NACCHO NEWS ALERT: COAG Health Ministers Council Communique acknowledge the importance #ACCHO’s advancing Aboriginal health

 

  Included in this NACCHO Aboriginal Health News Alert

  1. All issues 11 included in  Communique highlighting ACCHO health
  2. Health Ministers approve Australia’s National Digital Health Strategy
  3. Transcript Health Minister Hunt Press Conference

” The Federal Minister for Indigenous Health, Ken Wyatt, attended the COAG Health Council discussed the Commonwealth’s current work on Indigenous health priorities.

In particular this included the development of the 2018 iteration of the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013-2023 that will incorporate strategies and actions to address the social determinants and cultural determinants of health.

Ministers also considered progress on other key Indigenous health issues including building workforce capability, cultural safety and environmental health, where jurisdictions can work together more closely with the Commonwealth to improve outcomes for Aboriginal and Torres Strait Islander peoples.

Ministers acknowledged the importance of collaboration and the need to coordinate activities across governments to support a culturally safe and comprehensive health system.

Ministers also acknowledge the importance of community controlled organisations in advancing Aboriginal and Torres Strait Islander health. ”

1.Development of the next iteration of the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013–2023 COAG Health Council 

Read over 50 NACCHO NATSIHP Articles published over past 50 years

INTRODUCTION

The federal, state and territory Health Ministers met in Brisbane on August 4 at the COAG Health Council to discuss a range of national health issues.

The meeting was chaired by the Victorian Minister for Health, the Hon Jill Hennessy MP.

Health Ministers welcomed the New South Wales Minister for Mental Health, the Hon Tanya Davies MP, the Victorian Minister for Mental Health, the Hon Martin Foley MP, the ACT Minister for Mental Health Mr Shane Rattenbury and the Minister for Aged Care and Minister for Indigenous Health, the Hon Ken Wyatt AM, MP who participated in a joint discussion with Health Ministers about mental health issues.

Major items discussed by Health Ministers today included:

2.Andrew Forrest and the Eliminate Cancer Initiative

Mr Andrew Forrest joined the meeting to address Health Ministers in his capacity as Chairman of the Minderoo Foundation to discuss the Eliminate Cancer Initiative. The Minderoo Foundation is one of Autralia’s largest and most active philanthropic groups. It has established the Eliminate Cancer Initiatve (the Initiative), a global initiative dedicated to making cancer non-lethal with some of the world’s leading global medicine and anti-cancer leaders.

The Initiative is a united effort to convert cancer into a non-lethal disease through global collaboration of scientific, medical and academic institutes, commercially sustained through the support of the philanthropic, business and government sectors worldwide.

Australia has a critical role to play in this highly ambitious and thoroughly worthwhile goal.

3.Family violence and primary care

Today, Health Ministers discussed the significant health impacts on those people experiencing family violence.

Health Ministers acknowledged that health-care providers, particularly those in a primary care setting, are in a unique position to create a safe and confidential environment to enable the disclosure of violence, while offering appropriate support and referrals to other practitioners and services.

Recognising the importance of national leadership in this area, Ministers agreed to develop a plan to address barriers to primary care practitioners identifying and responding to patients experiencing family violence.

Ministers also agreed to work with the Royal Australian College of General Practitioners to develop and implement a national training package.

Further advice will be sought from Primary Health Networks on existing family violence services, including Commonwealth, State and NGO service providers in their regions, with a view to developing an improved whole-of-system responses to the complex needs of clients who disclose family violence

4.Fifth National Mental Health and Suicide Prevention Plan

Health Ministers endorsed the Fifth National Mental Health and Suicide Prevention Plan 2017-2022 and its Implementation Plan.

The Fifth Plan is focused on improvements across eight targeted priority areas:

1. Achieving integrated regional planning and service delivery

2. Effective suicide prevention

3. Coordinated treatment and supports for people with severe and complex mental illness

4. Improving Aboriginal and Torres Strait Islander mental health and suicide prevention

5. Improving the physical health of people living with mental illness and reducing early mortality

6. Reducing stigma and discrimination

7. Making safety and quality central to mental health service delivery

8. Ensuring that the enablers of effective system performance and system improvement are in place

The Fifth Plan also responds to calls for a national approach to address suicide prevention and will be used to guide other sectors and to support health agencies to interact with other portfolios to drive action in this priority area.

Ongoing collaboration and engagement across the sector and with consumers and carers is required to successfully implement the Fifth Plan and achieve meaningful reform to improve the lives of people living with mental illness including the needs of children and young people.

Health Ministers also agreed that mental health workforce issues would be considered by the Australian Health Ministers’ Advisory Council.

5.The National Psychosocial Supports Program

Health Ministers agreed to establish a time-limited working group to progress the Commonwealth’s National Psychosocial Supports program. This will have the objective of developing bilateral agreements to support access to essential psychosocial supports for persons with severe mental illness resulting in psychosocial disability who are not eligible for the NDIS.

Those bilateral agreements will take into account existing funding being allocated for this purpose by states and territories.

6.Strengthened penalties and prohibition orders under the Health Practitioner Regulation National Law

Health Ministers agreed to proceed with amendments to the Health Practitioner Regulation National Law (the National Law) to strengthen penalties for offences committed by people who hold themselves out to be a registered health practitioner, including those who use reserved professional titles or carry out restricted practices when not registered.

Ministers also agreed to proceed with an amendment to introduce a custodial sentence with a maximum term of up to three years for these offences.

These important reforms will be fast tracked to strengthen public protection under the National Law. Preparation will now commence on a draft amendment bill to be brought forward to Ministers for approval, with a view to this being introduced to the Queensland Parliament in 2018. The Western Australian Parliament is also expected to consider legislative changes to the Western Australian National Law.

7.Amendment to mandatory reporting provisions for treating health practitioner

Health Ministers agree that protecting the public from harm is of paramount importance as is supporting practitioners to seek health and in particular mental health treatment as soon as possible.

Health Ministers agreed that doctors should be able to seek treatment for health issues with confidentiality whilst also preserving the requirement for patient safety.

A nationally consistent approach to mandatory reporting provisions will provide confidence to health practitioners that they can feel able to seek treatment for their own health conditions anywhere in Australia.

Agree for AHMAC to recommend a nationally consistent approach to mandatory reporting, following discussion paper and consultation with consumer and practitioner groups, with a proposal to be considered by COAG Health Council at their November 2017 meeting, to allow the amendment to be progressed as part of Tranche 1A package of amendments and related guidelines.

8.National Digital Health Strategy and Australian Digital Health Agency Forward Work Plan 2018–2022

Health Ministers approved the National Digital Health Strategy and the Australian Digital Health Agency Work Plan for 2018-2022.

Download Strategy and work plan here  

The Strategy has identified the priority areas that form the basis of Australia’s vision for digital health.

This Strategy will build on Australia’s existing leadership in digital health care and support consumers and clinicians to put the consumer at the centre of their health care and provide choice, control and transparency.

Expanding the public reporting of patient safety and quality measures

Health Ministers supported Queensland and other interested jurisdictions to collaboratively identify options in relation to aligning patient safety and quality reporting standards across public and private hospitals nationally.

Ministers agreed that the Australian Commission on Safety and Quality in Health Care (ACSQHC) would undertake work with other interested jurisdictions to identify options in relation to aligning public reporting standards of quality healthcare and patient safety across public and private hospitals nationally.

The work be incorporated into the national work being progressed on Australia’s health system performance information and reporting frameworks.

 

9.National human biomonitoring program

Health Ministers noted that human biomonitoring data can play a key role in identifying chemicals which potentially cause adverse health effects and action that may need to be taken to protect public health.

Health Ministers agreed that a National Human Biomonitoring Program could be beneficial in assisting with the understanding of chemical exposures in the Australian population.

Accordingly, Ministers agreed that the Australian Health Ministers’ Advisory Council will explore this matter in more detail by undertaking a feasibility assessment of a National Human Biomonitoring Program.

Clarification of roles, responsibilities and relationships for national bodies established under the National Health Reform Agreement

States and territories expressed significant concern that the proposed Direction to IHPA will result in the Commonwealth retrospectively not funding activity that has been already delivered by states and territories but not yet funded by the Commonwealth.

States and territories were concerned that this could reduce services to patients going forward as anticipated funding from the Commonwealth will be less than currently expected.

The Commonwealth does not agree with the concerns of the states and territories and will seek independent advice from the Independent Hospital Pricing Authority (IHPA) to ensure hospital service activity for 2015-2016 has been calculated correctly. The Commonwealth committed to work constructively and cooperatively with all jurisdictions to better understand the drivers of increased hospital services in funding agreements.

10.Legitimate and unavoidable costs of providing public hospital services in Western Australia

Health Ministers discussed a paper by Western Australia on legitimate and unavoidable costs of providing public hospital services in Western Australia, particularly in regional and remote areas, and recognised that those matters create a cumulative disadvantage to that state. Health Ministers acknowledged that Western Australia will continue to work with the Commonwealth Government and the Independent Hospital Pricing Authority to resolve those matters.

11.Vaccination

Health Ministers unanimously confirmed the importance of vaccination and rejected campaigns against vaccination.

All Health Ministers expressed their acknowledgement of the outgoing Chair, the Hon Ms Jill Hennessy and welcomed the incoming Chair Ms Meegan Fitzharris MLA from the Australian Capital Territory.

Health Ministers approve Australia’s National Digital Health Strategy

Digital information is the bedrock of high quality healthcare.

The benefits for patients are signicant and compelling: hospital admissions avoided, fewer adverse drug events, reduced duplication of tests, better coordination of care for people with chronic and complex conditions, and better informed treatment decisions. Digital health can help save and improve lives.

To support the uptake of digital health services, the Council of Australian Governments (COAG) Health Council today approved Australia’s National Digital Health Strategy (2018-2022).

