NACCHO Aboriginal Health @strokefdn @HeartAust New Year’s resolutions : For your health in 2018 have your blood pressure checked , it could save your life. #FightStroke

 

 ” We hear so much at this time of year about New Year’s resolutions – eat healthy, quit smoking, get more exercise, drink more water. The list goes on and on and on. 

While these are all valid and well intentioned goals, I am urging you to do one simple thing for your health in 2018 which could save your life. 

Have your blood pressure checked.  

High blood pressure is a key risk factor for stroke and one that can be managed.”

By Stroke Foundation Clinical Council Chair Associate Professor Bruce Campbell see full Press Release Part 1 WEBSITE

NACCHO has published 48 Aboriginal Health and Heart  Articles in the past 6 Years

NACCHO has published 86 Aboriginal Health and Stroke Articles in the past 6 Years

  ” High blood pressure, also referred to as hypertension, is a major risk factor for stroke, coronary heart disease, heart failure, kidney disease, deteriorating vision and peripheral vascular disease leading to leg ulcers and gangrene.

Major risk factors for high blood pressure include increasing age, poor diet (particularly high salt intake), obesity, excessive alcohol consumption, and insufficient physical activity . A number of these risk factors are more prevalent among Indigenous Australians

Based on both measured and self-reported data from the 2012–13 Health Survey, 27% of Indigenous adults had high blood pressure.

Rates increased with age and were higher in remote areas (34%) than non-remote areas (25%).

Twenty per cent of Indigenous adults had current measured high blood pressure.

Of these adults, 21% also reported diagnosed high blood pressure.

Most Indigenous Australians with measured high blood pressure (79%) did not know they had the condition; this proportion was similar among non-Indigenous Australians.

Therefore, there are a number of Indigenous adults with undiagnosed high blood pressure who are unlikely to be receiving appropriate medical advice and treatment.

The proportion of Indigenous adults with measured high blood pressure who did not report a diagnosed condition decreased with age and was higher in non-remote areas (85%) compared with remote areas (65%).

PMC Aboriginal and Torres Strait Islander Health Performance Framework 2014 Report see extracts below PART 2 or in full HERE

Closing the gap in Aboriginal and Torres Strait Islander cardiovascular disease

Cardiovascular disease is the leading cause of death for Aboriginal and Torres Strait Islander people, who experience and die from cardiovascular disease at much higher rates than other Australians. 

Aboriginal and Torres Strait Islander people, when compared with other Australians, are:

  • 1.3 times as likely to have cardiovascular disease (1)
  • three times more likely to have a major coronary event, such as a heart attack (2)
  • more than twice as likely to die in hospital from coronary heart disease (2)
  • 19 times as likely to die from acute rheumatic fever and chronic rheumatic heart Disease (3)
  • more likely to smoke, have high blood pressure, be obese, have diabetes and have end-stage renal disease.(3)

From Heart Foundation website

Find your nearest ACCHO download the NACCHO FREE APP

ACCHO’s focusing on primary prevention through risk assessment, awareness and early identification and secondary prevention through medication.

Download the NACCHO App HERE

High blood pressure is a silent killer because there are no obvious signs or symptoms, the only way to know is to ask your ACCHO GP for regular check-ups.

Uncontrolled high blood pressure is one of the greatest preventable risk factors that contributes significantly to the cardiovascular disease burden.

The good news is that hypertension can be controlled through lifestyle modification and in more serious cases by blood pressure-lowering medications.”

Part 1 Stroke Foundation Press Release Continued :

A simple step to prevent stroke in 2018

Stroke is a devastating disease that will impact one in six of us. There is one stroke every nine minutes in Australia. Stroke attacks the human control centre – the brain – it happens in an instant and changes lives forever.

In 2018 it’s estimated there will be more than 56,000 strokes across the country. Stroke will kill more women than breast cancer and more men than prostate cancer this year.

But the good news is that it does not need to be this way. Up to 80 percent of strokes are preventable, and research has shown the number of strokes would be practically cut in half (48 percent) if high blood pressure alone was eliminated.

Around 4.1 million of us have high blood pressure and many of us don’t realise it. Unfortunately, high blood pressure has no symptoms. The only way to know if it is a health issue for you is by having it checked by your doctor or local pharmacist.

Make having regular blood pressure checks a priority for 2018. Include a blood pressure check in your next GP visit or trip to the shops. Be aware of your stroke risk and take steps to manage it. Do it for yourself and do it for your family.

If you think you are too young to suffer a stroke, think again. One in three people who has a stroke is of working age.

Health and fitness is big business. But before you fork out big bucks on a personal trainer or diet plan this year, do something simple and have your blood pressure checked.

It will only take five minutes, it’s non-invasive and it could save your life.

Declaration of Interest : Colin Cowell NACCHO Social Media Editor ( A stroke Survivor) was a board member and Chair of Stoke Foundation Consumer Council 2016-17

Part 2 PMC Aboriginal and Torres Strait Islander Health Performance Framework 2014 Report  or in full HERE

In 2012–13, 10% of Indigenous adults reported they had a diagnosed high blood pressure condition.

Of these, 18% did not have measured high blood pressure and therefore are likely to be managing their condition.

Indigenous males were more likely to have high measured blood pressure (23%) than females (18%).

The survey showed that an additional 36% of Indigenous adults had pre-hypertension (blood pressure between 120/80 and 140/90 mmHg).

This condition is a signal of possibly developing hypertension requiring early intervention. In 2012–13, after adjusting for differences in the age structure of the two populations, Indigenous adults were 1.2 times as likely to have high measured blood pressure as non-Indigenous adults.

For Indigenous Australians, rates started rising at younger ages and the largest gap was in the 35–44 year age group. Analysis of the 2012–13 Health Survey found a number of associations between socio-economic status and measured and/or self-reported high blood pressure.

Indigenous Australians living in the most relatively disadvantaged areas were 1.3 times as likely to have high blood pressure (28%) as those living in the most relatively advantaged areas (22%).

Indigenous Australians reporting having completed schooling to Year 9 or below were 2.1 times as likely to have high blood pressure (38%) as those who completed Year 12 (18%).

Additionally, those with obesity were 2 times as likely to have high blood pressure (37% vs 18%). Those reporting fair/poor health were 1.8 times as likely as those reporting excellent/very good/good health to be have high blood pressure (41% vs 22%).

Those reporting having diabetes were 2.2 times as likely to have high blood pressure (51% vs 23%), as were those reporting having kidney disease (57% vs 26%). One study in selected remote communities found high blood pressure rates 3–8 times the general population (Hoy et al. 2007).

Most diagnosed cases of high blood pressure are managed by GPs or medical specialists. When hospitalisation occurs it is usually due to cardiovascular complications resulting from uncontrolled chronic blood pressure elevation.

During the two years to June 2013, hospitalisation rates for hypertensive disease were 2.4 times as high for Aboriginal and Torres Strait Islander peoples as for non-Indigenous Australians. Among Aboriginal and Torres Strait Islander peoples, hospitalisation rates started rising at younger ages with the greatest difference in the 55–64 year age group.

This suggests that high blood pressure is more severe, occurs earlier, and is not controlled as well for Indigenous Australians.

As a consequence, severe disease requiring acute care in hospital is more common. GP survey data collected from April 2008 to March 2013 suggest that high blood pressure represented 4% of all problems managed by GPs among Indigenous Australians.

After adjusting for differences in the age structure of the two populations, rates for the management of high blood pressure among Indigenous Australians were similar to those for other Australians.

In December 2013, Australian Government-funded Indigenous primary health care organisations provided national Key Performance Indicators data on around 28,000 regular clients with Type 2 diabetes.

In the six months to December 2013, 64% of these clients had their blood pressure assessed and 44% had results in the recommended range (AIHW 2014w).

Implications

The prevalence of measured high blood pressure among Indigenous adults was estimated as 1.2 times as high as for non-Indigenous adults and hospitalisation rates were 2.4 times as high, but high blood pressure accounted for a similar proportion of GP consultations for each population.

This suggests that Indigenous Australians are less likely to have their high blood pressure diagnosed and less likely to have it well controlled given the similar rate of GP visits and higher rate of hospitalisation due to cardiovascular complications.

Research into the effectiveness of quality improvement programmes in Aboriginal and Torres Strait Islander primary health care services has demonstrated that blood pressure control can be improved by a well-coordinated and systematic approach to chronic disease management (McDermott et al. 2004).

Identification and management of hypertension requires access to primary health care with appropriate systems for the identification of Aboriginal and Torres Strait Islander clients and systemic approaches to health assessments and chronic illness management.

The Indigenous Australians’ Health Programme, which commenced 1 July 2014, provides for better chronic disease prevention and management through expanded access to and coordination of comprehensive primary health care.

Initiatives provided through this programme include nationwide tobacco reduction and healthy lifestyle promotion activities, a care coordination and outreach workforce based in Medicare Locals and Aboriginal Community Controlled Health Organisations and GP, specialist and allied health outreach services serving urban, rural and remote communities, all of which can be used to diagnose and assist Indigenous Australians with high blood pressure.

Additionally, the Australian Government provides GP health assessments for Indigenous Australians under the MBS, of which blood pressure measurement is one key element, with follow-on care and incentive payments for improved management, and cheaper medicines through the PBS.

The Australian Government-funded ESSENCE project ‘essential service standards’ articulates what elements of care are necessary to reduce disparity for Indigenous Australians for high blood pressure.

This includes recommendations focusing on primary prevention through risk assessment, awareness and early identification and secondary prevention through medication.

 

NACCHO Aboriginal Health and #Smoking Research Report : ‘Deadly progress’: substantial drop in Indigenous smoking from 2004-2015

“The research is a positive news story in Indigenous health, and more should be done to understand what is working to reduce Indigenous smoking” 

Professor Tom Calma, lead advocate for Indigenous tobacco control and Chancellor of the University of Canberra

Read Paper HERE

Read over 118 NACCHO Aboriginal Health and Smoking published over the past 5 years

A paper led by ANU researcher Associate Professor Ray Lovett published in the journal Public Health Research & Practice today found a substantial drop in smoking among Aboriginal and Torres Strait Islander people over the last ten years.

The research highlights the positive downward trends in daily smoking prevalence for young Indigenous people and Indigenous people living in urban areas.

The majority of Aboriginal and Torres Strait Islander adults (around six in ten) do not smoke daily.

According to the study, the proportion of Indigenous people smoking daily dropped by 9%, from 50% in 2004 to 41% in 2014.

Lovett explains, ‘As a result, there are 35,000 fewer daily smokers today than there would have been if things had stayed the same since 2004. This will lead to thousands of lives saved’.

‘The way we communicate statistics matters. In our work we focus on the progress made within the Aboriginal and Torres Strait Islander population, and we find that substantial progress has been achieved.

In contrast, when reports focus on the gap in smoking prevalence compared to the total Australian population, this can have negative consequences and can actually contribute to widening the gap’, said Lovett.

The team used data from national surveys conducted by the Australian Bureau of Statistics to assess trends in Indigenous smoking over time.

Dr Lovett and his research team are now working with two Aboriginal organisations, Central Australian Aboriginal Congress and Institute for Urban Indigenous Health, to better understand how their work contributes to the decline in smoking rates.

The full article can be found here: http://www.phrp.com.au/?p=37127

Discussion

The prevalence of daily smoking among Aboriginal and Torres Strait Islander adults in Australia has decreased by 8.6 percentage points (95% CI 5.5, 11.8), from 50.0% in 2004–05 to 41.4% in 2014–15.

