NACCHO Aboriginal Mental Health #RUOKDay @ruokday ? Download #RUOKSTRONGERTOGETHER resources a targeted #MentalHealth #SuicidePrevention campaign to encourage conversation within our communities. Contributions inc Dr Vanessa Lee @joewilliams_tew @ShannanJDodson

Regardless of where we live, or who our mob is, we can all go through tough times, times when we don’t feel great about our lives or ourselves. That’s why it’s important to always be looking out for each other.

If someone you know – a family member, someone from your community, a friend, neighbour or workmate – is doing it tough, they won’t always tell you.
Sometimes it’s up to us to trust our gut instinct and ask someone who may be struggling with life “Are you OK?”.

By asking and listening, we can help those we care about feel more supported and connected, which can help stop them from feeling worse over time.

That’s why this campaign has a simple message: Let’s talk. We are stronger together

“Nationally, Indigenous people die from suicide at twice the rate of non-Indigenous people. This campaign comes at a critical time.

As a community we are Stronger Together. Knowledge is culture, and emotional wellbeing can be learned from family members such as mothers and grandmothers.

These new resources from R U OK? will empower family members, and the wider community, with the tools to look out for each other as well as providing guidance on what to do if someone answers “No, I’m not OK”.”

Dr Vanessa Lee BTD, MPH, PhD Chair R U OK’s Aboriginal and Torres Strait Islander Advisory Group whose counsel has been integral in the development of the campaign

Read over 130 + NACCHO Aboriginal Health and Suicide Prevention articles

Click here to access the STRONGER TOGETHER resources on the RUOK? website

The Aboriginal and Torres Strait Islander Suicide Prevention Evaluation Project (ATSISPEP)

 I have struggled with depression and anxiety for as long as I can remember. I’m 32 years old and only this year did I have the first psychologist ever ask me about my family history and acknowledge the intergenerational trauma that runs through Indigenous families.

Like many others, I have thought about taking my own life. There were a myriad of factors that led to that point, and a myriad of factors that led to me not following through. But one of the factors was the immense weight of intergenerational trauma that I believe is embedded into my heart, mind and soul and at times feels too heavy a burden to carry.

We can break this cycle of trauma. We need culturally safe Indigenous-designed suicide prevention programs and to destigmatise conversations around mental health. My hope is that, by sharing my own experiences of dealing with this complex subject, other people will be able to see that intergenerational trauma affects all of our mob.

The more we identify and acknowledge it, we’ll be stronger together “

Shannan Dodson is a Yawuru woman and on the RUOK? Indigenous Advisory committee that has launched the Stronger Together campaign targeted at help-givers – those in our communities who can offer help to those who are struggling ;

See full story Part 2 Below or HERE

R U OK? has launched STRONGER TOGETHER, a targeted suicide prevention campaign to encourage conversation within Aboriginal and Torres Strait Islander communities.

Developed with the guidance and oversight of an Aboriginal and Torres Strait Islander Advisory Group and 33 Creative, an Aboriginal owned and managed agency, the campaign encourages individuals to engage and offer support to their family and friends who are struggling with life. Positive and culturally appropriate resources have been developed to help individuals feel more confident in starting conversations by asking R U OK?

The STRONGER TOGETHER campaign message comes at a time when reducing rates of  suicide looms as one of the biggest and most important challenges of our generation.

Suicide is one of the most common causes of death among Aboriginal and Torres Strait

Islander people. A 2016 report noted that on average, over 100 Aboriginal and Torres Strait Islander people end their lives through suicide each year, with the rate of suicide twice as high as that recorded for other Australians [1]. These are not just numbers. They represent lives and loved ones; relatives, friends, elders and extended community members affected by such tragic deaths.

STRONGER TOGETHER includes the release of four community announcement video

The video series showcases real conversations in action between Aboriginal and Torres Strait Islander advocates and role models.

The focus is on individuals talking about their experiences and the positive impact that sharing them had while they were going through a tough time.

“That weekend, I had the most deep and meaningful and beautiful conversations with my Dad that I never had.

My Dad was always a staunch dude and I was always trying to put up a front to, I guess, make my Dad proud. But we sat there, and we cried to each other.

I started to find myself and that’s when I came to the point of realising that, you know, I’m lucky to be alive and I had a second chance to help other people.”

When we talk, we are sharing, and our people have always shared, for thousands of years we’ve shared experiences, shared love. The only way we get out of those tough times is by sharing and talking and I hope this series helps to spread that message.”

Former NRL player and welterweight boxer Joe Williams has lent his voice to the series.

Born in Cowra, Joe is a proud Wiradjuri man. Although forging a successful professional sporting career, Joe has battled with suicidal ideation and bipolar disorder. After a suicide attempt in 2012, a phone call to a friend and then his family’s support encouraged him to seek professional psychiatric help.

Australian sports pioneer Marcia Ella-Duncan OAM has also lent her voice to the series. Marcia Ella-Duncan is an Aboriginal woman from La Perouse, Sydney, with traditional connection to the Walbunga people on the NSW Far South Coast, and kinship connection to the Bidigal, the traditional owners of the Botany Bay area.

“Sometimes, all we can do is listen, all we can do is be there with you. And sometimes that might be all you need. Or sometimes it’s just the first step towards a much longer journey,” said Marcia.

Click here to access the STRONGER TOGETHER resources on the RUOK? website.

If you or someone you know needs support, go to:

Part 2

Shannan Dodson is a Yawuru woman and on the RUOK? Indigenous Advisory committee that has launched the Stronger Together campaign targeted at help-givers – those in our communities who can offer help to those who are struggling ;

Originally Published the Guardian and IndigenousX

It is unacceptable and a national disgrace that there have been at least 35 suicides of Indigenous people this year – in just 12 weeks – and three were children only 12 years old.

The Kimberley region – where my mob are from – has the highest rate of suicide in the country. If the Kimberley was a country it would have the worst suicide rate in the world.

A recent inquest investigated 13 deaths which occurred in the Kimberley region in less than four years, including five children aged between 10 and 13.

Western Australia’s coroner said the deaths had been shaped by “the crushing effects of intergenerational trauma”.

When we’re talking about Indigenous suicide, we have to talk about intergenerational trauma; the transfer of the impacts of historical trauma and grief to successive generations.

These multiple layers of trauma can have a “cumulative effect and increase the risk of destructive behaviours including suicide”. Many of our communities are, in essence, “not just going about the day, but operating in crisis mode on a daily basis.”

I have struggled with depression and anxiety for as long as I can remember. I’m 32 years old and only this year did I have the first psychologist ever ask me about my family history and acknowledge the intergenerational trauma that runs through Indigenous families.

Like many others, I have thought about taking my own life. There were a myriad of factors that led to that point, and a myriad of factors that led to me not following through. But one of the factors was the immense weight of intergenerational trauma that I believe is embedded into my heart, mind and soul and at times feels too heavy a burden to carry.

Indigenous suicide is different. Suicide is a complex issue, there is not one cause, reason, trigger or risk – it can be a web of many indicators. But with Aboriginal and Torres Strait Islander people intergenerational trauma and the flow-on effects of colonisation, dispossession, genocide, cultural destruction and the stolen generations are paramount to understanding high Indigenous suicide rates.

When you think about the fact that most Indigenous families have been affected, in one or more generations, by the forcible removal of one or more children, that speaks volumes. The institutionalisation of our mob has had dire consequences on our sense of being, mental health, connection to family and culture.

Just think about that for a moment. If every Indigenous family has been affected by this, of course trauma is transmitted down through generations and manifests into impacts on children resulting from weakened attachment relationships with caregivers, challenged parenting skills and family functioning, parental physical and mental illness, and disconnection and alienation from the extended family, culture and society.

The high rates of poor physical health, mental health problems, addiction, incarceration, domestic violence, self-harm and suicide in Indigenous communities are directly linked to experiences of trauma. These issues are both results of historical trauma and causes of new instances of trauma which together can lead to a vicious cycle in Indigenous communities.

Our families have been stripped of the coping mechanisms that all people need to thrive and survive. And while Aboriginal and Torres Strait Islander people are resilient, we are also human.

Our history does shape us. Let’s start from colonisation. My mob the Yawuru people from Rubibi (Broome) were often brutally dislocated from our lands, and stripped of our livelihood. Our culture was desecrated and we were used for slave labour.

My great-grandmother was taken from her father when she was very young and placed in a mission in Western Australia. My grandmother and aunties then all finished up in the same mission. And two of those aunties spent a considerable time in an orphanage in Broome, although they were not orphans.

In 1907, a telegram from Broome station was sent to Henry Prinsep, the “Chief Protector of Aborigines for Western Australia” in Perth. It reads: “Send cask arsenic exterminate aborigines letter will follow.” This gives a glimpse of the thinking of the time and that of course played out in traumatic and dehumanising ways.

In the late 1940s a magistrate in the court of Broome refused my great-grandmother’s application for a certificate of citizenship under the Native Citizen Rights Act of Western Australia. Part of his reasons for refusing her application was that she had not adopted the manner and habits of civilised life.

My anglo grandfather was imprisoned for breaching the Native Administration Act of Western Australia, in that he was cohabiting with my grandmother. He was jailed for loving my jamuny (grandmother/father’s mother).

My dad lost his parents when he was 10 years old. My grandfather died in tragic circumstances – and then my grandmother, again in tragic circumstances, soon after.

My dad was collected by family in Katherine and taken to Darwin. There was a fear that he would be taken away – Indigenous families knew well the ways of the Native Welfare authorities, and I suspect they were protecting my dad from that fate. Unlike many Indigenous families, he was permitted to stay with them and became a state child in the care of our family.

My family has suffered from ongoing systematic racism and research has shown that racism impacts Aboriginal people in the same way as a traumatic event.

My family and community have suffered premature deaths from suicide, preventable health issues, grief and inextricable trauma.

We can break this cycle of trauma. We need culturally safe Indigenous-designed suicide prevention programs and to destigmatise conversations around mental health. My hope is that, by sharing my own experiences of dealing with this complex subject, other people will be able to see that intergenerational trauma affects all of our mob. The more we identify and acknowledge it, we’ll be stronger together.