Download Strategy and work plan here  

In a communique issued after their council meeting in Brisbane August 4 , the Health Ministers noted:

“The Strategy has identified the priority areas that form the basis of Australia’s vision for digital health. It will build on Australia’s existing leadership in digital health care and support consumers and clinicians to put the consumer at the centre of their health care and provide choice, control, and transparency.”

Australian Digital Health Agency (ADHA) CEO Tim Kelsey welcomed COAG approval for the new Strategy.

“Australians are right to be proud of their health services – they are among the best, most accessible, and efficient in the world.

Today we face new health challenges and rapidly rising demand for services. It is imperative that we work together to harness the power of technology and foster innovation to support high quality, sustainable health and care for all, today and into the future,” he said.

The Strategy – Safe, seamless, and secure: evolving health and care to meet the needs of modern Australia – identifies seven key priorities for digital health in Australia including delivery of a My Health Record for every Australian by 2018 – unless they choose not to have one.

More than 5 million Australians already have a My Health Record, which provides potentially lifesaving access to clinical reports of medications, allergies, laboratory tests, and chronic conditions. Patients and consumers can access their My Health Record at any time online or on their mobile phone.

The Strategy will also enable paper-free secure messaging for all clinicians and will set new standards to allow real-time sharing of patient information between hospitals and other care professionals.

Australian Medical Association (AMA) President Dr Michael Gannon has welcomed the Strategy’s focus on safe and secure exchange of clinical information, as it will empower doctors to deliver improved patient care.

“Doctors need access to secure digital records. Having to wade through paperwork and chase individuals and organisations for information is

archaic. The AMA has worked closely with the ADHA on the development of the new strategy and looks forward to close collaboration on its implementation,” Dr Gannon said.

Royal Australian College of General Practitioners (RACGP) President Dr Bastian Seidel said that the RACGP is working closely and collaboratively with the ADHA and other stakeholders to ensure that patients, GPs, and other health professionals have access to the best possible data.

“The Strategy will help facilitate the sharing of high-quality commonly understood information which can be used with confidence by GPs and other health professionals. It will also help ensure this patient information remains confidential and secure and is available whenever and wherever it is needed,” Dr Seidel said.

Pharmacy Guild of Australia National President George Tambassis said that technology would increasingly play an important role in supporting sustainable healthcare delivery.

“The Guild is committed to helping build the digital health capabilities of community pharmacies and advance the efficiency, quality, and delivery of healthcare to improve health outcomes for all Australians.

“We are working with the ADHA to ensure that community pharmacy dispensing and medicine-related services are fully integrated into the My Health Record – and are committed to supporting implementation of the National Digital Health Strategy as a whole,” George Tambassis said.

Pharmaceutical Society of Australia (PSA) President Dr Shane Jackson said that the Strategy would support more effective medicationmanagement, which would improve outcomes for patients and improve the efficiency of health services.

“There is significant potential for pharmacists to use digital health records as a tool to communicate with other health professionals, particularly during transitions of care,” Dr Jackson said.

The Strategy will prioritise development of new digital services to support newborn children, the elderly, and people living with chronic disease. It will also support wider use of telehealth to improve access to services, especially in remote and rural Australia and set standards for better information sharing in medical emergencies – between the ambulance, the hospital, and the GP.

Consumers Health Forum (CHF) Leanne Wells CEO said that the Strategy recognises the importance of empowering Australians to be makers and shapers of the health system rather than just the users and choosers.

“We know that when consumers are activated and supported to better self-manage and coordinate their health and care, we get better patient experience, quality care, and better health outcomes.

“Digital health developments, including My Health Record, are ways in which we can support that to happen. It’s why patients should also be encouraged to take greater control of their health information,” Leanne Wells said.

Medical Software Industry Association (MSIA) President Emma Hossack said that the Strategy distils seven key themes that set expectations at a national level.“The strategy recognises the vital role industry plays in providing the smarts and innovation on top of government infrastructure.

This means improved outcomes, research, and productivity. Industry is excited to work with the ADHA to develop the detailed actions to achieve the vision which could lead to Australia benefitting from one of the strongest health software industries in the world,” Emma Hossack said.

Health Informatics Society of Australia (HISA) CEO Dr Louise Schaper welcomed the Strategy’s focus on workforce development.

“If our complex health system is to realise the benefits from information and technology, and become more sustainable, we need clinical leaders with a sound understanding of digital health,” Dr Schaper said.

The Strategy was developed by all the governments of Australia in close partnership with patients, carers and the clinical professionals who serve them – together with leaders in industry and science.

The Strategy draws on evidence of clinical and economic benefit from many sources within Australia and overseas, and emphasises the priority of patient confidentiality as new digital services are implemented.

The ADHA has established a Cyber Security Centre to ensure Australian healthcare is at the cutting edge of international data security.

The ADHA, which has responsibility for co-ordinating implementation of the Strategy, will now be consulting with partners across the community to develop a Framework for Action. The framework will be published later this year and will detail implementation plans for the Strategy.

The National Digital Health Strategy Safe, seamless and secure: evolving health and care to meet the needs of modern Australia is available on

https://www.digitalhealth.gov.au/australias-national-digital-health-strategy (https://www.digitalhealth.gov.au/australias-national-digital-health-strategy)

Greg Hunt Press Conference

Topics: COAG Health Council outcomes; The Fifth National Mental Health and Suicide Prevention Plan; support for doctors and nurses mental health; hospital funding; same-sex marriage

GREG HUNT:
Today was a huge breakthrough in terms of mental health. The Fifth National Mental Health Plan was approved by the states.

What this is about is enormous progress on suicide prevention. It has actually become the Fifth National Mental Health and Suicide Prevention Plan, so a real focus on suicide prevention.

In particular, the focus on what happens when people are discharged from hospital, the group in Australia that are most likely to take their own lives.

We actually know not just the group, but the very individuals who are most at risk. That’s an enormous step.

The second thing here is, as part of that plan, a focus on eating disorders, and it is a still-hidden issue. In 2017, the hidden issue of eating disorders, of anorexia and bulimia, and the prevalence and the danger of it is still dramatically understated in Australia.

The reality is that this is a silent killer and particularly women can be caught up for years and years, and so there’s a mutual determination, a universal determination to progress on eating disorders, and that will now be a central part of the Fifth National Mental Health and Suicide Prevention Plan.

And also, as part of that, we’ve included, at the Commonwealth’s request today, a real focus on early intervention services for young people under 16. Pat McGorry has referred to it as CATs for Kids, meaning Crisis Assessment Teams, and the opportunity.

And this is a really important step because, for many families, when they have a crisis, there’s nowhere to turn. This is a way through. So those are all enormous steps forward.

The other mental health area where we’ve made big, big progress is on allowing doctors to seek routine mental health treatment.

There’s an agreement by all of the states and territories to work with the Commonwealth on giving doctors a pathway so as they can seek routine mental health treatment without being reported to the professional bodies.

JOURNALIST:
What has led to the increased focus on eating disorders? Has there been an uptick in the number of suicides resulting from that, or has there been an uptick in the number of cases?

GREG HUNT:
No, this has been silently moving along. It’s a personal focus. There are those that I have known, and then when we looked the numbers shortly after coming in, and dealt with organisations such as the Butterfly Foundation, they explained that it’s been a high level issue with the worst rate of loss of life amongst any mental health condition.

And so that’s a combination both of suicide, but also of loss of life due to physical collapse. And so it’s what I would regard as a personal priority from my own experience with others, but then the advocacy of groups like Butterfly Foundation has finally landed. It should’ve happened earlier, but it’s happening on our watch now.

JOURNALIST:
That would be my next question, is that I’m sure advocacy groups will say this is great that it’s happened, but it’s taken the Government so long. Why is it that you’re focussing on it now as opposed to…?

GREG HUNT:
I guess, I’ve only just become Minister. So from day one, this is one of the things I’ve wanted to do, and I’m really, personally, deeply pleased that we’ve made this enormous progress.

So I would say this, I can’t speak for the past, it is overdue, but on our watch collectively we’ve taken a huge step forward today.

Then the last thing is I’ve seen some reports that Queensland and Victoria may have been upset that some of their statistical anomalies were referred to what’s called IHPA (Independent Hospital Pricing Authority).

The reason why is that some of their figures simply didn’t pass the pub test.

The independent authority will assess them, but when you have 4000 per cent growth in one year in some services, 3300 per cent growth in some years in other services, then it would be negligent and irresponsible not to review them.

It may be the case that there was a more than 40-fold increase in some services, but the only sensible thing for the Commonwealth to do is to review it.

But our funding goes up each year every year at a faster rate than the states’ funding, and it’s gone up by $7.7 billion dollars since the current health agreement with the states was struck.

JOURNALIST:
Is that, sorry, relating to private health insurance, or is that something separate?

GREG HUNT:
No, that’s just in relation to, a couple of the states lodged claims for massive growth in individual items.

JOURNALIST:
Thank you. So was there a directive given today regarding private health policies to the states? Was that something that was discussed or something that …?

GREG HUNT:
Our paper was noted, and the states will respond. So we’ve invited the states to respond, they’ll respond individually.

JOURNALIST:
And regarding that mental health plan, besides their new focus on eating disorders, how is it different from previous mental health plans?

GREG HUNT:
So, a much greater focus on suicide prevention, a much greater focus on eating disorders, and a much greater focus on care for young children under 16.

JOURNALIST:
Is that something that you can give more specific details about? You’re saying there’s a much greater focus, but is there any specific information about what that would mean?

GREG HUNT:
As part of the good faith, the Commonwealth, I’ve written to the head of what’s called the Medical Benefits Schedule Review, so the Medicare item review, Professor Bruce Robinson and asked him and their team to consider, for the first time, specific additional treatment, an additional treatment item and what would be appropriate for eating disorders.

