Aboriginal Health #CoronaVirus News Alert No 60 : May 13 #KeepOurMobSafe #OurJobProtectOurMob :#Closingthegap: Aboriginal groups say #coronavirus should not delay new targets

” The pandemic should not be used by governments as a reason to delay the new agreement on closing the gap targets, a coalition of more than 50 Aboriginal peak organisations has warned ahead of the next scheduled meeting in June.

The Coalition of Peaks said the “quick and decisive” efforts of Aboriginal and Torres Strait Islander health organisations has kept Covid-19 from devastating communities so far, and shows that strong partnerships with governments make a big difference to Aboriginal health and safety.

But the virus has exposed the inequality between Indigenous and non-Indigenous people on many fronts, the lead convenor of the Coalition of Peaks, Pat Turner, said.

“Covid-19 is a pathogen, but it is also a diagnostic test being run on Australia – and the results are not good,” Turner said. “

Indigenous organisations say their success with Covid-19 shows strong partnerships with governments make a big difference

Originally published in The Guardian

For info Coalition of Peaks website

While Australians over 65 are considered at high risk of suffering the worst effects of Covid-19, in Aboriginal communities, where there is a higher chronic disease burden, anyone over 50 is considered vulnerable.

“Covid-19 doesn’t discriminate so the gap in potential outcomes is a result of the structural inequity that exists in Australia,” Turner said.

“It is not natural occurrence but the direct result of years of neglect, disinvestment and failed policies, developed without our input.”

In March last year, Australian governments signed a historic partnership agreement with the Coalition of Peaks on closing the gap. They have since developed four reform priorities that are yet to be formally adopted.

“This pandemic has shown just how important those reforms are,” Turner said.

The reforms are to have greater Aboriginal involvement in decision making and service delivery at a national, regional and local level. There is also a commitment to making sure government agencies and institutions undertake systemic and structural transformation, and strengthening community-controlled organisations to deliver the services Aboriginal people need.

Scott Morrison has already committed $1.5m for the fourth priority – a data project to support evidence-based policy and decision making by Indigenous communities.

“Our organisations and communities are best placed to respond to this crisis and yet are the same organisations and communities that have borne the brunt of repeated funding cuts and a rollercoaster of policy and administration changes,” she said.

Turner also said the absence of an Aboriginal and Torres Strait Islander national body or voice to parliament, bringing its collective expertise to respond to Covid-19, was “stark” in its absence.

“People have labelled Covid-19 as some sort of great equaliser but, in reality, its impact is not shared equally,” she said.

“The truth is that there can be no equality until we work together to dismantle structural inequity. Collective will is the only real equaliser.”

 

Aboriginal Health #CoronaVirus News Alert No 51 : April 30 #KeepOurMobSafe #OurJobProtectOurMob : First Nations people leading the way in COVID-19 pandemic planning, response and management

Pandemics are a serious public health risk for First Nations communities here and globally.

Measures to reduce risk of COVID-19 have been addressed swiftly taking the lessons from 2009 H1N1 pandemic .

The involvement of communities has been fundamental and pivotal to early change and action.

Making space for First Nations peoples to define the issues, determine the priorities, and suggesting solutions for culturally informed strategies that address local community needs may reduce health inequities and has potential to influence system changes.

Privileging First Nations voices, within a culturally appropriate governance structure, to develop and implement planning, response and management protocols can make a real difference.

The model has the potential to be replicated where public health agencies and First Nations practitioners and researchers have developed shared understanding.

Only time will tell now how we will fare over the coming months.”

Kristy Crooks, Dawn Casey and James S Ward published in the MJA

Download the article HERE

First Nations people leading the way in COVID-19

Aboriginal and Torres Strait Islander (respectfully hereafter First Nations) peoples of Australia have experienced poorer health outcomes than the rest of the Australian population during recent pandemics (1,2).

In 2009, during the H1N1 pandemic, diagnosis rates, hospitalisations and intensive care unit admissions occurred at 5, 8 and 3 times respectively the rate recorded among non-Indigenous peoples (1,2,3).

The vulnerability of First Nations people to COVID-19 is well understood by community leaders and non-Aboriginal policy makers and clinicians alike.

The risk for First Nations from COVID-19 taking hold are immense – the oldest continuous culture on the planet is at risk.

This is because of all of the following inter-related factors: an already high burden of chronic diseases; long-standing inequity issues related to service provision and access to health care, especially because 20% of First Nations people live in remote and very remote areas; and pervasive social and economic disadvantage in areas such as housing, education and employment.

Finally, and ironically, many of the interventions put in place to curb SARS COV2 are counter-cultural or near impossible because of overcrowded housing and extended family groups living together. This means interruption of cultural life as it has to be adapted to be consistent with new social isolation concepts.

Using lessons learnt from the H1N1 pandemic of 2009 First Nations clinicians, public health practitioners and researchers are strategically leading the way in public health planning, response and management for COVID-19 alongside our non-Indigenous dedicated allies.

The omission of First Nations Peoples from the 2009 National Action Plan for Human Influenza Pandemic (4, 5) not only disadvantaged those who most needed protection, but failed to identify First Nations peoples as being a high-risk population group, which resulted in worse outcomes previously mentioned. Research following the 2009 pandemic found that a “one size fits all” approach to infectious disease emergencies is unlikely to work, and partnerships between communities and government agencies for the management of public health emergencies could be improved (6, 7); and future pandemics should ensure First Nations peoples are appropriately engaged as active and equal participants in pandemic preparedness, responses, recovery and evaluation (6, 8).

During the early days of the COVID-19 pandemic we as a community have proactively proceeded to ensure this occurs.

Recognising that public health measures, containment strategies and risk communication often do not consider the socioeconomic, historical or cultural context of First Nations peoples it is appropriate that First Nations Peoples lead the way in pandemic planning. Pandemic plans developed and implemented with First Nations people leading, will likely mitigate risks and prevent from what happened in 2009 again.

On 6 March 2020 the Australian Government’s Department of Health convened the Aboriginal and Torres Strait Islander Advisory Group on COVID-19 to provide advice to ensure preparedness responses and recovery were planned for COVID-19.

The Advisory Group works on principles of shared decision-making, power-sharing, two-way communication, self-determination, leadership and empowerment.

The National Aboriginal Community Controlled Health Organisation (NACCHO) co-chairs the Advisory Group with the Department of Health and includes membership from the Aboriginal Community Controlled Organisation Sector, State and Territory Government representatives and Aboriginal communicable disease experts (9). The Advisory Group links to the Communicable Diseases Network Australia (CDNA) and reports to the Australian Health Protection Principal Committee (AHPPC).

Our brief is to ensure all stages of the pandemic are considered with an equity lens, are proportional to the risk of disease in communities, to discuss and work through logistical issues related to the pandemic especially in planning phases and that these actions should be locally-led, holistic and culturally safe to communities. The group initially met three times per week and currently meets twice weekly via video or teleconference.

The Advisory Group has provided strategic input into the development of the National Management and Operational Plan for Aboriginal and Torres Strait Islander Populations (10), and has made significant contribution to the COVID-19 Series of National Guidelines (11).

Added by NACCHO  : Welcome to the second in a series of #CommunityMatters broadcasts by Dr Janine Mohamed, Chair of Croakey Health Media. The broadcast discusses this article by Professor James Ward on the many actions underway to protect Aboriginal and Torres Strait Islander communities from the novel coronavirus.

To prepare communities for COVID-19 actions and advocacy of the Advisory Group have included:

Legislative changes: Strong advocacy and input to Government has ensured minimising non-essential travel by visitors to remote communities (12). The enactment of the Biosecurity Act has enabled restrictions being placed on many state/territory borders as well as national borders. In addition, many Aboriginal Land Councils have closed access and refused to issue new permits for visitors to communities within their remit.

