NACCHO Aboriginal Health and #Stroke : New Report : Regional and rural health divide : #stroke treatment a cruel lottery

 ” Aboriginal and Torres Strait Islander are between two and three times as likely to have a stroke than non-Indigenous Australians which is why increasing stroke awareness is crucial.

Too many Australians couldn’t spot a stroke if it was happening right in front of them. We know that in Aboriginal and Torres Strait Islander communities this awareness is even lower. We want all Australians, regardless of where they live or what community they’re from, to learn the signs of stroke.”

Stroke Foundation and Apunipima ACCHO Cape York Project

“It can happen to anyone — stroke doesn’t discriminate against colour, it doesn’t discriminate against age “

Photo above Seith Fourmile, Indigenous stroke survivor campaigns for culture to aid in stroke recovery

Regional and rural communities are bearing the brunt of Australia’s stroke burden, according to an updated Stroke Foundation report released today.

Download the Report here : NSF1586_Postcode2017_web

Read over 60 plus NACCHO stroke Articles HERE

“No Postcode Untouched: Stroke in Australia 2017”, found 12 of the country’s top 20 hotspots for stroke incidence were located in regional Australia and people living in country areas were 19 percent more likely to suffer a stroke than those living in metropolitan areas.

Stroke Foundation Chief Executive Officer Sharon McGowan said due to limited access to best practice treatment, regional Australians were also more likely to die or be left with a significant disability as a result a stroke.

“In 2017, Australians will suffer more than 56,000 strokes and many of these will be experienced by people living in regional Australia,’’ Ms McGowan said.

“Advancements in stroke treatment and care mean stroke is no longer a death sentence for many, however patient outcomes vary widely across the country depending on where people live.

“Stroke can be treated and it can be beaten. It is a tragedy that only a small percentage of Australian stroke patients are getting access to the latest treatments and ongoing specialist care that we know saves lives.”

See Video from the Project

Stroke Foundation Clinical Council Chair Associate Processor Bruce Campbell said Australian clinicians were leading the way internationally in advancements in acute stroke treatment, such as endovascular clot retrieval. However, the health system was not designed to support and deliver these innovations in treatment and care nationally.

“It is not fair that our health system forces patients into this cruel lottery,’’ A/Professor Campbell said.

“There are pockets of the country where targeted investment and coordination of services is resulting in improved outcomes for stroke patients.

“Consistent lack of stroke-specific funding and poor resourcing is costing us lives and money. For the most part, doctors and nurses are doing what they can in a system that is fragmented, under-resourced and overwhelmed.”

No Postcode Untouched: Stroke in Australia 2017 report and website uses data compiled and analysed by Deloitte Access Economics to reveal how big the stroke challenge is in each Australian federal electorate.

This data includes estimates of the number of strokes, survivors and the death rate, as well as those living with key stroke risk factors. It is an update of a Stroke Foundation report released in 2014.

The report shows the cities and towns where stroke is having its biggest impact and pinpoints future hotspots where there is an increased need for support.

Ms McGowan said stroke is a leading cause of death and disability in Australia, having a huge impact on the community and the economy. Media release

“Currently, there is one stroke in Australia every nine minutes, by 2050 – without action – this number is set to increase to one stroke every four minutes,’’ she said.

“Stroke doesn’t discriminate, it impacts people of all ages and while more people are surviving stroke, its impact on survivors and their families is far reaching.

“It doesn’t have to be this way. Federal and state governments have the opportunity to invest in proven measures to change the state of stroke in this country.”

In the wake of the report Stroke Foundation is calling for a funded national action plan to address the prevention and treatment of stroke, and support for stroke survivors living in the community.

Key elements include: A national action campaign to ensure every Australian household has someone who knows

Key elements include:

  •  A national action campaign to ensure every Australian household has someone who knows FAST – the signs of stroke and to call 000. Stroke is a time critical medical condition. Time saved in getting people to hospital and treatments = brain saved.

  •  Nationally coordinated telemedicine network – breaking down the barriers to acute stroke treatment.
  •  Ensuring all stroke patients have access to stroke unit care, and spend enough time on the stroke unit accessing the services and supports they need to live well after stroke.

The No Postcode Untouched:Stroke in Australia 2017 report was funded by an unrestricted educational grant from Boehringer Ingelheim.

Aboriginal Health and #prevention : New report : @Prevention1stAU health : How much does Australia spend and is it enough?

 ” The verdict is in: Prevention is better than cure when it comes to tackling Australia’s chronic disease burden, but is Australia pulling its weight when it comes to tackling the nation’s greatest public health challenge?

A new economic report looking at what Australia invests in preventive health has found Australia ranks poorly on the world stage and has determined that governments must spend more wisely to contain the burgeoning healthcare budget.

Treating chronic disease costs the Australian community an estimated $27 billion annually, accounting for more than a third of our national health budget.

Yet Australia currently spends just over $2 billion on preventive health each year, or around $89 per person.

One in two Australians suffer from chronic disease, which is responsible for 83 per cent of all premature deaths in Australia, and accounts for 66 per cent of the burden of disease.”

The report, Preventive health: How much does Australia spend and is it enough? was co-funded by the Heart Foundation, Kidney Australia, Alzheimer’s Australia, the Australia Health Promotion Association and the Foundation for Alcohol Research and Education.

Download the report HERE

Preventive-health-How-much-does-Australia-spend-and-is-it-enough_FINAL

Produced by La Trobe University’s Department of Public Health, the report examines trends in preventive health spending, comparing Australia’s spending on preventive health, as well as the funding models used, against selected Organisation for Economic Co-operation and Development (OECD) countries.

The report also explores the question: ‘how much should Australia be spending on preventive health?’

Treating chronic disease costs the Australian community an estimated $27 billion annually, accounting for more than a third of our national health budget.

Yet Australia currently spends just over $2 billion on preventive health each year, or around $89 per person. At just 1.34 per cent of Australian healthcare expenditure, the amount is considerably less than OECD countries Canada, New Zealand and the United Kingdom, with Australia ranked 16th out of 31 OECD countries by per capita expenditure.

Michael Thorn, Chief Executive of the Foundation for Alcohol Research and Education (FARE), a founding member organisation of the Prevention 1st campaign, says that when looking at Australia’s spend on prevention, it should be remembered that one third of all chronic diseases are preventable and can be traced to four lifestyle risk factors: alcohol and tobacco use, physical inactivity and poor nutrition.

“We know that by positively addressing and influencing lifestyle factors such as physical activity, diet, tobacco and   alcohol consumption, we will significantly reduce the level of heart disease, stroke, heart failure, chronic kidney disease, lung disease and type 2 diabetes; conditions that are preventable, all too common, and placing great pressure on Australian families and on Australia’s healthcare systems,” Mr Thorn said.

Report co-author, Professor Alan Shiell says we should not simply conclude that Australia should spend more on preventive health simply because we spend less than equivalent nations, and instead argues that Australia could and should spend more on preventive health measures based on the evidence of the cost effectiveness of preventive health intervention.

“The key to determining the appropriate prevention spend is to compare the added value of an increase in spending on preventive health against the opportunity cost of doing so.

“If the value of the increased spending on preventive health is greater than the opportunity cost, then there is a strong case to do so,” Professor Shiell said.

Professor Shiell says there is clear evidence that many existing preventive health initiatives are cost-effective.

“Studies suggest Australia’s health could be improved and spending potentially even reduced if government was to act on existing policy recommendations and increase spending on activities already considered cost-effective.

“We also suspect that the choice of funding mechanism, or how money is allocated to whom for prevention – is an important factor for the overall efficiency of health prevention expenditure,” Professor Shiell said.

The report highlights England’s efforts in evaluating and monitoring the cost effectiveness and success of its public health interventions and Mr Thorn believes Australia would do well to follow their lead.

“In the United Kingdom we have a conservative government no less, showing tremendous leadership to tackle chronic disease, with bold policy measures like the recently introduced sugar tax and broad-based physical activity programs, all of which are underpinned by robust institutional structures,” Mr Thorn said.

The report will be launched at a Forum at Parliament House in Canberra today, where public health experts, including the World Health Organization’s Dr Alessandro Demaio will explain how they would invest in preventive health if given $100 million to spend.

 

 

 

NACCHO Aboriginal Health #CarersGateway : Free online resources to support #Aboriginal #carers

It’s rewarding work, but without help Dolly finds herself emotionally and physically drained. Dolly reached out and found that she could get services to help her.

