NACCHO Aboriginal Health and #SuicidePrevention : #ATSISPC18 #refreshtheCTGRefresh Pat Turner CEO NACCHO Setting the scene panel : Health led solutions through Aboriginal Community Controlled Health #Leadership

” It is well established that Aboriginal led solutions deliver better outcomes.

Aboriginal community-controlled health services should be funded based on need and so that they can develop comprehensive suicide prevention initiatives with the communities they service. 

The Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project identifies successful Indigenous community led health led responses including providing positive health messages and mental health support underpinned by a cultural framework and tackling harmful drug and alcohol use.

These initiatives can be delivered by properly funded and supported Aboriginal Community Controlled Health Organisations.

I also believe in regular full health checks for at risk people so that critical issues that can impact on a persons wellbeing, like poor hearing, can be picked up and addressed early. 

We also know that mainstream mental health service provision for Aboriginal and Torres Strait Islander people across the country is inadequate and inappropriate.

Many people feel unsafe accessing the care they need.

Aboriginal Community Controlled Health Organisations should be priortised for funding to support our own people.” 

Pat Turner AM CEO NACCHO who is working with Aboriginal and Torres Strait Islander peak bodies across Australia to ask COAG for a seat at the table on the Closing the Gap Refresh: so that we get that policy right : Part 1 Below

Picture above @CroakeyNews : Prof Pat Dudgeon kicks off the keynote panel session: “Setting the scene”. #ATSISPC18. Prof Tom Calma, Prof Helen Milroy, and our CEO Pat Turner

See the #RefreshtheCTGRefresh Campaign post HERE

Read over 120 NACCHO Aboriginal Health and #SuicidePrevention articles published over last 6 years 

Suicide among Aboriginal and Torres Strait Islander communities is regularly in the media and public conversations. Often the focus is on an individual completed or attempted suicide or the negative statistics.

The second National Aboriginal and Torres Strait Islander Suicide Prevention Conference, to be held in Perth on November 20-21, will shift the focus to solutions identified by Indigenous people themselves. The program consists of only Indigenous people from Australia and internationally.

Our voices are important because it is our mob who understand what is going on in our communities best. We live and breathe it, with many of us either having considered taking our own lives, making an attempt or having had family members who have.

This is why the program includes a focus on community-based solutions. “

Summer May Finlay writes Part 2 below for Croakey 

Part 1 : Why an urgent need for action

  • Our people are more than twice as likely to commit suicide than other Australians.
  • Young Aboriginal and Torres Strait Islander men are the most at risk of suicide in Australia.
  • Those in remote area are more disproportionately affected
  • Suicide and self-inflicted injuries was the greatest burden of disease for our young people in 2011.
  • If, Western Australia’s Kimberley region was a country, it would have the worst suicide rate in the world, according to World Health Organisation statistics.
  • Rate of suicide for Aboriginal people in the Kimberley is seven times the rest of Australia.
  • This is not news to us: but it is unacceptable and it is why we are here today.

Aboriginal control

  • At the heart of suicide is a sense of hopelessness and powerlessness.
  • Our people feel this powerlessness at multiple levels, across multiple domains of our lives.
  • It is why we have the Uluru Statement from the Heart: a cry from Aboriginal and Torres Strait Islander peoples across the nation to have a say over matters that impact on us.
  • At the national level, it means a Voice to the Commonwealth Parliament and a full partnership between Indigenous people and governments on the Closing the Gap Refresh with COAG.
  • At the regional level, it is about the formation of partnerships – like in the Kimberley one on suicide prevention – working together and advocating as a region.
  • At the local level, it is about Aboriginal people being in control of the design and delivery of programs to their own people.
  • The importance of Aboriginal control or Indigenous led is highlighted consistently as a way to achieve better outcomes for our people.
  • This is also reinforced at the Kimberley Roundtable and in the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project.
  • Community-led actions are the most effective suicide prevention measure for our people. This fundamental point cannot be ignored if the situation is to change.

Healing

  • Aboriginal suicide rates have been accelerating since 1980.
  • Aboriginal people did not have a word for “suicide” before colonisation.
  • To go forward, we must go back and identify and draw on those aspects of our culture that gives us strength and identity.
  • We also must heal by acknowledging and addressing the effects of intergenerational trauma.
  • Part of healing must include challenging the continuing impacts of colonisation on Indigenous peoples’ contemporary lives.
  • Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project identifies the success of Elder-driven, on-country healing for youth which has the dual effect of strengthening intergenerational ties as well as increasing cultural connection.
  • Red Dust Healing is another example of cultural reconnection achieving positive outcomes with people at risk.
  • The Healing Foundation also achieves similar outcomes with the same principles of empowerment and connection to culture.

A public policy crisis

  • Almost all Aboriginal people who commit suicide are living below the poverty line.
  • Other common factors are:
    • Aboriginal people who have been incarcerated and come out of prison with little to no hope on the horizon.
    • Aboriginal people who are homeless.
    • Aboriginal people who have been recently evicted from their public housing rentals.
    • Aboriginal people who are exposed to violence and alcohol misuse and suffer domestic abuse.
    • Aboriginal people who have multiple underlying health and metal health issues.
    • Aboriginal people who are young; males; and those who live in remote areas.
  • This tells us that we need a comprehensive public policy response to address suicide rates in our people – that suicide in our people is linked to our status and situation more broadly in Australia.
  • It is therefore unacceptable that the National Partnership Agreement on Remote Indigenous Housing has been allowed to lapse and no further investment has been agreed.
  • We must overturn and replace the Community Development Program that is leaving our young people completely disengaged.
  • We must also tackle the issues that lead to the greater incarceration of our peoples, with greater investment in ear health programs, employment and education.
  • It is why we must join the call for Newstart to be raised, so that our people who cannot find work, are not living in poverty.
  • And it is why myself and NACCHO are working with Aboriginal and Torres Strait Islander peak bodies across Australia to ask COAG for a seat at the table on the Closing the Gap Refresh: so that we get that policy right.
  • Whilst these matters can be overlooked in our efforts to respond to suicide in our people, and because it is difficult for governments, but they are fundamental drivers.

 .

Part 2 Follow #ATSISPC18 for news from National Aboriginal and Torres Strait Islander Suicide Prevention Conference : From Croakey 

The second National Aboriginal and Torres Strait Islander Suicide Prevention Conference will take place in Perth this week.

Summer May Finlay, who will cover the discussions for the Croakey Conference News Servicetogether with Marie McInerney, writes below that the focus will be on community-based solutions, as well as listening to young people and LGBTIQ+ sistergirls and brotherboys.

For news from the conference on Twitter, follow #ATSISPC18@SummerMayFinlay@mariemcinerney and @CroakeyNews.


 

Healing and support crew on hand should the be needed 

Summer May Finlay writes:

Suicide among Aboriginal and Torres Strait Islander communities is regularly in the media and public conversations. Often the focus is on an individual completed or attempted suicide or the negative statistics.

The second National Aboriginal and Torres Strait Islander Suicide Prevention Conference, to be held in Perth on November 20-21, will shift the focus to solutions identified by Indigenous people themselves. The program consists of only Indigenous people from Australia and internationally.

Our voices are important because it is our mob who understand what is going on in our communities best. We live and breathe it, with many of us either having considered taking our own lives, making an attempt or having had family members who have. This is why the program includes a focus on community-based solutions.

While the term “Aboriginal and Torres Strait Islander” is used as a collective term for the Indigenous nations in Australia, each community within each nation is unique – culturally, socially and historically. This means that solutions need to be tailored to each community. Again, this focus is reflected in the conference program.

That’s not to say everyone in each community has the same needs and concerns. Within communities there are sub-groups who also have distinct needs, such as young people and LGBTQI+ sister girls and brother boys.

Representation matters

Our young people and community of LGBTIQ+ sistergirls and brotherboys experience disproportionate rates of suicide. Their voices on how to address the situation are important to hear, which is why these groups are well represented at the conference, with sessions where people will share their stories of ways forward.

Dion Tatow, a conference presenter, says the focus needs to be on ways forward because being “LGBTIQ+ sistergirls and brotherboys isn’t the cause of suicide, it is the discrimination and exclusion that are the cause”.

He says: “The shame [and] secrecy. You have to hide it, so it’s not good for your own health and wellbeing.”

Tatow is an Iman and Wadja man from Central Queensland and South Sea Islander (Ambrym Island, Vanuatu) and chairperson of gar’ban’djee’lum, a Brisbane-based, independent, social and support network for Aboriginal & Torres Strait Islander people with diverse genders, bodies, sexualities and relationships.

He believes that Aboriginal and Torres Strait Islander people and organisations like Aboriginal Community Controlled Health Organisations (ACCHOs) and cisgender people and mainstream organisations have a role to play in improving the health and wellbeing of LGBTIQ+ sistergirls and brotherboys.

However, many health services “staff aren’t trained to deal with some LGBTIQ+ sistergirls and brotherboys’ health concerns such as gender reassignment.” This can mean LGBTIQ+ sistergirls and brotherboys can feel uncomfortable accessing a service.

Safe spaces needed

Tatow believes that ACCHOs need to step up and become “safe spaces” for LGBTIQ+ sister girls and brother boys. He says that there is a perception among LGBTIQ+ sistergirls and brotherboys that ACCHOs may be unsafe, with concerns particularly around confidentiality.

According to Tatow, the program Safe and Deadly Spaces run by Aboriginal and Torres Strait Islander Community Health Service in Brisbane (ATSICHS) is a great example of what ACCHOs can do to offer appropriate services to LGBTIQ+ sister girls and brother boys.

ATSICHS is “committed to being inclusive of all sexual orientations, gender identities and intersex variations to ensure every member our community feels safe, accepted and valued when they access our services and programs”.

Young Aboriginal and Torres Strait islander people also have a strong presence at the conference.

Culture is Life, led by the Chief Executive Officer Belinda Duarte, has taken charge of the youth program. Culture is Life backs Aboriginal-led solutions that deepen connection and belonging to culture and country, and supports young Aboriginal and Torres Strait Islander people to thrive. This includes allowing young Aboriginal and Torres Strait Islander people to take on leadership roles.

Will Austin, 22, a Gunditjmara man, from South West Victoria who is the Community Relations manager for Culture is Life, was charged with leading development of the youth program. He believes that young people being part of the program was important because “Aboriginal leadership and expertise needs to be shared in a really inclusive way with young people through listening and reciprocity across the generations.”

Culture is key

Culture is Life, as the name implies, places culture at the centre of the work they do, and Austin sees culture as key to health and wellbeing for our young people, connecting to cultural practice in traditional and modern ways. He says:

Modern culture is marching down the street and finding the balances in different ways such as art, dance and contemporary dance, poems, song writing, music.

Our culture has been around for thousands of years and shared through our Elders. It will evolve. There is no better feeling than going out on country, dancing on country, feeling your feet on the earth your ancestors have walked on. Connecting to the ancient knowledge and using modern ways to communicate it.”

Katie Symes, Culture is Life General Manager – Marketing and Communications, also believes Culture is a key “protective factor” for Aboriginal and Torres Strait Islander young people.

Will Austin and Katie Symes encourage young people at the conference to have their voices heard.

Austin said: “Don’t be shame. Make sure you step up. Make sure you contribute to the conversations…young Indigenous people are the heartbeat of the nation.”

Symes said: “It’s important for young people to be supported to cut their teeth in a really safe space.”

And the conference is designed to be just that, a safe space.

Listening with heart

Culture is Life is promoting the importance of “Listening with our hearts to the lived experiences of First Nations young people, their friends, families and communities” through its LOVE and HOPE campaign, which aims to aims to raise awareness through communicating the evidence, lived experiences and Aboriginal-led solutions. This aim is echoed through the conference.

You can watch the two campaign videos featuring young Aboriginal and Torres Strait Islander people and Professor Pat Dudgeon, chair of the conference organising committee, here and here. Also follow the campaign on social media using the hashtags #loveandhope  #culturesquad  #cultureislife.

The conference showcases evidence from research and lived experience from Aboriginal and Torres Strait Islander people and Indigenous brother and sisters from other countries. The uniqueness of the program will lend itself to a unique experience for attendees.

This conference follows the first conference held in Alice Springs in 2016 as part of the Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project funded by the Commonwealth Government (see this Croakey report compiling coverage of the conference).

• If you or someone you know needs help or support, call Lifeline on 13 11 14 (24 hours-a-day), contact your local Aboriginal Community-Controlled Organisation, call Beyondblue on 1300 22 4636 or call Q Life: 1800 184 527.

• Further reading: On World Suicide Prevention Day, calls for the Federal Government to invest in Indigenous suicide prevention.

• The feature image above is detail from an artwork on the conference website: Moortang Yoowarl Dandjoo Yaanginy: Families (Cultures) Coming Together for a Common Purpose (Sharing) Shifting SandsThe website says: “This artwork represents our people doing business on country that is recovering from colonisation; our lands taken over, our cultures decimated, and our families separated, causing hardship, despair, and loss of hope

Aboriginal Health Alcohol and Other Drugs : Minister @KenWyatt and John Havnen #NACCHO deliver #NIDAC18 keynotes : What is currently being done to reduce the high levels of alcohol and other drug use within Aboriginal communities? 

 ” All of us want to see better health for First Nations Australians. 

We know that the excessive consumption of drugs and alcohol is associated with health problems in all societies.

It has been linked to chronic conditions such as cancer and liver disease, the spread of hepatitis and HIV, injuries and deaths from motor vehicle accidents and assaults, increased encounters with the law, deaths in custody, suicides and family breakdown.

The reasons why First Nations’ people engage in high risk drug and alcohol consumption are indeed, complex.

When families, communities, local organisations and governments join hands, we are powerful together.

