a goose that lays golden eggs

This is perhaps the silliest and most fiscally illiterate argument we hear about smoking. If governments really want to maximise smoking and tax receipts, they are doing a shockingly bad job of it. Smoking in Australia has fallen almost continuously since the early 1960s. In five of the 11 years to 2011, the Australian government received less tobacco tax receipts than it did the year before (see Table 13.6.6).

Plainly, as smoking continues to decline, diminishing tax returns will occur, although this will be cushioned by the rising population which will include some smokers.

In the meantime, tobacco tax is a win-win for governments and the community. It reduces smoking like nothing else, and it provides substantial transfer of funds from smokers to government for public expenditure.

Those of us who don’t smoke do not squirrel away what we would have otherwise spent on smoking in a jam jar under the bed. We spend it on other goods and services, benefiting the economy too.

16. Most smokers die from smoking caused diseases late in life, and we’ve all got to die from something

Smoking increases the risk of many different diseases, and collectively these take about ten years off normal life expectancy from those who get them.

Smoking is by far the greatest risk factor for lung cancer. In Australia, the average age of death for people with lung cancer is 71.4 (see Table 4.2), while life expectancy is currently 80.1 for men and 84.3 for women.

This means that, on average, men diagnosed with lung cancer lose 8.7 years and women 12.9 years (mean 10.8 years). Of course, some lose many more (Beatle George Harrison died at just 58, Nat King Cole at 45).

If a 20-a-day smoker starts at 17 and dies at 71, 54 years of smoking would see 394,470 cigarettes smoked. At ten puffs per cigarette, that’s some 3.94 million point-blank lung bastings.

It takes about six minutes to smoke a cigarette. So at 20 a day, smokers smoke for two hours each day. Across 54 years, that’s a cumulative 1,644 days of smoking (4.5 years of continual smoking if you put it all together).

So by losing ten years off life expectancy, each cigarette smoked takes about 2.2 times the time it takes to smoke it off the life expectancy that might otherwise have been enjoyed.

17. Smokers cost the health system far less than the government receives from tobacco tax

In June 2015, a senior staff member of Australian libertarian Senator David Leyonhjelm, Helen Dale tweeted:

In Australia, a now old report looking at 2004/05 data estimated the gross health care costs attributable to smoking “before adjustment for savings due to premature death” were $A1.836 billion. In that financial year, the government received $A7,816.35 billion in customs and excise duty and GST on tobacco.

Someone who thought that the fiscal ledger was all that mattered in good government might conclude from this that smokers easily pay their way and perhaps we should even encourage smoking as a citizen’s patriotic duty.

With smokers being considerate enough to die early, these noble citizens lay down their lives early and thus contribute “savings due to premature death” like failing to draw a state pension or needing aged care services late in life. Philip Morris notoriously gave this advice to the new Czech government in 1999.

Other assessments, though, might well point to the values inherent in such assessments. History’s worst regimes have often seen economically non-productive people as human detritus deserving death. Primo Levi’s unforgettable witnessing of this mentality in Auschwitz comes to mind.

18. Big Tobacco is starting to invade low-income nations, now that smoking is on the wane in the wealthiest nations

Sorry, but US and British manufacturers have been aggressively marketing cigarettes in places such as China since the early years of last century. These collectable posters show many featuring Chinese women.

The large populations, the often lax tobacco-control policies and the higher corruption indexes of many low- and middle-income nations makes many of these nirvanas for Big Tobacco.

There are fewer more nauseating experiences than reading the corporate social responsibility reports of tobacco transnationals and then seeing how they operate in smokers’ paradises such as Indonesia. This documentary says it all.

19. Millions of cigarette butts on the world’s beaches leach lots of toxic chemicals into oceans

Cigarette butts are the most discarded items in all litter. Every year uncounted millions if not billions are washed down gutters in storm water and find their way into rivers, harbours and oceans. Cigarette filters and butts contain toxic residue and experiments have shown that placing laboratory fish in containers for 48 hours with leachate extracted from used cigarette butts, 50% of the fish die. From this, we sometimes hear people exclaim that cigarette butts are not just unsightly, but they “poison the oceans”.