Development of national guidelines on COVID-19 to ensure Aboriginal and Torres Strait Islander people are accorded priority in the national response (11). Separate guidance focused on remote communities have also been developed, addressing circumstances and logistical challenges in these areas such as medical evacuation, community wide screening, limited isolation and quarantine spaces if SARS-COV2 initial cases are detected in this setting.

Health services planning: Almost all communities with significant First Nations populations have been in preparedness mode and have enacted local action plans to respond to COVID-19. In many cases this has extended beyond the development of a local plan but has included initiatives such as reconfiguring of clinics to facilitate testing, isolation of suspected cases as well as preparing staff in infectious disease training relevant to COVID-19. The Commonwealth Government has expanded telehealth (phone and video-based calls with health providers), ensuring those with chronic disease and other health conditions can receive health consultations via phone.

Establishing rapid testing in remote communities: The Advisory Group is working with the Kirby Institute to rapidly establish increased SARS COV2 testing capacity in communities across Australia using point of care platforms (nucleic acid amplification testing) that provide a result within 45 minutes from a nasopharyngeal swab. Overall, 87 rapid testing platforms will be placed in remote and regional settings, using a hub and spoke model.

Trained existing health care workers in communities will be provided with online training in the use of the platforms. This strategy will greatly enhance the ability to rapidly turn around test results reducing current test results times down from between 3-10 days to within a few hours for most communities across Australia.

This strategy will enable contacts to be tested early and ensure local action plans and strategies are enacted to minimise community transmission.

Infrastructure planning: Many communities have planned additional spaces for isolation and quarantine in the advent of an outbreak in communities, especially made difficult in the contexts of already overcrowded housing. In some cases, the minerals and exploration industry has offered communities unused accommodation and facilities during COVID-19 period.

Expanding testing sites: The Commonwealth Department of Health has facilitated the opening of GP-led respiratory clinics, including some in Aboriginal Community Controlled Health Services (ACCHS).

Workforce planning: Much discussion is still ongoing on the need to protect and maintain workforces in Aboriginal health care settings. Much of remote Australia is reliant on locum staff that will require quarantining prior to starting clinical activities within communities but this places additional strain on existing workforce capacity. Recent outbreaks among health care workers in remote Australia highlight the vulnerability of remote community populations.

 

Health promotion materials: Targeted communication resources for Aboriginal and Torres Strait Islander Australians have been developed (13). Health organisations have stepped up and developed local resources appropriate for their own community populations.

Many of these can be found on the NACCHO website. Other organisations have also created health education materials to help inform and educate their community populations. In many cases the development of culturally specific resources has been conducted by Aboriginal Health Workers and Practitioners.

Epidemiological tracking of COVID-19: Work has commenced to ensure accurate timely surveillance of cases among First Nations Peoples occurs. This will enable responses to be actioned swiftly and prevent loss of precious time in an outbreak situation.

Infectious disease modelling to help inform approaches: Mathematical models are being used to investigate the best approaches to use in communities once cases are identified. Additional social distancing, isolation, quarantine measures, contact testing, testing strategies are currently being developed to inform responses.

Advocacy: Significant advocacy across all levels of the response continue such as the ongoing need for adequate supply of personal protective equipment for the ACCHS sector, quarantine measures, and testing guidelines to name a few.

References

  1. Rudge S, Massey PD. Responding to pandemic (H1N1) 2009 influenza in Aboriginal communities in NSW through collaboration between NSW Health and the Aboriginal community-controlled health sector. New South Wales Public Health Bulletin. 2010 Apr 30;21(2):26-9.
  2. Flint SM, Davis JS, Su JY, OliverLandry EP, Rogers BA, Goldstein A, Thomas JH, Parameswaran U, Bigham C, Freeman K, Goldrick P. Disproportionate impact of pandemic (H1N1) 2009 influenza on Indigenous people in the Top End of Australia’s Northern Territory. Medical Journal of Australia. 2010 May;192(10):617-22.
  3. Kelly H, Mercer G, Cheng A. Quantifying the risk of pandemic influenza in pregnancy and Indigenous people in Australia in 2009. Eurosurveillance 2009;14:19441.
  4. Council of Australian Governments.Working Group on Australian Influenza Pandemic Prevention and Preparedness, Australia.Department of the Prime Minister and Cabinet, Scuffham PA, Hodgkinson B. National Action Plan for Human Influenza Pandemic. Department of the Prime Minister and Cabinet; 2006.
  5. Miller A, Durrheim DN. Aboriginal and Torres Strait Islander communities forgotten in new Australian National Action Plan for Human Influenza Pandemic:“Ask us, listen to us, share with us”. The Medical Journal of Australia. 2010 Sep 20;193(6):316-7.
  6. Massey P, Miller A, Durrheim D, Speare R, Saggers S, Eastwood K. Pandemic influenza containment and the cultural and social context of Indigenous communities.
  7. Driedger SM, Cooper E, Jardine C, Furgal C, Bartlett J. Communicating risk to Aboriginal Peoples: First Nations and Metis responses to H1N1 risk messages. PLOS one. 2013;8(8).
  8. Massey PD, Miller A, Saggers S, Durrheim DN, Speare R, Taylor K, Pearce G, Odo T, Broome J, Judd J, Kelly J. Australian Aboriginal and Torres Strait Islander communities and the development of pandemic influenza containment strategies: community voices and community control. Health Policy. 2011 Dec 1;103(2-3):184-90.
  9. Commonwealth of Australia, Department of Health. Aboriginal and Torres Strait Islander Advisory Group on COVID-19 Communiques. Canberra, ACT. 2020. [Updated 1 April 2020; cited 4 April 2020]. Available from: https://www.health.gov.au/committees-and-groups/aboriginal-and-torres-strait-islander-advisory-group-on-covid-19
  10. Commonwealth of Australia, Department of Health. Australian Health Sector Emergency Response Plan for Novel Coronavirus (COVID-19). Management Plan for Aboriginal and Torres Strait Islander populations. Operational Plan for Aboriginal and Torres Strait Islander populations. Canberra, ACT. 2020. [updated 30 March 2020; cited 4 April 2020] Available from: https://www.health.gov.au/sites/default/files/documents/2020/03/management-plan-for-aboriginal-and-torres-strait-islander-populations.pdf
  11. Commonwealth of Australia, Department of Health. Coronavirus Disease 2019 (COVID-19) CDNA National guidelines for public health units. Canberra, ACT. 2020. [updated 6 April 2020; cited 8 April 2020] Available from: https://www1.health.gov.au/internet/main/publishing.nsf/Content/7A8654A8CB144F5FCA2584F8001F91E2/$File/interim-COVID-19-SoNG-v2.5.pdf
  12. Commonwealth of Australia, Department of Health. Keeping communities safe from coronavirus: remote area travel restrictions. Canberra, ACT. 2020 [updated 9 April 2020, cited 14 April 2020]. Available from: https://www.health.gov.au/sites/default/files/documents/2020/04/keeping-communities-safe-from-coronavirus-remote-area-travel-restrictions.pdf
  13. Commonwealth of Australia, Department of Health. Coronavirus (COVID-19) advice for Aboriginal and Torres Strait Islander peoples and remote communities. Canberra, ACT. 2020 [updated 6 April 2020, cited 14 April 2020]. Available from: https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert/advice-for-people-at-risk-of-coronavirus-covid-19/coronavirus-covid-19-advice-for-aboriginal-and-torres-strait-islander-peoples-and-remote-communities

Aboriginal Health #CoronaVirus News Alert No 47 : April 27 #KeepOurMobSafe : #OurJobProtectOurMob : NACCHO is part of the group of national health professionals / peak health groups supporting the #COVIDSafe app : Plus FAQs

” As key representatives of Australia’s health professions this joint statement, with the Federal Minister for Health, the Hon Greg Hunt MP, supports and approves the COVIDSafe app as a critical tool in helping our nation fight the COVID-19 pandemic, protect and save lives.