Like Dolly, millions of people in Australia care for others who need help with their everyday lives.

A carer may be someone who looks after their husband or wife, partner, grandparent, uncle, aunty, cousin, child, grandchild or any other family member, a neighbour, a friend or someone in their community who needs help.

Everyone’s situation is different. Some carers look after someone who is an older person or who is unwell or has difficulties getting around. Some carers may look after someone who has a disability, a mental illness or dementia, a chronic condition or a long-term illness or drug and alcohol problems.

Many people looking after someone else don’t think of themselves as carers. They just see caring as what they do to help their families or friends or people in their communities.

Carers need help too – someone they can talk to and find out about services that can help. Carer Gateway is a free, Australian Government funded service that provides information for carers and helps people get in touch with their local services. People can ring up and have a private chat or go online and find out about support in their area, free financial and legal help and what to do in emergencies.  They can also get tips on how to look after themselves so they don’t get burnt out while caring for someone else.

Carer Gateway has short videos about real-life carers in the community – showing how they cope and deal with problems – and how they make the most of the time they spend caring for someone in need.

The videos include Dolly’s story. Dolly is a mother and full-time carer for her two adult daughters, who both need support with their everyday needs.

“It’s pretty much 24/7 around the clock. Four years ago, I realised I was doing a care role and I was also a working mum so quite busy. I thought you know what, it’s time for me to step back and start looking after my own,” she said.

There are free online resources to support Aboriginal carers, including a guided relaxation audio recording and information brochures and posters for use by health and community groups  which can also be ordered from the Carer Gateway ordering form and a Carer Gateway Facebook page to keep up to date on services and supports for carers.

To find out more, Carer Gateway can be contacted on 1800 422 737, Monday to Friday between 8am and 6pm,

or by visiting carergateway.gov.au

You can join the Carer Gateway Facebook community by visiting https://www.facebook.com/carergateway/

 

 

 

Aboriginal Health : Second Atlas of Healthcare Variation highlights higher Aboriginal hospitalisation rates for all 18 clinical conditions

 

“The report, compiled by the Australian Commission on Safety and Quality in Health Care, shows us that high hospitalisation rates often point to inadequate primary care in the community, leading to higher rates of potentially preventative hospitalization

The most disturbing example of this  has been the higher hospitalisation rates for all of the 18 clinical conditions surveyed experienced by Aboriginal and Torres Strait Islander Australians, people living in areas of relative socioeconomic disadvantage and those living in remote areas.

 Chairman of Consumers Health Forum, Tony Lawson who is a member of the Atlas Advisory Group.

 “Additional priorities for investigation and action are hospitalisation rates for specific populations with chronic conditions and cardiovascular conditions, particularly:

  • Aboriginal and Torres Strait Islander Australians
  • People living in remote areas
  • People at most socioeconomic disadvantage.

Please note

  • Features of the second Atlas include: Analysis of data by Aboriginal and Torres Strait Islander status

DOWNLOAD Key-findings-and-recommendations

Mr Martin Bowles Secretary Dept of Health  launches the Second Australian Atlas of Healthcare Variation

A new report showing dramatic differences in treatment rates around Australia signals a pressing need for reforms to ensure equitable access to appropriate health care for all Australians, the Consumers Health Forum, says.

“A seven-fold difference in hospitalisation for heart failure and a 15-fold difference for a serious chronic respiratory disease depending on place of residence, are among many findings of substantial variations in treatment rates in Australia revealed in the Second Australian Atlas of Healthcare Variation,” the chairman of Consumers Health Forum, Tony Lawson, said.

“While there are a variety of factors contributing to these differences,  the variation in health and treatment outcomes is, as the report states, an ‘alarm bell’ that should make us stop and investigate whether appropriate care is being delivered.

“These findings show that recommended care for chronic diseases is not always provided.  Even with the significant funding provided through Medicare to better coordinate primary care for people with chronic and complex conditions, fragmented health services contribute to suboptimal management, as the report states.

“We support the report’s recommendation for a stronger primary health system that would provide a clinical ‘home base’ for coordination of patient care and in which patients and carers are activated to develop their knowledge and confidence to manage their health with the aid of a healthcare team.

“The Atlas provides further robust reasons for federal, state and territory governments to act on the demonstrated need for a more effective primary health system that will ensure better and more cost effective care for all Australians.

“The Atlas also examined  variations in women’s health care, and its findings included a seven-fold difference in rates of hysterectomy and  21-fold  difference in rates of endometrial ablation.  The report states that rates of hysterectomy and caesarean sections in Australia are higher than reported rates in other developed nations.  These results highlight the need for continuing support and information on women’s health issues,” Mr Lawson said.

The Second Australian Atlas of Healthcare Variation (second Atlas) paints a picture of marked variation in the use of 18 clinical areas (hospitalisations, surgical procedures and complications) across Australia.

This Atlas, the second to be released by the Commission, illuminates variation by mapping use of health care according to where people live.  As well, this Atlas identifies specific achievable actions for exploration and quality improvement.

The second Atlas includes interventions not covered in the first Atlas, such as hospitalisations for chronic diseases and caesarean section in younger women. It also builds on the findings from the first Atlas – for example, examining hysterectomy and endometrial ablation separately, and examining rates of cataract surgery using a different dataset.

Priority areas for investigation and action arising from the second Atlas include use of:

  • Hysterectomy and endometrial ablation
  • Chronic conditions (COPD, diabetes complications)
  • Knee replacement.

Additional priorities for investigation and action are hospitalisation rates for specific populations with chronic conditions and cardiovascular conditions, particularly:

  • Aboriginal and Torres Strait Islander Australians
  • People living in remote areas
  • People at most socioeconomic disadvantage.

Healthcare Variation – what does it tell us

Some variation is expected and associated with need-related factors such as underlying differences in the health of specific populations, or personal preferences. However, the weight of evidence in Australia and internationally suggests that much of the variation documented in the Atlas is likely to be unwarranted. Understanding this variation is critical to improving the quality, value and appropriateness of health care.

View the second Atlas

The second Atlas, released in June 2017, examined four clinical themes: chronic disease and infection – potentially preventable hospitalisations, cardiovascular, women’s health and maternity, and surgical interventions.

Key findings and recommendations for action are available here.

View the maps and download the data using the interactive platform.

What does the Atlas measure?

The second Atlas shows rates of use of healthcare interventions (hospitalisations, surgical procedures and complications,) in geographical areas across Australia.  The rate is then age and sex standardised to allow comparisons between populations with different age and sex structures. All rates are based on the patient’s place of residence, not the location of the hospital or health service.

The second Atlas uses data from national databases to explore variation across different healthcare settings. These included the National Hospital Morbidity Database and the AIHW National Perinatal Data Collection.

Who has developed the second Atlas?

The Commission worked with the Australian Institute of Health and Welfare (AIHW) on the second Atlas.

The Commission consulted widely with the Australian government, state and territory governments, specialist medical colleges, clinicians and consumer representatives to develop the second Atlas.

Features of the second Atlas include:

  • Greater involvement of clinicians during all stages of development
  • Analysis of data by Aboriginal and Torres Strait Islander status
  • Analysis of data by patient funding status (public or private).

Table of Contents

Chapter 1 Chronic disease and infection: potentially preventable hospitalisations

1.1 Chronic obstructive pulmonary disease (COPD)
1.2 Heart failure
1.3 Cellulitis
1.4 Kidney and urinary tract infections
1.5 Diabetes complications

Chapter 2 Cardiovascular conditions

2.1 Acute myocardial infarction admissions
2.2 Atrial fibrillation

Chapter 3 Women’s health and maternity

3.1 Hysterectomy
3.2 Endometrial ablation
3.3 Cervical loop excision or cervical laser ablation
3.4 Caesarean section, ages 20 to 34 years
3.5 Third- and fourth-degree perineal tear

Chapter 4 Surgical interventions

4.1 Knee replacement
4.2 Lumbar spinal decompression
4.3 Lumbar spinal fusion
4.4 Laparoscopic cholecystectomy
4.5 Appendicectomy
4.6 Cataract surgery
Technical Supplement
About the Atlas
Glossary

Australian Atlas of Healthcare Variation data set specifications are available at http://meteor.aihw.gov.au/content/index.phtml/itemId/674758

 

NACCHO Aboriginal Health #WorldNoTobaccoDay : Cape York mob are saying “Don’t Make Smokes Your Story.”


