NACCHO Aboriginal Health #ClosingtheGap Download @AIHW Australia’s Welfare Report 2019 : Our mobs welfare is closely linked to health and is influenced by #socialdeterminants such as education, employment, housing, access to services, and community safety.

Indigenous wellbeing is shaped by the wellbeing of the community. In recent years there have been improvements in a range of areas of wellbeing for Aboriginal and Torres Strait Islander Australians.

Indigenous home ownership has risen over the past decade, from 34% in 2006 to 38% in 2016, household overcrowding has decreased, and fewer Indigenous Australians rely on government payments.

Education remains important in helping to overcome Indigenous disadvantage.

The employment gap between Indigenous and non-Indigenous Australians narrows as education levels increase.

There is no gap in the employment rates between Indigenous and non-Indigenous Australians with a university degree.

Despite these improvements, some Indigenous Australians experience widespread social and economic disadvantage.

One in 5 Indigenous Australians live in remote areas and fare worse than those in non-remote areas. They had lower rates of school attendance and employment, and were more likely to live in overcrowded conditions and in social housing.

Members of the Stolen Generations are another particularly disadvantaged group.

They were more likely than other Indigenous Australians to have been incarcerated, receive government payments as their main source of income, experience actual or threatened physical violence or experience homelessness.”

AIHW spokesperson Mr. Dinesh Indraharan.

” Many factors contribute to the welfare of Aboriginal and Torres Strait Islander Australians.

Welfare is closely linked to health and is influenced by social determinants such as education, employment, housing, access to services, and community safety. Contextual and historical factors are particularly important for understanding the welfare of Indigenous Australians.”

” Home ownership has an opportunity to formulate the next wave of transformative success for indigenous people.

Home ownership is a key pillar on the journey to economic independence for indigenous Australians, providing not only stable housing but also an anchor from which to build an asset base for current and future generations and equity for other investment and business opportunities.”

Dagoman-Wardaman man and chairman of Indigenous Business Australia Eddie Fry oversees a home loan program that is helping increasing numbers of Aboriginal and Torres Strait Islander people into home ownership. See Part 2 Below

The latest two-yearly snapshot of national wellbeing uses high-quality data to show how Australians are faring in key areas, including housing, education and skills, employment, social support and justice and safety.

The Australian Institute of Health and Welfare report Australia’s welfare 2019 was launched today in Canberra by Senator the Hon. Anne Ruston, Minister for Families and Social Services.

The report shows that record employment and an increase in education levels are contributing to Australia’s wellbeing but challenges facing the nation include housing stress among low-income earners.

Download the Report and Snapshot

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Australias-welfare-snapshots-2019

‘Australia’s welfare 2019 demonstrates the value in continuing to build an evidence base that supports the community, policy makers and services providers to better understand the varying and diverse needs of Australians,’ said AIHW spokesperson Mr. Dinesh Indraharan.

‘Australia is in the top third of Organisation for Economic Co-operation and Development (OECD) countries for a range of measures, including life satisfaction and social connectedness.

‘In 2018, 74% of people aged 15–64 were employed—the highest annual employment rate recorded in Australia. In July 2019 the female and total employment rates remain at record levels.’

The proportion of Australians working very long hours (50 or more per week) declined from 16% to 14% and more Australians are using part-time work to balance work with other activities including caring responsibilities.

However, in December 2018, about 9% of workers were underemployed, or unable to find as many hours of work as they would like. One in 9 families with children had no one in the family who was employed.

Generally, the higher a person’s level of education, the more opportunities they have in their working life.

‘Between 2008 and 2018 the proportion of students staying in school until Year 12 rose from 69% to 81% for males and from 80% to 89% for females,’ Mr Indraharan said.

‘In 2018, 65% of Australians aged 25–64 had a non-school qualification at Certificate III level or above. This is up from 55% in 2009.’

Australia has high levels of civic engagement with 97% of eligible people enrolled to vote in 2019—up from 90% in 2010 and strong rates of volunteering (contributing 743 million hours a year). But an estimated 1 in 4 Australians are currently experiencing an episode of loneliness – with people who live alone, young adults, males and people with children more likely to feel lonely.

Finding affordable housing remains a challenge for many Australians, with more people spending a higher proportion of their incomes on housing than in the past and fewer younger people owning their own homes.

‘More than 1 million low-income households were in housing stress in 2017-18, where they spent more than 30% of their income on rent or mortgage repayments,’ Mr Indraharan said.

There has been little change in income inequality since the mid-2000s—though it is higher now than it was in the 1980s—and wealth is more unequally distributed than income.

Most crime rates have fallen in recent years but Australia ranked in the bottom third of countries for people feeling safe walking alone at night.

‘Survey data shows rates of partner and sexual violence have remained relatively stable since 2005, while rates of total violence have fallen. However, the number and rate of sexual assault victims recorded by police has risen each year since 2011,’ Mr. Indraharan said.

Welfare services and support for people in need

Australian governments spent nearly $161 billion on welfare services and support in 2017-18, including $102 billion on cash payments to specific populations, $48 billion on welfare services and $10 billion on unemployment benefits. Per person spending on welfare increased an average of 1.3% a year—from $5,287 per person in 2001–02 to $6,482 in 2017–18.

Over the past 2 decades, there has been a notable fall in the number of people aged 18–64 receiving income support—down from 2.6 million in 1999 to 2.3 million in 2018. Put another way, in 1999, 22% of Australians aged 18–64 received income support, but this fell to 15% in 2018.