NACCHO Aboriginal Mental Health : Download report “Mental health in remote and rural communities “

 ” The poorer mental health of remote and rural Indigenous Australians is also impacted by the social determinants of Indigenous health, which are well recognised nationally and internationally.

These relate to the loss of language and connection to the land, environmental deprivation, spiritual, emotional and mental disconnectedness, a lack of cultural respect, lack of opportunities for self-determination, poor educational attainment, reduced opportunities for employment, poor housing, and negative interactions with government systems

The relationship of remoteness to health is particularly important for Indigenous Australians, who are overrepresented in remote and rural Australia (Australian Institute of Health and Welfare, 2014a).

The National Mental Health Commission (2014a, p. 19) identified that “the mental health needs of Aboriginal and Torres Strait Islander people are significantly higher than those of other Australians.”

Photo above

“ The women of Inkawenyerre, a small settlement in the Utopia community four hours by road north of Alice Springs, regularly take part in a different kind of mental health therapy, known as ‘narrative therapy.’

Narrative therapy taps into the centuries-old tradition among Aboriginal people of story-telling and expression through art. At the family Urapuntja Clinic, both women and children take part in narrative therapy.

They recreate what is commonly seen on any given evening in an Aboriginal community—people sitting around the fire, relating to one another and telling stories.

The activity is enjoyable for participants with group members often laughing and supporting one another as they tell stories and work on their painting—all while promoting good mental health living practice,”

Lynne Henderson, former RFDS Central Operations mental health clinician.

“People who live in the country get less access to care. And they become sicker,”

To increase the access to care, the RFDS said it needed a massive increase in funding. Country Australians see mental health professionals at only a fifth the rate of those who live in the city,

So there should be a five-fold increase in access to mental health care for country Australians.”

RFDS CEO Martin Laverty see story Part 2 below

Mental health in remote and rural communities

Mental health disorders are not more common in rural and regional Australia than they are in Australia’s cities, according to a new report from the Royal Flying Doctor Service (RFDS), but they are a lot harder to treat.

The report, Mental Health in Remote and Rural Communities, found about one in five remote and rural Australians — 960,000 people — experience mental illness.

Download the report HERE

RN031_Mental_Health_D5

But a combination of lack of access to facilities, social stigma, and cultural barriers present challenges to getting people the help they need.

AHCRA believes that’s something that everyone should be concerned about, with access to care regardless of location.

 

Part 1  Indigenous mental health and suicide

Data from the 2011 Australian Census demonstrated that 669,881 Australians, or 3% of the population, identified as Indigenous (Australian Bureau of Statistics, 2013b), and that 142,900 Indigenous Australians, or 21% of the Indigenous population, lived in remote and very remote areas (Australian Institute of Aboriginal and Torres Strait Islander Studies, 2014).

Around 45% of people in very remote Australia (91,600 people), and 16% of people in remote Australia (51,300 people) were Indigenous (Australian Bureau of Statistics, 2013b; Australian Institute of Aboriginal and Torres Strait Islander Studies, 2014).

In 2011–2012 around one-third (30%) of Indigenous adults reported high or very high levels of psychological distress—almost three times the rate for non-Indigenous Australians (Australian Bureau of Statistics, 2014).

In 2008–2012, in NSW, Queensland (Qld), WA, SA and the NT, there were 347 Indigenous deaths11 from mental health-related conditions (Australian Institute of Health and Welfare,

2015a). Specifically, age-standardised death data demonstrated that Indigenous Australians (49 per 100,000 population) were 1.2 times as likely as non-Indigenous Australians (40 per 100,000 population) to die from mental and behavioural disorders (Australian Institute of Health and Welfare, 2015a). Age-standardised deaths from mental and behavioural disorders increased with increasing age in both Indigenous and non-Indigenous Australians in 2008–2012.

Very few Indigenous and non-Indigenous Australians under the age of 35 years died as result of mental and behavioural disorders in 2008–2012. However, Indigenous Australians aged 35 years or older were more likely to die from mental and behavioural disorders than non-Indigenous

Australians in 2008–2012. Specifically, Indigenous Australians (7.2 per 100,000 population) aged 35–44 years were 5.7 times as likely as non-Indigenous Australians (1.3 per 1200,000 population) to die from mental and behavioural disorders (Australian Institute of Health and

Welfare, 2015a). In 2008–2012, Indigenous Australians (14.7 per 100,000 population) aged 45–54 years were 4.9 times as likely as non-Indigenous Australians (3.0 per 100,000 population) to die from mental and behavioural disorders (Australian Institute of Health and Welfare, 2015a).

In 2008–2012, Indigenous Australians (18.3 per 100,000 population) aged 55–64 years were 2.7 times as likely as non-Indigenous Australians (6.9 per 100,000 population) to die from mental and behavioural disorders (Australian Institute of Health and Welfare, 2015a). In 2008–2012,

Indigenous Australians (91.2 per 100,000 population) aged 65–74 years were 2.9 times as likely

as non-Indigenous Australians (31.3 per 100,000 population) to die from mental and behavioural disorders (Australian Institute of Health and Welfare, 2015a).

Further exploration of death data from mental and behavioural disorders illustrates the significant impact of psychoactive substance use (ICD-10-AM codes F10–F19) on Indigenous mortality (Australian Institute of Health and Welfare, 2015a). In 2008–2012, 29.1% of Indigenous deaths due to mental and behavioural disorders were the result of psychoactive substance use, such as alcohol, opioids, cannabinoids, sedative hypnotics, cocaine, other stimulants such as caffeine, hallucinogens, tobacco, volatile solvents, or multiple drug use. During this period, Indigenous Australians (7.3 per 100,000 populations) were 4.8 times as likely as non-Indigenous Australians to die as a result of psychoactive substance use (Australian Institute of Health and Welfare, 2015a).

Similarly, in 2006–2010, there were 312 Indigenous deaths from mental health-related conditions (Australian Institute of Health and Welfare, 2013a). Indigenous Australians living in NSW, Qld, WA, SA and the NT were 1.5 times as likely as non-Indigenous Australians to die from mental and behavioural disorders in 2006–2010 (Australian Institute of Health and Welfare, 2013a).

11 Deaths from mental and behavioural disorders do not include deaths from intentional self-harm (suicide). Intentional self-harm is coded under ICD-10-AM Chapter 19—Injury, poisoning and certain other consequences of external causes.

Age-standardised death data demonstrated that Indigenous males (49 per 100,000 population) were 1.7 times as likely as non-Indigenous males to die from mental and behavioural disorders. Indigenous females were 1.3 times as likely as non-Indigenous females to die from mental and behavioural disorders (Australian Institute of Health and Welfare, 2013a).

The greater number of deaths from mental and behavioural disorders with age may also represent the impact of conditions associated with ageing, such as dementia. For example, in 2014, Indigenous Australians (50.7 per 100,000 population) in NSW, Qld, SA, WA and the NT were 1.1 times as likely as non-Indigenous Australians (45.3 per 100,000 population) to die from dementia (including Alzheimer disease) (Australian Bureau of Statistics, 2016a).

In 2014–2015, Indigenous Australians (28.3 per 1,000 population) were 1.7 times as likely as non-Indigenous Australians (16.3 per 1,000 population) to be hospitalised for mental and behavioural disorders (Australian Institute of Health and Welfare, 2016a).

In 2011–2013, 4.2% of Indigenous hospitalisations were for mental and behavioural disorders (Australian Institute of Health and Welfare, 2015a). Age-standardised data demonstrated that Indigenous Australians (27.7 per 1,000 population) were twice as likely as non-Indigenous Australians (14.2 per 1,000 population) to be hospitalised for mental and behavioural disorders in 2011–2013 (Australian Institute of Health and Welfare, 2015a).

In 2008–2009, Indigenous young people aged 12–24 years (2,535 per 100,000 population) were three times as likely to be hospitalised for mental and behavioural disorders than non-Indigenous young people (Australian Institute of Health and Welfare, 2011).

 

The leading causes of hospitalisation for mental and behavioural disorders amongst Indigenous young people were schizophrenia (306 per 100,000 population), alcohol misuse (348 per 100,000 population) and reactions to severe stress (266 per 100,000 population) (Australian Institute of Health and Welfare, 2011).

A preliminary clinical survey of 170 Aboriginal and Torres Strait Islander Australians in Cape York and the Torres Strait, aged 17–65 years, with a diagnosis of a psychotic disorder, was undertaken to describe the prevalence and characteristics of psychotic disorders in this population (Hunter, Gynther, Anderson, Onnis, Groves, & Nelson, 2011).

Researchers found that: 62% of the sample had a diagnosis of schizophrenia, 24% had substance-related psychoses, 8% had affective psychoses, 3% had organic psychoses and 3% had brief reactive psychoses; Indigenous Australians aged 30–39 years were overrepresented in the psychosis sample compared to their representation in the population (37% of sample versus 29% of population) with slightly lower proportions in the 15–29 years and 40 years and older age groups; almost three-quarters (73%) of the sample were male (versus 51% for the Indigenous population as a whole); Aboriginal males (63% in the sample compared to 46% for the region as a whole) were overrepresented; a higher proportion of males (42%) than females (5%), and Aboriginal (44%) than Torres Strait Islander patients (10%) had a lifetime history of incarceration; comorbid intellectual disability was identified for 27% of patients, with a higher proportion for males compared to females (29% versus 20%) and Aboriginal compared to Torres Strait Islander patients (38% versus 7%); and alcohol misuse (47%) and cannabis use (52%) were believed to have had a major role in the onset of psychosis (Hunter et al., 2011).

In 2015, Indigenous Australians (25.5 deaths per 100,000 population) in Qld, SA, NT, NSW and WA were twice as likely as non-Indigenous Australians (12.5 deaths per 100,000 population) to die from suicide (Australian Bureau of Statistics, 2016b). In their spatial analysis of suicide, Cheung et al. (2012) concluded that higher rates of suicide in the NT and in some remote areas could be explained by the large numbers of Indigenous Australians living in these areas, who demonstrate higher levels of suicide compared with the general population.