Alcohol and other drugs, tobacco, lifestyle risk factors and social determinants represent more than half of the quest for health and life equality.

It’s now been 10 years since the launch of the Closing the Gap initiative.

The agenda is being refreshed and it’s time to refresh our approach – including by acknowledging the complexity of the drug and alcohol challenge and making even greater efforts to address it.

This conference NIDAC18 will be an important part of that solution – and I look forward to hearing the outcomes. ” 

Minister Indigenous Health Ken Wyatt see full speech Part 2 below

Read over 200 NACCHO Aboriginal Health Alcohol and Other Drugs articles we have published over past 6 years 

Part 1 NACCHO Keynote by John Havnen Senior Policy Officer 

The harmful use of alcohol is a problem for the Australian community as a whole – alcohol misuse and alcohol-related disease remains a recognised as a nationwide problem.

It is estimated that in 2011 alcohol misuse caused 5.1% of the total burden of disease in Australia.

Alcohol related harm has clear social and economic determinants and it is closely related to disadvantage.

As such Aboriginal and Torres Strait Islander communities, which as we all know rate disproportionately in all measures of disadvantage, experience higher rates of alcohol misuse and alcohol-related harm than non-indigenous Australians.

This discrepancy leads to Aboriginal and Torres Strait Islander people experiencing significant health and social problems in a rate unequal to non-Indigenous Australians. But not all of us drink, in the 2016 National Drug Strategy Household Survey, Indigenous Australians aged 14 and over were more likely to abstain from drinking alcohol than non-Indigenous Australians.

This abstinence rate has been increasing over the last decade with more and more of us deciding not to drink.

So although there are proportionately more Indigenous people than non-Indigenous people who refrain from drinking, those of us who do drink are more likely to do so at high-risk levels.

In 2014-15 the National Aboriginal and Torres Strait Islander Social Survey found 19% of Indigenous Australians over the age of 15 exceeded the lifetime risk guidelines for alcohol consumption.

This is no more than 2 standard drinks per day on average or no more than 4 drinks per occasion.

Even though the rate of harmful drinking has declined in recent years, this has been mainly in non-remote areas, so there is still high rates of harmful drinking in remote areas and drinking at risky levels puts a person at risk of medical and social problems.

Due to these high levels of risky drinking, Aboriginal and Torres Strait islanders are more likely to be hospitalised for alcohol-related conditions and accidents than non-Indigenous Australians including acute intoxication, liver disease, injuries, suicide or self-harm and cancer.

There is big differences in the rates with Indigenous males over 9 times more likely to need hospitalisation and Indigenous females 13 times more than non-Indigenous Australians.

These drinking patterns highlight that it is possible that risky drinking and binge drinking has been normalised within some communities and this could potentially act as a barrier to seeking treatment when needed.

However, alcohol is not the only substance that presents a major concern for in Aboriginal and Torres Strait Islander people.

In 2014-15, the National Aboriginal and Torres Strait Islander Social Survey stated that 30% of Indigenous Australians over the age of 15 years reported using an illicit substance in the previous 12-months.

This was an increase from 23% in 2008. The substances most commonly used by Aboriginal and Torres Strait islanders were cannabis with 19% reporting, non-prescription analgesics and sedatives (such as painkillers, sleeping pills and tranquillisers) at 13%, and amphetamines or speed with a rate of 5%.

Smoking has overtime become common place in Aboriginal and Torres Strait islander communities and whilst tobacco smoking is declining in Australia, rates remain disproportionately high among Aboriginal and Torres Strait Islander people.

Indigenous Australians more than twice as likely to be current daily smokers as non-Indigenous Australians.

Despite declines in rates of smoking in Aboriginal and Torres Strait Islander people in the last 20 years there appears to have been no change to the gap in smoking prevalence between the Indigenous and non-Indigenous Australian adult population.

Tobacco-related disease is responsible for between 1.5 and 8 times more deaths in the Aboriginal and Torres Strait islander community than in non-Indigenous Australians.

The harmful use of alcohol, in addition to tobacco and other drugs, are both the cause and effect of serious harm to physical health.

The health status of Aboriginal and Torres Strait Islander people is considerably lower than for non-Indigenous Australians with 71.0% of Indigenous Australians reporting having a long-term health condition compared with 55.3% of non-Indigenous Australians.

Those with long-term health conditions are also more likely to be a daily smoker or misuse alcohol and other drugs. Aboriginal and Torres Strait Islander people who experience multiple diagnoses are more likely to have more difficulty accessing treatment and have poorer outcomes when they do receive treatment than either a physical health condition or an alcohol or other drug disorder alone.

There is a well-known high rate of co-morbidity of substance use disorders with other mental health / social and emotional wellbeing issues, and medical conditions in particular chronic diseases.

These issues tend to cluster in individuals and communities along with other markers of social, economic and intergenerational disadvantage.

These high rates of comorbidity contribute to complexities in the treatment and causality of disorders and remains a significant challenge for the delivery of effective healthcare services for our people.

This is in part due to the complexity of the mental and physical health issues individuals display, and in part because of the burden of multiple disadvantages including; poverty and intergenerational disadvantage and this can reduce the capacity to engage consistently and meaningfully in treatment.

So, what is currently being done to reduce the high levels of alcohol and other drug use within Aboriginal and Torres Strait Islander communities?

Existing mainstream models of practice in the alcohol and other drug field have been developed within Western systems of knowledge and focus on a biomedical model with an emphasis on biological factors and discounts any psychological, environmental, and social influences. As a result, it is not generalisable to Aboriginal and Torres Strait islander culture and ignores important indigenous perspectives and needs.

Including the need for access to culturally appropriate and comprehensive services to address multiple problems, and the need for local links with Indigenous services.

Western alcohol and other drug services are based on an abstinence model and focuses on residential rehabilitation which is aimed more on the needs of alcohol users and not illicit drug users.

Residential alcohol and drug programs provide care and support for people within a residential community setting and can be medium to long-term duration of anywhere from 4 weeks to 12 months and but again only supports residents’ psychological needs only.

This model also lacks consideration to the prevention and early intervention strategies of risky drinking and drug use, lacks acknowledgement of family, culture and community which we know are important aspects in the holistic model of care.

Despite a paucity of data, the knowledge of how to prevent alcohol misuse among the general population – while not consistently translated to policy and practice – is extensive.

The evidence for the effectiveness of such programs for Indigenous Australians, however, remains scant.

Racism is still present in mainstream services so many Aboriginal and Torres Strait Islanders might have limited access to mainstream health services.

Systemic racism in the health system directly influences Indigenous Australians’ quality of and access to healthcare.

The severity of this impact intensifies levels of psychological stress, which is closely linked to poorer mental and physical health outcomes.

Racism not only provides a major barrier to Aboriginal and Torres Strait Islander peoples’ access to health care but also to receiving the same quality of healthcare services available to non-Indigenous Australians.

There is also a tendency to stereotype Aboriginal and Torres Strait Islanders as ‘drunks’ or ‘alcoholics’ which, as I have previously discussed today is not necessarily the case.

So, what will work if mainstream alcohol and other drug services have limited evidence for our people?

Historically, reactions to the concerns of alcohol and other drug misuse among Aboriginal and Torres Strait Islander people were driven not by governments, but by Aboriginal and Torres Strait Islander people themselves who recognised the fact that mainstream services were non-existent or largely culturally inappropriate.

Today, Indigenous Australians are acutely aware of the impacts of alcohol and other drugs and have been actively involved in responding to alcohol and other drugs misuse in their communities.

Any initiative to reduce the harmful effects of alcohol and other drugs in Aboriginal and Torres Strait Islander communities should be developed with, and led by, those communities.

There is value in supporting these communities, including the evaluation of strategies implemented so that communities can learn from their own and from other communities’ experience.

Any action that attempts to treat alcohol and other drugs needs to come from a holistic model of care that is comprehensive and culturally appropriate.

Awareness of the land, the physical body, clan, relationships, and lore, it is the social, emotional and cultural wellbeing of the whole community and not just the individual.

This is why western models of treatment just won’t work.

Comprehensive primary health care is a key strategy for improving the health of Indigenous Australians and is an important platform from which to address the complex health and social issues associated with alcohol and drug misuse.

A holistic approach locally designed and operated by Indigenous people is favoured in its ability to be tailored to community needs and in a cultural context that is owned and supported by the community. 

Despite inadequate funding and resources, the ACCHOs sector has been identified as having a unique role in making alcohol and other drug treatment services more accessible.

One of the unique attributes of Aboriginal controlled drug and alcohol services is that they are a practical expression of Aboriginal peoples’ self-determination, reflected in their governance and treatment models.

A recent example of what works is the pilot of an integrated model of care within Central Australian Aboriginal Congress based in Alice Springs.

Congress developed an integrated non-residential treatment model for Aboriginal and Torres Strait Islanders with alcohol and other drug issues and it is based on providing care for all aspects of health through three streams of care:

Social and cultural support – which is delivered by Indigenous workers with cultural knowledge, language skills and an in-depth knowledge of the Aboriginal community alongside social workers. This stream includes case management and care coordination, advocacy on behalf of clients, social support, cultural support, access to medical care, and opportunistic alcohol and other drug counselling and brief interventions.

Psychological therapy – which is carried out by qualified therapists delivering evidence-based treatments including cognitive behaviour therapy (CBT) and related psychological therapies and access to neuropsychological assessment and treatment. And:

Medical treatment – which is provided by Congress GPs and other members of the primary health care team, and includes medical assessments of alcohol and other drug clients, management of chronic disease and prescription of pharmacotherapies where appropriate to assist with alcohol withdrawal.

This model recognises the comorbidities that occur with alcohol and other drug clients and sought to address within a holistic approach that is adaptable based on needs of individuals.

In 2016-17, in the presenting alcohol and other drug clients, 28% received only one stream of care, 59% received two-streams and the remainder, 13% received all three streams of care.

The Congress ‘three streams model’ of care for alcohol and other drug treatment has been developed over many years to provide a single, integrated multidisciplinary service organised around social and cultural support; psychological therapy; and medical care.

In doing so, it reduces demands on clients presenting with alcohol and other drug issues to navigate multiple health care providers, and attempts to address their holistic needs, including advocacy and support around the social determinants of health and wellbeing including housing, welfare and employment, criminal justice, and basic life needs.

This is a great example of how well it can work when the system is correct and can be used as a model for other ACCHOs to learn from.

The diversity of Aboriginal Australia means that no service model can be simply transferred from one place to another. Instead, the strength of Aboriginal community-controlled health services is their capacity to adapt successful models to the particular needs, strengths and histories of the communities they serve.

But funding is a barrier in implementing optimal services in many regions.

A recent report on organisations conducting Indigenous-specific alcohol and other drug services found that a lack of government commitment to funding community-controlled organisations has compromised the capacity of Indigenous Australians to address alcohol and other drug issues within their own communities.

In addition, the capacity of Aboriginal community-controlled organisations to deliver services was severely constrained by staff shortages, lack of trained and qualified staff, and very limited access to workforce development programs.

Treatment is also not the only key, continuing to increase the community awareness and education about the effects of alcohol and other drugs and the treatment options for dealing with issues is vital.

Including a range of health promotion activities and groups including exercise and nutrition programs, tobacco use treatment and preventions groups to address the holistic needs is essential and well help to reduce the levels of risky drinking and the efficacy of treatment once in treatment.

We need to enable our people to have control over their health and improve health literacy on risky behaviours to help stop the impacts of alcohol and other drugs.

 Part 2 Minister Indigenous Health Ken Wyatt keynote 

Good morning. In West Australian Noongar language I say “kaya wangju” – hello and welcome.

I acknowledge the traditional custodians of the land on which we’re meeting, the Kaurna people, and pay my respects to Elders past and present.

The 5th National Indigenous Drug and Alcohol Conference is a positive opportunity to make progress on a difficult issue.

The conference theme is Responding to Complexity – and there certainly is no one-size-fits-all solution to the challenges our people face.

This is why we have to attack the scourge of drug and alcohol dependency and abuse on multiple fronts.

To form new partnerships.

To speak and to listen, with open minds and hearts.

All of us want to see better health for First Nations Australians.

We know that the excessive consumption of drugs and alcohol is associated with health problems in all societies.

It has been linked to chronic conditions such as cancer and liver disease, the spread of hepatitis and HIV, injuries and deaths from motor vehicle accidents and assaults, increased encounters with the law, deaths in custody, suicides and family breakdown.

The reasons why First Nations’ people engage in high risk drug and alcohol consumption are indeed, complex.

Working together, we are making progress, reducing binge drinking rates among our people from 38 per cent to 31 per cent between 2008 and 2014–15.

But there is still much work to be done.

As we see in the Aboriginal and Torres Strait Islander Health Performance Framework report, social determinants are estimated to make up 34 per cent of the gap in health outcomes between First Nations’ people and other Australians.

Together, with behavioural risk factors, such as alcohol, drug and tobacco use, they account for 53.2 per cent of the health gap.

Alcohol and drug abuse has a broad and insidious impact.

We have a moral and social imperative to work together to put an end to violence and dysfunction and the drug- and alcohol-driven neglect of children in our communities.

Our Government is committed to working with families and individuals to address substance misuse and to break the cycle of disadvantage that prevents children from attending school, and adults from going to work.

Particularly for the protection of children, we have invested over $10 million to provide better diagnosis and management, develop best practice interventions and services to support high-risk women.

A 10-year FASD Strategic Action Plan is in the final stage of development.

Just as important, we see outstanding examples of local warriors for health – like June Oscar and her team in Fitzroy Crossing – who have tackled alcohol in their communities, with life-changing results for children and families.

We must try harder to understand and address the underlying causes of alcohol and drug misuse.

The percentage of First Nations’ people who drink is no greater than for other Australians – in fact, there are many of our people who do not drink at all.