In 2017-18:

  • 1.2 million people (or 3 in 10 older people) received aged care services
  • 803,900 people were in social housing
  • 288,800 people were supported by Specialist Homeless Services
  • 280,000 people used specialist disability support services under the National Disability Agreement
  • 172,000 people were active participants in the National Disability Insurance Scheme (at June 2018)
  • 159,000 (or 1 in 35) children aged 0–17 received child protection services.

incarcerated, receive government payments as their main source of income, experience actual or threatened physical violence or experience homelessness.

Aboriginal and Torres Strait Islander Survey #HaveYourSay :

Pat Turner Lead Convener of the Coalition of Peaks invites community to share their voice on #ClosingtheGap

Part 2 From today’s Australian

More indigenous Australians than ever are homeowners, fewer live in overcrowded accommodation and Aboriginal and Torres Strait Islander people who rent are slowly shifting away from social housing in favour of private properties.

Figures to be published on Wednesday by the Australian Institute of Health and Welfare show almost two in five indigenous Australians were homeowners at the last census — of those, 12 per cent owned their home outright and 26 per cent had a mortgage. The number of indigenous households where the home is paid off or mortgaged has reached an estimated 263,000.

The rate of home ownership among indigenous Australians has gradually increased since 2006, while the home ownership rate among non-indigenous Australians has decreased slightly over the same period.

In 2006, 34 per cent of indigenous Australians owned their home or were paying it off.

By 2011 that figure had climbed to 36 per cent and at the 2016 census, 38 per cent of indigenous Australians either owned their homes outright or were paying off a mortgage.

In contrast, the percentage of non-indigenous Australians who either owned their home or were paying it off declined from 68 per cent in 2006 to 66 per cent in 2016.

Dagoman-Wardaman man and chairman of Indigenous Business Australia Eddie Fry oversees a home loan program that is helping increasing numbers of Aboriginal and Torres Strait Islander people into home ownership.

IBA approved more than $1bn in home loans to indigenous Australians over the past five years.

In 2014-15, IBA approved 517 home loans to Aboriginal and Torres Strait Islander people. In 2017-18, the number of home loans approved by IBA was a record 917.

“Home ownership has an opportunity to formulate the next wave of transformative success for indigenous people,” Mr Fry said.

“Home ownership is a key pillar on the journey to economic independence for indigenous Australians, providing not only stable housing but also an anchor from which to build an asset base for current and future generations and equity for other investment and business opportunities.”

The Australian Institute of Health and Welfare report used census data to show that, between 2006 and 2016, the proportion of indigenous households living in social housing fell from 29 per cent to 21 per cent.

The proportion of indigenous Australians renting privately increased from 27 per cent to 32 per ce

NACCHO Aboriginal Health and #refreshtheCTGRefresh : Download the @AIHW National Key Performance Indicators for Aboriginal and Torres Strait Islander primary health care: results for 2017 showing improvements in 16 out of a possible 23 measures

Between June and December 2017, improvements were seen in 16 out of a possible 23 measures for which comparable data for both periods were available (see Table S1 for details). Results for a further indicator remained stable between reporting periods.

The improvements were seen in 12 of the 15 process-of-care measures with comparable data. Improvements were also seen in 4 of the 8 outcome measures, while 1 outcome measure remained stable. The largest improvements (4 or 5 percentage points) were seen in the recording practices for the measuring of:

  • influenza immunisations for clients with type 2 diabetes, which rose from 31% to 36%
  • influenza immunisations for clients with chronic obstructive pulmonary disease (COPD), which rose from 32% to 37%
  • influenza immunisations for clients aged 50 and over, which rose from 32% to 36%. ” 

 Extract from good news from AIHW Report

 Download full 158 page report HERE

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Summary

This is the fifth national report on the Indigenous primary health care national Key Performance Indicators (nKPIs) data collection. It presents data on all 24 nKPI indicators for the first time.

Data for this collection are provided to the Australian Institute of Health and Welfare (AIHW) by primary health care organisations that receive funding from the Australian Government Department of Health to provide services to Aboriginal and Torres Strait Islander people. Some primary health care organisations included in the collection receive additional funding from other sources, including state and territory health departments.

As of the June 2017 data collection, changes have been made to the data extraction method, with the Department of Health introducing a new direct load reporting process. This allowed Communicare, Medical Director, and Primary Care Information System (PCIS) clinical information systems (CISs) to generate nKPI data within their clinical system, and transmit directly to the OCHREStreams portal. Best Practice services were provided with an interim tool while MMEx has always had direct load capability.

61.9 % our ACCHO’s

The new process was introduced to provide a greater level of consistency between CISs, but the change in the extraction method means that data from June 2017 onwards are not comparable with earlier collections.

As the June 2017 collection represents a new baseline for the collection, this report only presents data for June and December 2017.

For 2 indicators (Kidney function tests recorded and Kidney function test results) only December 2017 results are presented due to unresolved data quality issues in June 2017.

See Chapter 2 for more information on the change in extraction method, data quality, and the impact  on the collection, and Appendix E for data improvement projects and the nKPI/Online Service Reporting (OSR) review under way.

Improvements were seen for most indicators between June and December 2017. Although data from these 2 reporting periods are not comparable with earlier reporting periods, an overall pattern of improvement is in keeping with the pattern of improvement previously reported for the period June 2012 to May 2015 (see AIHW 2017). This indicates that health organisations continue to show progress in service provision.

Things to work on

For the 3 process-of-care indicators that did not show improvements—glycated haemoglobin (HbA1c) result recorded (6 months), cervical screening, and Medicare Benefits Schedule (MBS) health assessment for those aged 0–4—the changes were very small (0.5, 0.4, and 0.1 percentage points, respectively).