The COVIDSafe app has been created as a public health initiative, which will allow state and territory public health officials to automate and improve manual contact tracing.

Accelerating contact tracing will help slow the virus spreading and prevent illness as well as allow an earlier lifting of social distancing and other measures.

The COVIDSafe app will assist health authorities to suppress and eliminate the virus as part of the three key requirements for easing restrictions: Test, Trace and Respond. “

After you download and install the app from the Australian Apple App store or Google Play store, which you can also access from the government’s Covidsafe app page covidsafe.gov.au, you’ll be asked to register your name (or pseudonym), age range, postcode and phone number.

 ” The medical profession and the medical profession has released a joint statement with the government .In alphabetical order – the support and encouragement for people to download the app

Allied Health Professions of Australia, the Australian College of Nursing, the Australian College of Rural and Remote Medicine, the Australian Dental Association, the Australian Medical Association, the Australian Nursing and Midwifery Federation, the Council of Medical College Presidents of Australia representing all of the medical colleges, the National Aboriginal Community Controlled and Health Organisation, the Pharmaceutical Society of Australia, the Pharmacy Guild of Australia, the Rural Australian College of Physicians, the Royal Australian College of GPs and the Rural Doctors Association of Australia.

Download the Minister Greg Hunt’s full press conference transcript HERE

We thank Australians for their help in protecting each other and our doctors, nurses, carers, pharmacists, allied health professionals, dentists and support staff through their support for the difficult but life-saving social distancing measures.

We equally ask you to consider downloading the app to help protect our nurses, doctors, pharmacists, dentists, allied health professionals, carers and support staff. This will help us protect you and help you protect us.

The COVIDSafe app will also help keep you, your family and your community safe from further spread of the COVID-19 virus through early notification of possible exposure. It will be one of the tools we will use to help protect the health of the community by quickly alerting people who may be at risk of having contact with the COVID-19 virus.

Receiving early notification that you may have been exposed to the COVID-19 virus can save your life or that of your family and friends, particularly those who are elderly. It will mean you can be tested earlier and either be given the support you will need if diagnosed positive, while protecting others, or have the peace of mind of knowing you have not contracted what could be a life threatening disease.

The COVIDSafe app has been developed with the strongest privacy safeguards to ensure your information and privacy is strictly protected. We strongly encourage members of the public to download the app which will be available from your usual App Stores. The user registers to use the app by entering a name, age range, phone number and postcode and will receive a confirmation SMS text message to complete the installation of the COVIDSafe app.

Signing up to the COVIDSafe app is completely voluntary. We hope Australians will choose to support this app so that we can continue to fight the COVID-19 pandemic and give people more freedom to get on with their day-to-day lives.

The COVIDSafe app is part of our work to slow the spread of COVID-19. Having confidence we can find and contain outbreaks quickly will mean governments can ease restrictions while still keeping Australians safe.

The new COVIDSafe app is completely voluntary. Downloading the app is something you can do to protect you, your family and friends and save the lives of other Australians. The more Australians connect to the COVIDSafe app, the quicker we can find the virus.

For detailed questions and answers about this app, see our COVIDSafe app FAQs.

What COVIDSafe is for

The COVIDSafe app helps find close contacts of COVID-19 cases. The app helps state and territory health officials to quickly contact people who may have been exposed to COVID-19.

The COVIDSafe app speeds up the current manual process of finding people who have been in close contact with someone with COVID-19. This means you’ll be contacted more quickly if you are at risk. This reduces the chances of you passing on the virus to your family, friends and other people in the community.

State and territory health officials can only access app information if someone tests positive and agrees to the information in their phone being uploaded. The health officials can only use the app information to help alert those who may need to quarantine or get tested.

The COVIDSafe app is the only contact trace app approved by the Australian Government.

How COVIDSafe works

When you download the app you provide your name, mobile number, and postcode and select your age range (see Privacy). You will receive a confirmation SMS text message to complete installation. The system then creates a unique encrypted reference code just for you.

COVIDSafe recognises other devices with the COVIDSafe app installed and Bluetooth enabled. When the app recognises another user, it notes the date, time, distance and duration of the contact and the other user’s reference code. The COVIDSafe app does not collect your location.

To be effective, you should have the COVIDSafe app running as you go about your daily business and come into contact with people. Users will receive daily notifications to ensure the COVIDSafe app is running.

The information is encrypted and that encrypted identifier is stored securely on your phone. Not even you can access it. The contact information stored in people’s mobiles is deleted on a 21-day rolling cycle. This period takes into account the COVID-19 incubation period and the time it takes to get tested. For more, see Privacy.

When an app user tests positive for COVID-19

When someone is diagnosed with COVID-19, state and territory health officials will ask them or their parent/guardian who they have been in contact with. If they have the COVIDSafe app and provide their permission, the encrypted contact information from the app will be uploaded to a highly secure information storage system. State and territory health officials will then:

  • use the contacts captured by the app to support their usual contact tracing
  • call people to let them or their parent/guardian know they may have been exposed
  • offer advice on next steps, including:
    • what to look out for
    • when, how and where to get tested
    • what to do to protect friends and family from exposure

Health officials will not name the person who was infected.

After the pandemic

At the end of the Australian COVID-19 pandemic, users will be prompted to delete the COVIDSafe app from their phone. This will delete all app information on a person’s phone. The information contained in the information storage system will also be destroyed at the end of the pandemic.

Deleting the COVIDSafe app

You can delete the COVIDSafe app from your phone at any time. This will delete all COVIDSafe app information from your phone. The information in the secure information storage system will not be deleted immediately. It will be destroyed at the end of the pandemic. If you would like your information deleted from the storage system sooner, you can complete our request data deletion form.

Privacy

Your information and privacy is strictly protected.

Read the COVIDSafe Privacy Policy for details on how personal information collected in the app is handled.

A Privacy Impact Assessment was commissioned to ensure that privacy risks have been addressed. See the Privacy Impact Assessment Report and our Agency Response.

The Health Minister has issued a Determination under the Biosecurity Act to protect people’s privacy and restrict access to information from the app. State and territory health authorities can access the information for contact tracing only. The only other access will be by the COVIDSafe Administrator to ensure the proper functioning, integrity and security of COVIDSafe, including to delete your registration information at your request. It will be a criminal offence to use any app data in any other way. The COVIDSafe app cannot be used to enforce quarantine or isolation restrictions, or any other laws.

Get the app

Download on the Apple app store
Download on the Google play app store

Aboriginal #CoronaVirus News Alert No 43 : April 21 #KeepOurMobSafe : #OurJobProtectOurMob #Rural #Remote The coronavirus supplement is the biggest boost to Indigenous incomes since the 1970’s . It should be made permanent

It would be misguided to think Indigenous Australians need only temporary relief.

The Indigenous economy has been in crisis since 1788. The unemployment rate in places like Palm Island was 60% before the coronavirus hit.

The average duration of unemployment for Indigenous Australians is 73 weeks.

For Australia as a whole, it is 11 weeks.

The unfavourable job market now facing many Australians for the first time has been the normal state of affairs for many Indigenous people.