Equally, the impacts of trauma on the health of our communities cannot be ignored, because they add to the complexity of the challenge.

Trauma is no excuse for substance abuse, violence or neglect – but understanding its history can help us reduce its impact.

It reaches across generations of Aboriginal and Torres Strait Islander people, and must be acknowledged and addressed.

Significant health impacts have resulted from displacement from family and country, institutionalisation, racism, abuse and neglect.

This has led to increasingly high rates of incarceration and juvenile detention, suicide, family violence, children being taken into care, and poorer physical and mental health.

63 per cent of First Nations’ prisoners are incarcerated as a result of violent crimes and offences that cause harm.

First Nations’ offenders are also more likely to be under the influence of alcohol when they offend.

It’s a sad fact, that alcohol was involved in 80 per cent of cases of domestic homicide, where both the offender and the victim were First Nations’ people.

That’s more than three times the level of domestic homicides involving other Australians.

It’s also known that First Nations people who engage in alcohol-related crime are themselves more likely to be the victims of such offences.

The question is, how do we reduce high-risk levels of alcohol consumption?

Harm reduction programs can minimise the immediate danger posed by alcohol misuse; but our broader aim should be to reduce alcohol intake.

Our Government is investing in a series of activities which have been shown to be effective.

These range from alcohol restrictions to treatment and rehabilitation.

Under the Indigenous Advancement Strategy, the Government has committed around $70 million in 2017–18 to support over 80 Indigenous alcohol and other drug treatment services.

They are located in places with high First Nations’ populations, in capital cities and regional centres as well as outer regional and remote areas.

Alcohol is a particular problem in the Northern Territory.

Our Government recognises this and is providing more than $91 million over seven years for targeted local action to reduce alcohol related harm.

A significant part of our national support to reduce risk also includes primary healthcare and population health programs addressing smoking and alcohol, in urban, regional and remote locations across Australia.

Poor mental health as a result of drug and alcohol problems is a huge issue and one which I am pleased will be addressed during this important conference.

It is equally high on our Government’s agenda.

The Australian Health Ministers’ Advisory Council recently endorsed the National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing 2017–2023.

The council has prioritised development of a national Indigenous Health and Medical Workforce Plan, which aims to increase the number of Aboriginal doctors, nurses and health workers on country and in our towns and cities.

Primary Health Networks across Australia also have mental health and Aboriginal and Torres Strait Islander health among their priorities.

I am very keen to ensure Primary Health Networks provide a strong platform for culturally comfortable drug, alcohol and mental health services.

To that end, we have targeted more than $85 million to improve access for integrated, culturally appropriate and safe mental health services for First Nations people.

Our Primary Health Networks are also currently investing a further $79 million on the provision of alcohol and other drug services specifically designed to meet the needs of First Nations people, at the local level.

While the effects of alcohol and drugs can be dire, the insidious damage caused by tobacco is significant.

Statistics show that smoking is responsible for 23 per cent of the gap in health outcomes between First Nations’ people and other Australians.

That is why reducing smoking rates among Aboriginal and Torres Strait Islander people is central to our efforts to close the gap.

By supporting locally linked projects within a national campaign, we are seeing some success.

The daily smoking rate for First Nations’ people aged 15 years and over has declined from 49 per cent in 2002 to 39 per cent in 2014–15, with most of this since 2008, when targeted measures commenced.

However, the daily smoking rate in remote areas is still 47 per cent, and worryingly, the number of First Nations’ women smoking while pregnant remains far too high, at 46 per cent.

To continue supporting change for the better – through funding certainty and proven programs – we have gone to a four-year, $300 million funding commitment for the successful Tackling Indigenous Smoking program.

We are supporting Aboriginal and Torres Strait Islander specific education programs, as part of the National Tobacco Campaign.

“Don’t Make Smokes Your Story” targets First Nations’ smokers aged 15 years and over.

Since its third phase concluded at the end of June, evaluation has shown its effectiveness.

86 per cent of First Nations smokers were aware of the campaign.

7 per cent had quit and 26 per cent said they had reduced the amount they smoke.

If we can maintain this sort of momentum, I am we will see significant improvements in health in future.

We have also had significant success in reducing petrol sniffing, which can cause brain damage and even death.

Independent research undertaken since 2005 indicates that in communities with low aromatic fuel, petrol sniffing has dropped by 88 per cent.

Low aromatic fuel, subsidised by the Government, has now replaced regular unleaded in around 175 outlets in the Northern Territory, Queensland, Western Australia and South Australia.

There were special factors related to petrol sniffing which make it impractical to apply the same approach to alcohol and drug misuse.

But there is one big lesson from that success.

When families, communities, local organisations and governments join hands, we are powerful together.

Alcohol and other drugs, tobacco, lifestyle risk factors and social determinants represent more than half of the quest for health and life equality.

It’s now been 10 years since the launch of the Closing the Gap initiative.

The agenda is being refreshed and it’s time to refresh our approach – including by acknowledging the complexity of the drug and alcohol challenge and making even greater efforts to address it.

This conference will be an important part of that solution – and I look forward to hearing the outcomes.

NACCHO Aboriginal Health and #SocialDeterminants #Housing : Why do we need another study to evaluate the impact of housing policies on the health and wellbeing of our mob ?

 ” A new study will evaluate the impact of housing policies on the health and wellbeing of First Nations people thanks to a $250,000 grant from the Australian Government.

Shelter WA will lead this work around the country to assess environmental health impacts, short term versus long term policy vision and how we manage the construction and maintenance of housing for Aboriginal and Torres Strait Islander people.”

Minister Ken Wyatt Press Release See in full Part 1

A recent Senate Estimates have highlighted the failure of Indigenous Affairs Minister Nigel Scullion to negotiate a new remote Indigenous housing agreement with the states and territories.

In its May Budget, the Coalition effectively axed the National Partnership Agreement on Remote Indigenous Housing (NPARIH), which had invested $5.4 billion over the previous decade to address severe overcrowding.

The Government’s own independent review clearly states that “high levels of overcrowding and poor housing condition negatively impact on outcomes in health, education, employment and safety.

 The decision left Western Australia, Queensland and South Australia without any ongoing funding arrangement for remote Indigenous housing.

Shadow Housing and Homelessness Minister, Senator Doug Cameron, said the hearing also exposed the scale of the Coalition’s cuts to remote housing.

” Houses that are not well-maintained fall out of commission quickly and do not provide their basic function of supporting the health and wellbeing of tenants. While overcrowding is present, the need for maintenance is even greater.

Future funding is needed from governments as the costs of housing cannot be covered by rental income or other forms of investment due to market factors. Governments should work together to set a target for reducing the taxpayer subsidy for running social housing in remote Indigenous communities.

Ongoing funding, at least to maintain housing created, will protect the $5.4 billion investment already made under the Strategy. Without this funding, the Panel is confident houses will quickly fall out of commission, wasting the Strategy’s progress.”

See all the recommendations from 2017 Remote Housing Review Part 3 below

WA’s peak housing body has been angered enough to wade into a toxic fight over WA’s remote Indigenous communities, after Prime Minister Scott Morrison commented in Perth that the 10-year Commonwealth-state funding agreement was for “a couple of years” only, and that remote housing was a WA responsibility.

Twelve thousand outback residents wait in limbo, some suffering illnesses including leprosy, tuberculosis and trachoma – which has been described as a “national disgrace”, and is directly related to overcrowded, inadequate housing. ”

Read full media coverage Here 

 ” Indigenous affairs envoy Tony Abbott appears to be trying to make amends with the Borroloola community, who were less than impressed with his first visit, by giving them second hand RAAF base houses, some of which may already be over forty years old.

The NT News understands that the houses may only be liveable for two to five years and the NT Government provided feedback that they were not a suitable option.

The secretive process that the federal indigenous affairs envoy and NT Senator Nigel Scullion undertook in plucking 12 houses from beside the Stuart Hwy has come under scrutiny and questions have been raised as to the suitability of the homes, most of which were built in the late 1970s and have been sitting roadside for over four years.

Read NT media coverage HERE 

 

Read NACCHO Press release HERE

Part 1 Housing Study Aims to Improve Health of First Australians

The 2017 national My Life My Lead report highlighted housing’s importance, finding better housing conditions would improve First Australians’ health and were also linked to increased participation in education, employment and the community.

The Commonwealth’s investment through the National Partnership Agreement on Remote Indigenous Housing has delivered significant results.

Our Remote Housing Review, completed in partnership with leading Indigenous Australians, found that there had been a significant decrease in the proportion of overcrowded households in remote and very remote areas, falling from 52.1 per cent to 37.4 per cent by 2018.

Read or download the report HERE 

review-of-remote-housing

The Commonwealth remains committed to future investment in remote Indigenous housing and has agreed to provide $550 million for future remote housing investment in the Northern Territory.

Offers for further investment in Western Australia, Queensland and South Australia remain on the table for state governments to consider.

Shelter WA will work closely with project partners the National Aboriginal Congress and National Shelter to deliver this study, helping to ensure there is a strong First Nations voice and national perspective in future housing policy.

Work will commence immediately with the results of the study expected to be concluded by mid-2019.

 

Part 2 Labor Press Release October 2018

A recent Senate Estimates have highlighted the failure of Indigenous Affairs Minister Nigel Scullion to negotiate a new remote Indigenous housing agreement with the states and territories.

Shadow Housing and Homelessness Minister, Senator Doug Cameron, said today’s hearings also exposed the scale of the Coalition’s cuts to remote housing.

In its May Budget, the Coalition effectively axed the National Partnership Agreement on Remote Indigenous Housing (NPARIH), which had invested $5.4 billion over the previous decade to address severe overcrowding.

The Government’s own independent review clearly states that “high levels of overcrowding and poor housing condition negatively impact on outcomes in health, education, employment and safety.”

The decision left Western Australia, Queensland and South Australia without any ongoing funding arrangement for remote Indigenous housing. Evidence today from the Department of Prime Minister and Cabinet revealed that contrary to claims by Minister Scullion that “there are no cuts to housing”, no new Commonwealth funds have being delivered this year.

“As a matter of urgency, Minister Scullion must establish a program of negotiations with state and territory governments to resolve future

Commonwealth funding arrangements for remote Indigenous housing,” Senator Cameron said.

“Priority must be given to a building program that assists in reducing the negative health implications of severe overcrowding.”

Reports by the ABC just this week have drawn attention to the prevalence of Rheumatic Heart Disease in remote Indigenous communities. RHD is a preventable illness affecting about 6,000 Australians, with Indigenous children 55 times more likely to die from the disease than their non-Indigenous peers.

The causes can be as common as repeated throat and skin infections, caused by living in overcrowded housing conditions, but the consequences can be devastating, leading to permanent heart damage and even death.

“Despite the seriousness of the issues, Minister Scullion’s performance today was aggressive, amateurish and incompetent,” Senator Cameron said.

“It’s clear that if the Minister is unable to reach agreements with the states and territories he will be responsible for the ongoing poor health outcomes in remote communities.”

Labor believes a committed, ongoing partnership from all levels of government is essential to meet the scale of the need in remote communities.

The Morrison Government should be working cooperatively with Indigenous communities to ensure services are delivered as efficiently and effectively as possible. Senator Cameron said that in light of Minister’s performance, Prime Minister

Morrison should seriously consider whether he has confidence in his ability to carry out his responsibilities in the portfolio.

Part 3 8.3 Key Findings

Continued investment by governments will be required beyond 2018, at least in the maintenance of existing tenancies, where there are limited opportunities to recover costs through rent or other charges.

Governments should work together to set a target for reducing the minimum cost of taxpayer subsidy for the operational expense of running social housing in remote Indigenous communities.

High costs prohibit financial returns and mean funding is required for a remote housing program to be sustainable, even with improvements to PTM.

Government funding could be used to develop impact investment financing models, but this needs further exploration and trialling in less unfavourable markets, before it would be sensibly trialled in a remote context.

Future Directions – Panel recommendations

The Strategy has made a significant difference to the lives of many families in remote Indigenous communities. A long-term investment in remote Indigenous housing is needed for additional houses and to maintain existing stock.

Our recommendations build on the lessons learned from the Strategy and previous investment.

Recommendation: A recurrent program must be funded to maintain existing houses, preserve functionality and increase the life of housing assets

Houses that are not well-maintained fall out of commission quickly and do not provide their basic function of supporting the health and wellbeing of tenants. While overcrowding is present, the need for maintenance is even greater.

Future funding is needed from governments as the costs of housing cannot be covered by rental income or other forms of investment due to market factors. Governments should work together to set a target for reducing the taxpayer subsidy for running social housing in remote Indigenous communities.

Ongoing funding, at least to maintain housing created, will protect the $5.4 billion investment already made under the Strategy. Without this funding, the Panel is confident houses will quickly fall out of commission, wasting the Strategy’s progress.

To avoid creating two classes of housing in communities, a future agreement should include repairs and maintenance of all dwellings in remote Indigenous communities, not just those built or refurbished under the Strategy.

Recommendation: Investment for an additional 5,500 houses by 2028 is needed to continue efforts on Closing the Gap on Indigenous Disadvantage

The investment under the Strategy has improved the life outcomes of many Aboriginal and Torres Strait Islander families, but problematic overcrowding still exists and the population is growing.

An additional 5,500 dwellings are needed, to address current levels and the potential for a return to higher overcrowding levels due to population growth if efforts are not maintained.

An additional 5,500 dwellings are projected to further reduce overcrowding to a level of 25-30 per cent by 2028 and as such will continue to support efforts for Aboriginal and Torres Strait Islander people and Closing the Gap.

Recommendation: The costs of a remote Indigenous housing program should be shared 50:50 between the Commonwealth and the jurisdictions

Under the Strategy the Commonwealth was the sole funder of the program which meant jurisdictions lacked skin in the game and the Commonwealth reacted to protect its interest by introducing a series of processes that had unintended consequences.