In the case of cervical screening, this might be due to changes to the cervical screening program, which took effect from 1 December 2017 (see Chapter 4 for details).

Three outcome measures that did not show improvements—HbA1c result of 7% or less, low birthweight, and smoking status of women who gave birth in the previous 12 months—saw changes of between 0.8 and 1.8 percentage points.

Contents

  • 1 Introduction
    • The nKPI collection
    • Structure of this report
  • 2 Data quality
    • Data quality issues
    • Additional considerations for interpreting nKPI data
  • 3 Maternal and child health indicators
    • Why are these indicators important?
    • 3.1 First antenatal visit
    • 3.2 Birthweight recorded
    • 3.3 MBS health assessment (item 715) for children aged 0-4
    • 3.4 Child immunisation
    • 3.5 Birthweight result
    • 3.6 Smoking status of females who gave birth within the previous 12 months
  • 4 Preventative health indicators
    • Why are these important?
    • 4.1 Smoking status recorded
    • 4.2 Alcohol consumption recorded
    • 4.3 MBS health assessment (item 715) for adults aged 25 and over
    • 4.4 Risk factors assessed to enable cardiovascular disease (CVD) risk assessment
    • 4.5 Cervical screening
    • 4.6 Immunised against influenza-Indigenous regular clients aged 50 and over
    • 4.7 Smoking status result
    • 4.8 Body mass index classified as overweight or obese
    • 4.9 AUDIT-C result
    • 4.10 Cardiovascular disease risk assessment result
  • 5 Chronic disease management indicators
    • Why are these important?
    • 5.1 General Practitioner Management Plan-clients with type 2 diabetes
    • 5.2 Team Care Arrangement-clients with type 2 diabetes
    • 5.3 Blood pressure result recorded-clients with type 2 diabetes
    • 5.4 HbA1c result recorded-clients with type 2 diabetes
    • 5.5 Kidney function test recorded-clients with type 2 diabetes
    • 5.6 Kidney function test recorded-clients with cardiovascular disease
    • 5.7 Immunised against influenza-clients with type 2 diabetes
    • 5.8 Immunised against influenza-clients with chronic obstructive pulmonary disease
    • 5.9 Blood pressure result-clients with type 2 diabetes
    • 5.10 HbA1c result-clients with type 2 diabetes
    • 5.11 Kidney function test result-clients with type 2 diabetes-eGFR
    • 5.12 Kidney function test result-clients with type 2 diabetes-ACR
    • 5.13 Kidney function test result-clients with cardiovascular disease-eGFR
  • 6 Discussion
    • Data improvements
  • Appendix A: Background to the nKPI collection and indicator technical specifications
  • Appendix B: Data completeness
  • Appendix C: Comparison of nKPI results
  • Appendix D: State and territory and remoteness variation figures
  • Appendix E: Data improvement projects
  • Appendix F: Guide to the figures
  • Glossary
  • References

NACCHO Aboriginal Children’s Health @AIHW The health of Australia’s mums and bubs varies where they live

 ” In general across all indicators, Aboriginal and Torres Strait Islander mothers and babies and those outside metropolitan areas recorded poorer results.

‘For example, metropolitan areas had a rate of almost 4 infant and young child deaths per 1,000 births. The rate was around 1.4 times higher in regional areas with about 5 deaths per 1,000 births,’

‘While about 1 in 10 Australian mothers smoked during pregnancy overall, the rate was much higher for Aboriginal and Torres Strait Islander mothers, of whom almost half (46.5%) smoked at some point during their pregnancy.’

Download the full AIHW report HERE

AIHW_HC_Report_Child_and_maternal_health_April_2018

Read over 308 NACCHO Aboriginal Children’s health articles published over the past 6 years

The health of Australia’s pregnant women and their babies has improved across a range of health indicators, with infant death rates and the rate of women smoking during pregnancy on the decline, according to a new report from the Australian Institute of Health and Welfare (AIHW).

The report, Child and maternal health 2013–2015, presents findings on four indicators measuring the health of babies and their mothers:

  • infant and young child deaths,
  • the rate of newborn babies who are of a low birthweight,
  • mothers smoking during pregnancy, and
  • mothers attending antenatal care services during the first trimester of their pregnancy.

The report shows that despite generally positive results across these indicators nationally, these positive trends are not seen equally across Australia’s 31 Primary Health Network (PHN) areas.

‘For example, while nationally there has been a consistent decrease in the proportion of mothers smoking during pregnancy—falling from about 1 in 7 mothers in 2009 to 1 in 10 in 2015—rates in some PHN areas are nearly 18 times as high as in others,’ said AIHW spokesperson Anna O’Mahony.

‘The other indicators also varied, but to a lesser extent, with rates up to 3 times as high in some PHN areas’.

Northern Sydney PHN area (which includes the suburbs of Manly, Hornsby and Avalon) recorded the lowest rates for three of the four health indicators: low birthweight babies (4% of all births), mothers smoking during pregnancy (1% of mothers) and deaths among infant and young children (2 deaths per 1,000 live births).

In contrast, Northern Territory PHN area (which covers the whole of the Northern Territory) had the highest rates for two indicators low birthweight babies (8% of births) and infant and child deaths (8 deaths per 1,000 live births).

The Western NSW PHN area (which includes the Bathurst, Dubbo, Broken Hill and Orange) had the highest rate of mothers smoking during pregnancy, with almost one in four mothers smoking at any time during pregnancy (23%).

The AIHW reports on a range of topicsExternal link, opens in a new window.[https://www.aihw.gov.au/reports-statistics/population-groups/mothers-babies/overview]

relating to the health of mothers and their babies, but Ms O’Mahony noted that there is more to learn.