“Wasting a lot of money to buy cigarettes and it was making me sick, coughing a lot, and getting up late, and it smells on your clothes a lot. So I said to myself I would have to cut down smoking.”

“You don’t have to buy cigarettes, you don’t have to afford cigarettes for other people, you don’t have to get cigarettes. Just be strong and stand up for yourself and say no!”

Selena Possum, who has lived in Pormpuraaw for the last 20 years, is now a non-smoker. She says smoking affected her a lot

NACCHO Aboriginal Health #smoking #ACCHO events 31 May World #NoTobacco Day #QLD #VIC #WA #NT #NSW

May 31st is World No Tobacco Day and people from Cape York are saying “Don’t Make Smokes Your Story.”

Apunipima Cape York Health Council Tackling Indigenous Smoking (TIS) staff have been engaging with Cape York communities to develop an anti-smoking campaign.

The locally appropriate ‘Don’t Make Smokes Your Story’ campaign aims to raise awareness of the harms of smoking and passive smoking, the benefits of a smoke-free environment, and available quit support.

The Cape York ‘Don’t Make Smokes Your Story’ Campaign enables community members to share on film their stories about quitting, trying to quit and the impact of smoking on families and communities. It is hoped that by sharing their stories, others will be encouraged to share their stories too.

Coen local Amos James Hobson has never smoked in his life. He sees many young people start smoking “Just to be cool, to pick up a chick.” He says to all the young people out there, “Our people didn’t smoke, don’t smoke, it’s not good. It’s not our culture and it’s not our way.”

WATCH AMOS VIDEO STORY HERE HERE

Thala Wallace from Napranum has tried to quit three times and says “Every time it gets easier.” Her strategy is to “Try to find ways to occupy myself, snack-out on fruit or go to the gym, getting out and hanging out more with people who don’t smoke.”

Watch Thala story video here

The stories, as well as posters, social media posts and radio advertisements will be released from May 31st as Apunipima launches the Cape York ‘Don’t Make Smokes Your Story’ campaign.

The videos, including those featuring Amos, and Thala, will be distributed on the ‘What’s Your Story, Cape York?’ Facebook page and will be available on the Apunipima YouTube Channel here.

Apunipima received a Tackling Indigenous Smoking (TIS) Regional Tobacco Control Grant as part of the National Tackling Indigenous Smoking program.

To effectively reduce smoking rates in Cape York, Apunipima TIS staff have been engaging with communities to develop and implement a locally appropriate social marketing campaign to influence smoking behaviours and community readiness to address smoke-free environments. The Cape York campaign will align with a national ‘Don’t Make Smokes Your Story’ campaign.

NACCHO Aboriginal Health #Smoking #WNTD @AMAPresident awards #NT Dirty Ashtray Award for World #NoTobacco Day

“Research shows that smoking is likely to cause the death of two-thirds of current Australian smokers. This means that 1.8 million Australians now alive will die because they smoked.

The Northern Territory, a serial offender in failing to improve tobacco control, has been announced as the recipient of the AMA/ACOSH Dirty Ashtray Award for putting in the least effort to reduce smoking over the past 12 months.

But it seems that the Northern Territory Government still does not see reducing the death toll from smoking as a priority. Smoking is still permitted in pubs, clubs, dining areas, and – unbelievably – in schools.

The NT Government has not allocated funding for effective public education, and is still investing superannuation funds in tobacco companies.

“It is imperative that Governments avoid complacency, keep up with tobacco industry tactics, and continue to implement strong, evidence-based tobacco control measures.”

Ahead of World No Tobacco Day on 31 May, AMA President, Dr Michael Gannon, announced the results today at the AMA National Conference 2017 in Melbourne.

Previous NACCHO Press Release Good News :

NACCHO welcomes funding of $35.2 million for 36 #ACCHO Tackling Indigenous Smoking Programs

The Northern Territory, a serial offender in failing to improve tobacco control, has been announced as the recipient of the AMA/ACOSH Dirty Ashtray Award for putting in the least effort to reduce smoking over the past 12 months.

It is the second year in a row that the Northern Territory Government has earned the dubious title, and its 11th “win” since the Award was first given in 1994.

AMA President, Dr Michael Gannon, said that it is disappointing that so little progress has been made in the Northern Territory over the past year.

“More than 22 per cent of Northern Territorians smoke daily, according to the latest National Drug Strategy Household Survey, well above the national average of 13.3 per cent,” Dr Gannon said.

“Smoking will kill two-thirds of current smokers, meaning that 1.8 million Australian smokers now alive will be killed by their habit.

“But it seems that the Northern Territory Government still does not see reducing the death toll from smoking as a priority. Smoking is still permitted in pubs, clubs, dining areas, and – unbelievably – in schools.

“The Government has not allocated funding for effective public education, and is still investing superannuation funds in tobacco companies.”

Victoria and Tasmania were runners-up for the Award.

“While the Victorian Government divested from tobacco companies in 2014, and has made good progress in making its prisons smoke-free, its investment in public education campaigns has fallen to well below recommended levels, and it still allows price boards, vending machines, and promotions including multi-pack discounts and specials,” Dr Gannon said.

“It must end the smoking exemption at outdoor drinking areas and the smoking-designated areas in high roller rooms at the casino.

Learn more about the great work our Tackling Indigenous Smoking Teams are doing throughout Australia 100 + articles HERE

“Tasmania has ended the smoking exemption for licensed premises, gaming rooms and high roller rooms in casinos, but still allows smoking in outdoor drinking areas.

“While Tasmania has the second highest prevalence of smoking in Australia, the Tasmanian Government has not provided adequate funding to support tobacco control public education campaigns to the evidence-based level.  It should provide consistent funding to the level required to achieve reductions in smoking.”

Tasmania should also ban price boards, retailer incentives and vending machines, and divest the resources of the Retirement Benefits Fund (RBF) from tobacco companies, limit government’s interactions with the tobacco industry and ban all political donations, ACOSH said.

It should also ban all e-cigarette sale, use, promotion and marketing in the absence of any approvals by the Therapeutic Goods Administration.

Promotion

Download the app today & prepare to quit for World No Tobacco Day

Queensland has topped the AMA/ACOSH National Tobacco Control Scoreboard 2017 as the Government making the most progress on combating smoking over the past 12 months.

Queensland narrowly pipped New South Wales for the Achievement Award, with serial offender the Northern Territory winning the Dirty Ashtray Award for putting in the least effort.

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

“Disappointingly, no jurisdiction scored an A this year, suggesting that complacency has set in,” Dr Gannon said.

“Research shows that smoking is likely to cause the death of two-thirds of current Australian smokers. This means that 1.8 million Australians now alive will die because they smoked.

“It is imperative that Governments avoid complacency, keep up with tobacco industry tactics, and continue to implement strong, evidence-based tobacco control measures.”

The judges praised the Queensland Government for introducing smoke-free legislation in public areas, including public transport waiting areas, major sports and events facilities, and outdoor pedestrian malls, and for divesting from tobacco companies.

However, they called on all governments to run major media campaigns to tackle smoking, and to take further action to protect public health policy from tobacco industry interference.

31 May is World No Tobacco Day Tweet using “Protect health,reduce poverty, promote development”

NACCHO #SorryDay #NRW2017 supports @HeartAust and AHHA @AusHealthcare 18 Hospitals signed to #Lighthouse Hospital Project

 

“Aboriginal and Torres Strait Islander peoples are two-and-a-half times more likely to be admitted to hospital for heart events than non-Indigenous Australians.

For both sexes, Aboriginal and Torres Strait Islander peoples are more likely to have high blood pressure, be obese, smoke and a poor diet.”

Chief Executive Officer Heart Foundation Adjunct Professor John Kelly see Part 2 below Heart map

 ” I thought I was healthy and was quite prepared to ignore the warning signs.

I had a heart attack and survived. It could have been very different.

Having had the scare of a lifetime, Winmar made immediate changes 

At the time I had to change a lot of my dieting, the way you use salts in your food, alcohol, smoking. Those were the sacrifices you have to do as well, which don’t come easily,

“You’ve got to make that choice if you want to fulfil the rest of your life. I’m 52 this year and hopefully [for] another 10 or 15 years I’ll still be around.”