A genuine financial partnership between the Commonwealth and jurisdictions would focus the attention of both levels of government to the delivery of outcomes, not outputs. Shared responsibility for funding would establish a partnership that works toward shared goals.

If responsibility for funding is shared, then both levels of government have incentives to run an efficient program.

Recommendation: Establish a regional governance structure to facilitate better administration of the program

Commonwealth and jurisdiction governments need a way of working with each other and with communities that facilitates management of an inherently complex program. All parties should be able to contribute information and perspective to help guide sound decision making.

A regional governance framework would facilitate more effective collaboration between Commonwealth, jurisdiction and local governments, and communities. It would have the added benefit of bringing planning and decision making closer to the ground and would create a more responsive program. In addition, communities that can organise themselves will have a formal mechanism for input.

Bringing local government into the governance structure means the community and region would have a greater stake in the success of the program.

Recommendation: A higher level of transparency is required: a sound performance framework and information processes that are relevant to individuals and communities, and derivative of the information that is needed for regional governance of the program

One of the key failures of the Strategy was its information collection.

Improved transparency would foster mutual responsibility for all parties to identify problems and share solutions. It is important the reasons for decisions are known and all parties are incentivised to find innovative solutions to local problems.

By focusing on collecting data that is needed for decision making to serve overarching policy, performance indicators for the program as a whole can be developed that have real meaning in terms of the achievement of better and sustained housing amenity for Aboriginal and Torres Strait Islander people living in remote Australia.

Recommendation: Best practice fora should be established to share information across the Commonwealth, jurisdictions, regional governance bodies and service providers

To improve housing delivery, best practice, challenges and experience need to be shared. Multilateral fora between the Commonwealth and jurisdictions to share experiences are important. There should also be opportunities for regional governance bodies, service providers and community leaders to share their learnings.

Best practice fora should consider housing experiences outside communities and jurisdictions funded by the Strategy. Other jurisdictions, and urban and regional housing providers should be included in broader discussions for best practice in social and Indigenous housing.

Recommendation: A minimum five year rolling plan for the program should be established

The two year timeframes introduced as part of the competitive bids were too short for proper planning and undermined the effectiveness and efficiency of jurisdictions’ efforts to deliver the Strategy particularly for housing construction.

A minimum five year rolling plan for the program should be established with proper mechanisms for performance management and information systems as outlined in the previous recommendations.

A program that retains the intended long planning cycles in practice would enable better decision making and flexibility to respond to local conditions, incentivise investment in better systems, improve coordination between service providers and administrators, achieve economies of scale, and support the development of additional capacity and training of local workforces and businesses.

Recommendation: Regional sample surveys (using the survey–and–fix methodology of the Fixing Houses for Better Health program) must form a core part of the regional governance and monitoring strategy

A recurrent, proactive maintenance program is fundamental to preserve functionality and increase the life of existing housing assets in remote Indigenous communities. Cyclical maintenance programs must be developed more consistently across the program.

This should be reinforced by a requirement for regional sample surveys using the survey-and-fix methodology of the Fixing Houses for Better Health program.

The long-term cost of property management is decreased by having a cyclical maintenance program in place. Data from the surveys would enable the governance structure to make sound and evidence based policy decisions about delivery of the program and to develop long-term plans for additional construction, conduct repairs, and establish a recurrent and proactive maintenance program.

Recommendation: Details about certification of properties (at all stages of building, and for life after acceptance and tenanting) should be reported to the governance structure to ensure construction in remote communities is compliant with the appropriate building and certification standards and sub-standard builders are eliminated

Housing in remote communities must be built and upheld to the same effective standard as in urban areas. Compliance with existing Commonwealth and jurisdiction legislation for housing standards and the National Indigenous Housing Guide (that lifts the standard to that appropriate for remote areas) is not negotiable. Regulation of housing standards needs more assertive management across the project management life cycle – planning, project delivery, acceptance and post-acceptance functioning.

Certification of houses should be robust and require a level of compliance appropriate to remote environments, delivering the same amenity as applies for houses in urban areas. All non-arm’s length certification arrangements should be eliminated and independent scrutiny that houses meet standards post acceptance and for years after tenanting would add rigour.

This rigour will ultimately improve conditions for Aboriginal and Torres Strait Islander people, improve health and other social outcomes and will ultimately reduce costs and protect governments’ investment over the longer term.

Recommendation: The regional governance bodies should work with local employers to plan how to develop the local work force and create more local employment

The employment opportunities that arise from housing construction and maintenance activities have provided positive outcomes for communities in some areas. There is scope to increase efforts and derive benefits more broadly.

Where possible, local employment opportunities should be maximised and the local labour force developed in partnership with local businesses and councils. A regional governance body should work with local businesses or councils as potential employers, and with regional training organisations, to develop a plan to train and develop the local labour force and businesses.

Where local people are employed by local businesses or councils to do the work, it can reduce the cost of delivering PTM and improve the timeliness of response.

Recommendation: Comprehensive planning across governments, involving local communities, is essential for the next remote Indigenous housing national program

Town and community planning are important to ensure that communities are developing in ways that meet the aspirations of local people. Plans need to assess whether housing is appropriate for its location and local cultural requirements.

Governments should link and develop plans for infrastructure and housing together, under town and community planning principles. Plans should include housing-related infrastructure in parallel with housing delivery, and coordinate municipal and essential services requirements and infrastructure needs including the need for new land development or upgrades of essential services.

Plans should be completed to the same quality standard as applies for urban environments.

Governments should focus on resolution of land tenure in communities with significant need that have not received investment.

A long-term, coordinated effort between governments would avoid duplication in effort and wasted investment.

Recommendation: Tenancy education programs should be implemented. Outreach services for tenancy tribunals to improve access in remote communities should be funded

Consequences and enforcement of rights and responsibilities are important for both tenants and landlords. Tenants and landlords (jurisdictions) have frustrations in enforcing their rights and ensuring compliance with responsibilities.

Clear understanding of rights and responsibilities by tenants would assist. Better access to tenancy tribunals in remote communities could assist both tenants and landlords resolve complaints and enforce compliance. There are opportunities for sharing and replication of best practice in the creation of incentives for householders to look after and preserve their housing.

Activities that continue to support better application of PTM will assist tenants in managing their rights and responsibilities under the program.

 

NACCHO Aboriginal Health News : #NACCHOagm2018 Delegates agree unanimously to motion that the #CDP is discriminatory and is causing significant harm, hardship , distress and they call on cross bench senators to reject the Bill in its entirety

” The National Association of Aboriginal Controlled Community Health Services, in its submission, warned that extending the four-week payment cutoff penalty to CDP and requiring recipients to reapply would be much more difficult for people in remote areas who may have language barriers, lack access to a phone or have underlying cognitive or health impairments and will likely mean that Aboriginal people in CDP regions will have less access to income support payments than other Australians”.

The Australian 

 ” NACCHO is deeply concerned by the Community Development Program (CDP) and its impact on Aboriginal people living in remote areas or CDP regions. We believe that the CDP is discriminatory and is causing significant harm, hardship and distress to Aboriginal people across Australia. NACCHO does not support the CDP nor does it support the proposed Bill. We believe the proposed Bill will only worsen the impact of the current CDP.

The Senate must recognise the unanimous voice of Aboriginal and Torres Strait Islander people and reject this Bill.”

Background : Extracts from NACCHO submission  post 15 October Read in full

We haven’t come here to bash the government or criticise, we’ve come here with a solution and the solution is here and we’re willing to work with all government at all levels,” he said.

What it reminds me of is a modern day Wave Hill situation- where Aboriginal people were paid sugar, flour and tea,

Those sorts of conditions and that sort of wage offer and assistance for Aboriginal Australians should not be offered in this day and age.”

John Paterson, CEO of Aboriginal Peak Organizations said the current program is “not an effective piece of work” and claims it puts “so many breaches on Aboriginal people” 

Picture below speaking at Parliament House September 2018 see NITV SBS Article

Motion below by John Paterson on CDP to the NACCHO 2018 Conference, 1 Nov 2018

Moved: Tim Agius, Durri ACMS, Kempsey NSW

Seconded: Vicki O’Donnell, KAMS

Agreed unanimously.

That the NACCHO 2018 Conference endorses the following:

NACCHO member services are deeply concerned by the Community Development Program (CDP) and its impact on Aboriginal people living in remote areas or CDP regions.

We believe that the CDP is discriminatory and is causing significant harm, hardship and distress to CDP participants and their families and deepening poverty in communities.

We do not support the Social Security Legislation Amendment (Community Development Program) Bill 2018 (CDP Bill) currently before the Parliament. We believe the Bill will only worsen the impact of the current CDP.

In particular, the proposed application of the mainstream Targeted Compliance Framework (TCF) is inappropriate for remote community conditions and will result in a worsening of already unacceptable rates of serious breaches and penalties applied to participants and an increase in disengagement from the scheme.

Other proposed changes, such as reducing the number of hours that CDP participants must Work for the Dole and offering wage subsidies, can be achieved without the Bill.

We are heartened by the opposition to the Bill expressed by Labor and the Greens and the support for Aboriginal concerns expressed by cross bench members of the Senate.

We urge cross bench Senators to reject the Bill in its entirety.

We call for urgent and fundamental reform of the program to be achieved through direct engagement and collaboration with Aboriginal peak and community organisations.

We propose the Fair Work and Strong Communities scheme proposed by APO NT and a coalition of Aboriginal organisations and national peak bodies as the appropriate basis for this discussion.

 NACCHO Aboriginal Health and Food security #IndigenousNCDs : Welfare reform is targeting many remote-living Aboriginal people impoverishing them and resulting in the consumption of unhealthy foods that are killing them prematurely from non-communicable diseases

What national and average Closing the Gap figures do not tell us is just how badly the estimated 170,000 Indigenous people in remote and very remote Australia are faring. This region where I focus my work covers 86 per cent of the Australian continent.

In the last decade new race-based instruments have been devised to regulate Indigenous people including their forms of expenditure (via income management), forms of working via the Community Development Programme (CDP) and their places of habitation, where they might access basic citizenship services.

All these measures have implications for consumption of market commodities, including food from shops, and of customary non-market goods, including food from the bush.

Owing to deep poverty, many people can only purchase relatively cheap and unhealthy takeaway foods that are killing them prematurely from non-communicable diseases, like acute heart and kidney disorders, followed by lung cancer from smoking.

With income management Aboriginal people are being coerced to shop at stores according to the government’s rhetoric for their ‘food security’. Before the introduction of this regime many more people were exercising their ‘food sovereignty’ right to harvest far healthier foods from the bush.

Extracts from Jon Altman a research professor in anthropology at the Alfred Deakin Institute for Citizenship and Globalisation at Deakin University, Melbourne.

From New Matilda Read and subscribe HERE

A version of this article was first published in the Land Rights News

READ over 5 Articles NACCHO Aboriginal Health and Nutrition 

READ Articles NACCHO Aboriginal Health and Welfare Card 

” NACCHO is strongly opposed to the current cashless debit card trials as well as any proposal to expand. We also note that Aboriginal people are disproportionately affected by the trials and that they are in and proposed for locations where the majority participants are Aboriginal. Whilst it is not the stated intent of the trials, its impact is discriminatory.

NACCHO knows that some Aboriginal people and communities need additional support to better manage their lives and ensure that income support funds are used more effectively.

However, NACCHO is firmly of the view that there are significantly better, more cost efficient, alternative approaches that support improvements in Aboriginal wellbeing and positive decision making.

Aboriginal Community Controlled Health Services would be well placed to develop and implement alternative programs. We firmly believe that addressing the ill health of Aboriginal people, including the impacts of alcohol, drug and gambling related harm, can only be achieved by local Aboriginal people controlling health care delivery.

We know that when Aboriginal and Torres Strait Islander people have a genuine say over our lives, the issues that impact on us and can develop our own responses, there is a corresponding improvement in wellbeing. This point is particularly relevant given that the majority of trial participants are Aboriginal. “

Selected extracts from Submission to the Senate Community Affairs Legislation Committee Inquiry into the Social Services Legislation Amendment (Cashless Debit Card Trial Expansion) Bill 2018 

Download HERE 

NACCHO submission on cashless debit card final

As is the case in many countries, Indigenous people in Australia, New Zealand, United States of America and Canada are disproportionately affected by NCDs.

Diabetes, cardiovascular disease, cancer,  smoking related lung disease and mental health conditions are the five main NCDs identified by the World Health Organisation (WHO), and these are almost uniformly experienced by Indigenous peoples at higher rates than other people.

Indigenous people globally are disproportionately affected by diabetes. In Australia, Aboriginal and Torres Strait Islander peoples are 6 times more likely than the non-Indigenous population to die from diabetes. In Canada, Indigenous peoples are 3-5 times more likely to have diabetes than other citizens.

Indigenous people are also more likely to have Cardiovascular disease. Cardiovascular disease accounts for almost a quarter of the mortality gap between Aboriginal and Torres Strait Islander peoples and other Australians. Maori people are 3-4.2 times more likely to die from cardiovascular disease than other people in New Zealand.

These numbers are not improving, despite national rates of smoking decreasing, and increased social marketing aimed at reducing sugar consumption and increasing physical activity.

Mainstream solutions do little to reduce the burden of NCDs for Indigenous populations. The broader social determinants of health have a huge role to play, and until these are addressed in a meaningful way, Indigenous peoples will continue to experience an inequitable burden.

With colonisation having had a devastating impact on Indigenous peoples, and mainstream solutions unable to significantly reduce the rates of NCDs experienced by Indigenous peoples, a new paradigm is urgently required.

What is required is not more state based solutions but Indigenous led solutions.