For this reason, the temporary increase to income support should be made permanent, and the suspended mutual obligation requirements abolished.

Doing so, and normalising some of the anomalies of the current arrangement (such as the exclusion of disability support pensioners, age pensioners, and temporary residents) would provide all Australians with an income floor below which no one could fall.

For Indigenous Australians, it would lock in the biggest reduction in poverty rates since the 1970s.

It would be affordable — it’s only a question of our priorities.

The crisis has reminded us once again how much we depend on each other. We can use it to rebuild a society which is fairer and in which no one is forced to struggle in deep poverty.:” 

This article draws on the Francis Markam author’s contribution to the collection Indigenous Australians and the COVID-19 crisis: Perspectives on public policy, published by the Centre for Aboriginal Economic Policy Research at the ANU. From the Conversation 

 

On March 23 the government effectively doubled payments to the unemployed, single parents and students, introducing a new unconditional Coronavirus Supplement to go on top of existing allowances such as Newstart, Youth Allowance, Parenting Payment, Austudy and Abstudy.

From April 27 single unemployed adults will get around A$557.85 per week in income support, almost double the previous $282.85 per week.

This additional support is time-limited, applying for only six months.

As well as covering the newly unemployed, it’ll extend to existing recipients, meaning it’ll be paid to about 2.3 million Australians.


Read more: Coronavirus supplement: your guide to the Australian payments that will go to the extra million on welfare


At the same time, the onerous requirement for recipients in remote Australia to conduct “work-like activities” or face fines and suspensions, has itself been suspended because work-like activities carry added risk.

The temporary doubling is intended to shield those who find themselves unable to find work at a time when the government has shut down large sections of the economy.

But it will have another (welcome) unintended consequence: it will temporarily cut poverty among Indigenous Australia to new lows.

Most very remote Indigenous Australians live in poverty

Note graphic above added by NACCHO 

The income support system has failed for decades to keep Indigenous people out of poverty. At the time of the 2016 Census, 31% of Indigenous Australia lived below the poverty line of $404 per week.

And while the overall financial situation of Indigenous Australians improved over the decade from 2006 to 2016, in very remote Australia, poverty got worse.

Already alarmingly high in 2006 at 46%, by 2016 the proportion of very remote Indigenous Australians in poverty had climbed to 54%.


Percentage of Indigenous population living in poverty

Indigenous poverty rates using the ‘50% of median disposable equivalised household income’ poverty line. Markham and Biddle, 2018

Since then things have changed, for the worse.

According to Bureau of Statistics survey data, median Indigenous personal incomes fell from $482 per week in 2014-15 to $450 in 2018-19.

In remote Australia the fall was more precipitous.

Over those five years remote median Indigenous personal income fell from $375 per week to $310.


Median Indigenous income, 2014-15, 2019-19

Median gross personal weekly income, Indigenous population aged 15-64. Author’s calculations from the National Aboriginal and Torres Strait Islander Social Survey 2014-15 and National Aboriginal and Torres Strait Islander Health Survey 2018-19

The Coronavirus Supplement is set to dramatically change things.

Before the coronavirus outbreak about 27% of the Indigenous population aged 16 years or older were receiving payments that make them eligible for the Supplement.

The proportion who will actually get it be much greater, as many more will become unemployed or underemployed as a result of the crisis.


Read more: Three charts on: the changing status of Indigenous Australians


Indigenous workers are likely to be especially hit hard by the downturn due to discrimination and their more-precarious employment status.

The extra $225 per week is well-targeted at the poorest Indigenous Australians.

According to my estimates, around 38% of Indigenous adults in very remote areas will be eligible.

The biggest boost in 50 years

It is likely to be the most substantial increase in aggregate Indigenous incomes since Indigenous people won rights to equal wages and the full range of social security payments between 1969 and 1977.

In very remote areas, total community incomes are likely to increase by one quarter.

Indeed, so significant is the boost that remote community stores may run out of food as incomes start to catch up with people’s everyday needs, a concern expressed by the minister for Indigenous Australians Ken Wyatt.

It should be made permanent

NACCHO Aboriginal Health and Communities #CoronaVirus News Alerts March 13- 16 : Contributions from our CEO Pat Turner, Prime Minister Scott Morrison, Dr Mark Wenitong, Dr Norman Swan and Marion Scrymgour

In this special Corona Virus edition

1.Pat Turner NACCHO Appearance on The Drum

2.Prime Minister Scott Morrison’s press conference

3.Department of Health download videos

4.Dr Norman Swan

5.DR Mark Wenitong

6.Marion Scrymgour CEO NLC

Read all previous Aboriginal Health and Corona Virus articles published by NACCHO since January

1.Pat Turner NACCHO Appearance on The Drum

Pat Turner, CEO of the National Aboriginal Community Controlled Health Organisation (NACCHO), warned tonight that if the novel coronavirus gets into Aboriginal communities, “it will be absolute devastation without a doubt”.

In particular, she urged state and local governments to lift their games, but acknowledged that some local governments, like those in Alice Springs and Halls Creek, were acting.

Turner also called for action to address “the national disgrace” of inadequate Aboriginal housing given the implications for infection control, and for screening of communities in vulnerable areas, stating that the docking of a cruise ship in Broome today had caught health authorities unawares.

The ACCHO sector had been working very hard to get out information to communities and clinics, but needed the Government to fund their services at a realistic level, she told ABC TV’s The Drum program.” 

Urgent calls for more resources to protect Aboriginal and Torres Strait Islander communities from COVID-19 From Croakey Read HERE in full 

Watch the full episode of The Drum on IView (Available till 20 March )

2.Prime Minister Scott Morrison’s press conference

 “Today, I now want to move to the decisions that we have taken that were consistent with the plan that I’ve outlined to you.

First of all, the National Security Committee met before the National Cabinet today and we resolved to do the following things; to help stay ahead of this curve we will impose a universal precautionary self-isolation requirement on all international arrivals to Australia, and that is effective from midnight tonight.

Further, the Australian government will also ban cruise ships from foreign ports from arriving at Australian ports after an initial 30 days and that will go forward on a voluntary basis. The National Cabinet also endorsed the advice of the AHPPC today to further introduce social distancing measures.

Before I moved to those, I just wanted to be clear about those travel restrictions that I’ve just announced. All people coming to Australia will be required, will be required I stress, to self isolate for 14 days.

This is very important. What we’ve seen in recent, in the recent weeks is more countries having issues with the virus.

And that means that the source of some of those transmissions are coming from more and more countries.

Bans have been very effective to date. And what this measure will do is ensure that particularly Australians who are the majority of people coming to Australia now on these flights, when they come back to Australia, they’re self-isolation for 14 days will do an effective job in flattening this curve as we go forward.

And there are major decisions that were taken today that reflect changing where we are heading.

The facts and the science, the medical advice will continue to drive and support the decisions that we are making as a National Cabinet, as indeed as a federal Cabinet at the Commonwealth level.

But the truth is that while many people will contract this virus that it’s clear, just as people get the flu each year, it is a more severe condition than the flu, but for the vast majority, as I said last week, for the majority, around 8 in 10 is our advice, it will be a mild illness and it will pass. “

 Prime Minister Scott Morrison press conference 15 march : Download full Transcript here 

PM Scott Morrison press conference full transcript

Download PM Press Release

Prime Ministers Press Release

3.Department of Health campaign download videos 

Download Videos

Coronavirus video – Help Stop The Spread

Coronavirus video – Recent Traveller

Coronavirus video – Stay Informed

Coronavirus video – Good Hygiene Starts Here

Dr Norman Swan provides some simple advice regarding Coronavirus.