‘This includes improving data on mothers’ experiences with domestic violence, mental health issues, and alcohol consumption during pregnancy,’ she said.

The AIHW will next month be releasing its first report on the health and wellbeing of teenage mothers and their babies.

NACCHO #Aboriginal Health and #Immunisation @AIHW reports Aboriginal children aged 5 national immunisation rate of 94.6%

 ” Aboriginal and Torres Strait Islander people suffer a disproportionate burden from communicable diseases (diseases that can be transmitted from person to person), with rates of hospitalisation and illness due to these conditions many times higher than other Australians.1

Part 2  below presents results for children who were identified as Aboriginal and/or Torres Strait Islander on the AIR. “

 In 2015–16, Aboriginal and Torres Strait Islander children aged 5 had an even higher national immunisation rate of 94.6%. However, there was wider variation across PHN areas, ranging from 98.8% in the Gold Coast (Qld) to 89.4% in Western Victoria.”

Download Healthy Communities:

AIHW_HC_Report_Imm_Rates_June_2017

See Previous NACCHO Aboriginal Health and #WorldImmunisationWeek : @healthgovau Vaccination for our Mob

Part 1 Overview MORE INFO HERE

Immunisation is a safe and effective way to protect children from harmful infectious diseases and at the population level, prevent the spread of these diseases amongst the community.

Australia has generally high immunisation rates which have increased steadily over time, but rates continue to lag in some local areas.

This report focuses on local area immunisation rates for children aged 5 and shows changes in immunisation rates over time. It also presents 2015–16 immunisation rates for all children and Aboriginal and Torres Strait Islander children aged 1, 2 and 5.

Results are presented for the 31 Primary Health Network (PHN) areas. Where possible they are broken down into smaller geographic areas, including for more than 300 smaller areas and across Australian postcodes.

Further detailed rates are available in the downloadable Excel sheet and a new interactive web tool allows users to compare results over time by geography and age group.

This local-level information assists professionals to use their knowledge and context for their area, to target areas in need and develop effective local strategies for improvement.

The report finds:

  • Since 2011–12, childhood immunisation rates have improved nationally and across smaller areas, for all children and for Aboriginal and Torres Strait Islander children. Variation in rates still exists across local areas, however the gap between those areas with the highest and lowest rates is diminishing
  • Nationally 92.9% of all children aged 5 were immunised in 2015–16. All PHN areas achieved an immunisation rate of 90% or more, ranging from 96.1% in Western NSW to 90.3% in North Coast (NSW).

Summary

In 2015–16, childhood immunisation rates continued to improve nationally and in most local areas. Although rates vary across local areas, the gap in rates between the highest and lowest areas is diminishing.

This report focuses on immunisation rates for 5 year olds and presents results since 2011–12. It also provides the latest information for 1, 2 and 5 year olds for Australia’s 31 Primary Health Network (PHN) areas and smaller local areas.

From 2011–12 to 2015–16, there were notable improvements in rates for fully immunised 5 year olds. National rates increased from 90.0% to 92.9%. Rates increased for PHN areas too, as all areas reached rates above 90% in 2015–16.

Rates in smaller local areas (Statistical Areas Level 3, or SA3s) have also improved. In 2015–16, 282 of the 325 local areas had rates of fully immunised 5 year olds greater than or equal to 90%. This is up from 2011–12 when only 174 areas had rates in this range. Further, the difference in rates between the highest and lowest areas has decreased over time (Figure 1).

In 2015–16, the rate of fully immunised children varied across PHN areas for the three age groups:

  • 1 year olds – 95.0% to 89.8% (national rate 93.0%)
  • 2 year olds – 93.2% to 87.2% (national rate 90.7%)
  • 5 year olds – 96.1% to 90.3% (national rate 92.9%).

Part 2 Aboriginal and Torres Strait Islander children

Aboriginal and Torres Strait Islander people suffer a disproportionate burden from communicable diseases (diseases that can be transmitted from person to person), with rates of hospitalisation and illness due to these conditions many times higher than other Australians.1

This section presents results for children who were identified as Aboriginal and/or Torres Strait Islander on the AIR. These data are based on Medicare enrolment records.

For Aboriginal and Torres Strait Islander children, national immunisation rates in 2015–16 for 1 and 2 year olds were lower than the rates for all children (89.8% compared with 93.0% for 1 year olds, and 87.7% compared with 90.7% for 2 year olds).

In contrast, the national immunisation rate for Aboriginal and Torres Strait Islander children aged 5 years was higher than the rate for all children (94.6% compared with 92.9%).

Primary Health Network areas

In 2015–16, the percentages of fully immunised Aboriginal and Torres Strait Islander children varied across PHN areas for all three age groups as shown in Figure 6. The range in immunisation rates across PHN areas for the three age groups is outlined below.

  • 1 year olds – 94.2% in Tasmania to 76.1% in Perth North (WA)
  • 2 year olds – 93.4% in South Western Sydney (NSW) to 76.0% in Perth South (WA)
  • 5 year olds – 98.8% in Gold Coast (Qld) to 89.4% in Western Victoria.

Statistical Areas Level 4 (SA4s)

For Aboriginal and Torres Strait Islander children, Statistical Areas Level 4 (SA4s) were used instead of SA3s as the smallest geographic areas. There are larger populations in SA4s and this allows more reliable reporting for smaller population groups such as Aboriginal and Torres Strait Islander children.