Summer May Finlay Croakey 

Welfare reform is targeting many remote-living Aboriginal people impoverishing them and resulting in the consumption of unhealthy foods that are killing them prematurely from non-communicable diseases

Rome (Canberra) continues to fiddle while Black Australia burns. Professor Jon Altman weighs in on the ongoing disasters of government policy that have a tight grip on remote living Indigenous people.

In the last month I participated in two workshops. I used what I observed on my latest visit to Arnhem Land and what people were telling me to inform what I presented at the workshops.

The first workshop explored issues around excessive consumption by industrialised societies globally and how this is harming human health and destroying the planet. Workshop participants asked how such ‘consumptogenic’ systems might be regulated for the global good? My job was to provide a case study from my research on consumption by Indigenous people in remote Australia.

The second workshop looked at welfare reform in the last decade in remote Indigenous Australia. In this workshop I looked at how welfare reform by the Australian state after the NT Intervention was creatively destroying the economy and lifeways of groups in Arnhem Land who are looking to live on their lands and off its natural resources.

Here I want to share some of what I said.

BROADLY speaking Indigenous policy in remote Australia is looking to do two things.

The first is to Close the Gaps so that Indigenous Australians can one future day have the same socio-economic status as other Australians. In remote Australia this goal is linked to the project to ‘Develop the North’ via a combination of opening Aboriginal communities and lands to more market capitalism and extraction, purportedly for the improvement of disadvantaged Indigenous peoples and land owners.

While remote-living Indigenous people have economic and social justice rights to vastly improved wellbeing, in such scenarios of future economic equality based on market capitalism, the downsides of what I think of as ‘consumptomania’ are never mentioned.

The second aim of policy is the extreme regulation of Indigenous people and their behaviour, when deemed unacceptable. In a punitive manifestation of neoliberal governmentality, the Australian state, and its nominated agents, are looking to morally restructure Indigenous people to transform them into model citizens: hard-working, individualistic, highly educated, nationally mobile at least in pursuit of work (not alcohol), and materially acquisitive.

This paternalistic project of improvement makes no concessions whatsoever to cultural difference, colonial history of neglect, connection to country, discrimination, and so on.

In the last decade new race-based instruments have been devised to regulate Indigenous people including their forms of expenditure (via income management), forms of working via the Community Development Programme (CDP) and their places of habitation, where they might access basic citizenship services.

All these measures have implications for consumption of market commodities, including food from shops, and of customary non-market goods, including food from the bush.

We have all heard the bad news, year after year, report after report, that the government-imposed project of improvement, called ‘Closing the Gap’ and introduced by Kevin Rudd in 2008, is failing.

Using the government’s own statistics, after 10 years only one target, year 12 attainment, might be on track. I say ‘might’ because ‘attainment’ is open to multiple interpretations: is attainment just about attendance or about gaining useful life skills?

What national and average Closing the Gap figures do not tell us is just how badly the estimated 170,000 Indigenous people in remote and very remote Australia are faring. This region where I focus my work covers 86 per cent of the Australian continent.

What we are seeing in this massive part of Australia according to the latest census are the very lowest employment/population ratios of about 30 per cent for Indigenous adults (against 80% for non-Indigenous adults) and the deepest poverty, more than 50 per cent of people in Indigenous households currently live below the poverty line.

This is also paradoxically where Indigenous people have most land and native title rights, a recent estimate suggests that 43 per cent of the continent has some form of indigenous title; and is dotted with maybe 1000 small Indigenous communities with a total population of 100,000 at most.

Native title rights and interests give people an unusual and generally unregulated right to use natural resources for domestic consumption.

This form of consumption might include hunting kangaroos or feral animals like the estimated 100,000 wild buffalo in Arnhem Land.

Such hunting is good for health because the meat is lean and fresh; it is also good for the environment because buffalo eat about 30kg of vegetation a day and are environmentally destructive; and it is good for global cooling because each buffalo emits methane with a carbon equivalent value of about two tonnes per annum.

The legal challenge of gaining native title rights and interests is that claimants must demonstrate continuity of customs and traditions and connection to their claimed country. But in remote Australia, culture and tradition have been identified as a key element of the problem that is exacerbating social dysfunction. (That is unless tradition appears as fine art ‘high culture’ which is imagined to be unrelated to the everyday culture and is a favourite item for consumption by metropolitan elites.)

Hence the project of behavioural modification to eradicate Indigenous cultures that exhibit problematic characteristics, like sharing and a focus on kinship and reciprocity, to be replaced by western culture with its high consumption, individualistic and materially acquisitive characteristics.

Connection to country, at least if it involves living on it, is also deemed highly problematic by the Australian state if one wants to produce western educated, home-owning, properly disciplined neoliberal subjects — terra nulliusis now to be replaced by terra vacua, empty land.

Such empty land would be ripe for resource extraction and capitalist accumulation by dispossession Despite all the talk of mining on Aboriginal land, there are currently very few operating mines on the Indigenous estate. This is imagined as one means to Develop the North, but recent history suggests that the long-term benefits to Aboriginal land owners from such development will be limited.

MUCH of what I describe above in general terms resonates with what I have observed in Arnhem Land where I have visited regularly since the Intervention; and what I hear from Aboriginal people and colleagues working elsewhere in remote Indigenous Australia.

From 2007 to 2012 all communities in Arnhem Land were prescribed under NT Intervention laws. Since 2012, under Stronger Futures laws legislated in force until 2022, the Aboriginal population has continued to be subject to a new hyper-regulatory regime: income management, government-licenced stores, modern slavery-like compulsory work for welfare, enhanced policing, unimaginable levels of electronic and police surveillance, school attendance programs and so on.

The limited availability of mainstream work in this region as elsewhere means that most adults of working age receive their income from the new Community Development Program introduced in 2015. Weekly income is limited to Newstart ($260) for which one must meet a work requirement of five hours a day, five days a week if aged 18-49 years and able-bodied.

Of this paltry income, 50 per cent is quarantined for spending at stores where prices are invariably high, owing to remoteness.

The main aim of such paternalism is to reduce expenditure on tobacco and alcohol which cannot be purchased with the BasicsCard.

Shop managers that I have interviewed tell me that despite steep tax-related price rises (a pack of Winfield blue costs nearly $30) tobacco demand is inelastic and sales have not declined.

Since the year 2000, Noel Pearson has popularised his metaphor ‘welfare poison’. Pearson is referring figuratively to what he sees as the negative impacts of long-term welfare dependence. In Arnhem Land welfare is literally a form of poison because in the name of ‘food security’ people are forced to purchase foods they can afford with low nutritional value from ‘licenced’ stores.

However, paternalistic licencing to allow stores to operate the government-imposed BasicsCard is not undertaken equitably by officials from the Department of Prime Minister and Cabinet.

So one sees large, long-standing, community-owned and operated and mainly Indigenous staffed stores being rigorously regulated, managers argue over-regulated. Such stores are highly visible, as are their accounts.

But small private-sector operators (staffed mainly by temporary visa holders and backpackers) that have been established as the regional economy has been prised open to the free market appear under-regulated, even though they are also ‘licenced’ to operate the BasicsCard.

These private sector operators compete very effectively with community-owned enterprises because they only have a focus on commerce: all the profits they make and most of the wages they pay non-local staff leave the region.

Owing to deep poverty, many people can only purchase relatively cheap and unhealthy takeaway foods that are killing them prematurely from non-communicable diseases, like acute heart and kidney disorders, followed by lung cancer from smoking.

With income management Aboriginal people are being coerced to shop at stores according to the government’s rhetoric for their ‘food security’. Before the introduction of this regime many more people were exercising their ‘food sovereignty’ right to harvest far healthier foods from the bush.

This dramatic transformation has occurred as an unusual form of regional economy that involved a high level of customary activity has been effectively destroyed by the dominant government view that only prioritises engagement in market capitalism — that is largely absent in this region.

On one hand, we now see the most able-bodied hunters required to work for the dole every week day with their energies directed from what they do best.

On the other hand, the greatly enhanced police presence is resulting simultaneously in people being deprived of their basic equipment for hunting — guns and trucks — regularly impounded because they are unregistered or their users unlicenced.

People are being increasingly isolated from their ancestral lands and their hunting grounds.

Excessive policing, growing poverty, dependency and anomie are seeing criminality escalate with expensive fines for minor misdemeanours further impoverishing people and reducing their ability to purchase either more expensive healthy foods or the means to acquire bush foods.

A virtuous production cycle that until the Intervention saw much ‘bush food consumption’ has been disastrously reversed. Today, we see a vicious cycle where people regularly report hunger while living in rich Australia; people’s health status is declining.

Welfare reform and Indigeneity is indeed a toxic mix, poison, in remote regions like Arnhem Land.

I WANT to end with some more general conclusions.

On the regulation of Indigenous expenditure, we see a perverse policy intervention: the Australian government is committing what are sometimes referred to as Type 1 and Type 2 errors.

The former sees the government looking to regulate Indigenous consumption using the expensive instrument of income management that has cost over $1.2 billion to date, despite no evidence that it makes a difference.

The latter sees an absence of the proper regulation of supply in licences stores evident when stores with names like ‘The Good Food Kitchen’ sell cheap unhealthy take-aways.

In my view the racially-targeted and crude attempts to regulate Indigenous expenditure are unacceptable on social justice grounds.

Two principles as articulated by Guy Standing stand out.

‘The security difference principle’ suggests that a policy is only socially just if it improves the [food]security of the most insecure in society. Income management and work for the dole do not do this.

And ‘the paternalism test’ suggests that a policy like income management would only be socially just if it does not impose controls on some groups that are not imposed on the most-free groups in society.

Paternalistic governmentality in remote Australia is imposing tight regulatory frameworks on some people, even though the justifying ideology suggests that markets should be free and unregulated.

Sociologist Loic Wacquant in  Punishing the Poor shows how the carceral state in the USA punishes the poor with criminalisation and imprisonment; the poor there happen to be mainly black.

In Australia, punitive neoliberalism punishes those remote living Aboriginal people who happen to be poor and dependent on the state.

Once again there is a perversity in policy implementation.

Hence in Arnhem Land, people maintain strong vestiges of a hunter-gatherer subjectivity that when combined with deep poverty makes them avid consumers of western commodities that are bad for health (like tobacco that is expensive and fatty, sugary takeaway food that is relatively cheap).

At the same time commodities that might be useful to improve health, like access to guns and trucks essential for modern hunting, are rendered unavailable by a combination of poverty and excessive policing.

Australian democracy that is founded on notions of liberalism needs to be held to account for such travesties.

Long ago in 1859, John Stuart Mill, the doyen of liberals, wrote in  On Liberty: “…despotism is a legitimate form of government in dealing with barbarians, providing the end be their improvement and the means justified by actually effecting that end”.

In illiberal Australia today, authoritarian controls over remote living Indigenous people and their behaviour are again viewed as legitimate by the powerful now neoliberal state, even though there is growing evidence from remote Australia that things are getting worse.

I want to end with some suggested antidotes to the toxic mix that has resulted from welfare reform that is targeting many remote-living Aboriginal people and impoverishing them.

First, in my view despotism for some is never legitimate, so people should be treated equally irrespective of their ethnicity or structural circumstances.

Second, the Community Development Programme is a coercive disaster that is far more effective at breaching and penalising the jobless for not complying with excessive requirements than in creating jobs. CDP is further impoverishing people and should be replaced, especially in places where there are no jobs, with unconditional basic income support.

Third, people need to be empowered to find their own solutions to the complex challenges of appropriate development that accord with their aspirations, norms, values, and lifeways. Devolutionary principles of self-government and community control, not big government and centralised control, are needed.

Fourth, the native title of remote living people should be protected to ensure that they benefit from all their rights and interests. There is no point in legally allocating property rights in natural resources valuable for self-provisioning if people are effectively excluded from access to their ancestral lands and the enjoyment of these resources.

Finally, governments should support what has worked in the past to improve people’s diverse culturally-informed views about wellbeing and sense of worth.

While such an approach might not close some imposed ‘closing the gap’ targets, like employment as measured by standard western metrics, it will likely improve other important goals like reducing child mortality and enhancing life expectancy and overall quality of life.

 

 

NACCHO Aboriginal Health : Download @CSIROnews #FutureofHealth Report that provides a new path for national healthcare delivery, setting a way forward to shift the system from illness treatment, to #prevention.

Australians rank amongst the healthiest in the world with our health system one of the most efficient and equitable. However, the nation’s strong health outcomes hide a few alarming facts: 

  • There is a 10-year life expectancy gap between the health of non-Indigenous Australians and Aboriginal and Torres Strait Islander people
  • Australians spend on average 11 years in ill health – the highest among OECD countries
  • 63% (over 11 million) of adult Australians are considered overweight or obese
  • 60% of the adult population have low levels of literacy 
  • The majority of Australians do not consume the recommended number of serves from any of the five food groups.

From CSIRO Future of Health report

Download HERE full 60 Page Report NACCHO INFO FutureofHealthReport_WEB_180910

The CSIRO Future of Health report provides a list of recommendations for improving the health of Australians over the next 15 years, focussed around five central themes: empowering people, addressing health inequity, unlocking the value of digitised data, supporting integrated and precision health solutions, and integrating with the global sector.

CSIRO Chief Executive Dr Larry Marshall said collaboration and coordination were key to securing the health of current and future generations in Australia, and across the globe.

“It’s hard to find an Australian who hasn’t personally benefitted from something we created, including some world’s first health innovations like atomic absorption spectroscopy for diagnostics; greyscale imaging for ultrasound, the flu vaccine (Relenza); the Hendra vaccine protecting both people and animals; even the world’s first extended-wear contact lenses,” Dr Marshall said.

