NACCHO Aboriginal Health Resources Alert : NACCHO and @RACGP are pleased to launch the Aboriginal and Torres Strait Islander #715health assessment templates.

With support from the Department of Health, NACCHO and RACGP established a working group in 2019 to review and update Aboriginal and Torres Strait Islander annual health check templates.

Throughout 2020 we will be testing these templates for operability in a range of services.

We are keen to hear your feedback and will be conducting a survey later in the year.

A key recommendation was to update elements to better reflect age-appropriate health needs. This resulted in five new templates that span the life course:

  1. Infants and preschool (birth-5 years)  PDF  RTF
  2. Primary school age (5-12 years) PDF  RTF
  3. Adolescents and young people (12-24 years) PDF  RTF
  4. Adults (25-49 years) PDF  RTF
  5. Older people (50+ years) PDF  RTF

These are example health check templates that include recommended core elements.

The criteria for inclusion can be accessed in our template development information pack.

Adaptation of these templates to local needs and priorities is encouraged, with reference to current Australian preventive health guidelines that are culturally and clinically suitable to Aboriginal and Torres Strait Islander needs.

These templates are not intended to promote a tick box approach to healthcare, but rather to prompt clinicians to consider patient priorities, opportunities for preventive healthcare and common health needs.

As the Partnership Project continues, we are exploring opportunities for integration of health check activities into clinical software.

We are also interested to hear about your experiences of providing health checks via telehealth.

Contact aboriginalhealth@racgp.org.au to understand more or contribute your ideas and experiences.

Understand the purpose of the health check is to:

  • support initial and ongoing engagement in comprehensive primary healthcare in a culturally safe way
  • provide evidence-based health information, risk assessment and other services for primary and secondary disease prevention
  • identify health needs, including patient health goals and priorities
  • support participation in population health programs (eg immunisation, cancer screening), chronic disease management and other primary care services (eg oral health )

Know that a high-quality health check is:

  • a positive experience for the patient that is respectful and culturally safe
  • provided with a patient, not to a patient
  • useful to the patient and includes patient priorities and goals in health assessment and planning
  • supports patient agency
  • provided by the usual healthcare provider in the context of established relationship and trust
  • provided by a multidisciplinary team that includes Aboriginal and/or Torres Strait Islander clinicians
  • evidence-based as per current Australian preventive health guidelines that are generally accepted in primary care practice (eg National Aboriginal Community Controlled Health Organisation [NACCHO]–Royal Australian College of General Practitioners [RACGP] National guide to a preventive health assessment for Aboriginal and Torres Strait Islander people, Central Australian Rural Practitioner’s Association [CARPA] Standard Treatment Manual, etc)
  • provided with enough time (usually 30–60 minutes, with a minimum of 15 minutes with the GP) and often completed over several consultations
  • followed up with care of identified health needs (ie continuity of care).

Make sure your practice is providing health checks that are acceptable and valuable to patients by:

  • identifying Aboriginal and Torres Strait Islander patients in a welcoming, hospitable manner
  • explaining the purpose and process of the health check and obtaining consent
  • enquiring about patient priorities and goals
  • adapting the health check content to what is relevant and appropriate to the patient
  • asking questions in ways that acknowledge strengths, that are sensitive to individual circumstances and that avoid cultural stereotyping
  • completing the health check and identifying health needs
  • making a plan for follow-up of identified health needs in partnership with the patient
  • making follow-up appointments at the time of the health check, where possible
  • considering checking in with the patient about their experience of the health check, in order to support patient engagement and quality

Potential pitfalls of health checks:

  • A poor health check can lead to non- or dis-engagement in healthcare and has the potential to do harm – establish engagement and trust
  • Health checks can have highly variable content and quality
  • use endorsed high-quality templates
  • Increasing the number of health checks without a focus on quality may undermine benefit for patients – avoid quantity over quality
  • Health checks are not proxy for all preventive healthcare – they are one activity in the range of health promotion and disease-prevention activities in primary care
  • No follow-up will have no or minimal impact on improving health outcomes – follow up identified health needs
  • Cultural stereotyping – acknowledge the health impacts of racism and build a culturally safe practice

 

NACCHO Aboriginal Health Research Alert : @HealthInfoNet releases Summary of Aboriginal and Torres Strait Islander health status 2019 social and cultural determinants, chronic conditions, health behaviours, environmental health , alcohol and other drugs

The Australian Indigenous HealthInfoNet has released the Summary of Aboriginal and Torres Strait Islander health status 2019

This new plain language publication provides information for a wider (non-academic) audience and incorporates many visual elements.

The Summary is useful for health workers and those studying in the field as a quick source of general information. It provides key information regarding the health status of Aboriginal and Torres Strait Islander people across the following topics:

  • social and cultural determinants
  • chronic conditions
  • health behaviours
  • environmental health
  • alcohol and other drugs.

The Summary is based on HealthInfoNet‘s comprehensive publication Overview of Aboriginal and Torres Strait Islander health status 2019. It presents statistical information from the Overview in a visual format that is quick and easy for users to digest.

The Summary is available online and in hardcopy format. Please contact HealthInfoNet by email if you wish to order a hardcopy of this Summary. Other reviews and plain language summaries are available here.

Here are the key facts

Please note in an earlier version sent out 7.00 am June 15 a computer error dropped off the last word in many sentences : these are new fixed 

Key facts

Population

  • In 2019, the estimated Australian Aboriginal and Torres Strait Islander population was 847,190.
  • In 2019, NSW had the highest number of Aboriginal and Torres Strait Islander people (the estimated population was 281,107 people, 33% of the total Aboriginal and Torres Strait Islander population).
  • In 2019, NT had the highest proportion of Aboriginal and Torres Strait Islander people in its population, with 32% of the NT population identifying as Aboriginal and/or Torres Strait Islanders
  • In 2016, around 37% of Aboriginal and Torres Strait Islander people lived in major cities
  • The Aboriginal and Torres Strait Islander population is much younger than the non-Indigenous population.

Births and pregnancy outcomes

  • In 2018, there were 21,928 births registered in Australia with one or both parents identified as Aboriginal and/or Torres Strait Islander (7% of all births registered).
  • In 2018, the median age for Aboriginal and Torres Strait Islander mothers was 26.0 years.
  • In 2018, total fertility rates were 2,371 births per 1,000 for Aboriginal and Torres Strait Islander women.
  • In 2017, the average birthweight of babies born to Aboriginal and Torres Strait Islander mothers was 3,202 grams
  • The proportion of low birthweight babies born to Aboriginal and Torres Strait Islander mothers between 2007 and 2017 remained steady at around 13%.

Mortality

  • For 2018, the age-standardised death rate for Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT was 1 per 1,000.
  • Between 1998 and 2015, there was a 15% reduction in the death rates for Aboriginal and Torres Strait Islander people in NSW, Qld, WA, SA and the NT.
  • For Aboriginal and Torres Strait Islander people born 2015-2017, life expectancy was estimated to be 6 years for males and 75.6 years for females, around 8-9 years less than the estimates for non-Indigenous males and females.
  • In 2018, the median age at death for Aboriginal and Torres Strait Islander people in NSW, Qld, WA, SA and the NT was 2 years; this was an increase from 55.8 years in 2008.
  • Between 1998 and 2015, the Aboriginal and Torres Strait Islander infant mortality rate has more than halved (from 5 to 6.3 per 1,000).
  • In 2018, the leading causes of death among Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT were ischaemic heart disease (IHD), diabetes, chronic lower respiratory diseases and lung and related cancers.
  • For 2012-2017 the maternal mortality ratio for Aboriginal and Torres Strait Islander women was 27 deaths per 100,000 women who gave birth.
  • For 1998-2015, in NSW, Qld, WA, SA and the NT there was a 32% decline in the death rate from avoidable causes for Aboriginal and Torres Strait Islander people aged 0-74 years

Hospitalisation

  • In 2017-18, 9% of all hospital separations were for Aboriginal and Torres Strait Islander people.
  • In 2017-18, the age-adjusted separation rate for Aboriginal and Torres Strait Islander people was 2.6 times higher than for non-Indigenous people.
  • In 2017-18, the main cause of hospitalisation for Aboriginal and Torres Strait Islander people was for ‘factors influencing health status and contact with health services’ (mostly for care involving dialysis), responsible for 49% of all Aboriginal and Torres Strait Islander seperations.
  • In 2017-18, the age-standardised rate of overall potentially preventable hospitalisations for Aboriginal and Torres Strait Islander people was 80 per 1,000 (38 per 1,000 for chronic conditions and 13 per 1,000 for vaccine-preventable conditions).

Selected health conditions

Cardiovascular health

  • In 2018-19, around 15% of Aboriginal and Torres Strait Islander people reported having cardiovascular disease (CVD).
  • In 2018-19, nearly one quarter (23%) of Aboriginal and Torres Strait Islander adults were found to have high blood pressure.
  • For 2013-2017, in Qld, WA, SA and the NT combined, there were 1,043 new rheumatic heart disease diagnoses among Aboriginal and Torres Strait Islander people, a crude rate of 50 per 100,000.
  • In 2017-18, there 14,945 hospital separations for CVD among Aboriginal and Torres Strait Islander people, representing 5.4% of all Aboriginal and Torres Strait Islander hospital separations (excluding dialysis).
  • In 2018, ischaemic heart disease (IHD) was the leading specific cause of death of Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT

Cancer

  • In 2018-19, 1% of Aboriginal and Torres Strait Islander people reported having cancer (males 1.2%, females 1.1%).
  • For 2010-2014, the most common cancers diagnosed among Aboriginal and Torres Strait Islander people living in NSW, Vic, Qld, WA and the NT were lung cancer and breast (females) cancer.
  • Survival rates indicate that of the Aboriginal and Torres Strait Islander people living in NSW, Vic, Qld, WA, and the NT who were diagnosed with cancer between 2007 and 2014, 50% had a chance of surviving five years after diagnosis
  • In 2016-17, there 8,447 hospital separations for neoplasms2 among Aboriginal and Torres Strait Islander people
  • For 2013-2017, the age-standardised mortality rate due to cancer of any type was 238 per 100,000, an increase of 5% when compared with a rate of 227 per 100,000 in 2010-2014.