But a confined laboratory container does not remotely mirror real life exposures in oceans or rivers. There are some 1,338,000,000 cubic kilometers of water in the world oceans, so the contribution of cigarette butts to the toxification of all this could only excite a homeopath.

If we want to reduce tobacco litter, we need not wander into such dubious justifications. The best way by far is to keep reducing smoking. Industry attempts at portraying themselves as corporately responsible by running dinky little clean-up campaigns or distributing personal butt disposal canisters avoids their efforts to keep as many smoking as possible.

20. Tobacco companies care deeply about their best customers dying early

Naturally, all businesses would rather their customers lived as long as possible so that the cash registers can keep ringing out long and loud. Tobacco companies wish their products didn’t kill so many, but worship the god nicotine for its iron grip on so many.

Visit any tobacco transnational’s website and you will find lots of earnest and caring talk about the companies’ dedication to doing all they can to reduce the terrible harm caused by their products. All the major companies have now invested heavily in electronic cigarettes, so isn’t this a sign that they taking harm reduction seriously?

It might be if the same companies were showing any sign of taking their feet off the turbo-drive accelerator of opposing effective tobacco control policies. But they are doing nothing of the sort. All continue to aggressively attack and delay any policy like tax hikes, graphic health warnings, plain packaging and advertising bans wherever in the world these are planned for introduction.

For all their unctuous hand-wringing about their mission to reduce harm, they are all utterly determined to keep as many smoking as possible. Big Tobacco’s business plan is not smoking or ecigarettes. It’s smoking and ecigarettes. Smoke when you are able to, vape when you can’t. It’s called dual use and some 70% of vapers are doing just that. The tragedy now playing out in some nations is that too many gormless tobacco control experts are blind to this big picture.

NACCHO and RACGP Podcast

Do you smoke?’ A simple preventive activity for clinicians to engage with every patient.

With over 30 years’ experience in Indigenous health, Professor David Thomas from the Menzies School of Health Research discusses updates to the smoking topic from Chapter 1: Lifestyle, in the third edition

Listen to Episode one:

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

NACCHO Aboriginal Health Conferences and Events #SaveADate #NRW2019 : This weeks feature @ahmrc Twitter Festival 31 May #WorldNoTobaccoDay #CommunityControl #YourHealthYourFuture #Smoking Moderated by @amymcquire @timsenior @harleymcquire

This weeks featured NACCHO SAVE A DATE events

31 May AHMRC World No Tobacco Day Twitter Festival 

29th  – 30th  August 2019 NACCHO OCHRE DAY

4 November NACCHO Youth Conference -Darwin NT

5 – 7 November NACCHO Conference and AGM  -Darwin NT

Download the 2019 Health Awareness Days Calendar 

27 May to 5 June National Reconciliation Week #NRW2019

18 -20 June Lowitja Health Conference Darwin

2019 Dr Tracey Westerman’s Workshops 

5 July NAIDOC week Symposium

6 July National NAIDOC Awards Canberra

7 -14 July 2019 National NAIDOC Grant funding round opens

2-5 August Garma Festival 

29th  – 30th  August 2019 NACCHO OCHRE DAY

23 -25 September IAHA Conference Darwin

24 -26 September 2019 CATSINaM National Professional Development Conference

9-10 October 2019 NATSIHWA 10 Year Anniversary Conference

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

4 November NACCHO Youth Conference -Darwin NT

5 – 7 November NACCHO Conference and AGM  -Darwin NT

5-8 November The Lime Network Conference New Zealand 

This weeks featured NACCHO SAVE A DATE events

NACCHO and Croakey followers are invited to join Aboriginal Community Controlled Health Services in New South Wales in a Twitter Festival focused on tobacco control initiatives and successes across Australia.