This corresponds to an estimated 35 000 fewer Aboriginal and Torres Strait Islander adult daily smokers in 2014–15, compared with if the smoking prevalence had remained stable since 2004–05. Our findings indicate that thousands of premature deaths in Aboriginal and Torres Strait Islander people have been prevented by the reduction in daily smoking prevalence over the past decade.

Accurately determining the number of deaths averted requires additional data, such as cause-specific mortality. Declines in daily smoking among Aboriginal and Torres Strait Islander people were observed among both males and females, and were most evident among those aged 18–44 years, and those living in urban/regional areas.

The absolute decrease in smoking prevalence observed in the Aboriginal and Torres Strait Islander population is comparable with the decrease of 6.8 percentage points (95% CI 5.6, 7.9) in the total Australian population over the same period, although the base smoking prevalence was substantially lower in the total Australian population (21.3% in 2004–05). These results demonstrate that considerable progress has been made in the Aboriginal and Torres Strait Islander population in the past decade, matching in absolute terms the extent of progress made in the total Australian population.

Given the similar absolute decrease in smoking prevalence in the Aboriginal and Torres Strait Islander and total Australian population, the gap in smoking prevalence has remained relatively stable. This may appear inconsistent with the Australian Institute for Health and Welfare’s midterm report for the National Tobacco Strategy 2012–20185, which reported that the gap in smoking between Aboriginal and Torres Strait Islander people and non-Indigenous Australians had increased between 2008 and 2015.

The discrepancy arises from different methods used to report trends in smoking inequalities.9-11 Our analysis emphasises change in the absolute prevalence of smoking within the population (50.0% – 41.4% = 8.6% absolute prevalence decrease), whereas the midpoint report emphasises smoking prevalence in the Aboriginal and Torres Strait Islander population relative to the non-Indigenous population.5

In relative terms, the ratio of Aboriginal and Torres Strait Islander to total Australian smoking prevalence increased from 2.4 (50.0%:21.3%) in 2004–05 to 2.9 (41.4%:14.5%) in 2014–15. This demonstrates that reporting change in absolute versus relative terms can lead to fundamentally different conclusions, which could affect support for programs and policies.9-12

Focusing on relative differences in isolation can obscure progress at the population level; that is, the absolute number of Aboriginal and Torres Strait Islander adults quitting or not taking up smoking.

Further, research from other populations demonstrates that communicating information about health inequity using a progress frame (as used in this paper) rather than a disparity frame (i.e. focusing on the persisting gap) is associated with more positive emotional responses and increased interest in engaging in health-promoting behaviours.14 Therefore, we consider it ethical to report absolute progress in smoking prevalence.

The ambitious target to halve Aboriginal and Torres Strait Islander adult daily smoking prevalence to 23.9% by 20186 will not be achieved if current trends continue. However, this target would be reached within the next two decades if smoking prevalence continues to decrease at the current rate. If the success in smoking reduction observed within the younger age groups and those living in urban/regional areas is echoed in older age groups and in remote areas, this target may be reached earlier.

We observed significant reductions (about 10%) in daily smoking prevalence among the youngest age groups (18–24, 25–34 and 35–44 years). Data from the 2004–05 NATSIHS indicates that two-thirds of current and past Aboriginal and Torres Strait Islander smokers had begun smoking by age 1817; therefore, our findings of reduced smoking prevalence among younger adults is promising.

The Aboriginal and Torres Strait Islander population has a younger age profile than the total population, and therefore the potential population-level benefit of reducing smoking among younger adults is important.18

We observed reductions in daily smoking prevalence among male and female Aboriginal and Torres Strait Islander adults living in urban/regional areas. Given that the majority of Aboriginal and Torres Strait Islander people live in urban/regional settings, this is another encouraging finding at the population level.

We did not detect a significant change between 2004–05 and 2014–15 in daily smoking prevalence among Aboriginal and Torres Strait Islander adults living in remote areas. The observed stability of smoking prevalence in remote areas from 2004 to 2015 is consistent with trends from 1994 to 2004.7 Despite being the largest available datasets, the number of survey participants in remote areas was relatively small, and is likely to be insufficient to detect changes in prevalence.

Given the enduring high smoking prevalence among older age groups and in remote settings, improved intensive effort will be required to change the normalisation of tobacco use and correct potential misperceptions of tobacco use, particularly as older people may have had longer and more intense exposure to tobacco marketing.19

This includes continued and concerted effort from targeted Aboriginal and Torres Strait Islander tobacco control programs, in addition to national strategies.4,20

The prevalence of smoking is reduced by increased numbers of people quitting and not taking up smoking. Since 2008, there has been a concerted effort in public health strategies, policies and programs to reduce tobacco smoking in Aboriginal and Torres Strait Islander people.

Australia’s approach to tobacco control is comprehensive, and it is difficult to attribute changes to one program; however, continuing support for both whole-of-population and targeted strategies is required.

For example, recent evidence indicates that the introduction of graphic warning labels on cigarette packages led to increased understanding of and concern about the harms associated with smoking among Aboriginal and Torres Strait Islander people19,21, and research has demonstrated that smokers’ knowledge of the effects of second-hand smoke is associated with desire and attempts to quit.22 Our findings may indicate that programs and policies have been particularly effective at reducing smoking among young people and those living in urban/regional areas. It is more difficult to assess the potential effectiveness of programs and policies in remote settings; finer regional estimates are required to assess policy and program impacts in this setting.23

Strengths and weaknesses

This paper analyses multiple cross-sectional data, which are the most comprehensive data available on Aboriginal and Torres Strait Islander smoking status. Limitations of our approach include that comparability between survey estimates may be affected by differences in scope, sample design, coverage, and potential changes in the age structure of the population over time. The use of weighting generates estimates that are representative of the in-scope population, which were similarly defined across the four surveys. However, we note that the 2004–05 and 2008 surveys represent a somewhat smaller percentage (82–90%) of the Aboriginal and Torres Strait Islander population compared with the other surveys (95%); this may result from issues related to survey scope.17

We have restricted our analysis to current daily smoking – rather than including weekly or less frequent smoking – to enable consistent measurement across surveys, and to enable direct comparison with national tobacco targets.5,6 It is important to note that our analysis focused on cigarette smoking. Recent ABS surveys provide data on the use of other tobacco products (e.g. chewing tobacco); data on e-cigarette use are not yet available.

Although we include a comparison with daily smoking prevalence in the total Australian population as a benchmark, this article focuses on variation in daily current smoking trends within the Aboriginal and Torres Strait Islander population. We have presented comparable estimates for the total Australian population, rather than the non-Indigenous Australian population, because of the data that were available, and we may therefore underestimate the gap in prevalence between the Aboriginal and Torres Strait Islander and non-Indigenous populations. However, this underestimation is likely to be very small; for example, in 2014, the difference between daily adult smoking prevalence in the non-Indigenous population (14.2%; 95% CI 13.4, 15.0)3 versus the total Australian population (14.5%; 95% CI 13.6, 15.4) was marginal.

Conclusions

Applying a progress frame rather than a disparity frame and reporting absolute changes in smoking prevalence provides clear evidence of the substantial and significant declines in daily smoking prevalence among Aboriginal and Torres Strait Islander adults, which will result in considerable health gain. Particular success has occurred among younger adults and those living in urban/regional areas.

Despite this progress, the smoking prevalence in the Aboriginal and Torres Strait Islander population remains high, with an estimated 165 000 current adult daily smokers. It will be critical to learn from the success among younger adults and those in urban areas to effect change among older age groups and those in remote areas. Continuation and enhancement of a suite of tobacco control efforts are required.

 

 

 

 

 

 

 

 

 

 

NACCHO Aboriginal Health #Smoking : Features Our ACCHO Members at #OTCC2017 #Deadly good news stories #TAS #NT #NSW #QLD #WA #SA #VIC #TAS

1.1 #NACCHOagm2017 and Members’ Conference Program launched

1.2. National : The Redfern Statement Alliance Call for Funding to be Reinstated to the National Congress of Australia’s First Peoples

2. Tas: Tasmanian Aboriginal Centre at #OTCC2017

3. VIC : Victorian Aboriginal Health Service Healthy Lifestyle Team at #OTCC2017

4. NT : Miwatj AMS Arnhem Land and Congress at #OTCC2017

5.QLD : Deadly Choices at @OTCC2017

6 SA : AHCSA and Quitline at #OTCC2017

7.WA : Puntukurnu Aboriginal Medical Service ‘you CAN quit’ film project 

8. ACT/NSW  :Tom Calma Don’t Make Smokes Your Story

 View hundreds of ACCHO Deadly Good News Stories over past 5 years

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

 Email to Colin Cowell NACCHO Media    

Mobile 0401 331 251

Wednesday by 4.30 pm for publication each Thursday

1.1 #NACCHOagm2017 and Members’ Conference Program launched

 Download the 48 Page Conference Program

NACCHO 2017 Conference Program

You can follow on Twitter , Instagram and Facebook using HASH Tag #NACCHOagm2017

The NACCHO Members’ Conference and AGM will provided a forum for the Aboriginal community controlled health services workforce, bureaucrats, educators, suppliers and consumers to:

  • Present on innovative local economic development solutions to issues that can be applied to address similar issues nationally and across disciplines
  • Have input and influence from the ‘grassroots’ into national and state health policy and service delivery
  • Demonstrate leadership in workforce and service delivery innovation
  • Promote continuing education and professional development activities essential to the Aboriginal community controlled health services in urban, rural and remote Australia
  • Promote Aboriginal health research by professionals who practice in these areas and the presentation of research findings
  • Develop supportive networks
  • Promote good health and well-being through the delivery of health services to and by Indigenous and non-Indigenous people throughout Australia.

Conference Website

1.2. National : The Redfern Statement Alliance Call for Funding to be Reinstated to the National Congress of Australia’s First Peoples .

“We need to reset the relationship by supporting the operations of the National Congress of Australia’s First Peoples.”

Pat Turner, NACCHO CEO said a positive step is needed (Pictured above at Redfern Statement launch June 2016)

See Redfern Statement Update NACCHO Aboriginal Health Priorities : 1st Anniversary of the #Redfernstatement

On the eve that the Australian Government has secured a seat on the United Nations Human Rights Council, the Redfern Statement Alliance Leaders met to discuss its relationship with the Australian Government.

Securing this position to the UN Council does not reflect the relationship this Government has with Aboriginal and Torres Strait Islander people.

In 2008 there was bi-partisan support for the National Congress as an elected voice of Aboriginal and Torres Strait Islander People.

Co-Chair Jackie Huggins said, “National Congress is an elected body with more members than some of the major political parties. Although our relationship has improved with Government, it has been through minor contract work and is ineffective.”

Co-Chair Rod Little said, “National Congress is strongly committed to the implementation of the United Nations Declaration on the Rights of Indigenous Peoples.

We have consistently called on the Australian Government to honour its commitment and not just sit idly on the UN Human Rights Council when our people are suffering.”

The recent UN Special Rapporteur on the rights of Indigenous People’s report delivered a verdict to the Australian Government on the status of Aboriginal Australia and called for the reinstatement of funds to the National Congress of Australia’s First Peoples.