Diabetes

  • In 2018-19, 8% of Aboriginal people and 7.9% of Torres Strait Islander people reported having diabetes.
  • In 2015-16, there were around 2,300 hospitalisations with a principal diagnosis of type 2 diabetes among Aboriginal and Torres Strait Islander people
  • In 2018, diabetes was the second leading cause of death for Aboriginal and Torres Strait Islander people.
  • The death rate for diabetes decreased by 0% between 2009-2013 and 2014-2018.
  • Some data sources use term ‘neoplasm’ to describe conditions associated with abnormal growth of new tissue, commonly referred to as a Neoplasms can be benign (not cancerous) or malignant (cancerous) [1].

Social and emotional wellbeing

  • In 2018-19, 31% of Aboriginal and 23% of Torres Strait Islander respondents aged 18 years and over reported high or very high levels of psychological distress
  • In 2014-15, 68% of Aboriginal and Torres Strait Islander people aged 15 years and over and 67% of children aged 4-14 years experienced at least one significant stressor in the previous 12 months
  • In 2012-13, 91% of Aboriginal and Torres Strait Islander people reported on feelings of calmness and peacefulness, happiness, fullness of life and energy either some, most, or all of the time.
  • In 2014-15, more than half of Aboriginal and Torres Strait Islander people aged 15 years and over reported an overall life satisfaction rating of at least 8 out of 10.
  • In 2018-19, 25% of Aboriginal and 17% of Torres Strait Islander people, aged two years and over, reported having a mental and/or behavioural conditions
  • In 2018-19, anxiety was the most common mental or behavioural condition reported (17%), followed by depression (13%).
  • In 2017-18, there were 21,940 hospital separations with a principal diagnosis of International Classification of Diseases (ICD) ‘mental and behavioural disorders’ identified as Aboriginal and/or Torres Strait Islander
  • In 2018, 169 (129 males and 40 females) Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA, and the NT died from intentional self-harm (suicide).
  • Between 2009-2013 and 2014-2018, the NT was the only jurisdiction to record a decrease in intentional self-harm (suicide) death rates.

Kidney health

  • In 2018-19, 8% of Aboriginal and Torres Strait Islander people (Aboriginal people 1.9%; Torres Strait Islander people 0.4%) reported kidney disease as a long-term health condition.
  • For 2014-2018, after age-adjustment, the notification rate of end-stage renal disease was 3 times higher for Aboriginal and Torres Strait Islander people than for non-Indigenous people.
  • In 2017-18, ‘care involving dialysis’ was the most common reason for hospitalisation among Aboriginal and Torres Strait Islander people.
  • In 2018, 310 Aboriginal and Torres Strait Islander people commenced dialysis and 49 were the recipients of new kidneys.
  • For 2013-2017, the age-adjusted death rate from kidney disease was 21 per 100,000 (NT: 47 per 100,000; WA: 38 per 100,000) for Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and NT
  • In 2018, the most common causes of death among the 217 Aboriginal and Torres Strait Islander people who were receiving dialysis was CVD (64 deaths) and withdrawal from treatment (51 deaths).

Injury, including family violence

  • In 2012-13, 5% of Aboriginal and Torres Strait Islander people reported having a long-term condition caused by injury.
  • In 2018-19, 16% of Aboriginal and Torres Strait Islander people aged 15 years and over had experienced physical harm or threatened physical harm at least once in the last 12 months.
  • In 2016-17, the rate of Aboriginal and Torres Strait Islander hospitalised injury was higher for males (44 per 1,000) than females (39 per 1,000).
  • In 2017-18, 20% of injury-related hospitalisations among Aboriginal and Torres Strait Islander people were for assault.
  • In 2018, intentional self-harm was the leading specific cause of injury deaths for NSW, Qld, SA, WA, and NT (5.3% of all Aboriginal and Torres Strait Islander deaths).

Respiratory health

  • In 2018-19, 29% of Aboriginal and Torres Strait Islander people reported having a long-term respiratory condition .
  • In 2018-19, 16% of Aboriginal and Torres Strait Islander people reported having asthma.
  • In 2014-15, crude hospitalisation rates were highest for Aboriginal and Torres Strait Islander people presenting with influenza and pneumonia (7.4 per 1,000), followed by COPD (5.3 per 1,000), acute upper respiratory infections (3.8 per 1,000) and asthma (2.9 per 1,000).
  • In 2018, chronic lower respiratory disease was the third highest cause of death overall for Aboriginal and Torres Strait Islander people living in NSW, Qld, WA, SA and the NT

Eye health

  • In 2018-19, eye and sight problems were reported by 38% of Aboriginal people and 40% of Torres Strait Islander people.
  • In 2018-19, eye and sight problems were reported by 32% of Aboriginal and Torres Strait Islander males and by 43% of females.
  • In 2018-19, the most common eye conditions reported by Aboriginal and Torres Strait Islanders were hyperopia (long sightedness: 22%), myopia (short sightedness: 16%), other diseases of the eye and adnexa (8.7%), cataract (1.4%), blindness (0.9%) and glaucoma (0.5%).
  • In 2014-15, 13% of Aboriginal and Torres Strait Islander children, aged 4-14 years, were reported to have eye or sight problems.
  • In 2018, 144 cases of trachoma were detected among Aboriginal and Torres Strait Islander children living in at-risk communities in Qld, WA, SA and the NT
  • For 2015-17, 62% of hospitalisations for diseases of the eye (8,274) among Aboriginal and Torres Strait Islander people were for disorders of the lens (5,092) (mainly cataracts).

Ear health and hearing

  • In 2018-19, 14% of Aboriginal and Torres Strait Islander people reported having a long-term ear and/or hearing problem
  • In 2018-19, among Aboriginal and Torres Strait Islander children aged 0-14 years, the prevalence of otitis media (OM) was 6% and of partial or complete deafness was 3.8%.
  • In 2017-18, the age-adjusted hospitalisation rate for ear conditions for Aboriginal and Torres Strait Islander people was 1 per 1,000 population.

Oral health

  • In 2014-15, the proportion of Aboriginal and Torres Strait Islander children aged 4-14 years with reported tooth or gum problems was 34%, a decrease from 39% in 2008.
  • In 2012-2014, 61% of Aboriginal and Torres Strait Islander children aged 5-10 years had experienced tooth decay in their baby teeth, and 36% of Aboriginal and Torres Strait Islander children aged 6-14 years had experienced tooth decay in their permanent teeth.
  • In 2016-17, there were 3,418 potentially preventable hospitalisations for dental conditions for Aboriginal and Torres Strait Islander The age-standardised rate of hospitalisation was 4.6 per 1,000.

Disability

  • In 2018-19, 27% of Aboriginal and 24% of Torres Strait Islander people reported having a disability or restrictive long-term health
  • In 2018-19, 2% of Aboriginal and 8.3% of Torres Strait Islander people reported a profound or severe core activity limitation.
  • In 2016, 7% of Aboriginal and Torres Strait Islander people with a profound or severe disability reported a need for assistance.
  • In 2017-18, 9% of disability service users were Aboriginal and Torres Strait Islander people, with most aged under 50 years (82%).
  • In 2017-18, the primary disability groups accessing services were Aboriginal and Torres Strait Islander people with a psychiatric condition (24%), intellectual disability (23%) and physical disability (20%).
  • In 2017-18, 2,524 Aboriginal and Torres Strait Islander National Disability Agreement service users transitioned to the National Disability Insurance Scheme.

Communicable diseases

  • In 2017, there were 7,015 notifications for chlamydia for Aboriginal and Torres Strait Islander people, accounting for 7% of the notifications in Australia
  • During 2013-2017, there was a 9% and 9.8% decline in chlamydia notification rates among males and females (respectively).
  • In 2017, there were 4,119 gonorrhoea notifications for Aboriginal and Torres Strait Islander people, accounting for 15% of the notifications in Australia.
  • In 2017, there were 779 syphilis notifications for Aboriginal and Torres Strait Islander people accounting for 18% of the notifications in Australia.
  • In 2017, Qld (45%) and the NT (35%) accounted for 80% of the syphilis notifications from all jurisdictions.
  • In 2018, there were 34 cases of newly diagnosed human immunodeficiency virus (HIV) infection among Aboriginal and Torres Strait Islander people in Australia .
  • In 2017, there were 1,201 Aboriginal and Torres Strait Islander people diagnosed with hepatitis C (HCV) in Australia
  • In 2017, there were 151 Aboriginal and Torres Strait Islander people diagnosed with hepatitis B (HBV) in Australia
  • For 2013-2017 there was a 37% decline in the HBV notification rates for Aboriginal and Torres Strait Islander people.
  • For 2011-2015, 1,152 (14%) of the 8,316 cases of invasive pneumococcal disease (IPD) were identified as Aboriginal and Torres Strait people .
  • For 2011-2015, there were 26 deaths attributed to IPD with 11 of the 26 deaths (42%) in the 50 years and over age-group.
  • For 2011-2015, 101 (10%) of the 966 notified cases of meningococcal disease were identified as Aboriginal and Torres Strait Islander people
  • For 2006-2015, the incidence rate of meningococcal serogroup B was 8 per 100,000, with the age- specific rate highest in infants less than 12 months of age (33 per 100,000).
  • In 2015, of the 1,255 notifications of TB in Australia, 27 (2.2%) were identified as Aboriginal and seven (0.6%) as Torres Strait Islander people
  • For 2011-2015, there were 16 Aboriginal and Torres Strait Islander people diagnosed with invasive Haemophilus influenzae type b (Hib) in Australia
  • Between 2007-2010 and 2011-2015 notification rates for Hib decreased by around 67%.
  • In 2018-19, the proportion of Aboriginal and Torres Strait Islander people reporting a disease of the skin and subcutaneous tissue was 2% (males 2.4% and females 4.0%).