Heart and home: Nicky Winmar and his second chance at life

Nicky Winmar is famously remembered as the Indigenous player who confronted the crowd and pointed to his skin at Victoria Park in the early 1990s in a triumphant stand against racism in footy see full story Part 3 :

A chance meeting with the ACT chief executive of the Heart Foundation, Tony Stubbs, meant he simply had to endorse its message about a positive diet and lifestyle, especially with what’s at stake in Indigenous communities

” NACCHO will provide leadership and guidance to the Lighthouse team in enabling the local Aboriginal and Torres Strait Islander community and Aboriginal health workforce to be intimately involved in designing and implementing the program.

We are very supportive of this program and its contribution to National Sorry Day today, and to Reconciliation Week which starts tomorrow ’

CEO of the National Aboriginal Community Controlled Health Organisation (NACCHO) Patricia Turner pictured below

Download Press Release

Media Release_Sorry Day_Joint HF AHHA NACCHO V2 l

Part 1 : Press Release 18 hospitals sign up to close the gap in Aboriginal and Torres Strait Islander heart health

Eighteen hospitals from around Australia have signed up to the Lighthouse Hospital Project aimed at improving the hospital treatment of coronary heart disease among Indigenous Australians.

See Info HERE Phase 3

Lighthouse is operated and managed by the Heart Foundation and the Australian Healthcare and Hospitals Association (AHHA). It is funded by the Australian Government.

The 18 hospitals cover almost one-half of all cardiac admissions in Australia for Aboriginal and Torres Strait Islander peoples.

Heart Foundation National CEO Adjunct Professor John Kelly said closing the gap in cardiovascular disease between Indigenous and non-Indigenous Australians was a key Heart Foundation priority, and it was highly appropriate that today’s announcement coincided with National Sorry Day.

‘Cardiac care for Aboriginal and Torres Strait Islander peoples is serious business. Australia’s First Peoples are more likely to have heart attacks than non-Indigenous Australians, and more likely to have early heart disease onset coupled with other health problems, frequent hospital admissions and premature death[1].

‘Deaths happen at almost twice the rate for non-Indigenous Australians, yet Indigenous Australians appear to have fewer tests and treatments while in hospital, and discharge from hospital against medical advice is five times as high[2]’, Professor Kelly said.

AHHA CEO Alison Verhoeven says that Lighthouse aims to ensure Indigenous Australians receive appropriate evidence-based care in a culturally safe manner.

‘A critical component of success will be close and genuine collaboration with local Aboriginal and Torres Strait Islander leaders, communities and organisations in the design and implementation of the activities.

‘To borrow from the words of the Prime Minister, Lighthouse will encourage and support hospitals to do things ‘with’ Aboriginal people not ‘to’ them[3].

Free Blood Pressure HERE

See Previous NACCHO Heart Posts

“Many of the hospital admissions for Aboriginal and Torres Strait Islander peoples are preventable and the Heart Foundation is committed to closing the gap in health outcomes for Aboriginal and Torres Strait Islander peoples.”

Heart Foundation National Chief Executive Officer Adjunct Professor John Kelly said these maps brought together for the first time a national picture of hospital admission rates for heart-related conditions at a national, state and regional level.

Or Download report and press release

Australian Heart Maps Report 2016

What is the Lighthouse hospital project?

  • The Lighthouse hospital project is a joint initiative of the Heart Foundation and the Australian Healthcare and Hospitals Association (AHHA).
  • The aim: to improve care and health outcomes for Aboriginal and Torres Strait Islander peoples experiencing coronary heart disease, the leading cause of death among this population.

Australia is a privileged nation by world standards. Despite this, not everyone is equal when it comes to heart health and Aboriginal and Torres Strait Islander people are the most disadvantaged. The reasons are complex and not only medical in nature. Aboriginal and Torres Strait Islander people have a troubled history with institutions of all kinds, including hospitals.

The Lighthouse Hospital project aims to change this experience by providing both a medically and culturally safe hospital environment. A culturally safe approach to healthcare respects, enhances and empowers the cultural identity and wellbeing of an individual.

This project matters because the facts are sobering. Cardiovascular disease occurs earlier, progresses faster and is associated with greater co-morbidities in Aboriginal and Torres Strait Islander peoples. They are admitted to hospital and suffer premature death more frequently compared with non-Indigenous Australians[1].

Major coronary events, such as heart attacks, occur at a rate three times that of the non- Indigenous population. Fatalities because of these events are 1.5 times more likely to occur, making it a leading contributor to the life expectancy gap [2].

PART 3

http://www.theage.com.au/afl/afl-news/nicky-winmar-and-the-moment-he-got-his-second-chance-20170525-gwd8g4.html

Nicky Winmar thought he was healthy and was quite prepared to ignore the warning signs.

The former AFL champion was only 46 and initially dismissed his chest pains as indigestion. Even the next morning, as the pains continued, it took Winmar’s partner to convince him to see a doctor.

Thankfully they got to him in time. Winmar was admitted to hospital and had surgery to insert a stent in an artery. A great of the St Kilda Football Club, he’d had a heart attack and survived. It could have been very different.

That scary episode five years ago has served as Winmar’s wake-up call. His father died the same way, aged 50, on the eve of Winmar’s solitary appearance in an AFL grand final 20 years ago.

“The doctor looked at me and put me in a room with all these machines and said I was having a heart attack,” Winmar recalls.

“It knocked me for six. I’d always trained hard and kept myself well with good food. It gave me a shake-up.

“They put a stent in an artery to keep it open. Afterwards I was so weak I couldn’t get out of bed. I had to learn to walk again.”

Having had the scare of a lifetime, Winmar made immediate changes

“At the time I had to change a lot of my dieting, the way you use salts in your food, alcohol, smoking. Those were the sacrifices you have to do as well, which don’t come easily,” Winmar said.

“You’ve got to make that choice if you want to fulfil the rest of your life. I’m 52 this year and hopefully [for] another 10 or 15 years I’ll still be around.”

Winmar is famously remembered as the Indigenous player who confronted the crowd and pointed to his skin at Victoria Park in the early 1990s in a triumphant stand against racism in footy. The moment was captured by an Age photographer, Wayne Ludbey, and remains an iconic image in footy history.

Then last year Winmar publicly supported his son to highlight the importance of gay rights. Winmar had little to do with his son for nearly 20 years and the pair hadn’t spoken for a decade until, three years ago, Tynan Winmar decided it was time to reconnect and tell his father about his sexuality.

When Nicky Winmar decides to support a cause, he throws his full weight behind it. A chance meeting with the ACT chief executive of the Heart Foundation, Tony Stubbs, meant he simply had to endorse its message about a positive diet and lifestyle, especially with what’s at stake in Indigenous communities.

“When I first met him, he took a step back, thought about it and said this is my opportunity to do something about it,” Stubbs said.

The statistics around heart disease and Indigenous communities are disturbing.

“It’s the biggest single killer of Indigenous Australians,” Stubbs said.

“It’s nearly twice the rate of death of non-Indigenous. We think that gap is too big and we actually want to do something about that and bridge that.

“Unfortunately the Indigenous smoking rate is about 43 per cent, which is about two-and-a-half times the non-Indigenous rate. And in remote areas it’s actually 60 per cent.

“One of the key messages is around quitting smoking and making that decision. Certainly Nicky has done that. And he’s found a huge amount of benefit from that.”

Winmar has a simple message for those in Indigenous communities.

“It’s the No.1 killer in Indigenous communities and towns and country areas that we come from,” he said.

“It’s important that you do go and see your local GP with symptoms that do happen. Ring triple zero and do something about it straight away.”

Winmar is a Saints great across more than 200 matches but played his final AFL season with the Western Bulldogs in 1999. He enjoyed last year’s Doggies breakthrough premiership, especially because they were coached by his friend Luke Beveridge, but the thought of St Kilda’s first flag since 1966 brings a big smile to his face.

Perhaps a smile as big as the one he had when he realised he had a second chance.

1] Austalian Institute of Health and Welfare (AIHW) 2016. Australia’s health 2016. Australia’s health series no. 15. Cat. No AUS 199. Canberra: AIHW

[2] AIHW 2014, CHD and COPD in Indigenous Australians, Cat.No IHW 126

[3] Prime Minister Malcolm Turnbull. 10 February 2016. Speech to Parliament on the 2016 Closing the Gap Report.

Aboriginal #heart #stroke Health : $15 million #HealthBudget17 Investment in #PhysicalActivity and #healthylifestyles to #takethepressuredown

“We walk from the pier to the swimming pool, but everyone walks their own pace and distance.