NACCHO Aboriginal Health #FASDay #FASDprevention News : @NOFASDAustralia and @TheRACP call for mandatory warning labels and a national #FASD Prevention Campaign. An alcohol free pregnancy is everyone’s responsibility.

“ At NOFASD, across Australia, and around the world people took a minute today to pause and reflect on the struggles which individuals , families and communities face when they are living with Fetal Alcohol Spectrum Disorder (FASD).

At 9:09 on the 9th day of the 9th month we came together to raise awareness about the risks of alcohol and the importance of alcohol-free pregnancies.”

See NO FASD Press Release Part 2 Below

Read over 30 Aboriginal Health and #FASD articles published by NACCHO

“ Before the extra years were added to his sentence and before the trouble that led to them, authorities were warned that a teenage boy with severe cognitive impairments was deteriorating in Darwin’s Don Dale youth detention centre and needed help.

Key points:

  • A 17-year-old boy was recently sentenced to an additional four years’ jail over a riot in Don Dale in July 2018
  • The ABC has seen letters sent to authorities weeks before the riot, requesting urgent intervention
  • A Supreme Court judge accepted that conditions in the prison contributed to the boy’s offending

Legal letters seen by the ABC formally requesting urgent intervention in then-16-year-old Corey’s* “outrageous” treatment in the condemned facility were sent to the head of the Territory Families department and the NT Children’s Commissioner in June last year.

Legal Aid lawyers told authorities that the teenager — who has foetal alcohol spectrum disorder (FASD) and a history of trauma starting from abandonment in hospital at birth — had been kept in effective isolation, with little fresh air, sunlight and schooling, and had been threatened and assaulted by other boys inside Don Dale.

A spokesperson said Aboriginal health organisation Danila Dilba was taking over primary health care in the centre, support services had been “significantly” increased and an FASD component was added to staff induction training.

Olga Havnen, who is the chief executive of Danila Dilba, said Corey had been set up to fail in a system that couldn’t help him.

She said the teenager’s conviction for property damage to Don Dale was ironic, asking: “Who pays for the damage caused to this young person?”

Extracts from ABC Report : Read in full here

Part 1 RACP Press Release

Doctors from the Royal Australasian College of Physicians (RACP) are calling for the Australian Government to introduce mandatory pregnancy warning labels on alcohol products.

“Drinking alcohol while pregnant can lead to birth defects and lifelong neurodevelopmental problems associated with Fetal Alcohol Syndrome Disorders (FASD),” said Professor Paul Colditz, President of Paediatrics and Child Health at the RACP and an alcohol policy expert.

“FASD is the most common and preventable cause of serious brain injury in children in Australia. There is no cure for FASD, so prevention is everything. This is why clear and unambiguous messaging on the harms of drinking while pregnant is important and why such messaging should be mandatory across all alcohol product labels.

“With less than half of alcohol manufacturers currently using pregnancy warning labels we can’t look to the industry to self-regulate.

“There is also an inherent conflict of interest under the current approach where consumers are ultimately directed towards industry websites for warning information and may be exposed to contradictory messages.”

In its submission to the Food Regulation Standing Committee, the RACP makes a number of evidence-based recommendations about how to implement mandatory pregnancy warning labels.

The RACP recommends that behaviour change experts develop new text for warning labels. Graphics should feature on the label to convey the harms of alcohol to an unborn baby.

Consistency of messaging is important so warning labels should be standardised across the industry. Prominence of the labelling is also important.

“We know that pregnancy warning labels alone are not enough to prevent FASD, but we think it’s a step in the right direction for raising public awareness about the dangers of prenatal alcohol exposure,” Professor Colditz said.

The National Drug Strategy Household Survey 2016 found only 56 per cent of pregnant women said they abstained from drinking during pregnancy.

Part 2 NO FASD Press Release Continued

The Australian Medical Association (AMA) reports that 50% of Australian women experience an unplanned pregnancy.

The first few weeks of these unknown pregnancies are a major risk for prenatal alcohol exposure. Approximately 59% of Australian women drink alcohol at some time during their pregnancy, and estimates indicate that 1 in every 13 women who consume alcohol will have a child with FASD.

These numbers are staggering. The AMA states that “few accurate data on the prevalence of FASD in Australia is available but it is estimated that FASD affects roughly between 2% and 5% of the population in the United States”.

FASD is the most common preventable disability, and preventing FASD is a whole-of-community responsibility. Mothers never intentionally put their children at risk. Increasing awareness about the risks of drinking when you could be pregnant, and supporting women who are pregnant to abstain throughout their nine months, is essential for preventing alcohol-exposed pregnancies.

If you are pregnant, don’t drink alcohol. If you drink alcohol, don’t get pregnant.

Friends and partners can play a major role in supporting mothers to be alcohol free. For example it is much easier for a woman to say no to alcohol if her partner stops drinking too. We can support expectant mothers by organising fun alcohol-free activities, serving non-alcoholic drinks, and reducing or ceasing our own drinking.

If you, or anyone you know, is pregnant, planning or could be, NO ALCOHOL is the safest option

NACCHO Aboriginal Health Conferences and Events #Saveadate : This week @ShelleyWare #WomensHealthWeek @strokefdn and @QAIHC_QLD in partnership #strokeweek2019 Plus @SNAICC #SNAICC2019

Upcoming feature NACCHO SAVE A DATE events

This week

2 to 8 September 2019 National Stroke Week 

2 -8 September Women’s Health Week

2- 5 September 2019 SNAICC Conference

Next week

12 September R U OK Day


15-19 September 50 year of PHAA Annual Conference Adelaide 17 – 19 September #AustPH2019

23 -25 September IAHA Conference Darwin

24 -26 September 2019 CATSINaM National Professional Development Conference

2- 4 October  AIDA Conference 2019

9-10 October 2019 NATSIHWA 10 Year Anniversary Conference

16 October Melbourne Uni: Aboriginal and Torres Strait Islander Health and Wellbeing Conference

4 November NACCHO Youth Conference -Darwin NT

5 – 7 November NACCHO Conference and AGM  -Darwin NT

5-8 November The Lime Network Conference New Zealand

2 -8 September Women’s Health Week

 ” My family’s wellbeing is so important to me and, as an Indigenous woman, I am equally passionate about tackling the appalling health and life expectancy statistics of Aboriginal and Torres Strait Islander people. As an ambassador for Jean Hailes and Women’s Health Week, I feel I can be part of the solution by encouraging Indigenous women to take the time to put their health first.

You can put your health first too by being part of this year’s Women’s Health Week  It’s fun and free.” 

Shelley Ware Womens Health Week Ambassador : Note Shelley shared the above from the AFL Footy Record 

Read over 350 Aboriginal Womens Health articles published by NACCHO over the past 7 years

Five years ago I was delighted to become one of the first ambassadors for Jean Hailes’ Women’s Health Week. I am still so proud to be involved, helping to promote the importance of good health.

Growing up, sport was a natural part of our family life.  I played netball, participated in little athletics, swimming – even touch footy.  My Dad was a professional runner and Mum played netball too so if we weren’t at sport, we were watching our parents play.

My childhood was pretty idyllic until the awful day when my beloved Dad suffered a heart attack and passed away at the age of 51.  A few years later, Mum was diagnosed with breast cancer at age 50 following a routine mammogram.  Thankfully she beat it and is still doing well today.

I have a lot to watch out for in my yearly health checks, so it’s important I stay fit and healthy.

I have suffered from endometriosis, which, as well as being extremely painful, made conceiving my beautiful son Taj that much harder for my husband Steven and I.

My family’s wellbeing is so important to me and, as an Indigenous woman, I am equally passionate about tackling the appalling health and life expectancy statistics of Aboriginal and Torres Strait Islander people. As an ambassador for Jean Hailes and Women’s Health Week, I feel I can be part of the solution by encouraging Indigenous women to take the time to put their health first.

You can put your health first too by being part of this year’s Women’s Health Week

. It’s fun and free. Please sign up!

Follow @JeanHailes 

2. Welcome to the HealthInfoNet health topic on women.

This section provides information about Aboriginal and Torres Strait Islander women’s health and women’s business. Some of the content contained in this section is regarded as sensitive and private to Aboriginal and Torres Strait women. Information includes: cultural perspectives and practices, reproductive health, pregnancy, birth and midwifery, mothers and babies, and women’s cancers.


2 to 8 September 2019 National Stroke Week 

Stroke Week is an annual opportunity to raise awareness of stroke and the Stroke Foundation in Australia. The theme for 2019 is F.A.S.T heroes, recognising the people who spotted the signs of stroke and called an ambulance straight away, potentially saving a life.

Read over 100 Aboriginal Health and Stroke articles published by NACCHO over past 7 years

The Stroke Foundation and the Queensland Aboriginal and Islander Health Council are working together to create a new information resource.

The new resource will be based on My Stroke Journey and will be delivered by hospital health professionals to Aboriginal and Torres Strait Islander stroke survivors and their families. It will also be available for Aboriginal health workers in the community to use.

Aboriginal and Torres Strait Islander people are 1.5 times as likely to die from stroke as non-Indigenous Australians. They are younger too: their median age is 58 compared to 75 for non-Indigenous Australians. They also have poorer access to in-patient rehabilitation, secondary prevention to reduce risk of further stroke and community support to aid long-term recovery.

Focus groups have been held in Cairns, Rockhampton, Toowoomba and Townsville. Speaking with Aboriginal and Torres Strait Islander survivors, family members and health workers, we found:

1. My Stroke Journey is seen a good resource but the content could be clearer and simpler.
2. We need to include more photos and stories from Aboriginal and Torres Strait Islander people as well as using culturally appropriate activity examples and Indigenous art and design.
3. Work and finances (dealing with employers and  Centrelink) is a significant issue and needs more focus.
4. We need to have a marketing strategy to ensure it reaches people – engaging  hospital Aboriginal Liaison Officers and promote connection to Aboriginal health services.

The new resource will be available later this year. After that we hope to secure funding to take the new resource to Aboriginal health organisations in other states to continue our engagement, in line with our national mission.

See Website for more info

I discovered powerlifting after my stroke

By Charlotte Porter

Sometimes life takes an unexpected twist and nothing could be truer than that for me.