NACCHO Aboriginal Women and Children Health #MothersDay #IndigenousMums Aboriginal mothers are living with the fear their children could be taken. @HealingOurWay @DjirraVIC @JustinCCYP

“The fear these mothers, sisters, grandmothers and aunties have is justified and stems from lived experience and real situations.

There are real accounts of children being removed and often never being able to reconnect again. There is an acceptance this is not right. We need to see Aboriginal children reunified with their families.

As a white family you won’t have this feeling, as you parent, that a department could come and be involved in raising or even removing your children.

Institutional racism was part of the reason why so many Aboriginal children were still removed from their parents in Australia.

The view and past policies of Aboriginal people in Australia has been through the lens of white Australia, who see Aboriginal people as dysfunctional.

So the policies developed are saying we need to protect Aboriginal people from themselves.

Institutional racism has to be addressed to change a racist process of class and value … or lack of value.”

The Victorian Commissioner for Aboriginal Children and Young People, Justin Mohamed ( and former NACCHO Chair ) , said the over-representation of Aboriginal children in out-of-home care was an Australia-wide situation.

Originally published HERE

Link to community healing 

Key points:

  • Indigenous children are 10 times more likely to be removed from their families than other children
  • Victorian Commissioner for Aboriginal Children and Young People says institutional racism is part of the problem
  • A support service for Aboriginal families says women have a justified fear of the system

The Victorian Government announced a $10 million redress scheme for Stolen Generations survivors recently.

But many in the Australian Indigenous community say children are still being taken.

“I’d just given birth, my daughter was two hours old and we were in hospital when I received a call,” Gunditjmara and Yuin Nation mother Yaraan Bundle said.

“It’s extremely traumatic, at such a sacred time where you should be protected and nurtured, to experience the department coming and trying to remove your family.”

The department referred to is the Victorian Department of Health and Human Services (DHHS). It acknowledges that Aboriginal children are over-represented in out-of-home care.

National research shows Indigenous children are 10 times more likely to be removed from their families than other Australian children, and they make up 36 per cent of children living away from their parents in Australia.

Ms Bundle’s daughter remains with her, but so does the fear, anger, and frustration.

“I feel an intense fire deep within me, like a lioness protecting her babies. I always thought hospitals were the safest place for us to give birth, but now I understand they are not.”

Many women, same concerns

Indigenous mother Carla (not her real name) is eight months pregnant.

“Absolutely they’ll try and take my baby from me,” she said.

Carla has had children removed from her care with her children separated in different out-of-home care situations.

“I’ve got my own housing, I’ve done parenting courses, I’ve done everything they’ve said, as well as try and cope without my children, which is a struggle every day,” she said.

“This has put a big hole in my life. You can never heal that pain, and this has been happening to our people for generations.”

A Facebook post by an anonymous source complaining about a baby being taken from hospital.(Facebook)

Aunty Hazel volunteers her time supporting mothers as part of the organisation she began in 2014, called Grandmothers Against Removal.

Aunty Hazel said she remembered hiding as a child when the department came to take children from the mission she lived on.

Fighting for her family’s reunification is what inspired her to help other mothers.

“When you reflect back on these conversations you’re having with women, you’ll realise the essence of what they’re saying is like you’re talking to one person, not many,” Aunty Hazel said.

“By the time the children can get back they don’t know where they came from. It can be an 18-year sentence.”

‘Institutional racism’ part of the problem: commissioner

The Victorian Commissioner for Aboriginal Children and Young People, Justin Mohamed, said the over-representation of Aboriginal children in out-of-home care was an Australia-wide situation.

“Institutional racism has to be addressed to change a racist process of class and value … or lack of value.”

DHHS said, in a statement, self-determination for Aboriginal families was part of the solution.

“We’re working hard to address the unacceptable over-representation of Aboriginal children in out-of-home care and improving outcomes for Aboriginal children involved with child protection,” the statement said.

Antoinette Braybrook (far right) as a child with her brothers Shaun and Ryan in 1974.(Supplied: Antoinette Braybrook)

Connection to culture key to strengthening families

Antoinette Braybrook is the CEO of Djirra, a legal, cultural and support service for Aboriginal families.

She said she remembered DHHS coming to her door if she and her siblings missed any school, even though she had a happy and safe childhood.

“With my work with Djirra we see this happening all of the time with Aboriginal women, a justified fear of the system,” she said.

“It’s an approach that’s not about supporting. It’s about punishing.”

Waka Waka woman Naomi Murphy was taken from her parents when she was a child.

Ms Murphy’s mother is part of Australia’s Stolen Generations.

“My sister and I were taken two states away. My first suicide attempt was when I was 11 because I missed my parents like crazy,” she said.

“DHHS never stepped in because we were with white men. When I finally got home to my parents I was broken.”

Ms Murphy is now a mother herself, and said she has lived with threats her children could be taken.

“Healing started when I connected to my culture. It gives you purpose and identity,” she said.

“I had to learn how to be a mum because my mum was Stolen Generations and she didn’t know how to be a mum.”

NACCHO Aboriginal Women’s Health and #Smoking #IDM2020 #Midwives2020 News Alert : Dr @michelle_bovill : What ngidhi yinaaru nhal yayi (this woman told me) about smoking during pregnancy changes the conversation about this national priority.

 ” Let me make it clear right from the start. Aboriginal and Torres Strait Islander women are quitting smoking during pregnancy and care deeply about the health and wellbeing of their babies.

While there has been an acknowledgement that the proportion of Aboriginal and Torres Strait Islander women smoking during pregnancy has declined, reports more frequently measure and monitor smoking rates during pregnancy and compare these to non‐Aboriginal pregnant women.

For example, 43% of Aboriginal and Torres Strait Islander mothers reported smoking during pregnancy compared with 12% of non‐Aboriginal Australians.

I have been privileged to hear Aboriginal and Torres Strait Islander women from Worimi, Awabakal, Biripi, Goomeroi/Kamilaroi/Gamilaraay and Boandik communities share their stories with me about smoking and becoming pregnant.

I acknowledge my responsibility to pass on these stories to inform the conversations about smoking during pregnancy among Aboriginal and Torres Strait Islander women.

What ngidhi yinaaru nhal yayi (this woman told me) about smoking during pregnancy changes the conversation about this national priority.

What is now owed to these women is more action. Action by health professionals to advise Aboriginal and Torres Strait Islander women to quit smoking during pregnancy, and action to find meaningful support strategies to achieve abstinence. “

Selected extracts from

Michelle Bovill as published in MJA Journal

Download the publication HERE

mja250523

However, two things happen when we measure and monitor in this way. First, this approach assumes that Aboriginal and Torres Strait Islander communities are homogenous.

We are not; we are extremely diverse in cultures, customs and experiences. Second, it creates the impression that smoking during pregnancy is the issue and that Aboriginal and Torres Strait Islander women present a deficit.

This is detrimental because our lived experiences are not the same, nor have they been for generations. Colonisation, dispossession onto missions and reserves, the removal of children, unpaid labour, and refusal of the equal right to education, employment and health care over generations has led to a gap in social and cultural determinants of health.

This gap is founded on racist policies that positioned Aboriginal and Torres Strait Islander people as inferior to other Australians. The gap and deficit mentality follow us today and can be found in countless government reports on Aboriginal and Torres Strait Islander disadvantage.

When we don’t contextualise in terms of colonisation and the resulting social and cultural determinants of health, and fail to privilege Indigenous knowledges, we cannot truthfully address any area of health inequity.

While it has been identified that Aboriginal and Torres Strait Islander women experience multiple barriers to quitting smoking during pregnancy, little work has been conducted to ask Aboriginal and Torres Strait Islander mothers about their experiences of quitting and what they believe could support them to become smoke‐free during pregnancy.

Quit attempts are being made “A lot of people are more wanting to give up smoking but not having the information”

Across New South Wales, Queensland and South Australia, Aboriginal and Torres Strait Islander women often shared a desire to quit smoking and reported making several quit attempts during pregnancy. Aboriginal and Torres Strait Islander people in general are more likely than other Australians to make a quit attempt but are less likely to succeed, which raises the question, “what is happening when Aboriginal and Torres Strait Islander people make a quit attempt?”.

Stories of quit attempts lasting at least 24 hours but often less than a full week were often shared. If we listen to Aboriginal and Torres Strait Islander women, we can hear that motivation to quit is high.

The problem with reduction “I think doctors need to stop telling people to cut down”

Aboriginal and Torres Strait Islander women across communities yarra (say) reduction in cigarette consumption was suggested by health providers.

This tendency to advise reduction in tobacco consumption rather than recommending to women that they quit completely has been previously reported.

 Advising women to cut down cigarette consumption during pregnancy when they are unable to quit smoking is still being promoted across the country in clinical practice guidelines.

 If we only ever report quit rates, yet Aboriginal and Torres Strait Islander women are only being advised to reduce, how will we ever achieve the lower smoking rates of the non‐Aboriginal population?

“I was doing 10 to 15 cigarettes down to 1 to 2 cigarettes a day. I think that is a big, a big reduce”

Aboriginal and Torres Strait Islander women are proud of their success in reducing cigarette consumption. Why shouldn’t they be? Women are successfully following the advice of their health providers.