Before walking, an Aboriginal health worker takes the blood pressure of the walkers to let them know how their general health is.

The group was about “more than just walking”, with general health checks and healthy food offered as part of the weekly meet-up .We have young and old, Indigenous and non-Indigenous, and everyone gets on really well.”

Community liaison officer Joe Malone : Run jointly by Heart Foundation Walking and the Aboriginal and Torres Strait Island Community Health Service Northgate QLD , the meetings help keep local residents active.

Read Full story HERE

To find a local walking group, head to the Heart Foundation Walking website or call 1300 362 787

NACCHO Aboriginal Health : ” High blood pressure is a silent killer ” new Heart Foundation guidelines

“Disturbingly, about half of Australian adults are not physically active enough to gain the health benefits of exercise. This includes just under half of young people aged 25 to 34 years old. This puts them at higher risk of heart disease, stroke, some cancers and dementia in later life.

“But even moderate exercise is like a wonder drug. Being active for as little as 30 minutes a day, five days a week, can reduce risk of death from heart attack by a third, as well as help you sleep better, feel better, improve your strength and balance, and maintain your bone density. It also manages your weight, blood pressure and blood cholesterol. So we are delighted by the news of the Prime Minister’s $10 million walking challenge.”

Heart Foundation National CEO, Adjunct Professor John Kelly see full below

 ” The Stoke Foundation is excited to announce that the Stroke Foundation is partnering with Priceline Pharmacy for the 2017 Australia’s Biggest Blood Pressure Check campaign.

Australia’s Biggest Blood Pressure Check will take place Wednesday 17 May – Wednesday 14 June with a target to deliver 80,000 free health checks at over 320 locations around Australia including Priceline Pharmacy stores, selected shopping centres and Queensland Know your numbers sites.

Find your nearest free health check location HERE or your Aboriginal Community Controlled Health ( ACCHO )

Heart Foundation applauds Budget funding for Healthy Heart package

At a glance

Regular walking or other physical activity reduces:

  • All-cause mortality by 30%
  • Heart disease and stroke by 35%
  • Type 2 diabetes by 42%
  • Colon cancer by 30%
  • Breast cancer by 20%
  • Weight, blood pressure and blood cholesterol

The Heart Foundation welcomes a $10 million commitment in the Federal Budget to get more Australians active by investing in a walking revolution, and $5 million dedicated to helping GPs to encourage patients to lead a healthy lifestyle.

Federal Health Minister Greg Hunt has announced that $10 million over two years will be allocated to the Heart Foundation to lead the Prime Minister’s Walk for Life Challenge, which will support up to 300,000 Australians to adopt the easy way to better health – regular walking – by 2019.

“Physical inactivity takes an immense toll on the Australian community, causing an estimated 14,000 premature deaths a year – similar to that caused by smoking,” said Heart Foundation National CEO, Adjunct Professor John Kelly.

Heart Foundation Walking is Australia’s only national network of free walking groups. It has helped more than 80,000 Australians walk their way to better health since the program began in 1995, and currently has nearly 30,000 active participants. “We need to inspire Australians to be more active, and walking groups are a cheap, fun and easy way for them to get moving,” Professor Kelly said.

The Heart Foundation wants to see everyone ‘Move More and Sit Less’, including school students, sedentary workers and older Australians. “So we welcome the Government’s National Sports Plan, also announced in the Budget, to encourage physical activity at all levels, from community participation to elite sports.

“The Heart Foundation is also pleased to see a renewed commitment of more than $18 million to the National Rheumatic Fever Strategy, a critical program if we are to Close the Gap in health for Indigenous communities,” said Professor Kelly. “And we welcome the listing of the new heart failure medication Entresto on the Pharmaceutical Benefits Scheme, making it affordable for many more Australians, as well as funding for research into preventative care, and the development of a National Sport Plan, with its emphasis on participation.”

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

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

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

From Heart Foundation website

 

NACCHO Aboriginal Health #Heartweek : #hypertension – the biggest risk factor for #heartattack & #stroke for our mob

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

What you don’t know can hurt you. Heart disease and strokes are the biggest killers of Australians, and the biggest risk factor for both of them is high blood pressure.

But high blood pressure – known to doctors as ‘hypertension’ – is a silent killer because there are no obvious signs or symptoms, and many people don’t realise they have it. “

John Kelly CEO-National, Heart Foundation see Press release below

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

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

This year, the Heart Foundation’s annual campaign, Heart Week, will shine a spotlight on the importance of diagnosing and treating high blood pressure. In particular, the campaign encourages health professionals to get acquainted with the Heart Foundation’s new hypertension guidelines.

The guidelines recommend:

  • that the management of patients with hypertension should also consider absolute cardiovascular disease risk
  • different treatment strategies for individuals at high risk of a cardiovascular event to those at low absolute cardiovascular disease risk even if they have similar blood pressure readings
  • blood pressure-lowering therapy for patients with uncomplicated mild hypertension (systolic BP, 140–159 mmHg)
  • the benefits of lower targets of < 120 mmHg systolic for patients with at least moderate cardiovascular risk (10-year risk, 20%)
  • a healthy lifestyle, including not smoking, eating a nutritious diet and regular adequate exercise for all Australians.

Did you know that the Heart Foundation in partnership with NPS MedicineWise has produced a collection of hypertension resources for Aboriginal and Torres Strait Islander Australians, and that health professionals can obtain them for free?

The resources include a flipchart for educational sessions, a patient brochure on high blood pressure and flyers on the following medicines:

  • ACE inhibitors
  • angiotensin receptor blockers
  • beta blockers
  • calcium channel blockers
  • thiazide diuretics.

For more information about high blood pressure and Aboriginal and Torres Strait Islander people, see the Australian Indigenous HealthInfoNet web resource about cardiovascular disease.

John Kelly CEO-National, Heart Foundation Press release

New research by the Heart Foundation, released for Heart Week, has found that of the six million Australians who have high blood pressure, more than 2.7 million have high blood pressure that is not treated at all, and 1.4 million have high blood pressure that is treated but not controlled.

This is a recipe for tragedy for individuals and families, too many of whom will have to cope with sudden death or life-long disabilities. Even in young Australians, high blood pressure can cause serious long-term damage; it is linked to chronic kidney disease, as well as Alzheimer’s and other dementias.

The prevalence of uncontrolled high blood pressure is a ticking time-bomb in terms of our already overstretched health system. Each year, heart disease and stroke are responsible for more than 30,000 deaths and $3.1 billion in direct health costs, and their incidence is rising.

At the moment, most people do not realise how crucial blood pressure is to their health. Only seven percent of Australians know that hypertension is a risk factor for heart disease (it causes half of all heart disease deaths), and only two per cent would focus on lowering blood pressure as a way of reducing their heart disease risk. People are much more likely to nominate stress and alcohol as key triggers.

Perhaps surprisingly, the problem of lack of treatment is more common in the cities than in regional Australia. More adults in regional and rural Australia have high blood pressure (39 percent vs 31 percent in the cities). But their city cousins are much more likely to have untreated, uncontrolled high blood pressure (52 per cent vs 37 percent). This might be because people in the regions tend to have more health problems and are more likely to be seeing their GPs regularly.

All adult Australians should have their blood pressure checked by a doctor at least every two years. Every GP should be routinely checking the blood pressure of adult patients who present to them for any kind of problem.

High blood pressure can be managed and controlled.  Your eating patterns, alcohol intake, weight and level of physical activity have a strong influence on your blood pressure.

Many people need to take blood pressure-lowering medicine. You should work closely with your doctor to find the medicine that works best for you.

If you are among the one in 11 Australians who has not had a blood pressure check in the last two years, make that appointment today. Then urge the people you love to do the same. Consider it a heartfelt gift.

Our commitment

The Heart Foundation is a co-signatory to the national Close the Gap campaign. We are committed to improving the life expectancy and quality of life of Aboriginal and Torres Strait Islander people.  No plan or strategy can successfully address these health challenges unless it specifically addresses heart, stroke and blood vessel disease.

For more than a decade, the Heart Foundation has been building knowledge and experience in improving the cardiovascular health of Indigenous Australians.

Our priorities

The Heart Foundation has worked with Aboriginal and Torres Strait Islander peoples to identify the following seven priorities that need to addressed to tackle the unacceptable disparity in health outcomes suffered by the first Australians. The following documents outline how health practitioners can help reduce disparity.