Follow the discussions on Twitter and contribute your views by using the hashtags #CommunityControl and #YourHealthYourFuture.

Please encourage your networks and organisations to support the event by following the discussion and retweeting as much as possible.

Bookmark this Twitter list to follow guest tweeters and learn more from community leaders and organisations across the tobacco control space.


World No Tobacco Day program

Draft as at 28 May : Check Croakey for the latest program 

#CommunityControl #YourHealthYourFuture

(All times are AEST)

8am – 8:15am – Launch

#CommunityControl #YourHealthYourFuture moderators:

Amy McQuire (8am-1pm) @amymcquire

Tim Senior (8am-11am) @timsenior

Hayley McQuire (11am-1pm) @HayleyMcQuire


8.15-8:45am – Introductions

Aboriginal Health & Medical Research Council: Your health Your Future, the strengths of the Aboriginal Community Controlled Health Service sector

@ahmrc


8.45 -9.00 am – National Perspective

National Aboriginal Community Controlled Health Organisation: Tobacco Control from the Aboriginal Community Controlled Health Service sector nationally

@NACCHOAustralia

Read over 130 NACCHO Aboriginal Health and Smoking articles HERE

9:00-9:15am – Dead or Deadly

Waminda South Coast Women’s Health and Welfare Aboriginal Corporation

@Deadordeadly1


9:15-9:30am – Ministry of Health

NSW Health: The role of the government in supporting tobacco control

@NSWHealth


9:30-9:45am – Linking Tobacco Control & Culture

Cancer Institute NSW & Aboriginal Quitline

@cancerNSW

@AQuitline


9:45-10:00am – Tackling Indigenous Smoking

Desley Thompson, Ninti One

@ninti_one


10:00-10:15am – Awabakal

Awabakal: Celebrating success in tobacco control initiatives in Newcastle and the Hunter Valley NSW

@AWABAKAL


10:15-10:30am – Riverina Medical and Dental Aboriginal Corporation

AH&MRC tweeting live from RivMed: Celebrating success in tobacco control initiatives in the Riverina region NSW

@ahmrc


10:30-10:45am – Creating and Leveraging Strategic Partnerships

Cancer Council NSW

@CCNewSouthWales


10:45-11:15am – Sharing Our Successes

Victorian Aboriginal Community Controlled Health Organisation (VACCHO), Queensland Aboriginal and Islander Health Council (QAIHC), Aboriginal Medical Services Alliance Northern Territory (AMSANT)

@VACCHO_org

@QAIHC_QLD

@AMSANTaus


11.15 -11.30 am – Ready Mob

Galambila Aboriginal Medical Service

@ReadyMob


11:30-11:45am – International Perspective

IndigenousNCDs

@IndigenousNCDs


11:45-12:00pm – iSISTAQUIT

Dr Gillian Gould: Successes in reducing the incidence of smoking during pregnancy

@GillianSGould


12:00-12:15pm – Tobacco Control during Rehabilitation

The Glen Centre – Central Coast Drug and Alcohol Rehabilitation

@TheGlenCentre


12:15-12:30pm – A GP’s perspective

Dr Tim Senior

@timsenior


12:30-12:45pm – Walgett Aboriginal Medical Service

Walgett: Celebrating success in tobacco control initiatives in northern NSW

@Walgett_AMS


12:45-1:00pm – Wrapping It Up

Moderators:

Amy McQuire  @amymcquire

Hayley McQuire  @HayleyMcQuire


The Twitter festival is hosted by Croakey Professional Services on behalf of the AH&MRC. We thank the AH&MRC for organising the program. Bookmark this link to follow related stories

Download the NACCHO 2019 Calendar Health Awareness Days

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

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

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

Download the 53 Page 2019 Health days and events calendar HERE

naccho zockmelon 2019 health days and events calendar

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

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

To submit your events or update your info

Contact: Colin Cowell www.nacchocommunique.com

NACCHO Social Media Editor Tel 0401 331 251

Email : nacchonews@naccho.org.au

 

27 May to 5 June National Reconciliation Week #NRW2019 

At the heart of reconciliation is the relationship between the broader Australian community and Aboriginal and Torres Strait Islander peoples. To foster positive race relations, our relationship must be grounded in a foundation of truth.