The only randomised controlled trial conducted with Aboriginal and Torres Strait Islander women during pregnancy reported that 70% of women who were advised to quit smoking by their health provider made a quit attempt.

A recent survey of Aboriginal women who smoke revealed positive attitudes to advice and support from doctors (61%) and midwives (62%). However, health provider support for planned smoking cessation is reported to be weak.

Pregnancy is a life stage during which there are multiple opportunities to offer cessation support to mothers.

Each opportunity should repeat the unambiguous message that the best thing for mothers’ and babies’ health is to quit smoking completely, explain that they are not alone, and offer cessation support.

We therefore hit a dilemma: what cessation support should even be offered? Systematic reviews on Aboriginal tobacco control have concluded that there is limited evidence of effective programs for Aboriginal and Torres Strait Islander people in general as well as during pregnancy.

Community led initiatives are key to successful outcomes

“Everybody looks up to their Elders and stuff, as you know, maybe just a yarn or a get‐together to discuss smoking could help”

Aboriginal women in NSW yarra (speak) of their desire to receive support from their community and Elders. Elders understand community dynamics and the context of women’s lives in a way that (non‐Aboriginal) health providers cannot

. But what would this look like in a health care setting? How can we ensure that consistent messages are offered throughout community to support being smoke‐free?

“I was just thinking that these products, I wouldn’t use them. I’d think about the side effects”

Aboriginal and Torres Strait Islander pregnant women yarra (speak) of their desire to use non‐pharmacological and stress management approaches for smoking cessation. The use of alternative approaches (such as yoga and mindfulness) has been reported in white populations with high socio‐economic status; however, the effectiveness of some of these approaches is as yet uncertain.,

Aboriginal and Torres Strait Islander health does not focus on the individual, but rather the social, emotional and cultural wellbeing of the whole community in which each individual is able to achieve their full potential.

It is therefore important that any support program to address health inequities also focuses on community engagement and empowerment. Aboriginal and Torres Strait Islander women want control and ownership of the quitting process and should be empowered to quit smoking.

If we truly want to support Aboriginal and Torres Strait Islander women to quit smoking during pregnancy, we need to privilege their voices in the process of developing effective and meaningful supports.

I have been privileged to hear Aboriginal and Torres Strait Islander women from Worimi, Awabakal, Biripi, Goomeroi/Kamilaroi/Gamilaraay and Boandik communities share their stories with me about smoking and becoming pregnant.

I acknowledge my responsibility to pass on these stories to inform the conversations about smoking during pregnancy among Aboriginal and Torres Strait Islander women.

What ngidhi yinaaru nhal yayi (this woman told me) about smoking during pregnancy changes the conversation about this national priority.

What is now owed to these women is more action. Action by health professionals to advise Aboriginal and Torres Strait Islander women to quit smoking during pregnancy, and action to find meaningful support strategies to achieve abstinence.

Developing appropriate support strategies for Aboriginal and Torres Strait Islander people should draw on traditional and contemporary knowledges, values and practices.

Over the next 4 years, with the support of a National Health and Medical Research Council Early Career Fellowship and a National Heart Foundation Australian Aboriginal and Torres Strait Islander Award, I will commence this exploratory work in partnership with NSW Aboriginal communities through the Which Way? project.

This project will partner with four communities to explore what Aboriginal and Torres Strait Islander women desire to support smoking cessation and develop an Indigenous led evidence base on smoking cessation.

This work will build on the request for non‐pharmacological support and align with a holistic definition of health and wellbeing. It is my belief that by developing, implementing and evaluating a support strategy that Aboriginal and Torres Strait Islander women desire, our communities can achieve smoking abstinence.

Aboriginal Women’s Health #CoronaVirus News Alert No 44 : April 22 #KeepOurMobSafe : #OurJobProtectOurMob : The Australian Government needs to step up and better support Aboriginal women and children at-risk of violence amid COVID-19

 “The Australian government has promised a $1.1 billion health and domestic violence package to help protect vulnerable Australians during the COVID-19 crisis. But one of the most vulnerable groups of all, Aboriginal women and their children, may see little benefit at all.

Recent cuts to critical Aboriginal family violence services mean support for Aboriginal women and children vulnerable to domestic violence was already going backwards before the government’s latest promises.

New restrictions and social distancing also pose a unique challenge to the Aboriginal community-controlled sector, community health, social and family services that are relied on by Aboriginal women for family violence support.

Aboriginal women and children are significantly over-represented in all domestic and family violence statistics. Aboriginal women are 32 times as likely to be hospitalised due to family violence as non-Aboriginal women. Aboriginal children are seven times as likely to be the subject of substantiated child protection notifications, often due to family violence.

Shawana Andrews Associate Director, Melbourne Poche Centre for Indigenous Health, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne : Originally Published HERE

” The National Family Violence Prevention Legal Services Forum was formally established in May 2012. It is comprised of thirteen member organisations across Australia who are service providers under the Family Violence Prevention Legal Services (FVPLSs) Program.

FVPLSs provide specialist, culturally safe legal services and supports to Aboriginal and Torres Strait Islander victim/survivors of family violence across Australia.”

For FVPLS help CLICK HERE

Domestic violence, isolation and COVID-19

These higher risks are exacerbated during times of crisis and high stress, like now.

Even without COVID19 Aboriginal families face additional stressors like overcrowded housing, inequitable health care access, trauma and racism.

With so many intersecting issues, the psychological impact of quarantine and lockdown measures will be significant.

The National Aboriginal Community Controlled Health Organisation mobilised early to protect Aboriginal communities from COVID-19 and has worked hard to establish with the government an emergency response management plan to ensure an adequate response to the virus itself and its broader health impacts.

But recent advice from the Australian Indigenous Doctors Association (AIDA) suggests that Aboriginal people continue to face racism in the health system when seeking COVID-19 testing and treatment.

The child, family and social services sector has been less co-ordinated and there has been little to no specific response from the COAG Women’s Safety Council regarding Aboriginal women’s and children’s safety during this time.

The burden has once again fallen to the Aboriginal community-controlled sector which is responding within its limited available resources, mobilising its community structures and relying on social media to reach out to Aboriginal women.

With such a distracted health system and the ‘usual’ barriers still impacting upon access to care for Aboriginal people, Aboriginal women’s voices and needs risk once again being unheard.

A community acting against family violence

As remote Aboriginal communities close their borders and urban communities cope with lockdowns and move into crisis response mode, critical supports for Aboriginal women experiencing violence risk being either cut-off or significantly reduced due to inadequate resourcing.

Aboriginal women experiencing violence also rely heavily on their protective kinship relationships with other Aboriginal women. With social interaction currently limited to two people, COVID-19 measures will heavily impact upon both the formal and informal collective gatherings that Aboriginal women use for support.

Governments must therefore be proactive and provide specific financial and bespoke workforce support to leading Aboriginal health, social and family violence services to develop revolutionary, culturally-framed and safe mechanisms for Aboriginal women to seek the support they require.

Social media and technology is offering women some of the support they need and holds great potential in times such as these. This is one avenue of support for Aboriginal women if set up to support safety. Safe housing, appropriate legislation changes and community-based systems of reaching women and children whilst they are in lockdown are also critical.

The onus is on government to ensure the needs of at-risk Aboriginal women and children aren’t forgotten amid the COVID-19 crisis. Rohan Thomson/Getty Images

Listening to those working on the front line and across the sector is critical, as is listening to the voices of many Aboriginal women who are currently in desperate need of a government that responds to their needs.

The COVID-19 pandemic shouldn’t be remembered as the time during which governments failed to act and unprecedented numbers of Aboriginal women suffered at the hands of their violent partners or that the rates of Aboriginal children in out-of-home care soared even higher than the current alarming rate.

Time is running out for mobilising support for one of Australia’s most vulnerable groups.

Aboriginal women who live with violence show great resilience and agency day in, day out. In their mothering role, they work tirelessly to protect their children which includes mitigating the risk from both a violent partner and a violent child welfare system that often seeks to remove their children.

Aboriginal mothers need, now more than ever, opportunities to connect with trusted friends and family, help with safety plans, support for their children and ways to communicate safely.

In this context Aboriginal women generally have few supports, and the critical supports they do have are now at risk of being inaccessible or over-burdened.

Now is the time for governments to step up.

NACCHO Aboriginal Health #Stroke #Heart #ClosetheGap Research : @ANUmedia New recommendations for cardiovascular disease risk assessment and management in Aboriginal and Torres Strait Islander adults aged under 35 years

This is a great step in reducing the burden of cardiovascular disease in Aboriginal and Torres Strait Islander people.”

Our people have greater rates of heart disease and screening from a younger age will contribute to longer healthier lives. NACCHO encourages all Aboriginal Community Controlled Health Organisations to implement these new guidelines in their practices.

The Chair of the National Aboriginal Community Controlled Health Organisation, Donnell Mills

The updated recommendations are for Aboriginal and Torres Strait Islander individuals to receive:

  • Combined early screening for diabetes, chronic kidney disease and other cardiovascular (CVD) risk factors from the age of 18 years at latest;
  • Assessment of absolute CVD risk using an Australian CVD risk calculator from the age of 30 years at the latest.

New recommendations for CVD risk assessment and management were published today in the Medical Journal of Australia.

See all Close the gap articles in the MJA Journal HERE

The recommendations were endorsed by the National Aboriginal Community Controlled Health Organisation, Royal Australian College of General Practitioners, Central Australian Rural Practitioners Association and the Australian Chronic Disease Prevention Alliance, led by the Heart Foundation.

The approach to early screening was developed in partnership with the Australian National University’s Aboriginal Reference Group (Thiitu Tharrmay) and other Aboriginal and Torres Strait Islander leaders in CVD prevention.