– Wash your hands regularly with soap and water; or with hand sanitiser.

– Try to keep your distance from other people; and avoid physical contact

– If you need to sneeze or cough, do it into a fresh tissue which you then discard; or into your elbow.

– If you have a cough or a cold, it’s most likely that you have just a cough or a cold; but talk to your Doctor about it before turning up to a surgery.

For more information visit http://www.abc.net.au/coronavirus or http://www.health.gov.au

5. Dr Mark Wenitong

Dr Mark speaks with Black Star Radio about Coronavirus and the simple steps you can take to protect yourself.

“If you’re not sure, give the clinic a call and we’ll tell you what to do.” Dr Mark

 

6.Marion Scrymgour CEO NLC

“The NLC has received many calls from community members asking that we do all we can to ensure the safety and protection of Aboriginal people in their communities who are very concerned about the spread of COVID-19.

Should this virus break out in our communities, we don’t have the manpower to deal with this.

The NLC will be launching an information campaign in Indigenous languages to inform people about hygiene, testing for coronavirus and for them to avoid travel outside communities.

NLC staff have also cancelled their non-essential travel to communities including its regional council meetings.

“Somebody could come out and they could get infected and then go back into the community.

“The position we’re taking is if we can push back that virus taking hold in our communities, that’s a good thing. It means we can work at getting better prepared.”

The decision comes after the Northern Territory Government decided it will stop its employees from making non-essential travel to remote communities.

The NLC has received many calls from community members asking that we do all we can to ensure the safety and protection of Aboriginal people in their communities who are very concerned about the spread of COVID-19 “

Chief executive officer Marion Scrymgour said the move was to protect Aboriginal people in the communities who already faced issues like chronic health conditions, lack of resources and overcrowded housing.

Read in full HERE

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

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

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

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

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

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

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

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

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

It is well documented that there are:

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

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

Rationale

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

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

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

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

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

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

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

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

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

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

Relevant national frameworks and action plans

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

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

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

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

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

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

 

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

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

It has nine guiding principles:

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

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

What’s happening in practice?

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

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

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

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

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

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

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

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

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

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

Need help ?

Contact your nearest ACCHO or

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

Kids Help Line

1800 55 1800
www.kidshelpline.com.au

Lifeline Australia

13 11 14
www.lifeline.org.au

NACCHO Aboriginal Health and #HearingAwarenessWeek A/Prof @KelvinKongENT is working to #closethegap in ear health for Aboriginal and Torres Strait Islander kids by finding better treatments and preventative approaches so kids are not limited by their hearing.

I aim to make a national profile of the problem of ear disease and hearing loss. It is an important issue for all Australian levels of government, policy makers and health service providers.

The severe impact imposed by hearing loss needs greater acknowledgement, especially in communities where a majority of people are affected, such as the Aboriginal and Torres Strait Islander communities.

We are also seeing too many children in our urban, regional and rural communities being affected and waiting too long for access to specialist care.

This is a health problem that costs our nation a great deal of money, not just in medical treatments but in the social cost of people not receiving enough education to get a good job and provide security for themselves and their families in the future.

Associate Professor Kelvin Kong : Read interview full BIO Part 2

Read over 40 Aboriginal Health and Ear Hearing articles published by NACCHO

 “ Up to nine in every ten Aboriginal and Torres Strait Islander children under the age of three in the Northern Territory, suffer from otitis media, or “glue ear”, in one or both ears. If left untreated this can have a devasting impact on a child’s entire life trajectory.

The Hearing for Learning Initiative will increase early detection of otitis media, by training local community members to become ear experts that support on the ground health and education services. This will decrease the need for fly-in fly-out specialists, reduce the treatment waiting period and create employment opportunities for up to 40 community-based workers in the Northern Territory. ” 

Download Menzies Press Release 

Media release Hearing for learning a focus on Bathurst Island

World Hearing Day was on 3 March 2020. The theme this year is “Don’t let hearing loss limit you”.

World Hearing Day coincides with Hearing Awareness Week in Australia (1 to 7 March).

This year’s theme is “Don’t let hearing loss limit you”. This theme highlights how timely and effective interventions can help people with hearing loss reach their full potential.

World Hearing Day coincides with Hearing Awareness Week in Australia (1 to 7 March).

Hearing loss in Australia

In Australia, almost 4 million people have some form of hearing loss. This continues to grow as our population ages.

The most common causes of hearing loss are:

  • age-related
  • excessive exposure to loud noise

Hearing loss caused by exposure to loud noise is preventable. The best interventions for hearing loss are early interventions, no matter how old you are.

If you or someone you know is worried about hearing loss, we encourage you to have your hearing checked.

The Healthdirect website provides more information on the signs of hearing loss and ways to help prevent hearing loss.

Hearing Services Program

The Australian Government is working to reduce hearing loss and the consequences of hearing loss in Australia.

The Government’s $581 million Hearing Services Program provides high quality hearing services and devices to some of our most vulnerable people.

In 2018-19, the program delivered services to over 785,000 clients, including:

  • older Australians
  • veterans
  • young children
  • Aboriginal and Torres Strait Islander people
  • people living in rural and remote areas

The Australian Government has also committed $4 million in funding for up to 600,000 free online hearing tests for children. Parents of children aged between four and 17 can visit the Sound Scouts website for more information.

Find out more about hearing and hearing loss on the Hearing Services Program website.

Part 2 Interview with Associate Professor Kelvin Kong

From HERE

Ear disease in Australian Indigenous populations is deplorable. I am working to closing the gap in ear health to bring all Indigenous Australian children to the same level of well-being and health care access as their non-Indigenous counterparts.

The rates of ear disease are higher for Aboriginal and Torres Strait Islander children across Australia, with some communities having 90% of young children affected. This causes hearing loss leading to massive disadvantage in early learning and development of language and social skills, which can have devastating repercussions throughout life.

Our Newcastle ear research team works to understand the pathophysiology of chronic ear disease in Australian Indigenous and non-Indigenous sufferers to understand the nature of ear infections and find better treatments and preventative approaches in early childhood.

Unfortunately, some babies will acquire infections within the first months of life and go on to have recurrent infections that impact upon their ability to hear and learn. Importantly missing on hearing the voices (and stories) of their family members at this vitally important period of early development.

I aim to make a national profile of the problem of ear disease and hearing loss. It is an important issue for all Australian levels of government, policy makers and health service providers.

The severe impact imposed by hearing loss needs greater acknowledgement, especially in communities where a majority of people are affected, such as the Aboriginal and Torres Strait Islander communities. We are also seeing too many children in our urban, regional and rural communities being affected and waiting too long for access to specialist care.

This is a health problem that costs our nation a great deal of money, not just in medical treatments but in the social cost of people not receiving enough education to get a good job and provide security for themselves and their families in the future.

The journey of solving the ear health issues must be community led and translated into models of care that have a holistic approach. Our research must also have capacity and ensure any solutions are sustainable.

 

Why did you get into research?

It was heartbreaking growing up in the Worimi community enduring the health disparities first hand. I have always had a passion to help address the inequality and have been lucky enough to be afforded the opportunities to allow me to complete the full circle and be a care giver.

As an ENT surgeon I have treated people all across Australia, including people in Newcastle (Awabakal country), with terrible states of ear disease.

The lack of access to health care and the escalation of a problem that should have been addressed long ago, is a driver to increase the momentum of a solution.

The impact of research into the causes and interventions, cannot be overestimated, so that young babies will not progress to the stage where surgery is desperately needed to restore some hearing so they can participate in a normal childhood and have aspirations and dreams not limited by their hearing.