The Redfern Statement Alliance Leaders call on Prime Minister Turnbull to seize the opportunity to do the right thing and invest in the National Congress of Australia’s First Peoples as a lead Aboriginal and Torres Strait Islander community controlled organisation.

Australia is now going to be overseeing the human rights records of other nations whilst serious human rights violations are being committed against our people daily.

2. Tas: Tasmanian Aboriginal Centre at #OTCC2017

Here’s Tina Goodwin, TAC tobacco worker, on stage at the Oceania Tobacco Control Conference is Tasmania this week with Hone Harawura.

Tina announced Hone as the winner of the Tariana Turia award which recognises significant contributions to Indigenous tobacco control.

Hone has worked as a community activist and parliamentarian on many issues of importance to Maori. He wants to see tobacco companies sued for all of the death and destruction they cause to Maori, Aboriginal and other Indigenous communities.

Hone’s words: “Those bastards (Big Tobacco) are making people addicted and they are killing our people. Let’s sue them!”Anyone want to help with the legal case? Pictured below with Tom Calma

3. VIC : Victorian Aboriginal Health Service Healthy Lifestyle Team at #OTCC2017

Representing Deadly Dan and ready to take on day 1 of the Oceania Tobacco Control Conference 2017 in Hobart.

Very excited to hear from our friends in other Tackling Indigenous Smoking Teams and mainstream organisations from Aus, NZ and Pacific Islands today.

Learning about the progress and challenges as we aim for a Tobacco Free Pacific by 2025!

 

The team exploring kunanyi this morning. Checking out the view and getting our 30 minutes of exercise in before day 2 of the Oceania Tobacco Control Conference.

Having a great time. Loving learning about the rich Aboriginal history of this area and meeting other passionate like minded health professionals.

If you can’t tell from our faces it was very cold at the top!

#otcc2017#kunanyi#hobart#vahsHLT#StaySmokeFree

4. NT : Miwatj AMS Arnhem Land and Congress at #OTCC2017

5.QLD : Deadly Choices at @OTCC2017

6 SA : AHCSA and Quitline at #OTCC2017

7.WA : Puntukurnu Aboriginal Medical Service ‘you CAN quit’ film project ( Note not at #OTCC2017)

Young people in four remote communities in Western Australia’s East Pilbara — where up to 80 percent of community members smoke — have joined forces with filmmakers on a campaign to urge people to give up the deadly habit.

From NIT

The youngsters from Jigalong, Parnngurr, Punmu and Kunawarritji in WA are shedding light on the personal stories of local smokers to warn about the dangerous habit in a series of short films.

Fifteen-year-old Clintesha Samson, who was involved in the films and doesn’t smoke, said she would like to see people in her community stop for the sake of their health.

She said she thought film was a good way to get the message across.

The series of films are part of a ‘you CAN quit’ project that has documented the stories of community members who have kicked the habit and those who have been affected by smoking-related illnesses.

The project was organised by Puntukurnu Aboriginal Medical Service’s Tackling Indigenous Smoking team.

The young people involved were responsible for researching, shooting, editing and promoting the films.

Puntukurnu Aboriginal Medical Service regional tobacco coordinator Danika Tager said smoking rates in the East Pilbara were high and more needed to be done to support communities to address tobacco addiction.

“Smoking rates in remote East Pilbara communities are as high as 80 percent and tobacco use is the single most preventable cause of death and disease in this population,” Ms Tager said.

“Through this important film project we hope to encourage people in these communities to quit smoking, as well as air the many benefits of quitting and where they can find help and support.”

The films are being shown in communities and also aired on TV and social media.

The Puntukurnu Aboriginal Medical Service is a community-controlled health organisation that provides primary health care, 24-hour emergency services and preventative health and education programs in the communities of Jigalong, Parnngurr, Punmu and Kunawarritji.

8. ACT/NSW Tom Calma Don’t Make Smokes Your Story

Download the evaluation report

Evaluation-Report_National-Tobacco-Campaign-Indigenous

NACCHO Aboriginal Health and #Smoking : @our_ANU Report : #Indigenous smoking deaths on the rise despite people butting out

We have seen significant declines in smoking among Indigenous Australian adults over the past two decades that will bring major health benefits over time,

But we’re seeing tobacco’s lethal legacy from when smoking prevalence was at its peak.

We need a continued comprehensive approach to tobacco control, and the incorporation of Indigenous leadership, long-term investment and the provision of culturally appropriate materials and activities is critical to further reducing smoking,”

Dr Ray Lovett from the ANU Research School of Population Health.

Please note Dr Lovett will be speaking at the NACCHO Conference 31 Oct -2 Nov

Topic: Mayi Kuwayu: a national study of culture and wellbeing among Aboriginal and Torres Strait Islander peoples

Speaker: Dr Ray Lovett See NACCHO Conference Website

Smoking-related deaths among Indigenous Australians are likely to continue to rise and peak over the next decade despite big reductions in smoking over the past 20 years, a new study led by The Australian National University (ANU) has found.

Cigarette smoking is a leading contributor to the burden of morbidity and mortality among Aboriginal and Torres Strait Islander (hereafter respectfully referred to as Indigenous) Australians1, the total Australian population2, and in developed countries worldwide.3

The health impacts of smoking vary by smoking duration and intensity, but it is well established that smoking causes a range of health conditions.3 Although there have been marked smoking reductions in Australia4,5, the prevalence of smoking among Indigenous adults remains high, estimated at 41.4%, compared with 14.5% in the total Australian adult population.5

Smoking behaviour is influenced by factors including social, cultural and environmental factors, and tobacco control effectiveness.6 Indigenous tobacco use is also tightly tied to Australia’s history of colonisation; for example, tobacco was often used as a form of payment, and was issued as part of rations on mission stations.7

Dramatic decreases in smoking prevalence in the total Australian population suggest that the smoking epidemic is in its final stages.3,6 However, the stage of the tobacco epidemic among the Indigenous Australian population is less clear.

Understanding the stage of the epidemic provides insight into probable trends in smoking-attributable mortality, thereby enabling accurate communication of the likely impacts of smoking4, and informing relevant programs and policies.

This paper provides a perspective on the current stage of the smoking epidemic among Indigenous Australians based on an existing model of smoking epidemic stages3, and describes the expected short- and long-term implications for the wellbeing of the Indigenous population, and for programs and policies.

Stages of the smoking epidemic

Lopez proposed a four-stage model of cigarette consumption and mortality in 1994, characterising features of the smoking epidemic3; the model was updated in 2012.4 The proportion of the adult population that regularly smokes – and variation by characteristics such as age and sex – provides an indication of the extent to which smoking has been adopted.3 Smoking-attributable mortality, which can be crudely approximated by lung cancer deaths, provides insight into the health consequences of smoking at each stage of the epidemic.3,4 Central to the model is the long delay between smoking and its associated cancer mortality; even when the prevalence of smoking begins to decline, smoking-attributed mortality continues to increase, reflecting the smoking behaviours of up to three decades earlier.3,4

In short, Stage 1 of the tobacco epidemic marks the initial population uptake of smoking, with no evidence of smoking-attributable mortality. In Stage 2, the prevalence of smoking increases rapidly to its peak, alongside low but increasing smoking-attributable mortality. By Stage 3, awareness of the health hazards of smoking is common, and conditions are favourable for implementing tobacco control measures; while the prevalence of smoking remains stable or begins to decrease, smoking-attributable mortality rises rapidly. Stage 4 is represented by decreasing smoking prevalence and associated mortality to their lower limits, in a context of widespread awareness of tobacco harms and tobacco control measures

This research paper is published in the Public Health Research & Practice journal 

VIEW HERE

Read over 114 NACCHO Smoking articles published over 5 years

Lead researcher Dr Ray Lovett said the study found the lag between smoking and the onset of smoking-related diseases such as lung cancer means the number of smoking deaths was likely to keep climbing.

“On the positive side, we’ve seen a 43 per cent reduction in cardiovascular disease deaths, mainly from heart attacks, over the past 20 years among Indigenous people, in large part due to people quitting smoking.”

Smoking rates among Indigenous Australians have dropped from more than half the population in 1994 to two in five adults today. This is still two and a half times higher than the rest of the Australian population.

Dr Lovett said the substantial progress in reducing smoking rates, particularly in the past decade, was a clear sign that further reductions and improvements to Indigenous health could be achieved.

Co-researcher Dr Katie Thurber said the team analysed the available national health and death data from the past 20 years to conduct the study.

“The available data do not provide the full picture of smoking and its impacts for the Aboriginal and Torres Strait Islander population, so it’s important to understand these limitations and work towards improving data in the future,” said Dr Thurber from the ANU Research School of Population Health.

“Despite these challenges, we’ve managed to produce the first comprehensive assessment of the tobacco epidemic among Aboriginal and Torres Strait Islander Australians.”

The research paper is published in the Public Health Research & Practice journal and this issue of the journal celebrates 50 years since the 1967 referendum, when Australians voted to amend the Constitution to allow the Commonwealth to create laws for Indigenous people and include them in the Census.

 

NACCHO Aboriginal Health #Alcohol and other Drugs #GAPC2017 Download @AIHW National drug household survey

  ” The Australian Institute of Health and Welfare (AIHW) have released the National drug household survey: detailed findings 2016 report.

The report aims to provide insight into Australians’ use of, and attitudes to, drugs and alcohol in 2016.

A key finding of the report is around mental health and alcohol and other drug (AOD) use. ( see Part 2 below for full details )

Download the full 168 page report

National Drug Strategy Household Survey 2016

Read over 186 NACCHO Alcohol and other Drug articles published over 5 years

This report expands on the key findings from the 2016 National Drug Strategy Household Survey (NDSHS) that were released on 1 June 2017.

It presents more detailed analysis including comparisons between states and territories and for population groups. Unless otherwise specified, the results presented in this report are for those aged 14 or older.

Indigenous Australians

As Indigenous Australians constitute only 2.4 per cent of the 2016 NDSHS (unweighted) sample (or 568 respondents), the results must be interpreted with caution, particularly those for illicit drug use.

Smoking

In 2016, the daily smoking rate among Indigenous Australians was considerably higher than non-Indigenous people but has declined since 2010 and 2013 (decreased from 35% in 2010 to 32% in 2013 and to 27% in 2016) (Figure 8.7). The NDSHS was not designed to detect small differences among the Indigenous population, so even though the smoking rate declined between 2013 and 2016, it was not significant.

The Australian Aboriginal and Torres Strait Islander Health Survey (AATSIHS) and the National Aboriginal and Torres Strait Islander Social Survey (NATSISS) were specifically designed to represent Indigenous Australians (see Box 8.1 for further information).

After adjusting for differences in age structures, Indigenous people were 2.3 times as likely to smoke daily as non-Indigenous people in 2016 (Table 8.7).

Read over 113 NACCHO Smoking articles published last 5 years

Alcohol

Overall, Indigenous Australians were more likely to abstain from drinking alcohol than non-Indigenous Australians (31% compared with 23%, respectively) and this has been increasing since 2010 (was 25%) (Figure 8.8).

Among those who did drink, a higher proportion of Indigenous Australians drank at risky levels, and placed themselves at harm of an alcoholrelated injury from single drinking occasion, at least monthly (35% compared with 25% for non-Indigenous).

The (rate ratio) gap in drinking rates was even greater when looking at the consumption of 11 or more standard drinks at least monthly. Indigenous Australians were 2.8 times as likely as non-Indigenous Australians to drink 11 or more standard drinks monthly or more often (18.8% compared with 6.8%).