Across more than 80 SA4s, the percentage of Aboriginal and Torres Strait Islander children fully immunised in 2015–16 varied considerably:

  • 1 year olds – ranged from 95.9% in Central Coast (NSW) to 72.4% in Perth–North West (WA)
  • 2 year olds – ranged from 96.0% in Coffs Harbour–Grafton (NSW) to 71.2% in Perth–South East (WA)
  • 5 year olds – ranged from 100% in Murray (NSW) to 87.6% in Perth–South East (WA).

Figure 6: Percentage of Aboriginal and Torres Strait Islander children fully immunised and numbers not fully immunised, by Primary Health Network area, 2015–16

# Interpret with caution: This area’s eligible population is between 26 and 100 registered children.

Notes

  • Components may not add to totals due to rounding.
  • Data are reported to one decimal place, however for graphical display and ordering they are plotted unrounded.
  • These data reflect results for children recorded as Aboriginal and Torres Strait Islander on the AIR. Levels of recording may vary between local areas.

Source Australian Institute of Health and Welfare analysis of Department of Human Services, Australian Immunisation Register statistics, for the period 1 April 2015 to 31 March 2016, assessed as at 30 June 2016. Data supplied 2 March 2017.

ADDED June14

Influenza Vaccination During Pregnancy

Vaccination remains the best protection pregnant women and their newborn babies have against influenza.

Despite influenza vaccination being available free to pregnant women on the National Immunisation Program, vaccination rates remain low with only 1 in 3 pregnant women receiving the influenza vaccine.

Influenza infection during pregnancy can lead to premature delivery and even death in newborns and very young babies. Pregnant women can have the vaccine at any time during pregnancy and they benefit from it all through the year.

Health professional:

Pregnant women:

 

Aboriginal Health #NRW2017 Good News Alert 1 of 2 : Download @AIHW 8th National report Aboriginal health organisations

 ” This eighth national report presents information from 277 organisations, funded by the Australian Government to provide one or more of the following health services to Aboriginal and Torres Strait Islander people: primary health care; maternal and child health care; social and emotional wellbeing services; and substance-use services.

These organisations contributed to the 2015–16 Online Services Report downloadable.

Good News see in full below

Many health promotion group activities were provided, including around 7,600 physical activity/healthy weight sessions, 3,300 chronic disease support sessions and 2,000 tobacco-use treatment and prevention sessions.

With respect to maternal and child health care, around 12,900 home visits, 3,300 maternal and baby/child health sessions, 2,800 parenting skills sessions and 1,000 antenatal group sessions were done.

Download HERE NACCHO Resources 9.7 MB

NACCHO AIHW Aboriginal Health Organisations 2015-16

Or from AIHW website

Information is presented on the characteristics of these organisations; the services they provide; client numbers, contacts and episodes of care; staffing levels; and service gaps and challenges.

Key characteristics

Of the 204 organisations providing Indigenous primary health-care services:

  1. 72% (147) delivered services from 1 site, while 11% (23) had 2 sites and 17% (34) had 3 or more sites.
  2. 67% (136) were ACCHOs.
  3. 78% (159) had a governing committee or board and of these 72% had 100% Indigenous membership.
  4. 79% (162) were accredited against the Royal Australian College of General Practitioners (RACGP) and/or organisational standards.
  5. 28% (57) had more than 3,000 clients (see Table S3.2).

Policy context  : The health of Indigenous Australians

An estimated 744,956 Australians identified as Aboriginal and/or Torres Strait Islander in June 2016, representing 3% of the total Australian population (ABS 2014). In 2011, 10% of the Indigenous population identified as being of Torres Strait Islander origin, and almost two-thirds of the Torres Strait Islander population lived in Queensland.

The Indigenous population has a younger age structure compared with the non-Indigenous population.

In June 2011, the median age of the Indigenous population (the age at which half the population is older and half is younger) was 21.8, compared with 37.6 for the non-Indigenous population.

The birth rate for Indigenous women is also higher (2.3 babies per woman in 2013 compared with 1.9 for all women) (AIHW 2015d).

Most Indigenous Australians live in non-remote areas (79% in 2011); however, a higher proportion live in remote areas (21%), compared with non-Indigenous Australians (2%)

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The gap in health outcomes between Indigenous and non-Indigenous Australians is well documented, especially around life expectancy, infant mortality, child mortality, chronic disease prevalence, potentially preventable hospitalisations and the burden of disease (AIHW 2015a).

For example, a recent burden of disease study found that Indigenous Australians experienced a burden of disease 2.3 times the rate of non-Indigenous Australians, with diabetes 6 times as high.

Chronic diseases were responsible for more than two-thirds (70%) of the total health gap in 2011 and for 64% of the total disease burden among Indigenous Australians in 2011.

The 5 disease groups that caused the most burden were mental and substance use disorders (19% of total disease burden), injuries (which includes suicide) (15%), cardiovascular diseases (12%), cancer (9%) and respiratory diseases (8%).

The same study also suggests that much of this burden could be prevented and reducing exposure to modifiable risk factors may have prevented over one-third (37%) of the burden of disease in Indigenous Australians.

The risk factors contributing most to the overall disease burden were tobacco and alcohol use, high body mass, physical inactivity, high blood pressure and dietary factors (AIHW 2016a).

While there have been improvements in the health and wellbeing of Indigenous Australians, they remain disadvantaged compared with non-Indigenous Australians.

There are a number of interlinking issues that contribute to this gap, including the disadvantages Indigenous people experience in relation to the social determinants of health such as housing, education, employment and income; behavioural risk factors such as smoking, poor nutrition, and physical inactivity; and access to health services (AIHW 2015a).

