NACCHO Aboriginal Health and #Smoking : @KenWyattMP announces $35.2 million funding #ACCHO Anti-smoking programs

These health services are all delivering frontline services to prevent young Indigenous people taking up smoking and to encourage existing smokers to quit.

Reducing smoking rates is central to the Government’s efforts to close the gap in life expectancy, but requires a consistent, long-term commitment”

Minister for Indigenous Health, Ken Wyatt

Over 100 NACCHO Articles about smoking


The Australian Government will provide $35.2 million next financial year to continue anti-smoking programs targeted to Aboriginal and Torres Strait Islander people in regional and remote areas.

Minister for Indigenous Health, Ken Wyatt, said the Government had approved the continuation of funding to 36 Aboriginal Community ControlledHealth Services and one private health service.

“These health services are all delivering frontline services to prevent young Indigenous people taking up smoking and to encourage existing smokers to quit,”  .

“Reducing smoking rates is central to the Government’s efforts to close the gap in life expectancy, but requires a consistent, long-term commitment.

“Smoking causes the greatest burden of disease, disability, injury and earlydeath among Indigenous people and accounts for 23 per cent of the health gap between Indigenous and non-Indigenous Australians.”

Under the Council of Australian Governments (COAG) National Healthcare Agreement, all governments have committed to halving the 2008 adult daily smoking rate among Indigenous Australians, of 44.8 per cent, by 2018.

“The rate of smoking among Aboriginal and Torres Strait Islander people is still far higher than among other Australians and is damaging their health in many ways,” Minister Wyatt said.

It’s unlikely now that we will meet the COAG target, but we are making progress.

“It’s important that anti-smoking programs are meaningful for Indigenous people and changes made in recent years have ensured that only programs which are evidence based and effective are receiving grants.”

Continued funding for the 37 health services follows a preliminary evaluation of the Tackling Indigenous Smoking program which found that it was operating effectively and using proven approaches to changing smoking behaviour.

NACCHO Aboriginal Health : Our #ACCHO Members Good News Stories from #NT #WA #VIC #SA #NSW #QLD @KenWyattMP

1. NSW Jullums , Bullinah and Bulgarr Ngaru ACCHO/AMS

2. NSW Wellington Aboriginal Corporation AMS

3. South Australia Nunyara Aboriginal Health Service 

4.Western Australia : Aboriginal Health Council of WA.

5.Victorian Aboriginal Health Service (VAHS)

6. NT 6. NT Katherine West Health Board

7. QLD Deadly Choices and  Gurriny Yealamucka Health Service

 For NACCHO the acceptance that our Aboriginal controlled health services deliver the best model of integrated primary health care in Australia is a clear demonstration that every Aboriginal and Torres Strait Islander person should have ready access to these services, no matter where they live.

 Lets celebrate and share our ACCHO’s success

How to submit a NACCHO Affiliate

or Members Good News Story ? 

 Email to Colin Cowell NACCHO Media     Mobile 0401 331 251

Wednesday by 4.30 pm for publication each Thursday


1.Jullums (Lismore), Bullinah (Ballina), Bulgarr Ngaru Medical Aboriginal Corporation (Casino, Maclean and Grafton) Clinic’s

The idea of these workshops is to raise awareness around the different signs and symptoms of heart disease, and also around prevention and management of the disease.

“This is a new, collaborative approach to addressing this issue, but we’re also working together with existing avenues such as healthy lifestyle and exercise programs to assist participants to make the most of what they’ll be learning.”

Aboriginal Chronic Care Officer with NNSWLHD, Anthony Franks

A series of workshops is being held in Northern NSW to raise awareness of the risk factors for heart disease and engage with Aboriginal and Torres Strait Islander women on ways to reduce their chances of becoming one of the statistics.

Download dates and venues Northern NSW Workshops dates and Venues

ABORIGINAL and Torres Strait Islander women are at least three times more likely to be hospitalised due to heart disease than their caucasian counterparts.

Heart disease is the leading single cause of death among Aboriginal and Torres Strait Islander Australians.

The program consists of three one-day workshops, with the first being held in March at various sites across the North Coast.

The participants will attend each of the three workshop days in March, May and July, with the aim of continuing the education and providing feedback and follow up at the later meetings.

The workshops are a collaboration between the Northern NSW Local Health District (NNSW LHD), local Aboriginal Medical Services (AMS), North Coast Primary Health Network (NCPHN), Solid Mob, and the NSW and Queensland Government health coaching services, Get Healthy and On Track. They are funded by the National Heart Foundation.

Workshops are being held in Grafton, Muli, Casino, Ballina, Maclean, Goonellabah and Tweed Heads.

2. Wellington Aboriginal Corporation Health Service 

Health expo to change bad habits in men

The Wellington Aboriginal Corporation Health Service hosted the QuiBFit Aboriginal Men’s Health Expo in Dubbo.

About 120 men participated from across the region which includes Orange, Coonabarabran, Walgett, Wellington, Dubbo, Parks and Goodooga.

A major focus was tackling Indigenous smoking and mental health and wellbeing.

Wellington Aboriginal Corporation Health Service chief executive Darren Ah See said a lot of th e focus in the Indigenous health sector is on “mums and bubs”.

“It’s good to have an event like this for men because they are the reluctant ones about getting their health checks”, he said.

“We want to try to change that norm and get men to take responsibility not only around their health and wellbeing but to be the leaders of their communities and families.

“It’s all about social and health wellbeing but it is also about mentorship and trying to encourage families and individuals to head in the right direction”.

The expo culminated with a corroboree, with more than 300 people attending.

Western NSW Local Health District Aboriginal health and wellbeing director Brendon Cutmore said it was extremely important to focus on preventive health at the expo.

“It is really our opportunity as Aboriginal men to take control of our lives, whether that be through eliminating some of the negative habits people have, things such as smoking, drugs and alcohol, “he said.

“Coming to these types of event sand having discussions around how to make your life healthier, how to be a leader in the community and how to be a leader in your family and how your actions reflect on the people around you – that’s a big take home message.

 3.Nunyara Aboriginal Health Service Whyalla SA

 “ I encouraged Aboriginal and Torres Strait Islander women to attend the gathering in Whyalla to benefit from the stories and experiences of their peers.

It is important that these gatherings to take place in regional areas so Aboriginal and Torres Strait Islander women living outside of Adelaide have the chance to network and share community news.

Previous gatherings have been very successful and attracted many participants from across the state.

These events are also an opportunity for the State Government to strengthen ties with local service providers and gain insight into matters affecting the community.

Status of Women Minister Zoe Bettison

Co-facilitator’s Kimberley from OfW and Zena Wingfield for the in Whyalla today

The first State Aboriginal Women’s Gathering for 2017 was held in Whyalla this week

The gathering took place on Tuesday 28 March at Nunyara Aboriginal Health Service, Whyalla Stuart.

The gatherings gave Aboriginal and Torres Strait Islander women an opportunity to discuss a range of issues and share news from their communities.

Guest speakers presented information on topics including health, women’s legal services, sports and recreation, mental health and wellbeing, and caring support.

Status of Women Minister Zoe Bettison said the gatherings give women the opportunity to learn from each other, share experiences and discuss issues, in a safe and supportive environment.

The Office for Women has partnered with Whyalla’s Nunyara Aboriginal Health Service to convene this event.


In 2016, five separate State Aboriginal Women’s Gatherings were held across the state to make it easier for women in regional areas to participate.

Whyalla was identified as a significant location for the first gathering of 2017 as a way to provide support and information to Aboriginal women in the region.

Gatherings have also been planned for 2017 in the Far West Coast and the South East.

For more information about the State Aboriginal Women’s Gatherings visit

4. Aboriginal Health Council of WA.

“ The prevalence of ear disease and hearing loss in Aboriginal kids has a major effect on their speech and educational development, social interactions, employment and future wellbeing,

While many children are vulnerable to chronic ear disease, in WA it represents a significant burden for Aboriginal children who can experience their first onset within weeks following birth.

Aboriginal children can also have more frequent and longer lasting episodes compared to non-Aboriginal children.”

AHCWA Chairperson Michelle Nelson-Cox said poor ear health was a significant problem among Aboriginal people, particularly children.

Training program to improve ear health among Aboriginal people

A training program to assist Aboriginal Health Workers to provide ear health care to their communities is being delivered around the state by the Aboriginal Health Council of WA.

The two week ear health training program was delivered in four different locations last year, and 23 Aboriginal Health Workers (AHWs) have graduated from the course so far.

The program is scheduled to be delivered in at least four more locations this year including Perth, Broome and Kalgoorlie. More trainings will be scheduled for the second half of the year.

The program teaches AHWs how to manage ear infections, carry out screening, identify risk factors and plan ear health promotion and strategies.

AHCWA Chairperson Michelle Nelson-Cox said poor ear health was a significant problem among Aboriginal people, particularly children.

“The prevalence of ear disease and hearing loss in Aboriginal kids has a major effect on their speech and educational development, social interactions, employment and future wellbeing,” she said.

“While many children are vulnerable to chronic ear disease, in WA it represents a significant burden for Aboriginal children who can experience their first onset within weeks following birth.

“Aboriginal children can also have more frequent and longer lasting episodes compared to non-Aboriginal children.”

Ms Nelson-Cox said people in regional areas were more susceptible to ongoing ear problems.

“Children living in remote communities have some of the highest rates of chronic ear disease in the world,” she said.