About 1 in 5 (20%) Indigenous Australian exceeded the lifetime risk guidelines in 2016; a slight but non-significant decline from 23% in 2013, and significantly lower than the 32% in 2010. The proportion of non-Indigenous Australians exceeding the lifetime risk guidelines in 2016 was 17.0% and significantly declined from 18.1% in 2013.

Illicit drugs

Other than ecstasy and cocaine, Indigenous Australians aged 14 or older used illicit drugs at a higher rate than the general population (Table 8.6). In 2016, Indigenous Australians were: 1.8 times as likely to use any illicit drug in the last 12 months; 1.9 times as likely to use cannabis; 2.2 times as likely to use meth/amphetamines; and 2.3 times as likely to misuse pharmaceuticals as non-Indigenous people. These differences were still apparent even after adjusting for differences in age structure (Table 8.7). There were no significant changes in illicit use of drugs among Indigenous Australians between 2013 and 2016.

Read over 64 NACCHO Ice drug articles published last 5 years

1 in 8 Australians smoke daily and 6 in 10 have never smoked

  • Smoking rates have been on a long-term downward trend since 1991, but the daily smoking rate did not significantly decline over the most recent 3 year period (was 12.8% in 2013 and 12.2% in 2016).
  • Among current smokers, 3 in 10 (28.5%) tried to quit but did not succeed and about 1 in 3 (31%) do not intend to quit.
  • People living in the lowest socioeconomic areas are more likely to smoke than people living in the highest socioeconomic area but people in the lowest socioeconomic area were the only group to report a significant decline in daily smoking between 2013 and 2016 (from 19.9% to 17.7%).

8 in 10 Australians had consumed at least 1 glass of alcohol in the last 12 months

  • The proportion exceeding the lifetime risk guidelines declined between 2013 and 2016 (from 18.2% to 17.1%); however, the proportion exceeding the single occasion risk guidelines once a month or more remained unchanged at about 1 in 4.
  • Among recent drinkers: 1 in 4 (24%) had been a victim of an alcohol-related incident in 2016; about 1 in 6 (17.4%) put themselves or others at risk of harm while under the influence of alcohol in the last 12 months; and about 1 in 10 (9%) had injured themselves or someone else because of their drinking in their lifetime.
  • Half of recent drinkers had undertaken at least some alcohol moderation behaviour. The main reason chosen was for health reasons.
  • A greater proportion of people living in Remote or very remote areas abstained from alcohol in 2016 than in 2013 (26% compared with 17.5%) and a lower proportion exceeded the lifetime risk guidelines (26% compared with 35%).

About 1 in 8 Australians had used at least 1 illegal substance in the last 12 months and 1 in 20 had misused a pharmaceutical drug

  • In 2016, the most commonly used illegal drugs that were used at least once in the past 12 months were cannabis (10.4%), followed by cocaine (2.5%), ecstasy (2.2%) and meth/amphetamines (1.4%).
  • However, ecstasy and cocaine were used relatively infrequently and when examining the share of Australians using an illegal drug weekly or more often in 2016, meth/amphetamines (which includes ‘ice’) was the second most commonly used illegal drug after cannabis.
  • Most meth/amphetamine users used ‘ice’ as their main form, increasing from 22% of recent meth/amphetamine users in 2010 to 57% in 2016.

Certain groups disproportionately experience drug-related risks

  • Use of illicit drugs in the last 12 months was far more common among people who identified as being homosexual or bisexual; ecstasy and meth/amphetamines use in this group was 5.8 times as high as heterosexual people.
  • People who live in Remote and very remote areas, unemployed people and Indigenous Australians continue to be more likely to smoke daily and use illicit drugs than other population groups.
  • The proportion of people experiencing high or very high levels of psychological distress increased among recent illicit drug users between 2013 and 2016—from 17.5% to 22% but also increased from 8.6% to 9.7% over the same period for the non-illicit drug using population (those who had not used an illicit drug in the past 12 months).
  • Daily smoking, risky alcohol consumption and recent illicit drug use was lowest in the Australian Capital Territory and highest in the Northern Territory.

The majority of Australians support policies aimed at reducing the acceptance and use of drugs, and the harms resulting from drug use

  • There was generally greater support for education and treatment and lower support for law enforcement measures.

‘In 2016, 42% of meth/amphetamine users had a mental illness, up from 29% in 2013, while the rate of mental illness among ecstasy users also rose from 18% to 27%,’ said AIHW spokesperson, Matthew James. ‘Drug use is a complex issue, and it’s difficult to determine to what degree drug use causes mental health problems, and to what degree mental health problems give rise to drug use.’

About 1 in 20 Australians reported misusing pharmaceuticals, with 75% of recent painkiller users reporting misusing an ‘over the counter’ codeine product in the past 12 months. The AIHW will be publishing more detailed data on pharmaceutical misuse later in 2017.

In addition to illicit drugs, the report also provides insights into Australians’ use of alcohol and tobacco, and notes some improvements in risky behaviour (such as driving while under the influence of alcohol), as well as improved smoking rates among people living in lower socioeconomic areas.

Source: Australian Institute of Health and Welfare

 Part 3 Mental illness rising among meth/amphetamine and ecstasy users

Mental illnesses are becoming more common among meth/amphetamine and ecstasy users, according to a report released today by the Australian Institute of Health and Welfare (AIHW).

The report, National Drug Strategy Household Survey: detailed findings 2016, builds on preliminary results released in June, and gives further insight into Australians’ use of, and attitudes to, drugs and alcohol in 2016.

The report shows that among people who had recently (in the last 12 months) used an illicit drug, about 27% had been diagnosed or treated for a mental illness—an increase from 21% in 2013. Rates of mental illness were particularly high—and saw the most significant increases—for meth/amphetamine and ecstasy users.

‘In 2016, 42% of meth/amphetamine users had a mental illness, up from 29% in 2013, while the rate of mental illness among ecstasy users also rose from 18% to 27%,’ said AIHW spokesperson Matthew James.

‘Drug use is a complex issue, and it’s difficult to determine to what degree drug use causes mental health problems, and to what degree mental health problems give rise to drug use’.

Similarly, the report also reveals a complex relationship between employment status and drug use.

‘For example, people who were unemployed were about 3 times as likely to have recently used meth/amphetamines as employed people, and about 2 times as likely to use cannabis or smoke tobacco daily. On the other hand, employed people were more likely to use cocaine than those who were unemployed,’ Mr James said.

Today’s report also shows higher rates of drug use among people who identify as gay, lesbian or bisexual, with the largest differences seen in the use of ecstasy and meth/amphetamines.

‘Homosexual and bisexual people were almost 6 times as likely as heterosexual people to use each of these drugs, and were also about 4 times as likely to use cocaine as heterosexual people, and 3 times more likely to use cannabis or misuse pharmaceutical drugs.’ Mr James said.

Overall, about 1 in 20 Australians reported misusing pharmaceuticals, with 75% of recent painkiller users reporting misusing an ‘over the counter’ codeine product in the past 12 months. The AIHW will be publishing comprehensive data on pharmaceutical misuse later in 2017.

‘Our report also shows that more Australians are in favour of the use of cannabis in clinical trials to treat medical conditions—87% now support its use, up from 75% in 2013. We also found that 85% of people now support legislative changes to permit its use for medical purposes in general, up from 69% in 2013,’ Mr James said.

In addition to illicit drugs, today’s report also provides insights into Australians’ use of alcohol and tobacco, and notes some improvements in risky behaviour (such as driving while under the influence of alcohol), as well as improved smoking rates among people living in lower socioeconomic areas.

The report also contains data for each state and territory in Australia, and shows differences in drug use between the jurisdictions. For example, recent use of meth/amphetamine was highest in Western Australia, but the use of cocaine was highest in New South Wales.

NACCHO Aboriginal Health and @sistaquit Smoking : Smoking rates among pregnant Indigenous women tackled in major research project

 ” 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 

See full ABC report here or Part 2 below

Part 1 Project update 26 September

Currently we have received EOIs from about 20 ACCHS in 5 states that we are targeting for the SISTAQUIT study. These states are NSW, QLD, SA, WA and NT.

These sites will now undergo a two-way discussion for mutual interest, and to find out what protocols we need to go through to get their communities signed up.

We are aiming for 30 services to be signed up to SISTAQUIT by end of the year.

We will have a trade table at the NACCHO AGM, so interested CEOs and managers of ACCHS can get more information,  meet with Joley Manton face-to-face, and sign up their interest or consent.

Our pilot study “ICAN QUIT in Pregnancy” has been successful wrapped up, and we are applying our learnings to go forward to this larger SISTAQUIT trial.

We would like to thank pilot ACCHS services in NSW, SA and QLD for their tremendous support in making this happen.

What does the SISTAQUIT™ in Pregnancy study aim to do?

Our study aims to improve the provision of timely, evidence-based smoking cessation support to pregnant women attending Aboriginal Medical Services (AMS), by training health providers such as GPs, Aboriginal Health Workers and midwives in culturally appropriate smoking cessation care.

The SISTAQUIT intervention (culturally appropriate smoking cessation training for health providers) has been developed over a decade. We most recently explored the feasibility and acceptability of the SISTAQUIT intervention through the ICAN QUIT in Pregnancy pilot study with six Aboriginal Community Controlled Health services.

We aim to increase the proportion of health providers offering assistance in quitting to pregnant smokers and to improve the quit rates of pregnant smokers, measured by carbon monoxide testing during pregnancy and after birth. We also aim to improve birth weights and respiratory outcomes of the babies in the first six months of life.

We are currently seeking EOIs from AMS interested in participating in the trial. Funding is available to cover AMS trial participation costs, and pregnant mothers will be offered a voucher for their time for each study visit.

Contact Details

School of Medicine and Public Health, University of Newcastle:

Assoc. Prof. Gillian Gould: gillian.gould@newcastle.edu.au

Ms Joley Manton: sistaquit@newcastle.edu.au;  Phone: (02) 4033 5720

Website: www.newcastle.edu.au/SISTAQUIT

Part 2

 

SISTAQUIT project aiming to help 450 Indigenous women quit smoking.

 “We want to show that SISTAQUIT works, and that women are able to quit with our approach.

We wanted to be able to reach out eventually to any service in Australia through the internet, so we decided to do that through interactive webinars.

We know now that quite a few chronic diseases are set up by babies being exposed to smoking when they’re in the womb,”

Associate Professor Gould said

It is hoped a large-scale research project will help provide clearer solutions for tackling smoking rates among pregnant Indigenous women across the country.

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.

“From that point of view, it is important.

“We know that one of the problems is that women are not given enough help to quit smoking.”

Associate Professor Gould has been working on the multi-phase research project for a number of years.

In the first phase of the study, the research team worked with Indigenous communities in the NSW Hunter Valley to develop a suite of resources to train health providers in supporting women while they quit smoking.

Many of those resources have been digitally focused.

Phase two involved a pilot project using those resources, and was implemented in NSW, South Australia and Queensland.

“We had trained all of the health providers at those services,” Associate Professor Gould said

Project aiming to give health workers effective tools

With the pilot study finished, the research is now expanding into 30 Aboriginal medical centres around the country, with the SISTAQUIT project aiming to help 450 Indigenous women quit smoking.

“We will link up with the services, and we’re conducting three one-hour webinars, which will be live and interactive,” Associate Professor Gould said.