In the lead up to Christmas last year, I was busy juggling a family and two jobs. Like many mums at that time of year, there was a lot to do and not enough hours in the day.

I woke up one morning with a really bad headache. I’ve had my fair share of headaches in recent years after having a pituitary gland tumour, but this one was intense. I remember telling my husband about it, but I couldn’t afford to take the day off work, so I pushed myself to get dressed and get out the door.

I work in disability services and spent the morning with two separate clients. When my shift finished at 12.30pm, I sat in my car and couldn’t move. After a few minutes, I somehow managed to drive to our local Aboriginal Medical Service where, thankfully, I got to see the doctor straight away.

I recall the doctor saying hello and asking me to come in her office, but I couldn’t lift myself out of my seat. The doctor walked towards me and asked if I was okay

“No, I can’t move. I’m so sorry. I feel awful and I have a huge headache,” I replied.

The doctor asked me to lift my arm, but I couldn’t and the left side of my face was slightly droopy. She told me I needed to get to hospital immediately.

I live in country New South Wales. I went to my local hospital, but I was rushed to a larger one within half an hour of arrival.

A brain scan showed a small aneurism in the back of my head, which had a leak. It was too small to be clamped, so I was given a drug to reduce the pressure in my head.

Two days later, I was discharged.

This is when my major challenges began – I lost all of my strength in my arm. I was slightly overweight, so had to change my diet. I had to let go of my stress and I was tired.

I had 16 weeks of bed rest before starting light gym work and physio.

At the beginning I struggled. I had to learn how to do everyday tasks again like holding a spoon and fork and lifting my arm. I didn’t want to be a burden on my family.

There were lots of tears, but there were plenty of laughs and accomplishments as well. Some days I was so lethargic, but others I felt good enough to go to the gym. I learnt to read my body much better.

I wanted to be a good role model for my children, so I set goals every day. At one stage it was to walk to the toilet by myself now it’s to deadlift 200 kilograms (equivalent to two fridges!) by the end of the year!

This brings me to powerlifting. I made a huge effort to go to the gym regularly to work on my fitness, coordination and strength. I kept pushing through the pain to regain the capacity in my arm. My doctor said I was bouncing back quicker than expected.

I always knew I was a strong person, but then I discovered powerlifting by chance on social media. I started following the account of a woman with mad skills and I was inspired. With the help of a personal trainer, I tried it myself and LOVED it!

Now, I train up to five times a week.

Together with my family, powerlifting has given me something positive to focus on after my stroke.

I am 32 and there is no looking back

The Stroke Foundation recommends the F.A.S.T. test as an easy way to remember the most common signs of stroke.

Using the F.A.S.T. test involves asking these simple questions:

Face Check their face. Has their mouth drooped?

Arms Can they lift both arms?

Speech Is their speech slurred? Do they understand you?

Time Is critical. If you see any of these signs call 000 straight away.

Think F.A.S.T., act FAST

A stroke is always a medical emergency. The longer a stroke remains untreated, the greater the chance of stroke-related brain damage.

Emergency medical treatment soon after symptoms begin improves the chance of survival and successful rehabilitation.

Facial weakness, arm weakness and difficulty with speech are the most common symptoms or signs of stroke, but they are not the only signs.

Other signs of stroke

The following signs of stroke may occur alone or in combination:

  • Weakness or numbness or paralysis of the face, arm or leg on either or both sides of the body
  • Difficulty speaking or understanding
  • Dizziness, loss of balance or an unexplained fall
  • Loss of vision, sudden blurring or decreased vision in one or both eyes
  • Headache, usually severe and abrupt onset or unexplained change in the pattern of headaches
  • Difficulty swallowing

Sometimes the signs disappear within a short time, such as a few minutes. When this happens, it may be a transient ischaemic attack (TIA).

If you or someone else experiences the signs of stroke, no matter how long they last, call 000 immediately.

2- 5 September 2019 SNAICC Conference

Preliminary program and registration information available to download now!

We are thrilled to have Dusty Feet Mob performing on Day 2 of the 8th SNAICC National Conference, 2-5 Sept. 2019

Visit  for more information.

12 September R U Ok Day


Regardless of where we live, or who our mob is, we can all go through tough times. Times when we don’t feel great about our lives or ourselves. That’s why it’s important to always be looking out for each other. Together, we’re stronger right?’

Download the full kit

Ask the question – R U OK?

If someone you know – a family member, someone from your community, a friend, neighbour or workmate – is doing it tough, they won’t always tell you. Sometimes it’s up to us to trust our gut instinct and ask someone who may be struggling, R U OK? By asking and listening, we can help those we care about feel more supported and connected, which can help stop them from feeling worse over time.

Help to start the conversation.

The Conversation Guide contains lots of valuable information on how to go about asking R U OK? as well as the importance of listening with an open mind, encouraging action, and checking in. Posters are available too, to put up in your workplace, school or community group as a reminder to ask people, R U OK?

Don’t forget! R U OK?Day – 12 September 2019

It’s important to ask the question every day. We need to trust the signs and your instinct if you feel someone might be struggling. R U OK?Day is a national reminder, to reach our to your mob. Learn more about the signs to watch our for that something might be up

A conversation can change a life. 

Watch these videos to hear personal stories from mob across the country, talking about how being asked R U OK? helped them through a tough time. Use the links below to view and share these stories with your friends and community.

Connect on social media #RUOKStrongerTogetherMake sure your mob know that they can talk to you if they need to. Share your support by posting our social media graphics on you social networks. These graphics promote the importance of checking in with people and asking R U OK? Sometimes we all need a reminder.

We’ve developed a range of resources to help you start the conversation.

Download the Digital Kit – link this to Stronger Together page , or you can order printed copies at

15-19 September 50 year of PHAA Annual Conference Adelaide 17 – 19 September 

The Australian Public Health Conference (formally the PHAA Annual Conference) is a national conference held by the Public Health Association of Australia (PHAA) which presents a national and multi-disciplinary perspective on public health issues. PHAA members and non-members are encouraged to contribute to discussions on the broad range of public health issues and challenges, and exchange ideas, knowledge and information on the latest developments in public health.

Through development of public health policies, advocacy, research and training, PHAA seeks better health outcomes for Australian’s and the Conference acts as a pathway for public health professionals to connect and share new and innovative ideas that can be applied to local settings and systems to help create and improve health systems for local communities.

In 2019 the Conference theme will be ‘Celebrating 50 years, poised to meet the challenges of the next 50’. The theme has been established to acknowledge and reflect on the many challenges and success that public health has faced over the last 50 years, as well as acknowledging and celebrating 50 years of PHAA, with the first official gathering of PHAA being held in Adelaide in 1969.

Conference Website 


Expressions of interest closing soon!

Calm minds, Strong bodies, Resilient spirit

Are you an Aboriginal and/or Torres Strait Islander aged between 18 and 25 who is passionate about improving the health of your community?

Join us at the 2019 QAIHC Youth Health Summit in Brisbane on 12 September 2019. We want to hear from you about what is needed to help Aboriginal and Torres Strait Islander young people in your community thrive.

The Summit will be a powerful day of sharing and learning, and will cover a range of topics including:

  • Exercise
  • Healthy relationships
  • Support networks
  • Mental health
  • Nutrition
  • Sexual health
  • LGBTQI needs
  • Chronic disease.

All sessions will be facilitated in an environment of cultural safety to promote honest and free discussions between everyone in attendance.

This Summit will help us shape QAIHC’s Youth Health Strategy 2019-2022 which will support Queensland’s Aboriginal and Torres Strait Islander Community Controlled Health Organisations.



Express an interest in attending the Youth Health Summit

23 -25 September IAHA Conference Darwin

24 September

A night of celebrating excellence and action – the Gala Dinner is the premier national networking event in Aboriginal and Torres Strait Islander allied health.

The purpose of the IAHA National Indigenous Allied Health Awards is to recognise the contribution of IAHA members to their profession and/or improving the health and wellbeing of Aboriginal and Torres Strait Islander peoples.

The IAHA National Indigenous Allied Health Awards showcase the outstanding achievements in Aboriginal and Torres Strait Islander allied health and provides identifiable allied health role models to inspire all Aboriginal and Torres Strait Islander people to consider and pursue a career in allied health.

The awards this year will be known as “10 for 10” to honour the 10 Year Anniversary of IAHA. We will be announcing 4 new awards in addition to the 6 existing below.

Read about the categories HERE.

24 -26 September 2019 CATSINaM National Professional Development Conference



The 2019 CATSINaM National Professional Development Conference will be held in Sydney, 24th – 26th September 2019. Make sure you save the dates in your calendar.

Further information to follow soon.

Date: Tuesday the 24th to Thursday the 26th September 2019

Location: Sydney, Australia

Organiser: Chloe Peters

Phone: 02 6262 5761


2- 4 October  AIDA Conference 2019


Location:             Darwin Convention Centre, Darwin NT
Theme:                 Disruptive Innovations in Healthcare
Register:              Register Here

The AIDA 2019 Conference is a forum to share and build on knowledge that increasingly disrupts existing practice and policy to raise the standards of health care.

People with a passion for health care equity are invited to share their knowledges and expertise about how they have participated in or enabled a ‘disruptive innovation to achieve culturally safe and responsive practice or policy for Indigenous communities.

The 23rd annual AIDA Conference provides a platform for networking, mentoring, member engagement and the opportunity to celebrate the achievements of AIDA’S Indigenous doctor and students.

9-10 October 2019 NATSIHWA 10 Year Anniversary Conference


2019 Marks 10 years since the formation of NATSIHWA and registrations are now open!!!

During the 9 – 10 October 2019 NATSIHWA 10 Year Anniversary Conference will be celebrated at the Convention Centre in Alice Springs

Bursaries available for our Full Members

Not a member?!

Register here today to become a Full Member to gain all NATSIHWA Full Member benefits

Come and celebrate NATSIHWA’s 10 year Anniversary National Conference ‘A Decade of Footprints, Driving Recognition’ which is being held in Alice Springs. We aim to offer an insight into the Past, Present and Future of NATSIHWA and the overall importance of strengthening the primary health care sector’s unique workforce of Aboriginal and/or Torres Strait Islander Health Workers and Health Practitioners throughout Australia.