“We want to spread the message in regional communities that early detection and treatment of ear diseases in children is vital to ensure optimum development of speech, language, and to minimise the long term effects on educational performance.”

AHCWA has also launched a giant inflatable ear to be used as an interactive teaching tool among Aboriginal communities.

Koobarniny, which means ‘big’ in the Noongar language, is believed to be the first of its type in Australia.

Koobarniny is currently being used at different events around the metropolitan area, but it’s hoped it will travel to regional areas in the future.

 5. Victorian Aboriginal Health Service (VAHS)
 7. QLD Deadly Choices and  Gurriny Yealamucka Health Service

It’s been a great couple of days in the North with today’s visit by Steve Renouf, Lote Tiquiri & Brisbane Broncos James Roberts at the DC Yarrabah Gurriny Yealamucka Health Service Aboriginal Corporation

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NACCHO #ClosetheGapday Editorial Comment and Download #CTG 2017 Progress and Priorities Report

 ” Achieving health equality for Aboriginal and Torres Strait Islander people will be impossible without a sincere, committed effort to understand and address racism in this country. That is why the Close the Gap Campaign continues to call for a national inquiry into the prevalence of racism and its impact.

The old cliché about persisting with the same failure in the hope of a different outcome is sadly the lived reality of much of the government policies regarding our people.

It is time to do something different.”

NACCHO CEO Pat Turner AM and Co- Chair Close the Gap Campaign

Opinion editorial 16 March see below in full ” It’s time to re-think Aboriginal and Torres Strait Islander health

Closing the gap in health equality between Aboriginal and Torres Strait Islander people and other Australians is an agreed national priority but governments are failing to meet nearly every key measure. This has to change.”

That’s the blunt assessment delivered by Close the Gap Campaign co-chairs, Jackie Huggins and Patricia Turner :

Photo : NACCHO CEO Pat Turner and #CTG co chair Dr Jackie Huggins launch 2017 #CloseTheGap Progress & Priorities Report

Dr Huggins, who is also co-chair of the National Congress of Australia’s First Peoples, and Ms Turner, who is chief executive of the National Aboriginal Community Controlled Health Organisation, released the Close the Gap Campaign 2017 Progress and Priorities Report in Sydney today (  16 March ) to mark National Close the Gap Day.

Download the report HERE     CTG Report 2017

CTG 2017 report : 15 Recommendations :  “We have the Solutions

New Engagement ( The remaining 12 below )

  1. The Federal, State and Territory governments renew the relationship with Aboriginal and Torres Strait Islander peoples, by engaging with sector leaders on the series of calls in the Redfern Statement, and that they participate in a National Summit with Aboriginal and Torres Strait Islander leaders in 2017, to forge a new path forward together.
  2. The Federal Government restore previous funding levels to the National Congress of Australia’s First Peoples as the national representative body for Aboriginal and Torres Strait Islander peoples, and work closely with Congress and the Statement signatories to progress the calls in the Redfern Statement.
  3. The Federal Government hold a national inquiry into racism and institutional racism in health care settings, and hospitals in particular, and its contribution to Aboriginal and Torres Strait Islander inequality, and the findings be incorporated by the Department of Health in its actioning of the Implementation Plan of the National Aboriginal and Torres Strait Islander Health Plan 2013-2023.

It’s time to re-think Aboriginal and Torres Strait Islander health

Op-ed by Patricia Turner, CEO, National Aboriginal Community Controlled Health Organisation and co-chair of the Close the Gap Campaign.

Today [16 March 2017] is National Close the Gap Day. It is a day to acknowledge our resilience and a day to focus attention on the significant gap in health equality between Aboriginal and Torres Strait Islander people and non-Indigenous Australians.

The facts are indisputable. Governments at all levels are failing Australia’s First Peoples. We have shorter lifespans and we are sicker and poorer than the average non-Indigenous Australian.

The Close the Gap Campaign began in 2006. One of the Campaign’s first accomplishments was to convince the Federal Government of the need to plan and set targets to improve health equality for Aboriginal and Torres Strait Islander people.

We’ve now had almost a decade of Closing the Gap Strategy by successive federal governments. Prime Minister Malcolm Turnbull’s most recent report to Parliament, in February 2017, was not good news. Most of the Closing the Gap targets are unlikely to be met by 2030. Frustratingly, child mortality rates are going backwards.

Today, the Close the Gap Campaign’s Progress and Priorities Report 2017 reflects on the continuing failure of the Government’s Closing the Gap Strategy and outlines a series of recommendations that can begin to turn the tide.

As a co-chair of Close the Gap Campaign and CEO of the National Aboriginal Community Controlled Health Organisation, I see the impact of a lack of coordination between federal, state and territory governments on addressing Aboriginal and Torres Strait Islander health.

The Federal Government’s recent announcement to refresh the strategy is timely and a dialogue should begin with Aboriginal and Torres Strait Islander peak health organisations on how to address the health challenges our people face.

We expect much more from the state and territory governments. The Federal Government has a clear leadership role but the states are simply not doing enough to address inequality in their jurisdictions.

New arrangements between state, territory and federal governments must begin with a clear focus on addressing the social and cultural determinants of health.

Aboriginal and Torres Strait Islander affairs should not be managed in siloes. Instead, we need to take account of the factors that contribute to good health: housing, education, employment and access to justice. Aboriginal and Torres Strait Islander leaders from across these sectors are already working together to make these policy connections – governments must follow suit.

Cultural determinants matter. There is abundant evidence about the importance of self-determination, freedom from the grind of casual and systemic racism, discrimination and poverty. For over 200 years we have been burdened with laws, systems and institutes that perpetuate disadvantage.

But our cultures and traditions still endure; we remain the traditional custodians of the land you walk on.

Last year, 140 Aboriginal community-controlled health organisations (ACCHOs) provided nearly 3 million episodes of care to over 340,000 clients by more than 3,000 Indigenous staff. It is clear that putting Aboriginal health in Aboriginal hands works.

Recently, Flinders University highlighted the success of the Central Australian Aboriginal Congress in Alice Springs, noting its ability to provide a one stop-shop with outreach services, free medicine and advocacy.

The benefits of having Aboriginal health in Aboriginal hands are evident in other case studies which show reductions in the numbers of young smokers, increased immunisations rates, and increased numbers of child health checks in our local communities.

The Federal Government’s rhetoric about economic empowerment and opportunity should be replaced with significant public policy initiatives and the delivery of specific outcomes. Politicians often speak about the optimism, resilience and determination of our people but how about speaking today, right now, about meaningful actions, engagement and self-determination for us all.

CTG 2017 report 15 Recommendations :  “We have the Solutions

Prime Minister, and all Members of Parliament I say to you that Aboriginal and Torres Strait Islander people have the solutions to the difficulties we face.

Consider for a moment the 2.5 million episodes of care delivered to our people by Aboriginal Community Controlled Heath Organisations each year.

This community-controlled work is echoed by many of our organisations here today, and amplified by countless individual and community efforts working for change.

Imagine this work stretching out over decades as it has.

We need a new relationship that respects and harnesses this expertise, and recognises our right to be involved in decisions being made about us.

A new relationship where we have a seat at the table when policies are developed.”

Dr Jackie Huggins Redfern Statement Parliamentary Event, 14 February 2017

Reinvigorating the national approach to health inequality

4.     State and Territory governments recommit to the Close the Gap Statement of Intent, and develop and implement formal partnerships with the Federal Government with agreed roles, funding and accountability with the provision of annual reports on their efforts to close the gap from each jurisdiction.


5.     The Federal, State and Territory governments work together to develop a National Aboriginal and Torres Strait Islander Health Workforce Strategy to meet the vision of the National Health Plan.

Social and Cultural Determinants of Health

6.     The Federal Government develop a long-term National Aboriginal and Torres Strait Islander Social and Cultural Determinants of Health Strategy.

Implementation Plan

The Implementation Plan is a major commitment by the Federal Government and must be adequately resourced for its application and operation. As such, the Government should:

7.     Identify geographic areas with both high levels of preventable illnesses and deaths and inadequate services, and development of a capacity-building plan for Aboriginal Community Controlled Health Organisations (ACCHOs) in those areas.

8.     Fund the process required to develop the core services model and the associated workforce, infrastructure, information management and funding strategies required.

9.     Ensure Aboriginal and Torres Strait Islander health funding is maintained at least at current levels until the core services, workforce and funding work is finalised, when funding should be linked directly with the Implementation Plan.

10. Ensure the timely evaluation and renewal of related frameworks upon which the Implementation Plan relies.


11. Finalise and resource the National Plan for Aboriginal and Torres Strait Islander Mental Health and Social and Emotional Wellbeing. This plan should incorporate and synthesise the existing health, mental health, suicide and drugs policies and plans – and should be an immediate priority of all governments.

12. Ensure that the consultation process for the next iteration of the Implementation Plan be based on genuine partnership with Aboriginal and Torres Strait Islander people, in a way that is representative and properly funded so that First Peoples can be full and equal development partners.

Primary Health Networks

13. The Federal Government mandate formal agreements between Primary Health Networks (PHNs) and ACCHOs in each region that:

a.     specify Aboriginal and Torres Strait Islander leadership on Indigenous issues and identify the specific roles and responsibilities of both the PHNs and the ACCHOs.

b.     include workforce targets for Aboriginal and Torres Strait Islander health professionals and include mandatory Aboriginal and Torres Strait Islander representation on the clinical committees of every PHN.

14. The Federal Government mandate ACCHOs as preferred providers of health services for Aboriginal and Torres Strait Islander people provided through PHNs.

