NACCHO #closingtheGap Aboriginal Health and the #Redfernstatement Its time for this new approach

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“Aboriginal Community Controlled Health Organisations deliver 2.5 million episodes of care a year in their local communities – and are the only health and leadership models making inroads on Close the Gap targets.

Our teachers, education professionals and family violence experts are delivering real results on the ground in their communities every single day – despite chronic underfunding and an ad hoc policy approach based on three year election cycles.

“Today we are seeking a new relationship, a genuine partnership and a commitment to ongoing structured engagement,”

National Congress of Australia’s First People’s Co-chair Dr Jackie Huggins said Aboriginal and Torres Strait Islander organisations have worked with our people on the ground for decades and have shown they have solutions.

 ” We acknowledge the strength of culture and kinship, and those strong bonds that can helpshape higher expectations and better outcomes.

I want to pay tribute in particular to the Indigenous women who demonstrate that strength every day. The mums and the grandmas and aunties and sisters, who never give up.

We must ensure that the education system, and all those in it, believe in the dreams of our young people. That we support each student and lift them up, and give them every opportunity to get the most out of their education.

I know that you would all agree that a solid education is the surest way to get from the firstIndigenous doctor, to the 500th and then the 5,000th “

Prime Minster Address to the Indigenous Business Reception see article 2 below

Aboriginal leaders seek new relationship with government through historic Redfern Statement

Aboriginal leaders seek new relationship with government through historic Redfern Statement Australia’s leading Aboriginal and Torres Strait Islander peaks will today demand a new relationship with government as they deliver the historic Redfern Statement direct to the Prime Minister at Parliament House.

In the lead up to today’s 9th Closing the Gap Report to Parliament, the leaders will call on the Prime Minister to support the historic Redfern Statement, a road map to better address the appalling disadvantage gap between Australia’s First

Peoples and non-Indigenous Australians by working with them as genuine partners.

National Congress of Australia’s First People’s co-chair Mr Rod Little said: “After 25 years, eight Federal election cycles, seven Prime Ministers, eight Ministers for Indigenous Affairs, 400 recommendations, and countless policies, policy changes, reports, funding promises and funding cuts, it’s time to draw a line in the sand.

“We need a new relationship that respects and harnesses our expertise, and guarantees us a seat at the table as equal partners when governments are making decisions about our lives.”

The Redfern Statement was released during last year’s Federal Election campaign by Aboriginal and Torres Strait Islander leaders from health, justice, children and families, disability, and family violence prevention sectors.

The statement calls for changes across these sectors through structured engagement with Aboriginal and Torres Strait Islander people, and is supported by more than 30 major mainstream organisations, including  the Australian Medical Association and Law Council.

Read the full Redfern Statement here: http://nationalcongress.com.au/aboutus/redfern-statement/

ABOUT THE REDFERN STATEMENT

The historic Redfern Statement calls for changes that address housing, health, education, justice, disability and representation for Aboriginal people, including:

Restoration of funding cut from the Indigenous Affairs Budget;

• Urgent reforms to the controversial Indigenous Advancement Strategy;

• Renewed commitment to closing the gap within a generation, with the inclusion of justice targets aimed at reducing incarceration and family violence;

• Re-establishment of the Department of Aboriginal and Torres Strait Islander Affairs;

• Restoration of funding for the National Congress of First Peoples – as a representative voice for Aboriginal people;

Restoration of funding to national peak bodies to co-design policy and drive implementation – allowing this new partnership to function effectively;

• Implementation of recommendations by the Council for Aboriginal Reconciliation – including an agreement-making framework (treaty) and constitutional reform.

The Redfern Statement has been developed by national Aboriginal and Torres Strait Islander peak and representative bodies including:

National Congress of Australia’s First Peoples

First Peoples Disability Network (FPDN)

National Aboriginal and Torres Strait Islander Legal Services (NATSILS)

National Aboriginal Community Controlled Health Organisations (NACCHO)

National Family Violence Prevention Legal Services (FVPLS)

SNAICC – National Voice for our Children

The Healing Foundation, and The National Health Leadership Forum (NHLF).

The Statement also has the overarching support of The Change the Record Coalition; Close the Gap Steering Committee, and Family Matters campaigns.

Prime Minster Address to the Indigenous Business Reception :

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Thank you, Shelley and thank you Tina and your family for that really moving Welcome to

Country.

Picture above Dakota Tompkins interviewing the Prime Minister

Yoonggu gulanyin ngalawiri, dhunayi, Ngoonawal dhowrrra.

Today we are meeting together on Ngunnawal country and we acknowledge and pay our respects to their elders.

I acknowledge and pay my deep respects to your people, the Ngunnawal people, who as you said Tina, have walked these lands, and met on these lands, forever, for time beyond our imagination, for time out of mind.

I extend our respects to all of your elders past and present and to the future elders, to the young dancers tonight, and to all our First Australian People and their elders, including of course, all of the outstanding achievers and role models here today.

Of course I want to acknowledge and welcome all of my ministerial and parliamentarycolleagues, especially Nigel Scullion, the Minister for Indigenous Affairs and of course Ken Wyatt, Minister for Aged Care and Indigenous Health and – as you know – the first Indigenous Australian to be a Minister in a Commonwealth Government.

Welcome all.

Now today is the 9th anniversary of the National Apology to the Stolen Generations.

We acknowledge today, as we did in the House earlier, the loss, the grief, and the heartache past policies created for our First Australians.

But despite these injustices and that trauma, you and your people have shown a courage and resilience which is extraordinary.

Tonight, we acknowledge the remarkable lives of so many Aboriginal and Torres Strait Islander Australians, who are thriving and succeeding in their chosen fields. Your stories are not deficit, but of surplus; not of despondency but of a relentless and determined optimism.

You lead and you inspire by your example. So many lives of achievement. Rishelle Hume, a senior human resources consultant at Chevron, whose work supporting Aboriginal people to grow in their careers spans two decades and many industries.

Cherisse Buzzacott, an Arrente woman who is helping women give birth safely and providing vital midwifery support to women in remote parts of the Northern Territory.

Or the Kongs—a family of firsts. Marilyn and Marlene were the first Indigenous medical graduates at Sydney University. Marlene became a GP and public health expert; Marilyn became the first Indigenous obstetrician and their brother Kelvin, the first Indigenous surgeon in Australia. Kelvin and his wife are here with us this evening.

Another young doctor, Vinka Barunga, is now the first Indigenous doctor in Derby, a town two hours out of Broome, where she grew up swimming, fishing and playing with a plastic stethoscope. She’s a proud Worora woman, going back to her community. She would have been here tonight, but work has called her away.

We also have with us Dr Cass Hunter, Mibu Fischer, and Karlie Noon—all working at CSIRO on research that impacts Indigenous communities. Karlie has just won a scholarship, one of two new CSIRO Aboriginal and Torres Strait Islander scholarships, to undertake postgraduate studies in STEM subjects. Congratulations, Karlie.

Tanya Denning, a talented journalist and producer now managing the National Indigenous Television station that celebrates Indigenous Culture, voices and storytelling.

And so many others; people working caring for country, in health, social services,education, science, technology, law, the arts, politics, public service, defence and much more.

We acknowledge the strength of culture and kinship, and those strong bonds that can helpshape higher expectations and better outcomes.

I want to pay tribute in particular to the Indigenous women who demonstrate that strength every day. The mums and the grandmas and aunties and sisters, who never give up.

We must ensure that the education system, and all those in it, believe in the dreams of our young people. That we support each student and lift them up, and give them every opportunity to get the most out of their education.

I know that you would all agree that a solid education is the surest way to get from the firstIndigenous doctor, to the 500th and then the 5,000th. To make sure that in years to come, we’re not talking about one or two hundred Indigenous lawyers or accountants, but thousands of them.

So I want to thank all the organisations, some of whom are here tonight, for their investment in the dreams of these young people: Aurora Foundation, the Australian Indigenous Mentoring Experience, Career Trackers, AFL Cape York House, and many more, but too many to name.

And already we can point to progress. In the seven years to 2015, the gap in Year 12 attainment shrunk by close to 15 percent, and in the decade to 2015, the number of

Indigenous students enrolling in higher education nearly doubled.

The higher the level of education, the smaller the gap between Indigenous and non- Indigenous employment. For tertiary-educated Indigenous people, there is no gap. There is no gap.

We are making progress, and you are part of it.

And each of you are Ambassadors for change. Your determination and resilience is a demonstration to others that through hard work, anything is possible. Your stories are vitally important, your example is vitally important in creating that change.

Indigenous life is extraordinarily diverse and extraordinarily rich. It unfolds in the remotest parts of our nation as well as in the heart of our busiest cities and suburbs; far away in the Tiwi Islands, right here in the centre of Government, in the bush and on the coast. It encompasses extraordinary talent, vision and determination.

So Tonight I want to challenge all those present, and people right across Australia to tell your stories. To widen our lens. To focus the attention of our nation, on your hard work and your achievements.

We want to have a nation where our indigenous children are limited only by their imagination.