The poorer mental health of remote and rural Indigenous Australians is also impacted by the social determinants of Indigenous health, which are well recognised nationally and internationally.

These relate to the loss of language and connection to the land, environmental deprivation, spiritual, emotional and mental disconnectedness, a lack of cultural respect, lack of opportunities for self-determination, poor educational attainment, reduced opportunities for employment, poor housing, and negative interactions with government systems

Part 2 Flying Doctors fight barriers to treat mental illness in rural Australia

Source ABC

Like so many in the bush, Brendan Cullen has a lot on his plate.

He manages a 40,000-hectare property south of Broken Hill. There are 8,000 sheep to keep track of. And that’s just a fraction of the number he looked after previously at another station.

A few years ago, the mustering, the maintenance, juggling bills and family — it all caught up to him.

“You just bottle stuff up. And sometimes you can’t find an out,” he said.

“In the bush you have a lot of time by yourself.”

He spent a lot of that time thinking about his problems. But Mr Cullen was lucky.

He heard about a mental health clinic being run by the Royal Flying Doctor Service (RFDS) in a nearby community and decided to go along.

“Catching up with one of the mental health nurses gave me the tools to be able to work out how I go about living a day-to-day life,” he said.

“My life’s a hell of a lot easier now than what it used to be.”

Mental health disorders are not more common in rural and regional Australia than they are in Australia’s cities, according to a new report from the RFDS, but they are a lot harder to treat.

The report, Mental Health in Remote and Rural Communities, found about one in five remote and rural Australians — 960,000 people — experience mental illness.

But a combination of lack of access to facilities, social stigma, and cultural barriers present challenges to getting people the help they need.

“People who live in the country get less access to care. And they become sicker,” RFDS CEO Martin Laverty said.

To increase the access to care, the RFDS said it needed a massive increase in funding.

“Country Australians see mental health professionals at only a fifth the rate of those who live in the city,” Mr Laverty said.

“So there should be a five-fold increase in access to mental health care for country Australians.”

The impact of distance and isolation when it comes to treating mental disorders can be seen in suicide rates. In remote Australia, the rate is nearly twice what it is in major metropolitan areas — 19.6 deaths per 100,000 people.

The suicide rate is even greater in very remote communities.

If you or anyone you know needs help:

The RFDS has responded by increasing its mental health outreach. In communities like Menindee, about an hour’s drive from Broken Hill in the far west of New South Wales, a mental health nurse is on call once a fortnight.

“I have needed them in the past. I got down to rock bottom at one stage. Even now I appreciate that support,” Menindee resident Margot Muscat said.

Ms Muscat plays an active role in the remote community. But she has also felt pressure in the past to manage that role, her work, and family commitments.

Mental health counselling has given her a valuable outlet.

“Just to know that I wasn’t alone. And that you don’t have to take the drastic step of suiciding, so to speak,” Ms Muscat said.

Some the RFDS’s mental health counselling is done over the airwaves. From its regional base in Broken Hill, mental health nurse Glynis Thorp counsels patients over the phone. Often calls are simply people checking in.

“It’s critically important…often there might only be two people on the property. So no one to talk to maybe,” she said.

“We might get out to a clinic every fortnight, but we might have follow up phone calls to check how people are going. For myself it’s probably a ratio of four to one.”

The RFDS report reveals every year hundreds of serious mental illness incidents require airplanes to be dispatched to remote areas to fly patients out for treatment.

Over three years from July 2013 the RFDS conducted 2,567 ‘aeromedical retrievals’.

The leading causes for evacuation flights due to mental disorder are

The RFDS also uses airplanes to carry its mental health nurses to very remote areas. On a typical day in Broken Hill, the medical team takes off just after dawn to head to three communities hundreds of kilometres away: Wilcania, White Cliffs and Tilpa.

In the opal mining town of White Cliffs, the mental health nurse sees patients at the local clinic. One is “Jane”, who doesn’t want her full name used.

“Without them, we would really be lost here,” she said.

Jane has been counselled by the RFDS and was recently directed to mental health treatment in Broken Hill. But she’s still reluctant to talk openly in town about the help she’s getting.

“In a small community it’s not wise to talk to other people in town,” she said. “And mental health, it does carry a stigma.”

Back on his station south of Broken Hill, Mr Cullen believes that stigma over mental health is slowly changing in the bush.

“People get wind that someone’s had a mental health problem, people talk now. As opposed to, let’s go back five years even, 10 years. It was a closed book,” he said.

“With these clinics, once upon a time you might have had a dental nurse, a doctor, and the like.

“But now you have a mental health nurse…And these clinics are close by. So you’re able to go to them. They come to you.”

NACCHO Aboriginal Health : Delivery to @DaveGillespie of #RuralHealthConf priority delegate recommendations

 

 ” Rural and regional Australians have higher rates of major diseases including heart disease and stroke, chronic lung conditions, diabetes, asthma, and arthritis.

We also have a persistent and disturbingly large gap in health outcomes and life expectancy, between Indigenous and non-Indigenous Australians “

Minister Gillespie said Australia’s long life expectancy and good average health outcomes disguised unacceptable differences between population groups and communities, particularly in rural Australia : See Full Response press release from Minister below

After four action-packed days, the 14th National Rural Health Conference with its theme of ‘A World of Rural Health’, has concluded with the delivery of the priority recommendations to emerge from the event to Assistant Minister for Health, David Gillespie.

According to CEO of the NRHA, David Butt, “the Conference provided an excellent opportunity for learning and sharing the evidence of what works in rural and remote health.

“People who live and work in rural and remote Australia have the knowledge about what works and what needs to change to improve health and wellbeing.

“Very importantly, through the conference they have identified key recommendations for health systems reform, to improve the health and wellbeing of the seven million people who live in rural and remote Australia,” Mr Butt said.

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AUSTRALIA LEADS IN INNOVATION FOR RURAL HEALTH

Press Release

The Coalition Government’s innovative reforms to improve the health of rural, regional and remote communities were today showcased to the 14th World Rural Health Conference.

In his opening address to the conference in Cairns, Assistant Minister for Health, Dr David Gillespie, outlined a series of major changes to improve rural health which will start or bed down over the coming year.

These included:

  •  legislation to establish the first independent National Rural Health Commissioner;
  •  pathways to recognise rural GPs as “Rural Generalists”;
  •  Primary Health Networks across Australia commission health services to ensure that local health needs are met;
  •  federally funded mental health services including suicide prevention and drug and alcohol rehabilitation now managed at the regional level by PHNs;
  •  200 general practices and Aboriginal Community Controlled Health Services will soon start providing Health Care Home services, to coordinate care for people with chronic conditions.

Minister Gillespie said Australia’s long life expectancy and good average health outcomes disguised unacceptable differences between population groups and communities, particularly in rural Australia.

Rural and regional Australians have higher rates of major diseases including heart disease and stroke, chronic lung conditions, diabetes, asthma, and arthritis.

“We also have a persistent and disturbingly large gap in health outcomes and life expectancy, between Indigenous and non-Indigenous Australians,” he said.

Minister Gillespie also represented the Prime Minister, Malcolm Turnbull, at the National Rural Health Alliance Conference held as part of the World of Rural Health event.

“I know that it takes determination, resilience and flexibility to provide the care that your patients need, without the resources available to your counterparts in the cities,” Minister Gillespie said.

“The Prime Minister shares my passion – your passion – for rural Australia.

“Like you, and me, he believes that Australians have a right to high quality, affordable and accessible health care, wherever they live and whatever their circumstances.

“Meeting the needs of rural families and communities is one of the top priorities in the long term national health plan.”

Smile: $11m reduces gap in rural and remote dental services

Press Release 2

People living and working in rural and remote Australia will now have access to dental services that were previously unavailable.

Assistant Minister for Health, Dr David Gillespie, said today that the Coalition Government is providing $11 million to the Royal Flying Doctor Service (RFDS) to provide dental services.

“The Royal Flying Doctor Service is well-placed to provide these essential mobile outreach dental services in rural and remote Australia,” Minister Gillespie said.

“Where there is an identified market failure and there are gaps in services, it is important that the Government steps in to provide assistance. Today we deliver on our election commitment to ensure people outside our major cities have better access to high quality dental services.”

The Government provides funding to the RFDS under the RFDS Program, which aims to ensure access to essential emergency aeromedical and other primary health care services in rural and remote areas of Australia.

“The Flying Doctor welcomes this new funding for dental services in rural and remote Australia,” RFDS of Australia CEO, Martin Laverty, said.

“There are only one third the dentists in remote areas, with 72 dentists per 100,000 people in major cities, and less than 23 per 100,000 people in remote areas.”

“The research statistics are compelling, with more than one-third of remote area residents living with untreated decay. Essentially, when people from remote areas visit the dentist, they are more likely to require acute intervention – 1 in 3 had a tooth extraction in a year, compared with less than 1 in 10 in metropolitan areas.”

“This funding from the Federal Government will enable the Flying Doctor to expand its dental outreach program to start tackling the disparity that exists between city and the bush – and for that we are very, very thankful”.

On 28 June 2016, the Government announced it would continue to support the RFDS by extending its contract for continued delivery of aeromedical services until 30 June 2020.

The announcement included a commitment of an additional $11 million over two years for the RFDS to expand its existing non-Commonwealth funded dental services for the period 1 April 2017 to 31 March 2019.

Labor Party Response

Labor supports the development of a national rural health strategy and associated implementation plan, as part of ensuring there is clear and targeted action towards closing the gap in health outcomes between Australians living in rural areas and their metropolitan peers. 