Take home messages

  1. Most heart attacks and strokes can be prevented, and in the last 20 years, the rate of deaths from CVD in Aboriginal and Torres Strait Islanders peoples has almost halved.
  2. High risk of cardiovascular disease begins early among Aboriginal and Torres Strait Islander peoples and is mainly due to diabetes and renal diseaseIt is recommended that there should be:
    1. Combined early screening for diabetes, chronic kidney disease and cardiovascular disease risk factors from the age of 18 years. This should include assessment of blood glucose level or glycated haemoglobin, estimated glomerular filtration rate, serum lipids, urine albumin to creatinine ratio, and other risk factors such as blood pressure, history of familial hypercholesterolaemia, and smoking status.
    2. Assessment of absolute CVD risk using an Australian CVD risk calculator from the age of 30 years. Outside of Communicare, the best CVD risk calculator to use is auscvdrisk.com.au/risk-calculator/
  3. What you can do: Assessment of CVD risk as part of a health check. The most important part of this check-up is working with your doctor to manage your risk factors to improve your heart health and help you live a healthier, longer life.

” Around 80% of heart attacks and strokes can be prevented with optimal care. Cardiovascular disease (CVD) remains a leading contributor to Aboriginal and Torres Strait Islander mortality despite a 40% decrease in deaths in the past two decades and significant decreases in smoking prevalence.

High risk of CVD begins early among Aboriginal and Torres Strait Islander peoples, mainly in people with diabetes and/or renal disease.

Our program of work, funded by the Australian Government Department of Health, is focused on improving prevention of cardiovascular disease for Aboriginal and Torres Strait Islander peoples through:

  • Revision and alignment of clinical practice guidelines ( see part 2 below )
  • Revision and enhanced Medicare Benefits Schedule items for prevention of chronic disease
  • Workforce education and engagement

See ANU program website

Read over 80 Aboriginal Heart health articles published by NACCHO over past 8 Years 

Read over 100 Aboriginal and Stroke articles published by NACCHO over past 8 years 

To combat high risk of heart attack and strokes, Aboriginal and Torres Strait Islander people should have had their heart checked by a GP by age 18 at the latest, according to new national recommendations.

As part of a regular health check with a GP, the recommendations launched today have moved the age Indigenous people should get screened for Cardiovascular Disease (CVD) down from 35 to 18.

Based on research from The Australian National University (ANU), a host of health professionals and Aboriginal and Torres Strait Islander CVD experts have agreed on the latest efforts to continue closing the gap on early heart attacks among Indigenous Australians.

“We have seen great improvements in CVD prevention and this was highlighted in this year’s Closing the Gap speech,” said ANU lead researcher, Dr Jason Agostino.

“However, it remains a leading cause of preventable death in Aboriginal and Torres Strait Islander peoples. We need to be doing all we can to prevent it.

“Just about every Aboriginal person I know has a family member or a community member who’s died young from a heart attack or stroke. We need to change that.

“We can improve things by picking up conditions like diabetes and kidney disease early and starting conversations about treatment.”

In the last 20 years, the rate of deaths from heart attacks and strokes among Aboriginal and Torres Strait Islanders peoples have almost halved.

However, three out of four Aboriginal and Torres Strait Islander adults under 35 have at least one CVD risk factor.

Rheumatic Heart Disease Australia’s Senior Cultural Advisor, Vicki Wade, is a 62-year-old cardiac nurse who has heart disease. She said it is important to remind community and health workers about the risks of CVD.

“Although rates have improved, the statistics are frightening. We have generations of Aboriginal people who are not seeing their grandchildren growing up because of heart attack and stroke,” Mrs Wade said.

“This is a chance for local solutions, community engagement and health workers to be educated.”

Fellow author, Heart Foundation Chief Medical Adviser, cardiologist Professor Garry Jennings, said: “Evidence shows that Indigenous Australians have CVD risk factors like diabetes, high blood pressure and high cholesterol at a young age. We need to prevent, identify and treat these.”

Aboriginal and Torres Strait Islanders should now undergo CVD risk factor screening from 18 years, at the latest, and use Australian CVD risk calculators from age 30.

“It’s easy to do. The assessment involves the normal parts of a health check with a blood and urine test. It is quick and can be done by your local GP,” said Dr Agostino.

“For the vast majority it will be bulk-billed and free.”

The move is backed by the Royal Australian College of General Practitioners, the National Aboriginal Community Controlled Health Organisation, The Australian Chronic Disease Prevention Alliance, and the Editorial Committee for Remote Primary Health Care Manuals.

“This is about getting consistency everywhere. This is what Aboriginal and Torres Strait Islander leaders and the evidence is telling us we should do,” Dr Agostino said.

“Many GPs are already screening as early as 15 but some GPs and nurses don’t know about the need to test early.

“This is about doing what we can to pick up risk factors early and close the gap on early heart attacks and strokes.”

RACGP Aboriginal and Torres Strait Islander Health Chair, Associate Professor Peter O’Mara welcomed the new recommendations, saying they could make a real difference in improving health outcomes for Aboriginal and Torres Strait Islander peoples.

“We cannot hope to close the gap without making evidence-based changes – these new recommendations are a positive step to improving early detection and treatment of CVD.

“The RACGP has over 40,000 members, including 10,000 members in the faculty of Aboriginal and Torres Strait Islander health. While many GPs know about early screening not all do. These new recommendations will help spread awareness among GPs, improving access to early screening and quality care.”

Under the new recommendations, young adults with type 2 diabetes and microalbuminuria, kidney disease, and very high blood pressure or high cholesterol will be identified as high- risk of CVD.

Want more information and resources?

A team at ANU is developing a toolkit on risk communication in CVD: Healing Heart Communities. Designed as a resource for all clinical staff in primary care, it aims to support conversations about CVD risk.

During development, the team has consulted the Australian National University’s Aboriginal Reference Group (Thiitu Tharrmay) and partnered with We are Saltwater People, an Indigenous-owned graphic design company based in QLD to create original artwork, design and layout.

You can find these initial resources here: [

NACCHO Aboriginal Mental Health News : Download @MenziesResearch and @orygen_aus A practice guide for ‘Improving the Social and Emotional Wellbeing of Young Aboriginal and Torres Strait Islander people

 ” Menzies Research and Orygen Australia have developed & just published a practice guide for ‘Improving the Social and Emotional Wellbeing of Young Aboriginal and Torres Strait Islander people’.

Little is known about how best to practically meet the social and emotional wellbeing (SEWB) needs of young Aboriginal and Torres Strait Islander people, particularly those with severe and complex mental health needs.

Yet, there is an urgent need for health programs and services to be more responsive to the mental health needs of this population.

Based on recent statistics, 67 per cent of Aboriginal and Torres Strait Islander young people aged 4-14 years have experienced one or more of the following stressors:

  • death of family/friend;
  • being scared or upset by an argument or someone’s behaviour; and
  • keeping up with school work. “

Download the Report HERE ( See PDF for all research references )

orygen-Practice-Guide-to-improve-the-social-and-emotional-wellbeing-of-young-Aboriginal-and-Torres-Strait-Islander-people

Read over 250 Aboriginal Mental Health articles published by NACCHO over past 8 Years

It is well documented that there are:

  • high rates of psychological distress, mental health conditions, and suicide noted among Aboriginal and Torres Strait Islander young people when compared to non-Aboriginal young people;
  • a lack of evidence-based and culturally informed resources to educate and assist health professionals to work with this population; and
  • notable gaps between knowledge and practice, which limits opportunities to improve the SEWB of young Aboriginal and Torres Strait Islander people.

This promising practice guide draws on an emerging, yet disparate, evidence-base about promising practices aimed at improving the SEWB of Aboriginal and Torres Strait Islander young people. It aims to support service providers, commissioners, and policy-makers to adopt strengths-based, equitable and culturally responsive approaches that better meet the SEWB needs of this high-risk population.

Rationale

The Australian Government appointed Orygen to provide Australia’s 31 Primary Health Networks (PHNs) with expert leadership and support in commissioning youth mental health initiatives.

Orygen has subsequently commissioned Menzies School of Health Research to identify and document promising practice service approaches in improving SEWB among young Aboriginal and Torres Strait Islander people with severe and complex mental health needs. This promising practice guide is an output of that work.

What do we know about the social and emotional wellbeing of Aboriginal and Torres Strait Islander young people?

It is recognised that Aboriginal and Torres Strait Islander societies provided the optimal condition for their community members’ mental health and social and emotional wellbeing before European settlement.

However, the Australian Psychological Society has acknowledged that these optimal conditions have been continuously eroded through colonisation in parallel with an increase in mental health concerns.2

There is clear evidence about the disproportionate burden of SEWB and mental health concerns experienced among Aboriginal and Torres Strait Islander people. The key contributors to the disease burden among Aboriginal and Torres Strait Islander young people aged 10-24 years are:1 suicide and self-inflicted injuries (13 per cent), anxiety disorder (eight per cent) and alcohol use disorders (seven per cent).3

Based on recent statistics, 67 per cent of Aboriginal and Torres Strait Islander young people aged 4-14 years have experienced one or more of the following stressors:

  • death of family/friend;
  • being scared or upset by an argument or someone’s behaviour; and
  • keeping up with school work.4

The stressors have a cumulative impact as these children transition into adolescence and early adulthood. Another study has shown that Aboriginal and Torres Strait Islander young people are at higher risk of emotional and behavioural difficulties.5

This is linked to major life stress events such as family dysfunction; being in the care of a sole parent or other carers; having lived in a lot of different homes; being subjected to racism; physical ill-health of young people and/or carers; carer access to mental health services; and substance use disorders. These factors are all closely intertwined.