“We [also] have this booklet that women receive, and within that booklet are embedded different videos.

“The women can use an app on their phone, and when they scan the little screenshot of the video that’s in the booklet, they can hear [information] from Aboriginal and Torres Strait Islander health professionals which is going to help them quit smoking.

“We’re mainly aiming it at the health professionals — GPs, midwives, Aboriginal health workers — to give them training, and then they have these resources that are going to, in consultation with women, help them quit.

“By doing it this way and being able to do it in enough women, we will get the answer — ‘is this approach the best approach?’ — and therefore, can the Government then scale-up our approach to make those webinars and resources available across the whole of Australia?”

Cultural sensitivities are observed in the training materials, and Associate Professor Gould said that helped build trust.

“We’re talking to women, giving them accurate, factual messages, but in a way that’s delivered by people they would trust,” she said.

“We’ve developed the whole approach with Aboriginal medical services, and we’ve had Aboriginal investigators on our team guiding us and working very closely with us

“By doing it this way and being able to do it in enough women, we will get the answer — ‘is this approach the best approach?’ — and therefore, can the Government then scale-up our approach to make those webinars and resources available across the whole of Australia?”

Cultural sensitivities are observed in the training materials, and Associate Professor Gould said that helped build trust.

“We’re talking to women, giving them accurate, factual messages, but in a way that’s delivered by people they would trust,” she said.

“We’ve developed the whole approach with Aboriginal medical services, and we’ve had Aboriginal investigators on our team guiding us and working very closely with us

Hopes smoking rates will drop

The study is set to last until 2021, and Associate Professor Gould was optimistic the approach would help reduce rates of smoking.

“This is the real world; it’s a real-world study, so this is what life is like,” she said.

“In our pilot study so far, we’ve had four women quit out of 22, which means we’ve already got a quit rate of almost 25 per cent. The usual quit rate is about 3 per cent. So, we think we’re doing pretty good.

“We’re aiming in the bigger trial to improve the quit rate from the baseline of 3 per cent up to 11 per cent, but already in our pilot we’ve exceeded our aim.

“You never know if this is going to work or not, and that’s why [we’re] doing the study

 

NACCHO Aboriginal Health #Strokeweek : #Fightstroke Aboriginal people are up to three times more likely to suffer a stroke than non-Indigenous

 

” Aboriginal and Torres Strait Islander people are up to three times more likely to suffer a stroke than non-Indigenous Australians and almost twice as likely to die, according to the Australian Bureau of Statistics. It’s an alarming figure and one that  prompted the National Stroke Foundation in 2016 to urge the Federal Government to fund a critical $44 million awareness campaign in a bid to close the gap .

The good news is most strokes are preventable and treatable.

However communities need to be empowered to protect themselves from this insidious disease.”

Sharon McGowan, Stroke Foundation CEO ( see full Aboriginal Stroke statistics part 2 below

Download the 48 Page support guide :

journeyafterstroke_indigenous_0

Read over 75 Stroke related articles published by NACCHO over past 5 years

“Never had I ever come across one ( stroke ) or heard much about them. I had nothing to do with them,”

When I woke up, I didn’t know what was going on. I couldn’t communicate. I couldn’t tell anyone I was still here. It was really scary. I’d never seen the effects of a stroke.

First, I lost my voice, then my vision, my [ability to] swallow and my movement of all my body parts. I lost all my bowel and bladder function. I’ve still got bad sight but I can see again. My speech took about six months.

With help from the Aboriginal Disability Network, they advocated to get me out and get the right support equipment at home “

For Tania Lewis, an Awabakal woman, stroke was something that only happened to older people. But in 2011, Tania suffered a severe stroke at the age of 39 that would leave her with permanent right-sided hemiplegia – paralysis of one side of the body.

Pictured above : Editor of NACCHO Communique and Stroke Foundation Consumer Council Board Member Colin Cowell (left ) with fellow stroke survivor Tania Lewis at an NDIS workshop in Coffs Harbour conducted by Joe Archibald (right )

Part 1 Stroke Foundation in 2016 called on government to close the gap

Originally published here

A stroke occurs when supply of blood to the brain is disturbed suddenly. The longer it remains untreated, the heightened the risk of stroke-related brain damage.

Medical treatment during the first onset of symptoms can significantly improve a sufferer’s chance of survival and of successful rehabilitation.

In Australia, stroke is the leading cause of long-term disability in adults, accounting for 25 per cent of all chronic disability. The NSF reports that roughly 50,000 strokes occur per year with over 437,000 people living with stroke across the country. While severity varies, two thirds of victims, like Tania, are left with impeding disabilities

But in 2011, Tania suffered a severe stroke at the age of 39 that would leave her with permanent right-sided hemiplegia – paralysis of one side of the body.

The burden of stroke doesn’t just fall on the patient, but can take a significant toll on family and carers.

“The doctor at the hospital tried to take Power of Attorney and Guardianship away from me and give it to the Guardianship Board, because he didn’t believe that [my husband] Len or anyone could look after me,” Tania recalls.

“I was put through hell. I figured life wasn’t worth living anymore because they took everything away from me. I couldn’t go home to my family. So I tried to off myself.

“Then all of a sudden, one day the doctor said, ‘You can go home. We can’t rehabilitate you anymore’. At home, I was having seizures for a while. My hubby wouldn’t sleep. He and his mum would take shifts looking after me. We tried to get assistance but there was nothing for young people. So one day, my husband collapsed on the lounge room floor from exhaustion. It was just a nightmare. That’s how I ended up in aged care.”

Tania spent the next two and a half years between three aged care facilities.

“I wouldn’t wish it upon nobody,” she says.

It was during her nightly ritual of chatting with her daughter via Facebook that Tania typed “young people in nursing homes” into Google. The search engine’s results would lead to her life-changing encounter with the YPINH.

“With help from the Aboriginal Disability Network, they advocated to get me out and get the right support equipment at home. Whatever I need, physio, OT – they’ve got my back. I can’t thank them enough for what they’ve done for me.”

Today, Tania is working with the Aboriginal Disability Network, helping Indigenous Australians navigate their way through the National Healthcare System.

It has long been recognised that Aboriginal and Torres Strait Islander people have a life expectancy that is approximately 20 years less than non-Indigenous Australians (Australian Bureau of Statistics). Recent data from the ABS shows that up to 80 per cent of the mortality gap can be attributed to chronic diseases such as heart disease, stroke, diabetes and kidney disease.

For many Aboriginal communities, especially those in remote regions, socio-economic factors play an important role. Kerin O’Dea from Darwin’s Menzies School of Health Research cites unemployment, poor education outcomes and limited access to fresh foods as key factors in her paper, Preventable chronic diseases among Indigenous Australians.

Lifestyle related risks such as smoking, alcohol misuse, stress, poor diet, and inadequate physical activity also need to be addressed, according to the Australian Institute of Health and Welfare .

But the first step, McGowan says, is for indigenous stroke sufferers to recognise the signs of a stroke in themselves and their family members. The NSF recommends the F.A.S.T. test as the most effective way to remember the most common signs of a stroke.

Face: Check their face. Has their mouth drooped?
Arms: Can they lift both arms?
Speech: Is their speech slurred? Do they understand you?
Time: Is critical. If you see any of these signs call 000 straight away.

“If I had known that because I’d lost my vision I had suffered a stroke, I could’ve put two and two together and got help, but I didn’t know anything,” Tania says.

“I was a heavy smoker, but not anymore – no way. Life’s too important. I didn’t ever know anything about a stroke – I was more thinking when you smoke, you can have lung problems and lose your fingers, like on the packets. But they don’t say anything about a stroke – they don’t advertise that stuff.”

The Stroke Foundation called on the Federal Government to fund an urgent $44 million campaign to address the gap in stroke care. For more information on stroke and the campaign, visit strokefoundation.com.au.

Part 2 Aboriginal Stroke Facts

From here

  • The incidence rate of stroke for Aboriginal and Torres Strait Islander Australians has been found to be 2.6 times higher for men and 3.0 for women (Australian Institute of Health and Welfare, 2008; Katzenellenbogan et al. 2010) compared to non-Aboriginal and Torres Strait Islander Australians and many suggest that these figures may in fact be underestimates (Thrift et al 2011).
  • Aboriginal and Torres Strait Islander Australians are known to experience stroke at a younger age than their non-Aboriginal and Torres Strait Islander counterparts, (Katzenellenbogen et al., 2010; Australian Institute of Health and Welfare, 2004) with 60% of Aboriginal and Torres Strait Islander non-fatal stroke burden occurring in the 25-54 year age-group compared to 24% in the non-Aboriginal and Torres Strait Islander group (Katzenellenbogen et al., 2010).
  • The prevalence of stroke is similarly significantly higher at younger ages among Aboriginal and Torres Strait Islander people (Katzenellenbogen 2013), with a significantly higher prevalence of co-morbidities among Aboriginal and Torres Strait Islander patients under 70 years of age, including heart failure, atrial fibrillation, chronic rheumatic heart disease, ischaemic heart disease, diabetes and chronic kidney disease. This reflects the increased clinical complexity among Aboriginal and Torres Strait Islander stroke patients compared with non-Aboriginal/Torres Strait Islander patients.
  • Aboriginal and Torres Strait Islander stroke patients aged 18–64 years have a threefold chance of dying or being dependent at discharge compared to non-Aboriginal and Torres Strait Islander patients (Kilkenny et al., 2012).

NACCHO Aboriginal Health and Smoking : Survey #Nosmokes How #socialmedia supports positive health behaviour

How does accessing the NoSmokes health campaign support anti-smoking behaviour in Aboriginal and Torres Strait Islander youth?

What is this project about?

The aim of this project is to explore how the NoSmokes health campaign supports Aboriginal and Torres Strait Islander youth to deal with smoking situations. We will also explore whether accessing NoSmokes supports young people to stay quit or resist starting smoking.

What are the benefits of the project?
This project will help us to understand more about how online technology and social media can be used to support positive health behaviour, particularly in relation to smoking. You may also learn more about your own confidence in dealing with a number of different smoking situations.

What will I have to do?

To participate you must use /view

1.NoSmokes Facebook page.

VIEW HERE

2. NoSmokes website.

VIEW HERE

3. NoSmokes YouTube channel.

VIEW HERE

4. NoSmokes  Instagram page

VIEW HERE

5.and be 16 years of age or older.

Your participation is voluntary, so you don’t need to take part if you don’t want to. If you choose to take part, you will complete an online questionnaire answering questions about: your experience with smoking; your experience of NoSmokes, your confidence in dealing with different smoking situations. This will take around 20-25 minutes.

If there are any questions in the survey you don’t like, or that you do not feel comfortable answering, then leave that question and move onto the next one. You can complete the survey on your mobile phone or computer. If you change your mind about participating, or are feeling uncomfortable, you can choose to stop the survey at any time by closing the web page or by not pressing the ‘submit’ button. Any data collected before you withdraw will be deleted at the end of the data collection period.

What will happen to my information?

Only the researcher will have access to the individual information provided by participants. Privacy and confidentiality will be assured at all times. The project findings will be used as part of the researcher’s Honours Thesis project, and will be published on the NoSmokes and Ninti One websites. The research may also be presented at conferences and written up for publication.

Only anonymous information will be gathered – you will not be required to provide any identifiable personal information, such as your name or date of birth. No one will know you have taken part in this research from reading the thesis, reports or other publications.