To show Indigenous children from Shepparton to the Tiwi Islands, from Redfern to Alice Springs, that they can be anything they set their mind to.

That little girl can be anything she sets her mind to, Tina. That’s the dream, that’s the goal.

So that being Aboriginal and Torres Strait Islander means to be successful; to achieve, to have big dreams and high hopes, and to draw strength from your identity as an Indigenous man or woman in this great country.

There is a room full of role models right here.

When we include the stories like those we honour tonight, we shine a light on the richness and diversity of our First Australians. We light, you light, the way for others to follow.

So Congratulations on your success and thank you for paving the way for so many

Indigenous Australian success stories to come.

I am now honoured to invite another great role model, another inspiration, my dear friend,

the very wise Ken Wyatt, Minister for Aged Care, Minister for Indigenous Health, the first Indigenous Member of the House of Representatives and first Indigenous Minister in a Commonwealth Government.

[END]

 

NACCHO Aboriginal Health “Ministerial Champions ” visit our remote #ACCHOS #CapeYork and #DerbyWA

 

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 ” Ministerial champion ”  for Indigenous Health Ken Wyatt toured the Derby Aboriginal Health Service  with NACCHO CEO  Pat Turner : See background story 2 below

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Story 1

 ” Ministerial Champion for Wujal Wujal ” Leeanne Enoch MP, Minister for Innovation, Science and Digital Economy and Minister for Small Business recently visited the Apunipima Cape York Health Council.

Image (L-R) Director-General Jamie Merrick, Minister Enoch, Apunipima CEO Cleveland Fagan

The Minister, accompanied by the Government Champion for Wujal Wujal, Jamie Merrick, Director-General, Department of Science, Information Technology and Innovation met with Apunipima’s senior managers to discuss the services and activities Apunipima provides to Wujal Wujal – a remote Aboriginal community which lies 70 km south of Cooktown.

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The Champions program is based around supporting Mayors and communities to achieve the social and economic outcomes which they identify as important.

Apunipima CEO Cleveland Fagan said he welcomed the visit with the Minister and Director-General.

‘We were pleased to meet with Minister Enoch and Mr. Merrick to discuss our role in supporting the community and leadership in Wujal Wujal to achieve the goals that matter to the community.’

‘Apunipima provides culturally appropriate primary health care to the people of Wujal Wujal including a GP, Maternal and Child Health Nurse and Midwife, Podiatrist, Dietitian and Diabetes Educator.’

‘There are some real success stories when it comes to the health of the people of Wujal Wujal – 100 percent of children aged 12, 24 and 60 months are fully immunised, 75 percent of newborn bubs are within the normal weight range and nearly 90 percent of clients with type 2 diabetes have a GP Management Plan in place.’

‘There are some challenges, particularly around smoking rates and obesity and we will be working with community to address these health issues.’

‘We look forward to continuing to work closely with Minister Enoch and the Queensland Government to continue to improve the health of Aboriginal and Torres Strait Islander people living in Cape York.’

Story 2 Derby Aboriginal Health Service

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Mission

To deliver holistic primary health care services which;

  • ŸAre based on the social justice principles of equity and access
  • ŸAddress the needs of Aboriginal people, and
  • ŸRespect and reflect the cultural values of the communities we serve.

The Derby Aboriginal Health Service has been established by Aboriginal people for Aboriginal people, with the purpose of;

  • Empowering Aboriginal people in the prevention and management of ill-health, and in the promotion of well-being for individuals, families and communities, as well as;
  • Empowering Aboriginal people in the processes of decision-making, planning and service delivery

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History

In early 1995 Winun Ngari Aboriginal Corporation received funding from the Aboriginal and Torres Strait Islander Commission (ATSIC) to carry out a comprehensive health planning exercise for Aboriginal people and communities in the Jayida Buru Ward of the Malarabah ATSIC Regional Council of the West Kimberley.

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This region includes Aboriginal Communities in and around Derby town, south of Derby along the Fitzroy Valley, north east of Derby and along the Gibb River Road and Outstations north along the coast and up into the Mitchell Plateau.  The Jayida Buru Health Strategy was the result of this process, and was the first health strategy for Aboriginal people in the Derby region which was developed from the Aboriginal perspective.

Amongst its findings was recognition that:

“…there appears to be little acknowledgement of the diverse needs of these population groups in the structure and operation of most mainstream services in the Derby region.  These services often operate under constraints imposed by a Perth based policy and practise…and an organisational culture that excludes Aboriginal people from information and decision making”.

The Strategy outlined five key objectives;

  • Aboriginal community and self-management of health related issues
  • ŸService and program planning based on identical local health need
  • ŸA comprehensive, integrated and coordinated range of programs and services
  • ŸEquitable access to services
  • ŸAppropriate levels of resource allocation

and determined that;

“There are compelling reasons for the establishment of an Aboriginal Health Service in the Jayida Buru region; the health needs of the Aboriginal people in the region greatly exceed the capacity of the mainstream provider; the scope and models of mainstream service provision are not currently culturally appropriate or readily accessible; and there is no choice of health provider available to us.”

In April 1997 the Winun Ngari Aboriginal Corporation Committee established a Derby Aboriginal Medical Service (DAMS) Committee.  This committee, with the support of the Winun Ngari Committee and Administration, began its struggle to establish a culturally appropriate health service to address the concerns raised through the Jayida Buru Health Strategy.

Funding from the Office of Aboriginal and Torres Strait Islander Health (OATSIH) was received in early 1997.   On September 17, the first committee of the Derby Aboriginal Health Service Council was elected.

NACCHO Promotion

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NACCHO has announced the publishing date for the 9 th edition of Australia’s first national health Aboriginal newspaper, the NACCHO Health News .

Publish date 6 April 2017

Working with Aboriginal community controlled and award-winning national newspaper the Koori Mail, NACCHO aims to bring relevant advertising and information on health services, policy and programs to key industry staff, decision makers and stakeholders at the grassroots level.

And who writes for and reads the NACCHO Newspaper ?

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While NACCHO’s websites ,social media and annual report have been valued sources of information for national and local Aboriginal health care issues for many years, the launch of NACCHO Health News creates a fresh, vitalised platform that will inevitably reach your targeted audiences beyond the boardrooms.

NACCHO will leverage the brand, coverage and award-winning production skills of the Koori Mail to produce a 24 page three times a year, to be distributed as a ‘lift-out’ in the 14,000 Koori Mail circulation, as well as an extra 1,500 copies to be sent directly to NACCHO member organisations across Australia.

Our audited readership (Audit Bureau of Circulations) is 100,000 readers

For more details rate card

Contact : Colin Cowell Editor

Mobile : 0401 331 251

Email  : nacchonews@naccho.org.au

NACCHO Aboriginal Health and Chronic Disease #prevention

 

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 ” The Australian Chronic Disease Prevention Alliance recommends that the Australian Government introduce a health levy on sugar-sweetened beverages, as part of a comprehensive approach to decreasing overweight and obesity, and with revenue supporting public education campaigns and initiatives to prevent chronic disease and address childhood obesity.

A health levy on sugar-sweetened beverages should not be viewed as the single solution to the obesity epidemic in Australia.

Rather, it should be one component of a comprehensive approach, including restrictions on children’s exposure to marketing of these products, restrictions on their sale in schools, other children’s settings and public institutions, and effective public education campaigns[42].

Health levy on sugar-sweetened beverages

ACDPA Position Statement

Key messages

  •  The Australian Chronic Disease Prevention Alliance (ACDPA) recommends that the Australian Government introduce a health levy on sugar-sweetened beverages (sugary drinks)i, as part of a comprehensive approach to decreasing overweight and obesity.
  •  Sugar-sweetened beverage consumption is associated with increased energy intake and in turn, weight gain and obesity. Obesity is an established risk factor for type 2 diabetes, heart disease, stroke, kidney disease and certain cancers.
  •  Beverages are the largest source of free sugars in the Australian diet. One in two Australians usually exceed the World Health Organization recommendation to limit free sugars to 10% of daily intake (equivalent to 12 teaspoons of sugar).
  •  Young Australians are the highest consumers of sugar-sweetened beverages, along with Aboriginal and Torres Strait Islander people and socially disadvantaged groups.
  •  Young people, low-income consumers and those most at risk of obesity are most responsive to food and beverage price changes, and are likely to gain the largest health benefit from a levy on sugary drinks due to reduced consumption.
  •  A health levy on sugar-sweetened beverages in Australia is estimated to reduce consumption and potentially prevent thousands of cases of type 2 diabetes, heart disease and stroke over 25 years. The levy could generate revenue of $400-$500 million each year, which could support public education campaigns and initiatives to prevent chronic disease and address childhood obesity.
  •  A health levy on sugar-sweetened beverages should not be viewed as the single solution to the obesity epidemic in Australia. Rather, it should be one component of a comprehensive approach, including restrictions on children’s exposure to marketing of these products, restrictions on their sale in schools, other children’s settings and public institutions, and effective public education campaigns.

i ‘Sugar-sweetened beverages’ and sugary drinks are used interchangeably in this paper. This refers to all non-alcoholic water based beverages with added sugar, including sugar-sweetened soft drinks and flavoured mineral waters, fortified waters, energy and electrolyte drinks, fruit and vegetable drinks, and cordials. This term does not include milk-based products, 100% fruit juice or non-sugar sweetened beverages (i.e. artificial, non-nutritive or intensely sweetened). 2

About ACDPA

The Australian Chronic Disease Prevention Alliance (ACDPA) brings together five leading non-government health organisations with a commitment to reducing the growing incidence of chronic disease in Australia attributable to overweight and obesity, poor nutrition and physical inactivity. ACDPA members are: Cancer Council Australia; Diabetes Australia; Kidney Health Australia; National Heart Foundation of Australia; and the Stroke Foundation.