“As the world is changing faster than ever before, we’re looking to get ahead of these changes by bringing together Team Australia’s world-class expertise, from all sectors, and the life experiences of all Australians to set a bold direction towards a brighter future.”

The report highlighted that despite ranking among the healthiest people in the world, Australians spent on average of 11 years in ill health – the highest among OECD countries.

Clinical care was reported to influence only 20 per cent of a person’s life expectancy and quality of life, with the remaining 80 per cent relying on external factors such as behaviour, social and economic support, and the physical environment.

“As pressure on our healthcare system increases, costs escalate, and healthy choices compete with busier lives, a new approach is needed to ensure the health and wellbeing of Australians,” CSIRO Director of Health & Biosecurity Dr Rob Grenfell said.

The report stated that the cost of managing mental health related illness to be $60 billion annually, with a further $5 billion being spent on managing costs associated with obesity.

Health inequities across a range of social, economic, and cultural measures were found to cost Australia almost $230 billion a year.

“Unless we shift our approach to healthcare, a rising population and increases in chronic illnesses such as obesity and mental illness, will add further strain to the system,” Dr Grenfell said.

“By shifting to a system focussed on proactive health management and prevention, we have an exciting opportunity to provide quality healthcare that leaves no-one behind.

“How Australia navigates this shift over the next 15 years will significantly impact the health of the population and the success of Australian healthcare organisations both domestically and abroad.”

CSIRO has been continuing to grow its expertise within the health domain and is focussed on research that will help Australians live healthier, longer lives.

The Future of Health report was developed by CSIRO Futures, the strategic advisory arm of CSIRO.

More than 30 organisations across the health sector were engaged in its development, including government, health insurers, educators, researchers, and professional bodies.

Australia’s health challenges:

  • Australians spend on average 11 years in ill health – the highest among OECD countries.
  • 63 per cent (over 11 million) of adult Australians are considered overweight or obese.
  • There is a 10-year life expectancy gap between the health of non-Indigenous Australians and Aboriginal and Torres Strait Islander peoples.
  • 60 per cent of the adult population have low levels of health literacy.
  • The majority of Australians do not consume the recommended number of serves from any of the five food groups.

The benefits of shifting the system from treatment to prevention:

  • Improved health outcomes and equity for all Australians.
  • Greater system efficiencies that flatten the cost curve of health financing.
  • More impactful and profitable business models.
  • Creation of new industries based on precision and preventative health.
  • More sustainable and environmentally friendly healthcare practices.
  • More productive workers leading to increased job satisfaction and improved work-life balance.

More info : www.csiro.au/futureofhealth

NACCHO Aboriginal Health supports our First Nations Media @FNMediaAust #OurMediaMatters Campaign : Download nine calls for action that the Government needs to address

We are asking Governments to be part of growing and sustaining our sector for the benefit of First Nations peoples as well as developing greater understanding of our cultures for the benefit of non- Indigenous Australia

Our national network includes more than 40 organisations that service 235 broadcast locations. Collectively those radio services reach nearly 50% of Aboriginal and Torres Strait Islander people across the country with audiences of around 320,000 listeners each week

We are producing and broadcasting content in over twenty languages. We’ve been making media through film, television, radio and print for more than four decades and in recent years diversified to on-line platforms.

People watch and listen and interact because our media tell positive stories about First Nations people relevant to their community and lives, and in many places, it’s in their first language.

Our media engages our audiences in a two-way dialogue that is both culturally appropriate and relevant.

Our media is an essential service, particularly in the many areas across Australia where it is the only means of receiving emergency information and health messages, including local languages.

Our media saves lives in the immediate sense as a primary source of information, but also through the stories we tell and the impact those stories have on our people’s social and emotional wellbeing.

That’s why our media has impact and that’s why we want Governments to recognise that our media matters.

First Nations Media Australia chair Dot West

#OurMediaMatters was the message First Nations media organisations from around the country  took directly to politicians and policy makers in Canberra this week from Monday 20 August .

FNMA’s goals in calling for action are to close the gap on disadvantage, to inform, connect and empower communities, to provide meaningful jobs, skills and business opportunities, and to provide our children with opportunities, a strong sense of identity, inclusion and pride in their languages and culture.

Download the full call to action

Calls-For-Action-2018-Consolidated-CFA-Documents

Peak body First Nations Media Australia (FNMA) showcased the work of member organisations and how First Nations media services play a crucial role in increasing community cohesion, building community resilience and creating meaningful employment and economic opportunity

Picture below 2017 Conference

The Festival theme was Lutjurringkulala Nintiringama Ngapartji Ngapartji meaning ‘come together to learn and share’.

Over 100 delegates travelled the long red desert highway to be welcomed to Country, culture, big night skies and Tjukurrpa by Irrunytju traditional owners and community leaders. The opening ceremony featured a Turlku (dance) performance of the Minyma Kutjara (Two Sisters) story that passes Irrunytju community. The week-long event affirmed the remote Aboriginal and Torres Strait Islander media industry as a powerful and connected voice for generations to come.

Broadcasters

Imparja Television

Indigenous Community Television (ICTV)

National Indigenous Radio Service (NIRS)

National Indigenous Television (NITV)

Broadband for the Bush Alliance

Aboriginal Medical Services Alliance NT

Australian Communications Consumer Action Network (ACCAN)

Australian Smart Communities Association

Central Australian Aboriginal Media Association

Central Desert Shire Council

Central Land Council (CLC)

Centre for Appropriate Technology (CAT)

Centre for Remote Health (CRH)

Desert Knowledge Australia (DKA)

Ethos Global Foundation

Frontier Services

Indigenous Remote Communications Association

Infoxchange

Mid West Development Commission

National Centre of Indigenous Excellence

National Rural Health Alliance

Ninti One

Regional Development Australia, Northern Territory

Remote Area Planning and Development (RAPAD)

Swinburne Institute for Social Research

TelSoc

FNMA has identified nine calls for action to Government that address four key aims

  • To increase jobs and skills
  • To improve the sector’s capacity and sustainability
  • To enhance social inclusion, and
  • To preserve culture and language.

Some of the calls for action are budget neutral and simply ask for policy amendments to recognise First Nations broadcasters as a separate license category under the Broadcasting Services Act.

  1. Broadcasting Act Reform for First Nations Broadcasting. Download
  2. Increase in Operational and Employment Funding. Download
  3. Live and Local Radio Expansion Program. Download
  4. Strengthening of First Nations News Services. Download
  5. Expanding Training and Career Pathway Programs. Download
  6. Upgrading Infrastructure and Digital Networks. Download
  7. Recognising First Nations Broadcasters as the Preferred Channel for Government Messaging. Download
  8. Preserving First Nations Media Archives. Download
  9. Establishing an Annual Content Production Fund. Download

Other calls for action would require a funding commitment, for example to underpin First Nations media capacity to act as training and employment hubs.

NACCHO Aboriginal Health and local #Adoption : @CAACongress @SNAICC and @AbSecNSW streamed live today August 14 from Canberra , public hearing local adoption : Plus @AMSANTaus full submission

 

We are aware that this Inquiry was called in the wake of recent media coverage relating to the issue of adoption of Aboriginal children, including the Minister’s own comments that adoption policies should be changed to allow more Aboriginal children to be adopted by non-Aboriginal families.

AMSANT would like to emphasise the importance of informed discussion on this issue and draws the Committee’s attention to the following, put forward in March of this year as part of a joint statement from Aboriginal and Torres Strait Islander leaders in response to media coverage:

We need to have a more rational and mature discussion aimed at achieving better social, community, family and individual outcomes for all Aboriginal and Torres Strait Islander children and young people. We must work to ensure that the drivers of child protection intervention are addressed, rather than continuing with a poorly designed and resourced system that reacts when it’s too late, after families have already reached breaking point and children have been harmed1

See Full AMSANT Submission Part 2 Below

 

“As detailed in our submission, AbSec is strongly opposed to the coerced adoption of Aboriginal children by statutory child protection systems. Adoption orders are characterised by the absence of key safeguards to ensure the safety and wellbeing of Aboriginal children.

They fail to uphold an Aboriginal child’s fundamental rights to family, community and culture, and the importance of these connections to our life long wellbeing and resilience. They are not in the best interests of our children.

In particular, it must be noted that past policies of the forced separation of Aboriginal children and young people from their families, communities, culture and Country is regarded as a key contributor to this ongoing over-representation. It is not a solution.

AbSec, alongside QATSICPP and SNAAICC, call for the development of Aboriginal and Torres Strait Islander community-led approaches to the care of our children “

ABSEC Submission Download Here

ABSEC Adoption submission

SNAICC Submission Download Here

Snaicc Adoption submission

 Part 1 Next public hearing for local adoption inquiry

The House of Representatives Standing Committee on Social Policy and Legal Affairs will hold a public hearing into a nationally consistent framework for local adoption in Australia.

The Committee will hear from the Central Australian Aboriginal Congress, the Secretariat of National Aboriginal and Islander Child Care – National Voice for our Children (also known as SNAICC), and the Aboriginal Child, Family and Community Care State Secretariat (NSW) (also known as AbSec).

A detailed program for the hearing is available from the inquiry webpage (www.aph.gov.au/localadoption).

Public hearing details: Tuesday 14 August, 4.40pm (approx) to 6.00pm, Committee Room 1R2, Parliament House, Canberra

The Central Australian Aboriginal Congress

SNAICC (Secretariat of National Aboriginal and Islander Child Care) – National Voice for our Children

AbSec – the Aboriginal Child, Family and Community Care State Secretariat (NSW)

The hearings will be streamed live in audio format at aph.gov.au/live.

Members of the public are welcome to attend the hearing however there will be limited seating available.

Further information about the inquiry, including the terms of reference and submissions published so far, is available on the inquiry webpage.

Part 2 AMSANT submission to The Standing Committee on Social Policy and Legal Affairs: Inquiry into local adoption

AMSANT welcomes the opportunity to provide a submission to the Inquiry into Local Adoption. As the peak body for the community controlled Aboriginal primary health care sector in the Northern Territory AMSANT advocates for equity in health, focusing on supporting the provision of high quality comprehensive primary health care services for Aboriginal communities.

This submission provides an overview of AMSANT’s position in relation to Aboriginal children in Child Protection, including Out of Home Care (OOHC) and potential adoption, and also responds directly to Terms of Reference 1 and 2 of the Inquiry.

Overview

AMSANT embraces a social and cultural determinants of health perspective which recognises that health and wellbeing are profoundly affected by a range of interacting economic, social and cultural factors. Accordingly, we advocate for a holistic and child-centred approach to Child Protection that seeks first and foremost to address the underlying causes of abuse and neglect through prevention and early intervention.

We are aware that this Inquiry was called in the wake of recent media coverage relating to the issue of adoption of Aboriginal children, including the Minister’s own comments that adoption policies should be changed to allow more Aboriginal children to be adopted by non-Aboriginal families.

AMSANT would like to emphasise the importance of informed discussion on this issue and draws the Committee’s attention to the following, put forward in March of this year as part of a joint statement from Aboriginal and Torres Strait Islander leaders in response to media coverage:

We need to have a more rational and mature discussion aimed at achieving better social, community, family and individual outcomes for all Aboriginal and Torres Strait Islander children and young people. We must work to ensure that the drivers of child protection intervention are addressed, rather than continuing with a poorly designed and resourced system that reacts when it’s too late, after families have already reached breaking point and children have been harmed1.

As captured in this statement it is essential that efforts to improve outcomes for children and families in contact with the Child Protection System stem from an understanding that abuse and neglect of children are most often the result of deeper family conflict or dysfunction, arising from social, economic and/or psychological roots.

In cases where children do need to be removed from family, decisions about what kind of placement, including adoption, is most appropriate for that child should occur in line with the following principles:

 Child-centred approach that allows for children to have a say in decisions that affect them

 OOHC for Aboriginal children delivered by Aboriginal Community Controlled Services (ACCSs)

 Adoption of a set of national standards for the rights of children in care

 Maintaining connection to family, community, culture and country, including prioritising adoption by extended family or if that is not possible, Aboriginal families who are not related.

 Improved support for kinship carers

1 See full statement here: http://www.snaicc.org.au/snaicc-statement-14-march-2018-joint-statement-aboriginal-torres-strait-islander-leaders-recent-media-coverage-around-child-protection-children/ Inquiry into local adoption

Stability and permanency for children in out-of-home care with local adoption as a viable option

Transition of OOHC to Aboriginal Community Control

Evidence clearly demonstrates that culturally competent services lead to increased access to services by Aboriginal children and their families2. Aboriginal led and managed services are well-placed to overcome the many barriers that exist for Aboriginal families and children to access services3, such as:

 a lack of understanding of the OOHC system and how to access advice and support;

 a mistrust of mainstream legal, medical, community and other support services;

 an understanding of the cultural or community pressures not to seek support, in particular perceptions of many Aboriginal families that any contact with the service system will result in the removal of their child4.

As the evaluation of child and family service delivery through the Communities for Children program identifies, “Indigenous specific services offer Indigenous families a safe, comfortable, culturally appropriate environment that is easier to access and engage with.”5 In addition, they are also going to be better at locating, training and supporting Aboriginal foster carers. This provides the opportunity to increase the quality of OOHC for Aboriginal children at significant lesser cost than the current “professional” foster care arrangements that are too often being put in place for Aboriginal children.

Following the lead of NSW, who in 2012 commenced a process of transfer to community control, there is a project currently being undertaken by the Aboriginal Peak Organisations NT (APO NT), in collaboration with the NT Government, to develop a strategy for the transition of OOHC to Aboriginal community control in the NT. Victoria has also confirmed that all OOHC service provision for Aboriginal children and families will be provided by community controlled services, with Queensland and Western Australia both exploring similar shifts.