During the 9-10 October 2019 delegates will be exposed to networking opportunities whilst immersing themselves with a combination of traditional and practical conference style delivery.

Our intention is to engage Aboriginal and/or Torres Strait Islander Health Workers and Health Practitioners in the history and knowledge exchange of the past, todays evidence based best practice programs/services available and envisioning what the future has to offer for all Aboriginal and/or Torres Strait Islander Health Workers and Health Practitioners.

Watch this space for the guest speaker line up, draft agenda and award nominations

15-17 October IUIH System of Care Conference

15 October IUIH 10 year anniversary

Building on the success of last year’s inaugural conference, the 2019 System of Care Conference will be focusing on further exploring and sharing the systems and processes that deliver this life changing way of looking at life-long health care for Aboriginal and Torres Strait Islanders.

This year IUIH delivers 10 years of experience in improving health outcomes for Aboriginal and Torres Strait Islander people with proven methods for closing the gap and impacting on the social determinants of health.

The IUIH System of Care is evidence-based and nationally recognised for delivering outcomes, and the conference will share the research behind the development and implementation of this system, with presentations by speakers across a range of specialisations including clinic set up, clinical governance, systems integration, wrap around services such as allied and social health, workforce development and research evidence.

If you are working in:

  • Aboriginal and Torres Strait Islander Community Controlled health services
  • Primary Health Networks
  • Health and Hospital Boards and Management
  • Government Departments
  • The University Sector
  • The NGO Sector

Watch this video for an insight into the IUIH System of Care Conference.

Download brochure HERE IUIH System of Care Conference 2019 WEB

This year, the IUIH System of Care Conference will be offering a number of half-day workshops on Thursday 17 October 2019, available to conference attendees only. The cost for these workshops is $150 per person, per workshop and your attendance to these can be selected during your single or group registration.

IUIH are also hosting a 10 years of service celebration dinner on Tuesday 15 October – from 6.30-10pm. Tickets for this are $150 per person and are not included in the cost of registration.

All conference information is available here

15 October IUIH 10 year anniversary

16 October Melbourne Uni: Aboriginal and Torres Strait Islander Health and Wellbeing Conference

The University of Melbourne, Department of Rural Health are pleased to advise that abstract
submissions are now being invited that address Aboriginal and Torres Strait Islander health and

The Aboriginal & Torres Strait Islander Health Conference is an opportunity for sharing information and connecting people that are committed to reforming the practice and research of Aboriginal & Torres Strait Islander health and celebrates Aboriginal knowledge systems and strength-based approaches to improving the health outcomes of Aboriginal communities.

This is an opportunity to present evidence-based approaches, Aboriginal methods and models of
practice, Aboriginal perspectives and contribution to health or community led solutions, underpinned by cultural theories to Aboriginal and Torres Strait Islander health and wellbeing.
In 2018 the Aboriginal & Torres Strait Islander Health Conference attracted over 180 delegates from across the community and state.

We welcome submissions from collaborators whose expertise and interests are embedded in Aboriginal health and wellbeing, and particularly presented or co-presented by Aboriginal and Torres Strait Islander people and community members.

If you are interested in presenting, please complete the speaker registration link

closing date for abstract submission is Friday 3 rd May 2019.
As per speaker registration link request please email your professional photo for our program or any conference enquiries to E.

Kind regards
Leah Lindrea-Morrison
Aboriginal Partnerships and Community Engagement Officer
Department of Rural Health, University of Melbourne T. 03 5823 4554 E.

4 November NACCHO Youth Conference -Darwin NT

The NACCHO Youth Conference will again take place the day before the Members Conference on Monday 4 November at the Darwin Convention Centre.

The conference theme is Healthy Youth – Healthy Futures and it is a day of learning, sharing, and connecting on health issues affecting young Aboriginal and Torres Strait Islander people.

This year we aim to have around 80 youth delegates attend to hear from guest speakers, voice their ideas and solutions and connect with the other future leaders in the sector.

Registrations will open in early September 2019, so please encourage the young people from your community who you think will benefit attending.

I strongly encourage those who can afford it to arrange for your youth delegates to remain for the Members Conference and AGM so they can increase their understanding of the Sector as a whole and learn how to network and build useful contacts.

Darwin Convention Centre

Website to be launched soon

Conference Co-Coordinators Ros Daley and Jen Toohey 02 6246 9309

5 – 7 November NACCHO Conference and AGM  -Darwin NT

As you may be aware, this year’s conference is being held in Darwin on Tuesday 5 and Wednesday 6 of November at the Darwin Convention Centre.

The theme for our conference is Because of Them We Must: Improving Health Outcomes for 0 to 29 Year Olds and will focus on how our Sector is working to improve the health and wellbeing outcomes for children, youth and young adults.

Clearly those in the 0 – 29 year age bracket are a significant proportion of our total population. If we can get their health and wellbeing outcomes right, we should hopefully overtime reduce the comorbidity levels which are so debilitating for so many of our older people.

There are many amazing examples in our sector of how we work with young people. I would like to see us share them at the conference.

Please let us know if you have an idea for a presentation that will highlight innovative and successful work that you do in this area.

To make a submission please complete this online form.

If you have any questions or would like further information contact Ros Daley and Jen Toohey on 02 6246 9309 or via email

Darwin Convention Centre

Website to be launched soon

Conference Co-Coordinators Ros Daley and Jen Toohey 02 6246 9309

7 November

On Thursday 7 November, following the NACCHO National Members Conference, we will hold the 2019 AGM. In addition to the general business, there will be an election for the NACCHO Chair and a vote on a special resolution to adopt a new constitution for NACCHO.

Once again, I thank all those members who sent delegates to the recent national members’ workshop on a new constitution at Sydney in July. It was a great success thanks to your involvement and feedback.

5-8 November The Lime Network Conference New Zealand 

This years  whakatauki (theme for the conference) was developed by the Scientific Committee, along with Māori elder, Te Marino Lenihan & Tania Huria from .

To read about the conference & theme, check out the  website. 

NACCHO Aboriginal Health and Alcohol Research : New ADAC APP a will be ‘game changer’ to gauge realistic drinking habits says @ScottADAC

“Obviously there’s people who want the research done to help their community.

Once we get this app going, it’ll become very clear very quickly where the money should be spent.

That doesn’t mean you’ve just got to chuck money at them, but having Aboriginal-controlled issues and understanding which way they want to go.”

Jimmy Perry, a Ngarrindjerri/Arrernte man and an Aboriginal health worker involved in the project, said communities had a positive response.

 Read over over 200 Aboriginal Health Alcohol and Other Drugs articles published by NACCHO over the past 7 years 

Download the APP Research


Originally published HERE 

Researchers say a new app has the potential to more accurately reflect the nation’s drinking habits.

The ADAC and app researchers hoped the app would be available to download by the end of the year.

Key points : 

  • App developers say it will get a more accurate drinking history than a face-to-face interview with a trained health professional
  • The Aboriginal Drug and Alcohol Council says the app could replace the National Drug Strategy Household Survey
  • Researchers say alcohol consumption among Aboriginal women is under-represented by up to 700 per cent in national surveys

The Grog App was designed for use by Indigenous Australians but could be used by anyone.

Dr Kylie Lee, a senior research fellow at the Centre of Research Excellence in Indigenous Health and Alcohol who was also involved in the app’s development, said the new technology would create a more accurate database.

“Aboriginal women, their drinking is under-represented in the national surveys by up to 700 per cent and 200 per cent in men.

“Undeniably we need to do better … this app offers a great opportunity to do that.”

Researchers believe the app would elicit greater detail than the National Drug Strategy Household Survey which has been used for more than 30 years.

Dr Lee said the prospect of collating improved data collection on the difficult topic of drug and alcohol consumption was “exciting”.

“I think it really could be a game changer because it’s giving an opportunity for a safe place where they can just tell their story in terms of what they use or what they drink,” she said.

How it works

Take a Virtual Tour HERE

Participants answer a range of broad and specific questions on the app about alcohol and based on that information, they are allocated into a category on a sliding scale from ‘non-drinker’ to ‘high risk’.

Dr Lee said immediate feedback was very helpful.

She said the app could alleviate issues in the way alcohol data was typically collected, for example participants were more likely to be asked about standard drinks but not non-standard containers.

“Like a soft drink bottle, a juice bottle, a sports bottle et cetera so the app has facilities to show how much you put in the bottle,” Dr Lee said.

“It’s very exciting the level of detail you’re going to get.”

Professor Kate Conigrave, the app’s chief investigator and an addiction specialist at Royal Prince Alfred Hospital, agreed the new technology could provide greater clarity.

“I’m aware of the traps,” she said.

“One patient I saw had been recorded by a doctor as drinking three standard drinks a day but when I took a drinking history I said, ‘what do you drink them out of?’, and he showed me a sports bottle,” Professor Conigrave said.

“He was drinking three full sports bottles of wine a day, so that’s about 30 standard drinks a day.”

PHOTO: Professor Conigrave says the images used in the app can trigger the participant’s memory, making their drinking history more accurate. (Supplied: Kate Conigrave)

Professor Conigrave said the national health survey often contained “tiny” numbers from Indigenous communities.

“The sample sizes are so small, it’s hard to get a meaningful picture,” she said.

She said the app would provide a level of comfortability and anonymity which may lead to more accurate data, than an interview with a trained health professional.

“People can be a bit embarrassed about what they’re drinking and it can be a bit hard to admit to someone you know, ‘when I drink I have 12 cans of beer,'” she said.

Taking it to the communities

The app is in its second phase of testing.

In the first phase, Aboriginal and Torres Strait Islanders in remote, regional and urban parts of South Australia and Queensland were asked to describe their drinking habits.

Research on the app has now progressed to the second round, during which the focus was on the technology’s validity as an on-the-ground survey tool.

Scott Wilson, who was leading the development of the app at the Aboriginal Drug and Alcohol Council (ADAC), said the second phase was a “major prevalence study” which would include participants from the local hospital and prison.

The location for the trial has not been made public.