Aboriginal and Torres Strait Islander peoples have long called for a comprehensive process of truth-telling about Australia’s colonial history. Our nation’s past is reflected in the present, and will continue to play out in future unless we heal historical wounds.

Today, 80 per cent of Australians believe it is important to undertake formal truth telling processes, according to the 2018 Australian Reconciliation Barometer. Australians are ready to come to terms with our history as a crucial step towards a unified future, in which we understand, value and respect each other.

Whether you’re engaging in challenging conversations or unlearning and relearning what you know, this journey requires all of us to walk together with courage. This National Reconciliation Week, we invite Australians from all backgrounds to contribute to our national movement towards a unified future.

What is National Reconciliation Week?

National Reconciliation Week (NRW) is a time for all Australians to learn about our shared histories, cultures, and achievements, and to explore how each of us can contribute to achieving reconciliation in Australia.

The dates for NRW remain the same each year; 27 May to 3 June. These dates commemorate two significant milestones in the reconciliation journey— the successful 1967 referendum, and the High Court Mabo decision respectively.

Reconciliation must live in the hearts, minds and actions of all Australians as we move forward, creating a nation strengthened by respectful relationships between the wider Australian community, and Aboriginal and Torres Strait Islander peoples.

Resources HERE

18 -20 June Lowitja Health Conference Darwin


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

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

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

More Info 

2019 Dr Tracey Westerman’s Workshops 

More info and dates

5 July NAIDOC week Symposium

Symposium: Our Voice, Our Truth
Kick off NAIDOC week in Canberra with a Symposium event with keynote speakers and expert panel on the topic of good governance through strong leadership. A daylong event, fully catered with morning and afternoon tea, lunch and post-event drinks and canapes with entertainment to conclude.
This is an exclusive ticketed event in a stunning lakeside venue with limited seats available. Save the date – July 5 – and follow https://www.facebook.com/ailcleaders/ on Facebook to be the first in line to book tickets
6 July National NAIDOC Awards Canberra

7 -14 July 2019 National NAIDOC Grant funding round opens

VOICE. TREATY. TRUTH.

We invite you to walk with us in a movement of the Australian people for a better future.

The Indigenous voice of this country is over 65,000 plus years old.

They are the first words spoken on this continent. Languages that passed down lore, culture and knowledge for over millennia. They are precious to our nation.

It’s that Indigenous voice that include know-how, practices, skills and innovations – found in a wide variety of contexts, such as agricultural, scientific, technical, ecological and medicinal fields, as well as biodiversity-related knowledge.  They are words connecting us to country, an understanding of country and of a people who are the oldest continuing culture on the planet.

And with 2019 being celebrated as the United Nations International Year of Indigenous Languages, it’s time for our knowledge to be heard through our voice.

For generations, we have sought recognition of our unique place in Australian history and society today. We need to be the architects of our lives and futures.

For generations, Aboriginal and Torres Strait Islander peoples have looked for significant and lasting change.

Voice. Treaty. Truth. were three key elements to the reforms set out in the Uluru Statement from the Heart. These reforms represent the unified position of First Nations Australians.

However, the Uluru Statement built on generations of consultation and discussions among Indigenous people on a range of issues and grievances. Consultations about the further reforms necessary to secure and underpin our rights and to ensure they can be exercised and enjoyed by Aboriginal and Torres Strait Islander peoples.

It specifically sequenced a set of reforms: first, a First Nations Voice to Parliament enshrined in the Constitution and second, a Makarrata Commission to supervise treaty processes and truth-telling.