AMSANT supports APO NT’s vision that Aboriginal children and young people in out of home care, as a priority, are placed with Kinship or Aboriginal foster carers and supported to retain culture, identity and language.

Strengthening the voice of children in decisions that affect them

Article 12 of the United Nations Convention on the Rights of the Child states; “Children have the right to say what they think should happen when adults are making decisions that affect them and to have their opinions taken into account” 6.

There is a need for Child Protection proceedings to be more responsive to the child’s aspirations and needs. An approach taken in Family Law known as child-inclusive family dispute resolution has been shown to produce better outcomes for families with parenting disputes, including greater stability of care and contact patterns, and greater contentment of children with those arrangements7. Central to this approach is the use of an independent, specially trained child health professional to conduct interviews before any decision is made about them.

There is no reason why a similar approach couldn’t be taken in terms of long term care arrangements for children but with specific provisions for continuing contact with family and community.

Maintaining connection with family, kin and country

In line with international convention, Aboriginal children and families have the right to enjoy their cultures in community with their cultural groups (UNCRC, article 30; UNDRIP, articles 11-13). This right has been enshrined in these conventions to reflect the wealth of evidence that show culture, language and connection to country are protective factors for at-risk communities8.

The Aboriginal Torres Strait Islander Placement Principle (ATSIPP) has been developed to ensure recognition of the value of culture and the vital role of Aboriginal children, families and communities to participate in decisions about the safety and wellbeing of children.

Despite the commitment from all States and Territories to fully implement this principle under the National Framework for Protecting Australia’s Children, in 2015 only 34.7% of Aboriginal children in the NT were placed in care in accordance with the Child Placement principle, compared with a national average of 65.6%, and only 3.3% of children were placed with relatives or kin, compared with 48.8% at the national average9.

This reflects the need for better practice relating to kinship care in the NT including;

– early identification of kinship networks when the child first comes to the attention of Child Protection, rather than when a crisis point has been reached;

– increased access to supports and training for kinship carers (see below);

– support services to birth parents to strengthen the option for reunification;

– development of cultural support plans for all Aboriginal children to ensure meaningful connection to family, culture and community is maintained.

Improved support for kinship carers

A lack of adequate support for kinship carers can contribute to placement breakdown, and escalation for children and young people in the statutory OOHC system, including entry into residential care.

Conversely, home based care and placement stability are associated with a range of better health, education, economic and wellbeing outcomes.

Improved access to the following would support kinship carers in maintaining more stable placements for the children in their care:

– Ensure a comprehensive assessment of the child has been conducted and a care plan, incorporating cultural supports for Aboriginal children, is developed and fully implemented.

– Ensure access to training courses across a broad range of issues (parenting solutions, behavioural management, understanding and responding to trauma etc.)

– Increased financial support to bring payments in line with foster carers.

It is important to note that even for many long-term, stable care arrangements, including for children in kinship care, adoption may not be seen as a viable option due to the loss of supports that would be incurred in transitioning from ‘carer’ to ‘parent’.

In this way it is clear that the type of placement reflects neither stability and permanency nor wellbeing for the child, but rather the particular vulnerabilities and needs of the child and their carer. Adequately meeting these needs should remain the paramount focus of any efforts to create stable, loving homes for children in care.

Appropriate guiding principles for a national framework or code for local adoptions within Australia

In order to ensure that the rights and needs of the child remain central to all Care and Protection operations, AMSANT advocates that Australia adopt a set of national standards that set out the rights of children in care, which would be modelled on the Council of Europe’s 2005 Recommendation on the Rights of Children Living in Residential Institutions10.

This recommendations sets out a list of basic principles, specific rights of children living in residential institutions and guidelines and quality standards in view of protecting the rights of children living in residential institutions, irrespective of the reasons for and the nature of the placement. It advocates that the placement of a child should remain the exception and that the placement must guarantee full enjoyment of the child’s fundamental rights.

 

NACCHO Aboriginal Health and Obesity NEWS : 1.Network Submission to the Select Committee’s #Obesity Epidemic in Australia Inquiry and our 13 recommendations: 2.Healthy Food Partnership Survey

 

” The 2012-13 Health Survey identified that Indigenous adults were 1.6 times as likely to be obese as non-Indigenous Australians, with the prevalence increasing more rapidly in Aboriginal school-aged children.

Overweight and obesity in childhood are important predictors of adult adiposity, increasing the risk of developing a range of medical conditions, each of which is a major cause of morbidity, mortality and health expenditure.

While it is surprisingly clear what needs to be done to improve the health of Indigenous children, recent cuts to Indigenous preventative workforce and nutrition programs throughout Australia have severely reduced the capacity to respond.

Comprehensive primary health care is a key strategy for improving the health of Indigenous Australians and is an important platform from which to address complex health and social issues associated with obesity.

Closing the Gap, including the gap attributable to obesity, requires ensuring the ACCHS sector is resourced to deliver the full range of core services required under a comprehensive and culturally safe model of primary health care.

The effectiveness of ACCHSs has long been recognised, with many able to document better health outcomes than mainstream services for the communities they serve. “

Extract from NACCHO Network Submission to the Select Committee’s Obesity Epidemic in Australia Inquiry. 

Download the full 15 Page submission HERE

Obesity Epidemic in Australia – Network Submission – 6.7.18

 ” The Healthy Food Partnership is a mechanism for government, the public health sector and the food industry to cooperatively tackle obesity, encourage healthy eating and empower food manufacturers to make positive changes.

The Healthy Food Partnership’s Reformulation Working Group has developed draft reformulation targets for sodium, sugars and/or saturated fats, in 36 sub-categories of food.  These food categories are amongst the highest contributors of sodium, sugars and saturated fat to Australian population level intakes.”

See Healthy Food Partnership Survey Part 2 Below

Read over 50 NACCHO Aboriginal Health and Obesity articles published in past 6 years 

 

Introduction to NACCHO Network Sumission and selected extracts 

The National Aboriginal Community Controlled Health Organisation (NACCHO) is the peak body representing 143 Aboriginal Community Controlled Health Services (ACCHSs) across Australia.

ACCHSs provide comprehensive primary health care to Aboriginal and Torres Strait Islander people through over 300 Aboriginal medical clinics throughout Australia.

ACCHSs deliver three million episodes of care to around 350,000 people each year, servicing over 47% of the Aboriginal population, with about one million episodes of care delivered in remote areas.

The Aboriginal Community Controlled Health Service (ACCHS) sector is the largest single employer of Indigenous people in the country, employing 6,000 staff, the majority of whom are Aboriginal or Torres Strait Islander.

The evidence that the ACCHS model of comprehensive primary health care delivers better outcomes than mainstream services for Aboriginal people is well established.

Without exception, where Aboriginal people and communities lead, define, design, control and deliver services and programs to their communities, they achieve improved outcomes.

The ACCHS model of care has its genesis in Aboriginal people’s right to self-determination, and is predicated on principles that incorporate a holistic, person-centred, whole-of-life, culturally secure approach.

The ACCHS principles of self-determination and community control remain central to wellbeing and sovereignty of Aboriginal people. Equipped with inequitable levels of funding and resources ,

ACCHSs continue to meet the ongoing challenges of addressing the burden of disease in Aboriginal communities.

Executive summary

The National Aboriginal Community Controlled Health Organisation (NACCHO) welcomes the opportunity to provide input into the Inquiry into the Obesity epidemic in Australia.

Aboriginal and Torres Strait Islander people represent approximately 3% of the Australian population yet are disproportionately over-represented on almost every indicium of social, health and wellbeing determinant.

Social determinants and historical factors such as intergenerational trauma, racism, social exclusion, and loss of land and culture are commonly recognised as causative factors for these disparities.

In 2008 the Council of Australian Governments (COAG) committed to addressing the health disparity between Aboriginal and Torres Strait Islander peoples and non-Indigenous Australians by adopting the Closing the Gap initiative. Whilst gaining some success in achieving convergence for some health indicators, wide health and wellbeing disparity still remains for both children and adults.

The life expectancy gap between Indigenous and non-Indigenous Australians remains 10.6 years for males and 9.5 years for females.

As a major contributor to morbidity and mortality among Indigenous Australians, obesity is estimated to account for 16% of the health gap between Aboriginal and Torres Strait Islander peoples and the total Australian population.

Comprehensive primary health care is a key strategy for improving the health of Indigenous Australians and is an important platform from which to address complex health and social issues associated with obesity.

Closing the Gap, including the gap attributable to obesity, requires ensuring the ACCHS sector is resourced to deliver the full range of core services required under a comprehensive and culturally safe model of primary health care. The effectiveness of ACCHSs has long been recognised, with many able to document better health outcomes than mainstream services for the communities they serve.

Combating the burden of obesity and its health effects for Indigenous Australians demands a strategic and coordinated whole-of-society approach at a national level by the Federal Government.

Without coordinated, sustained national action, efforts to improve the health status of Aboriginal children are likely to fail. In recognising the need to seriously address this critical and increasing gap in Indigenous health, NACCHO welcomes this inquiry and proposes the following recommendations:

  1. Government to work in partnership with NACCHO and the ACCHS sector to develop policies and plans that are responsive to the needs of Aboriginal communities
  2. A commitment to increase the understanding of Aboriginal and Torres Strait Islander peoples of the health significance of overweight and obesity, and facilitating access for these communities to resources which support healthy eating and physical activity
  3. Additional investment to build organisational capacity within the ACCHS sector and to increase the capacity of Aboriginal Health Promotion Officers to maintain a focus on public health initiatives
  4. Government to encourage professional support systems for, and assist Aboriginal Health Worker’s and other primary care workers to provide advice to adults and children about weight management as part of existing health checks and screening programs – this may be achieved by encouraging the MBS Aboriginal Health Check item to communicate more effectively the importance of physical activity, nutrition and weight management
  5. Fund the development of Aboriginal and Torres Strait Islander cultural awareness training for health care professionals covering care, education and information relating to food, physical activity, lifestyle choices and health service arrangements
  6. In understanding that health promotion is more difficult in regional and rural Australia, targeted funding should be dedicated to these areas to overcome the pervasive problems associated with distance
  7. A commitment to ongoing consultation with Aboriginal communities on what can be achieved at a local level to effectively promote healthy eating and physical activity for children
  8. Facilitate access for Aboriginal and Torres Strait Islander communities to resources which support lifestyle changes, including access to information, physical activity opportunities, and healthy food choices
  9. The prevalence of childhood obesity and the absence of culturally specific programs for Aboriginal and Torres Strait Islander people warrants further work in the development of culturally appropriate programs and tailored communication strategies alongside mainstream campaigns and messages
  10. Given the paucity of studies on Indigenous children, there is a need for further research on effective obesity prevention interventions for Indigenous families. This requires commitment to more detailed monitoring of young Indigenous children’s diets and their physical activity
  11. Government to work with the food industry and community stores to implement retail intervention strategies to positively influence access to and consumption of healthy food choices for Aboriginal and Torres Strait Islander communities
  12. Consider mechanisms to sustain programs on physical activity, nutrition and weight management that have proven effective
  13. Ensure significant participation of Aboriginal and Torres Strait Islander people in national surveys and evaluations by enhancing the sampling frame and applying culturally appropriate recruitment strategies

Evidence-based measures and interventions to prevent and reverse childhood obesity, including experiences from overseas jurisdictions

Evidence-based profiling of obesity and overweight in Indigenous Australian children has been poor, with very little known about the effectiveness of culturally adapted children’s interventions. Given the impact on health, finances and community, the need for better strategies and interventions to manage obesity are now being recognised by the entire health system.

Historically, initiatives have focused on nutrition or physical activity as separate entities and have shown modest effects. In recent years, global interventions considering the wider ‘obesogenic environment’ have been recommended, with policymakers and public health practitioners increasingly turning to evidence-based strategies to discover effective interventions to childhood obesity.

It is important to note, however, that the rapidly growing body of literature has meant many recommendations for childhood obesity have often relied on research that has not been systematically reviewed and focused more on assessing the internal validity of study results than on evaluating the external validity, feasibility or sustainability of intervention effects.

Experience in several countries has shown that successful obesity prevention during childhood can be achieved through a combination of population-based initiatives.li There is strong evidence for the effectiveness of school-based strategies, acting as an ideal setting for interventions to support healthy behaviours, and can also potentially reach most school age 9 children of diverse ethnic and socioeconomic groups. The Centre for Disease Control and Prevention (CDC) recommends a curriculum that is culturally appropriate and a school environment that reflects the culture within the community by demonstrating cultural awareness in healthy eating and physical activity practices.l

Examples of school-based strategies include policies that limit student access to foods and beverages that are high in fats and sugar, contributing to decreased consumption during the school dayliii, and efforts to increase physical activity leading to a lowered body mass indexliv and improved cognitive abilities,lv especially in younger children. An evaluation of a school-based health education program for urban Indigenous youth found compromising results in physical activity, breakfast intake and fruit and vegetable consumption, all of which are core components of healthy weight management.lvi

Studies have examined the effectiveness of culturally specific versions of programs to tackle obesity, including a US study comparing a mainstream program with a culturally adapted version. Findings were that cultural adaptations improved recruitment and retention numbers, with the authors recommending that to improve program design, ethnic communities and organisations should be approached to collaborate with researchers in design, modifications, recruitment techniques, implementation, evaluation and interpretation of results.lvii

A 2013 Canadian pilot evaluation of a whole-school health promotion program, Healthy Buddies, involved researchers consulting Aboriginal community members about how the program could be more effective, sustainable and culturally appropriate, resulting in a new version called Healthy Buddies – First Nations. Prior to implementation, communities were able to review the program and tailor its cultural appropriateness. Lesson content and visual aids were amended to resemble Aboriginal children, as well as Aboriginal food and activities.lviii In promoting social responsibility through the buddy system, the program showed a significant lowering in BMI and waist circumference and was considered particularly important for remote communities.