This position statement is one of a suite of ACDPA statements, which provide evidence-based information and recommendations to address modifiable risk factors for chronic disease. ACDPA position statements are designed to inform policy and are intended for government, non-government organisations, health professionals and the community.

www.acdpa.org.au

Chronic disease

Chronic diseases are the leading cause of illness, disability, and death in Australia, accounting for around 90% of all deaths in 2011[1]. One in two Australians (i.e. more than 11 million) had a chronic disease in 2014-15 and almost one quarter of the population had at least two conditions[2].

However, much chronic disease is actually preventable. Around one third of total disease burden could be prevented by reducing modifiable risk factors, including overweight and obesity, physical inactivity and poor diet[2].

Overweight and obesity

Overweight and obesity is the second greatest contributor to disease burden and increases risk of type 2 diabetes, heart disease, stroke, kidney disease and some cancers[2].

The rates of overweight and obesity are continuing to increase. Almost two-thirds of Australians are overweight or obese and one in four Australian children are already overweight or obese[2]. Children who are overweight are also more likely to grow up to become overweight or obese adults, with an increased risk of chronic disease and premature mortality[3].

The cost of obesity in Australia was estimated to be $8.6 billion in 2011-12, comprising $3.8 billion in direct costs and $4.8 billion in indirect costs[4]. If no further action is taken to slow obesity rates in Australia, the cost of obesity over the next 10 years to 2025 is estimated to total $87.7 billion[4].

Free sugars and weight gain

There is increasing evidence that high intake of free sugarsii is associated with weight gain due to excess energy intake and dental caries[5]. The World Health Organization (WHO) strongly recommends reducing free sugar intake to less than 10% of total energy intake (equivalent to around 12 teaspoons of sugar), or to 5% for the greatest health benefits[5].

ii ‘Free sugars’ refer to sugars added to foods and beverages by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates.

In 2011-12, more than half of Australians usually exceeded the recommendation to limit free sugar intake to 10%[6]. There was wide variation in the amounts of free sugars consumed, with older children and teenagers most likely to exceed the recommendation and adults aged 51-70 least likely to exceed the recommendation[6]. On average, Australians consumed around 60 grams of free sugars each day (around 14 teaspoons)[6]. Children and young people were the highest consumers, with adolescent males and females consuming the equivalent of 22 and 17 teaspoons of sugar each day respectively [6].

Beverages contribute more than half of free sugar intake in the Australian diet[6]. In 2011-12, soft drinks, sports and energy drinks accounted for 19% of free sugar intake, fruit juices and fruit drinks contributed 13%, and cordial accounted for 4.9%[6]. 3

Sugar-sweetened beverage consumption

In particular, sugar-sweetened beverages are mostly energy-dense but nutrient-poor. Sugary drinks appear to increase total energy intake due to reduced satiety, as people do not compensate for the additional energy consumed by reducing their intake of other foods or drinks[3, 7]. Sugar-sweetened beverages may also negatively affect taste preferences, especially amongst children, as less sweet foods may become less palatable[8].

Sugar-sweetened beverages are consumed by large numbers of Australian adults and children[9], and Australia ranks 15th in the world for sales of caloric beverages per person per day[10].

One third of Australians consumed sugar-sweetened beverages on the day before the Australian Health Survey interview in 2011-12[9]. Of those consuming sweetened beverages, the equivalent of a can of soft drink was consumed (375 mL)[9]. Children and adolescents were more likely to have consumed sugary drinks than adults (47% compared with 31%), and consumption peaked at 55% amongst adolescents[9]. Males were more likely than females to have consumed sugary drinks (39% compared with 29%)[9].

Australians living in areas with the highest levels of socioeconomic disadvantage were more likely to have consumed sugary drinks than those in areas of least disadvantage (38% compared with 31%)[9]. Half of Aboriginal and Torres Strait Islander people consumed sugary drinks compared to 34% of non-Indigenous people[9]. Amongst those consuming sweetened beverages, a greater amount was consumed by Aboriginal and Torres Strait Islanders than for non-Indigenous people (455 mL compared with 375 mL)[9]. 4

The health impacts of sugar-sweetened beverage consumption

WHO and the World Cancer Research Fund (WCRF) recommend restricting or avoiding intake of sugar-sweetened beverages, based on evidence that high intake of sugar-sweetened beverages may increase risk of weight gain and obesity[7, 11]. As outlined earlier, obesity is an established risk factor for a range of chronic diseases[2].

The Australian Dietary Guidelines recommend limiting intake of foods and drinks containing added sugars, particularly sugar-sweetened beverages, based on evidence of a probable association between sugary drink consumption and increased risk of weight gain in adults and children, and a suggestive association between soft drink consumption and an increased risk of reduced bone strength, and dental caries in children[3].

Type 2 diabetes

Sugar-sweetened drinks may increase the risk of developing type 2 diabetes[3]. Evidence indicates a significant relationship between the amount and frequency of sugar-sweetened beverages consumed and increased risk of type 2 diabetes[12, 13]. The risk of type 2 diabetes is estimated to be 26% greater amongst the highest consumers (1 to 2 servings/day) compared to lowest consumers (<1 serving/month)[13].

Cardiovascular disease and stroke

The consumption of added sugar by adolescents, especially sugar-sweetened soft drinks, has been associated with multiple factors that can increase risk of cardiovascular disease regardless of body size, and increased insulin resistance among overweight or obese adolescents[14].

A high sugar diet has been linked to increased risk of heart disease mortality[15, 16]. Consuming high levels of added sugar is associated with risk factors for heart disease such as weight gain and raised blood pressure[17]. Excessive dietary glucose and fructose have been shown to increase the production and accumulation of fatty cells in the liver and bloodstream, which is linked to cardiovascular disease, and kidney and liver disease[18]. Non-alcoholic fatty liver disease is one of the major causes of chronic liver disease and is associated with the development of type 2 diabetes and coronary heart disease[18].

There is also emerging evidence that sugar-sweetened beverage consumption may be independently associated with increased risk of stoke[19].

Chronic kidney disease

There is evidence of an independent association between sugar-sweetened soft drink consumption and the development of chronic kidney disease and kidney stone formation[20]. The risk of developing chronic kidney disease is 58% greater amongst people who regularly consume at least one sugar-sweetened soft drink per day, compared with non-consumers[21].

Cancer

While sugar-sweetened beverages may contribute to cancer risk through their effect on overweight and obesity, there is no evidence to suggest that these drinks are an independent risk factor for cancer[7]. 5

A health levy on sugar-sweetened beverages

WHO recommends that governments consider taxes and subsidies to discourage consumption of less healthy foods and promote healthier options[22]. WHO concludes that there is “reasonable and increasing evidence that appropriately designed taxes on sugar-sweetened beverages would result in proportional reductions in consumption, especially if aimed at raising the retail price by 20% or more”[23].

Price influences consumption of sugar-sweetened beverages[24, 25]. Young people, low-income consumers and those most at risk of obesity are most responsive to food and beverage price changes, and are likely to gain the largest health benefit from a levy on sugary drinks due to reduced consumption[23]. While a health levy would result in lower income households paying a greater proportion of their income in additional tax, the financial burden across all households is small, with minimal differences between higher- and lower-income households (less than $5 USD per year)[26].

A 2016 study modelled the impact of a 20% ad valorem excise tax on sugar-sweetened beverages in Australia over 25 years[27]. The levy could reduce sugary drink consumption by 12.6% and reduce obesity by 2.7% in men and 1.2% in women[27]. Over 25 years, there could be 16,000 fewer cases of type 2 diabetes, 4,400 fewer cases of ischaemic heart disease and 1,100 fewer strokes[27]. In total, 1,600 deaths could potentially be prevented[27].

The 20% levy was modelled to generate more than $400 million in revenue each year, even with a decline in consumption, and save $609 million in overall health care expenditure over 25 years[27]. The implementation cost was estimated to be $27.6 million[27].

A separate Australian report is supportive of an excise tax on the sugar content of sugar-sweetened beverages, to reduce consumption and encourage manufacturers to reformulate to reduce the sugar content in beverages[28]. An excise tax at a rate of 40 cents per 100 grams was modelled to reduce consumption by 15% and generate around $500 million annually in revenue[28]. While a sugary drinks levy is not the single solution to obesity, the introduction of a levy could promote healthier eating, reduce obesity and raise revenue to combat costs that obesity imposes on the broader community.