Shadow Minister for Health Catherine King announced Labor’s support for a strategy at the National Rural Health Conference in Cairns, calling on the Government to join in bipartisan support.

“The impact of inequity on health and recognising the challenges that some groups face which require more targeted support – including rural and remote Australians – was a clear theme to emerge from Labor’s National Health Summit in March,” Ms King said

“We think that a national rural health strategy is an important step to ensuring we have a defined roadmap to improving health outcomes for Australians living outside our big cities and I hope the Government follows our lead.”

Shadow Assistant Minister for Medicare, Tony Zappia, said while Labor welcomes the implementation of the National Rural Health Commissioner, this single role will not be a cure-all.

“The National Rural Health Commissioner would aid in the implementation of a national rural health strategy, but we still need to have an understanding of where we are going, and what we are trying to achieve in rural heath,” Mr Zappia said.

“A national rural health strategy would help achieve this goal of all levels of Government working more closely together, to reduce fragmentation and duplication.”

Opportunity to support a special edition #HealthElection16 NACCHO Aboriginal Health Newspaper PUBLISH DATE June 29

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Closing 17 June for publishing election week 29 June

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Response to our NACCHO Aboriginal Health Newspaper from our members, community, stakeholders and Government  has been nothing short of sensational over the past 3 years , with feedback from around the country suggesting we really kicked a few positive goals for Aboriginal health.

NACCHO is the national peak body for Aboriginal health. It is entrusted to represent the needs and interests of Aboriginal health on behalf of its members in the national arena.

NACCHO has and continues to be a living embodiment of the aspirations of Aboriginal people

10 good reasons to advertise in the NACCHO Aboriginal Health Newspaper :

  1. Highly targeted health sector from CEO’s to all staff audience
  2. Quality production and guaranteed national distribution in partnership with the award-winning Koori Mail 14,000 printed copies
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  9. Targeted at Aboriginal consumer / clients
  10. Support NACCHO vision to Close the Gap

Our media partner Koori Mail Turns 25 this week

The Koori Mail is an Australian media institution, 100% owned and controlled by Aboriginal people. The fortnightly newspaper circulates all states and covers the issues that matter the most to black Australians. 25 years since its first print, the Indigenous paper is still breaking ground for Indigenous journalism.

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Editorial Opportunities

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This 24-page newspaper is produced and distributed as an insert in the Koori Mail, circulating 14,000 full-colour print copies nationally via newsagents and subscriptions.

Our audited readership (Audit Bureau of Circulations) is 100,000 readers!

Our target audience also includes over 1,500 NACCHO member and affiliate health organisations, relevant government departments, subsidiary indigenous health services and suppliers, as well as the end-users of Australian Indigenous health services nationally.

Your advertising support means we can build this newspaper to a cost-neutral endeavour, thereby guaranteeing its future.

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NACCHO #healthelection16 : Client contacts at Aboriginal health organisations continue to increase

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Australian Government-funded primary health care organisations saw around 435,000 individual clients through over 3.5 million episodes of care, an average of 8.2 episodes of care per client, in 2014-15, according to a report released today by the Australian Institute of Health and Welfare (AIHW).

DOWNLOAD THE REPORT AIHW Aboriginal Health Organisations May 2016

The report, Aboriginal and Torres Strait Islander health organisations: Online services report-key results 2014-15 includes information from 278 organisations across Australia providing health services to Aboriginal and Torres Strait Islander people.

Seventy-three per cent of these organisations (203) provided primary health-care services and 68% (138) of these were Aboriginal Community Controlled Health Organisations.

‘The health services and activities provided by these organisations play an important role in delivering health care to Indigenous people,’ said AIHW spokesperson Dr Fadwa Al-Yaman.

‘This includes clinical care, health promotion, child and maternal health, social and emotional wellbeing support and substance-use prevention’.

In 2014-15, most organisations (220) provided maternal and child health services, with 7,400 Indigenous women accessing antenatal services through 34,100 visits. Around 22,100 health checks for Indigenous children aged 0-4 years were conducted.

Social and emotional wellbeing services-counselling, family tracing and reunion support services-were provided by 97 organisations employing 221 counsellors, a 17% increase in counsellors compared with 2013-14.

Substance-use services were offered at 67 organisations, and saw 25,200 clients through 151,000 episodes of care, an average of 6 episodes of care per client.

Compared with 2013-14, the number of client contacts increased by 9% while client numbers increased by 4%. Over time, the average number of contacts per client per year has increased from 7.7 in 2008-09 to 11.6 in 2014-15.

There were 4,454 health staff employed in primary health care organisations and 2,905 other staff. Just over half (53%) of all staff were Indigenous. The most common health workers were nurses and midwives (15%), followed by Aboriginal health workers (11%) and doctors (6%).

‘Staffing varied by location, with 39% of nurses and midwives employed in Very remote areas and 31% of Aboriginal health workers employed in Outer regional areas,’ said Dr Al-Yaman.

Client contacts by nurses and midwives represented 50% of all client contacts in Very remote areas compared with 29% nationally.

The AIHW is a major national agency set up by the Australian Government to provide reliable, regular and relevant information and statistics on Australia’s health and welfare.

This seventh national report presents information from 278 organisations across Australia, funded by the Australian Government to provide one or more of the following health services to Aboriginal and Torres Strait Islander people: primary health care, maternal and child health care, social and emotional wellbeing services, and substance-use services. These organisations participated in the 2014–15 Online Services Report data collection. Information is presented on the characteristics of these organisations, the health services and activities provided to clients and staffing levels. Other information presented includes client numbers, client contacts and episodes of care, and service gaps and challenges.

Primary health client contacts increased

  • In 2014–15, 203 of the organisations (73%) were funded to provide primary health-care services and many of these were Aboriginal Community Controlled Health Organisations (138 or 68%).
  • These organisations employed 7,359 full-time equivalent staff and just over half (53%) were Indigenous, a similar proportion to 2013–14 (53%). The workforce was made up of 4,454 health staff (61%) and 2,905 other staff (39%). Nurses and midwives were the most common type of health worker, representing 15% of employed staff. This was followed by Aboriginal health workers (11%) and doctors (6%). However, the relative proportions of these varied by remoteness area, with more nurses and midwives being employed in Very remote areas (39%) and more Aboriginal health workers in Outer regional areas (31%).
  • Health staff provided primary health-care services to around 434,600 clients through 5.0 million client contacts. Since 2013–14, client contacts increased by 9%. Although the number of staff per 1,000 clients was similar to 2013–14 (18 per 1,000 clients), the number of contacts per client showed a small increase and continued an upward trend in average contacts per client overtime, which has gone from 7.7 in 2008–09 to 11.6 in 2014–15.

An average of nearly 5 antenatal visits per woman

In 2014–15, 220 of the organisations (79%) provided maternal and child health services, either through primary health or New Directions funding. Around 34,100 antenatal visits were reported for 7,400 Indigenous women, an average of 4.6 visits per woman. Around 22,100 child health checks were conducted for Indigenous children aged 0–4 years.

More social and emotional wellbeing counsellors

In 2014–15, 97 of the organisations (35%) were funded to provide social and emotional wellbeing services. They employed 221 counsellors, an increase of 17% compared with 2013–14. Around 60% of counsellors were Indigenous, a similar proportion to 2013–14 (62%). Services were provided to around 21,100 clients through 100,200 client contacts.

Amphetamines seen as an important substance-use issue

In 2014–15, 67 of the organisations (24%) were funded to provide substance-use services. They saw around 25,200 clients through 151,000 episodes of care. Most episodes of care (89%) were for non-residential or after-care services. The proportion of these organisations that reported amphetamines as one of their most important issues in terms of staff time and organisational resources increased from 45% in 2013–14 to 70% in 2014–15.

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NACCHO #Aboriginal Health Special Feature : 20 Indigenous health research papers

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” This study aimed to examine the accuracy of patient self-reported screening status for diabetes, high cholesterol and cervical cancer among Aboriginal and Torres Strait Islander patients when compared with pathology records.

The study was undertaken in an Aboriginal Community Controlled Health Service (ACCHS). ACCHSs are culturally competent primary health care services and represent self-determination in the provision of health care. They are ideal settings for delivering prevention activities to Aboriginal and Torres Strait Islander people.”

From Insights into nutritionists’ practices and experiences in remote Australian Aboriginal communities

The Australian and New Zealand Journal of Public Health is the Journal of the Public Health Association of Australia and is published six times a year, in February, April, June, August, October and December

The current issue features Indigenous health 20 research papers

1.Aboriginal and Torres Strait Islander health: accuracy of patient self-report of screening for diabetes, high cholesterol and cervical cancer

Chronic diseases including diabetes, cardiovascular disease and cancer account for the majority of excess deaths and diseases among Aboriginal and Torres Strait Islander people, despite being largely preventable.1 Prevention activities such as regular screening are likely to produce significant health gains.2 To achieve these gains clinicians need appropriate, valid and reliable measures of a patient’s screening history.

Patient self-report is often used by clinicians as a quick and inexpensive way to obtain information about a patient’s screening status. Self-report is also used to determine the effectiveness of interventions intended to increase screening rates. The accuracy of self-report is therefore critical. Research studies in non-Indigenous primary care settings,3–11 including Australia,12–15 have shown that relying on self-report can result in significant under-estimation of the proportion of people who require screening. Under-estimating the time period since a patient’s last screening has been reported, especially among minority populations16,17 including indigenous native American women.18 Studies have also found that self-reported population survey data often under-estimates the prevalence of screening, particularly among marginalised population groups.9,10,19,20

Few published studies have investigated the validity of self-reported health issues among Aboriginal and Torres Strait Islander people in Australia. One study found self-reported information under-estimated the smoking status of pregnant Indigenous women,21 and another found a modest correlation between self-report and measured physical activity among Aboriginal children.22

This study aimed to examine the accuracy of patient self-reported screening status for diabetes, high cholesterol and cervical cancer among Aboriginal and Torres Strait Islander patients when compared with pathology records. The study was undertaken in an Aboriginal Community Controlled Health Service (ACCHS). ACCHSs are culturally competent primary health care services and represent self-determination in the provision of health care. They are ideal settings for delivering prevention activities to Aboriginal and Torres Strait Islander people.