“In the big major surveys people in those areas are always excluded,” Mr Wilson said.

“When you consider that I might be in hospital for an alcohol-related illness or I might be in jail because of an alcohol or drug-related crime, my voice or results are never included.”

The ADAC and app researchers hoped the app would be available to download by the end of the year.

In the meantime, they planned to have discussions with the government over the future use of the app and pursue grant opportunities.

Dr Lee said she was excited for the potential of the new technology.

“Eventually I think it would be a great tool to roll out nationally … using it in the same way as the National Drug Strategy Household Survey,” she said

NACCHO Aboriginal Health #ClosingTheGap #NAIDOC2019 : @AIHW Key results report 2017-18 Aboriginal and Torres Strait Islander health organisations:

Findings from this report:

  • Just under half (45%) of organisations provide services in Remote or Very remote areas

  • In 2017–18, around 483,000 clients received 3.6 million episodes of care

  • Nearly 8,000 full-time equivalent staff are employed in these organisations and 4,695 (59%) are health staff

  • Organisations reported 445 vacant positions in June 2018 with health vacancies representing 366 (82%) of these
  • In 2017–18, nearly 200 organisations provided a range of primary health services to around 483,000 clients, 81% of whom were Indigenous.
  • Around 3.6 million episodes of care were provided, nearly 3.1 million of these (85%) by Aboriginal Community Controlled Health Services.

See AIHW detailed Interactive site locations map HERE

In 2017–18, Indigenous primary health services were delivered from 383 sites (Table 3). Most sites provided clinical services such as the diagnosis and treatment of chronic illnesses (88%), mental health and counselling services (88%), maternal and child health care (86%), and antenatal care (78%). Around two-thirds provided tobacco programs (69%) and substance-use and drug and alcohol programs (66%).

Most organisations provided access to a doctor (86%) and just over half (54%) delivered a wide range of services, including all of the following during usual opening hours: the diagnosis and treatment of illness and disease; antenatal care; maternal and child health care; social and emotional wellbeing/counselling services; substance use programs; and on‑site or off-site access to specialist, allied health and dental care services.

Most organisations (95%) also provided group activities as part of their health promotion and prevention work. For example, in 2017–18, these organisations provided around:

  • 8,400 physical activity/healthy weight sessions
  • 3,700 living skills sessions
  • 4,600 chronic disease client support sessions
  • 4,100 tobacco-use treatment and prevention sessions.

In addition to the services they provide, organisations were asked to report on service gaps and challenges they faced and could list up to 5 of each from predefined lists. In 2017–18, around two-thirds of organisations (68%) reported mental health/social and emotional health and wellbeing services as a gap faced by the community they served.

This was followed by youth services (54%). Over two-thirds of organisations (71%) reported the recruitment, training and support of Aboriginal and Torres Strait Islander staff as a challenge in delivering quality health services.

Read full report and all data HERE

This is the tenth national report on organisations funded by the Australian Government to provide health services to Aboriginal and Torres Strait Islander people.

Indigenous primary health services

Primary health services play a critical role in helping to improve health outcomes for Aboriginal and Torres Strait Islander people. Indigenous Australians may access mainstream or Indigenous primary health services funded by the Australian and state and territory governments.

Information on organisations funded by the Australian Government under its Indigenous Australians’ health programme (IAHP) is available through two data collections: the Online Services Report (OSR) and the national Key Performance Indicators (nKPIs). Most of the organisations funded under the IAHP contribute to both collections (Table 1).

The OSR collects information on the services organisations provide, client numbers, client contacts, episodes of care and staffing levels. Contextual information about each organisation is also collected. The nKPIs collect information on a set of process of care and health outcome indicators for Indigenous Australians.

There are 24 indicators that focus on maternal and child health, preventative health and chronic disease management. Information from the nKPI and OSR collections help monitor progress against the Council of Australian Governments (COAG) Closing the Gap targets, and supports the national health goals set out in the Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013–2023.

Detailed information on the policy context and background to these collections are available in previous national reports, including the Aboriginal and Torres Strait Islander health organisations: Online Services Report—key results 2016–17 and National Key Performance Indicators for Aboriginal and Torres Strait Islander primary health care: results for 2017.

At a glance

This tenth national OSR report presents information on organisations funded by the Australian Government to provide primary health services to Aboriginal and Torres Strait Islander people. It includes a profile of these organisations and information on the services they provide, client numbers, client contacts, episodes of care and staffing levels. Interactive data visualisations using OSR data for 5 reporting periods, from 2013–14 to 2017–18, are presented for the first time.

Key messages

  1. A wide range of primary health services are provided to Aboriginal and Torres Strait Islander people. In 2017–18:
  • 198 organisations provided primary health services to around 483,000 clients, most of whom were Aboriginal and Torres Strait Islander (81%).
  • These organisations provided around 3.6 million episodes of care, with nearly 3.1 million (85%) delivered by Aboriginal Community Controlled Health Services (ACCHSs).
  • More than two-thirds of organisations (71%) were ACCHSs. The rest included government-run organisations and other non-government-run organisations.
  • Nearly half of organisations (45%) provided services in Remoteand Very remote
  • Services were delivered from 383 sites across Australia. Most sites provided the diagnosis and treatment of chronic illnesses (88%), social and emotional wellbeing services (88%), maternal and child health care (86%), and antenatal care (78%). Around two-thirds provided tobacco programs (69%) and substance-use and drug and alcohol programs (66%).

See this AIHW detailed Interactive site locations map HERE

  1. Organisations made on average nearly 13 contacts per client

In 2017–18, organisations providing Indigenous primary health services made around 6.1 million client contacts, an average of nearly 13 contacts per client (Table 2). Over half of all client contacts (58%) were made by nurses and midwives (1.8 million contacts) and doctors (1.7 million contacts). Contacts by nurses and midwives represented half (49%) of all client contacts in Very remote areas compared with 29% overall.

  1. Organisations employed nearly 8,000 full-time equivalent (FTE) staff

At 30 June 2018, organisations providing Indigenous primary health services employed nearly 8,000 FTE staff and over half of these (54%) were Aboriginal or Torres Strait Islander. These organisations were assisted by around 270 visiting staff not paid for by the organisations themselves, making a total workforce of around 8,200 FTE staff.

Nurses and midwives were the most common type of health worker (14% of employed staff), followed by Aboriginal and Torres Strait Islander health workers and practitioners (13%) and doctors (7%). Nurses and midwives represented a higher proportion of employed staff in Very remote areas (22%).

  1. Social and emotional health and wellbeing services are the most commonly reported service gap

Organisations can report up to 5 service gaps faced by the community they serve from a predefined list of gaps. Since this question was introduced in 2012–13, the most commonly reported gap has been for mental health and social and emotional health and wellbeing services. In 2017–18, this was reported as a gap by 68% of organisations.


NACCHO Aboriginal Health and #CancerAwareness : @JacintaElston @KelvinKongENT Hey you mob It’s ok to talk about #cancer – For assistance download #YarnforLife resources

“Yarn for Life aims to reduce feelings of shame and fear associated with cancer and highlights the importance of normalising conversation around cancer and encouraging early detection of the disease.

It also emphasises the value of support along the patient journey.”

Professor Jacinta Elston, Pro Vice-Chancellor (Indigenous), Monash University, said that finding cancer early gave people the best chance of surviving and living well.

“Yarn for Life seeks to empower Aboriginal and Torres Strait Islander people to participate in screening programs, discuss cancer with their doctor or health care worker openly, and if cancer is diagnosed, complete their cancer treatment.”

Australia’s first Australian Aboriginal surgeon Associate Professor Kelvin Kong, University of Newcastle : continued below 

Download Yarn for Life Resources HERE

Read over 80 Aboriginal and Torres Strait Islander Cancer Awareness articles published by NACCHO over past 7 years 

In a national first, Cancer Australia has launched Yarn for Life, a new initiative to reduce the impact of cancer within Aboriginal and Torres Strait Islander communities by encouraging and normalising discussion about the disease.

Cancer is a growing health problem and the second leading cause of death among Indigenous Australians who are, on average, 40 percent more likely to die from cancer than non-indigenous Australians.

The multi-faceted health promotion Yarn for Life has been developed by and with Indigenous Australians, and weaves the central message that it is okay to talk about cancer by sharing personal stories of courage and survivorship from Aboriginal and Torres Strait Islander people.

Yarn for Life features 3 individual experiences of cancer which are also stories of hope.

“While significant gains have been made with regard to cancer overall, Aboriginal and Torres Strait Islander people continue to experience disparities in cancer incidence and outcomes. Cancer affects not only those diagnosed with the disease but also their families, carers, Elders and community,” said Dr Helen Zorbas, CEO, Cancer Australia.

Associate Professor Kong said it was also important for health services to support better outcomes for Indigenous patients by being culturally aware.

“For Aboriginal and Torres Strait Islander people, health and connection to land, culture community and identity are intrinsically linked. Optimal care that is respectful of, and responsive to, the cultural preferences, sensitivities, needs and values of patients, is critical to good health care outcomes.”

The Yarn for Life initiative is supported by two consumer resources which outline what patients should expect at all points on the cancer pathway.

Yarn for Life will feature television, radio and social media resources designed to be shared with friends, family and the community, to carry on the Yarn for Life conversation online.


Finding cancer early gives you the best chance of getting better and living well. The good news is there are things you can do to find cancer early. If there are any changes in your body that could be due to cancer, it’s really important to have them checked out. Speak to your health worker about:

  • any new or unusual changes in your body
  • how you are feeling
  • whether you are in any pain
  • whether anyone in your family has or had cancer
  • any other problems that are worrying you.

Free screening programs

It’s also important that you and your family participate in screening programs for breast, bowel and cervical cancers.

You can find out more about these free programs including how old you need to be to participate at Remember most of us will need to go to a check-up or screening at some point in our lives—so there’s no shame in talking to family or friends about it as well as your health care worker.


NACCHO Aboriginal Health #Prevention2019 News Alert : Downloads @AIHW releases Burden of Disease study and an overview of health spending that provides an understanding of the impact of diseases in terms of spending through our health system.

 ” This report analyses the impact of more than 200 diseases and injuries in terms of living with illness (non-fatal burden) and premature death (fatal burden).