There is public support for a levy on sugar-sweetened beverages. Sixty nine percent of Australian grocery buyers supported a levy if the revenue was used to reduce the cost of healthy foods[29]. A separate survey of 1,200 people found that 85% supported levy revenue being used to fund programs reducing childhood obesity, and 84% supported funding for initiatives encouraging children’s sport[30].

An Australian levy on sugar-sweetened beverages is supported by many public health groups and professional organisations.

 

NACCHO Aboriginal Health Funding alert : $13.1m infrastructure grants for existing regional, rural and remote general practices.

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 ” Grants may be used for a range of infrastructure projects, including construction, fit-out and/or renovation of an existing general practice building, supply and installation of information and communication technology equipment or medical equipment.

Grants of up to $300,000 will be provided to successful applicants in 2017. All successful applicants will be required to match the Commonwealth funding contribution.”

Assistant Minister for Rural Health Dr David Gillespie

“Improved training facilities, such as communication technology, will also ensure that rural doctors can increase their own training opportunities, so they can continue to keep their skills current and maintain their practice at the high level that they strive for and that rural communities deserve.”

Dr Ewen McPhee, President of the Rural Doctors Association of Australia (RDAA) see full press release below

The Australian Government has committed $13.1 million in funding under the Rural General Practice Grants Program (the Program) for grants up to $300,000 each to deliver improved health services through additional infrastructure, increased levels of teaching and training for health practitioners, and more opportunities to deliver ‘healthy living’ education to local communities.

The Program will provide an opportunity for general practices within Modified Monash Classification 2-7 to deliver increased health services in rural and regional communities.

The Program commences with a call for Expressions of Interest (EOI), in which suitable organisations will be identified and subsequently invited to submit a full application.

Project Officer Details Name: Health State Network
Ph: 02 6289 5600 E-mail: Grant.ATM@health.gov.au
Closing date 2:00 pm AEDST on 13 December 2016

Submit your detail here

Teaching, training and retaining the next generation of health workers in rural, regional and remote Australia is a priority for the Coalition Government.

Assistant Minister for Rural Health Dr David Gillespie said the Coalition Government has moved to streamline the former Rural and Regional Teaching Infrastructure Grants program to better respond to the needs of rural communities and support the work of rural general practices.

“A more streamlined and simplified two-step application process is now open through the new Rural General Practice Grants (RGPG) program,” Dr Gillespie said.

“General practice in rural Australia faces unique challenges in healthcare including the ability to attract and retain a health workforce.

“The RGPG program will enable existing health facilities to provide teaching and training opportunities for a range of health professionals within the practice and for practitioners to develop experience in training and supervising healthcare workers.

“I believe that strong, accessible primary care in regional Australia helps alleviate pressure on the public hospital system and at the same time it also provides opportunities for earlier intervention and better patient outcomes.”

“Our Government wants Australians, no matter where they live, to have access to quality health services,” Dr Gillespie said.

“I also want our health professionals who live and work in rural, regional and remote Australia to have access to teaching and training opportunities so they remain in general practice and in the communities that need them the most.”

Grant documentation will be available from the Department of Health’s Tenders and Grants page at www.health.gov.au/tenders.

Rural doctors congratulate government on new grants program

Australian rural doctors are today welcoming the announcement of a streamlined Rural General Practice Grants (RGPG) program, just announced by Dr David Gillespie, Assistant Minister for Rural Health.

Dr Ewen McPhee, President of the Rural Doctors Association of Australia (RDAA), said that the announcement was a reflection of the importance the Coalition Government places on rural and remote health care.

“We are extremely pleased that Minister Gillespie has been so proactive in his Rural Health portfolio, and he has shown a great understanding of the need for increased training facilities to enable the education of the next generation of rural doctors,” Dr McPhee said.

“The RGPG will allow more of our highly skilled doctors in rural areas to improve their training capacity, allowing them to take on more young doctors in training and ensure they have access to quality educational opportunities in rural areas.

“Research shows us that young doctors who undertake training in rural areas, and have a good experience in their placement, are more likely to choose rural medicine as a career.

“Grants enabling doctors to improve and expand their training facilities will play a key role in the recruitment and retention of the rural doctor workforce of the future,” Dr McPhee said.

While infrastructure grants have been available for rural practices for some time, the application process was onerous, complicated and time consuming, putting it out of the reach of many small practices who did not have the time or expertise to successfully apply.

Grants can be used for a range of projects, including construction, fit-out and/or renovation of an existing general practice building, supply and installation of information and communication technology equipment or medical equipment.

“Simplifying and streamlining the process will ensure that these smaller clinics will no longer be disadvantaged by the system,” Dr McPhee said.

Many doctors enjoy the opportunity to engage with young doctors and be a part of their training journey. We look forward to more of our colleagues being able to participate in this way thanks to the Coalition’s commitment to rural health.

“Improved training facilities, such as communication technology, will also ensure that rural doctors can increase their own training opportunities, so they can continue to keep their skills current and maintain their practice at the high level that they strive for and that rural communities deserve.

“We thank Minister Gillespie for his recognition of the importance of this area.”

The third Rural Health Stakeholder Roundtable was held at Parliament House in Canberra on the 16 November 2016.

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Twenty years ago one of Australia’s greatest health challenges was a lack of doctors coming through the system.

Today, that challenge has been overcome with latest research predicting a surplus of 7000 doctors by 2030,” the Federal Minister for Rural Health, Dr David Gillespie, said today.

“The new challenge is no longer the number of doctors in our nation’s health workforce, but where they are distributed.

“This issue, along with the need for greater numbers of allied health professionals in the bush, are among the major topics to be discussed at the third Rural Health Stakeholder Roundtable at Parliament House in Canberra today,” Dr Gillespie said.

“The Roundtable was attended by an impressive representation of rural health stakeholders, from rural doctors associations, medical educators, rural health consumer and advocacy groups, Aboriginal medical services, rural and remote allied health organisations and health workforce professionals.

“We have an outstanding health workforce in the regional, rural and remote areas of this country and today’s roundtable is designed to get all the key players together with government to work out the very best strategies to support them and the work they do for our more isolated communities.”

Minister Gillespie said the Coalition Government is investing record funding in health as part of its commitment to strengthen the regional, rural and remote health system so that Australians living in these areas have access to the best care available.

“Our Government is working in partnership with these people to deliver health care to rural and remote communities through a broad range of initiatives as part of our record funding investment in the health portfolio.”

The Roundtable will discuss today the establishment of the National Rural Health Commissioner (the Commissioner), a new role to champion the cause of rural practice.

The Commissioner will work with rural, regional and remote communities, the health sector, universities, specialist training colleges and across all levels of Government to improve rural health policies.

Another priority item on the agenda is the development of the National Rural Generalist Pathway. This will improve access to training for doctors in rural, regional and remote Australia, and recognise the unique combination of skills required for the role of a rural generalist.

“General practitioners with advanced skills in areas such as general surgery, obstetrics, anaesthetics and mental health are commonly required in the bush also,” Dr Gillespie said.

“We want to make sure these skills are encouraged, developed and properly remunerated.”

Minister Gillespie said the Coalition Government had increased its investment in education and training initiatives both in medical and allied health professions to create a longer term ‘pipelines’ of boosting the rural health workforce.

“The new multidisciplinary training pipeline incorporating the Rural Clinical Schools and University Departments of Rural Health across regional Australia will be a critical component as we boost the capacity of training through our investment in Regional Training Hubs to bring more doctors and allied health professionals to the bush,” he said.

In response to recommendations put forward to the Rural Classification Technical Working Group, an independent group that has assisted the Government to implement the new geographical classification system, I announce today that more support will be provided to medical practitioners working in Cloncurry, Queensland and Roebourne, Western Australia.

“I am pleased to also announce an additional workforce support in the form of a rural loading will be applied to all doctors working in these two towns from 1 January 2017,”  Minister Gillespie said.

“The additional loading will be up to $25,000 per annum through the General Practice Rural Incentives Program and will recognise exceptional circumstances faced in attracting and retaining a workforce in these locations.

“The Coalition Government’s broader health reforms will have direct benefits for regional, rural and remote health, with the patient at the centre of care. Localised, integrated, community-driven health care is the order of the day,” Dr Gillespie said.

“The Rural Health Stakeholder Roundtable is a central part of informing policy reform in rural Australia and I am looking forward to fruitful discussions with participants today.”

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NACCHO #ABS Aboriginal Health Download Report : Consumption of Food Groups from the Australian Dietary Guidelines, 2012-13

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Aboriginal and Torres Strait Islanders consume too little of the five major food groups and too much sugar and other discretionary foods, according to figures released by the Australian Bureau of Statistics (ABS) today.

DOWNLOAD the Report

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Like the rest of the population, Aboriginal and Torres Strait Islander peoples’ diets fail to meet the 2013 Australian Dietary Guidelines, which recommend minimum serves for vegetables, fruit, dairy products, lean meats and alternatives, and grain-based foods.

ABS Director of Health, Louise Gates said the latest results showed Aboriginal and Torres Strait adults consumed an average of 2.1 serves of vegetables per day, which is less than half of the 5-6 serves recommended by the Guidelines.