In addition, a broader range of social and emotional wellbeing issues result from colonisation and its intergenerational legacies: grief and loss; trauma; removal from family and cultural dislocation; racism and discrimination (DoH 2013).

Policy responses

In 2008 a framework was developed to tackle Aboriginal and Torres Strait Islander disadvantage, with 6 targets established to close the gap between Indigenous and non-Indigenous people. These targets were agreed with all states and territories through the Council of Australian Governments (COAG).

National Aboriginal and Torres Strait Islander Health Plan

Following on from the COAG targets, the Australian Government worked with Aboriginal and Torres Strait Islander people to produce the National Aboriginal and Torres Strait Islander Health Plan 2013–2023.

This sets out a 10-year plan for the direction of Indigenous health policy and provides a long-term, evidence-based policy framework to close the gap in Indigenous disadvantage.

The vision outlined in the Health Plan around health system effectiveness is that the Australian health system delivers primary health care that is evidence-based, culturally safe, high quality, responsive and accessible to all Aboriginal and Torres Strait Islander people (DoH 2013).

An Implementation Plan sits alongside the Health Plan, detailing the actions to be taken by the Australian Government and other key stakeholders to implement the Health Plan (DoH 2015b).

It identifies 20 goals to support the achievement of the COAG targets around the effectiveness of the health system and priorities across the life course, from maternal health and parenting, childhood health and development, adolescent and youth health, healthy adults and healthy ageing.

A technical companion document to the Implementation Plan outlines these goals and how they will be measured (AIHW 2015b).

The second stage of the Implementation Plan will be released in 2018 and will further develop actions and goals in the domain of social and cultural determinants of health and health system effectiveness.

It will also seek to increase engagement between Australian Government agencies, state, territory and local governments, the Aboriginal community-controlled health sector, the non-government sector and the corporate/private sector (DoH 2017).

Progress on achieving the Implementation Plan goals will be reported every two years in line with the release of the Aboriginal and Torres Strait Islander Health Performance Framework. The findings will be incorporated into the Department of Health’s Annual Report and will inform the Prime Minister’s annual Closing the Gap report. Progress on the goals will also be publically reported on the DoH and AIHW websites from mid-2017 (DoH 2015b).

The good news

• In 2015–16, 204 organisations provided a wide range of primary health-care services to around 461,500 clients through 3.9 million episodes of care. Over 1 million episodes of care (26%) were in Very remote areas and these areas had the highest average number of episodes of care per client (10). Over time there has been an increase in the average episodes of care per client, from 5 in 2008–09 to 8 in 2015–16.

• Around 7,766 full-time equivalent staff were employed and just over half (53%) were Aboriginal and Torres Strait Islander. Nurses and midwives were the most common type of health worker, representing 15% of employed staff, followed by Aboriginal and Torres Strait Islander health workers and practitioners (13%) and doctors (7%). Nurses and midwives represented a higher proportion of employed staff in Very remote areas (24%).

• Many health promotion group activities were provided, including around 7,600 physical activity/healthy weight sessions, 3,300 chronic disease support sessions and 2,000 tobacco-use treatment and prevention sessions. With respect to maternal and child health care, around 12,900 home visits, 3,300 maternal and baby/child health sessions, 2,800 parenting skills sessions and 1,000 antenatal group sessions were done.

• In the 93 organisations funded specifically to provide social and emotional wellbeing services, 216 counsellors provided support services or Link Up services to around 18,900 clients through 88,900 client contacts.

• In the 80 organisations funded specifically to provide substance-use services, around 32,700 clients were seen through 170,400 episodes of care. Most clients (81%) and episodes of care (87%) were for non-residential substance-use services.

Things to note

• Over half the organisations providing primary health-care services reported mental health/social and emotional wellbeing services as a service gap (54%), and two-thirds (67%) reported the recruitment, training and support of Aboriginal and Torres Strait Islander staff as a challenge in delivering quality health services.

• Some organisations felt clients with high needs had to wait too long for some services, in particular to access specialist and dental services. For example, 53 (28%) organisations providing on-site or off-site access to dental services still felt clients with high needs often had to wait a clinically unacceptable time for dental services.

For most specialist and allied health services, more organisations in Remote and Very remote areas felt clients with high needs had to wait too long to access services.

 

NACCHO Eye Health : 1 in 2 Australians affected by eye problems—higher for Indigenous Australians

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More than half (54%) of all Australians report having at least one long term eye health condition, with nearly half the population wearing glasses or contact lenses, according to data released today by the Australian Institute of Health and Welfare (AIHW).

SEE EYE HEALTH DATA PAGE

Eye health conditions may be present from birth, may exist as a result of illness or injury, or may have developed over time due to ageing.

PHOTO Above : SEE NACCHO Report Great Progress in Indigenous eye health

‘In 2011-12, almost 12 million Australians reported having an eye health condition, with long and short sightedness the most commonly reported conditions, and there’s been an increase in these conditions in recent years,’ said AIHW spokesperson Mardi Ellis.

Between 2001 and 2012, the proportion of the population affected by long sightedness rose from about 22% to 26%, while short sightedness increased from around 21% to 23%.

The likelihood of having a long term eye condition increased with age, with 95% of people aged 55 and over affected by an eye health condition, compared with 11% of those aged 0-14.

‘Eye conditions were more common among females than males, and much more common among Indigenous Australians than nonindigenous Australians,’ Ms Ellis said.

Aboriginal and Torres Strait Islander people experience higher rates of preventable blindness and vision loss than other Australians, and are more than twice as likely as non Indigenous Australians to have complete or partial blindness.

Aboriginal and Torres Strait Islander Australians are almost one and a half times more likely to have cataracts, but despite this, are less likely than other Australians to undergo cataract extraction surgery.