Relevant national frameworks and action plans

The Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013-2023 (2015) was developed by the Australian Government Department of Health in close consultation with the National Health Leadership Forum. It has a strong emphasis on a whole-of-government approach to addressing the key priorities identified throughout the plan.

The overarching vision is to ensure that the strategies and actions of the plan respond to the health and wellbeing needs of Aboriginal and Torres Strait Islander people across their life course. This includes a focus on young people.6

The National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing 2017-2023 provides more specific direction by highlighting the importance of preventive actions that focus on children and young people.7 This includes:

  • strengthening the foundation;
  • promoting wellness;
  • building capacity and resilience in people and groups at risk;
  • provide care for people who are mildly or moderately ill; and
  • care for people living with severe mental illness.

In addition, the National Action Plan for the Health of Children and Young People 2020-2030 identifies building health equity, including principles of proportionate universalism, as a key action area and identifies Aboriginal and Torres Strait Islander children and young people as a priority population.8

Social and emotional wellbeing frameworks relating to Aboriginal and Torres Strait Islander people

 

Over the past decades, multiple frameworks have been developed to support the SEWB of Aboriginal and Torres Strait Islander people in Australia.4-8 These have identified some common elements, domains, principles, action areas and methods.7, 9-12

One of the most comprehensive frameworks is the National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing 2017-2023, which has a foundation of development over many years.13

It has nine guiding principles:

  1. Health as a holistic concept: Aboriginal and Torres Strait Islander health is viewed in a holistic context that encompasses mental health and physical, cultural and spiritual health. Land is central to wellbeing. Crucially, it must be understood that while the harmony of these interrelations is disrupted, Aboriginal and Torres Strait Islander ill-health will persist.
  2. The right to self-determination: Self-determination is central to the provision of Aboriginal and Torres Strait Islander health services and considered a fundamental human right.
  3. The need for cultural understanding: Culturally valid understandings must shape the provision of services and must guide assessment, care and management of Aboriginal and Torres Strait Islander peoples’ health problems generally and mental health concerns more specifically. This necessitates a culturally safe and responsive approach through health program and service delivery.
  4. The impact of history in trauma and loss: It must be recognised that the experiences of trauma and loss, a direct result of colonialism, are an outcome of the disruption to cultural wellbeing. Trauma and loss of this magnitude continue to have intergenerational impacts.
  5. Recognition of human rights: The human rights of Aboriginal and Torres Strait Islander peoples must be recognised and respected. Failure to respect these human rights constitutes continuous disruption to mental health (in contrast to mental illness/ill health). Human rights specifically relevant to mental illness must be addressed.
  6. The impact of racism and stigma: Racism, stigma, environmental adversity and social disadvantage constitute ongoing stressors and have negative impacts on Aboriginal and Torres Strait Islander peoples’ mental health and wellbeing.
  7. Recognition of the centrality of kinship: The centrality of Aboriginal and Torres Strait Islander family and kinship must be recognised as well as the broader concepts of family and the bonds of reciprocal affection, responsibility and sharing.
  8. Recognition of cultural diversity: There is no single Aboriginal or Torres Strait Islander culture or group, but numerous groupings, languages, kinship systems and tribes. Furthermore, Aboriginal and Torres Strait Islander people live in a range of urban, rural or remote settings where expressions of culture and identity may differ.
  9. Recognition of Aboriginal strengths: Aboriginal and Torres Strait Islander people have great strengths, creativity and endurance and a deep understanding of the relationships between human beings and their environment.13

While the principles outlined above are not specific to young Aboriginal and Torres Strait Islander people, they are considered to be appropriate within the context of adopting a holistic life-course approach.

What’s happening in practice?

This promising practice guide attempts to collate disparate strands of evidence that relate to enhancing youth mental health; improving Aboriginal and Torres Strait Islander SEWB; and strategies for addressing severe and complex mental health needs.

It has been well documented that there are significant limitations in the evaluation of Aboriginal and Torres Strait Islander health programs and services across Australia.22-24 The Australian Governments’ Productivity Commission Inquiry into

Mental Health and the Lowitja Institute are, at the time of producing this document, looking at ways to strengthen work in this space.24, 25

In the absence of high-quality evaluation reports, the term ‘promising practice’ is used throughout this guide.

This is consistent with the terminology used by the Australian Psychological Society through its project about SEWB and mental health services in Australia (http://www.sewbmh.org.au/).

It adopts a strengths-based approach26 which acknowledges and celebrates efforts made to advance work in this space in the absence of strong practice-based evidence.

This is achieved through the presentation of five active case studies.

These reflect organizational, systems and practice focused service model examples. The principles included in the National Strategic Framework for Aboriginal and Torres Strait Islander Peoples’ Mental Health and Social and Emotional Wellbeing 2017-2023 have been mapped against each case study to illustrate how these privilege Aboriginal and Torres Strait Islander ways of knowing, doing and being.

Each case study includes generic background information to provide important contextual information; key messages or lessons learned, and reflections from staff involved in the project.

They have been developed in consultation with both the commissioning PHN and the service/organisation funded to develop and/or deliver the framework, program and service. Where possible, Aboriginal and Torres Strait Islander stakeholders were consulted during the development of the case studies.

Need help ?

Contact your nearest ACCHO or

If the situation is an emergency please call 000
If you wish to speak to someone immediately who can help call:

Kids Help Line

1800 55 1800
www.kidshelpline.com.au

Lifeline Australia

13 11 14
www.lifeline.org.au

NACCHO Aboriginal Health #InternationalWomensDay #EachforEqual #IWD2020 : Our tribute to our 10 Women NACCHO Board of Directors and 71 #ACCHO CEO’s of our majority female workforce

1.National : Donnella Mills – Chair NACCHO and Wuchopperen Health Service   

2.NT: Donna Ah Chee Central Australian Aboriginal Congress

3.NSW: LaVerne Bellear Redfern Aboriginal Medical Service

4.TAS: Raylene Foster Tasmanian Aboriginal Corporation

5.NT: Olga Havnen Danila Dilba Health Service

6.VIC: Karen Heap Ballarat & District Aboriginal Co-operative

7.SA: Willhelmine Lieberwirth South Australia

8.WA: Lesley Nelson South West Aboriginal Medical Service

9.ACT: Julie Tongs Winnunga Nimmityjah Health and Community Service

10. QLD: Gail Wason Mulungu Primary Health Care Service

International Women’s Day 2020 campaign theme is #EachforEqual

An equal world is an enabled world.

Individually, we’re all responsible for our own thoughts and actions – all day, every day.

We can actively choose to challenge stereotypes, fight bias, broaden perceptions, improve situations and celebrate women’s achievements.

Collectively, each one of us can help create a gender equal world.

Let’s all be #EachforEqual.

Aboriginal women are the best advocates and leaders for health and wellbeing in their own families and in the broader community.

They are proving to be effective role models, mentors and influencers for the next generation of Aboriginal female leaders.

Recently NACCHO CEO Pat Turner told a women’s leadership summit (Pictured above in centre )

As mothers, aunts, grandmothers, sisters and daughters, Aboriginal and Torres Strait Islander women have culturally and historically always played a pivotal role in supporting and caring for families in our communities so working in the health sector was a natural progression.

For over 47 years Indigenous health activists like Dr Naomi Mayers, Coleen Shirley (Mum Shirl) Smith AM MBE, Jill Gallagher AO, Vicki O’Donnell, Pamela Mam, and the late Mary Buckskin have been just some of our leaders who have successfully advocated for community controlled, culturally respectful, needs based approach to improving the health and wellbeing outcomes of our people.

See previous NACCHO #IWD Tribute HERE 

As a result of their leadership and years of commitment as role models they have now paved the way for 10 women to be on the NACCHO board, 71 Indigenous women promoted to CEO’s out of 145 Organisations who employ over 6,000 staff with a majority being Indigenous woman

Our ACCHO network has successfully provided a critical and practical pathway for the education, training and employment for many Indigenous women.But much more needs to be done to develop viable career pathways to graduate more Indigenous women doctors, nurses and allied health professionals.

Last year NACCHO, RANZCOG and other medical college Presidents met with the Minister for Indigenous Health and other ministers in Canberra who are all determined to do everything possible to Close the Gap in health outcomes.

Creating career pathways for Indigenous women in our workforce will be a good starting point to continue supporting the theme ” More powerful together ”

1.National : Donnella Mills – Chair NACCHO and Wuchopperen Health Service QLD 

Donnella is a Torres Strait Islander woman with ancestral and family links to Masig and Nagir in the Torres Strait.

She is a Cairns–based lawyer with LawRight, a Community Legal Centre which coordinates the provision of pro-bono civil legal services to disadvantaged and vulnerable members of the community. Donnella is currently the project lawyer for the Wuchopperen Health Justice Partnership through a partnership with LawRight. This innovative Health Justice Partnership is an exciting model of providing access to justice, where lawyers and health professionals collaborate to provide better health outcomes and access to justice for patients with legal issues.

Donnella said she was “very excited about the opportunity to contribute to working the new Chairperson, the new board and the NACCHO Executive to drive the national health debate, develop community led solution, and to champion why Community-Controlled is the pinnacle model in achieving greater autonomy and self-determination for Aboriginal and Torres Strait Islander people.

Utilising a legal lens in which to view health, social justice, human rights, and access to justice, my commitment is to deliver expanded and enhanced innovative health services that are community driven and community led, addressing core systemic social determinant issues that have a direct impact on our Aboriginal and Torres Strait Islander people.”

2.NT: Donna Ah Chee CEO Central Australian Aboriginal Congress

Ms Ah Chee is the Chief Executive Officer of the Central Australian Aboriginal Congress Aboriginal Corporation, the Aboriginal community controlled primary health care service in Alice Springs.

Ms Ah Chee is a Bundgalung woman from the far north coast of New South Wales and has lived in Alice Springs for over 25 years.