15. The Federal Government develop and implement agreed accountability, evaluation and reporting arrangements to support the provision of primary health care for Aboriginal and Torres Strait Islander peoples in each PHN area.[i]


The Campaign believes that the PHN program has the potential to make a significant positive difference in health outcomes for all Australians if they are culturally safe and properly engaged with the Aboriginal and Torres Strait Islander community within their network area.

The ability of PHNs to deliver culturally safe, high-quality primary health care for Aboriginal and Torres Strait Islander people will be seen in the lived experience of the people.


It is essential that Federal Government ensure that the PHNs are engaging with ACCHOs to ensure the best primary health care is afforded to Aboriginal and Torres Strait Islander people, as well as the broader community. Competitive tendering processes for PHNs that award contracts to organisations that are able to write the best proposal may well be at the expense of organisations that can provide the best services in terms of access, quality and outcomes.

However, formal partnerships between PHNs and ACCHOs should reduce rather than exacerbate current funding inequities and inefficiencies.

It is the Campaign’s view that ACCHOs must be considered the ‘preferred providers’ for health services for Aboriginal and Torres Strait Islander people.

Where there is either no existing ACCHO or insufficient ACCHO services, capacity should be built by the establishment of new ACCHOs or within existing ACCHOs (or have capacity development of existing ACCHOs) within the PHN area to extend their services to the identified areas of need.

Where it is appropriate for mainstream providers to deliver a service, they should be looking to partner with ACCHOs to better reach the communities in need.[i]

The Campaign welcomes the collaboration between the Department of Health and the National Aboriginal Community Controlled Health Organisation to develop the Primary Health Networks (PHNS) and Aboriginal Community Controlled Health Organisations (ACCHOS) – Guiding Principles which are intended to provide:

…guidance for actions to be taken by each party across six key domains: Closing the Gap; cultural competency; commissioning; engagement and representation; accountability, data and reporting; service delivery; and research.[ii]

Having a shared understanding of the key domains of focus and the principles of engagement and collaboration are a good start, however, more can be done to formalise the relationship between PHNs and ACCHOs.

Cultural Safety

The need for culturally safe services, with safe spaces that support the holistic concept of health is well established.

ACCHOs continue to be the exemplar for cultural safety standards as they are, by their very existence, best placed to respond to the health needs of the community based on implicit cultural understanding.[iii]

Again, it is encouraging to see some indications that the PHNs are looking to incorporate culturally safe practices as evidenced by the Guiding Principles document between PHNs and ACCHOs. The Guiding Principles state:

‘An understanding of Aboriginal and Torres Strait Islander culture is important to partners who wish to engage with Aboriginal and Torres Strait Islander people effectively and as equals.

Underpinning the Guiding Principles is a shared knowledge that will ensure:

  • respectful culturally sensitive consultation
  • recognition that Aboriginal and Torres Strait Islander health outcomes will be achieved when Aboriginal and Torres Strait Islander people control them, and
  • that commissioned service delivery will be a strengths-based approach reflecting the United Nations Declaration on the Rights of Indigenous Peoples.’[iv]

Respect of culture must be embedded in all PHN practice and management, from formalised cooperation with ACCHOs, the delivery of services and the investments made in the non-Indigenous workforces so that they understand and value Cultural Safety and its importance for Aboriginal and Torres Strait Islander people seeking care.

 The Close the Gap Campaign

Close the Gap Campaign co-chair Jackie Huggins highlighted the resilience of Indigenous people and cautioned against feeling disheartened by the slow pace of change.

“When Tom Calma started the Close the Gap Campaign in 2006, he set a 25-year goal to achieve health equality between Aboriginal and Torres Strait Islander peoples and non-Indigenous peoples,” Dr Huggins said.

This was an intentionally ambitious time frame. Nevertheless, Tom and the other early Campaign members knew that every inch the gap closed between First Australians and non-Indigenous Australians translated into lives saved and lives improved.

The Australian community agreed. Since then more than 220,000 Australians have signed the close the gap pledge for change.

“Despite the significant challenges we face to make health equality a reality in this country, it is the commitment of the hundreds of thousands of people that have pledged their support to closing the gap that give us courage and strength to press on.

“In communities across Australia we are seeing more and more of our people rising above the obstacles of institutional racism, generational trauma and low expectations to become nurses, doctors, social workers, youth workers, health workers, administrators, teachers and community leaders.

Our people, with the support of the many non-Indigenous people committed to health equality, are best placed to lead the changes needed today, tomorrow and over the next decade,” Dr Huggins said.






NACCHO Aboriginal #Ear Health : #ClosingtheGapDay and hearing loss: an invisible barrier obstructs progress


“Avoidance is a way of coping with anxiety about being shamed. Repeated avoidance results in limited engagement and poor outcomes for programs designed to Close the Gap.

The use of hearing loss responsive communication strategies can help to deal with this barrier

 These strategies can be as important as culturally appropriate processes in programs.

Indeed, there is an overlap between the two. For those with hearing loss, what is said in culturally familiar language within a culturally familiar process is easier to understand.”

Hearing loss among Indigenous Australians is a largely unseen barrier to Closing the Gap programs, according to Dr Damien Howard and Jody Barney, who explain how to be “hearing loss responsive” in service delivery and communications.

Originally published

 ” Indigenous Australians have one of the highest levels of ear disease and hearing loss in the world.

Rates are up to ten times more than non-Indigenous Australians and the National Aboriginal Community Controlled Health Organisation estimates Indigenous healthcare is currently 30 to 50 years behind the rest of the country “

Read or Share all NACCHO Ear and Hearing Articles HERE

This weeks NACCHO Aboriginal Health News Alerts will  include

Tuesday Save a date Wednesday Job alerts Thursday NACCHO Members Good News

How to submit ? Email to Colin Cowell NACCHO Media   4.30 pm  day before publication

Communication difficulties caused by the widespread unidentified hearing loss among Indigenous people in Australia continue to undermine the effectiveness of Closing the Gap programs.

An Aboriginal worker with mild hearing loss once commented: “You see that look, the look that tells you they are thinking you are some stupid blackfella and you don’t want to say you don’t understand; ‘Can you tell me it again?’

“You just want to get away and never want to work with them again if you can help it.”

Many people act on these kinds of feelings. They seek to avoid people, situations and service providers because of these reactions. The everyday communication difficulties caused by their hearing loss contribute to anxiety and disengagement. They will often seek to avoid education, health and employment support services designed to help them.

For instance, people may not go to health clinics, or do not comply with provided treatment. Avoidance of specialist medical appointments is one feature of this. In some specialist medical visits to remote communities, 50% of patients do not attend booked appointments. This can have dire health implications for individuals. It is also an immense waste of resources.

When hearing loss begins early in life, it has greater impact than the late onset hearing loss that is experienced by non-Indigenous Australians who are hard of hearing. Their hearing loss is generally caused by occupational noise exposure and ageing.

Indigenous hearing loss is usually caused by endemic childhood middle ear disease. Children with current ear disease often have a temporary hearing loss. Repeated infections can cause lasting damage and some level of permanent mild to moderate hearing loss. Up to 70% of Indigenous people are affected — fewer in urban communities, more in remote communities.

The impact of this hearing loss is pervasive.

We know that school attendance rates for Indigenous children with hearing loss are below those for other students. We know they experience more difficulty with learning when they do attend school. We know they display more behavioural problems when at school. We know Indigenous workers with hearing loss have difficulty securing and holding jobs, have greater performance difficulties and frequently avoid participation in workplace training.

There is also increasing concern about hearing loss as a factor in the over-representation of Indigenous people in the criminal justice system; 94% of prison inmates in the Northern Territory have been found to have a significant degree of hearing loss.

Those familiar with Indigenous disadvantage may wonder why they have not heard about the incidence and impact of hearing loss among adults. One reason is that early onset conductive hearing loss is mostly invisible.

First, most Indigenous people who are hard of hearing are not aware that their hearing is not normal. The early origin of their hearing loss means it is something they have experienced for most of their life. For them, what they how they hear is ‘normal’. If asked, they would deny having a hearing loss.

Second, service providers (teachers, nurses, doctors, trainers, health professionals, social workers and police among them) are unlikely to recognise poor hearing as an issue for people they work with. Communication difficulties arising from hearing loss are generally attributed only to language and cultural differences, or to limited intelligence or poor motivation. The latter two perceptions, when noticed by clients astute in reading body language, can further compound disengagement.

It is easy to imagine that hearing aids are all that is needed to resolve issues. They can help some, but will not resolve all communication difficulties.

The communication issues experienced by an adult with early onset hearing loss are the result of both current hearing loss and the ‘legacy effects’ of unidentified hearing loss since childhood. These may include a preference for visual communication strategies, anxiety related to an intense fear of being ‘shamed’ and a limited store of contextual knowledge that helps with understanding what is said.

A store of contextual knowledge is what people normally acquire through fully hearing what is said to them, and around them. Without a store of relevant contextual knowledge — the big picture — what is said in any situation is harder to understand. So people with early onset hearing loss not only have trouble hearing what is said, but they also frequently have difficulty understanding what they hear.

Avoidance is a way of coping with anxiety about being shamed. Repeated avoidance results in limited engagement and poor outcomes for programs designed to Close the Gap.

The use of hearing loss responsive communication strategies can help to deal with this barrier. These strategies can be as important as culturally appropriate processes in programs. Indeed, there is an overlap between the two. For those with hearing loss, what is said in culturally familiar language within a culturally familiar process is easier to understand.