What would be the ultimate goal for your research?

The ultimate goal is for all Australian children, both Indigenous and non-Indigenous, to have the same chance of having healthy ears, no matter where they reside in Australia.

We need everyone to have enough awareness of the problems, to put the time and resources into finding treatments and interventions, so that no child should expect to go through life suffering the loneliness, loss of self-esteem and lack of education that many children experience with ear disease and as adults in later life.

Biography

Kelvin graduated from the University of NSW in 1999. He embarked on his internship at St. Vincent’s Hospital in Darlinghurst and pursued a surgical career, completing resident medical officer and registrar positions at various attachments. Along the way, he has been privileged in serving the urban, rural and remote communities.

He was awarded his fellowship with the Royal Australasian College of Surgeons in 2007. Once completed he pursued further training in Paediatric ENT surgery, being grateful and honored by his fellowship at The Royal Children’s Hospital, Melbourne in 2007-8. He is now practising in Newcastle (Awabakal Country) as a Surgeon specializing in Paediatric & Adult Otolaryngology, Head & Neck Surgery (Ear, Nose & Throat Surgery).

He has joined an outstanding group of surgeons at Hunter ENT and together they provide a varied comprehensive practice. He has a very broad adult and paediatric Otology, Rhinology and Laryngology practice, whilst having special interests in Paediatric Airway, Adult and Paediatric Cochlear Implantation, Voice and Swallow disorders and Head & Neck Cancer management.

He is an active member of RACS and ASOHNS, serving on the Indigenous Health and Fellowship Services Committees. He has published articles and presented on a variety of ear, nose and throat conditions as well as Indigenous health issues both nationally and internationally.  He is active in reviewing articles for publication, lecturing and teaching allied health professional, medical students at several universities and both unaccredited and advanced medical and surgical trainees. His commitment and professionalism was recognised in July 2017 when he was appointed the Secretary of the Australian New Zealand Society of Paediatric Otolaryngology. He was also honored to have won the Australian Indigenous Doctor of the year in 2017.

As Australia’s first Indigenous surgeon, Assoc. Prof. Kong is committed to improving the ear health of Indigenous children and has often participated in news articles and television interviews to bring the attention of the Australian public to the disparity in Indigenous and non-Indigenous child health. He makes regular trips to Australia’s remote regions to provide ear health services that would otherwise not be available.

Kelvin hails from the Worimi people of Port Stephens, north of Newcastle, NSW, Australia. Being surrounded by health, he has always championed for the improvement of health and education. Complementing his practice as a surgeon, he is kept grounded by his family, who are the strength and inspiration to him, remaining involved in numerous projects and committees to help give back to the community.

Future Focus

Being able to hear is such a privilege often taken for granted. The quality of life through the enjoyment if sound and education is a human right. I want everyone to understand the importance of ear disease in childhood and particularly how vital it is that we stop this problem from affecting so many Australian Indigenous children. We need to work together to raise the standards of living and access to medical care so that our First people are not living from one generation to the next in sub-standard circumstances.  We need to see our children finishing their education, able to gain employment and live alongside non-Indigenous Australians with the same opportunities and the same quality of life. We need see them to strive toward their dreams.

Specialised/Technical Skills

  • Consultant ear, nose and throat surgeon
  • Causes of ear infections
  • Paediatric Airway
  • Adult and Paediatric Cochlear Implantation
  • Voice and Swallow disorders
  • Head & Neck Cancer management
  • Randomised controlled trials
  • Aboriginal and Torres Strait Islander health
  • Educator
  • Policy development
  • Mentor
  • Father, Husband, Brother, Worimi man

Affiliations

 

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

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

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

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

HealthInfoNet Director, Professor Neil Drew

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

Download HERE 

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

The annual Overview contains updated information across many health conditions.

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

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

The initial sections of the Overview provide information about:

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

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

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

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

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

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

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

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

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

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

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

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

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

Download the PowerPoint HERE

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

NACCHO Aboriginal Health and the #ClosingtheGap debate : Professor Ian Ring  “  For actual progress to occur  I suggest 7 steps fundamental shifts in policy and practice  to turn around the efforts to #closethegap “

The good news is that the lack of progress in Closing the Gaps can be turned around, but this requires capitalising on the opportunities presented by the COAG partnership and a fundamental shift in the way programs are run.

I am encouraged that First Peoples and government are finally in the one forum where funding and policy can be aligned and jurisdictional and Indigenous responsibilities assigned and monitored – through the Partnership Agreement with the Coalition of Peak Aboriginal and Torres Strait Island Organisations and the Council of Australian Governments(COAG).

This is a historic development, but one which enables but does not necessarily, of itself, guarantee progress.

For actual progress to occur, there needs to be some fundamental shifts in policy and practice.

I suggest the following 7 steps to turn around the efforts to close of the gap “

Professor Ian Ring AO, Hon DSc see full CV part 2 below : Original published ANTAR 

Read over 600 Aboriginal and Close the Gap articles published by NACCHO over past 8 years

Read all the Coalition of Peaks Closing the Gap articles published by NACCHO 

Noting the Prime Minister Scott Morrison will deliver his governments Closing the Gap report Wednesday 12 February

Close the Gap, Coalition of Peaks and Closing the Gap what is the difference ?

Close the Gap is a public awareness campaign focused on closing the health gap. It’s run by numerous NGOs, Indigenous health bodies and human rights organisations.

The campaign was formally launched in 2007, after the release of the social justice report by the Aboriginal and Torres Strait Islander social justice commissioner, Dr Tom Calma.

Close the Gap gained support from state and federal governments when the Council of Australian Governments (Coag) set two health aims among their six targets in 2008: achieving health equality within a generation and halving the gap in mortality rates for children under five within a decade.

In 2008 then prime minister Kevin Rudd and then opposition leader Brendan Nelson also signed the Close the Gap statement of intent.

The Coalition of Peaks is a representative body comprised of around fifty Aboriginal and Torres Strait Islander community controlled peak organisations that have come together to be partners with Australian governments on closing the gap, a policy aimed at improving the lives of Aboriginal and Torres Strait Islander people.

In 2016, Australian governments wanted to refresh the closing the gap policy which had been in place for ten years.  During this refresh process, many Aboriginal and Torres Strait Islander organisations told governments that we needed to have a formal say on the design, implementation and evaluation of programs, services and policies that affect us.

In March 2019, the Coalition of Peaks entered an historic formal Partnership Agreement on Closing the Gap with the Council of Australian Governments (COAG) which sets out shared decision making on Closing the Gap.

View the Coalition of Peaks Website HERE 

Closing the Gap

Closing the Gap is the name given to Coag’s 2008 national strategy to tackle Indigenous inequality, which includes the Indigenous Reform Agreement, a commitment to closing the gap between Indigenous and non-Indigenous Australians within a specific timeframe, with six key targets

View the latest Closing the Gap Website HERE

” Everyone deserves the right to a healthy future and the opportunities this affords.

However, many of Australia’s First Peoples are denied the same access to healthcare that non-Indigenous Australians take for granted.

Despite a decade of Government promises the gap in health and life expectancy between Aboriginal and Torres Strait Islander peoples and other Australians is widening.

The Close the Gap Coalition — a grouping of Indigenous and non-Indigenous health and community organisations — together with nearly 200,000 Australians are calling on governments to take real, measurable action to achieve Indigenous health equality by 2030.” 

National Close the Gap Day March 17 Campaign website

Ian Ring suggests the following 7 steps to turn around the efforts to close of the gap 

1.Target Setting

Firstly, target setting is not simply a process of setting out what results would be desirable but needs to take into account what actual services and resources would be required to achieve the targets – and how long it would take to both measure and achieve them. Targeting and budgeting must go hand in hand, and targeting without budgeting is simply a recipe for failure and disappointment.

