Oct 17 2016

NACCHO #NNW2016 Aboriginal Health and Nutrition : What works to keep our mob healthy and strong?

” More effective action is urgently required in order to reduce the unacceptable health inequalities experienced by Aboriginal and Torres Strait Islander peoples.

During National Nutrition Week, 16-22 October 2016 NACCHO highlights food insecurity and nutrition-related chronic conditions are responsible for a large proportion of the ill-health experienced by Australia’s First Peoples who, before colonisation, enjoyed physical, social and cultural wellbeing for tens of thousands of years. Food and nutrition programs, therefore, play an important role in the holistic approach to improving health outcomes for Aboriginal and Torres Strait Islander peoples. ”

Key Recommendations

Consistent incorporation of nutrition and breastfeeding advice into holistic maternal and child health care services.
Creation of dedicated positions for Aboriginal or Torres Strait Islander people to be trained and supported to work with their local communities to improve food security and nutrition.
Development of strategies which increase access to nutritious food, such as meal provision or food subsidy programs, should be considered for families experiencing food insecurity.
Adoption of settings-based interventions (e.g. in schools, early childhood services and sports clubs) which combine culturally-appropriate nutrition education with provision of a healthy food environment.

The evidence suggests that the most important factor determining the success of Aboriginal and Torres Strait Islander food and nutrition programs is community involvement in (and, ideally, control of) program development and implementation.

Working in partnership with Aboriginal or Torres Strait Islander health professionals and training respected community members to deliver nutrition messages are examples of how local strengths and capacities can be developed. Incorporation of Aboriginal and Torres Strait Islander knowledge and culture into program activities is another key feature of strength-based practice which can be applied to food and nutrition programs.”

Food and nutrition programs for Aboriginal and Torres Strait Islander Australians: what works to keep people healthy and strong?

Download full report food-and-nutrition-programs-aboriginal-what-works

The authors would also like to acknowledge the National Aboriginal Community Controlled Health Organisation (NACCHO) for their contribution to this work.

Deeble Institute for Health Policy Research, Australian Healthcare and Hospitals Association (AHHA), Canberra.

Nutrition Australia, the country’s leading non-profit nutrition organisation and creators of the Healthy Eating Pyramid, is challenging all Australians to take the pledge to eat more veg during National Nutrition Week, 16-22 October 2016.

With an alarming 96% of Australians failing to eat their recommend daily intake of vegetables, Nutrition Australia’s Try For 5 theme encourages all Australians to discover new ways to add veg to their day.

The recommended daily intake for people over 4 years of age is around 5 serves of vegetables and legumes a day (75g per serve), yet data from the Australia Bureau of Statistics shows that the average Australian eats around half that amount.

“It’s the food group that we eat the least, yet it’s the one we should eat from the most!” said Lucinda Hancock, Accredited Nutritionist and CEO of Nutrition Australia Vic Division.

“Whether they’re fresh, frozen or canned, eating a rainbow of vegetables every day is one of the easiest things we can do to improve our health and wellbeing.”

“Vegetables are full of vitamins, minerals, fibre and antioxidants which all help keep our minds and bodies working day-to-day, and reduce our risk of chronic disease in the future.”

President of Nutrition Australia, Rob Rees said “Our Healthy Eating Pyramid has been advising Australians to eat a diet of mostly plant foods, including vegetables and legumes, for over 30 years. Sadly, we know that most Australians don’t eat the balanced diet that’s recommended by the Pyramid, and this is why we’re seeing such high rates of diet-related diseases.”

“In fact the average Australian gets over a one third of their daily kilojoules (energy) from ‘junk foods’, like biscuit and cakes, confectionery, take away foods, sugary drinks and alcohol,“ said Mr Rees .

Nutrition Australia is supporting the Try For 5 goal with 3 key strategies to boost vegetable intake:

Eat a rainbow

Eating a variety of vegetables each day exposes us to a wide range of nutrients for better health. We should eat different coloured vegetables every day because each colour carries its own set of unique health-promoting properties called ‘phytochemicals’ that give vegetables their colour, flavour, taste and even smell.