Other key components of hearing loss responsive service provision include the following:

  • using highly visual communication strategies
  • minimising background noise during conversations
  • using the language clients know best
  • using ‘pre-learning’ – providing information in advance to help explain the context, so people can better understand what will be discussed
  • services having amplification devices to use as part of service delivery
  • training staff in the use of more effective communication strategies — this includes training workers to recognise hearing loss, develop necessary skills and avoid responses that prompt shame, anxiety and disengagement

We believe Closing the Gap programs will continue to fall short of targeted outcomes until they are designed to be responsive to the needs of those with hearing loss.

NACCHO Save a dates Register your event here

22 March2017 Indigenous Ear Health Workshop  in Adelaide


The 2017 Indigenous Ear Health Workshop to be held in Adelaide in March will focus on Otitis Media (middle ear disease), hearing loss, and its significant impact on the lives of Indigenous children, the community and Indigenous culture in Australia.

The workshop will take place on 22 March 2017 at the Adelaide Convention Centre in Adelaide, South Australia.

The program features keynote addresses by invited speakers who will give presentations aligned with the workshop’s main objectives:

  • To identify and promote methods to strengthen primary prevention and care of Otitis Media (OM).
  • To engage and coordinate all stakeholders in OM management.
  • To summarise current and future research into OM pathogenesis (the manner in which it develops) and management.
  • To present the case for consistent and integrated funding for OM management.

Invited speakers will include paediatricians, public health physicians, ear nose and throat surgeons, Aboriginal health workers, Education Department and a psychologist, with OM and hearing updates from medical, audiological and medical science researchers.

The program will culminate in an address emphasising the need for funding that will provide a consistent and coordinated nationwide approach to managing Indigenous ear health in Australia.

Those interested in attending may include: ENT surgeons, ENT nurses, Aboriginal and Torres Strait Islander health workers, audiologists, rural and regional general surgeons and general practitioners, speech pathologists, teachers, researchers, state and federal government representatives and bureaucrats; in fact anyone interested in Otitis Media.

The workshop is organised by the Australian Society of Otolaryngology Head and Neck Surgery (ASOHNS) and is held just before its Annual Scientific Meeting (23 -26 March 2017). The first IEH workshop was held in Adelaide in 2012 and subsequent workshops were held in Perth, Brisbane and Sydney.

For more information go to the ASOHNS 2017 Annual Scientific Meeting Pre-Meeting Workshops section at

Or contact:

Mrs Lorna Watson, Chief Executive Officer, ASOHNS Ltd

T: +61 2 9954 5856   or  E

NACCHO Aboriginal Women’s Health #IWD17 : Five myths about the new cervical screening program that refuse to die

 ” With the burden of cervical cancer being much greater for Indigenous women (the incidence of cervical cancer is twice, and mortality four times, as high than non-Indigenous Australians), it’s important that Aboriginal and Torres Strait Islander communities stay informed of the new national cervical screening program.”

Terri Foran, Lecturer in the School of Women’s and Children’s Health, UNSW

This article was originally published on The Conversation. Read the original article.

For information on pap tests or the cervical screening program, contact Pap Test Register infoline on 13 15 56, talk to your GP or look up your nearest ACCHO

Picture above : The Free NACCHO App contains a geo locator, which will help you find the nearest Aboriginal Community Controlled Health Organisation (302 Clinics ) in your area and

 Provides heath information online and telephone on a wide range of topics and where you can go to get more information or assistance should you need urgent help

Download details HERE

Women are confused about what changes to the cervical screening program will mean for their sexual health.

The online petition against changes to Australia’s cervical cancer screening program has revealed more than 70,000 people (most of whom we could assume are women) are deeply concerned about what the upcoming changes mean. The Conversation

Their comments also reveal a number of misconceptions about the new screening program, which will now be rolled out in December 2017, rather than in May as planned.

It seems that in concentrating on the science behind shifting away from Pap smears every two years to testing for the human papillomavirus (HPV) every five years, our medical authorities have failed to convince many Australian women this move will save lives.

Convincing women to come on board is, of course, critical to the success of the new screening program, which is forecast to improve cervical cancer detection rates by at least 15 per cent and is good news for women.

So let’s have a look at some common misconceptions and concerns about changes to the cervical cancer screening program raised by some of my patients and by the many people signing up to the petition.

Myth #1: no more Pap tests means no more invasive examinations

Quite a few of my patients have thought the new screening program means the end of invasive examinations. And I say “unfortunately not”. For most women the collection procedure will be exactly the same as before. This means you will still have to lie on a couch and a doctor or nurse will still insert the dreaded speculum. This instrument is needed to hold the vaginal walls gently apart so that the cervix at the end of the vagina can be seen.

Two small brushes are used to sample cells from both the outside of the cervix and from the opening which leads up to the uterus. Rather than the specimen being smeared on a slide (as with Pap smears), the two brushes are swizzled around in a preservative liquid, which separates out most of the collected cells and any HPV, the virus responsible for at least 99.7% of cervical cancers.

But it’s not until the specimen gets to the pathology lab that the process really changes.

First, the specimen is checked for HPV and only if HPV is present will cells be examined for signs of pre-cancer or cancer.

There is also the option for women who have previously avoided having Pap tests for cultural, religious or personal reasons to collect their own HPV sample. It is estimated that even if a woman has only one self-collected test at age 30 she reduces her risk of cervical cancer by about 40%.


Myth #2: the new test could miss types of cervical cancer not related to HPV

Almost 85% of cervical cancers are actually skin cancers, triggered not by the sun but by HPV. This type of cervical cancer usually takes about 15-20 years to develop. So, HPV testing gives us a chance to detect potential problems long before there is anything to see on a Pap test.

In the new program, women who carry the highest risk HPV types will then have their cells examined using a more sensitive test known as liquid-based cytology. They will also be automatically referred to a gynaecologist for further tests. If other kinds of HPV are found, a check whether the cells show any changes will guide whether the woman is referred for other tests or simply monitored more closely.

 Pap Tests

Women who have previously avoided having Pap tests for cultural, religious or personal reasons can soon collect their own HPV sample.

Some 15% of cervical cancers start in glandular cells. HPV also triggers these cancers but they are often beyond the reach of the little brushes used to collect cells in a Pap test. They can hide away quietly, growing and spreading for many years before they are detected.

When you hear of someone diagnosed with cervical cancer after previously normal Pap tests it is almost always a glandular-type cancer.

The good news is that HPV testing should pick up this kind of cancer earlier and more reliably than a regular Pap test.

There are also some very rare cervical cancers (less than 1%) that start off from muscle, nerve or pigment cells deep within the cervix and are not related to HPV infection. It is true that the new screening program is not designed to detect these types of cancer but then they were also almost impossible to detect on a traditional Pap test as well.


Myth #3: young women will miss out on early detection if screening starts at 25

There are many online testimonies from women signing the petition saying they had cervical cancer before the age of 25. It is more likely that most of these were pre-cancerous changes because cervical cancer in this age group is really rare – around 1.7 in 100,000 Australian women under 25.

Unfortunately, in the nearly 30 years our present screening program has been running there has been no significant impact on the numbers of cervical cancers reported in Australian women under 25.

Another complication in this younger age group is that cellular changes may look worse than they actually are because of a robust immune reaction to the HPV infection. Unfortunately this can lead to well-meaning advice to treat changes that are very likely to get better on their own.


Myth #4: less cervical testing reduces the chances of picking up other cancers such as ovarian and uterine cancer

Pap tests were designed to pick up pre-cancerous changes in the cells of the cervix. They are absolutely useless at detecting endometriosis, polyps, ovarian cancer or sexually transmitted infections other than HPV. They occasionally pick up uterine cancer if it is advanced enough for the cells to be shedding through the cervix that day.

The important point here is that screening tests are only for women with no symptoms. If a woman develops symptoms, such as irregular bleeding, pain or abnormal vaginal discharge, she needs to see her doctor for advice regardless of when she had her last cervical screening test.


Myth #5: the government is motivated by a cheaper option and will shift the costs of the test to the woman herself

The new tests are more expensive than a traditional Pap test, but because they are so much more sensitive there is no need to do them as frequently.

They will be funded under Medicare just as the Pap test is now. Any out-of-pocket costs depend on whether health care providers bulk bill (as they often do with screening tests) or charge the scheduled fee.



NACCHO #IWD2017 Aboriginal Women’s #justjustice :Indigenous, disabled, imprisoned – the forgotten women of #IWD2017


” Merri’s story is not uncommon. Studies show that women with physical, sensory, intellectual, or psychosocial disabilities (mental health conditions) experience higher rates of domestic and sexual violence and abuse than other women.

More than 70 per cent of women with disabilities in Australia have experienced sexual violence, and they are 40 per cent more likely to face domestic violence than other women.

Indigenous women are 35 times more likely to be hospitalised as a result of domestic violence than non-Indigenous women. Indigenous women who have a disability face intersecting forms of discrimination because of their gender, disability, and ethnicity that leave them at even greater risk of experiencing violence — and of being involved in violence and imprisoned

Kriti Sharma is a disability rights researcher for Human Rights Watch

This is our last NACCHO post supporting  International Women’s Day

Further NACCHO reading

Women’s Health ( 275 articles )  or Just Justice  See campaign details below

” In-prison programs fail to address the disadvantage that many Aboriginal and Torres Strait Islander prisoners face, such as addiction, intergenerational and historical traumas, grief and loss. Programs have long waiting lists, and exclude those who spend many months on remand or serve short sentences – as Aboriginal and Torres Strait Islander people often do.