2.Needs-Based Funding

Secondly, it is a cardinal principle behind government social policy that service provision should be related to need. For example, no one questions the fact that far more is spent on health care for the elderly than on the young who enjoy much better health.

However, while in broad terms the level of need for health care in Aboriginal and Torres Strait Islander people, based on the Burden of Disease studies is approximately 2.3 times higher than for the rest of the population, though the jurisdictions spend $2 approximately pc (87% of needs based requirements) on health for every $1 spent on the rest of the population, the Commonwealth only spends $1.21pc on Aboriginal and Torres Strait Islander people for every $1 spent on the rest of the population (barely half [53%] of the needs based requirements).

This is particularly important as the Commonwealth is largely responsible for the out-of-hospital services required to bring down preventable admissions and deaths. It is utopian and unrealistic to believe that gaps can be closed by spending relatively less on people with worse health.

This is not a plea for some kind of special deal for First Peoples but rather for a level of expenditure that anyone else of the population with equivalent need would receive.

Funds are required to address market failure, particularly with the underuse of Commonwealth funding schemes (MBS/PBS) and to fill current service gaps with services that work and particularly, services designed by and for Aboriginal people (ACCHS). Similar principles apply to other areas of government policy and service provision eg housing, education, welfare etc.

3.Focus on Services

Thirdly, there seems to be a widespread belief that targets are somehow self-fulfilling, that all that is required is to set targets, measure them and that somehow or other the targets can be achieved.

This is of course nonsense, but indicative of the need for skills training in health planning and related fields (see below). Having set targets, it is absolutely necessary to consider what services are required to achieve the targets, what services are available and what services are missing, and the investment required to fill the service gaps. For services that are available, it is fundamentally important to have evaluation as a mandatory routine to see if the services are accessible, and effective – and if not, why not, and then take the necessary management decisions to improve service delivery (see management below).

4.Training

There is clear evidence across a range of fields (health, education, housing, justice etc) that significant progress is possible using methods that are tried and tested.

But Aboriginal health and related issues are not so simple that anyone can tackle them effectively. They are complex and require considerable skills and service delivery experience for effectiveness.

Throwing staff in at the deep end is inefficient, and not fair either to the staff or to Indigenous people. Health planning, for example, is a defined skill and requires specific training and a manifest lack of planning skills lies at the heart of suboptimal service delivery A fundamental understanding of culture is an absolute necessity as is a very solid grounding in service delivery experience. The need for training extends right across the board and applies to clinicians, health service administrators  and public servants.

For each individual the question needs to be asked – what training does this person require in order to fulfil their role with maximum effectiveness? It is time for amateur hour to come to an end and for the development and implementation of a National Training Plan to ensure all involved are adequately equipped  for their individual roles – and it will not be possible to adequately realise on the investments involved in Indigenous service provision without appropriate staff training.

5.Management

For many, the concept of management is little better than sitting around and hoping that somehow, miraculously, next year’s results will be better. That is not how Gaps are Closed.

A formal, integrated, multilayered management system is required – supported by appropriate information and evaluation systems.

At the service delivery level there needs to be formal review processes, at least mid-year and annually, to consider both process and outcome measures in relation to the specified targets – with a timeframe that is based on trajectories which set out what results can and should be expected at different points of time.These measures need to be replicated at regional and jurisdictional levels in the context of a wider consideration of staffing, training and resourcing issues. At the national level the focus needs to be on both resourcing and policy issues. At every level, the question needs to be how well are we doing, and what needs to be done to achieve better results – and then to take the appropriate management decisions required to achieve the targets.

6.Continuous Quality Improvement

There is incontrovertible evidence that sizeable and rapid gains are possible in both chronic disease  and in the health of mothers and babies. But those gains require high quality services and are not achieved without proper systems for measuring, monitoring and improving the quality of services.

Such approaches are standard throughout industry and need to be a formal component of health service delivery and other areas of social policy. CQI processes have been used for some services but need to be mandated and funded as a national requirement so that everyone involved in Indigenous service provision lives and breathes service quality enhancement and participates in the formal processes involved.

7.Learning from national and international experience

There are many fine examples of Indigenous Health service delivery – and some of the best health services in the country are provided by the Aboriginal Community Controlled Health Services.

The Institute of Urban Indigenous Health in South-East QLD (IUIH) is an outstanding example of how to integrate Primary Health Care services, both Indigenous and mainstream, under Aboriginal and Torres Strait Islander leadership. in achieving the desired results in term of Closing the Gap.

It is just one of a number of examples around the country, but such examples need to become systematic, comprehensive and national throughout Australia. There are similar examples of services for mothers and babies which reduce low birth weight rates and lower perinatal mortality. In the important field of chronic disease, it has been demonstrated that systematic application of current knowledge can achieve dramatic reductions in mortality in short time periods.  We know what to do, have shown that impressive results can be achieved but nationally, progress in both child health and chronic disease falls a long way short of what is required. There needs to be formal support programs, to replicate successful models of these services, adapted as needed to meet local needs, right throughout Australia.

Similarly, successful programs like Housing for Health, developed for the Commonwealth (and subsequently dropped [!] but picked up by the NSW government) have improved housing and consequently health, and doing so by training and employing local Aboriginal people. It beggars belief that programs of such obvious worth are not universally delivered across Australia, and that needs to be rectified as a matter of urgency.

In other fields, child development and justice reinvestment programs have been shown to be effective and cost effective, both in Australia and overseas, but implemented on a piecemeal and patchy basis in Australia. That cannot continue.

Government budgets tend to focus on outlays rather than investment – and more importantly, return on investment. This is inefficient and, in the end, wasteful. The recent NZ Wellbeing budget shows a different approach and needs careful consideration.

Conclusion

None of the measures above are radical or untested or impossible to implement. Indeed, they are standard throughout much of the world. Not implementing them has proved costly in terms of poor results and suboptimal returns on investment.

The time for amateurism is over and Australia needs to lift its game. and these standard measures, under First Peoples leadership, and in the context of the COAG partnership, we can make a significant contribution to the achievement of Australia’s national Goals to Close the Gap.

The Gaps can and should be closed – but not by fine words and good intentions.

Much progress is possible in relatively short periods of time and Australia could and should be the world leader in Indigenous affairs.

Part 2 Professor Ian Ring AO, Hon DSc

Professor Ian Ring AO, Hon DSc is a Professorial Visiting Fellow, School of Public Health and Community Medicine, University of New South Wales, Adjunct Professor in the School of Indigenous Australian Studies, James Cook University and Honorary Professorial Fellow in the Research and Innovation Division at Wollongong University.

He was previously Head of the School of Public Health and Tropical Medicine at James Cook University, Principal Medical Epidemiologist and Executive Director, Health Information Branch, at Queensland Health, and Foundation Director of the Australian Primary Health Care Research Institute at the Australian National University.

He has been a Member of the Board of the Australian Institute of Health, Member of the Council of the Public Health Association and the Australian Epidemiological Association.

He is an Expert Advisor to the Close the Gap Steering Committee and a member of the International Indigenous Health Measurement Group, Aboriginal and Torres Strait Islander Demographic Statistics Expert Advisory Group, Scientific Reference Group Indigenous Clearinghouse, Australian Indigenous HealthInfoNet Advisory Board, and AMA Taskforce on Indigenous Health.