The study found that: chronic diseases such as cancer, cardiovascular diseases, and musculoskeletal conditions contributed the most burden in Australia in 2015 and 38% of the burden could have been prevented by removing exposure to risk factors such as tobacco use, overweight and obesity, and dietary risks.

The overall health of the Australian population improved substantially between 2003 and 2015 and further gains could be achieved by reducing lifestyle-related risk factors, according to a new report by the Australian Institute of Health and Welfare (AIHW). ‘

Download aihw-bod-22

The Australian Burden of Disease Study: Impact and causes of illness and death in Australia 2015, measures the number of years living with an illness or injury (the non-fatal burden) or lost through dying prematurely (the fatal burden).

In 2015, Australians collectively lost 4.8 million years of healthy life due to living with or dying prematurely from disease and injury,’ said AIHW spokesperson Mr Richard Juckes.

The disease groups causing the most burden in 2015 were cancer, cardiovascular diseases, musculoskeletal conditions, mental and substance use disorders and injuries.

After accounting for the increase in size and ageing of the population, there was an 11% decrease in the rate of burden between 2003 and 2015.’

Most of the improvement in the total burden resulted from reductions in premature deaths from illnesses and injuries such as cardiovascular diseases, cancer and infant and congenital conditions.

‘Thirty eight per cent of the total burden of disease experienced by Australians in 2015 could have been prevented by reducing exposure to the risk factors included in this study,’ Mr Juckes said.

‘The 5 risk factors that caused the most total burden in 2015 were tobacco use (9.3%), overweight & obesity (8.4%), dietary risks (7.3%), high blood pressure (5.8%) and high blood plasma glucose—including diabetes (4.7%).’

For the first time, living with illness or injury caused more total disease burden than premature death. In 2015, the non-fatal share was 50.4% and the fatal share was 49.6% of the burden of disease.

Also released today is an overview of health spending that provides an understanding of the impact of diseases in terms of spending through the health system.

The data in Disease expenditure in Australia relates to the 2015–16 financial year only and suggests the highest expenditure groups were musculoskeletal conditions (10.7%), cardiovascular diseases (8.9%) injuries (7.6%) and mental and substance use disorders (7.6%).

‘Together the burden of disease and spending estimates can be used to understand the impact of diseases on the Australian community. However they can’t necessarily be compared with each other, as there are many reasons why they wouldn’t be expected to align,’ Mr Juckes said.

‘For example, spending on reproductive and maternal health is relatively high but it is not associated with substantial disease burden because the result is healthy mothers and babies more often than not.

‘Similarly, vaccine-preventable diseases cause very little burden in Australia due to national investment in immunisation programs.’


Table of contents

  • Summary
  • 1 Introduction
    • What is burden of disease?
    • How can burden of disease studies be used?
    • What can’t burden of disease studies tell us?
    • How is burden of disease measured?
    • What is the history of burden of disease analysis?
    • What’s new in the Australian Burden of Disease Study 2015 and this report?
  • 2 Total burden of disease
    • What is the total burden of disease in Australia?
    • How does total burden vary across the life course?
    • Which disease groups cause the most burden?
    • Which diseases cause the most burden?
    • How does disease burden change across the life course?
  • 3 Non-fatal burden of disease
    • What is the overall non-fatal burden in Australia?
    • How does living with illness vary across the life course?
    • Which disease groups cause the most non-fatal burden?
    • Which diseases cause the most non-fatal burden?
    • How does non-fatal disease burden change across the life course?
  • 4 Fatal burden of disease
    • What is the overall fatal burden in Australia?
    • How does years of life lost vary at different ages?
    • Which disease groups cause the most fatal burden?
    • Which diseases cause the most fatal burden?
    • How does fatal disease burden change across the life course?
  • 5 Health-adjusted life expectancy
    • HALE as a measure of population health
    • On average, almost 90% of years lived are in full health
    • Years of life gained are healthy years
    • HALE is unequal across states and territories
    • HALE varies by remoteness of area lived
    • HALE is unequal between socioeconomic groups
  • 6 Contribution of risk factors to burden
    • How are risk factors selected?
    • What is the contribution of all risk factors combined?
    • Which risk factors contribute the most burden?
    • How do risk factors change through the life course?
  • 7 Changes over time
    • How should changes between time points be interpreted?
    • How has total burden changed over time?
    • How have the non-fatal and fatal burden changed over time?
    • How have risk factors changed over time?

  • 8 Variation across geographic areas and population groups
    • Burden of disease by state and territory
    • Burden of disease by remoteness areas
    • Burden of disease by socioeconomic group
  • 9 International context and comparisons
    • What is the international context of burden of disease studies?
    • Can the ABDS 2015 be compared with international studies?
    • How does Australian burden compare internationally?
  • 10 Study developments and limitations
    • What are the underlying principles of the ABDS?
    • What stayed the same between Australian studies?
    • What changes were made in the ABDS 2015?
    • What are the data gaps?
    • What are the methodological limitations?
    • What opportunities are there for further analysis?
  • Appendix A: Methods summary
    • 1 Disease and injury (condition) list
    • 2 Fatal burden
    • 3 Non-fatal burden
    • 4 Total burden of disease
    • 5 Health-adjusted life expectancy
    • 6 Risk factors
    • 7 Overarching methods/choices
  • Appendix B: How reliable are the estimates?
    • ABDS 2015 quality index
  • Appendix C: Understanding and using burden of disease estimates
    • Different types of estimates presented in this report
    • Interpreting estimates
    • What can estimates from 2015 tell us about 2019?
  • Appendix D: Additional tables and figures
  • Appendix E: List of expert advisors
  • Acknowledgments
  • Abbreviations
  • Symbols
  • Glossary
  • References
  • List of tables
  • List of figures
  • Related publications

NACCHO Aboriginal #MentalHealth #SuicidePrevention @NMHC Communique : @GregHuntMP roundtable meeting to review investment to date in mental health and suicide prevention : #TimeToFixMentalHealth #TomCalma @AUMentalHealth @FrankGQuinlan @PatMcGorry @amapresident @headspace_aus

” Minister for Health, Greg Hunt, hosted a Government-led roundtable this week to review investment to date in mental health and suicide prevention, to hear from the sector on current gaps and priorities, to understand what is and is not working, and to advise on the upcoming national forum on youth mental health and suicide prevention.

Minister Hunt and Prime Minister Scott Morrison are committed to working towards zero-suicide for all Australians, including our youth.

From the National Mental Health Commission 6 June 

( The Indigenous ) Suicide rates are an appalling national tragedy that is not only depriving too many of our young people of a full life, but is wreaking havoc among our families and communities.

As anyone who has experienced a friend or family member committing suicide will know, the effects are widespread and devastating and healing can be elusive for those left behind.

It is time that we draw a line under this tragic situation that is impacting so significantly on Aboriginal and Torres Strait Islander communities  “

Noting Professor Tom Calma AO was a participant in the meeting via telephone link and opened the meeting with a discussion on Indigenous suicide. 

See this quote and 140 Plus Aboriginal Health and Suicide Prevention articles published by NACCHO in last 7 Years 

Those in attendance welcomed the Government’s commitment, with a number noting that suicide prevention needs to be a priority across all age groups, especially those groups with the highest suicide rates.

The conversation covered a range of key issues, challenges and opportunities for reform and action. Particular discussion points included:

  • Social determinants of mental health: there is a fundamental need to focus on the social determinants of mental health for all Australians, noting and emphasising the range of factors that contribute to distress in young Australians. This is an important factor for all young people and communities, with particular reference to the factors impacting on Aboriginal and Torres Strait Islander children and youth.
  • The impact of trauma and disadvantage: conversation centred on the impacts of trauma and disadvantage and the importance of supporting, for example, young people in out-of-home care, those living in poverty and individuals who are in the justice system.
  • Support for children and families: in order to improve the lives of young Australians, there is a need to better support children and families in the early years. This includes support for neurodevelopmental disorders. In the same way headspace has been developed for young people, there was a suggestion that mental health services focused on children and families could show real benefits.  There is strong support for a focus on prevention
  • Support for Schools: a continued need was highlighted around the role of, and support for, schools, including primary schools and early learning centres. Schools are a critical component of a ‘whole of community’ approach in building supportive environments for children and young people.   It was suggested that for families who may not seek services but who were in need a way of ‘connecting’ may be through digital tools, to identify and support children and parents in those families.
  • Impact on youth: young people can be seriously impacted and influenced by the suicide death of other young people who are their friends, peers, family members or celebrities. More timely and sophisticated data and comprehensive local responses are needed to assist in the reduction of risk for further lives being lost following a suicide.
  • Data: The importance of being able to collect, analyse and provide accurate data was highlighted.  This data is significant across mental health services and particularly for suicide prevention, treatment and support services.
  • Service reform: there is a need for service reform to better respond to people with mental health concerns that are too complex to be managed by a GP at a primary health care level but not so acute as to require specialist tertiary mental health services. While there are some good programs and services to build upon, there is a lack of equity across all regions and access remains a key issue for those requiring psychological and other services. We also need to integrate mental health services with drug and alcohol services.
  • Workforce development: there is an urgent need to focus on training and supporting the diverse professionals working with those at risk of or with mental health issues – health and allied health staff, drug and alcohol workers, school counsellors, psychologists, peer workers and many others. The role of peer workers was recognised as being a critical one and this must be included in all workforce development strategies and initiatives.
  • Peer and carer support: many families and peers supporting those who are in suicidal distress and/or living with challenging mental health and drug and alcohol concerns needed immediate and quality support themselves as they are also at risk for mental ill-health. Families and friends are the largest non-clinical workforce providing care and support for Australians and there is an immediate need to provide better supports for them.
  • Regional and national leadership: while attendees were supportive of regional planning and action, it was suggested that stronger guidance at a national level was needed in order to ensure equity and quality of service responses across the country, with a recognition of the importance of the role of Primary Health Networks.  Further work is needed to ensure that the roles and responsibilities of all governments were clarified, together with accountability. The Fifth National Mental Health and Suicide Prevention Plan, and particularly the Suicide Prevention Implementation Plan, are key drivers for clearer accountability and integrated and coordinated responses.
  • Funding models: there was discussion on how best to fund services across the range of needs, including the current review of Medicare and the role of private health insurance.