“Aboriginal and Torres Strait Islander adults consumed almost one serve (or 30 per cent) less vegetables than non-Indigenous people,” said Ms Gates.

“They also consumed just one serve of fruit on average, half the recommended two serves per day.”

In remote Australia, Aboriginal and Torres Strait Islander people consumed less than one serve (0.9) of fruit (e.g. less than one medium sized apple) and less than one serve (0.9) of dairy products (e.g. less than one cup of milk) per day, which was lower than those living in urban areas (1.3 serves for both fruit and dairy products).

However, Aboriginal and Torres Strait Islander people living in remote areas consumed around half a serve more of grain foods and lean meats and alternatives than people living in urban areas.

“The data also shows that 41 per cent of the population’s total daily energy intake came from energy-dense, nutrient-poor ‘discretionary foods’, such as sweetened beverages, alcohol, cakes, confectionery and pastry products,” said Ms Gates.

On average, this equates to over six serves of discretionary foods per day, triple the number of vegetable serves consumed. The Australian Dietary Guidelines recommend limiting discretionary foods to occasional, small amounts.

KEY FINDINGS

The 2013 Australian Dietary Guidelines (ADG or the Guidelines) recommend that Australians “Enjoy a wide variety of nutritious foods from the Five Food Groups every day and drink plenty of water”.1

This publication provides analysis on the consumption of the Five Food groups from the Australian Dietary Guidelines using nutrition data collected in the 2012-13 National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey (NATSINPAS).

FIVE FOOD GROUPS

In 2012-13, Aboriginal and Torres Strait Islander people consumed an average total of 10 serves of foods from the Five Food Groups per day.

Vegetables and legumes/beans group

    • Aboriginal and Torres Strait Islander people aged two years and over consumed an average of 1.8 serves of vegetables and legumes/beans per day compared with 2.7 among non-Indigenous people.
    • The number of vegetable serves consumed increased with age, with children aged 2-18 years consuming 1.4 serves per day on average compared with 2.1 among adults aged 19 years and over.
    • The average daily consumption of vegetable and legumes/beans serves for each age-sex group of Aboriginal and Torres Strait Islander people was considerably less than the respective recommendations.

Fruit group

    • Around 1.2 serves of fruit (including fruit juice and dried fruit) were consumed per day on average by Aboriginal and Torres Strait Islander people aged two years and over, compared with 1.5 serves per day in the non-Indigenous population.
    • Fresh or canned fruit made up 62% and one-third (34%) came from fruit juice.
    • Children consumed more serves of fruit than adults, averaging 1.6 serves per day compared with 1.0 respectively.
    • Aboriginal and Torres Strait Islander people living in non-remote areas consumed more serves of fruit on average than those living in remote areas (1.3 serves compared with 0.9).
    • The average daily consumption of 1.0 serves of fruit by Aboriginal and Torres Strait Islander adults was half the recommended two serves.

Milk, yoghurt, cheese and alternatives group

    • Aboriginal and Torres Strait Islander people aged two years and over consumed an average of 1.2 serves of milk, yoghurt, cheese and alternatives per day, compared with 1.5 serves among non-Indigenous people.
    • Dairy milk made up almost two-thirds (65%) of this food group, followed by cheese (30%).
    • The average daily consumption of milk, yoghurt, cheese and alternatives for each age-sex group of Aboriginal and Torres Strait Islander people, with the exception of children aged 2-3 years and girls 4-8 years, was considerably lower than the respective recommend number of serves.

Lean meats and poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans group

    • The average consumption of lean meats and poultry, fish, eggs, tofu, nuts and seeds and legumes/beans was around 1.6 serves per day for Aboriginal and Torres Strait Islander people aged two years and over, slightly less than for non-Indigenous Australians (1.7 serves).
    • People living in remote areas consumed more serves of lean meats and poultry, fish, eggs, tofu, nuts and seeds and legumes/beans than those living in non-remote areas (2.0 serves compared with 1.4).
    • Lean red meats made up almost half (49%) of the serves of lean meats and poultry, fish, eggs, tofu, nuts and seeds and legumes/beans. The contribution of lean red meats was higher for people living in remote areas compared with non-remote (61% compared with 44%)
    • The average daily consumption of lean meats and poultry, fish, eggs, tofu, nuts and seeds and legumes/beans for each age-sex group of Aboriginal and Torres Strait Islander people, with the exception of girls 2-3 years, was considerably less than the respective recommendations.


Grain (Cereal) foods group

    • On average, Aboriginal and Torres Strait Islander people aged two years and over consumed around 4.1 serves of grain (cereal) foods per day, compared with 4.5 serves among non-Indigenous Australians.
    • Aboriginal and Torres Strait Islander people in remote areas consumed more serves of grain (cereal) foods on average than those in non-remote areas (4.6 serves compared with 4.0 serves)
    • One-quarter (25%) of grain (cereal) foods consumed were from wholegrain and/or high fibre varieties.
    • The average number of serves of grain (cereal) foods consumed by Aboriginal and Torres Strait Islander boys aged 4-13 years and girls aged 4-11 was equal to or greater than the recommendation.

WATER

The Guidelines also include the recommendation that Australians drink plenty of water. In 2012-13, the average amount of plain water, including both bottled and tap, consumed by Aboriginal and Torres Strait Islander people was around one litre per day (997 ml), 76 ml less than the average for non-Indigenous people (1,073 ml). An additional 262 ml of water was consumed from other non-discretionary beverages such as tea and coffee. Plain water contributed just under half (48%) of Aboriginal and Torres Strait Islander peoples’ total beverage consumption, slightly less than that of non-Indigenous Australians (50%).

UNSATURATED SPREADS AND OILS

The Guidelines also recommend a daily allowance for unsaturated fats, oils and spreads. In 2012-13, Aboriginal and Torres Strait Islander people aged 2 years and over consumed an average 1.4 serves of unsaturated spreads and oils from non-discretionary sources.

DISCRETIONARY FOODS

The Guidelines recommend that discretionary foods (i.e. those not necessary for nutrients but are often high in saturated fat, salt, sugar or alcohol) are only consumed sometimes and in small amounts. However, over two-fifths (41%) of total daily energy in 2012-13 came from foods and beverages classified as discretionary. 2

According to the Guidelines, a serve of discretionary food is around 500-600 kJ. Based on this, Aboriginal and Torres Strait Islander people consumed an average of 6.1 serves of discretionary foods per day, which was higher than the non-Indigenous population average of 5.5 serves. The leading contributors to serves of from discretionary foods were alcoholic beverages (10%), soft drinks (9.1%), potato products such as chips and fries (8.2%), pastries (7.1%), cakes and muffins (6.4%) and confectionary (6.3%).

This graph shows the mean serves consumed from the five Australian Dietary Guidelines food groups and unsaturated spreads and oils from non-discretionary sources plus serves of discretionary foods for Australians aged 2 years and over by Indigenous status

(a) Based on Day 1. See Glossary for definition.
(b) From non-discretionary sources unless otherwise specified.
(c) A discretionary serve is defined as 500-600 kJ. Discretionary serves were derived by summing energy from discretionary foods and dividing by 550 kJ. Does not include meats that do not meet the ADG criteria but are not flagged as discretionary.
Sources: National Aboriginal and Torres Strait Islander Nutrition and Physical Activity Survey, 2012-13 and the National Nutrition and Physical Activity Survey, 2011-12.

ENDNOTES

1. National Health and Medical Research Council, 2013, Australian Dietary Guidelines. Canberra: Australian Government. <https://www.nhmrc.gov.au/_files_nhmrc/publications/attachments/n55_australian_dietary_guidelines_130530.pdf >, Last accessed 27/10/2016

2. See discussion of Discretionary foods from 4364.0.55.007 – Australian Health Survey: Nutrition First Results – Foods and Nutrients, 2011-12, <http://www.abs.gov.au/ausstats/abs@.nsf/Lookup/by%20Subject/4364.0.55.007~2011-12~Main%20Features~Discretionary%20foods~700 >

More details are available in Australian Aboriginal and Torres Strait Islander Health Survey: Consumption of food groups from Australian Dietary Guidelines (cat. no. 4727.0.55.008), available for free download from the ABS website, http://www.abs.gov.au.

partnerships-naccho

1. Call to action to Present
at the 2016 Members Conference closing 8 November
See below or Download here

2.NACCHO Partnership Opportunities

3. NACCHO Interim 3 day Program has been released

4. The dates are fast approaching – so register today

 

NACCHO #APSAD @APSADConf Aboriginal Health and #ICE :New study show #Ice use in rural Australia has more than doubled since 2007

 

An ice pipe in Melbourne, Monday, July 2, 2007. The item was one of 76,00 dangerous products seized last financial year, a record total haul for an Australian state or territory. (AAP Image/Julian Smith) NO ARCHIVING

” The study has raised particular concerns given rural Australians already have poorer health outcomes, with shorter life expectancies and significantly higher mortality rates, mental illness, chronic disease, family and domestic violence and more.