She has been actively involved in Aboriginal affairs for many years, especially in the area of Aboriginal adult education and Aboriginal health. In June 2011, Ms Ah Chee moved to Canberra to take up the position of Chief Executive Officer of the National Aboriginal Community Controlled Organisation before returning to Congress in July 2012.

Ms Ah Chee convened the Workforce Working Party under the Northern Territory Aboriginal Health Forum, was Chairperson of the Central Australian Regional Indigenous Health Planning Committee, a member of the Northern Territory Child Protection External Monitoring Committee and jointly headed up the Northern Territory Government’s Alcohol Framework Project Team.

She currently sits on the National Drug and Alcohol Committee and at a local level, represents the Congress on the People’s Alcohol Action Coalition.

3.NSW: LaVerne Bellear CEO Redfern Aboriginal Medical Service

LaVerne Bellear a descendant from the Nunukle Tribe of south-eastern Queensland, grew up in the northern part of the Bundjalung Nation (north coast New South Wales).

LaVerne strongly believes that empowering Aboriginal people will create opportunity to make better informed decisions and choices regarding personal management of health care, ultimately resulting in better health outcomes. LaVerne has extensive experience in Aboriginal health, having worked in community health, Aboriginal controlled health services and as the Director, Aboriginal Health, Northern Sydney Local Health District.

Recently, LaVerne has taken up the position of CEO, Aboriginal Medical Service Cooperative at Redfern, New South Wales.

She has been a state representative on a number of working parties and committees concerning Aboriginal health. LaVerne has a Bachelor of Business, a Professional Certificate in Indigenous Research in Training and Practices and is studying a Master of Public Health at The University of New South Wales.

4.TAS: Raylene Foster Tasmanian Aboriginal Corporation

Raylene Foster is a palawa women from the Cygnet area. She commenced her career in hospitality, becoming a chef, and then moved into adult teaching within the TAFE institute.

Raylene took on a six-month secondment to Tasmanian Aboriginal Centre in 1995 and stayed; she has now been with the TAC for over 20 years

She’s had varying roles within the TAC, including the Director of the Aboriginal Community School, Workforce Development Officer, Emotional and Social Wellbeing Coordinator and over the past 15 years the Manager of the Tasmanian Aboriginal Centre in the South, which includes the Aboriginal Health Service.

Raylene has a Graduate Certificate in Administration and an Advanced Diploma in Human Resources, as well as Diploma of Alcohol and Other Drugs and Mental Health and a facilitator in the SMART Recovery program. Raylene is passionate about children’s wellbeing and keeping families connected to break the cycle of institutionalisation, separations and trauma-related illnesses.

Raylene’s Abstract For This Months Rural Health Conference in Hobart 

See Website 

The Aboriginal cultural camp was an initiative that commenced in 2016 for Tasmanian registrars, GPs and members of the Tasmanian Aboriginal community. We wanted to go beyond the basic requirements of attendance at cultural training, to offer an immersion in to Aboriginal culture, on Aboriginal country, with mutual benefit for the Aboriginal and non-Aboriginal communities.

The camp is held annually at trawtha makuminya, Aboriginal-owned land in the Central Highlands of Tasmania, from a Friday afternoon until a Sunday afternoon. Registrars, General Practitioners, Practice Staff and General Practice Training Tasmania staff and family members attend, in addition to the TAC staff Camp Organisers and Caterers, Cultural and Land Educators, Elders and community members.

The weekend involves an official welcome speech, dance and music, yarning around the campfire, guided walks with discussion about Aboriginal history, the land and stone tools, kayaking, basket weaving, hand stencilling, clap stick making, and a session of “You Can’t Ask That”. There is a medical education session and participants hear from an Aboriginal Health Worker and Aboriginal Enrolled Nurse about the services offered by the Tasmanian Aboriginal Centre.

There is a lot of informal discussion about culture and life stories shared by both the adults and the children.

The feedback given to date, both informally and through the evaluation forms, is overwhelmingly positive. Participants value the beautiful location, the opportunity to spend time with community members outside the clinical setting, the obvious connection to country displayed by the Aboriginal community and the sharing of stories in a cultural exchange.

5.NT: Olga Havnen CEO Danila Dilba Health Service Darwin 

Olga is of Western Arrente descent and grew up in Tennant Creek. Her great-grandfather was Ah Hong, a Chinese cook who worked on the Overland Telegraph Line[2] whose partner was an Aboriginal woman in Alice Springs.

Their daughter Gloria, Havnen’s grandmother, was the first Aboriginal woman to own a house in Alice Springs. Havnen’s father was a Norwegian sailor who jumped ship in Adelaide and her mother, Pegg lived in Tennant Creek. Havnen went to boarding school in TownsvilleQueensland.[3]

Olga Havnen has held positions as the Aboriginal and Torres Strait Islander Programs Co-ordinator for the Australian Red Cross, Senior Policy Officer in the Northern Territory Government’s Indigenous Policy Unit, Indigenous Programs Director with the Fred Hollows Foundation, and Executive Officer with the National Indigenous Working Group.

And was the Coordinator General of Remote Service Provision from 2011 until October 2012, when the Northern Territory Government controversially abolished the position.[4]

She released one report which detailed deficiencies in Northern Territory and Commonwealth Government’s service provision to remote communities in the Northern Territory.[5]

She is currently the Chief Executive Officer of the Danila Dilba Health Service in Darwin, an Aboriginal Community Controlled Health Service.[1]

Havnen gave evidence at the Royal Commission into the Protection and Detention of Children in the Northern Territory critical of the outcomes and delivery of the Northern Territory National Emergency Response, commonly referred to as the Intervention stating “the experience of the Intervention was such a debacle you’d never want that repeated, but I do think that there is a role for the federal government in here in the Northern Territory”,

6.VIC: Karen Heap Ballarat & District Aboriginal Co-operative : Chair VACCHO 

Karen Heap, a Yorta Yorta woman, has been the CEO of Ballarat and District Aboriginal Cooperative for 12 years and brings with her a vast amount of knowledge and skillsets procured from extensive experience within the Aboriginal Service Sector.

Karen Heap was recently the winner of the Walda Blow Award ( pictured above )

This award was established by DHHS in partnership with the Victorian Commissioner for Aboriginal Children and Young People, in memory of Aunty Walda Blow – a proud Yorta

Yorta and Wemba Wemba Elder who lived her life in the pursuit of equality.

Aunty Walda was an early founder of the Dandenong and District Aboriginal Cooperative and worked for over 40 years improving the lives of the Aboriginal community. This award recognises contributions of an Aboriginal person in Victoria to the safety and wellbeing of Aboriginal and/or Torres Strait Islander children and young people.

Karen ensures the safety and wellbeing of Aboriginal and/or Torres Strait Islander children and young people are always front and centre.

Karen has personally committed her support to the Ballarat Community through establishing and continuously advocating for innovative prevention, intervention and reunification programs.

As the inaugural Chairperson of the Alliance, Karen contributions to establishing the identity and achieving multiple outcomes in the Alliance Strategic Plan is celebrated by her peers and recognised by the community service sector and DHHS.

Karen’s leadership in community but particularly for BADAC, has seen new ways of delivering cultural models of care to Aboriginal children, carers and their families, ensuring a holistic service is provided to best meet the needs of each individual and in turn benefit the community.

7.SA: Willhelmine Lieberwirth South Australia 

 

A Kokatha and Antakirinja woman, Wilhelmine honours her rich family ancestry. She has worked in human services roles, most recently as an Aboriginal Cultural Consultant with Child and Family Health Services and has been instrumental in the Safely Sleeping Aboriginal Babies in South Australia.

Wilhelmine and her family have lived in Whyalla for generations and have been active participants advocating on local health matters, including supporting the local ACCHO Nunyara Aboriginal Health Service Inc.

8.WA: Lesley Nelson CEO South West Aboriginal Medical Service

SWAMS are united by the drive and passion to provide culturally safe, accessible and holistic health care to the Aboriginal people of the South West. WA

As an organisation, they continue to attract and employ culturally appropriate and professional staff members. SWAMS employs over 70 staff members including specialist Aboriginal Health Practitioners, Dietitians, Nurses, Midwives, Mental Health workers and Social Workers and because of this, we are able to provide a large and diverse range of services to the community.

In addition to this, they strive to create Aboriginal career pathways and opportunities across the sector and maintain a positive percentage of ATSI employees

Last year as preparations got underway for the South West Aboriginal Medical Service’s 20th anniversary, centre chief executive officer Lesley Nelson has reflected on how far indigenous health has advanced in the South West in that time.

Ms Nelson said the centre started small with a handful of staff and a desire to improve Aboriginal health outcomes in the region.

Over the next 20 years, it expanded with clinics in Bunbury, Busselton, Manjimup, Collie and Brunswick.

“We started after local elders held discussions with a number of key groups about developing a culturally appropriate service to address the health-related issues of the South West’s Indigenous population,” she said.

“Since then we’ve gone from strength-to-strength, offering a number of employment opportunities in the sector, training programs and improved health outcomes.”

Ms Nelson said the local service played an important role in the community.

“Being based in a number of country towns ensured locals can access our services conveniently, especially if they lack transport options to the bigger cities,” she said.

“We offer an important service because we intervene and manage issues early on and slowly we are improving the health of the South West Noongar people.

“We are also standing out nationally when it comes to maternal and child health.”

Moving forward, SWAMS are keen to continue growing, participating in more research studies and working collaboratively with other similar services to offer a whole of community approach to improved health.

9.ACT: Julie Tongs Winnunga Nimmityjah Health and Community Service

Julie Tongs OAM has been the Chief Executive Officer of Winnunga Nimmityjah Aboriginal Health and Community Services since 1998.  Julie has more than 30 years experience working in Aboriginal and Torres Strait Islander affairs and in particular has extensive experience in advising, formulating, implementing and evaluating public health initiatives, programs and policy at a local, regional and national level.