(Makarrata is a word from the language of the Yolngu people in Arnhem Land. The Yolngu concept of Makarrata captures the idea of two parties coming together after a struggle, healing the divisions of the past. It is about acknowledging that something has been done wrong, and it seeks to make things right.)

Aboriginal and Torres Strait Islander people want their voice to be heard. First Nations were excluded from the Constitutional convention debates of the 1800’s when the Australian Constitution came into force.  Indigenous people were excluded from the bargaining table.

Aboriginal and Torres Strait Islander peoples have always wanted an enhanced role in decision-making in Australia’s democracy.

In the European settlement of Australia, there were no treaties, no formal settlements, no compacts. Aboriginal and Torres Strait Islander people therefore did not cede sovereignty to our land. It was taken away from us. That will remain a continuing source of dispute.

Our sovereignty has never been ceded – not in 1788, not in 1967, not with the Native Title Act, not with the Uluru Statement from the Heart. It coexists with the sovereignty of the Crown and should never be extinguished.

Australia is one of the few liberal democracies around the world which still does not have a treaty or treaties or some other kind of formal acknowledgement or arrangement with its Indigenous minorities.

A substantive treaty has always been the primary aspiration of the Aboriginal and Torres Strait Islander movement.

Critically, treaties are inseparable from Truth.

Lasting and effective agreement cannot be achieved unless we have a shared, truthful understanding of the nature of the dispute, of the history, of how we got to where we stand.

The true story of colonisation must be told, must be heard, must be acknowledged.

But hearing this history is necessary before we can come to some true reconciliation, some genuine healing for both sides.

And of course, this is not just the history of our First Peoples – it is the history of all of us, of all of Australia, and we need to own it.

Then we can move forward together.

Let’s work together for a shared future.

Download the National NAIDOC Logo and other social media resources.

2-5 August Garma Festival 

Garma Website

29th  – 30th  Aug 2019 NACCHO OCHRE DAY

Venue: Pullman Hotel – 192 Wellington Parade, East Melbourne Vic 3000

Website to be launched soon

23 -25 September IAHA Conference Darwin

24 September

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

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

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

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

Read about the categories HERE.

24 -26 September 2019 CATSINaM National Professional Development Conference

 

 

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

Further information to follow soon.

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

Location: Sydney, Australia

Organiser: Chloe Peters

Phone: 02 6262 5761

Email: admin@catsinam.org.au

9-10 October 2019 NATSIHWA 10 Year Anniversary Conference

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

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

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

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

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

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

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

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

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

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

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

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

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

4 November NACCHO Youth Conference -Darwin NT

Darwin Convention Centre

Website to be launched soon

Conference Co-Coordinator Ben Mitchell 02 6246 9309

ben.mitchell@naccho.org.au

5 – 7 November NACCHO Conference and AGM  -Darwin NT

Darwin Convention Centre

Website to be launched soon

Conference Co-Coordinator Ben Mitchell 02 6246 9309

ben.mitchell@naccho.org.au

5-8 November The Lime Network Conference New Zealand 

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

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

NACCHO Aboriginal Women’s Health and How to #quitsmoking during #pregnancy with @sistaquit Plus #WorldNoTobaccoDay2019 May31 #WNTD2019 #WNTD

” Every year, on 31 May, the World Health Organization (WHO) and global partners celebrate World No Tobacco Day (WNTD). The annual campaign is an opportunity to raise awareness on the harmful and deadly effects of tobacco use and second-hand smoke exposure, and to discourage the use of tobacco in any form.

The focus of World No Tobacco Day 2019 is on “tobacco and lung health.” The campaign will increase awareness on:

  • the negative impact that tobacco has on people’s lung health, from cancer to chronic respiratory disease,
  • the fundamental role lungs play for the health and well-being of all people.