Try something new

Trying new things is a great strategy to boost your vegetable intake. Whether that’s trying new vegetables, a new recipe, or trying vegetables in a way that you normally don’t consume them like at breakfast or in a snack. Experimenting with vegetables and preparing foods can give you the knowledge, skills and confidence to easily prepare vegetables to suit your tastes, which makes you more likely to buy, cook and consume them.

Love your legumes

2016 is International Year of the Pulse (another term for legumes) and they are a cheap and versatile source of fibre, protein plus many other important nutrients. We should have 2–3 serves of legumes a week for health benefits.

Sibylla Stephen is one half of children’s band, Teeny Tiny Stevies, who are ambassadors for National Nutrition Week 2016.

Mum-of-two Sibylla and her bandmate and sister, Beth, are releasing the animated video for their song “I Ate A Rainbow” during National Nutrition Week, which was written as a tool to help parents teach their children about why we should eat different coloured vegetables every day.

And it’s a perfect match with the storybook, I’m having a rainbow for dinner published by Nutrition Australia’s Queensland Division.

“I’m thrilled to be an ambassador for National Nutrition Week because I think we can all do with learning some new quick and easy ways to feed ourselves and our families with vegetables,” Sibylla said.

“My children are four and one, and their relationship with food changes as they get older. It can be incredibly frustrating to get them to eat their veggies, but I always encourage them to try different veggies cooked in different ways, and learn what they do and don’t like.

“As parents we try so hard to make sure our kids are well nourished, but the stats show that we’re not taking our own advice. I think ‘eating a rainbow’ is a great message for children and adults alike!”

Report continued

The National Aboriginal and Torres Strait Islander Health Plan takes a “whole-of-life” approach to improving health outcomes. Priority areas include maternal health and parenting; childhood health and development; adolescent and youth health; healthy adults and healthy ageing.

This Policy Issues Brief provides a synthesis of the evidence for food and nutrition programs at each of these life stages. It answers questions such as, what kind of food and nutrition programs are most effective for Aboriginal and Torres Strait Islander peoples? And, how should these food and nutrition programs be developed and implemented?

Nutrition research has been criticised for focusing too much on quantifying dietary risks and deficits, without offering clear solutions.

Increasingly, Aboriginal organisations are calling for strength-based approaches, which utilise community assets to promote health and wellbeing.

Evidence-based decision-making must consider not only what should be done, but also how food and nutrition policies and programs can be developed to support the existing strengths of Aboriginal and Torres Strait Islander communities.

National Nutrition Week runs from 16-22 October 2016. Click here for recipes, tips and resources to discover new ways to add veg to your day.

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Sep 23 2016

NACCHO #Health Press Release : #AIHW reveals the extent of the health crisis facing Aboriginal communities

“In a wealthy country such as Australia, I am appalled by the unacceptable gap in the health of Aboriginal people and non-Aboriginal people. More than one-third (37%) of the diseases or illness experienced by Aboriginal people are preventable.

“We need to act before another generation of young Aboriginal people have to live with avoidable diseases and die far too young.

If we are serious about turning this crisis around we need sustained investment in evidence-based programs for Aboriginal people, by Aboriginal people, through Aboriginal community controlled health services – a model we know works.

Matthew Cooke Chair of NACCHO pictured above with Vice Chair Sandy Davies

New figures show that Aboriginal and Torres Strait Islander people experience ill health at more than double that of non-Indigenous Australians.

The peak Aboriginal health organisation, the National Aboriginal Community Controlled Health Organisation (NACCHO) said the report highlights the urgent need for a rethink on actions to address the already known and growing crisis in Aboriginal health.

The report from the Australian Institute of Health and Welfare (AIHW) released today shows Aboriginal Australians experience a burden of disease at 2.3 times the rate of non-Indigenous Australians.

Download the report aihw-australian-burden-of-disease-study

NACCHO Chair, Matthew Cooke, said it is the first ever in-depth study of the scale of disease in Indigenous communities.

See AIHW Press Release

“It’s given us a clearer picture of the real impact for Aboriginal communities of poor health in terms of years of health lives lost, quality of life and wellbeing and what the risks factors really are,” Mr Cooke said.

“It’s shown that we still have a massive challenge to address the overwhelming level of non-fatal burden in mental health in particular – which makes up 43 per cent of non-fatal illness in men and 35 per cent of these conditions in women.