Instead, evidence shows that prison worsens mental health and wellbeing, damages relationships and families, and generates stigma which reduces employment and housing opportunities .

To prevent post-release deaths, diversion from prison to alcohol and drug rehabilitation is recommended, which has proven more cost-effective and beneficial than prison , International evidence also recommends preparing families for the post-prison release phase. ‘

Dying to be free: Where is the focus on the deaths occurring post-prison release? Article 1 Below

Article from Page 17 NACCHO Aboriginal Health Newspaper out Wednesday 16 November , 24 Page lift out Koori Mail : or download

naccho-newspaper-nov-2016 PDF file size 9 MB

As the world celebrates International Women’s Day, this week  I think of ‘Merri’, one of the most formidable and resilient women I have ever met.

A 50-year-old Aboriginal woman with a mental health condition, Merri grew up in a remote community in the Kimberley region of Western Australia. When I met her, Merri was in pre-trial detention in an Australian prison.

It was the first time she had been to prison and it was clear she was still reeling from trauma. But she was also defiant.

“Six months ago, I got sick of being bashed so I killed him,” she said. “I spent five years with him [my partner], being bashed. He gave me a freaking [sexually transmitted] disease. Now I have to suffer [in prison].”

I recently traveled through Western Australia, visiting prisons, and I heard story after story of Indigenous women with disabilities whose lives had been cycles of abuse and imprisonment, without effective help.

For many women who need help, support services are simply not available. They may be too far away, hard to find, or not culturally sensitive or accessible to women.

The result is that Australia’s prisons are disproportionately full of Indigenous women with disabilities, who are also more likely to be incarcerated for minor offenses.

For numerous women like Merri in many parts of the country, prisons have become a default accommodation and support option due to a dearth of appropriate community-based services. As with countless women with disabilities, Merri’s disability was not identified until she reached prison. She had not received any support services in the community.

Merri has single-handedly raised her children as well as her grandchildren, but without any support or access to mental health services, life in the community has been a struggle for her.

Strangely — and tragically — prison represented a respite for Merri. With eyes glistening with tears, she told me: “[Prison] is very stressful. But I’m finding it a break from a lot of stress outside.”

Today, on International Women’s Day, the Australian government should commit to making it a priority to meet the needs of women with disabilities who are at risk of violence and abuse.

In 2015, a Senate inquiry into the abuse people with disabilities face in institutional and residential settings revealed the extensive and diverse forms of abuse they face both in institutions and the community. The inquiry recommended that the government set up a Royal Commission to conduct a more comprehensive investigation into the neglect, violence, and abuse faced by people with disabilities across Australia.

The government has been unwilling to do so, citing the new National Disability Insurance Scheme (NDIS) Quality and Safeguard Framework as adequate.

While the framework is an important step forward, it would only reach people who are enrolled under the NDIS. Its complaints mechanism would not provide a comprehensive look at the diversity and scale of the violence people with disabilities experience, let alone at the ways in which various intersecting forms of discrimination affect people with disabilities.

The creation of a Royal Commission, on the other hand, could give voice to survivors of violence inside and outside the NDIS. It could direct a commission’s resources at a thorough investigation into the violence people with disabilities face in institutional and residential settings, as well as in the community.

The government urgently needs to hear directly from women like Merri about the challenges they face, and how the government can do better at helping them. Whether or not there is a Royal Commission, the government should consult women with disabilities, including Indigenous women, and their representative organizations to learn how to strengthen support services.

Government services that are gender and culturally appropriate, and accessible to women across the country, can curtail abuse and allow women with disabilities to live safe, independent lives in the community.

Kriti Sharma is a disability rights researcher for Human Rights Watch



How you can support #JustJustice

• Download, read and share the 2nd edition – HERE.

Buy a hard copy from Gleebooks in Sydney (ask them to order more copies if they run out of stock).

• Send copies of the book to politicians, policy makers and other opinion leaders.

• Encourage journals and other relevant publications to review #JustJustice.

• Encourage your local library to order a copy, whether the free e-version or a hard copy from Gleebooks.

• Follow Guardian Australia’s project, Breaking the Cycle.

Readers may also be interested in these articles:

NACCHO Aboriginal Health #KHW17 #Kidneysfirst :Ten bad food habits that will kill you

 ‘ Almost half of heart-related deaths are caused by 10 bad ­eating habits.

Diets high in salt or sugary drinks are responsible for ­thousands of deaths from heart disease, stroke and type 2 ­diabetes, according to a study. Scientists also blamed a lack of fruit and vegetables and high ­levels of ­processed meats.

Researchers looked at all 702,308 deaths from heart ­disease, stroke and type 2 diabetes in the US in 2012 and found that 45 per cent were linked with “suboptimal consumption” of 10 types of nutrients. They mapped data on dietary habits from population surveys, along with estimates from previous research of links between foods and disease, on to data about the deaths to come up with the figures.”

Originally published in The Australian

This is our last NACCHO post supporting Kidney Health Week / Day

Further NACCHO reading

Sugar Tax     Obesity     Diabetes    Nutrition/Healthy Foods

The highest proportion of deaths, at 9.5 per cent, was linked with eating too much salt, while a low intake of nuts and seeds was linked with 8.5 per cent.

Eating processed meats was linked with 8.2 per cent of deaths and a low amount of seafood omega-3 fats with 7.8 per cent. Low intake of vegetables ­accounted for 7.6 per cent and low intake of fruit 7.5 per cent.

Sugary drinks were linked with 7.4 per cent, a low intake of whole grains with 5.9 per cent, low polyunsaturated fats with 2.3 per cent and high unprocessed red meats with 0.4 per cent.

The research, published in the journal JAMA, also found men’s deaths were more likely to have links to poor diet than women’s.

Key Points

Question  What is the estimated mortality due to heart disease, stroke, or type 2 diabetes (cardiometabolic deaths) associated with suboptimal intakes of 10 dietary factors in the United States?

Findings  In 2012, suboptimal intake of dietary factors was associated with an estimated 318 656 cardiometabolic deaths, representing 45.4% of cardiometabolic deaths. The highest proportions of cardiometabolic deaths were estimated to be related to excess sodium intake, insufficient intake of nuts/seeds, high intake of processed meats, and low intake of seafood omega-3 fats.

Meaning  Suboptimal intake of specific foods and nutrients was associated with a substantial proportion of deaths due to heart disease, stroke, or type 2 diabetes.


Importance  In the United States, national associations of individual dietary factors with specific cardiometabolic diseases are not well established.

Objective  To estimate associations of intake of 10 specific dietary factors with mortality due to heart disease, stroke, and type 2 diabetes (cardiometabolic mortality) among US adults.

Design, Setting, and Participants  A comparative risk assessment model incorporated data and corresponding uncertainty on population demographics and dietary habits from National Health and Nutrition Examination Surveys (1999-2002: n = 8104; 2009-2012: n = 8516); estimated associations of diet and disease from meta-analyses of prospective studies and clinical trials with validity analyses to assess potential bias; and estimated disease-specific national mortality from the National Center for Health Statistics.

Exposures  Consumption of 10 foods/nutrients associated with cardiometabolic diseases: fruits, vegetables, nuts/seeds, whole grains, unprocessed red meats, processed meats, sugar-sweetened beverages (SSBs), polyunsaturated fats, seafood omega-3 fats, and sodium.

Main Outcomes and Measures  Estimated absolute and percentage mortality due to heart disease, stroke, and type 2 diabetes in 2012. Disease-specific and demographic-specific (age, sex, race, and education) mortality and trends between 2002 and 2012 were also evaluated.

Results  In 2012, 702 308 cardiometabolic deaths occurred in US adults, including 506 100 from heart disease (371 266 coronary heart disease, 35 019 hypertensive heart disease, and 99 815 other cardiovascular disease), 128 294 from stroke (16 125 ischemic, 32 591 hemorrhagic, and 79 578 other), and 67 914 from type 2 diabetes.

See for full text

The authors, from Cambridge University and two US institutions, said that their results should help to “identify priorities, guide public health planning and inform strategies to alter dietary habits and improve health”.

In an editorial, Noel Mueller and Lawrence Appel, of the Johns Hopkins Bloomberg School of Public Health, said: “Policies that affect diet quality, not just quantity, are needed … There is some precedence, such as from trials of the Mediterranean diet plus supplemental foods, that modification of diet can reduce cardiovascular disease risk by 30 per cent to 70 per cent.”

Keeping your kidneys healthy

It is important to maintain a healthy weight for your height. The food you eat, and how active you are, help to control your weight.

Healthy eating tips include:

  • Eat lots of fruit, vegetables, legumes and wholegrain bread and rice.
  • At least once a week eat some lean meat such as chicken and fish.
  • Look at the food label and try to choose foods that have a low percentage of sugar and salt and saturated fats.
  • Limit take-away and fast food meals.

Exercise regularly

It’s recommended that you do at least 30 minutes of physical activity most days of the week  – exercise leads to increased strength, stamina and energy.

The key is to start slowly and gradually increase the time and intensity of the exercise. You can break down any physical activity into three ten-minute bursts, which can be increased as your fitness improves

Drink plenty of fluids and listen to your thirst.

If you are thirsty, make water your first choice. Water has a huge list of health benefits and contains no kilojoules, is inexpensive and readily available.