 A complex, variable picture has emerged of methamphetamine use across the country, What is clear is that there has been a disproportionately larger increase in the misuse of methamphetamine, including crystal methamphetamine, in rural locations compared to other Australian locations.

 At the same time, it’s very concerning there has been no increase in the number of people accessing help in rural areas. We need to urgently establish whether existing support services simply don’t have the capacity to deal with demand for drug treatment, or whether there are there significant reasons.

 Contributing factors to rural drug problems include lower educational attainment, low socioeconomic status, higher unemployment, isolation and the deliberate targeting of rural communities by illegal distribution networks.

Professor Ann Roche, Director of the National Centre for Education and Training on Addiction at Flinders University.

Read 51 NACCHO Articles about Aboriginal Health and Ice

 

Australians is on the rise have now been confirmed with the first documented evidence released today at the APSAD Scientific Alcohol and Drugs Conference.

The study – the most detailed examination to date – found lifetime and recent methamphetamine and recent crystal methamphetamine (ice) use is significantly higher among rural than other Australians, at rates double or more.

In addition, recent crystal methamphetamine use in rural Australia has more than doubled since 2007 – increasing by 150 per cent from 0.8 per cent to 2.0 per cent of people reporting lifetime and recent use.

“For some time now there have been anecdotal reports suggesting a high and increasing level of methamphetamine use in rural Australia, but this was unsupported by evidence.

Now we have this proof, the next challenge is to understand why and determine how we can best tackle this problem,” said Professor Ann Roche, Director of the National Centre for Education and Training on Addiction at Flinders University.

Significantly, more rural men and employed rural Australians use methamphetamine than their city, regional or Australian counterparts, with use most prevalent in men aged 18-25 years.

Recent methamphetamine use in rural teens aged 14-17 years also appears to be much higher than in urban areas.

The study has raised particular concerns given rural Australians already have poorer health outcomes, with shorter life expectancies and significantly higher mortality rates, mental illness, chronic disease, family and domestic violence and more.

“Our findings warrant targeted attention, especially given the pre-existing health and social vulnerabilities of rural Australians. We need tailored strategies and interventions to address this growing health problem,” said Professor Roche.

The research is being presented for the first time at the annual summit of the Australasian Professional Society on Alcohol and other Drugs (APSAD), the APSAD Scientific Alcohol and Drugs Conference, held in Sydney from 30 October to 2 November.

Ice campaign/youth: Did the federal government’s campaign, ‘What are you doing on ice’ really work?

Barriers to treatment: What are the most significant obstacles preventing people seeking treatment for their methamphetamine use? Available upon request

Women/Methamphetamines: A look at the specific treatment barriers faced by women and how to overcome them.

The global burden of methamphetamine disorders: An overview of the proportion of disease burden attributable to substance use disorders and differences in the distribution and burden of amphetamine use disorders between countries, age, sex, and year.

New treatment for methamphetamine addiction: Treatment options for methamphetamine dependence are currently limited, but a drug licensed in Australia for the treatment of attention deficit hyperactivity disorder could be an important innovation.

Comorbid mental and substance use disorders: The top 10 causes of burden of disease in young Australians (15-24 years) are dominated by mental health and substance use disorders.

OTHER MONDAY HIGHLIGHTS

 Opening by The Hon. (Pru) Prudence Jane Goward, MP NSW Minister for Medical Research, Minister for Prevention of Domestic Violence and Sexual Assault, and Assistant Minister for Health

Cannabis as Medicine in Australia: Where are we now, where are we heading to, where might we end up? Professor Nicholas Lintzeris

Friend or Enemy? Emeritus Professor Geoffrey Gallop, Director, Graduate School of Government, University of Sydney and Former Premier of Western Australia

About APSAD Sydney 2016

The APSAD Scientific Alcohol and Drugs Conference is the southern hemisphere’s largest summit on alcohol and other drugs attracting leading researchers, clinicians, policy makers and community representatives from across the region. The Conference is run by the Australasian Professional Society on Alcohol and other Drugs (APSAD), Asia Pacific’s leading multidisciplinary organisation for professionals involved in the alcohol and other drug field.

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This year’s theme: Strengthening Our Future through Self Determination

As you are aware, the  2016 NACCHO Members’ Meeting and Annual General Meeting will be in Melbourne this year 6-8 December
1. Call to action to Present
at the 2016 Members Conference closing 8 November
See below or Download here

2.NACCHO Partnership Opportunities

3. NACCHO Interim 3 day Program has been released

4. The dates are fast approaching – so register today

An ice pipe in Melbourne, Monday, July 2, 2007. The item was one of 76,00 dangerous products seized last financial year, a record total haul for an Australian state or territory. (AAP Image/Julian Smith) NO ARCHIVING

NACCHO Aboriginal Women’s Health : Cancer support group leader urges her mob to get regular, free breast screens

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“Many women ignore the BreastScreen Australia invitation when it arrives in the mail. They often think that breast cancer won’t happen to them. But breast cancer doesn’t discriminate, it can happen to anyone.

90% of women diagnosed with breast cancer don’t have a family history.

Go and get screened. Don’t leave it. BreastScreen Australia is a free service; so there is no reason why women shouldn’t participate,”

Margarette Fisher, a Ngarrindjeri woman who lives in Perth, has facilitated a small cancer support group for the past four years.

See below links for Breastscreen materials for Aboriginal and Torres Strait Islander peoples

Alongside facilitating the group, she is a specialist coordinator at Derbarl Yerrigan Health Centre and has been in the Aboriginal health industry for many years. She has seen first-hand the effects that breast cancer has had on her family, group members, and the community.

Margarette explains that early detection is so important because breast cancer affects not only the family involved, but the whole community.

“That’s why it’s good to catch it early instead of leaving it too late. The heart ache it causes. When we’ve lost someone we know, the whole community feels it. It’s a big thing.”

Margarette encourages women to get regular breast screens every two years because they can pick up abnormalities before people can feel them or notice any symptoms.

“I think even if you feel healthy and don’t show signs, you should get checked out just to be on the safe side.”

The BreastScreen van travels to communities and various locations, including Derbarl Yerrigan, every two years. Margarette says that some women get shame or feel uncomfortable about getting their breasts screened but afterwards are happy to have done their mammogram.

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“If you’re feeling a little bit stressed or uncomfortable you can always bring a friend or family member with you to your appointment,” says Margarette.

After their mammogram I’ll ask them “was it that bad?” and they say “oh no I don’t know what I got all stressed about.” And when you say to them “so will you come back in a couple of years?” They say, “yeah, we’ll be back.”

“Many women ignore the BreastScreen Australia invitation when it arrives in the mail. They often think that breast cancer won’t happen to them. But breast cancer doesn’t discriminate, it can happen to anyone. 90% of women diagnosed with breast cancer don’t have a family history. Go and get screened. Don’t leave it.”

“BreastScreen Australia is a free service; so there is no reason why women shouldn’t participate,” she says.

BreastScreen Australia invites all women aged 50 to 74 for free breast screening. Aboriginal and Torres Strait Islander women can get a free BreastScreen test every two years, which is the best way to detect breast cancer early.

Call 13 20 50 and make an appointment at your nearest BreastScreen Australia clinic, or visit one of the mobile clinics when it comes to your community.

Materials for Aboriginal and Torres Strait Islander peoples

How you can share positive health messages and  stories about Aboriginal Community Controlled Health issues ? Closing this week for advertising and editorial

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Editorial Opportunities : We are now looking to all our members, programs and sector stakeholders for advertising, compelling articles, eye-catching images and commentary for inclusion in our next edition.Maximum 600 words (word file only) with image

More info and Advertising rate card

Contact editor Colin Cowell 0401 331 251

or email nacchonews@naccho.org.au

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REGISTER HERE

NACCHO #NTRC Royal Commission and Aboriginal Health : #FASD , Malnutrition, hearing and #mentalhealth are major factors

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 ” The profoundly damaging consequences of heavy drinking by pregnant women, malnutrition in early childhood and intergenerational “psychic trauma” are neither properly diagnosed nor treated in Aborigines coming into contact with the law, a royal commission has heard.

The effects of these conditions, which can stunt a child for life, meant affected youngsters were both more likely to become involved in criminal activity and less likely to benefit from punitive forms of rehabilitation.”

As reported in the Australian today

 ” Studies linked FAS-D to a “profound level of social morbidity in terms of violence, engagement in the justice system, depression, suicidal thoughts, suicide, very low chance of meaningful occupation and a very high risk of being in prison as adults requiring mental institution and support with drug addiction

Professor Boulton and NACCHO FASD Articles

 ” Most infants with FASD are irritable, have trouble eating and sleeping, are sensitive to sensory stimulation, and have a strong startle reflex. They may hyperextend their heads or limbs with hypertonia (too much muscle tone) or hypotonia (too little muscle tone) or both. Some infants may have heart defects or suffer anomalies of the ears, eyes, liver, or joints.

Adults with FASD have difficulty maintaining successful independence. They have trouble staying in school, keeping jobs, or sustaining healthy relationships. They require long-term support and some degree of supervision in order to succeed. “

Make FASD History  Image above a full story see below

 “Many boys caught up in the Northern Territory’s juvenile justice system suffer a “disease of disadvantage” that has crippled almost every aspect of their lives, the Northern Territory’s royal commission into youth detention and protection has heard.