NACCHO Aboriginal Children’s Health #BacktoSchool : What our kids eat can affect not only their physical health but also their mood, mental health and learning

“When kids eat a healthy diet with a wide variety of fruit and vegetables in that diet, they actually perform better in the classroom.​     

They’re going to have better stamina with their work, and at the end of the day it means we’ll get better learning results which will impact on them in the long term.”

Marlborough Primary School principal

We know that fuelling children with the appropriate foods helps support their growth and development.

But there is a growing body of research showing that what children eat can affect not only their physical health but also their mood, mental health and learning.

The research suggests that eating a healthy and nutritious diet can improve mental health¹, enhance cognitive skills like concentration and memory²‚³ and improve academic performance⁴.

In fact, young people that have the unhealthiest diets are nearly 80% more likely to have depression than those with the healthiest diets

Continued Part 1 Below

Aboriginal and Torres Strait Islander people suffer increased risk of chronic disease such as type 2 diabetes and heart disease.

Eating healthy food and being physically active lowers your risk of getting kidney disease and type 2 diabetes, and of dying young from heart disease and some cancers.

Being a healthy weight can also makes it easier for you to keep up with your family and look after the kids, nieces, nephews and grandkids. “

Continued Part 2 Below

Part 1

Children should be eating plenty of nutritious, minimally processed foods from the five food groups:

  1. fruit
  2. vegetables and legumes/beans
  3. grains (cereal foods)
  4. lean meat and poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans
  5. milk, yoghurt, cheese and/or their alternatives.

Consuming too many nutritionally-poor foods and drinks that are high in added fats, sugars and salt, such as lollies, chips and fried foods has been connected to emotional and behavioural problems in children and adolescents⁵.

In fact, young people that have the unhealthiest diets are nearly 80% more likely to have depression than those with the healthiest diets¹.

Children learn from their parents and carers. If you want your children to eat well, set a good example. If you help them form healthy eating habits early, they’re more likely to stick with them for life.

So here are some good habits to start them on the right path.

Eat with your kids, as a family, without the distraction of the television. Children benefit from routines, so try to eat meals at regular times.

Make sure your kids eat breakfast too – it’s a good source of energy and nutrients to help them start the day. Good choices are high-fibre, low-sugar cereals or wholegrain toast. It’s also a good idea to prepare healthy snacks in advance for them to eat in between meals.

Encourage children to drink water or milk rather than soft drinks, cordial, sports drinks or fruit juice drinks – don’t keep these in the fridge or pantry.

Children over the age of two years can be given reduced fat milk, but children under the age of two years should be given full cream milk.

Why are schools an important place to make changes?

Schools can play a key role in influencing healthy eating habits, as students can consume on average 37% of their energy intake for the day during school hours alone!6

A New South Wales survey found that up to 72% of primary school students purchase foods and drinks from the canteen at least once a week7. Also, in Victoria, while around three-quarters (77%) of children meet the guidelines for recommended daily serves of fruit, only one in 25 (4%) meet the guidelines for recommended daily serves of vegetables8; and discretionary foods account for nearly 40 per cent of energy intake for Victorian children9.

It’s never too late to encourage healthier eating habits – childhood and adolescence is a key time to build lifelong habits and learn how to enjoy healthy eating.

Get started today

You can start to improve students’ learning outcomes and mental wellbeing by promoting healthy eating throughout your school environment.

Some ideas to get you started:

This blog article was originally published on Healthy Eating Advisory Service . 

Part 2

Aboriginal and Torres Strait Islander people suffer increased risk of chronic disease such as type 2 diabetes and heart disease.

Eating healthy food and being physically active lowers your risk of getting kidney disease and type 2 diabetes, and of dying young from heart disease and some cancers.

Being a healthy weight can also makes it easier for you to keep up with your family and look after the kids, nieces, nephews and grandkids.

Aboriginal and Torres Strait Islander people may find it useful to chose store foods that are most like traditional animal and plant bush foods – that is, low in saturated fat, added sugar and salt – and use traditional bush foods whenever possible.

The Healthy Weight Guide provides information about maintaining and achieving a healthy weight.

It tells you how to work out if you’re a healthy weight. It lets you know up-to-date information about what foods to eat and what foods to avoid and what and how much physical activity to do. It gives you tips on setting goalsmonitoring what you dogetting support and managing the challenges.

There are also tips on how to eat well if you live in rural and remote areas.

The national Live Longer! Local Community Campaigns Grants Program supports Indigenous communities to help their people to work towards and maintain healthy weights and lifestyles. For more information, see Live Longer!.

Part 3 Parents may not always realise that their children are not a healthy weight.

If you think your child is underweight, the following information will not apply to your situation and you should seek advice from a health professional for an assessment.

If you think your child is overweight you should see your health professional for an assessment. However, if you’re not sure whether your child is overweight, see if you recognise some of the signs below. If you are still not sure, see your health professional for advice.

Overweight children may experience some or all of the following:

  • Having to wear clothes that are too big for their age
  • Having rolls or skin folds around the waist
  • Snoring when they sleep
  • Saying they get teased about their weight
  • Difficulty participating in some physically active games and activities
  • Avoiding taking part in games at school
  • Avoiding going out with other children

Signs that a child is at risk of becoming overweight, if they are not already, include:

  • Eating lots of foods high in saturated fats such as pies, pasties, sausage rolls, hot chips, potato crisps and other snacks, and cakes, biscuits and high-sugar muesli bars
  • Eating take away or fast food meals more than once a week
  • Eating lots of foods high in added sugar such as cakes, biscuits, muffins, ice-cream and deserts
  • Drinking sugar-sweetened soft drinks, sports drinks or cordials
  • Eating lots of snacks high in salt and fat such as hot chips, potato crisps and other similar snacks
  • Skipping meals, including breakfast, regularly
  • Watching TV and/or playing video games or on social networks for more than two hours each day
  • Not being physically active on a daily basis.

For more information:

References for Part 1

1 Jacka FN, et al. Associations between diet quality and depressed mood in adolescents: results from the Australian Healthy Neighbourhoods Study. Aust N Z J Psychiatry. 2010 May;44(5):435-42. https://doi.org/10.3109/00048670903571598571598
2 Gómez-Pinilla, F. (2008). Brain foods: The effects of nutrients on brain function. Nature Reviews Neuroscience, 9(7), 568-578. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2805706/
3 Bellisle, F. (2004). Effects of diet on behaviour and cognition in children. British Journal of Nutrition, 92(2), S227–S232
4 Burrows, T., Goldman, S., Pursey, K., Lim, R. (2017) Is there an association between dietary intake and academic achievement: a systematic review. J Hum Nutr Diet. 30, 117– 140 doi: 10.1111/jhn.12407. https://onlinelibrary.wiley.com/doi/pdf/10.1111/jhn.12407
5 Jacka FN, Kremer PJ, Berk M, de Silva-Sanigorski AM, Moodie M, Leslie ER, et al. (2011) A Prospective Study of Diet Quality and Mental Health in Adolescents. PLoS ONE 6(9): e24805. https://doi.org/10.1371/journal.pone.0024805
6 Bell AC, Swinburn BA. What are the key food groups to target for preventing obesity and improving nutrition in schools? Eur J Clin Nutr2004;58:258–63
7 Hardy L, King L, Espinel P, et al. NSW Schools Physical Activity and Nutrition Survey (SPANS) 2010: Full Report (pg 97). Sydney: NSW Ministry of Health, 2011
8 Department of Education and Training 2019, Child Health and Wellbeing Survey – Summary Findings 2017, State Government of Victoria, Melbourne.
9 Department of Health and Human Services 2016, Victoria’s Health; the Chief Health Officer’s report 2014, State Government of Victoria, Melbourne.