A collective agreement and strong commitment was reached that a collaborative approach is vital to achieving improved mental health outcomes for all Australians, including children and youth.

There is significant support for a 2030 Vision for mental health and suicide prevention, to be led by the Commission and to ensure that the systematic changes required to best service the community can be identified, prioritised and achieved. This Vision would be look beyond the current plans and strategies.

Attendees acknowledged the commitment to mental health and quality program responses in recent years, together with the increased funding in the 2019/20 federal budget for expanded youth and adult mental health services in the community, together with initiatives to strengthen the collection of critical data around suicide and mentally healthy workplaces.  They also noted the current enquiries being undertaken by the Productivity Commission and the Victorian Royal Commission.  However, there needs to be an increased focus on longer term systems reform.  The Commission has been tasked with taking a leading role in this and will work closely with the sector to develop a reform pathway.

Participants embraced the importance of hope, recognising not only the significant investment to date but that youth mental health services in Australia have been copied by other nations.  There is strong support for improvements in mental health and suicide prevention across all levels of government and community.

As outlined by the Minister for Health, this was an opportunity to review the current status and continue this important discussion.  It is one of many conversations that will continue with the sector at organisational, group and individual levels.

The Commission will provide updates in sector engagement and discussions as they occur.

Lucy Brogden

Chair, National Mental Health Commission

Christine Morgan

CEO, National Mental Health Commission


Aboriginal Health and Smoking #WNTD2019 31 May News Alerts #CommunityControl #YourHealthYourFuture: Over 7 years 130 Plus articles Including 20 myths about smoking that will not die

“Smoking kills. Smoking robs people, including young people, of their health.

Governments must do more to help people to stop smoking, or to not take up the deadly habit in the first place.

Strong government actions, including making packaging unappealing, keeping tobacco products out of view, and keeping tobacco prices high, have helped to encourage people to quit, or young people not to start.

The Minister for Indigenous Health, Ken Wyatt, is to be commended for continuing funding of $183.7 million over four years for the Tackling Indigenous Smoking program.

Releasing the AMA/ACOSH National Tobacco Control Scoreboard on World No Tobacco Day, AMA President, Dr Tony Bartone

NACCHO and Croakey followers are invited to join Aboriginal Community Controlled Health Services in New South Wales in a Twitter Festival focused on tobacco control initiatives and successes across Australia.

NACCHO will be posting 8.45 to 9.00 AM Follow NACCHO

Follow the discussions on Twitter and contribute your views by using the hashtags #CommunityControl and #YourHealthYourFuture.

Please encourage your networks and organisations to support the event by following the discussion and retweeting as much as possible.

See full program 8.00 to 1.00 Pm HERE

Our special thanks to Tom Calma who has been our NO 1 promoter of our alerts 

Read or subscribe to NACCHO Daily Aboriginal Health News Alerts

“Across forty years I’ve come to recognise many factoid-driven myths about smoking that just won’t die. If I asked for a dollar each time I had to refute these statements, I’d have accumulated a small fortune.

Their persistence owes much to their being a vehicle for those who utter them to express unvoiced but clear sub-texts that reflect deeply held beliefs about women, the disadvantaged, mental illness, government health campaigns and the “natural”.

Let’s drive a stake through the heart of ten of the most common myths.”

Simon Chapman  Emeritus Professor in Public Health, University of Sydney

Originally published in The Conversation 

1. Women and girls smoke more than men and boys

Women have never smoked more than men. Occasionally, a survey will show one age band where it’s the other way around, but from the earliest mass uptake of smoking in the first decades of last century, men streaked out way ahead of women.

In 1945 in Australia, 72% of men and 26% of women smoked. By 1976, men had fallen to 43% and women had risen to 33%.

As a result, men’s tobacco-caused death rates have always been much higher than those of women. Women’s lung cancer rates, for example, seem unlikely to reach even half the peak rates that we saw among men in the 1970s.

Currently in Australia, 15% of men and 12% of women smoke daily.

But what about all the “young girls” you can see smoking, I’m always being told. In 2014, 13% of 17-year-old male high school students and 11% of females smoked. In two younger age bands, girls smoked more (by a single percentage point).

Those who keep on insisting girls smoke more are probably just letting their sexist outrage show about noticing girls’ smoking than their ignorance about the data.

2. Quit campaigns don’t work on low socioeconomic smokers

In Australia, 11% of those in the highest quintile of economic advantage smoke, compared with 27.6% in the lowest quintile. More than double.

So does this mean that our quit campaigns “don’t work” on the least well-off?

Smoking prevalence data reflect two things: the proportion of people who ever smoked, and the proportion who quit.

If we look at the most disadvantaged group, we find that a far higher proportion take up smoking than in their more well-to-do counterparts. Only 39.5% have never smoked compared with 50.4% of the most advantaged – see table 9.2.6).

When it comes to quitting, 46% of the most disadvantaged have quit compared to 66% of the least disadvantaged (see table 9.2.9).

There is a higher percentage of the disadvantaged who smoke mainly because more take it up, not because disadvantaged smokers can’t or won’t quit. With 27.6% of the most disadvantaged smoking today, the good news is that nearly three-quarters don’t. Smoking and disadvantage are hardly inseparable.

3. Scare campaigns ‘don’t work’

Countless studies have asked ex-smokers why they stopped and current smokers about why they are trying to stop. I have never seen such a study when there was not daylight between the first reason cited (worry about health consequences) and the second most nominated reason (usually cost).

For example, this national US study covering 13 years showed “concern for your own current or future health” was nominated by 91.6% of ex-smokers as the main reason they quit, compared with 58.7% naming expense and 55.7% being concerned about the impact of their smoking on others.

If information and warnings about the dire consequences of smoking “don’t work”, then from where do all these ex-smokers ever get these top-of-mind concerns? They don’t pop into their heads by magic. They encounter them via anti-smoking campaigns, pack warnings, news stories about research and personal experiences with dying family and friends. The scare campaigns work.

4. Roll-your-own tobacco is more ‘natural’ than factory made

People who smoke rollies often look you in the eye and tell you that factory made cigarettes are full of chemical additives, while roll-your-own tobacco is “natural” – it’s just tobacco. The reasoning here that we are supposed to understand is that it’s these chemicals that are the problem, while the tobacco, being “natural”, is somehow OK.

This myth was first turned very unceremoniously on its head when New Zealand authorities ordered the tobacco companies to provide them with data on the total weight of additives in factory made cigarettes, roll-your-own and pipe tobacco.

For example, data from 1991 supplied by WD & HO Wills showed that in 879,219kg of cigarettes, there was 1,803kg of additives (0.2%). While in 366,036kg of roll-your-own tobacco, there was 82,456kg of additives (22.5%)!

Roll-your-own tobacco is pickled in flavouring and humectant chemicals, the latter being used to keep the tobacco from drying out when smokers expose the tobacco to the air 20 or more times a day when they remove tobacco to roll up a cigarette.

5. Nearly all people with schizophrenia smoke

It’s true that people with mental health problems are much more likely to smoke than those without diagnosed mental health conditions. A meta-analysis of 42 studies on tobacco smoking by those with schizophrenia found an average 62% smoking prevalence (range 14%-88%). But guess which study in these 42 gets cited and quoted far more than any of the others?

If you said the one reporting 88% smoking prevalence you’d be correct. This small 1986 US study of just 277 outpatients with schizophrenia has today been cited a remarkable 1,135 times. With colleagues, I investigated this flagrant example of citation bias (where startling but atypical results stand out in literature searches and get high citations – “wow! This one’s got a high number, let’s quote that one!”).

By googling “How many schizophrenics smoke”, we showed how this percolates into the community via media reports where figures are rounded up in statements such as, “As many as 90% of schizophrenic patients smoke.”

Endlessly repeating that “90%” of those with schizophrenia smoke does these people a real disservice. We would not tolerate such inaccuracy about any other group.

6. Everyone knows the risks of smoking

Knowledge about the risks of smoking can exist at four levels:

  • Level 1: having heard that smoking increases health risks.
  • Level 2: being aware that specific diseases are caused by smoking.
  • Level 3: accurately appreciating the meaning, severity, and probabilities of developing tobacco related diseases.

Level 4: personally accepting that the risks inherent in levels 1–3 apply to one’s own risk of contracting such diseases.

Level 1 knowledge is very high, but as you move up the levels, knowledge and understanding greatly diminish. Very few people, for example, are likely to know that two in three long term smokers will die of a smoking caused disease, nor the average number of years that smokers lose off normal life expectancy.

7. You can reduce the health risks of smoking by just cutting down

It’s true that if you smoke five cigarettes a day rather than 20, your lifetime risk of early death is less (although check the risks for one to four cigarettes a day here).

But trying to “reverse engineer” the risk by just cutting down rather than quitting has been shown in at least four large cohort studies such as this one to confer no harm reduction.

If you want to reduce risk, quitting altogether should be your goal.

8. Air pollution is the real cause of lung cancer

Air pollution is unequivocally a major health risk. By “pollution”, those who make this argument don’t mean natural particulate matter such as pollen and soil dusts, they mean nasty industrial and vehicle pollution.

The most polluted areas of Australia are cities where pollution from industry and motor vehicle emissions are most concentrated. Remote regions of the country are the least polluted, so if we wanted to consider the relative contributions of air pollution and smoking to smoking-caused diseases, an obvious question to ask would be “does the incidence of lung cancer differ between heavily polluted cities and very unpolluted remote areas?”

Yes it does. Lung cancer incidence is highest in Australia in (wait for this …) in the least polluted very remote regions of the country, where smoking prevalence happens also to be highest.

9. Smokers should not try to quit without professional help or drugs

If you ask 100 ex-smokers how they quit, between two-thirds and three-quarters will tell you they quit unaided: on their final successful quit attempt, they did not use nicotine replacement therapy, prescribed drugs, or go to some dedicated smoking cessation clinic or experience the laying on of hands from some alternative medicine therapist. They quit unaided.