Jody Barney, who works as a deaf indigenous community consultant, told the inquiry she has spoken to several young Aboriginal people with hearing impairments who have had their faces covered by spit hoods and bound behind bars.

News Report

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The Royal Commission website is available at https://www.childdetentionnt.royalcommission.gov.au.

Moreover they were perpetuating, meaning the effects could be passed through neurological and genetic means from generation to generation, the Royal Commission into the Protection and Detention of Children in the NT heard today.

The Commission looks likely to probe these effects more deeply, following depressing but insightful evidence given by University of Newcastle professor of pediatrics John Boulton, who clearly captured the commissioners’ interest.

“I think the Foetal Alcohol Spectrum Disorder issue, together with the evidence that we have had this afternoon about deafness, throws such a complexion upon the participation of so many of these children in the criminal justice system, not to mention the child protection system, that we need to look at this carefully,” Commissioner Margaret White said.

“I think it’s fairly original inasmuch as the other many reports that we’ve been exposed to … have not had an opportunity to consider these areas of study.”

Professor Boulton told the Commission there was an urgent need for FAS-D and to be recognised under the National Disability Insurance Scheme. He said estimates in Canada of the lifelong cost of treating the condition reached into the millions of dollars.

“If there are one or two per cent of the total population of whom a fraction are severely affected with FASD, and therefore suffer the huge mental health and other subsequent complications and disabilities with FASD, then we are talking about an enormous burden to the overall Australian community in the tens of millions of dollars,” he said.

Studies linked FAS-D to a “profound level of social morbidity in terms of violence, engagement in the justice system, depression, suicidal thoughts, suicide, very low chance of meaningful occupation and a very high risk of being in prison as adults requiring mental institution and support with drug addiction” Professor Boulton continued.

He likened FAS-D to the thalidomide disaster, heavy metal poisoning or radiation sickness.

Professor Boulton said progress had been made through alcohol restrictions brought about in the Kimberley towns of Halls Creek and Fitzroy Crossing by local women. He said the restrictions had produced a “massive reduction in the amount of violence and of women seeking refuge”, and that there was evidence young children were growing better.

Earlier in the day the Commission was told many Aboriginal youngsters from the remotest areas suffered hearing problems related to ear infections in early life. In one example retold before the Commission, a boy before court had been crash tackled by a guard who thought he was trying to escape, when in fact the boy simply hadn’t heard an instruction.

Deafness holding NT’s indigenous kids back

Many boys caught up in the Northern Territory’s juvenile justice system suffer a “disease of disadvantage” that has crippled almost every aspect of their lives, the Northern Territory’s royal commission into youth detention and protection has heard.

Jody Barney, who works as a deaf indigenous community consultant, told the inquiry she has spoken to several young Aboriginal people with hearing impairments who have had their faces covered by spit hoods and bound behind bars.

“Taking away another sense from a person who already has a limited sense is frightening. And that fear stays forever… long after their sentence,” she said.

Footage of boys being tear gassed, shackled and put in spit hoods at Don Dale Youth Detention Centre was aired on national television in July, sparking the royal commission

Psychologist Damien Howard told the inquiry a chronic housing shortage is creating an “epidemic” of hearing loss in indigenous children that leads to learning difficulties, family breakdown and criminal involvement.

“It’s very much a disease of disadvantage,” Dr Howard told Darwin’s Supreme Court.

Crowded housing overwhelms a child’s capacity to maintain hygiene, allows infections to pass quickly, and increases exposure to cigarette smoke and loud noises, while the poverty limits nutrition.

On average, non-Aboriginal kids experience middle ear disease for three months of their childhood while indigenous children can get fluctuating hearing loss for more than two years.

This can result in a permanent condition, which Dr Howard says is a “smoking gun” leading to over-representation in the criminal justice system.

Make FASD History

Fetal Alcohol Spectrum Disorders (FASD) are 100% preventable. If a woman doesn’t drink alcohol while she is pregnant, her child cannot have FASD.

There is a humanitarian crisis in the Fitzroy Valley region of remote North Western Australia, which has one of the highest Fetal Alcohol Spectrum Disorders (FASD) in the world.

The effects of alcohol on the fetal brain are a common cause of intellectual impairment in developed countries. Problems that may occur in babies exposed to alcohol before birth include low birth weight, distinctive facial features, heart defects, behavioural problems and intellectual disability.

Most infants with FASD are irritable, have trouble eating and sleeping, are sensitive to sensory stimulation, and have a strong startle reflex. They may hyperextend their heads or limbs with hypertonia (too much muscle tone) or hypotonia (too little muscle tone) or both. Some infants may have heart defects or suffer anomalies of the ears, eyes, liver, or joints.

Adults with FASD have difficulty maintaining successful independence. They have trouble staying in school, keeping jobs, or sustaining healthy relationships. They require long-term support and some degree of supervision in order to succeed.

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Bright Blue is very proud to partner with Nindilingarri Cultural Health Services to support the development and implementation of a comprehensive, evidence-based prevention and community capacity building programme, which aims to make FASD history.

The outcomes of this programme will work to:

  • Improve the health, quality of life and social and economic potential for the next generation of Fitzroy Valley children, and thus the fabric of the community itself;
  • Identify practical strategies that can be implemented elsewhere in Aboriginal and non-Aboriginal communities to reduce and eliminate FASD;
  • Make WA a leader in FASD prevention;
  • Decrease costs associated with service provision, productivity, welfare and justice.

stacks_image_6848Led by Aboriginal community leaders Maureen Carter and June Oscar; and Paediatrician Dr James Fitzpatrick, it is important that the leadership of the Marulu strategy reflects the community ownership of the process.

Bright Blue needs your support to assist in prevention and capacity building, to develop an effective community – level support for women to abstain from drinking during pregnancy and child bearing years, so that all babies born in this community and across Australia have a full potential for a long and productive life.

Become a part of history. Together, let’s make FASD history.

The inquiry led by co-commissioners Margaret White and Mick Gooda continues.

NACCHO Aboriginal health News : Murri Carnival promotes Deadly Choices #ACCHO health messages

deadly

But importantly, there’s plenty of healthy food around the place and I think the big thing is we can all get together and meet and see people we haven’t seen for a long time.

“To have something like this and promote important health messages at the Murri Carnival is great, as we promote the benefits of living healthy”.

League legend Steve Renouf told NITV’s League Nation Live

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Some boys from Murri United under 15’s team finished doing a Tobacco Survey! Thanks boys

The 2016 Murri Carnival will showcase Queensland Indigenous Rugby League at its best, but also provide an important health message to all involved.

The Murri Carnival is not just about Rugby League, with plenty of events happening away from the footy field.

League legend Steve Renouf is an ambassador for the carnival and will have two of his sons participating in the junior tournament.

Whilst the Queensland and Australian star is happy to play a part in the Rugby League showcase, he’s also thrilled to be making an impact on the health of many Indigenous Australians.

 Murri Rugby

Organisers have ensured that the event is a drug, smoke, alcohol and sugar free carnival as well as providing free health checks, with plenty of fun stuff as well for the younger at heart.

“There’s a lot of fun stuff happening around the ground with rides and that for the kids,” Renouf told NITV’s League Nation Live.

The Murri Carnival is already underway, but the Senior Men’s and Women’s competitions begin on Wednesday at Redcliffe Oval in Queensland.

Unlike the New South Wales equivalent, the Murri Carnival isn’t a knockout tournament, with each team guaranteed three matches.

Renouf says the fact that teams play a pool format gives the Murri Carnival a significant boost over its Koori Knockout rival.

 Murri Rugby

“That’s very important I think when you’ve got guys from all over the state, they don’t want to just play a game and be knocked out, that’s it,” said Renouf.

“There are some very good players amongst those playing and we do have scouts here. Even if you’re not going to be in the team that wins the competition, you still get the opportunity to show your wares.”

NITV will show coverage of the Semi Finals and Final of the Murri Carnival. Check your local guides for more information.

NACCHO Aboriginal Health News : Save $745 million a year by eliminating Indigenous health gap in the NT

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” The total costs resulting from Indigenous health inequality in the NT during 2009–2013 were estimated to be about $16.7 billion, equivalent to nearly one-fifth of the NT gross state product (GSP) for this period (Box 4).14

This result suggests that eliminating the Indigenous health gap could potentially save $745 million each year in direct health costs alone.

In the medium and long term, closing the gap would save $13 billion in indirect and intangible costs over 5 years; savings in direct health costs would be less than one-quarter of the total long term financial benefit of closing the gap.”

The economic benefits of eliminating Indigenous health inequality in the Northern Territory MJA Photo AMA

Download the report nt-health-equity

The Northern Territory covers one-sixth of the Australian landmass, but includes only 1% of its population. Aboriginal and Torres Strait Islander (Indigenous) people constitute about 27% of the NT population (compared with 2.5% nationally) (Box 1).1

Compared with the rest of the population, Indigenous Australians have disproportionate levels of social isolation, poverty, unemployment, lack of education, and inadequate access to health care.2 They also suffer poorer health; for Indigenous people in the NT born between 2010 and 2012, life expectancy at birth was 63 (men) and 69 years (women),3 17 and 14 years less than for non-Indigenous Territorians.