  1. Reduce consumption of tobacco and make healthy lifestyle choices easy (PDF)
  2. Improve early identification and ongoing management of cardiovascular risk factors (PDF)
  3. Improve access to timely and culturally appropriate diagnostic services (PDF)
  4. Strengthen the prevention, diagnosis and treatment of rheumatic heart disease (PDF)
  5. Improve in-hospital disparities in care for patients experiencing acute coronary syndrome (ACS) (PDF) 
  6. Improve participation in cardiac rehabilitation and ongoing care (PDF)
  7. Improve access and adherence to medication across the continuum of the patient journey (PDF)

More information

References

  1. Australian Institute of Health and Welfare (AIHW). Cardiovascular disease and its associated risk factors in Aboriginal and Torres Strait Islander peoples 2004 05, Cat. No. CVD 29, June 2008.
  2. AIHW: Mathur S, Moon L, Leigh S. 2006. Aboriginal and Torres Strait Islander people with coronary heart disease: further perspectives on health status and treatment. Cardiovascular disease series no. 25. Cat. No. CVD 33. Canberra: Australian Institute of Health and Welfare.
  3. Australian Institute of Health and Welfare (AIHW). Heart, stroke and vascular diseases Australian facts 2004. AIHW Cat. No. CVD 27. Canberra: AIHW and National Heart Foundation of Australia (Cardiovascular Disease Series No. 22).

Guidelines, tools and position statements

Source: Heart Foundation and Australian Indigenous HealthInfoNet

Links

NACCHO Aboriginal Health and #Nutrition : FYI delegates #WCPH2017 Aboriginal traditional foods key role in protecting against #chronicdisease

“We have long understood that native animal and plant foods are highly nutritious.

There is no evidence that Aboriginal and Torres Strait Islander people had diabetes or cardiovascular disease whilst maintaining a diet of traditional foods, and it has been shown that reverting to a traditional diet can improve health.

In addition to demonstrating significant health benefits, traditional foods remained an integral part of identity, culture and country for Aboriginal and Torres Strait Islander people, while also alleviating food insecurity in remote communities.”

Menzies researcher and lead author Megan Ferguson see research paper in full below

Photo above :  Frank told us how the ‘old people’, which literally means his ancestors, lived under the trees, gathered food and fished in the swamp. He said that during the dry, they used to build a sort of rock stepping-stone bridge to access the island in the swamp where they would gather magpie goose eggs.

Photo above  : With a focus to improve community nutrition, over 2000 bush tucker trees and conventional fruits were planted at the Barunga Community, south of Katherine.

Aboriginal people have been using bush tucker for over 50,000 years, but it was hoped the plantation would lure more children onto a free feed of fruit, instead of a portion of chips. Some of the bush tucker fruits being planted include the Black Plum, Bush Apple, Cocky Apple, Red Bush Apple, and White Currant

 ” The bush tucker diet was high in nutritional density, offering good levels of protein, fibre, and micronutrients. It was low in sugar and glucose, and lower in insulin than similar western foods, and the hunter-gatherer lifestyle meant plenty of physical activity. Some animal foods such as witchetty grubs and green ants were high in fat, but most native land animals were lean, especially when compared with the domesticated animals eaten today.

It was this knowledge of the land that sustained the Aboriginal people of the Northern Territory for tens of thousands of years “

Your Complete Guide to Bush Tucker in the Northern Territory

Traditional food trends in remote Northern Territory communities

The majority of Aboriginal people living in remote Northern Territory communities are regularly using traditional foods in their diets according to research from Menzies School of Health Research published in the Australian and New Zealand Journal of Public Health see below

The paper, Traditional food availability and consumption in remote Aboriginal communities in the Northern Territory reports that a nutritious diet including the consumption of traditional foods plays a key role in protecting against chronic disease for Aboriginal and Torres Strait Islander people living in remote communities.

‘Surveys conducted in remote Northern Territory (NT) communities revealed almost 90% of people consumed a variety of traditional foods each fortnight.

‘In relation to food insecurity we also found that 40% of people obtained traditional food when they would otherwise go without food due to financial hardship or limited access to stores,’ Ms Ferguson said.

The list of traditional food reported during the research is extensive and includes a range of native animal foods including echidna, goanna, mud mussel, long-neck turtle and witchetty grubs and native plant foods including green plum, yam and bush onion.

The 20 remote NT communities surveyed reported that traditional foods were available year round.

‘There is still much to be learnt about the important contribution traditional foods makes to nutrition and health outcomes. We need to work with Aboriginal and Torres Strait Islander leaders to understand more about contemporary traditional food consumption. This is crucial to informing broader policy that affects where people live, how they are educated, employment and other livelihood opportunities,’ Ms Ferguson said.

The article will be available at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1753-6405

Traditional food availability and consumption in remote Aboriginal communities in the Northern Territory, Australia

Objective: To explore availability, variety and frequency consumption of traditional foods and their role in alleviating food insecurity in remote Aboriginal Australia.

Methods: Availability was assessed through repeated semi-structured interviews and consumption via a survey. Quantitative data were described and qualitative data classified.

Results: Aboriginal and non-Indigenous key informants (n=30 in 2013; n=19 in 2014) from 20 Northern Territory (NT) communities participated in interviews. Aboriginal primary household shoppers (n=73 in 2014) in five of these communities participated in a survey. Traditional foods were reported to be available year-round in all 20 communities. Most participants (89%) reported consuming a variety of traditional foods at least fortnightly and 71% at least weekly. Seventy-six per cent reported being food insecure, with 40% obtaining traditional food during these times.

Conclusions: Traditional food is consumed frequently by Aboriginal people living in remote NT.

Implications for public health: Quantifying dietary contribution of traditional food would complement estimated population dietary intake. It would contribute evidence of nutrition transition and differences in intakes across age groups and inform dietary, environmental and social interventions and policy. Designing and conducting assessment of traditional food intake in conjunction with Aboriginal leaders warrants consideration.

Aboriginal and Torres Strait Islander Australians have experienced a rapid nutrition transition since colonisation by Europeans 200 years ago, similar to that experienced by other Indigenous populations globally.1 The traditional food system provided a framework for society and was interwoven with culture, a framework that is now eroded by a food system with no distinct cultural ties or values.2 Early reports of Aboriginal people prior to European contact indicate that they were lean and healthy, attributable to an active lifestyle and a nutrient-dense diet characterised by high protein, polyunsaturated fat, fibre and slowly digested carbohydrates.3 The diet was sourced from a wide range of uncultivated plant foods and wild animals and was influenced by the seasons and geographical location; although there were differences in the food sources by location, there were similarities in the overall nutrient profile.3,4 Since colonisation, this nutritious diet has been systematically replaced by high intakes of refined cereals, added sugars, fatty (domesticated) meats, salt and low intakes of fibre and several micronutrients.5–7

There is no evidence that Aboriginal people maintaining traditional diets had diabetes or cardiovascular disease.4 However, the integration of non-traditional foods into the contemporary diet of Aboriginal Australians has led to an excessive burden of lifestyle-related chronic diseases.3 A nutritious diet, such as that afforded by the consumption of traditional foods, plays a key role in protecting against these conditions. Short-term reversion to a traditional diet has demonstrated significant weight loss, improvement in risk factors of diabetes and cardiovascular disease and improvements in glucose tolerance and other abnormalities related to type 2 diabetes mellitus among a small group of Aboriginal Australians.8,9

High levels and a wide variety of polyunsaturated fatty acids, in the context of overall lower fat content, found in native animal foods are one of the benefits of a traditional diet; reported to reduce the risk of developing obesity, type 2 diabetes mellitus and cardiovascular diseases.3,4Traditional foods remain an integral part of the contemporary Aboriginal and Torres Strait Islander diet strongly linked to identity, culture and country. An analysis of national data collected in 2008 reported that 72% of participants aged over 15 years living in remote communities reported having harvested wild foods in the past 12 months;10 and yet there is a dearth of information on the contribution of traditional foods to the contemporary diet of Aboriginal and Torres Strait Islander people.7,11 Most available information is also limited to describing harvesting behaviours and preferences.11 A recent environmental study, for example, in two Australian tropical river catchments reported more than one harvesting trip per fortnight for households in which 42 different animal and plant species were collected over a two-year period. This study also described the food-sharing networks that are likely to play a crucial role in alleviating food insecurity;12 of which 31% of Aboriginal and Torres Strait Islander people living in remote communities report to experience.13Some researchers estimate that more than 90% of foods are purchased and traditional foods contribute less than 5% to dietary energy intake,5 others argue that in some contexts the proportion of purchased foods is much lower.14