Systematic and evidence-based reviews have suggested promise in tailoring programs to be more culturally appropriate for specific ethnic and culturally diverse groups. The 2014 Global Nutrition Report, which examined the limited access to supermarkets and a reliance on fast-food as contributing to the growing prevalence of obesity in American Indian communities, recommended that interventions need to be multi-faceted, culturally sensitive, grounded in cultural traditions, and developed with full participation of American Indian communities.lix

Similar recommendations were made in a review by Toronto Public Health, identifying that interventions targeting children from low socioeconomic or culturally diverse backgrounds can positively impact on physical activity levels and dietary intake. This highlights the need to consider focusing on specific cultural backgrounds, like Indigenous Australians, when planning obesity prevention interventions to achieve better outcomes.

The role of the food industry in contributing to poor diets and childhood obesity in Australia

Improving the access to and availability of nutritious food is a vital step to combating the prevalence of obesity. Indigenous people living in rural and remote areas in particular face significant barriers in accessing nutritious and affordable food.

The level and composition of food intake is influenced by socio-economic status, high prices, poor quality fruit and vegetables in community stores, and unavailability of many nutritious foods.lxi This is indeed exacerbated by the exposure to high levels of unhealthy food marketing across a range of media. 10

The ubiquitous marketing of unhealthy food creates a negative food culture, undermining nutrition recommendations.

Substantial research documents the extensiveness and persuasive nature of food marketing in Australia; importantly, the vast majority of all food and drink marketing, regardless of medium or setting, is for food and drinks high in fat, sugar and/or salt.lxii Australian children are exposed to high levels of unhealthy food marketing through a range of mediums, including sponsorship arrangements with children’s sport. With research identifying a logical sequence of effects linking food promotion to individual-level weight outcomes,lxiii it is clear that food marketing influences children’s attitudes and subsequent food consumption.

Australia’s National Preventative Health Taskforce has highlighted the importance of restricting inappropriate marketing of unhealthy food and beverages to children as a cost-effective obesity prevention strategy.lxiv Clear affirmative action in Australia to such marketing has been lacking to date, compounding the need for Government to explore options for regulating the production, marketing and sale of energy-dense and nutrient-poor products to reduce consumption.

Research has shown that the prevalence of obesity increases and consumption of fruit and vegetables decreases with increasing distance to grocery stores and supermarketslxv and a higher density of convenience stores and take-away food outlets.lxvi Cost is also a major issue, with the price of basic healthy foods increased by 50% or more in rural and remote areas where there is a higher proportion of Indigenous residents compared to non-Indigenous residents than in urban areas.lxvii The purchasing behaviour of children is particularly sensitive to price, and can have significant effects over time.

Foods of better nutritional choice, including fresh fruits and vegetables, are often expensive due to transportation and overhead costs, or only minimally available.lxviii Comparatively, takeaway and convenience food, often energy-dense and high in fat or sugar, are less affected by cost and availability.

A study of intake of six remote Aboriginal communities, based on store turnover, found that intake of energy, fat and sugar was excessive, with fatty meats making the largest contribution to fat intake.lxx Compared with national data, intake of sweet and carbonated beverages and sugar was much higher in these communities, with the proportion of energy derived from refined sugars approximately four times the recommended intake.

Recent evidence from Mexico indicates that implementing health-related taxes on sugary drinks and on ‘junk’ food can decrease purchase of these foods and drinks.lxxi A recent Australian study predicted that increasing the price of sugary drinks by 20% could reduce consumption by 12.6%.lxxii Revenue raised by such a measure could be directed to an evaluation of effectiveness and in the longer term be used to subsidise and market healthy food choices as well as promotion of physical activity.

It is imperative that all of these interventions to promote healthy eating should have community-ownership and not undermine the cultural importance of family social events, the role of Elders, or traditional preferences for some food. Food supply in Indigenous communities needs to ensure healthy, good quality foods are available at affordable prices.

In Summary

It is widely understood that many Aboriginal and Torres Strait Islander people, predominantly children, are at high-risk of ill-health due to overweight and obesity. This is likely to lead to a widening gap in health outcomes for Indigenous Australians if prevention efforts are not improved. Despite the identified health and economic gains which can be achieved by using a social determinants and culturally appropriate approach, Australia is yet to embed such thinking in health policy.

Policy in isolation will not solve the epidemic of childhood obesity for Indigenous children. What is required, is urgent action to address poverty, education, unemployment and housing, all of which are factors that shape a child’s ability to engage with healthy behaviours. There also needs to be close ongoing national monitoring through the collection of comparable data; more detailed monitoring of the composition of young Indigenous children’s diets and physical activity is necessary to determine whether patterns are changing in response to interventions.

Undeniably, strategic investment is needed to implement population-based childhood obesity prevention programs which are effective and also culturally appropriate, evidence-based, easily understood, action-oriented and motivating. Interventions must be positioned within broad strategies addressing the continuing social and economic disadvantages that many Indigenous people experience and need to have an emphasis on training community-based health workers, particularly in the ACCHS sector who are best placed to respond to the increasing rates of obesity and associated health concerns for Aboriginal and Torres Strait Islander people.

The ACCH sector has a central role in promoting and improving health outcomes for Indigenous people yet requires additional targeted funding and resources to implement new initiatives, including intervention, education, and research to encourage physical activity and healthy nutrition. Indeed, multifaceted strategies involving the public, private and ACCHS sector, along with community participation and government support, are required to gradually reverse this trend.

NACCHO and its Affiliates in each State and Territory appreciate the opportunity to make this submission on behalf of our member services. With circumstances unimproved after years of policy approaches, the need remains to overturn the prevalence of overweight and obesity of Indigenous people. There needs to be a commitment at all levels of government in terms of funding, policy development, and support for the implementation of culturally appropriate programs and services. There must be a recognition that self-determination of Aboriginal and Torres Strait Islander people will be the foundation of true progress.

NACCHO strongly recommend that Government engage in meaningful dialogue with NACCHO, NACCHO’s Affiliates in each State and Territory and ACCHSs in relation to the proposals canvassed in this response; and work in partnership to address the significant prevalence of obesity in Aboriginal and Torres Strait Islander people, especially children

 

Part 2 Overview Healthy Food Partnership Survey 

The Healthy Food Partnership is a mechanism for government, the public health sector and the food industry to cooperatively tackle obesity, encourage healthy eating and empower food manufacturers to make positive changes.

The Healthy Food Partnership’s Reformulation Working Group has developed draft reformulation targets for sodium, sugars and/or saturated fats, in 36 sub-categories of food.  These food categories are amongst the highest contributors of sodium, sugars and saturated fat to Australian population level intakes.

Please note the different closing dates relating to feedback on the various nutrient targets.

Why We Are Consulting

The Healthy Food Partnership (Partnership) recognises that many companies are already reformulating their products to improve the nutritional quality and aims to build on (rather than replicate) these efforts.

It is not the intention of the Partnership to disadvantage companies that are already reformulating, but to recognise and support their efforts to date, and encourage those companies that are yet to engage in reformulation activities to move towards improving the nutritional profile of their products.  Targets will create certainty for industry of what they, and their competitors, should be aiming for.

Feedback is sought on the feasibility of the draft targets, the appropriateness of the draft category definitions (including products which are included or excluded), and the proposed implementation period (four years).  Consultation feedback will inform the final recommendations of the Reformulation Working Group, to the Partnership’s Executive Committee.

Deidentified information from submissions will be provided to the Reformulation Working Group and other committees involved with the Healthy Food Partnership.

Submissions will be published at the end of the consultation period, unless confidentiality has been requested.

Begin survey

Aboriginal Health #Socialdeterminants and #Remote Housing Debate : @NACCHOChair urges Federal Government to maintain funding $ for remote Indigenous housing

“ NACCHO is extremely disappointed that the Commonwealth Government has recently walked away from all States’ Remote Housing funding agreements and only maintained smaller scale arrangements in the Northern Territory.

States have been offered short-term agreements and committed fewer funds.

Simply put, decent housing and reducing homelessness is critical to improving health outcomes for Aboriginal people’

We know it’s a significant concern for State Governments too

Mr John Singer Chairperson of NACCHO See full Press Release Part 1

It is morally reprehensible that the Federal Government can walk away from ongoing funding for remote communities after being involved in this space for 50 years.

If the PM does not step in to resolve this issue – as requested in a formal letter sent to him by WA Premier Mark McGowan on May 11 – he will be showing his true stripes as the so-called PM for Closing the Gap.

We want to Close the Gap – not slam the door.”

WA Housing Minister Peter Tinley : Read full Press Release Below Part 2 Remote communities’ campaign calls on Commonwealth for a fair go

“The people living in WA’s 165 remote communities are amongst the most vulnerable in Australia. There are significant challenges in servicing their communities to a suitable standard.

For the Federal Government to suggest that this is solely a State responsibility is a nonsense.

I would urge all Australians – including all members of the Liberal and National State Opposition whose silence on this issue to date has been noted – to get on board with this campaign.”

I’ve spent a lot of my life having to deal with the slings and arrows of being an Aboriginal person. Nigel Scullion is just the latest in that , he’s clearly unsuitable to try to resolve this issue and I am surprised and disappointed that he would resort to such rhetoric.”

WA Aboriginal Affairs Minister Ben Wyatt in The Guardian

WA minister says Scullion ‘unsuitable’ to resolve remote Indigenous housing dispute

and Press Release Part 2

“Without a decent place to live, the task of closing the gap in health or education becomes only more difficult,”

Shadow Assistant Minister for Indigenous Affairs, Senator Patrick Dodson said housing underpins all of the Close the Gap targets. See Part 3

Download NACCHO Press Release

NACCHO URGES FEDERAL GOVERNMENT TO MAINTAIN HOUSING Agreements

The National Aboriginal Community Controlled Health Organisation (NACCHO) is extremely concerned that the Federal Government has cut funding for the National Partnership Agreement on Remote Indigenous Housing.

Housing conditions in remote communities remain substandard, overcrowded and there are high rates of homelessness in remote communities. All of these contribute to poor health outcomes and prevalence of third world diseases like trachoma and rheumatic heart disease.

The WA State Government’s ‘Don’t Walk Away’ campaign, calls on the Federal Government not to abandon remote communities in Western Australia. For more information, visit http://www.dontwalkaway.wa.gov.au

NACCHO requests that the National Partnership Agreement on Remote Indigenous Housing funding is maintained to support efforts in Closing the Gap policies of the Federal government and Agreements with all States signed as a matter of urgency.

Part 2 Remote communities’ campaign calls on Commonwealth for a fair go

The WA McGowan Government started a campaign to pressure the Federal Government to not abandon 165 remote communities in Western Australia.

The ‘Don’t Walk Away’ campaign featured online and print media advertising, and promote a website with a call to action for people concerned about the plight of the almost 12,000 people living in remote communities across WA.

June 30 marked the end of a 10-year, $1.2 billion funding agreement between the Federal Government and the WA Government to support remote communities through the provision of housing.

The WA Government contributes about $90 million annually to maintain these communities through the provision of essential services such as power, water and waste management, infrastructure and regular maintenance activity.

The Federal Government’s own independent Remote Housing Review has identified that about 1,300 new homes will need to be built in WA in the coming decade to address issues of overcrowding in remote communities and to cater for population growth.

But despite months of haggling, the Federal Government has indicated it intends to wash its hands of further involvement in the provision of housing for remote services after making a payment of about $60 million over the next three years.

This will leave an approximate $400 million gap in the State’s finances over the forward estimates.

The State Government today issued a national call to action for all caring Australians to lobby Prime Minister Malcolm Turnbull – the so-called PM for Closing the Gap – to solve the current impasse and prevent indigenous Australians living in remote communities from further disadvantage.

For more information, visit http://www.dontwalkaway.wa.gov.au

Part 3 Labor Press Release TURNBULL WALKS AWAY FROM REMOTE INDIGENOUS HOUSING

Malcolm Turnbull has turned his back on remote Indigenous communities in Western Australia, South Australia and Queensland, with funding for remote housing in those states ceasing yesterday.

This is despite Senator Nigel Scullion’s repeated claims to contrary over the past six months.

This year’s Budget confirmed there would be no additional funding for these states in the National Partnership Agreement on Remote Indigenous Housing. Only the NT will continue to receive Commonwealth support to tackle overcrowding.

Shadow Homelessness Minister Doug Cameron said the Turnbull Government is walking away from remote communities. “This cut shows an appalling lack of leadership and a complete misunderstanding of the Close the Gap framework,” Senator Cameron said.

“Overcrowding is a root cause of Indigenous disadvantage because it leads to a range of other social and health problems in remote communities. Prior to the Budget, Senator Scullion’ described claims he was cutting the agreement as ‘fiction’ and ‘nonsense’.

In December 2017, Senator Scullion told the Guardian Australia that “commonwealth officials are in discussion with their state counterparts regarding future funding arrangements. This will include further Commonwealth funding.”

Shadow Assistant Minister for Indigenous Affairs, Senator Patrick Dodson, said housing underpins all of the Close the Gap targets. “Without a decent place to live, the task of closing the gap in health or education becomes only more difficult,” Senator Dodson said.

According to a 2017 review of the program, by 2018 the strategy will have delivered 4,000 new houses and 7,500 refurbishments The NPA is estimated to have led to a significant decrease in the proportion of overcrowded houses in remote and very remote areas.

It has also been a driver of job creation and Indigenous business’s in many remote communities.

With Malcolm Turnbull’s refresh of the Close the Gap strategy now underway, it is critical that the Turnbull Government does not walk away from any of the current targets.

Instead of walking away from programs that work – the Turnbull Government should be working with Indigenous communities to ensure services are delivered as efficiently and effectively as possible.