Sugary soft drinks are packed full of ‘empty kilojoules’, which means they contain a lot of sugar but have no nutritional value.

Some fruit juices are high in sugar and do not contain the fibre that the whole fruit has.

The role of the kidneys is often underrated when we think about our health.

In fact, the kidneys play a vital role in the daily workings of your body. They are so important that nature gave us two kidneys, to cover the possibility that one might be lost to an injury.

We can live quite well with only one kidney and some people live a healthy life even though born with one missing. However, with no kidney function death occurs within a few days!

The kidneys play a major role in maintaining your general health and wellbeing. Think of them as a very complex, environmentally friendly, waste disposal system. They sort non-recyclable waste from recyclable waste, 24 hours a day, seven days a week, while also cleaning your blood.

Most people are born with two kidneys, each one about the size of an adult fist, bean-shaped and weighing around 150 grams each. The kidneys are located at both sides of your backbone, just under the rib cage or above the small of your back. They are protected from injury by a large padding of fat, your lower ribs and several muscles.

Your blood supply circulates through the kidneys about 12 times every hour. Each day your kidneys process around 200 litres of blood. The kidneys make urine (wee) from excess fluid and unwanted chemicals or waste in your blood.

Urine flows down through narrow tubes called ureters to the bladder where it is stored. When you feel the need to wee, the urine passes out of your body through a tube called the urethra. Around one to two litres of waste leave your body each day as urine.

Resource Library

Kidneys are the unsung heroes of our bodies and perform a number of very important jobs:

  • Blood pressure control – kidneys keep your blood pressure regular.
  • Water balance – kidneys add excess water to other wastes, which makes your urine.
  • Cleaning blood – kidneys filter your blood to remove wastes and toxins.
  • Vitamin D activation – kidneys manage your body’s production of this essential vitamin, which is vital for strong bones, muscles and overall health.

All this makes the kidneys a very important player in the way your body works and your overall health.

NACCHO celebrating #IWD2017 Women in Aboriginal Health leadership : Pat Turner AM CEO and @DrDawnCasey COO


” She describes her current role with NACCHO as “going back to her roots” after many years working for the museum sector.

At NACCHO she looks at health care policies seeking to promote health for Aboriginal communities. “Indigenous people are much more affected by chronic diseases because of their genetics so we try to help them and improve their situation.

She has always followed a strategy to involve professionals from different origins into her teams. “I always wanted to be sure that our job vacancies were advertised on those media easy to access by migrant and indigenous communities.

This is how she has managed to develop greatly multicultural teams.”

From recently published article see article 1 Below

 ” As a public servant in the Commonwealth Department of Education, I quickly gathered that recruitment practices and regulations severely limited employment and promotion opportunities for women and Aboriginal and Torres Strait Islander people.”

Read more:  How woman of influence Dawn Casey closed the gap on racism

Dr Dawn Casey PSM FAHA , currently the chief operating officer for the National Aboriginal Community Controlled Health Organisation (NACCHO), has a solid background across multiple sectors.

Dr  Casey is the former chairperson of the Indigenous Land Corporation and Indigenous Business Australia, and a former director of the Powerhouse Museum, Western Australian Museum and the National Museum of Australia.

In both 2012 and 2015, she was selected as one of The Australian Financial Review and Westpac 100 Women of Influence.

 Pat Turner AM CEO

 ” The National Aboriginal Community Controlled Health Organisation (NACCHO) in 2016 appointed a new Chief Executive Officer, Patricia Turner.

NACCHO Chairperson, Matthew Cooke when welcoming Ms Turner and said he looked forward to working with her to build on NACCHO’s successes and continue work to improve the health of Aboriginal and Torres Strait Islander people across Australia.

“We are thrilled to have a leader of Pat’s calibre join our team,” Mr Cooke said.

“Her breadth of experience in senior leadership positions in government, business and academia for more than 40 years means she is well placed to continue to implement NACCHO’s strategic plan to enhance and expand the Aboriginal Community Controlled Health Sector.

“Her high level experience in government gives her good insights into negotiating the best possible solutions to increase our chances of Closing the Gap in ensuring improved health outcomes for our people

From NACCHO press release April 2016 see full Bio Article 2 Below


 ” Like many Aboriginal and Torres Strait Islander people, I have always believed I had the responsibility to speak out and to help in any way I could. I was a little older than 13 in the 1960s when, attending homework classes arranged by the One People of Australia League, I explained how my parents were finding it hard to find a house. Not long after we had a house to rent.

At that time I began to realise how unfairly I and other Aboriginal and Torres Strait Islander students were being treated. Living in Cairns, I didn’t fully appreciate how Australia had developed and continues to develop laws and policies that are racist and not conducive to creating and maintaining a just society.

Though we were all poor, lived in old and dilapidated houses and were confronted with discrimination on a daily basis, there was a great community spirit. On the one hand there was the agitating for justice and civil rights and on the other the organisation of social activities. Aboriginal and Torres Strait Islander families came together for dances, huge weddings and weekend card games. Our fathers worked as labourers in various places: Cairns City Council, the Queensland Railways, the wharves, sugar cane farms, sawmills. We marched every year in the Labour Day parade.”

Read more:

Dawn Casey – “Museums usually talk about dead things… Contemporary issues should also fit in these spaces

From recently published article

However, it is her experience within the arts that is especially remarkable. She has been in charge of the direction of three of the largest Australian museums: The National Museum of Australia, Western Australia Museum and the Powerhouse Museum.

Unquestionably, one of her bigger achievements has been her contribution to what she calls the “democratization of museums.” Or, in other words, her assistance to “make the arts and museums more stimulating and accessible to bigger audiences.”

Raised in Cairns, Australia, Casey comes from the Tagalaka clan. As she explains, her personal experience and professional background has been determined because of her indigenous and female identity. She was denied access to education. “I always wanted to study French but it was not possible for indigenous people to take that course. Also, my parents would have never allowed me to do it,” she remembers. Casey’s story is a tale of hard work and overcoming obstacles. Her persistence had a clear intention.

“I know what been discriminated means. My own experience showed me how unfair and wrong the system was.”

Being a woman made things even more complicated. “Sometimes I didn’t even have the opportunity to be interviewed,” Casey recognizes.

Despite these difficulties, she has not allowed them to stop her having a successful career. Her career and contributions have been acknowledged with a number of awards, such as three Commonwealth Public Service Australia Day Medals.

Remarkably for someone who has worked with so many of Australia’s leading museums, Casey admits that she only stepped into a museum for the first time when she was 30. “It was quite a boring experience,” she admits, but this experience convinced her of the power that these institutions could have to act as effective communicative tools able to make communities understand both their pasts and presents.

“Museums usually talk about dead things, explorers and settlers,” says Casey. “They are the place to showcase very well-researched materials that make us aware of our history. These are extremely relevant. But I think that contemporary issues – that can be more accessible and interesting to everyone – should also fit in these spaces,” she adds.

Casey has thus worked very hard to this end. While working as a director at the Powerhouse Museum in Sydney she helped to organize Muslim cultural exhibitions aiming to attract people from diverse communities to come together, techno-nights looking to engage younger generations, and even Harry Potter exhibitions seeking to capture the attention of children.

“I think it is a matter of combining very in-depth researched topics with lighter subjects that can arrive to other types of audiences,” she explains.

At the Salzburg Global Seminar session in February 2017, The Art of Resilience: Creativity, Courage, and Renewal, Casey helped to link the challenges affecting indigenous communities with other current issues such as the difficulties that refugees all over the world are facing.

“They might look as opposite problems. But in my opinion they are both issues saying a lot about the nature of a country. In both situations, either when we stop a boat and do not allow people to enter our country, or when we do not recognize the rights of certain groups of people in their own land, we are disrespectful with human beings and this says a lot about the nature of a nation,” she states.

This was the second time that Casey attended a session at Salzburg Global Seminar. She was a previously a participant in 2011 at the session Libraries and Museums in an Era of Participatory Culture. She fondly remembers that the session was “a great opportunity to share and exchange ideas – something that does not happen frequently when you are a museum director and it is always you who is supposed to sell things to others. This is one of the reasons why I appreciate being part of this open space again to enjoy the dialogue and be able to exchange ideas

 ” Eye health and good vision is an important issue for everyone, but particularly for Aboriginal and Torres Strait Islander people.

It accounts for a significant proportion of the health gap between Indigenous and non-Indigenous people. I’m pleased to report that progress is being made.

The National Eye Health Survey, released on World Sight Day this year, also tells an important story. Rates of blindness amongst Aboriginal and Torres Strait Islander people have improved from 6 times to 3 times as much compared with non-Indigenous people.

And the prevalence of active trachoma among children in at-risk communities fell from 21% in 2008 to 4.6% in 2015.

The Roadmap to Close the Gap for Vision has played a part in prompting actions that contribute to this improvement. The Roadmap outlines a whole of system approach to improving Indigenous eye health, and achieving equity between Aboriginal and non-Aboriginal eye health outcomes.

There is however still work to be done on Closing the Gap for Vision. For example, half of Indigenous participants with diabetes had not had the recommended retinal examination.

NACCHO has been involved with the Roadmap from its inception, and had a long relationship with Indigenous Eye Health at the University of Melbourne, and with RANZCO. We’re pleased with the great work and good progress being made.”

