The National Aboriginal Community Controlled Health Organisation (NACCHO) has expressed grave concerns that the COAG Reform Council responsible for monitoring progress towards close the gap targets will close next week on 30 June.
At the 2014 NACCHO Health Summit in Melbourne today, Chairman of the COAG Reform Council, John Brumby, presented the findings of the Council’s final work on Aboriginal and Torres Strait Islander health monitoring, Healthcare in Australia 2012-13: Comparing outcomes by Indigenous status.
NACCHO chairperson Justin Mohamed thanked John Brumby and his Council staff for their efforts to ensure government policy to close the gap was translated into on-ground improvements for Australia’s First Peoples and their communities.
“It was six years ago that Australian governments took on the significant challenge of closing the gap on Aboriginal and Torres Strait Islander disadvantage in health, education, employment and other social areas,” Mr Mohamed said.”
“In that time Mr Brumby and his team have monitored progress on closing the gap, and reported publicly and free of political influence.”
“Today’s report confirms that for all the significant achievement made, including a decrease in the Aboriginal infant mortality rate by 35%, there remains work to be done to improve outcomes in other areas.”
“We are really worried that the millions of dollars being cut from across Aboriginal affairs at the Federal level, plus the introduction of new arrangements in accessing primary health care and changes to unemployment benefits, could potentially push the closing the gap targets even further from reach.”
“It’s now been more than a year since the National Partnership Agreement has lapsed and we still don‚t have any clear advice on how states, territories and the commonwealth plan to coordinate addressing the closing the gap targets.”
“Now there will be no independent umpire able to evaluate progress ‘or lack of it’ and hold state and territory governments and the Federal Government accountable.”
“The Federal Government must urgently outline how it plans on keeping this priority area of health and social reform on track during the long-term commitment needed to close the gap”, Mr Mohamed said.
Article by: Kerry Arabena, Director and Chair of Indigenous Health,1and Chair2 1Onemda VicHealth Koori Health Unit, University of Melbourne, Melbourne, VIC.2National Aboriginal and Torres Strait Islander Health Equality Council, Canberra, ACT.
Continuing to close the health gap will require innovation; long-term, systematic approaches that improve the quality and integrity of data; collaborations and partnerships that reflect an ecological approach to health, and recognition of the proper place and contribution of Aboriginal and Torres Strait Islander peoples in Australian society
At long last there are signs that the gaps between the health of Aboriginal and Torres Strait Islander people and non-Indigenous people are closing — but systematic, long-term action needs to continue both within and outside the health system to realise true health equality, and for us to know that we have achieved it.
According to the 2012 report of the Aboriginal and Torres Strait Islander Health Performance Framework, a number of positive trends in Aboriginal and Torres Strait Islander health include:
the mortality rate has declined significantly (by 33%) between 1991 and 2010 among people living in Western Australia, South Australia and the Northern Territory combined;
deaths due to avoidable causes decreased significantly in WA, SA and the NT combined, down 24% between 1997 and 2010;
deaths from respiratory disease decreased significantly from 1997 to 2010, and the gap with non-Indigenous Australians has also narrowed; and
mortality among infants aged less than 1 year declined by 62% between 1991 and 2010, perhaps reflecting the benefits of immunisation, improved access to primary health care services, the use of antibiotics and earlier evacuation to hospital for acute infections.1
Of course there remain areas where the gap persists or in some cases has grown, including chronic disease, injury, cancer, disability and low birthweight babies. It appears that in some areas (such as cancer) improvements in the quality, accessibility and impact of treatment are resulting in significantly improved death rates for non-Indigenous Australians, but Aboriginal and Torres Strait Islander people are missing out. The causes of this discrepancy seem to lie in disparities in stage at diagnosis, treatment received and survival rates.
Cutting across these trends are persistent gaps in the quality of data. Our inability to know whether large investments made in recent years in Aboriginal and Torres Strait Islander health are paying off should be a major focus for future strategies. In general, our population does not seem to be benefiting from the same level of sophisticated population-level tracking, health assessment or data integrity that majority populations take for granted.2 Good data are crucial, not just to know the impact of what we have done, but to guide what we are doing.
In this context it is pleasing to see the recent process of developing a new national plan to guide future investments in Aboriginal and Torres Strait Islander health, developed through a collaborative process including Aboriginal and Torres Strait Islander peak bodies, communities, services, researchers, advocates and clinicians.3 The new national plan needs to set directions for the next 10 years and expand and align with an ecological view of health, include concepts important to Aboriginal and Torres Strait Islander peoples and influence other sectors that affect health, such as education, employment, housing and early childhood development. This multifocal approach could have implications for the design, implementation and evaluation of projects, and will necessitate a reconceptualisation of partnerships and collaborations, while fostering innovations and knowledge exchange.
Finally, we will need to redress some of the less palatable aspects of the health system that contribute to inequality, such as racism.4 Embodied in dubious practices, disparities in access and subtle variations in effort within health and other institutions and programs, racism has had and continues to have a real and damaging impact on the health of Aboriginal and Torres Strait Islander people. It is clear that full health equality cannot be achieved until racism and other practices that deny our status and rights as the original and First Peoples of Australia can be overcome. My hope is that not only do we redress racism in health and other systems, but that this nation recognises and enables each and every Aboriginal and Torres Strait Islander person the opportunity to rise to the full potential of our existence.
LIt.search enables the user to search the worldwide PubMed database and confine their search to articles about Aboriginal and Torres Strait Islander health. With one click the tool provides access to all available literature in this field and to 27 predefined search topics.
Funded by the Lowitja Institute and developed in partnership with Flinders Filters at Flinders University, LIt.search will be launched at 3.30pm today at the Primary Health Care Research Conference at the Hilton in Sydney.
Lowitja Institute Director and launch host, Professor Lisa Jackson Pulver AM, is keenly aware of how useful this tool will be, not just for students, but for anyone interested in Aboriginal and Torres Strait Islander health. ‘Some of our students are absolutely baffled by the amount of information available on the Internet. A tool like this is critical in providing the best quality information to help them through their studies, as well as helping policy makers make the best informed decisions,’ said Professor Jackson Pulver.
Flinders Filters Project Manager, Dr Jennifer Tieman, has been pleased to be involved with a project that will provide greater access to the wealth of literature available on PubMed about the health of Australia’s First peoples. ‘Given the importance of the Closing the Gap strategy, access to the research knowledge about Australian Aboriginal and Torres Strait health is crucial. The LIt.search tool will help health care providers, community organisations, academics, researchers and policy makers find this literature quickly and easily’ said Dr Tieman.
The Lowitja Institute would like to thank Flinders University, the Flinders Filters project team, the PHC Search Filter team and Media Insights for their great work and support in developing LIt.search.
LIt.search is now available on the Lowitja Institute website.
The Lowitja Institute is Australia’s only national health research institute with a sole focus on Aboriginal and Torres Strait Islander peoples.