If you are interested in viewing the results of this research, a summary report will be available on the NoSmokes website http://nosmokes.com.au/ in December 2017. You can also request a copy of the final thesis by emailing Neeti Rangnath on u3105740@uni.canberra.edu.au.

Researcher
Neeti Rangnath
Honours Student
Discipline of Psychology, Faculty of Health
University of Canberra, ACT 2601
Email: u3105740@uni.canberra.edu.au
Supervisor
Dr Penney Upton
Associate Professor in Health
Centre for Research and Action in Public Health
University of Canberra, ACT 2601
Ph: 02 6201 2638
Email: penney.upton@canberra.edu.au
Data storage
During the project, the anonymous data will be stored securely on a password protected computer, and then stored securely on the University of Canberra network server. The information will be kept for 5 years, after which it will be destroyed according to University of Canberra protocols.

Ethics Committee Clearance
The project has been approved by the Human Research Ethics Committee of the University of Canberra (HREC 17-83).

Queries and Concerns
If you have any questions or concerns about this project you can contact the researchers, whose details are provided at the top of this form. If you are concerned about the conduct of this project please contact

Mr Hendryk Flaegel, Ethics and Compliance Officer at the University of Canberra (p) 02 6201 5220 (e) humanethicscommittee@canberra.edu.au

There are no anticipated risks associated with participating in this research. However, if completing this questionnaire makes you feel uncomfortable, sad, or angry about your own smoking or the smoking behaviour of someone you know, you are encouraged to visit the following website to find support with smoking-related issues in your state or territory:

http://www.quitnow.gov.au/internet/quitnow/publishing.nsf 

Consent Statement 
I have read and understood the information about the research. I am not aware of any reason that I should not be participating in this research, and I agree to participate in this project. I have had the opportunity to ask questions about my participation in the research. All questions I have asked have been answered to my satisfaction.

Complete consent and start survey here

 

NACCHO Aboriginal Health and #Smoking : @TheMJA #npc Mass-reach #anti-smoking campaigns must return

Disadvantaged groups are and should be a key focus of action to reduce smoking further. This has long been recognised, including in the report of the National Preventative Health Taskforce, which specifically called for action in relation to Aboriginal and Torres Strait Islander people and other highly disadvantaged groups, such as people with mental health problems,”

The evidence tells us that we need a mix of approaches. We need whole-of-community approaches, with measures such as tax increases and strong mass media campaigns, which benefit disadvantaged groups disproportionately. We also need specific targeted approaches, as this article notes: the Talking About the Smokes project and the Tackling Indigenous Smoking program have played valuable role in complementing mainstream activity.”

 Professor Mike Daube, professor of health policy at Curtin University, welcomed calls for further action on smoking prevalence in disadvantaged groups, and said that a mix of approaches was needed. Professor Daube told MJA InSight.

Read over 100 NACCHO Smoking articles published in past 5 years

NACCHO Aboriginal Health and Smoking : Download Tackling Indigenous Smoking Program prelim. evaluation report

TARGETED tobacco control strategies are urgently needed to tackle the “remarkably high” smoking rates in some high-risk groups, according to Australian authors, but leading public health experts say reinstatement of mass-reach campaigns should be a priority.

Writing in the MJA, Professor Billie Bonevski, a health behaviour scientist and researcher at the University of Newcastle, and co-authors said that the overall smoking prevalence in Australia was now 14%, but among population subgroups, such as those with severe mental illness and those who had been recently incarcerated, the rates were upwards of 67%.

Tobacco use among Aboriginal and Torres Strait Islander people also remained high, with the prevalence among Indigenous people aged 15 years and older being about 39% in 2014–15.

Listen to Podcast HERE

The authors said that a truly comprehensive approach to tobacco control should include targeted campaigns in high smoking prevalence populations.

“If we are truly concerned about this issue, we must focus more attention on the groups that are being left behind,” they wrote.

Novel, targeted interventions and increased delivery of evidence-based interventions was needed, the authors said, noting that tobacco harm reduction strategies, such as vaporised nicotine, should also be further investigated.

In an MJA InSight podcast, lead author Professor Bonevski said that smoking was still “almost … socially acceptable” in some subgroups, such as those from low socio-economic populations.

“People who have lower incomes end up smoking from a younger age and, by the time they reach adulthood, they are more heavily nicotine dependent and … it becomes much harder to quit,” she said. “This is a vicious cycle in terms of socio-economic status contributing to high smoking rates, and then high smoking rates contributing to poor health, and then poor health keeping you in that low socio-economic status group, and so on.”

Professor Simon Chapman, Emeritus Professor in the University of Sydney’s School of Public Health, said that targeting high smoking prevalence subgroups sounded sensible “until we unpack what targeting involves”.

“The world-acclaimed, highly successful Australian national Quit campaign has been scandalously mothballed since 2013. So, talk of fracturing what is now a zero-budgeted, non-operational population-wide campaign into multiple targeted campaigns is currently a ‘brave’ call,” he said.

Professor Chapman said that Australia’s main goal should be to restore our “family silver”: properly funded, mass reach campaigns that reach all subgroups.

He pointed to research, published in 2014, that found that the decline in smoking prevalence in Australia – from 23.6% in 2001 to 17.3% in 2011 – was largely due (76%) to stronger smoke-free laws, tobacco price increases and greater exposure to mass media campaigns.

Professor Chapman said that higher smoking rates among disadvantaged groups were more likely to be explained by higher uptake, than by failure to quit.

He noted that 22.7% of the most disadvantaged people were ex-smokers, versus 26.9% of the least disadvantaged. “But only 53.5% of the least disadvantaged people have never smoked, compared with 62.9% of the most advantaged,” he said.

Professor Chapman said that labour-intensive interventions were inefficient in preventing uptake among young people.

“It remains the case that most kids who don’t start smoking and most smokers who quit do not attribute their status to a discrete intervention,” he said.

Professor Mike Daube, professor of health policy at Curtin University, welcomed calls for further action on smoking prevalence in disadvantaged groups, and said that a mix of approaches was needed.

See opening statement

 

Professor Daube said that strong action at the public policy and health system levels was crucial.

“At the policy level, this should include immediate resumption by the federal government of national mass media campaigns, which have, incomprehensibly, been absent over the past 4 years; and action to combat the tobacco industry’s cynical strategies to counter the impacts of tax increases and plain packaging,” he said.

“We also need more than lip service within health systems about the physical health of people with mental health problems, not least through support and assistance in quitting smoking. There are some who try, but they are the exception.”

Professor Daube said that the suggestion that vaporised nicotine may play a role in reducing smoking was “very speculative”, and still “some way ahead of the evidence”.

“[We] should await any determination by the [Therapeutic Goods Administration] as to their safety and efficacy,” he said.

Earlier in 2017, the TGA decided to uphold the ban on vaporised nicotine in e-cigarettes in Australia

NACCHO Research Alert : @NRHAlliance Aboriginal health risk factors #rural and #remote populations

 ” Health risk factors like smoking, excessive drinking, illicit drug use, lack of physical activity, inadequate fruit and vegetable intake and overweight have powerful influences on health, and there are frequently clear inter-regional differences between the prevalence of these.

While it can be argued that there is some degree of personal choice involved in whether individuals have a poor health risk profile, there is clear evidence that external factors such as environment, opportunity, and community culture each have very strong influences.

For example, access to affordable healthy food can often be poor in smaller communities and this, coupled with lower incomes in these areas, adversely affects the quality of peoples’ diets, the prevalence of overweight, and consequently the prevalence of chronic disease.”

From the National Rural Health Alliance Research View HERE

National data pertaining to personal health risk factors typically comes from the ABS National Health Survey and the AIHW National Drug Strategy Household Survey (NDSHS). Some State and Territory Health Departments run their own health surveys (which cannot be aggregated nationally with each other or with the ABS survey because of the different methodologies and definitions used (think different State rail gauges). Consequently data describing aspects of health in regional and especially remote areas can be thin (ie with imprecise estimates in some or all areas).

Example 1

Table 14: Fruit and vegetable consumption, Aboriginal and Torres Strait Islander people 15+ years, 2012-13

Roughly 60% of Aboriginal and Torres Strait Islander Australians 15+ in Major cities and regional/rural areas have inadequate fruit intake, closer to 50% in remote areas (compared with around 50% of all Australians 18+ in major cities and regional/rural areas).

Roughly 95% of Aboriginal and Torres Strait Islander Australians 15+ in Major cities and regional/rural areas have inadequate vegetable intake, perhaps higher (98%) in Very remote areas (compared with around 90%-94% of all Australians 18+ in major cities and regional/rural areas).

Example 2

NACCHO provided graphic

Table 16 Below : Overweight and Obesity, Aboriginal and Torres Strait Islander people 15+ years, 2012-13

Aboriginal and Torres Strait Islander people in rural/regional and Remote areas (29%-33%) were a little more likely to be overweight than those in Major cities (28%), with those in Very Remote areas (26%) least likely to be overweight.

Aboriginal and Torres Strait Islander people in Inner regional areas (41%) were more likely to be obese than those in Major cities (38%), but those in Outer regional (36%) and remote areas (~33%) were less likely to be obese.

Overall, Aboriginal and Torres Strait Islander people in Inner Regional areas were most likely to be overweight/obese (70%), those in Major cities, Outer Regional and Remote areas were less likely to be overweight/obese (~66%), while those in Very Remote areas were the least likely to be overweight/obese (59% )

At the time of writing, the most recent National Health Survey was conducted in 2014-15[1], while the most recent AIHW NDSHS[2] was conducted in 2016, with most recently available results from the 2013 NDSHS. The most recent ABS Australian Aboriginal and Torres Strait Islander Health Survey[3] was conducted in 2012-13.

Some organisations (eg the Public Health Information Development Unit (PHIDU)) have calculated modelled estimates for small areas (eg SLA’s and PHN’s), where the prevalence of some risk factors has been predicted based on the age, sex and socioeconomic profile of the population living there.

Some sites (eg ABS) present risk factor data as crude rates, other sites (eg PHIDU) present risk factor data as age-standardised rates.  The advantage of the age-standardised rates is that the effect of age is largely removed from inter-population comparisons.

For example, older populations (eg those in rural/regional areas) would be expected to have higher average blood pressure than younger (eg Major cities) populations even though the underlying age-specific rates happened to be identical in both populations (because older people tend to have higher blood pressure than younger people).

While crude rates for the older population will be higher, the age-standardised rates in such a comparison would be the same – indicating a higher rate that is entirely explainable by the older age of one of the populations.

Both crude and age standardised rates are useful in understanding the health of rural and remote populations.

 


[1] http://www.abs.gov.au/ausstats/abs@.nsf/mf/4364.0.55.001

[3] http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4727.0.55.0012012-13?OpenDocumentSmoking

Table 1: Smoking status, by remoteness, 2013 and 2014-15

MC

IR

OR/Remote

Percentage

Current daily smoker (18+) (crude) 2014-15 (a)

13.0

16.7

20.9

Current smoker (18+) (Age standardised) 2014-15 (b) (includes daily, weekly, social etc smoking)

14.6

19.0

22.4

MC

IR

OR

Remote+ Very Remote

Current smoker (daily, weekly, or fortnightly) 14+ (crude) 2013 (c)

14.2

17.6

22.6

24.6

Current smoker (daily, weekly, or fortnightly) 14+ (Age standardised) 2013 (d)

14.2

18.6

23.6

24.4

Mean number of cigarettes smoked per week, smokers aged 14 years or older 2013 (e)

85.9

113.1

109.4

126.2

Sources:

Compared with Major cities (13%), the prevalence of daily smoking by people 18 years and older in Inner regional (17%) and Outer regional/Remote areas (21%) is higher.