 Ms Patricia Turner, Chief Executive Officer, of the National Aboriginal Community Controlled Health Organisation (NACCHO) launching  The 2016 Annual Update on the Implementation of the Roadmap to Close the Gap for Vision

Pat Turner pictured above with Mark Daniell President, RANZCO,  and Prof Hugh Taylor at the launch.

Born and raised in Alice Springs in the Northern Territory, Patricia (Pat) Turner ‘s long association with Canberra began with a temporary position with the Public Service Board, leading to the Social Policy Branch of the Department of Aboriginal Affairs (DAA) in 1979.

Joining the Australian Public Service (APS) in Alice Springs as a switchboard operator in the Native Affairs Department , she moved to Canberra in 1978, joining the senior executive ranks of the public service in 1985, when she became Director of the DAA in Alice Springs, N.T. (1985-86). Pat then became First Assistant Secretary, Economic Development Division in the DAA, and in 1989, Deputy Secretary. She worked as Deputy Secretary in the Department of the Prime Minister and Cabinet during 1991-92, with oversight of the establishment of the Council for Aboriginal Reconciliation and with responsibility for the Office of the Status of Women among other matters. Between 1994 -1998, Pat was CEO of the Aboriginal and Torres Strait Islander Commission, which made her the most senior Indigenous government official in Australia. After stints in senior positions at the Department of Health and at Centrelink, Pat Turner left the APS and Canberra in 2006, returning to Alice Springs with her mother to live. There, she has continued to advocate on the behalf of indigenous people, including taking on what she described as ‘one of the best working experiences of my life’ as CEO of National Indigenous Television (2006 -2010). Other memorable experiences include the period when she was Festival Director of the 5th Festival of Pacific Arts in Townsville, Queensland (1987 -88) and when she held the Chair of Australian Studies at Georgetown University in Washington DC (1998-99). Turner holds a Masters Degree in Public Administration from the University of Canberra where she was awarded the University prize for Development Studies.

Pat Turner, the daughter of an Arrente man and a Gurdanji woman, was born in 1952 and raised in Alice Springs. She had three Aboriginal grandparents and one white grandfather and asserts that ‘[t]he only thing I inherited from the latter was his surname’. From the other three she inherited a strong sense of family and Aboriginal identity that has been a constant source of strength and support throughout the course of her life, regardless of where she was living. She is related to Aboriginal activist and public servant, the late Charles Perkins though her paternal grandmother’s family line.

The third of five children, Turner was a good student who loved to read anything and everything. A book about the Russian ballerina, Anna Pavlova, was one of her favourites, a fact that now makes Turner laugh. ‘I can see the humour,’ she says, ‘in a little Aboriginal girl in the desert idolising a graceful dancer from Russia, but I can’t really explain it!’ Life during term was a disciplined one with her mother and siblings, attending school, doing chores and homework and helping out her grandmother after school. During holidays, she would travel out bush with her Dad while he erected windmills on far flung properties. He was one of a handful of Aboriginal men who fought the odds to establish his own business. Although it meant he spent substantial amounts of time away from the family, it made a significant financial difference, not the least being the stability of home ownership. The family was able to gather the resources to build a brick home on the east side of town, away from the fibro cottages at ‘The Gap’ to the south.

In 1963 the family was shattered by Alec Turner’s death in an accident at work. Apart from the obvious emotional trauma brought about by his death, the family experienced extreme financial hardship, as their mother experienced great difficulty in the search for permanent employment. As a widow, Emma Turner was entitled to welfare but the lack of respect she was accorded by the welfare officers charged with determining her fitness to receive a widow’s pension had a profound impact on young Pat, who bristled with indignation and their intervention. Her mother’s courage and grit in the face of such difficult circumstances was a constant source of inspiration. She was one of many strong women leaders in their community, says Turner, who kept their families together against many odds and with little assistance. ‘Their integrity, courage and family values were second to none. They knew when and how to use their authority.’

Another source of inspiration was that provided by the example of Uncle Charlie Perkins. In 1965, Woman’s Day magazine provided funds for thirteen-year-old Pat and her Nanna Hetty Perkins to travel to Sydney to attend his graduation from Sydney University. The graduation ceremony had a very big impact on her and the importance of the model provided by her uncle, who stressed the importance of education to improving the lives of indigenous people, cannot be under-estimated. Pat determined that she would get a good education herself, and approached the local welfare branch in Alice Springs with her high school reports, telling them she wanted to go to school in Adelaide. In her third year at high school, and with a day’s notice to travel, they agreed to her request.

Living in a Church of England Girls’ Hostel that mainly housed white girls from the country, Pat began school in Adelaide at Adelaide Girls High School. She missed her family, but was not isolated from extended family. Indeed, she would attend Aboriginal Progress Association meetings with her Uncle John Moriarty, and met Don Dunstan on one occasion. Her time in Adelaide introduced her to Aboriginal politics and the history of their struggle for self determination and she brought that interest and commitment home when she returned for holidays.

Turner transferred her enrolment to Nailsworth Technical College in her last two years so she could get some practical education in commercial subjects that she thought would help her to get a job. After obtaining her leaving certificate, she and some friends embarked on a working holiday around Australia. She stopped long enough in Melbourne to complete her matriculation through the Council of Adult Education.

Turner’s career in the APS began in the early 1970s. Returning to Alice Springs from Melbourne, she joined the Department of Interior (Welfare Branch) as a switchboard operator. Her tenure coincided with the election of the Whitlam Federal Government in 1972 and the subsequent extensive changes to the administration of Aboriginal Affairs in Australia, including the creation of a specific Department of Aboriginal Affairs. One of Turner’s first acts as a public servant keen to influence the agenda was to request the role of driver for the Minister, Gordon Byrant, whenever he came to town, so that she ‘could talk to him directly about the way things are’.

She was still in Alice Springs when her talent was spotted and she was selected to receive training in a new program to establish community welfare offices. Upon completing this education, she moved from administration into a role as a welfare officer, the first Aboriginal woman to hold the position in Alice Springs. She became adept at rolling out programs to assist Aboriginal youths at risk and worked hard at building collaborative links between branches of the public service in order to achieve better outcomes for the public. This was a skill that she was renowned for throughout the course of her career, whether the tasks be working as a liaison officer at the Commonwealth heads of Government Meeting (CHOGM) in Melbourne, in 1981, a member of the taskforce set to manage the Papal visit to Alice Springs in 1986, or directing the 5th Festival of Pacific Arts in Townsville, Queensland in 1987-88.

As time went by and her experience developed Turner became more committed to the politics of self determination for Aboriginal people over the assimilationist policies that prevailed. At a professional level, this meant being a firm supporter of community based service delivery of health and welfare programs for Aboriginal people. It also meant that she became increasingly frustrated by the tertiary studies in community development and social work that she undertook in 1976 at the South Australian Institute of Technology. Moving with a radical group of students, she found the subject offerings did not engage deeply enough with need for real social change, instead offering ‘band aid solutions’ that weren’t relevant to Australian conditions.

The mid to late 1970s were a time of deep political engagement for Pat, as she connected with the politics of women’s liberation, the union movement, the anti-uranium movement and the struggle for social justice and land rights for Aboriginal people. She was elected Vice President of the Federal Council for the Advancement of Aborigines and Torres Strait Islanders (FCAATSI) in 1976, and worked hard in the position to get students involved in Aboriginal politics. The organization itself underwent some stressful times, as the nature of Aboriginal politics changed and as funding for organisations became far more competitive. Pat eventually presided over the winding up of FACAATSI in the late 1970s. She moved to Canberra in 1978 and got a temporary job with the Public Service Board in the Equal Opportunity Branch, undertaking an audit of APS positions to identify those that should be filled by Aboriginal and Torres Strait Islander people. This gave her an ideal opportunity to learn and understand the APS pecking order, and the authority to shake up the thinking of some old heads. After meeting the human resources manager at the Department of Aboriginal Affairs, she was dismayed to be told that of a staff of two hundred, only twenty positions would be suitable! ‘As a junior officer, I found myself telling quite senior staff to reassess their thinking’. She also learned how resistant many individuals were to change. She used the time to observe, campaign, learn who was important, who had the power to get results, and how to get money to fund programs she was interested in. It was time well spent, because it provided demonstrable prove that a well prepared, effective public service could affect real change for the good. The summary note (above) indicates just how effective Pat was as a public servant.

Determined to use her position as a place where she could demonstrate her value while encouraging new ways of thinking about the administration of Aboriginal Affairs, Turner never described herself as a rebel; rather, she was an administrator who was prepared to speak up and put racists in the public service in their place. She learned the value of good preparation, of treating staff and colleagues with respect and stressed the importance of diversity; of people, and experiences, to the public service. And while she argues that people like Lowitja O’Donoghue and Charles Perkins were the real Aboriginal leaders in the public service, she accepts that her climb through the ranks did provide her with positional leadership opportunities that gave her the power to influence policy matters. She was lucky to be able to combine her personal interests with positional leadership, but was careful to never abuse this privilege, through her scrupulous attention to process and her devotion to hard work. Leadership, for her, was balancing the best interest of the government with the best interests of Aboriginal people. As a public servant, she was always driven to serve Aboriginal people to the best of her ability while fostering open lines of communication with the minister of the day and providing full and frank advice.

Turner retired from the APS in 2006, not particularly happy with the state of the organisation she was leaving, but happy about the prospect of spending more time with family and focusing on grass roots projects. She worked on the development of the recently launched (2013) National Indigenous Television until 2010. In 2011, she was appointed to the advisory council of the Australian National Preventative Health Agency. Her much loved mother, whose courage and commitment to family were a constant source of support, passed away in 2010. Turner now lives back in Alice Springs with her sister and niece. And no matter how dissatisfied she might feel about how her career in the APS ‘wound down’ she is, deservedly, very proud of her own career. ‘I’ve had a wonderful career,’ she says, ‘and I am grateful for the opportunity I had to contribute to nation building’.