2.Insights into nutritionists’ practices and experiences in remote Australian Aboriginal communities

Access to and adequate intake of a range of foods to meet the body’s energy and nutrient requirements is a universal cornerstone of good health and wellbeing. Among Aboriginal Australians, nutrition plays a significant direct and indirect role in suboptimal growth and development in children and the excessive burden of preventable chronic disease in adults.1,2 Public health nutrition is an integral part of population health that seeks to promote optimal nutrition status and good health, and prevent illness and associated economic and social costs of disease.3–5

For more than 20 years, public health and community nutritionists have worked in the Northern Territory (NT) within remote Aboriginal communities, both within the government public health sector and non-government organisations, such as Aboriginal Community Controlled Health Organisations. The term ‘public health nutritionist’ refers to practitioners working in population approaches to public health nutrition.

In the remote Aboriginal context, stakeholders within the food landscape can include remote community stores/shops, schools, childcare, aged-care facilities and health centres, community groups, Aboriginal health workers (AHWs) and families and individuals.6 Within these settings, nutritionists ideally work with and through local community members, including AHWs, to jointly address expressed food and nutrition-related priorities. For these reasons, the terms ‘community nutritionist’ and ‘public health nutritionist’ have been used interchangeably. The term ‘dietitian’ tends to refer to practitioners focusing on clinical and individual aspects of nutritional health. Increasingly, dietetic qualifications are mandatory for nutritionists working with remote Aboriginal communities, as many practitioners also provide a clinical service.

In remote Aboriginal communities, nutritionists perform numerous functions calling for a wide range of competencies that require social, communication and relationship building skills3 and cultural adeptness, including a culturally competent7 and culturally safe approach.8 The call for nutrition practitioners, and their training and employment structures, to move towards broader sociological9 and critical10 approaches appears especially relevant in a cross-cultural world where food permeates many aspects of life. This also supports the internationally agreed notion of ‘health’ that recognises the existence of various cultural and world views, and the imperative of supporting the layers of social and ecological factors that underpin one’s state of health by addressing healthcare at multiple levels.11 Across all these skills and levels, one universal and fundamental element is communication. All health workers in cross-cultural settings must communicate across social and cultural world views. Clear health communication is vital to assist with understanding and to empower individuals and groups to make informed decisions.12,13 Community empowerment is one key element of successful community nutrition interventions.14 Nutritionists working in remote Aboriginal communities ideally engage with a range of community stakeholders, including Aboriginal health and local community workers.

Remote health staff and health services speak of numerous challenges in providing remote health services and the complexities of delivering primary and health promotion services.15–19 While high staff turnover is a considerable issue,17 little is understood of the challenges facing nutrition practitioners especially in this cross-cultural context.20,21 We used a qualitative methodology to explore communication methods, education practices and approaches, perceived challenges and the potential role of nutritionists. The study aimed to support nutritionists working in remote Aboriginal communities and inform ongoing efforts to create supportive environments that promote nutritional health and effective communication and facilitate behaviour change.

3.Legally invisible: stewardship for Aboriginal and Torres Strait Islander health

4. The comparative cost of food and beverages at remote Indigenous communities, Northern Territory, Australia (pages S21–S26)

5. Use of electronic visual recording to aid assessment of dietary intake of Australian Aboriginal children living in remote communities

6. Bundap Marram Durn Durn: Engagement with Aboriginal women experiencing comorbid chronic physical and mental health conditions

7.The economic feasibility of price discounts to improve diet in Australian Aboriginal remote communities

8. Trachoma in remote Indigenous Australia: a review and public health perspective

9. The value of partnerships: lessons from a multi-site evaluation of a national social and emotional wellbeing program for Indigenous youth

10.Hypertension: high prevalence and a positive association with obesity among Aboriginal and Torres Strait Islander youth in far north Queensland

SEE ALL ARTICLES HERE

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NACCHO #closethegap Suicide: Lifeline calls for specialist hotline to address high Indigenous suicide rates

 

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“There are some communities out there were there are a multitude of both state and federal services and showing very little for all the effort and the money,”

“The question is why? And I think part of the answer is that there needs to be much more involvement of Aboriginal people through governance structures that are appropriate to have a say how those resources are used.

“It’s important because many Aboriginal people will not be comfortable ringing a general service and speaking to a non-Aboriginal person.

“There needs to be, and I have seen this over my almost 40 years now in Aboriginal affairs, a specific service that is culturally appropriate.”

New South Wales parliamentarian and former state Labor leader Linda Burney said the Federal Government should seriously consider the proposal.

Ms Burney, who is a Wiradjuri woman and will be making a tilt at federal politics in the upcoming election, said a national, Aboriginal-led initiative was needed to address many of the issues surrounding mental health and disadvantage.

“Child suicide was a growing problem in indigenous communities. Children’s exposure to family violence was a “major contributor” to the mental health of young people.  services needed more funding for mental health, with remote communities having limited access through Aboriginal Medical Services and the Royal Flying Doctor Service. 

“We must be delivering services to the people, not (forcing) them to come to the services because Aboriginal people in remote communities are on the lowest incomes in the country.”

Sandy Davies, the deputy chairman of the National Aboriginal Community Controlled Health Organisation :Picture above : Indigenous children up to 14 years were nine times more likely to kill themselves than non-indigenous children

Crisis support service Lifeline is calling for the Commonwealth to support an Aboriginal-specific arm of the hotline, to tackle the high rates of suicide in Aboriginal communities.

Lifeline Central West, which covers about one third of New South Wales, has proposed establishing a national call centre in the central west city of Dubbo run by Aboriginal counsellors.

It has written a letter to the Federal Minister for Indigenous Affairs Nigel Scullion, asking for financial support for the so-called YarnUp Confidential service.

It was hoped the call centre would take up to 70,000 calls per year and create 118 new Aboriginal jobs in Dubbo, costing about $10 million to run annually.

Australian Bureau of Statistics figures released this week showed suicide rates among Indigenous people were about twice those of non-Indigenous people.

Lifeline Central West executive director Alex Ferguson said the rates would only continue to rise unless the Commonwealth took urgent action.

Mr Ferguson said while similar services were run locally in some communities, there was a need for a unified service based on the Lifeline model.

“Look at the scorecard and I think you’ll find their policies are either misdirected or failing,” Mr Ferguson said.

“At the moment we don’t have dialogue and we need to have a dialogue within the Aboriginal community and the broader regional communities.

“The idea is simply to put an Aboriginal feeling, a wash, a spirit through the Lifeline model, so that we can actually have Aboriginals working with Aboriginals under a properly trained and structured environment.”

‘They don’t trust us, in many cases they don’t like us’

Mr Ferguson said many Aboriginal people did not feel comfortable conveying their concerns to non-Indigenous counsellors.

“They don’t trust us, in many cases they don’t like us, and that’s why the YarnUp model is based on Aboriginals working with Aboriginals, but doing it in a very structured way, which is the Lifeline training and telephony model,” Mr Ferguson said.

Mr Ferguson said there had been an “uninspiring” response from the Government, and was disappointed it had not offered an alternative solution.

“Nobody has put up anything else to either push YarnUp our of the way and or has actually ever criticised the content of YarnUp,” Mr Ferguson said.

“By the time you keep going around this sort of ‘it’s not in my backyard’ type argument, there is the continual flow of death and the resultant trauma in the community.”

The Federal Member for Parkes Mark Coulton said the broadly supported the model and will next week lobby the Indigenous Affairs Minister Nigel Scullion for a trial.

But he said many local organisations were already doing similar work and there was a risk of duplicating services.

“I was in Bourke a couple weeks ago and there was another group there that has got a mental health program for school-aged students,” Mr Coulton said.

“This is not an empty field, there are a lot of people out there in this space.

“But I think the Lifeline model has worked well and I think to extend that into a specialised service for Aboriginal people will be I think a worthwhile exercise.”

Need for national, culturally appropriate approach

If you or anyone you know needs help, you can call Lifeline on 13 11 14.

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NACCHO Telehealth News Alert : NT Telehealth community trial has saved time, money and improved access to care

 

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“Telstra has worked with NT Health and the Aboriginal Medical Services Alliance Northern Territory (AMSANT) to pilot the NTCS with the Anyinginyi Health Aboriginal Corporation in Tennant Creek and the Santa Teresa Health Centre near Alice Springs. This has provided the clinics with dedicated services that connect into NT Health’s existing telehealth network.”

An independent evaluation of the Northern Territory’s telehealth trial has recommended that the project continue and that the telehealth network be developed further until the services are embedded into routine practice.

The NT Department of Health began the trial in June 2014 to provide telehealth services to clinics in the Katherine, Barkly and Central Australian regions from hospital specialists in Alice Springs, Katherine and Darwin.

Specialist appointments available include cardiac, orthopaedic, haemotology, oncology, dermatology and urology, with specialists burns services now being provided by SA Health.

In October 2014, the NT government signed a contract with Telstra Health to improve the network infrastructure as part of the wider National Telehealth Connection Service.

Telstra has worked with NT Health and the Aboriginal Medical Services Alliance Northern Territory (AMSANT) to pilot the NTCS with the Anyinginyi Health Aboriginal Corporation in Tennant Creek and the Santa Teresa Health Centre near Alice Springs. This has provided the clinics with dedicated services that connect into NT Health’s existing telehealth network.

Figures released today as part of the evaluation show that telehealth consultations have grown from about 200 a year to more than 1000 and have delivered savings of more than $1.1 million in travel costs.