The campaign also serves as a call to action, advocating for effective policies to reduce tobacco consumption and engaging stakeholders across multiple sectors in the fight for tobacco control. ”

See full detail of World No Tobacco Day Part 2 Below

” In 2014 it was reported 45 per cent of surveyed Indigenous mothers smoked during pregnancy, compared to 13 per cent of non-Indigenous pregnant women.

Those figures have spurred University of Newcastle associate professor Gillian Gould to study what can be done to help reduce rates of Indigenous women smoking while pregnant.

It’s not only that they may be born with low birth rate, or have risks of premature birth, but it can set them up for things like obesity, diabetes, a higher risk of heart disease, and lots of respiratory illnesses.”

Smoking rates among pregnant Indigenous women tackled in major research project 

“ It’s imperative that Indigenous women have good access to smoking cessation services as 43 per cent of Indigenous women smoke. Essentially, we’re trying to ensure that Indigenous people have the same health outcomes as non-Indigenous people and we need to start before they’re born. 

Nothing like this is currently available and there are many systematic barriers that prevent women from accessing medical or antenatal care, which is a problem as it means women may present later than usual during their pregnancy,” Associate Professor Gould said.

We want to start the conversation about smoking as early as possible and found that many general practitioners and obstetricians lack the confidence or skills to provide this specialised type of knowledge.

Some women also receive mixed messages about the safety of quitting smoking or using nicotine replacement therapy during their pregnancy, so this initiative will bring health providers up to speed with the latest evidence-based treatment methods.”

Associate Professor Gould see full Press Release Part 1

Read over 130  + NACCHO Aboriginal health and Smoking articles HERE

Part 1

Health professionals and organisations will receive additional training and resources to help support Indigenous women quit smoking during pregnancy under a new multi-million dollar initiative being funded by the Australian Government Department of Health.

Led by renowned smoking cessation expert, Associate Professor Gillian Gould, the initiative will enable health practitioners who treat a pregnant woman in any medical capacity to complete an online training module and access a range of tailored treatment materials.

With smoking in pregnancy having a major impact on the lifelong health of mother and child, including birth complications and low birth weight, Associate Professor Gould said quitting smoking early in pregnancy would help to close the gap on Indigenous health.

As a general practitioner and researcher with the University of Newcastle and Hunter Medical Research Institute (HMRI)*, Associate Professor Gould said the iSISTAQUIT (Supporting Indigenous Smokers to Assist Quitting) initiative would help to provide a culturally sensitive and consistent approach to delivering better care across the country.

Building on lessons and findings from a separate pilot program, also led by Associate Professor Gould, iSISTAQUIT will feature online training via webinars that are self-paced, along with hard copy material such as a treatment manual and patient booklet.

“Many of the resources were developed during the pilot program and trialled across six states, so we’ve adapted them slightly and made them suitable for online delivery,” Associate Professor Gould said.

“Our pilot study revealed that 41 per cent of participants made quit attempts and the resources resulted in a quit rate of 14 per cent and increased engagement between Indigenous women and services.

“Ideally we want these resources to be available to all health practitioners and will look to disseminate them through our existing networks across Aboriginal services, professional colleges and bodies, primary health networks, obstetricians, hospital departments and other medical services throughout Australia when they become available.”

On April 4, 2019 the Department of Health awarded $3,891,801 to the initiative, from the Tackling Indigenous Smoking program. The national development of iSISTAQUIT will commence in the next few months from a newly-established centre in Coffs Harbour.

HMRI is a partnership between the University of Newcastle, Hunter New England Health and the community.

 Part 2 How tobacco endangers the lung health of people worldwide

World No Tobacco Day 2019 will focus on the multiple ways that exposure to tobacco affects the health of people’s lungs worldwide.

These include:

Lung cancer. Tobacco smoking is the primary cause for lung cancer, responsible for over two thirds of lung cancer deaths globally. Second-hand smoke exposure at home or in the work place also increases risk of lung cancer. Quitting smoking can reduce the risk of lung cancer: after 10 years of quitting smoking, risk of lung cancer falls to about half that of a smoker.