‘Some improvements have been seen, however cataract extraction among Indigenous Australians has increased from 5.6 per 1,000 population in 2010-11 to 7.3 per 1,000 in 2013-14,while the rate for other Australians remained steady,’ Ms Ellis said.

The AIHW is a major national agency set up by the Australian Government to provide reliable, regular and relevant information and statistics on Australia’s health and welfare.

NACCHO Health Workforce reports : Australia’s medical workforce continues to grow across all regions of Australia

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The medical workforce is continuing to grow, with increased supply across all regions of Australia, according to a report released by the Australian Institute of Health and Welfare (AIHW).

DOWNLOAD THE AIHW REPORT HERE

Report :ACCC proposes to re-authorise collective negotiations by the AMA (see below)

The report, Medical workforce 2012, provides information on the demographic and employment characteristics of medical practitioners who were registered in Australia in 2012.

It shows that in 2012, there were 91,504 medical practitioners registered in Australia.

‘Between 2008 and 2012, the number of medical practitioners employed in medicine rose by just over 16% from 68,455 to 79,653,’ said AIHW spokesperson Teresa Dickinson.

The supply of medical practitioners across all states and territories compared to the population rose by almost 9% between 2008 and 2012, from 344 to 374 full-time equivalent medical practitioners per 100,000 people.

About two thirds (66%) of medical practitioners gained their initial medical qualification in Australia.

The supply of medical practitioners was not uniform across the country, with supply generally being greater in Major cities than in Remote or Very remote areas. However, the supply of general practitioners was highest in Remote and Very remote areas, at 134 full-time equivalent GPs per 100,000 people.

About 94% (75,258) of employed medical practitioners were working as clinicians, of whom 35% were specialists and 35% were general practitioners. ‘Physician’, which includes general medicine, cardiology and haematology, was the largest main speciality of practice (5,918). ‘Surgery’ was the second largest (4,275). Of employed non-clinicians, more than half were researchers (27.8%) or administrators (24.5%).

‘Women are increasingly represented in the medical practitioner workforce, with the proportion of female medical practitioners up from 35% to 38% between 2008 and 2012,’ Ms Dickinson said.

The average age of medical practitioners remains steady at around 46.

The average weekly hours worked by employed medical practitioners remained stable between 2008 and 2012. In 2012, male medical practitioners worked an average of 45 hours per week, while female medical practitioners worked an average of 38 hours per week.

The AIHW is a major national agency set up by the Australian Government to provide reliable, regular and relevant information and statistics on Australia’s health and welfare.

ACCC proposes to re-authorise collective negotiations by the AMA

The Australian Competition and Consumer Commission has issued a draft determination proposing to re-authorise a collective bargaining arrangement put forward by the Australian Medical Association (AMA)* for ten years.

The collective bargaining arrangements allow each relevant state and territory AMA to negotiate on behalf of general practitioners who provide services in public hospitals and health facilities in rural and remote areas.

“Collective negotiation can deliver reduced transaction costs. A single negotiation and sharing these cost savings should provide more effective input into contracts,” ACCC Deputy Chair Dr Michael Schaper said.

“This may also lead to greater attraction and retention of doctors in rural areas, where access to sufficient medical services could otherwise be limited.”

The ACCC has also granted interim authorisation for the proposed arrangements. The ACCC’s previous authorisation of these arrangements expires on 28 February 2014.

“Interim authorisation will allow the relevant AMAs to continue to collectively bargain with state and territory health departments, providing some stability and certainty in this area,” Dr Schaper said.

Interim authorisation allows the parties to engage in the conduct prior to the ACCC considering the substantive merits of the application.

Interim authorisation will commence on 1 March 2014 and will remain in place until the date that the ACCC’s final determination comes into effect or is revoked.

Authorisation provides immunity from court action for conduct that might otherwise raise concerns under the competition provisions of the Competition and Consumer Act 2010.  Broadly, the ACCC may grant an authorisation when it is satisfied that the public benefit from the conduct outweighs any public detriment.

Further information about the application for authorisation and the granting of interim authorisation is available on the authorisation register.

NACCHO Aboriginal health news alert :Over $140 billion spent on health in 2011–12

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More than $140 billion was spent on health in Australia in 2011-12, according to a report released today by the Australian Institute of Health and Welfare (AIHW).

DOWNLOAD REPORT HERE

The report, Health expenditure Australia 2011-12, shows health spending was estimated to be $140.2 billion in 2011-12-up from $132.6 billion in 2010-11 and from $82.9 billion 10 years earlier in 2001-02 (after adjusting for inflation).

SPEND ON INDIGENOUS HEALTH $4.60 Billion

Almost 70% of total health expenditure during 2011-12 was funded by governments, with the Australian Government contributing 42.4%, and state and territory governments contributing 27.3%. The remaining 30.3% was funded by individuals, private health insurers, and other non-government sources.

As a proportion of Australia’s gross domestic product (GDP), health spending was 9.5% in 2011-12, up from 9.3% in 2010-11 and 8.4% in 2001-02.

‘Over the decade from 2001-02, the ratio of health spending as a proportion of GDP and taxation revenue has risen, particularly following the global financial crisis,’ said AIHW CEO David Kalisch.

Over the decade to 2011-12, the Australian Government ratio of health expenditure to taxation revenue rose by 4.0 percentage points to 26.4%, while the state and territory governments’ ratio rose by 8.1 percentage points to 24.5%.

‘Our analysis of health inflation suggests that in recent years annual price rises in the broader economy have generally been greater than price rises in the health sector’, Mr Kalisch said.