Telehealth attendances in Tennant Creek had grown from 62 in 2013-14 to 519 in the trial period of July 2014 to September 2015, an increase of 737 per cent.

In Alice Springs, they have grown from 33 to 192, and from 100 to 331 in Katherine.

NT Chief Minister Adam Giles said the program had also reduced did not attend rates.

“This is a fantastic achievement and demonstrates that telehealth is delivering better health outcomes in regional and remote communities and reducing the need for patients to travel long distances to access health services,” Mr Giles said in a statement.

“It’s also helped reduce costs to the Patient Travel Assistance Scheme budget with savings estimated of at least $1.189 million on travel costs alone, while the rate of patients not attending their appointments was substantially lower than for standard hospital outpatient clinics.”

Health Minister John Elferink said an evaluation report into the telehealth trial had recommended the project continue and that the telehealth network be developed further until the services are embedded into routine practice.

“Telehealth services clearly have an important and growing role to play in ensuring more Territorians get more access to the health care they need,” he said.

“The government will now consider the recommendations of the evaluation report and look at what resources and training we need to provide to extend the use of telehealth services in the Territory.”

Trial project leader Sam Goodwin, acting executive director of medical and clinical services at the Alice Springs Hospital, said telehealth was good for patients and health professionals, and was delivering efficiencies for the health system.

“Clinicians on the frontline have summarised the telehealth pilot very nicely,” Dr Goodwin said. “’It is not often you can say that you have saved money and everyone has got really good health care for that saving, and you are not losing anything – usually when you make savings of money you have lost something’.”

NACCHO Newspaper

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 Celebrating the 10th Anniversary of the Close the Gap Campaign for the governments of Australia to commit to achieving equality  for Indigenous people in the areas of health and  life expectancy within 25 years.”

Next publication date 6 April 2016

Advertising and editorial closes 18 March 2016

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Response to this NACCHO media initiative has been nothing short of sensational over the past 3 years , with feedback from around the country suggesting we really kicked a few positive goals for national Aboriginal health.

Thanks to all our supporters, most especially our advertisers, NACCHO’S Aboriginal Health News is here to stay.

NACCHO 10 th Anniversary Close the Gap invitation to host travelling photographic exhibition

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Aboriginal Health in Aboriginal Hands for Healthy Futures Exhibition and travelling road show 2016

Invitation to:

NACCHO Aboriginal Community Controlled Health Organisation members

NACCHO Affiliates

NACCHO Stakeholders

Aboriginal and Torres Strait Islander peak bodies

National Peak body Health organisations

Research groups

NACCHO partners and supporters

Find out how you can host this exhibition March -December 2016

 –see application below

Celebrating the 10th Anniversary of the Close the Gap Campaign for the governments of Australia to commit to achieving equality  for Indigenous people in the areas of health and  life expectancy within 25 years.

The National Aboriginal Community Controlled Health Organisation (NACCHO) in partnership with Wayne Quilliam Photography has developed a visual narrative that has been created to foster awareness, exploration and understanding of Aboriginal health in Aboriginal hands.

Our exhibition of 20 + photographic images, melded with a series of video interviews embedded within the images will stimulate individual thinking and dialogue relating to the 10th anniversary of ‘Close the Gap’ campaign celebrated in March 2016.

The exhibition will launched at Parliament House on 17 th March National Close the Gap Day

The series of interviews will engage and educate the viewer with valuable insight into the personal and professional health journeys of ACCHO board members, CEO’s, medical staff, Aboriginal Health Workers, Health Promotion Teams and community members.

This project has been developed to allow Aboriginal people across the country to share their views, dreams, aspirations and thoughts relating to the importance of Aboriginal Health In Aboriginal Hands for healthy futures.

And in an election year to showcase the why investment in the Aboriginal Community Controlled Health is vitally important to Close the GAP

Background

In May 2015 NACCHO engaged a production team to record and edit interviews with Aboriginal health leaders and community members in approx. 20 urban, rural and remote member locations throughout all states and territories of Australia. At each site NACCHO will be producing a summary 30 minute (approx.) video featuring interviews with the board, CEO, medical, Aboriginal Health Workers, Health Promotion Teams and community members.

Wayne Quilliam award winning Aboriginal photographer was appointed Creative Director to record videos and still photographs with Yale MacGillivray a young Aboriginal woman appointed Managing Editor for the project. The original pilot and Redfern AMS was produced by NITV

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All 300 (approx.) full interviews will be available for viewing on NACCHO TV YouTube channel and website (subject to members and interviewee approval) and videos and photographs will be available to each NACCHO participating member service for websites and community CDS etc.

Once edited down into a 30 minute format all 20 episodes will be made available to NITV and other Aboriginal media groups for broadcast and other projects  All Interviews footage will also be available for specialist educational video compilations for governance, management, doctors, Aboriginal Health Worker etc.

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Proposed Close the Gap 10th Anniversary National Aboriginal Healthly Futures photography and video Exhibition roadshow 2016

It is proposed to develop a travelling interactive roadshow consisting of approx. 20 images from the series to achieve the following objectives:

Healthy Futures Videos will highlight how investing in NACCHO the national authority in comprehensive Aboriginal primary health care and its 150 members will lead to generational change and Close the Gap

In our Healthy Futures Videos interviews with ACCHO chairs, board members CEOs Management Doctors Dentists, chemists Aboriginal Health Workers/Allied Health workers and health promotional teams they will highlight how our national Aboriginal health leaders’ play an important role in ensuring Aboriginal health remains in Aboriginal hands thru our vast network of these Aboriginal community controlled health organisations.

Healthy Futures Videos will highlight success stories that our Aboriginal Community Controlled Health Organisations (ACCHOs) are making towards Closing the Gap targets and key priorities in areas such Early Childhood development

Healthy Futures Videos will illustrate how keeping our people well and on the road to good health through our ACCHOs is a key principle objective of NACCHO and all our members.

Healthy Futures Videos will highlight how we achieve this is by working in collaboration with our national partners and stakeholders to address the expansion of our health services and to meet the growing health needs of Aboriginal and Torres Strait Islander people in urban, rural and remote Australia.

Front Page Postive picThe Exhibition

Using QR codes these images will link to interviews thru your phone or Ipad.

The CTG exhibition will be launched at Parliament House Canberra on the Anniversary 17  March and then make the portable exhibition available to participating members and affiliates to hold their own state based events. The exhibition will also be offered to other major Aboriginal and Health conferences who wish to celebrate Aboriginal Health and Close the Gap.

Alicia Hari a Health Promotion Officer and Lucretius Willett a Healthy Lifestyle Officer at the Gurriny Yealamuca Health Service in Yarrabah FNQ are just two of the approx.300 board , staff and community in 20 urban, regional and remote NACCHO member organisations being interviewed for our “ Aboriginal health in Aboriginal hands for healthy futures “ video series and 2016 photographic exhibition road show

OR CONTACT

Colin Cowell Project consultant TEL 0401 331 215 Email

 Submit your “Expression of Interest ” to host the exhibition in 2016

naccho-home-nov2015

NACCHO Aboriginal Health News: Overview of Australian Indigenous health status released

WADEYE ABORIGINAL CLINIC NT

The Overview of Australian Indigenous health status 2014 (Overview) has been released providing a comprehensive summary of the most recent indicators of the health of Aboriginal and Torres Strait Islander people.

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DOWNLOAD the REPORT HERE overview_of_indigenous_health_2014

The Overview shows that the health of Aboriginal and Torres Strait Islander people continues to improve slowly.

The Overview confirms that there have been declines in infant mortality rates and an increase in life expectancy. There have also been improvements in a number of areas contributing to health status such as increased immunisation coverage and a slight decrease in the prevalence of tobacco use among Indigenous people.

The Overview is an important part of the HealthInfoNet‘s translation research, which contributes to ‘closing the gap’ in health between Indigenous and other Australians by making research and other knowledge available in a form that is easily understood and readily accessible to both practitioners and policy makers.

View Website for report info

HealthInfoNet Director, Professor Neil Drew, said ‘The Overview is our flagship publication and has proved to be a valuable resource for a very wide range of health professionals, policy makers and others working in the Aboriginal and Torres Strait Islander health sector.

The Overview provides an accurate, evidence based summary of many health conditions in a form that makes it easy for time poor professionals to keep up to date with the current health status of Aboriginal and Torres Strait Islander people throughout Australia.

This year, as part of our ongoing commitment to quality improvement we have made some important changes, including a statement on the appropriate use of terminology and a commitment to enhancing a strengths based approach to understanding health issues

Key facts

Population

  • At 30 June 2014, the estimated Australian Indigenous population was 713,600 people.
  • For 2014, it was estimated that NSW had the highest number of Indigenous people (220,902 people, 31% of the total Indigenous population).
  • For 2014, it was estimated that the NT had the highest proportion of Indigenous people in its population (30% of the NT population were Indigenous).
  • In 2011, around 33% of Indigenous people lived in a capital city.
  • There was a 21% increase in the number of Indigenous people counted in the 2011 Census compared with the 2006 Census.
  • The Indigenous population is much younger than the non-Indigenous population.

Births and pregnancy outcome

  • In 2013, there were 18,368 births registered in Australia with one or both parents identified as Indigenous (6% of all births registered).
  • In 2013, Indigenous mothers were younger than non-Indigenous mothers; the median age was 24.9 years for Indigenous mothers and 30.8 years for all mothers.
  • In 2013, total fertility rates were 2,344 births per 1,000 for Indigenous women and 1,882 per 1,000 for all women.
  • In 2012, the average birthweight of babies born to Indigenous mothers was 3,211 grams compared with 3,373 grams for babies born to non-Indigenous mothers.
  • In 2012, the proportion of low birthweight babies born to Indigenous women was twice that of non-Indigenous women (11.8% compared with 6.2%).