There is consensus that closing the health gap between Indigenous and non-Indigenous Australians requires concerted efforts by all sections of society. In 2009, Australian governments announced a vision for eliminating this gap within a generation: that is, by 2031 (“Closing the Gap”).4 The main focus was on broad consultations with Indigenous people about a range of measures, including health, childcare, schooling and economic participation.4

In this regard, two important questions were asked but remained largely unexplored:

  • How much does the Indigenous health gap cost society?

  • What are the potential economic benefits if the gap were to be eliminated?

The purpose of our study was to provide basic information on the potential economic benefits of reducing the Indigenous health gap, by quantifying the magnitude of the economic burden associated with Indigenous health inequality in the NT on the basis of standard cost-of-illness methodology and using the most recent data.57

Methods

Life expectancy was calculated using population and death data for 2009–2013. Indigenous and non-Indigenous resident population and death registration data were gathered from the Australian Bureau of Statistics and the Australian Coordinating Registry.8 The cost-of-illness approach was adopted for estimating the costs associated with the Indigenous health gap from a societal perspective; that is, all costs were included, regardless of who paid or received the payment: individuals, health care providers, Indigenous and non-Indigenous populations, or a government.7 This approach casts light on the overall magnitude and distribution of the economic costs of illness. All values were expressed in 2011 Australian dollars to account for inflation.

The total monetary value of the Indigenous health gap was estimated by calculating cost differences between the Indigenous and non-Indigenous populations in three categories: direct health costs (hospital, primary care, and other health services, including public health);9 indirect costs associated with lost productivity (missed income, welfare payments, and missed tax revenue, assuming equal opportunity for employment for Indigenous and non-Indigenous people);7 and intangible costs associated with premature deaths (based on years of life lost, YLL).7

Direct health costs were derived from data on overall health expenditure for Australia and expenditure for Indigenous people specifically;9,10 expenditure for non-Indigenous people was calculated by subtracting Indigenous expenditure from total expenditure. The cost differential (excess cost) for Indigenous health care was estimated by calculating the difference between actual expenditure on Indigenous health care and the estimated expenditure if the per capita costs were the same as for non-Indigenous NT residents.

A workforce supply and demand framework was used to assess the indirect costs caused by lost productivity, based on census data and other sources for employment, taxation and welfare payment data (Box 2).1,7,11 Indirect costs (productivity loss) encompassed excess welfare payments by governments, missed tax revenue, and lost efficiencies for the economy related to inadequate human capital development and human resources utilisation. The estimation of indirect costs is described in the Appendix.

The intangible costs attributable to the higher burden of disease were estimated by multiplying the excess YLLs by the value of a statistical life-year (VSLY).12 The YLLs were calculated using NT death data linked with the age-specific life expectancies from the Australian Burden of Disease (BOD) study.13 Following the BOD methodology, YLLs were not discounted for future years, and were costed at $120 000 per life-year, based on the review by Access Economics.12 Sensitivity analysis was undertaken with VSLY assumed to be $50 000, $100 000 or $140 000 per YLL. General inflation rates were applied to pricing the VSLY between 2009 and 2013.

Ethics approval

This study was endorsed by the Human Research Ethics Committee of the NT Department of Health and the Menzies School of Health Research (reference, HREC-2015-2400).

Results

Between 1 January 2009 and 31 December 2013, 9867 deaths of NT residents were registered; 62% were males, and 47% were Indigenous Australians (mean age at death, 51 years v 67 years for non-Indigenous deaths).

Life expectancy at birth for Indigenous men and women was 64 and 69 years respectively, each 15 years lower than for non-Indigenous residents (79 and 84 years respectively).

Over the 5-year study period, direct health costs totalled $9.3 billion (2011 dollars), of which 58% were incurred by Indigenous patients (Box 3), more than double their proportion of the NT population. Per capita expenditure for Indigenous patients was 3.2 times that for non-Indigenous patients (based on total 5-year estimated resident population numbers: Indigenous, 345 968; non-Indigenous, 819 551). This ratio was slightly higher for hospital (3.5) than for primary care and other services (each 3.1). The total excess direct health costs were estimated at $3.7 billion during the 5 years, equivalent to about 40% of total expenditure (Box 3).

The indirect costs arising from lost productivity were estimated by matching the Indigenous supply–demand balance (equilibrium) with that of the non-Indigenous workforce (Box 2).

The excess costs associated with lost productivity attributable to the Indigenous health gap were estimated to be $1.17 billion in 2011, of which $359 million (31%) were excess welfare payments, $293 million (25%) foregone tax revenue, and $515 million (44%) lost efficiencies (Appendix). The total costs of lost productivity attributed to Indigenous health inequality totalled $5.8 billion during 2009–2013 (Box 4).

Wage responsiveness (elasticity) of demand was 1.8, and responsiveness of supply of the Indigenous workforce was 1.5, indicating that the demand and supply for the Indigenous workforce were respectively 80% and 50% higher than those for the non-Indigenous workforce (each 1.0 for demand and supply; Box 2). Based on Box 2, about 20 000 extra jobs at the average wage level would be required to close the gap, equivalent to a 14% expansion of the NT economy.

The intangible cost (burden of disease) estimates were based on excess YLLs. Over the 5-year period, there were 153 458 YLLs in the NT, 87 439 of which (57%) were attributable to Indigenous people, a rate that was 3.1 times that for the non-Indigenous population. The excess 59 571 Indigenous YLLs was equivalent to a total cost of $7.2 billion between 2009 and 2013 (Box 4). Intangible costs comprised the largest category of excess costs in the NT (43%), substantially higher than either direct health costs (22%) or indirect costs caused by lost productivity (35%) (Box 4).

The total costs resulting from Indigenous health inequality in the NT during 2009–2013 were estimated to be about $16.7 billion, equivalent to nearly one-fifth of the NT gross state product (GSP) for this period (Box 4).14 This result suggests that eliminating the Indigenous health gap could potentially save $745 million each year in direct health costs alone.

In the medium and long term, closing the gap would save $13 billion in indirect and intangible costs over 5 years; savings in direct health costs would be less than one-quarter of the total long term financial benefit of closing the gap.

The results of our sensitivity analysis are included in the Appendix.

Discussion

We present evidence that Indigenous health inequality in the NT is both substantial and costly. The total costs attributable to Indigenous health inequality between 2009 and 2013 amounted to $16.7 billion, equivalent to 19% of GSP, a measure of the size of the NT economy. As a comparison, the costs of health inequalities for African, Asian and Hispanic Americans in the United States were estimated to be US$1.24 trillion during 2003–2006, corresponding to 2.4% of the American gross domestic product (GDP).5 The life expectancy gap between black and white Americans was only 4 years in 2010,15 as opposed to the 15 years between the Indigenous and non-Indigenous populations in the NT. A European Union study showed that the cost associated with socio-economic health inequalities was equivalent to 9.4% of GDP.6

Using the general equilibrium what-if analysis, an earlier Deloitte Access Economics study reported that the Indigenous employment gap imposed a cost of close to 10% of GSP in the NT.2 Our study found that 40% of direct health costs in the NT were associated with Indigenous health inequality, higher than the corresponding figures in the US (30%) and EU studies (20%).5,6

Our findings suggest that there would be enormous financial benefits for the NT in the longer term should closing the gap become a reality. The evidence we have presented implies that the total potential long term benefits would be $3.3 billion annually in real terms, and a boost of nearly 20% of GSP in relative terms (Box 4), double the projection by the Deloitte study (9% over 20 years).2 A possible explanation for this difference may be the different focuses of the studies: the Deloitte analysis concentrated on employment, whereas we assessed much broader benefits from a societal perspective. Closing the gap is feasible: between 1994 and 2008, Indigenous employment in Australia increased by 55–70%.16

There are many contributors to health inequality in the NT. Poverty is a cause and consequence of ill health, and the Indigenous population is particularly vulnerable to poverty, especially in remote areas. For example, the NT market basket survey of food and drink prices found that in 2014 they were 54% higher in remote than in urban areas.17 After adjusting for these higher prices, the real income of the average Indigenous person living in a remote community was only 29% of the overall NT average.

Thirty per cent of NT Indigenous people are located 50 kilometres or more from a primary school and 100 kilometres or more from a health clinic. Remote areas lack economies of scale; 87% of NT Indigenous communities have populations of less than 100 people. Strategies for redressing health disparities should consider how the impact of remoteness might be ameliorated. Solutions may include ensuring access to essential government services for people residing in remote areas, and facilitating resettlement for those who wish to move to larger population centres.18 Overcoming the effects of remoteness, improving public housing, and raising living standards are necessary prerequisites for closing the gap,19 and will also allow economies of scale and a larger population base, which mean that education and health services can be provided more efficiently. This, in turn, will facilitate better access to labour markets for Indigenous people.