The estimated recurrent expenditure on health per person in 2011-12 was $5,881, a rise from $5,681 per person in 2010-11 and $4,062 in 2001-02 (after adjusting for inflation).

Public hospital spending was the biggest component of health expenditure in 2011-12, accounting for $42.0 billion, or 31.8% of recurrent expenditure. The largest component of the overall rise in health spending was also spending on public hospital services (up by $2.1 billion), making up almost a third of the growth in recurrent health expenditure.

The Australian Government’s share of public hospital funding was 38.2% in 2011-12, down from 39.6% in 2010-11. The state and territory governments’ share of public hospital expenditure was 53.3% in 2011-12, up from 52.0% in 2010-11.

The AIHW is a major national agency set up by the Australian Government to provide reliable, regular and relevant information and statistics on Australia’s health and welfare.

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NACCHO JOB Opportunities:

Are you interested in working in Aboriginal health?

NACCHO as the national authority in comprenhesive Aboriginal primary health care currently has a wide range of job oppportunities in the pipeline.

Register your current or future interest with our HR TEAM HERE

NACCHO health news: Aboriginal Australians more likely to be seriously or fatally injured in land transport accidents

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Aboriginal and Torres Strait Islander Australians are more likely to be injured in land transport accidents than other Australians, according to a report released Friday 26 July 2013 by the Australian Institute of Health and Welfare (AIHW).

PURCHASE THE REPORT HERE

The report, Injury of Aboriginal and Torres Strait Islander people due to transport: 2005-06 to 2009-10, looks at death and serious injury of Aboriginal and Torres Strait Islander people in Australia due to land transport accidents over the five-year period 2005-06 to 2009-10.

It shows that Indigenous Australians were 2.8 times more likely to be fatally injured due to land transport accidents, and 1.3 times more likely to be seriously injured compared with other Australians.

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‘One of the main reasons for this finding is that a much larger proportion of Indigenous people live in remote regions, where rates of land transport injury were highest overall’, said AIHW spokesperson Professor James Harrison.

‘But, even after taking the remoteness factor into account, Indigenous land transport fatalities were higher than expected.’

‘The good news is that fatal injury rates among Aboriginal and Torres Strait Islander people, as well as non-Indigenous Australians dropped over the five years from 2005–06 to 2009-10—by about 8% and 6% per year respectively,’ Professor Harrison said.

‘However, serious injury rates for Indigenous Australians rose by about 2% per year over the five-year period, while serious injury rates for other Australians dropped by about 1% per year.’

Indigenous Australians who were fatally or seriously injured in land transport accidents were less likely to have been drivers and more likely to have been passengers than other Australians.

‘Among Indigenous Australians, drivers made up 27% of all fatal injuries due to land transport accidents while passengers made up 32%. Among other Australians these figures were 36% and 14% respectively,’ Professor Harrison said.

‘For serious injuries among Indigenous Australians, 15% of those injured were drivers and 19% were passengers. Among other Australians, the figures were 21% and 9% respectively.’

Due to issues with data, Tasmania and the Australian Capital Territory were not included in the report.

The AIHW is a major national agency set up by the Australian Government to provide reliable, regular and relevant information and statistics on Australia’s health and welfare.

Further information: Professor James Harrison, tel. (08) 8201 7620, mob 0405 031 467
For media copies of the report: 02 6249 5048/02 6249 5033 or email

NACCHO Healthly futures : Towards better Indigenous health data-national best practice

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Our Aboriginal Community Controlled Health teams are making a difference

Download the report: Towards better Indigenous health data

 This report describes Phase 1 of a support and evaluation project for the
AIHW National best practice guidelines for collecting Indigenous status in health data sets (the Guidelines).
 
The project, conducted between July 2011 and December 2012, helped to implement the Guidelines in selected areas, to document implementation activities, to collect baseline information, and to identify barriers to and facilitators for implementation.
 
The processes for, and status of, Guidelines implementation varied across data sets and health sectors in scope for this project.

  • In the hospitals sector (which supplies data for the National Hospital Morbidity Database and National Perinatal Data Collection), Indigenous status data are generally of high quality and additional support for Guidelines implementation is not currently required.
  • The drug treatment services sector (which supplies data for the Alcohol and Other Drugs Treatment Services National Minimum Data Set) includes a mix of government and non- government service providers. Some jurisdictions have distributed the Guidelines and undertaken activities in the sector to improve data, but there is scope for more work on implementation in the sector.
  • The mental health services sector (which supplies data for the National Residential and Community Care databases) has undergone reforms with implications for data collection. Future support for Guidelines implementation will be considered as these changes are embedded.
  • The National Diabetes Register has limited coverage of diabetes in the Aboriginal and Torres Strait Islander population, and Guidelines implementation is therefore not a priority at this stage.
  • Cancer registries require upstream work in the general practice sector and pathology messaging to improve identification; the project will provide support in these sectors where possible.
  • The general practice sector is notable as identification is needed for service delivery as well as for data improvements. Targeted support to the general practice sector was provided in Phase 1 of the project and will continue in the next phases of the project.

Further implementation of the Guidelines could be facilitated by:

  • recognising non-jurisdiction stakeholders as essential partners in Guidelines implementation, as the capacity of jurisdictions to implement the Guidelines varies across health sectors
  • supporting jurisdiction implementation processes; for example, by strengthening reporting mechanisms through more detailed description of Guidelines implementation activities to better monitor progress and by identifying areas in need of greater support
  • providing targeted support in selected areas to assist in the systematic implementation of the Guidelines
  • fostering national coordination in the general practice sector.