Mortality

  • In 2006-2010, the age-standardised death rate for Indigenous people was 1.9 times the rate for non-Indigenous people.
  • Between 1991 and 2010, there was a 33% reduction in the death rates for Indigenous people in WA, SA and the NT.
  • For Indigenous people born 2010-2012, life expectancy was estimated to be 69.1 years for males and 73.7 years for females, around 10-11 years less than the estimates for non-Indigenous males and females.
  • In 2008-2012, age-specific death rates were higher for Indigenous people than for non-Indigenous people across all age-groups, and were much higher in the young and middle adult years.
  • For 2010-2012, the infant mortality rate was higher for Indigenous infants than for non-Indigenous infants; the rate for Indigenous infants was highest in the NT.
  • From 1998 to 2012, there were significant declines in infant mortality rates for Indigenous infants.
  • For 2012, the leading causes of death among Indigenous people were cardiovascular disease, neoplasms (almost entirely cancers), and injury.
  • In 2006-2010, for direct maternal deaths the rate ratio was almost 4 times higher for Indigenous women than for non-Indigenous women.

Hospitalisation

  • In 2012-13, 4.0% of all hospitalisations were of Indigenous people.
  • In 2012-13, the age-standardised separation rate for Indigenous people was 2.7 times higher than for other Australians.
  • In 2012-13, the main cause of hospitalisation for Indigenous people was for care involving dialysis, responsible for 48% of Indigenous separations.

Selected health conditions

Cardiovascular disease

  • In 2012-2013, 13% of Indigenous people reported having a long-term heart or related condition; after age-adjustment, these conditions were around 1.2 times more common for Indigenous people than for non-Indigenous people.
  • In 2012, hospitalisation rates for circulatory disease were 1.6 times higher for Indigenous people than for non-Indigenous people.
  • In 2012, cardiovascular disease was the leading cause of death for Indigenous people, accounting for 25% of Indigenous deaths.
  • In 2012, the age-adjusted death rate for Indigenous people was 1.6 times the rate for non-Indigenous people.

Cancer

  • In 2005-2009, age-adjusted cancer incidence rates were slightly lower for Indigenous people than for non-Indigenous people.
  • In 2004-2008, the most common cancers diagnosed among Indigenous people were lung and breast cancer.
  • In 2012-13, age-standardised hospitalisation rates for cancer were lower for Indigenous people than for non-Indigenous people.
  • In 2012, the age-standardised death rate for cancer for Indigenous people was 1.5 times higher than for non-Indigenous people.

Diabetes

  • In 2012-2013, 8% of Indigenous people reported having diabetes; after age-adjustment, Indigenous people were 3.3 times more likely to report having some form of diabetes than were non-Indigenous people.
  • In 2013-14, age-adjusted hospitalisation rates for diabetes for Indigenous males and females were 3 and 5 times the rates for other males and females.
  • In 2012, Indigenous people died from diabetes at 7 times the rate of non-Indigenous people.

Social and emotional wellbeing

  • In 2012-13, 69% of Indigenous adults experienced at least one significant stressor in the previous 12 months.
  • In 2012-13, after age-adjustment, Indigenous people were 2.7 times as likely as non-Indigenous people to feel high or very high levels of psychological distress.
  • In 2008, 90% of Indigenous people reported feeling happy either some, most, or all of the time.
  • In 2011-12, after age-adjustment, Indigenous people were hospitalised for ICD ‘Mental and behavioural disorders’ at 2.1 times the rate for non-Indigenous people.
  • In 2012-13, there were 16,393 hospital separations with a principal diagnosis of ICD ‘Mental and behavioural disorders’ identified as Indigenous.
  • In 2012, the death rate for ICD ‘Intentional self-harm’ (suicide) for Indigenous people was 2.0 times the rate reported for non-Indigenous people.

Kidney health

  • In 2009-2013, after age-adjustment, the notification rate of end stage renal disease was 6.2 times higher for Indigenous people than for non-Indigenous people.
  • In 2012-13, care involving dialysis was the most common reason for hospitalisation among Indigenous people.
  • In 2008-2012, the age-standardised death rate from kidney disease was 2.6 times higher for Indigenous people than for non-Indigenous people.

Injury

  • In 2012-13, after age-adjustment, Indigenous people were hospitalised for injury at nearly twice the rate for other Australians.
  • In 2012-13, the hospitalisation rate for assault was 34 times higher for Indigenous women than for other women.
  • In 2012, injury was the third most common cause of death among Indigenous people, accounting for 15% of Indigenous deaths.

Respiratory disease

  • In 2012-2013, 31% of Indigenous people reported having a respiratory condition. After age-adjustment, the level of respiratory disease was 1.2 times higher for Indigenous than non-Indigenous people.
  • In 2012-2013, 18% of Indigenous people reported having asthma.
  • In 2012-13, after age-adjustment, rates for Indigenous people were 4.4 times higher for chronic obstructive pulmonary disease, 3.3 times higher for influenza and pneumonia, 1.8 times higher for asthma, 1.8 times higher for acute upper respiratory infections and 1.4 times higher for whooping cough, than for their non-Indigenous counterparts.
  • In 2012, after age-adjustment, the death rate for respiratory disease for Indigenous people was 2.2 times that for non-Indigenous people.

Eye health

  • In 2012-2013, eye and sight problems were reported by 33% of Indigenous people.
  • In 2008, the rate of low vision for Indigenous adults aged 40 years and older was 2.8 times higher than for their non-Indigenous counterparts.
  • In 2008, the rate of blindness for Indigenous adults aged 40 years and older was 6.2 times higher than for their non-Indigenous counterparts.

Ear health and hearing

  • In 2012-2013, ear/hearing problems were reported by 12% of Indigenous people.
  • In 2012-13, the hospitalisation rate for ear/hearing problems for Indigenous children aged 0-3 years was 0.8 times lower the rate for non-Indigenous children and the rate for Indigenous children aged 4-14 years was 1.6 times higher than the rate for non-Indigenous children.

Oral health

  • In 2007-2008 in NSW, SA, Tas and the NT, Indigenous children had more dental problems than non-Indigenous children.
  • In 2004-2006, caries and periodontal diseases were more prevalent among Indigenous adults than among non-Indigenous adults.

Disability

  • In 2008, after age-adjustment, Indigenous people were 2.2 times as likely as non-Indigenous people to have a profound/core activity restriction.

Communicable diseases

  • In 2006-2010, after age-adjustment, the notification rate for tuberculosis was 12.5 times higher for Indigenous people than for Australian-born non-Indigenous people.
  • In 2011-2013, the crude notification rate for hepatitis B was 5 times higher for Indigenous people than non-Indigenous people.
  • In 2011-2013, the crude notification rate for hepatitis C for Indigenous people was 3.7 times higher for Indigenous people than for non-Indigenous people.
  • In 2007-2010, notification rates for Haemophilus influenza type b were 12.9 times higher for Indigenous people than for non-Indigenous people.
  • In 2011, the age-standardised rate of invasive pneumococcal disease was 8 times higher for Indigenous people than for other Australians.
  • In 2007-2010, the age-standardised notification rate of meningococcal disease was 2.7 times higher for Indigenous people than for other Australians; the rate for Indigenous children aged 0-4 years was 3.8 times higher than for their non-Indigenous counterparts.
  • In 2013, Indigenous people had higher crude notification rates for gonorrhoea, syphilis and chlamydia than non-Indigenous people.
  • In 2013, age-standardised rates of human immunodeficiency virus (HIV) diagnosis were 1.3 times higher for Indigenous than non-Indigenous people.
  • In some remote communities, more than 70% of young children had scabies and pyoderma.

Factors contributing to Indigenous health

Nutrition

  • In 2012-2013, less than one half of Indigenous people reported eating an adequate amount of fruit (42%) and only one-in-twenty ate enough vegetables (5%) on a daily basis.

Physical activity

  • In 2012-13, 46% of Indigenous adults met the target of 30 minutes of moderate intensity physical activity on most days.
  • In 2012-2013, after age-adjustment, 62% of Indigenous people in non-remote areas reported that they were physically inactive, a similar level to that of non-Indigenous people.

Bodyweight

  • In 2012-2013, 66% of Indigenous adults were classified as overweight or obese; after age-adjustment, the level of obesity/overweight was 1.2 times higher for Indigenous people than for non-Indigenous people.

Immunisation

  • In 2013, 93% of Indigenous children aged 5 years were fully immunised against the recommended vaccine-preventable diseases.

Breastfeeding

  • In 2010, breastfeeding initiation levels were similar among Indigenous and non-Indigenous mothers (87% and 90% respectively).

Tobacco use

  • In 2012-13, 44% of Indigenous adults were current smokers; after age-adjustment, this proportion was 2.5 times higher than the proportion among non-Indigenous adults.
  • Between 2002 and 2013, there has been a decline in the number of cigarettes smoked daily among Indigenous people.
  • In 2011, 50% of Indigenous mothers reported smoking during pregnancy.

Alcohol use

  • In 2012-13, 23% of Indigenous adults abstained from alcohol; this level was 1.6 times higher than among the non-Indigenous population.
  • In 2012-2013, after age-adjustment, lifetime drinking risk was similar for both the Indigenous and non-Indigenous population. In 2008-10, after age-adjustment, Indigenous males were hospitalised at 5 times and Indigenous females at 4 times the rates of their non-Indigenous counterparts for a principal diagnosis related to alcohol use.
  • In 2006-2010, the age-standardised death rates for alcohol-related deaths for Indigenous males and females were 5 and 8 times higher respectively, than those for their non-counterparts.

Illicit drug use

  • In 2012-13, 22% of Indigenous adults reported that they had used an illicit substance in the previous 12 months.
  • In 2005-2009, the rate of drug-induced deaths was 1.5 times higher for Indigenous people than for non-Indigenous people.

 

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