This variation likely relates to the diverse study contexts, including where people live, with higher intakes of traditional foods suggested to be consumed in small outstations rather than communities and townships.14 Until recently, most estimates of population level dietary intake have been limited to store-purchased food and drinks,5–7 an extremely valuable source of data, though one the authors acknowledge is limited by a lack of information on traditional food intake. The 2011–13 National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey (NATSINPAS), which included a 24-hour dietary recall, provided the first set of dietary intake data of Aboriginal and Torres Strait Islander people nationally, though it did not aim to provide an estimate of traditional food intake.13This paper explores informant interview and self-report data relating to the: i) availability, ii) frequency and iii) variety of traditional food consumption. It also reports on the role of traditional food in alleviating food insecurity. For this study, traditional food included all native and introduced animal and plant foods procured for consumption. It was conducted as part of the SHOP@RIC study.15

Methods

Sample

A survey of contextual factors, defined as factors that may influence food purchases from the community store, was conducted in each of the 20 communities participating in the SHOP@RIC study, in the Northern Territory (NT), Australia.15 This included a rapid appraisal of traditional food availability through an interview with two key informants who had resided in the community for the previous 12 months. The study was not designed to collect comprehensive data on seasonal availability of traditional foods.

The cohort participating in the customer survey of the SHOP@RIC study15 was drawn from five very remote Aboriginal communities in the NT randomly selected from 20 study communities. All five communities had one food store, most had community-based food programs such as school nutrition and aged care meal programs and all were considered to have access to a traditional food supply from their surrounding lands. Households in each of the five communities were randomly selected and an eligible adult (i.e. community resident, plans to reside in the community for 12 months, >18 years, purchases food from the community store, and is the primary shopper) was invited to participate in a series of three surveys; pre-, post- and six-months post intervention. On completion of each survey, a $20 gift of fruit, vegetables and water was provided. The study aimed to include 150 customers in the cohort.

Data collection

The survey of contextual factors was conducted in English by a research team member, either in person or by telephone, at a time convenient to the key informant. Data were collected at two time points. As early as possible in 2014 and 2015, participants were interviewed about events in the previous year, including traditional food hunted or gathered. Initially, contact was made with the Shire/Council Services Manager of each community, who was invited to participate and recommend another suitable local person to complete the interview. The manager was selected due to their overall knowledge of a broad range of factors affecting store purchases, including population movement, community income and provision of essential services. If this manager could not be contacted, contact was made with someone in the community who was already associated with the main project to determine the most suitable people in the community to respond to these questions.

The customer survey was conducted by a research team, which included an Aboriginal community-based researcher trained in the conduct of the study. Interviews were conducted in English, with translation provided by the local researcher where necessary. The third survey (six months post intervention) was conducted from May 2014 to December 2014, in one community every two months in line with the main study design.15 This survey included a measure of frequency and variety consumption of traditional food in the preceding two weeks and questions to elicit information on the role of these foods in alleviation of food insecurity, the results of which are presented in this paper. A short script introduced the set of questions, noting that these included all hunted and gathered foods, which might be referred to by participants as traditional foods or bush foods, and included introduced species. The questions and response options were: How often do you eat traditional foods? (never, 1 day a fortnight, 1 day a week, 2–3 days a week, on most days, everyday). What type of traditional foods have you eaten? In the last 12 months, were there any times that you ran out of food, and couldn’t afford to buy more? (yes, no). If yes, how often did this happen? (once per week, once every 2 weeks, once per month, don’t know). Are there days when you don’t have enough food and feel hungry? (yes, no). What things can you do to get food on these days? Pictorial resources, with examples of foods known to be consumed across Central Australia and the Top End of the NT, grouped into similar food types, served as prompts. This study did not aim to collect data at the species level as nutrient analysis was not planned. These measures were based on a systematic review of the literature and expert consensus, and were pilot tested in line with the development of the overall customer survey.

Data analysis

The data from the contextual factor survey was entered into an Access database and exported to Excel for analysis. One author (CG) collated the data and verified with MF. Traditional food sources recalled being available over the calendar year and/or at different seasonal periods were described. The quantitative data from the customer survey were described, using Stata Version 14.0 (Stata, College Station, Texas, USA). The qualitative data from the customer survey were managed in an Access database and exported to Excel. One author (CB) allocated each individual food to one of eight categories,16 clarifying any difficult classification of foods with JB and MF.

Ethics

The study was approved by the Human Research Ethics Committee of the NT Department of Health and Menzies School of Health Research, the Central Australian Human Research Ethics Committee and Deakin University Human Research Ethics Committee. Written informed consent was obtained from all participants.

Results

Participants

At least one interview was conducted in each of the 20 study communities for the years 2013 or 2014. In 2013, 30 participants across 19 of the 20 study communities contributed to the contextual data; the participants held roles in the local council, government welfare agency, store, health centre, aged care facility, school and training and employment program. In 2014, 19 participants across 15 of the 20 study communities contributed to the repeat survey, holding roles in the local council, government welfare agency, store, health centre, community men’s program, research institute and training and employment program or were a community resident not in paid employment. In some cases, mobility from employed roles and from the community prevented repeat interview with the same informants each year.

Seventy-three participants aged 18 years or over, most of whom were female (97%), over the age of 35 years (69%) and not in paid employment (56%) contributed to the third customer survey. The participants differed marginally from the original cohort (92% female, 64% >35 years of age, 62% not in paid employment).

Annual availability of traditional food

Traditional foods were consistently reported for all 20 communities to be available year round. Informants reported hunting activity, with someone from all communities recalling a variety of animal foods that were available over the year or that hunting and fishing occurred. Informants from 15 communities across the Top End and Central Australia reported a variety of plant foods available in the previous 12 months. In four of the five communities where no plant foods were reported, it should be noted that data were only able to be collected for one of the two time points.

The survey did not intend to collect data on environmental or other impacts on the availability of the traditional food supply. It is worth noting that informants from three Top End communities and one customer survey participant from a fourth Top End community reported that goanna were in limited numbers or no longer available due to the impact of cane toads. In two Top End communities it was said that turkey were scarce or no longer available and in one of these communities, that the availability of yams had reduced due to environmental damage caused by introduced animals.

Frequency of traditional food consumption

Most (89%) participants reported consuming traditional foods on at least a fortnightly basis, in the two weeks preceding the survey. Seventy-one per cent of participants reported consuming traditional foods at least weekly.

Variety of traditional foods consumed

The variety of traditional foods reported to be available across 20 communities and consumed by participants in the five communities is reported in Table 1. There were a range of different native animal and plant foods and a smaller number of introduced animal foods recalled.

Table 1. List of the varietya of traditional foods reported to be available in communities and to be consumed in the preceding two weeks by a customer cohort.
Community data set (n=20) Participant data set (n=73)
  1. a: Foods listed as per participant response to an open-ended question which did not specify how to identify foods (e.g. as food category [e.g. seafood], food [e.g. fish] or species [e.g. barramundi]). The adjective ‘bush’ and ‘wild’ was provided at times with some foods (e.g. bush turkey and turkey). Occasionally participants used both local and English language; only the English language name is reported here.
  2. b: Echidna was often referred to as porcupine; buffalo as bullocky; cow as beef, cattle or killer.        c: The term shellfish was not used by participants in the customer cohort.
Animals
Native land animals Bandicoot, carpet snake, duck (diving duck), echidna,b emu, goanna (perentie), goose (magpie goose), honey, honey ant, kangaroo, lizard, possum, turkey, wallaby Black-headed snake, duck, echidna,b emu, goanna, goose, kangaroo, turkey
Introduced land animals Buffalo,b cow,b pig Buffalo,b cow,b pig
Fish or seafood Crab (mud crab), crocodile, crocodile egg, dugong, fish (barramundi, black bream, bream, catfish, fresh- and saltwater fish), shellfish (large creek mussel, long bum, mud mussel, mussel, oyster), prawn, stingray, turtle (long-neck turtle, sea turtle, short-neck turtle), turtle egg, water goanna Crab (mud crab), fish (barramundi, black bream, catfish, red snapper), mangrove worm, shellfishc (cone shell, long bum, mud mussel, oyster, periwinkle), stingray, turtle (long-neck turtle, sea turtle, short-neck turtle), turtle egg, water goanna
Witchetty grub Witchetty grubs Witchetty grub
Sugar bag Sugar bag
Plants
Fruit or berry Apple, banana, berry (blackcurrant, conga berry), cashew tree fruit, fruit (not specified), plum (black plum, green plum and sugar plum), sultana Apple, banana, berry, plum (black plum, green plum), raisin, sultana, tomato
Yam or root vegetables Potato, yam Potato, yam (budgu)
Other plants Bean, onion, tomato Bulb (sandy beach bulb), onion
Seed or nut Cashew tree nut Kora (seed)

The role of traditional food consumption in alleviating food insecurity

Most participants (76%) reported experiencing food insecurity. Of the coping strategies identified, 40% related to obtaining traditional food during times they went without food and 53% were borrowing food or money during these times.