So if you ask the question: “What method is used by most successful quitters when they quit?” The answer is cold turkey.

Fine print on this English National Health Service poster states a bald-faced lie by saying that “There are some people who can go cold turkey and stop. But there aren’t many of them.” In the years before nicotine-replacement threapy and other drugs were available, many millions – including heavy smokers – quit smoking without any assistance. That’s a message that the pharmaceutical industry was rather not megaphoned

10. Many smokers live into very old age: so it can’t be that harmful

In just the way that five out of six participants in a round of deadly Russian roulette might proclaim that putting a loaded gun to their head and pulling the trigger caused no harm, those who use this argument are just ignorant of risks and probability.

Many probably buy lottery tickets with the same deep knowing that they have a good chance of winning.

11. Today’s smokers are all hard core, addicted smokers who can’t or won’t give up

This claim is the essence of what is known as the “hardening hypothesis”: the idea that decades of effort to motivate smokers to quit has seen all the low-hanging fruit fall from the tree, leaving only deeply addicted, heavy smokers today.

The key index of addicted smoking is the number of cigarettes smoked per day. This creates a small problem for the hardening hypothesis: in nations and states where smoking has reduced most, the average number of cigarettes smoked daily by continuing smokers has gone down, not up. This is exactly the opposite of what the hardening hypothesis would predict if remaining smokers were mostly hard core.

12. Smoking is pleasurable

Repeated studies have found that around 90% of smokers regret having started, and some 40% make an attempt to quit each year. There’s no other product with even a fraction of such customer disloyalty.

But I’m always amused at some die-hard smokers’ efforts explain that they smoke for pleasure and so efforts to persuade them to stop are essentially just anti-hedonistic tirades. Many studies have documented that the “pleasure” of smoking centres around the relief smokers get when they have not smoked for a while. The next nicotine hit takes away the discomfort and craving they have been experiencing.

This argument is a bit like saying that being beaten up every day is something you want to continue with, because hey, it feels so good when the beating stops for a while.

13. Light and mild cigarettes deliver far less tar and nicotine to the smoker than standard varieties

Several nations have outlawed cigarette descriptors such as “light” and “mild” because of evidence that such products do not deliver lower amounts of tar and nicotine to smokers, and so are deceptive.

The allegedly lower yields from cigarettes labelled this way resulted from a massive consumer fraud.

Cigarette manufacturers obtained these low readings by laboratory smoking machine protocols which took a standardized number of puffs, at a standardized puff velocity. The smoke inhaled by the machine was then collected in glass “lungs” behind the machine and the tar and nicotine weighed to give the readings per cigarette.

But the companies didn’t tell smokers two things. So-called light or mild cigarettes had tiny, near-invisible pin-prick perforations just on the filter (see picture). These holes are not covered by the “lips” or “fingers” of the laboratory smoking machine, allowing extra air to be inhaled and thus diluting the dose of tar and nicotine being collected.

But when smokers use these products, two things happen. Their lips and fingers partially occlude the tiny ventilation holes, thus allowing more smoke to be inhaled. Smokers unconsciously “titrate” their smoking to obtain the dose of nicotine that their brain’s addiction centres demand: they can take more puffs, inhale more deeply, leave shorter butt lengths or smoke more cigarettes.

Today, where use of these descriptors has been stopped, the consumer deception continues with the companies using pack colours to loudly hint to smokers about which varieties are “safer”.

Magnification and location of filter ventilation holes. Author collection

14. Filters on cigarettes remove most of the nasty stuff from cigarettes

We’ve all seen the brown stain in a discarded cigarette butt. But what few have seen is how much of that same muck enters the lungs and how much stays there.

This utterly compelling video demonstration shows how ineffective filters are in removing this deadly sludge. A smoker demonstrates holding the smoke in his mouth and then exhales it through a tissue paper, leaving a tell-tale brown stain. He then inhales a drag deep into his lungs, and exhales it into a tissue. The residue is still there, but in a much reduced amount. So where has the remainder gone? It’s still in the lungs!

15. Governments don’t want smoking to fall because they are addicted to tobacco tax and don’t want to kill a goose that lays golden eggs

This is perhaps the silliest and most fiscally illiterate argument we hear about smoking. If governments really want to maximise smoking and tax receipts, they are doing a shockingly bad job of it. Smoking in Australia has fallen almost continuously since the early 1960s. In five of the 11 years to 2011, the Australian government received less tobacco tax receipts than it did the year before (see Table 13.6.6).

Plainly, as smoking continues to decline, diminishing tax returns will occur, although this will be cushioned by the rising population which will include some smokers.

In the meantime, tobacco tax is a win-win for governments and the community. It reduces smoking like nothing else, and it provides substantial transfer of funds from smokers to government for public expenditure.

Those of us who don’t smoke do not squirrel away what we would have otherwise spent on smoking in a jam jar under the bed. We spend it on other goods and services, benefiting the economy too.

16. Most smokers die from smoking caused diseases late in life, and we’ve all got to die from something

Smoking increases the risk of many different diseases, and collectively these take about ten years off normal life expectancy from those who get them.

Smoking is by far the greatest risk factor for lung cancer. In Australia, the average age of death for people with lung cancer is 71.4 (see Table 4.2), while life expectancy is currently 80.1 for men and 84.3 for women.

This means that, on average, men diagnosed with lung cancer lose 8.7 years and women 12.9 years (mean 10.8 years). Of course, some lose many more (Beatle George Harrison died at just 58, Nat King Cole at 45).

If a 20-a-day smoker starts at 17 and dies at 71, 54 years of smoking would see 394,470 cigarettes smoked. At ten puffs per cigarette, that’s some 3.94 million point-blank lung bastings.

It takes about six minutes to smoke a cigarette. So at 20 a day, smokers smoke for two hours each day. Across 54 years, that’s a cumulative 1,644 days of smoking (4.5 years of continual smoking if you put it all together).

So by losing ten years off life expectancy, each cigarette smoked takes about 2.2 times the time it takes to smoke it off the life expectancy that might otherwise have been enjoyed.

17. Smokers cost the health system far less than the government receives from tobacco tax

In June 2015, a senior staff member of Australian libertarian Senator David Leyonhjelm, Helen Dale tweeted:

In Australia, a now old report looking at 2004/05 data estimated the gross health care costs attributable to smoking “before adjustment for savings due to premature death” were $A1.836 billion. In that financial year, the government received $A7,816.35 billion in customs and excise duty and GST on tobacco.

Someone who thought that the fiscal ledger was all that mattered in good government might conclude from this that smokers easily pay their way and perhaps we should even encourage smoking as a citizen’s patriotic duty.

With smokers being considerate enough to die early, these noble citizens lay down their lives early and thus contribute “savings due to premature death” like failing to draw a state pension or needing aged care services late in life. Philip Morris notoriously gave this advice to the new Czech government in 1999.

Other assessments, though, might well point to the values inherent in such assessments. History’s worst regimes have often seen economically non-productive people as human detritus deserving death. Primo Levi’s unforgettable witnessing of this mentality in Auschwitz comes to mind.

18. Big Tobacco is starting to invade low-income nations, now that smoking is on the wane in the wealthiest nations

Sorry, but US and British manufacturers have been aggressively marketing cigarettes in places such as China since the early years of last century. These collectable posters show many featuring Chinese women.

The large populations, the often lax tobacco-control policies and the higher corruption indexes of many low- and middle-income nations makes many of these nirvanas for Big Tobacco.

There are fewer more nauseating experiences than reading the corporate social responsibility reports of tobacco transnationals and then seeing how they operate in smokers’ paradises such as Indonesia. This documentary says it all.

19. Millions of cigarette butts on the world’s beaches leach lots of toxic chemicals into oceans

Cigarette butts are the most discarded items in all litter. Every year uncounted millions if not billions are washed down gutters in storm water and find their way into rivers, harbours and oceans. Cigarette filters and butts contain toxic residue and experiments have shown that placing laboratory fish in containers for 48 hours with leachate extracted from used cigarette butts, 50% of the fish die. From this, we sometimes hear people exclaim that cigarette butts are not just unsightly, but they “poison the oceans”.

But a confined laboratory container does not remotely mirror real life exposures in oceans or rivers. There are some 1,338,000,000 cubic kilometers of water in the world oceans, so the contribution of cigarette butts to the toxification of all this could only excite a homeopath.

If we want to reduce tobacco litter, we need not wander into such dubious justifications. The best way by far is to keep reducing smoking. Industry attempts at portraying themselves as corporately responsible by running dinky little clean-up campaigns or distributing personal butt disposal canisters avoids their efforts to keep as many smoking as possible.

20. Tobacco companies care deeply about their best customers dying early

Naturally, all businesses would rather their customers lived as long as possible so that the cash registers can keep ringing out long and loud. Tobacco companies wish their products didn’t kill so many, but worship the god nicotine for its iron grip on so many.

Visit any tobacco transnational’s website and you will find lots of earnest and caring talk about the companies’ dedication to doing all they can to reduce the terrible harm caused by their products. All the major companies have now invested heavily in electronic cigarettes, so isn’t this a sign that they taking harm reduction seriously?

It might be if the same companies were showing any sign of taking their feet off the turbo-drive accelerator of opposing effective tobacco control policies. But they are doing nothing of the sort. All continue to aggressively attack and delay any policy like tax hikes, graphic health warnings, plain packaging and advertising bans wherever in the world these are planned for introduction.

For all their unctuous hand-wringing about their mission to reduce harm, they are all utterly determined to keep as many smoking as possible. Big Tobacco’s business plan is not smoking or ecigarettes. It’s smoking and ecigarettes. Smoke when you are able to, vape when you can’t. It’s called dual use and some 70% of vapers are doing just that. The tragedy now playing out in some nations is that too many gormless tobacco control experts are blind to this big picture.

NACCHO and RACGP Podcast

Do you smoke?’ A simple preventive activity for clinicians to engage with every patient.

With over 30 years’ experience in Indigenous health, Professor David Thomas from the Menzies School of Health Research discusses updates to the smoking topic from Chapter 1: Lifestyle, in the third edition

Listen to Episode one:

Smoking & Smoking Cessation with Prof David Thomas on The National Guide Podcast