Chronic respiratory disease. Tobacco smoking is the leading cause of chronic obstructive pulmonary disease (COPD), a condition where the build-up of pus-filled mucus in the lungs results in a painful cough and agonising breathing difficulties. The risk of developing COPD is particularly high among individuals who start smoking at a young age, as tobacco smoke significantly slows lung development. Tobacco also  exacerbates asthma, which restricts activity and contributes to disability. Early smoking cessation is the most effective treatment for slowing the progression of COPD and improving asthma symptoms.

Across the life-course. Infants exposed in-utero to tobacco smoke toxins, through maternal smoking or maternal exposure to second-hand smoke, frequently experience reduced lung growth and function. Young children exposed to second-hand smoke are at risk of the onset and exacerbation of asthma, pneumonia and bronchitis, and frequent lower respiratory infections.

Globally, an estimated 165 000 children die before the age of 5 of lower respiratory infections caused by second-hand smoke. Those who live on into adulthood continue to suffer the health consequences of second-hand smoke exposure, as frequent lower respiratory infections in early childhood significantly increase risk of developing COPD in adulthood.

Tuberculosis. Tuberculosis (TB) damages the lungs and reduces lung function, which is further exacerbated by tobacco smoking. About one quarter of the world’s population has latent TB, placing them at risk of developing the active disease. People who smoke are twice as likely to fall ill with TB. Active TB, compounded by the damaging lung health effects of tobacco smoking, substantially increases risk of disability and death from respiratory failure.

Air pollution. Tobacco smoke is a very dangerous form of indoor air pollution: it contains over 7 000 chemicals, 69 of which are known to cause cancer. Though smoke may be invisible and odourless, it can linger in the air for up to five hours, putting those exposed at risk of lung cancer, chronic respiratory diseases, and reduced lung function.

Goals of the World No Tobacco Day 2019 campaign

The most effective measure to improve lung health is to reduce tobacco use and second-hand smoke exposure. But knowledge among large sections of the general public, and particularly among smokers, on the implications for the health of people’s lungs from tobacco smoking and second-hand smoke exposure is low in some countries. Despite strong evidence of the harms of tobacco on lung health, the potential of tobacco control for improving lung health remains underestimated.

The World No Tobacco Day 2019 campaign will raise awareness on the:

  • risks posed by tobacco smoking and second-hand smoke exposure;
  • awareness on the particular dangers of tobacco smoking to lung health;
  • magnitude of death and illness globally from lung diseases caused by tobacco, including chronic respiratory diseases and lung cancer;
  • emerging evidence on the link between tobacco smoking and tuberculosis deaths;
  • implications of second-hand exposure for lung health of people across age groups;
  • importance of lung health to achieving overall health and well-being;
  • feasible actions and measures that key audiences, including the public and governments, can take to reduce the risks to lung health posed by tobacco.

The cross-cutting theme of tobacco and lung health has implications for other global processes, such as international efforts to control noncommunicable diseases (NCDs), TB and air pollution for promoting health. It serves as an opportunity to engage stakeholders across sectors and empower countries to strengthen the implementation of the proven MPOWER tobacco control measures contained in the WHO Framework Convention for Tobacco Control (WHO FCTC).


Call to action

Lung health is not achieved merely through the absence of disease, and tobacco smoke has major implications for the lung health of smokers and non-smokers globally.

In order to achieve the Sustainable Development Goal (SDG) target of a one-third reduction in NCD premature mortality by 2030, tobacco control must be a priority for governments and communities worldwide. Currently, the world is not on track to meeting this target.

Countries should respond to the tobacco epidemic through full implementation of the WHO FCTC and by adopting the MPOWER measures at the highest level of achievement, which involves developing, implementing, and enforcing the most effective tobacco control policies aimed at reducing the demand for tobacco.

Parents and other members of the community should also take measures to promote their own health, and that of their children, by protecting them from the harms caused by tobacco.

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].