Discussion

This exploratory study demonstrates that traditional food makes an important contribution to the contemporary diet of Aboriginal people living in remote NT communities. In 20 remote communities, traditional foods were reported to be available year round. A high frequency and wide variety of traditional foods were reported to be consumed by participants across five remote communities. In this exploratory study, more animal foods than plant foods were recalled to have been consumed and commonly a few animal foods predominated. Accessing traditional foods was reported to be a means of alleviating food insecurity for almost half the people who experienced food insecurity.

There are limited records of the traditional diet of Aboriginal and Torres Strait Islander people prior to European colonisation. Available reports describe gender roles, with women providing daily sustenance through collecting plant foods and small animals and men hunting large animals on a less regular basis, with the balance of plant and animal foods determined by factors including location and season.3 Studies of Canadian Aboriginal people suggest a high intake of traditional animal foods as part of the contemporary diet.17,18 This study suggests that an understanding of the contribution that animal (native and introduced) and plant foods make to the contemporary diet among Aboriginal and Torres Strait Islander people of Australia is warranted.

The frequent self-reported consumption of animal sources of traditional foods, suggests that contemporary population-level dietary assessment using store purchasing data has the potential to over-estimate nutrient deficiencies, particularly of protein, a concern we have previously raised.7,19 In Aboriginal populations elsewhere, it is estimated that traditional foods might contribute anywhere from 10% to 36% of energy and disproportionately to protein and other micronutrients,17,20–23 representing an important dietary contribution. Even weekly or fortnightly consumption of a nutrient-dense food, such as that reported to be consumed in this study, is likely to make an important contribution to the diet.11 Introduced land animal foods, such as buffalos, cattle and pigs, were reported to be hunted and consumed by participants. The contribution of introduced land animals may be influenced by availability and in some areas may be well integrated into the traditional food system.5 In the absence of volume consumption data, it is not possible to draw conclusions on the dietary contribution of introduced land animals. Although these foods contribute to dietary protein intake, the higher quantity of fat and poorer fatty acid profile, compared with native animal foods, is worth noting.3

We have demonstrated that it is possible to measure frequency consumption and to some extent variety of traditional foods consumed – in fact, our impression was that people enjoyed talking about these foods. We acknowledge the limitations of traditional dietary assessment methods, including additional challenges in remote contexts such as the practice of sharing community meals,12,24–27 though also consider that attributes such as the high regard given to traditional food, may aid assessment.24,27,28 Studies have demonstrated how standard tools can be modified to assess individual dietary intake with Aboriginal populations29 and lessons can be learnt from previous dietary survey work in remote Australian Aboriginal communities.15,26

Comprehensive assessment of traditional food consumption would serve a number of purposes. These data would provide an understanding of the different types of traditional foods consumed and the contribution they make to the contemporary diet of Aboriginal people across Australia. This information would assist in developing targeted strategies to ensure sustainable access and increased consumption of traditional foods. This study was not designed to examine differences in consumption of traditional foods across age, gender and other population groups. International studies in Aboriginal populations have found higher intakes of nutrient-poor store foods in young people and higher intakes of traditional foods in older people.17,22,23,30,31 In addition to contributing to improved health through dietary intake, the socio-cultural contribution and opportunity for physical activity that traditional foods provide is important to recognise.21,32,33 The impact that climate change, changes in the natural environment and development policies regarding land and sea use may have on traditional food use and thus health and wellbeing is critical to understand.12,32,34 Although not designed to collect information on environmental and other impacts on traditional food, this study suggests that introduced animals are affecting the availability of small animal and plant foods, at least in the Top End of the NT.

In addition to being nutritionally superior, traditional foods are considered to be a low-monetary form of sustenance, important in a context where people generally have low incomes and where the cost of food is high.12,18,20,35 Similar to our findings, 40% of coastal urban-dwelling Aboriginal people reported increased access of wild resources at times of financial hardship.32 In a small Western Australian outstation, hunting for various types of wild foods has been shown to respond differently to market and economic scarcity.33 The harvest of traditional foods and food sharing networks reduce the reliance on the market economy,10,12 important in a context where high numbers of people report to be food insecure. Others share our opinion that further understanding the role of traditional foods in the diet and in alleviating food insecurity36 is crucial in an environment where few, if any, significant changes are occurring in terms of the high cost of food and prevailing low-income levels.

Data regarding the contribution of traditional foods in the diet and role in livelihoods of Aboriginal people living in remote communities will be important in relation to broader environmental and social policy making. Evidence of the contribution of traditional foods to the contemporary diet of remote Aboriginal people is crucial to informing broader government policy that affects where people live, how they are educated, employment and other livelihood opportunities.10 It has been suggested that the use of traditional foods may be gaining interest nationally and internationally, and in addition to being good for human and environmental health, could provide economic and employment opportunities for Aboriginal and Torres Strait Islander Australians.37 There is a developing interest in sustainability of traditional foods in environmental protection efforts,12 such as working with Aboriginal people to develop adaption strategies to mitigate the impact of climate change on the environment and traditional food supply.32,34 Similarly, traditional food data are used internationally to maintain and improve availability and access to traditional foods as a result of global warming and environmental insults, such as contamination.17,18,21

There are three limitations related to our survey methodology. First, this study relies on self-report data, which is considered to be biased by recall and reporting. To address this, the data were collected through a facilitated recall methodology,38 which improves recall through the use of locally relevant prompts and questions.39 While respondents were asked to recall intake in the preceding two weeks only, it is possible that foods consumed beyond this timeframe were recalled. Second, the individual dietary data was collected from participants in only five remote NT communities; however, these were randomly selected from a larger sample of 20 communities and were spread across the NT. Third, the data were collected based on recall of a two-week period from participants in each community. Normally, frequency consumption data would be collected over a longer period to account for factors such as seasonality, although it has been collected in some studies for shorter periods.17 It was not within the scope of this study to collect longer-term data. The data were, however, collected over a 10-month period from the five communities, two months apart and have been supported by annual availability of traditional foods data from key informants across 20 communities. The key limitation in relation to the semi-structured interviews was that the key informants did not always include an Aboriginal person from each community and so reports of annual availability of traditional foods are likely to be conservative.

Implications

Although focused on availability, frequency and variety, this study provides an important step in improving non-Aboriginal knowledge of the contribution of traditional food in the contemporary diet of Aboriginal Australians living in remote Australia. This study suggests that it is possible to collect data regarding the contribution of traditional foods to diet. These data would complement population-level data collected through community store sales. Data of the nutrient profiles of many traditional foods exists and continues to be built on in Australia. Through a strong collaboration with Aboriginal people, methods for conducting individual dietary assessment of traditional food intake could be developed, which could include methodologies such as repeated 24-hour recall, visual recall40 and food frequency questionnaires, resulting in validated tools for ongoing use in this context. Our limited data, combined with national and international evidence suggest that priorities should include understanding differences across ages, gender, education and employment status and across remote, regional and urban areas in Australia. It is crucial that these processes align with developments in the broader environmental and societal work in this area.

Acknowledgements

The authors are grateful to community residents who provided data and acknowledge that the ownership of Aboriginal knowledge and cultural heritage is retained by the informant. The authors thank Prof Kylie Ball, Anthony Gunther, Elaine Maypilama and Carrie Turner who contributed to the development of the customer survey, those who assisted with pilot testing the customer survey and Federica Barzi who assisted with analyses. The Stores Healthy Options Project in Remote Indigenous Communities was funded by the National Health and Medical Research Council (1024285). The contents of the published material are solely the responsibility of the individual authors and do not reflect the views of the NHMRC. Julie Brimblecombe is supported through a National Heart Foundation Fellowship (100085