The NDSH survey reflects these trends albeit with a slightly different age group (14+) and a different definition of smoking (daily plus less frequently), but the NDSH survey adds detail for remote areas where smoking rates are higher again (around 25% versus around 23% in Outer regional).

In addition, the average number of cigarettes smoked by each smoker is higher in regional/rural areas (~110/week) than in Major cities (86/week), and higher again (126/week) in remote areas.

 

Smoking – exposure, uptake, establishment, quitting

Table 2: Smoking characteristics by Remoteness, 2013, 2014 and 2014-15

MC

IR

OR

remote

8.8

17.8

19.3

27.8

Proportion of pregnant women who gave birth and smoked at any time during the pregnancy (2013, crude, National Perinatal Data Collection, exposure tables, Table 5.1.2 )

8.5

17.0

18.9

27.5

Proportion of pregnant women who gave birth and smoked in the first 20 weeks of pregnancy (2013, crude, National Perinatal Data Collection) exposure tables, Table 5.2.2)

3.6

3.1

4.1

*9.4

Proportion of dependent children (aged 0–14) who live in a household with a daily smoker who smokes inside the home (2013, crude, NDSHS exposure tables, Table 6.3)

2.5

2.0

2.7

*2.9

Proportion of adults aged 18 or older who live in a household with a daily smoker who smokes inside the home (2013, crude, NDSHS, exposure tables, Table 7.3)

16.2

15.4

14.7

15.5

Average age at which people aged 14–24 first smoked a full cigarette (2013, crude, NDSHS, uptake tables, Table 9.3)

17.8

22.7

17.8

28.3

Proportion of 12–17 year old secondary school students smoking at least a few puffs of a cigarette (2014, crude, Australian Secondary Students Alcohol and Drug Survey 2014, uptake tables, Table 10.3

54.7

61.1

64.9

67.2

Proportion of persons (aged 18 or older) who have smoked a full cigarette (2013, crude,  NDSHS, uptake tables, Table 10.8)

2.5

3.4

2.5

3.7

Proportion of secondary school students (aged 12–17) who have smoked more than 100 cigarettes in their lifetime (2014, crude, Australian Secondary Students Alcohol and Drug Survey 2014, transition tables, Table 2.3)

20.2

25.9

44.1

45.2

Proportion of young people (aged 18–24) who have smoked more than 100 cigarettes in their lifetime (2013, crude, NDSHS, transition tables, Table 2.6)

21.3

16.8

19.0

15.5

Quitting: Proportion successfully gave up for more than a month (2013, crude, NDSHS, cessation tables, Table 4.3)

29.2

34.2

31.7

32.9

Quitting, Proportion unsuccessful (2013, crude, NDSHS, cessation tables, Table 4.3)

46.3

48.0

47.4

45.2

Quitting: Proportion any attempt (2013, crude, NDSHS, cessation tables, Table 4.3)

35.2

36.3

36.1

36.0

Mean age at which ex-smokers aged 18 or older reported no longer smoking (2013, crude, NDSHS, cessation tables, Table 11.2)

53.1

51.5

46.3

45.0

The proportion of ever smokers aged 18 or older who did not smoke in the last 12 months (2013, crude, NDSHS, cessation tables, Table 12.3)

4.9

6.0

4.8

7.0

Proportion of secondary school students (aged 12–17) who were weekly smokers (2014, crude, Australian Secondary Students Alcohol and Drug Survey 2014, established tables, Table 1.3)

6.9

9.3

6.8

10.4

Proportion of secondary school students (aged 12–17) who were monthly smokers (2014, crude, Australian Secondary Students Alcohol and Drug Survey 2014, established tables, Table 13.3)

13.0

16.7

21.2

18.8

Proportion of adults aged 18 or older who are daily smokers (2014-15, crude, ABS NHS, established tables, Table 3.3)

10.9

7.8

2.9

n.p.

Proportion of smokers aged 18 or older who are occasional smokers (smoke weekly or less than weekly) (2014-15, crude, ABS NHS, established tables, Table 14.3)

40.1

44.7

42.3

52.7

Proportion of Aboriginal and Torres Strait Islander people aged 18 or older who are daily smokers (2012-13, crude, ABS Australian Aboriginal and Torres Strait Islander Health Survey 2012–13, established tables, Table 8i.3)

Source: http://www.aihw.gov.au/alcohol-and-other-drugs/data/ (sighted 11/7/17)
Note: Those estimates above with asterix have large standard errors and should be treated carefully.

Women in rural and remote areas were much more likely to smoke during pregnancy, with 28% of women in remote areas smoking during pregnancy, compared with 18-19% in regional/rural areas, and 9% in Major cities.

It is unclear whether exposure to environmental tobacco smoke varies by remoteness.

Young people outside major cities appeared to have their first cigarette at an earlier age (~15 years as opposed to ~16 years in Major cities.

Secondary school students in Inner regional (~23%) and remote (~28%) areas were more likely to have had at least a few puffs of a cigarette than those in major cities (~18%).

While 20% of young people in Major cities had smoked more than 100 cigarettes in their lifetime, 26%, 44% and 45% of young people in Inner regional, Outer regional and remote areas had done so.

People outside Major cities were as likely or slightly more likely to have attempted to quit smoking, but were less likely to be successful (and more likely to be unsuccessful).

A higher proportion of secondary students outside Major cities were weekly or monthly smokers (6%, 5% and 7% in IR, OR and remote areas versus 5% in Major cities weekly, 9%, 7%, and 10% in IR, OR and remote areas versus 7% in Major cities monthly).

Table 3: Current daily smoker, Aboriginal and Torres Strait Islander people 15+ years, by Remoteness, 2012-13

MC

IR

OR

R

VR

Crude Percent

Current daily smoker

36.2

40.9

39.8

47.4

51.1

Source: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4727.0.55.0012012-13?OpenDocument Table 2 (sighted 12/7/17)

Prevalence of smoking amongst Aboriginal and Torres Strait Islander people 15 years and older is around 35%-40% in Major cities and regional/rural areas, and close to 50% in remote areas. Note that while the pattern is similar in Table 2 and Table 3 above, the figures for 18+ and 15+ year olds are slightly different.

Smoking Trends

Table 4: Comparison of declines in smoking rate estimates across remoteness areas, people 18+, based on ABS NHS surveys, 2001 to 2011-12

Survey year

MC

IR

OR/Rem

Australia

Crude percent daily smokers

2001

21.9

21.9

26.5

22.4

2004-05

19.9

23.0

26.2

21.3

2007-08

17.5

20.1

26.1

18.9

2011-12

14.7

18.3

22.2

16.1

2014-15

13.0

16.7

20.9

14.5

Source: ABS National Health Surveys

From Table 4 above, rates of smoking have clearly declined in Major cities areas, but have been slower to decline in Inner regional and Outer regional/Remote areas. Rates of smoking in rural areas, apparently static last decade, now appear to be declining. Rates in Major cities and Inner regional areas have declined to 0.59 and 0.76 times the 2001 rates in these areas. The 2014-15 rate in Outer regional areas is 0.79 times the 2001 rate.

Figure 1: Daily smokers 18 years and older, 2007-08, 2011-12 and 2014-15, NHS

Figure 1: Daily smokers 18 years and older, 2007-08, 2011-12 and 2014-15, NHS

Source: ABS NHS http://www.aihw.gov.au/alcohol-and-other-drugs/data/ established tables, Table 3.3 (sighted 11/7/17)

Figure 2: Smokers 14 years and older, 2007, 2010 and 2013, NDSHS

Figure 2: Smokers 14 years and older, 2007, 2010 and 2013, NDSHS

Source: AIHW NDSHS http://www.aihw.gov.au/alcohol-and-other-drugs/data/ tobacco smoking table S3.12 (sighted 11/7/17)

Note: Smokers include daily, weekly and less frequent smokers.

Figures 1 and 2 above both show clear declines in Major cities and Inner regional areas, but the trend in Outer regional and Remote areas is less clear, with ABS data showing a decline in daily smoking rates for people aged 18+ between 2007-8 and 2014-15, but NDSHS data showing little change in smoking rates for people 14+ between 2007 and 2013.

Alcohol

Table 5: Alcohol risk status, by remoteness, 2013 and 2014-15

Alcohol consumption

MC

IR

OR/Rem

Exceeded 2009 NHMRC lifetime risk guidelines, people 18+, crude %, 2014-15 (a)

16.3

18.4

23.4

Exceeded 2009 NHMRC lifetime risk guidelines, people 15+, age standardised %, 2014-15 (b)

15.7

17.4

22.0

Exceeded 2009 NHMRC single occasion risk guidelines, people 18+, crude %, 2014-15 (a)

42.7

48.5

46

MC

IR

OR

R/VR

Abstainer/ex-drinker, crude %, 14+, 2013 (c)

23.1

18.9

20.5

17.5

Low lifetime risk, crude %, 14+, 2013 (c)

60.2

62

56.9

47.6

High lifetime risk, crude %, 14+, 2013 (c)

16.7

19.1

22.6

34.9

low single occasion risk, crude %, 14+, 2013 (c)

40.4

41.8

38.1

30.8

Single occasion risk less than weekly, crude %, 14+, 2013 (c)

23.5

24.4

23.6

22.8

Single occasion risk at least weekly, crude %, 14+, 2013 (c)

13

14.9

17.8

28.9

Sources:

Table 6: Alcohol consumption against 2009 NHMRC guidelines, Aboriginal and Torres Strait Islander people 15+ years, by Remoteness 2012-13

MC

IR

OR

R

VR

Percent

Exceeded lifetime risk guidelines

18.0

18.7

18.2

22.5

14.3

Exceeded single occasion risk guidelines

56.7

57.4

50.7

59.0

41.4

Source: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4727.0.55.0012012-13?OpenDocument Table 2 (sighted 12/7/17)

The figures in Table 6 are not strictly comparable with those for the total population in Table 5, because  Table 6 refers to people who are 15 years and older, while Table 5 refers to people who are 18 years and older.

The percentage of the 15+ ATSI population exceeding 2009 NHMRC Lifetime risk guidelines is around 15-20% with little apparent inter-regional variation, compared with, for the total population 18+,  16% in Major cities, increasing to 23% in Outer regional/remote areas.

The percentage of the 15+ ATSI population exceeding the 2009 single occasion risk guidelines is around 50-60%, and around 40% in Very remote areas, compared with, for the total population 18+,  40-50% in Major cities, rural and regional areas.