View the full record at Australian Women’s Register

NACCHO Aboriginal #kidneysfirst Health #KHW17: International research finds food subsidies and taxes improve dietary choices


The global food system is causing a staggering toll on human health. And this is very costly, both in terms of real healthcare expenses and lost productivity.

Our findings suggest that subsidies and taxes are a highly effective tool for normalizing the price of foods toward their true societal costs. 

This will not only prevent disease but also reduce spiraling healthcare costs, which are causing tremendous strain on both private businesses and government budgets.”

Senior author Dariush Mozaffarian, M.D., Dr.P.H., dean of the Friedman School


Here are some sobering facts on #obesity from a report by @KidneyHealth as we mark #KidneyHealthWeek


#Kidneyfirst Aboriginal Health Key points


Aboriginal and Torres Strait Islander people are more likely to have end stage kidney disease and be hospitalised or die with chronic kidney disease than non-Indigenous people.4

The greater prevalence of chronic kidney disease in some Aboriginal and Torres Strait Islander communities is due to the high incidence of traditional risk factors, including diabetes, high blood pressure and smoking, in addition to higher levels of inadequate nutrition, alcohol abuse, streptococcal throat and skin infection, poor living conditions and low birth weight, which is linked to reduced nephron development.4

Aboriginal and Torres Strait Islander people experience a higher burden of disease; two and a half times that of non-Indigenous people.

A large part of the burden of disease is due to chronic diseases such as cardiovascular disease, diabetes, cancer, chronic respiratory disease and chronic kidney disease.

This higher burden can be reduced by identifying chronic disease earlier and through the management of risk factors and the disease itself. See more about the management of risk factors here.

A new systematic review and meta-analysis finds that lowering the cost of healthy foods significantly increases their consumption, while raising the cost of unhealthy items significantly reduces their intake.

Food subsidies and taxes significantly improve dietary choices

Interventions that alter food prices can improve people’s diets, leading to more healthy choices and fewer unhealthy choices

While everyone has a sense that food prices matter, the magnitude of impact of food taxes and subsidies on dietary intakes, and whether this varies by the food target, has not been clear. For the review, a team of researchers identified and pooled findings from a total of 30 interventional and longitudinal studies, including 11 that assessed the effect of higher prices (taxation) of unhealthy foods and 19 that assessed the effect of lower prices (subsidies) of healthy foods.

The findings were published in PLOS ONE on March 1.

“To date, evidence on effectiveness of fiscal policies on diet has mostly come from cross-sectional studies, which cannot infer causality. This is why we evaluated studies that examined the relationship between food price and diet over time,” said co-first author Ashkan Afshin, M.D., former postdoctoral fellow at the Friedman School of Nutrition Science & Policy at Tufts University and now at the University of Washington. “Our results show how 10 to 50 percent changes in price of foods and beverages at checkout could influence consumers’ purchasing behaviors over a relatively short period of time.”

In the pooled analysis, each 10 percent decrease in price of fruits and vegetables increased their consumption by 14 percent, and each 10 percent decrease in price of other healthy foods increased their consumption by 16 percent. A change in price of fruits and vegetables was also associated with body mass index (BMI): for every 10 percent price decrease, BMI declined by 0.04 kg/m2.

Conversely, each 10 percent price increase of sugar-sweetened beverages and unhealthy fast foods decreased their consumption by 7 percent and 3 percent, respectively. Every 10 percent price increase in unhealthy foods and drinks was associated with a trend toward lower BMI (per 10 percent price increase: -0.06 kg/m2), but this did not achieve statistical significance.

By merging findings from 23 interventional and 7 prospective cohort studies, the researchers evaluated relationships between the change in the price of specific foods or beverages and the change in their intake. Studies evaluated people’s reported intake or data on sales of foods and beverages. The study populations included children, adults, or both; and countries included the United States, the Netherlands, France, New Zealand, and South Africa. Price change interventions were conducted in various settings such as cafeterias, vending machines and supermarkets. The findings were centrally pooled in a meta-analysis.

Co-first author is Jose Penalvo, Ph.D., M.Sc., Friedman School of Nutrition Science & Policy at Tufts University. Additional authors on this study are Liana Del Gobbo, Ph.D., Stanford University School of Medicine; Jose Silva, M.D., Boston Medical Center; Melody Michaelson, M.Sc., Tufts University School of Medicine; Martin O’Flaherty, M.D., Ph.D., University of Liverpool; Simon Capewell, M.D., D.Sc., University of Liverpool; Donna Spiegelman, D.Sc., Harvard T.H. Chan School of Public Health; and Goodarz Danaei, M.D., D.Sc., Harvard T.H. Chan School of Public Health.

This work was supported by awards from the National Heart, Lung, and Blood Institute of the National Institutes of Health (HL098048, HL115189) and from The New York Academy of Sciences’ Sackler Institute for Nutrition Science. For conflicts of interest disclosure, please see the study.

Afshin, A., Penalvo, J., Del Gobbo, L., Silva, J., Michaelson, M., O’Flaherty, M., Capewell, S., Spiegelman, D., Danaei, G., Mozaffarian, D. (2017, March 1). The prospective impact of food pricing on improving dietary consumption: A systematic review and meta-analysis. PLOS ONE. doi: 10.1371/journal.pone.0172277

About the Friedman School of Nutrition Science and Policy at Tufts University

The Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy at Tufts University is the only independent school of nutrition in the United States. The school’s eight degree programs – which focus on questions relating to nutrition and chronic diseases, molecular nutrition, agriculture and sustainability, food security, humanitarian assistance, public health nutrition, and food policy and economics – are renowned for the application of scientific research to national and international policy.

NACCHO Aboriginal #prevention Health : #ALPHealthSummit : With $3.3 billion budget savings on the table, Parliament urged to put #preventivehealth on national agenda


 ” Recently the Federal Government has spoken in favour of investment in preventive health.

 In an address to the National Press Club in February this year, Prime Minister Malcolm Turnbull said, “in 2017, a new focus on preventive health will give people the right tools and information to live active and healthy lives”.

Health Minister Greg Hunt echoed that sentiment on 20 February announcing the Government was committed to tackling obesity.

Prevention 1st, however, argues the need for a more comprehensive, long-term approach to the problem. Press Release


NACCHO was represented at the #ALPHealthSummit by Chair Matthew Cooke pictured above with Stephen Jones MP

Leading health organisations are calling on the Commonwealth to address Australia’s significant under-investment in preventive health and set the national agenda to tackle chronic disease ahead of Labor’s National Health Policy Summit today.

Chronic disease is Australia’s greatest health challenge, yet many chronic diseases are preventable, with one third of cases traced to four modifiable risk factors: poor diet, tobacco use, physical inactivity and risky alcohol consumption.

Adopting preventive health measures would address significant areas flagged as critical by the both major parties, including ensuring universal access to world-class healthcare, preventing and managing chronic disease, reducing emergency department and elective surgery waiting times, and tackling health inequalities faced by Indigenous Australians.


Prevention 1st – a campaign led by the Foundation for Alcohol Research and Education (FARE), the Public Health Association of Australia (PHAA), Consumers Health Forum of Australia (CHF Australia), and Alzheimer’s Australia – is urging the ALP to adopt the group’s Pre-Budget submission recommendations as part of the party’s key health policy framework.

FARE Chief Executive Michael Thorn says it is up to federal policymakers to address Australia’s healthcare shortfalls and that Labor has the perfect opportunity to reignite its strong track record and lead the way in fixing the country’s deteriorating investment in preventive healthcare.

“Australia’s investment in preventive health is declining, despite chronic disease being the leading cause of illness in Australia. Chronic disease costs Australian taxpayers $27 billion a year and accounts for more than a third of our national health budget. The ALP has both the opportunity and a responsibility as the alternate government to set the national agenda in the preventive healthcare space. Ultimately, however, it falls to the Government of the day to show leadership on this issue,” said Mr Thorn.

Its Pre-Budget submission 2017-18, Prevention 1st identifies a four-point action plan targeting key chronic disease risk factors.

Prevention 1st has called for Australia to phase out the promotion of unhealthy food and beverages, and for long overdue national public education campaigns to raise awareness of the risks associated with alcohol, tobacco, physical inactivity, and poor nutrition. Under the proposal, these measures would be supported by coordinated action across governments and increased expenditure on preventive health.

The costed plan also puts forward budget savings measures, recommending the use of corrective taxes to maximise the health and economic benefits to the community. Taxing products appropriate to their risk of harm will not only encourage healthier food and beverage choices but would generate much needed revenue – around $3.3 billion annually.

With return on investment studies showing that small investments in prevention are cost-effective in both the short and longer terms, and the opportunity to contribute to happier and healthier communities, Consumers Health Forum of Australia Chief Executive Officer Leanne Wells urged both the Australian Government and Opposition to take advantage of the opportunity to stem the tide of chronic disease.

“There is an obvious benefit in adopting forward-thinking on preventive healthcare to reduce pressure on the health budget and the impact of preventable illness and injury on society,” Ms Wells said.

The ALP National Health Policy Summit will be held at Parliament House in Canberra on Friday 3 March.

View the submission

View media release in PDF