Julie has been a national leader and strong advocate of quality improvement initiatives within the Aboriginal Community Controlled sector.

Julie is the recipient of a number of awards, including the ACT Governor General’s Centenary Medal and the ACT Indigenous Person of the Year. In 2011 Julie received the ACT Local Hero Award within the Australian of the Year Awards 2012, and in 2012 Julie was honoured with the Medal of the Order of Australia.

Julie’s vision is that Winnunga continues to build on its reputation as a national leader in the provision of holistic primary health care services delivered in a culturally appropriate environment that achieves improved health outcomes for Aboriginal and Torres Strait Islander people. Julie is committed to ensuring that Winnunga offers services that are delivered consistent with best practice standards.

10 .QLD: Gail Wason Mulungu Primary Health Care Service

We see the best way to build capacity and capability within our corporation is by encouraging strong leaders, maintaining effective governance, ensuring strong systems, and keeping focused on accountable performance management.

Mulungu help our clients to make informed decisions. We work in health but we also work across education and job opportunities. Our model supports individuals who want to do the best for themselves, their family and their community.’

CEO Gail Wason.

Gail is the Chief Executive Officer of Mulungu Primary Health Care Service in Mareeba. She has over 25 years’ experience in Aboriginal affairs and health, and an unwavering commitment to improving the health and wellbeing of her community.

Gail strives to ensure that the community has access to the full range of high quality, culturally appropriate primary health care services that empowers clients to fully participate in the management of their own health.

She has served as QAIHC’s Far North Queensland Director and Chairperson of QAIHC’s Finance Committee and has worked closely with the Board for many years.

Mulungu Aboriginal Corporation Medical Centre is an Aboriginal community-controlled health organisation working to improve the lives of Indigenous people in and around Mareeba.

The centre was established in 1991 and incorporated under the CATSI Act in 1993.

The rural town of Mareeba—a word from local Aboriginal language meaning ‘meeting of the waters’—is located on the Atherton Tablelands where the Barron River meets Granite Creek. Traditionally Muluridji people inhabited this land.

‘Although the bright lights of Cairns are only 65 kilometres away we feel like a stand-alone, small country town,’ says chair of the Mulungu board of directors (and valued volunteer) Alan Wason. ‘We have a population of 10,000 and our own identity separate from Cairns.’

The town of Mareeba may be a little tucked away but it has much to offer, including Mulungu Aboriginal Corporation Medical Centre—a bright, open, modern building—which employs a large professional staff who work as a team and support each other. Everyone is passionate about providing top quality holistic health care to the community through Mulungu’s programs and services.

Mulungu’s mission is to provide comprehensive primary health care to the community in culturally, socially and emotionally appropriate ways. It’s about handing back power to the people to manage their own health, wellbeing and spiritual needs. So as well as providing clinical health care services Mulungu ‘auspices’ other important primary health care programs, including the Mareeba Children and Families Centre (CFC), Mareeba Parent and Community Engagement (PaCE) Program, and the Mareeba Young and Awesome Project (MY&A).

The MY&A Project tackles the problem of binge drinking in the community. Its aim is to motivate young people (aged 12 to 25) to get involved in constructive activities that they might enjoy—and to get them away from drinking alcohol. This two-year project is funded by the Australian Government.

‘We help our clients to make informed decisions,’ says Gail Wason. ‘We work in health but we also work across education and job opportunities. Our model supports individuals who want to do the best for themselves, their family and their community.’

It’s all about changing and improving lives.

To learn more about Mulungu Aboriginal Corporation Medical Service visit http://mulungu.org.au.

NACCHO Aboriginal Health #AODConnect Resources Alert : Download an app to improve access to #alcohol and other #drugs AOD service information for Aboriginal and Torres Strait Islander communities

The AODconnect app has been developed by the Australian Indigenous HealthInfoNet Alcohol and Other Drugs Knowledge Centre to help alcohol and other drug (AOD) workers, community members and health professionals working in the AOD sector to locate culturally appropriate services.

The app aims to support efforts to reduce harmful substance use among Aboriginal and Torres Strait Islander people.

Read over 200 Aboriginal Health Alcohol and other Drugs articles published by NACCHO over past 8 years 

Aboriginal and Torres Strait Islander people are increasingly using online platforms to share and access information about different health topics.

The ownership and use of mobile phones in rural and remote Aboriginal and Torres Strait Islander communities is widespread and increasing, making apps a viable way to provide people living in these regions with access to health information.

AODconnect provides an Australia-wide directory of over 270 Aboriginal and Torres Strait Islander AOD treatment services.

It delivers a portable way to easily access information about service providers such as contact details and program descriptions, helping to facilitate initial contact and referral.

App

Once the app has been downloaded, users can search for AOD services even when their internet connection is unstable or not available.

This is especially useful in rural and remote areas of Australia where the Internet coverage is not always extensive or reliable.

The app enables users to search for services by state, territory, region and postcode via either an interactive map of Australia or by alphabetical listing.

Services can be filtered by the type of treatment they provide: counselling and referral, harm reduction and support groups, outreach, mobile patrols and sobering up shelters, residential rehab, withdrawal management and young people.

The services listed on the app are also available through the Alcohol and Other Drugs Knowledge Centre website.

The app is free to download on both iOS and Android devices.

If you would like to have your service added to the app or would like more information about the AODconnect app, please contact the Alcohol and Other Drugs Knowledge Centre email: aodknowledgecentre@healthinfonet.org.au or Ph: (08) 9370 6336.

Alcohol and other drugs GP education program


NACCHO Aboriginal Health Resources Alert : Download @HealthInfoNet Overview of Aboriginal and Torres Strait Islander health status 2019 : Continuing to show important positive developments for our mob

In the Overview we strive to provide an accurate and informative summary of the current health and well-being of Aboriginal and Torres Strait Islander people.

In doing so, we want to acknowledge the importance of adopting a strengths-based approach, and to recognise the increasingly important area of data sovereignty.

To this end, we have reduced our reliance on comparative data in favour of exploring the broad context of the lived experience of Aboriginal and Torres Strait islander people and how this may impact their health journey “

HealthInfoNet Director, Professor Neil Drew

The Overview of Aboriginal and Torres Strait Islander health status (Overview) aims to provide a comprehensive summary of the most recent indicators of the health and current health status of Australia’s Aboriginal and Torres Strait Islander people.

Download HERE 

Overview+of+Aboriginal+and+Torres+Strait+Islander+health+status+2019

The annual Overview contains updated information across many health conditions.

It shows there has been a range of positive signs including a decrease in death rates, infant mortality rates and a decline in death rates from avoidable causes as well as a reduction in the proportion of Aboriginal and Torres Strait Islander people who smoke.

It has also been found that fewer mothers are smoking and drinking alcohol during pregnancy meaning that babies have a better start to life.

The initial sections of the Overview provide information about:

  • the context of Aboriginal and Torres Strait Islander health
  • social determinants including education, employment and income
  • the Aboriginal and Torres Strait Islander population
  • measures of population health status including births, mortality and hospitalisation.

The remaining sections are about selected health conditions and risk and protective factors that contribute to the overall health of Aboriginal and Torres Strait Islander people.

These sections include an introduction and evidence of the extent of the condition or risk/protective factor. Information is provided for state and territories and for demographics such as sex and age when it is available and appropriate.

The Overview is a resource relevant for the health workforce, students and others requiring access to up-to-date information about the health of Aboriginal and Torres Strait Islander people.

This year, the focus will be mainly on the Aboriginal and Torres Strait Islander data and presentation is within the framework of the strength based approach and data sovereignty (where information is available).

As a data driven organisation, the HealthInfoNet has a publicly declared commitment to working with Aboriginal and Torres Strait Islander leaders to advance our understanding of data sovereignty and governance consistent with the principles and aspirations of the Maiam nayri Wingara Data Sovereignty Collective (https://www.maiamnayriwingara.org).

As we have done in previous years, we continue our strong commitment to developing strengths based approaches to assessing and reporting the health of Aboriginal and Torres Strait Islander people and communities.

It is difficult to make comparisons between Aboriginal and Torres Strait Islander people and non- Indigenous Australian populations without consideration of the cultural and social contexts within which people live their lives.

As in past versions, we still provide information on the cultural context and social determinants for the Aboriginal and Torres Strait Islander population.

However, for the selected health topics and risk/protective factors we have removed many of the comparisons between the two populations and focused on the analysis of the Aboriginal and Torres Strait Islander data only.

In an attempt to respond to the challenge issued by Professor Craig Ritchie at the 2019 AIATSIS conference to say more about the ‘how’ and the ‘why’ not just the ‘what’ where comparisons are made and if there is evidence available, we have provided a brief explanation for the differences observed.

Accompanying the Overview is a set of PowerPoint slides designed to help lecturers and others provide up-to-date information.

  • In 2019, the estimated Australian Aboriginal and Torres Strait Islander population was 847,190.
  • In 2019, NSW had the highest number of Aboriginal and Torres Strait Islander people (the estimated population was 281,107 people, 33% of the total Aboriginal and Torres Strait Islander population).
  • In 2019, NT had the highest proportion of Aboriginal and Torres Strait Islander people in its population, with 32% of the NT population identifying as Aboriginal and/or Torres Strait Islander.
  • In 2016, around 37% of Aboriginal and Torres Strait Islander people lived in major cities.
  • The Aboriginal and Torres Strait Islander population is much younger than the non-Indigenous population.

Download the PowerPoint HERE

Overview+of+Aboriginal+and+Torres+Strait+Islander+health+status+2019_+key+facts