Alcohol trends

Table 7: Type of alcohol use and treatment for alcohol, by remoteness area (per 1,000 population)

MC

IR

OR

R/VR

single occasion risk (monthly) 2004

287

304

321

370

2007

285

292

312

437

2010

274

312

329

413

2013

250

273

315

422

lifetime risk 2004

200

215

234

262

2007

199

210

238

314

2010

189

225

251

310

2013

167

191

226

349

very high risk – yearly 2004

167

185

206

243

2007

172

183

206

288

2010

161

183

218

266

2013

151

166

194

258

very high risk – monthly 2004

77

84

104

130

2007

78

89

100

153

2010

79

94

113

154

2013

70

70

100

170

very high risk – weekly 2004

21

27

41

38

2007

24

28

24

50

2010

37

43

54

78

2013

27

28

38

70

Closed treatment episodes 2004–05

61

72

60

58

2007–08

76

84

80

129

2010–11

69

96

87

135

2013–14

68

79

93

155

Source: NDSHS,  http://www.aihw.gov.au/alcohol-and-other-drugs/data/  alcohol -supplementary data tables, Table S18

Notes:
Single occasion risk (monthly): Had more than 4 standard drinks at least once a month
Lifetime risk: On average, had more than 2 standard drinks per day
Very high risk (yearly): Had more than 10 standard drinks at least once a year
Very high risk (monthly): Had more than 10 standard drinks at least once a month
Very high risk (weekly): Had more than 10 standard drinks at least once a week

There is a clear increase in the prevalence of people who drink alcohol in such a way as to increase their single occasion risk (eg from car accident, assault, fall, etc) and their lifetime risk (eg from chronic disease – liver disease, dementia, cancer etc) as remoteness increases.

In 2013, single occasion risk ranged from 25% of people 14 years or older in major cities to 42% of people in remote areas, while lifetime risk increased from 17% in major cities to 35% in remote areas.

In 2013, The prevalence of people who drank more than 10 standard drinks in one sitting at least once per week, increased from just under 3% in Major cities to 7% in remote areas.

In 2013-14, there were just under 70 closed treatment episodes per 1,000 people living in Major cities, increasing to around 80 and 90 per 1,000 population in Inner and Outer regional areas, to 155 per 1,000 people living in remote Australia.

 

Illicit drug use 2013

Table 8: Illicit drug use, “recent users” 14+, 2013

MC IR OR remote

Crude percent

Cannabis

9.8

10.0

12.0

13.6

Ecstasy

2.9

1.5

1.6

*1.8

Meth/amphetamine

2.1

1.6

2.0

*4.4

Cocaine

2.6

0.8

*1.1

*2.5

Any illicit drug

14.9

14.1

16.7

18.7

Source: AIHW National Drug Strategy Household Survey, 2013. http://www.aihw.gov.au/alcohol-and-other-drugs/data/  Illicit drug use (supplementary) tables S5.6, S5.11, S5.17, S5.21, S5.26.

Note: * indicates large standard error (therefore some degree of uncertainty)

Illicit drug use appears to be higher in Outer regional and remote areas compared with Major cities and Inner regional areas, in large part due to higher rates of cannabis use in these areas, but with apparent lower use of ecstasy and cocaine in regional areas compared with Major cities.

 

Physical activity

Table 9: Physical inactivity, people 18+, 2014-15

MC

IR

OR/Remote

Percentage of people aged 18+ who undertook no or low exercise in the previous week (crude) (a)

64.3

70.1

72.4

Percentage of people aged 18+ who undertook no or low exercise in the previous week (age standardised) (b)

64.8

68.6

71

Sources:
(a) ABS NHS (http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0012014-15?OpenDocument Table 6.3)
(b) PHIDU (ABS NHS data) (http://phidu.torrens.edu.au/social-health-atlases/data#social-health-atlas-of-australia-remoteness-areas) sighted 18/7/2017

Note that level of exercise is based on exercise undertaken for fitness, sport or recreation in the last week.

Physical inactivity appears to be more prevalent with remoteness, increasing from 65% of people in Major cities to 71% in Outer regional/remote areas.

Table 10: Average daily steps, 2011-12

MC

IR

OR/Rem

Average daily steps, 18+ years, 2011-12 (a)

7,393

7,388

7,527

Average daily steps, 5-17years, 2011-12 (b)

9,097

9,266

9,160

Sources:

In 2011-12, adults living in Outer regional/Remote areas took slightly more steps than those living in Major cities or Inner regional areas, while the number of steps taken by children and adolescents in regional/Remote areas was slightly greater compared with those in Major cities.

Table 11: Average time spent on physical activity and sedentary behaviour by persons aged 18+, 2011-12

MC

IR

OR/Remote

Australia

Hours

Physical activity(a)

3.9

3.4

3.9

3.8

Sedentary behaviour (leisure only)(b)

29.3

28.0

27.9

28.9

Sedentary behaviour (leisure and work)(b)

40.2

35.2

36.0

38.8

Notes:
(a) Includes walking for transport/fitness, moderate and vigorous physical activity.
(b) Sedentary is defined as sitting or lying down for activities.

Source: ABS 2011-12 Australian Health Survey (Physical activity) http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0042011-12?OpenDocument  Table 5.1

Adults living in Inner regional and Outer regional/Remote areas were about as likely as (or very slightly less likely than) those in Major cities to be sedentary in their leisure time, but appeared to be slightly less likely to be sedentary overall (ie their work involved a greater level of physical activity).

Table 12: Whether children aged 2-17 years met physical and screen-based activity recommendations, 2011-12

MC

IR

OR/Rem

Crude percentage

Met physical activity recommendation on all 7 days(a)(b)

27.5

34.3

34.2

Met screen-based activity recommendation on all 7 days(b)(c)

28.0

29.7

31.0

Met physical activity and screen-based recommendations on all 7 days (a)(b)(c)

9.7

10.9

14.2

Notes:
(a) The physical activity recommendation for children 2–4 years is 180 minutes or more per day, for children 5-17 years it is 60 minutes or more per day. See Physical activity recommendation in Glossary.
(b) In 7 days prior to interview.
(c) The screen-based recommendation for children 2–4 years is no more than 60 minutes per day, for children 5-17 years it is no more than 2 hours per day for entertainment purposes.

Source:
ABS 2011-12 Australian Health Survey (Physical activity) http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0042011-12?OpenDocument  Table 14.3

Children in rural and regional Australia appeared more likely (34% vs 28%) to meet physical activity recommendations and slightly more likely (30%vs 28%) to meet screen-based activity recommendations than their Major cities counterparts.

 

Fruit and vegetable consumption

Table 13: Fruit and vegetable consumption, people 18+ years, by remoteness, 2014-15

MC

IR

OR/Remote

Crude Percentage

Inadequate fruit consumption(a)

50.0

50.6

51.2

Inadequate fruit consumption(b)

50.4

48.3

48.0

Inadequate vegetable consumption(a)

93.4

93.5

89.3

Inadequate vegetable consumption(b)

n.p.

n.p.

n.p.

Sources:
(a) ABS NHS (http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0012014-15?OpenDocument Table 6.3)
(b) PHIDU (ABS NHS data) (http://phidu.torrens.edu.au/social-health-atlases/data#social-health-atlas-of-australia-remoteness-areas) sighted 18/7/2017

Note that adequacy of consumption is based on comparison with 2013 NHMRC guidelines.

Half of adult Australians eat insufficient fruit, with little clear difference between major cities and regional/rural areas.

Around 90% of adult Australians ate insufficient vegetables, with little clear difference between major cities and regional/rural areas.

Table 14: Fruit and vegetable consumption, Aboriginal and Torres Strait Islander people 15+ years, 2012-13

MC

IR

OR

R

VR

Crude Percent

Inadequate daily fruit consumption (2013 NHMRC Guidelines)

59.0

60.6

56.9

54.9

49.1

Inadequate daily fruit consumption (2003 NHMRC Guidelines)

62.1

63.6

59.8

58.3

51.6

Inadequate daily vegetables consumption (2013 NHMRC Guidelines)

95.9

93.5

93.6

94.5

97.9

Inadequate daily vegetables consumption (2003 NHMRC Guidelines)

93.8

90.6

90.5

91.2

96.1

Source: http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4727.0.55.0012012-13?OpenDocument Table 2 (sighted 12/7/17)

Roughly 60% of Aboriginal and Torres Strait Islander Australians 15+ in Major cities and regional/rural areas have inadequate fruit intake, closer to 50% in remote areas (compared with around 50% of all Australians 18+ in major cities and regional/rural areas).

Roughly 95% of Aboriginal and Torres Strait Islander Australians 15+ in Major cities and regional/rural areas have inadequate vegetable intake, perhaps higher (98%) in Very remote areas (compared with around 90%-94% of all Australians 18+ in major cities and regional/rural areas).

 

 

Overweight and Obesity

Table 15: Overweight and Obesity, people 18+ years, by remoteness, 2014-15

MC

IR

OR/Remote

Crude Percentage

Persons, overweight/obese (a)

61.1

69.2

69.2

Age standardised percentage

Males overweight (b)

43.8

41.1

34.3

Males obese (b)

25.8

33.1

38.2

Females overweight (b)

28.9

28.3

30.1

Females obese (b)

25.0

32.4

33.7

People  overweight (b)

36.2

34.4

31.4

People obese (b)

25.4

32.6

35.8

Sources:
(a) ABS NHS (http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0012014-15?OpenDocument Table 6.3)
(b) ABS NHS http://phidu.torrens.edu.au/social-health-atlases/data#social-health-atlas-of-australia-remoteness-areas

Adults in rural/regional areas are more likely to be overweight or obese than people in Major cities (69% vs 61%).

However, there were inter-regional BMI and gender differences:

  • Compared with those in Major cities, males in Inner regional and especially Outer-regional areas were less likely to be overweight (41% and 34%, vs 44%) but much more likely to be obese (33% and 38% vs 26%).
  • Compared with those in Major cities, females in Inner regional and Outer-regional areas were about as likely to be overweight (~29%) but much more likely to be obese (~33% vs 25%).

 

Table 16: Overweight and Obesity, Aboriginal and Torres Strait Islander people 15+ years, 2012-13

MC

IR

OR

R

VR

Crude Percent

Overweight

27.5

28.8

30.1

32.5

26.4

Obese

37.9

41.3

36.2

33.1

32.3

Overweight/obese

65.4

70.1

66.2

65.6

58.8

Aboriginal and Torres Strait Islander people in rural/regional and Remote areas (29%-33%) were a little more likely to be overweight than those in Major cities (28%), with those in Very Remote areas (26%) least likely to be overweight.

Aboriginal and Torres Strait Islander people in Inner regional areas (41%) were more likely to be obese than those in Major cities (38%), but those in Outer regional (36%) and remote areas (~33%) were less likely to be obese.

Overall, Aboriginal and Torres Strait Islander people in Inner Regional areas were most likely to be overweight/obese (70%), those in Major cities, Outer Regional and Remote areas were less likely to be overweight/obese (~66%), while those in Very Remote areas were the least likely to be overweight/obese (59%).

These figures compare with 61% – the prevalence of overweight/obesity for (predominantly non-Indigenous) people living in Major cities.

 

High blood pressure

Table 17: High blood pressure, people 18+, by Remoteness, 2014-15

MC

IR

OR/Remote

Percentage

Crude % (a)

21.9

27.1

24

Age standardised % (b)

22.7

24.6

22.1

Sources:

(a) ABS NHS (http://www.abs.gov.au/AUSSTATS/abs@.nsf/DetailsPage/4364.0.55.0012014-15?OpenDocument Table 6.3)
(b) ABS NHS http://phidu.torrens.edu.au/social-health-atlases/data#social-health-atlas-of-australia-remoteness-areas

Age for age, people in rural/regional Australia appeared to be as likely, or very slightly more likely to have high blood pressure than their counterparts in Major cities (~23% vs ~24%). However, because people in rural/regional areas are older (on average), the prevalence of people with high blood pressure is higher (~26% vs 22%) than

Updated 31/07/2017
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