The AIHW report found that injuries, including suicide, heart disease and cancer are the biggest causes of death in Aboriginal people. Levels of diabetes and kidney disease are five and seven times higher in Aboriginal people than non-Aboriginal people.

Mr Cooke said the report must trigger a rethink on how health programs are funded and delivered to Aboriginal people.

“The risk factors causing health problems include tobacco use, alcohol use, high body mass, physical inactivity, high blood pressure, high blood glucose and dietary factors – all of which can be addressed with the right programs on the ground and delivered by the right people.

“All levels of government should urgently act on this evidence; we need to see these findings translated into programs, policies and funding priorities that are proven to work. Too many programs aimed at addressing Aboriginal health are still fragmented, out of touch with local communities, unaffordable or inaccessible.

“If we are serious about turning this crisis around we need sustained investment in evidence-based programs for Aboriginal people, by Aboriginal people, through Aboriginal community controlled health services – a model we know works.”

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Sep 16 2016

NACCHO Aboriginal #Heart Health : Why are Aboriginal children still dying from rheumatic heart disease?

” The social, economic and human consequences of the disease are profound. Indigenous Western Australians with rheumatic heart disease die, on average, at 40 years old. Children must travel for heart surgery; young adults live with premature disability; and pregnant women face high-risk pregnancies.

Rheumatic heart disease remains an outstanding, preventable blight for a nation committed to closing the life-expectancy gap. Australia has a national approach to acute rheumatic fever and rheumatic heart disease control. We must not only ensure this approach continues, but that it expands, with properly funded, evidence-based interventions.

Jonathan Carapetis Professor, Paediatrics, Telethon Kids Institute

The above are critical elements of the Endgame Strategy, currently under development by the END RHD Centre of Research Excellence. See www.rhdaustralia.org.au The Conversation, CC BY-ND

Originally published The Conversation

This article is the second in our three-part series on blinding, deafening and sometimes deadly conditions in Indigenous Australian children that have little to no impact on their non-Indigenous counterparts. You can read yesterday’s piece on trachoma here. Tomorrow’s article will look at otitis media.

It seems far-fetched to think a sore throat or skin sore could take a lasting toll on your health, leading to heart failure and premature death. But this is the reality for many Indigenous children and young people in Australia’s most vulnerable communities.

For these young people, what we might consider a relatively harmless infection with streptococcus bacteria, in the throat or on the skin, can be the start of a tragic pathway towards life-threatening rheumatic heart disease (RHD).

Yet this pathway is completely avoidable; indeed in mainstream Australia, it is usually avoided. Today, most doctors in major Australian cities will not see a case of acute rheumatic fever, the precursor to RHD. Only around 50 years ago, though, children’s hospital wards were full of children with the two conditions.

The reality is different for Indigenous people. Young Indigenous Australians in the Northern Territory are up to 122 times more likely to have rheumatic heart disease than their non-Indigenous counterparts.

https://datawrapper.dwcdn.net/Dk5Il/3/

Rheumatic heart disease is responsible for the highest gap in life expectancy between Indigenous and non-Indigenous Australians; higher than diabetes or kidney failure.

So why is the condition still prevalent among Indigenous Australians?

From sore throat to heart disease

Infection by the Group A Streptococcus bacterium can manifest as either a strep throat or impetigo, commonly known as skin sores.

When fighting a strep infection, around 3% to 6% of people develop an abnormal response which leads to the body’s immune system attacking its own tissues. This happens due to a combination of bacterial, genetic and environmental factors and results in acute rheumatic fever. Symptoms include sore joints, fevers and inflammation of heart valves – which is the most damaging.

When acute rheumatic fever occurs repeatedly, often over many years, valve damage worsens and becomes permanent, resulting in rheumatic heart disease.

Heart valves are like doors in the heart that allow blood to move in one direction only. When they are damaged, the valves allow blood to leak in the wrong direction. This reduces the heart’s ability to pump blood effectively and ultimately leads to heart failure, stroke and sometimes early death.

Heart valves are like doors in the heart that allow blood to move in one direction only. from shutterstock.com

The pathway to rheumatic heart disease and its complications can be stopped at various points along the way. Acute rheumatic fever can be prevented if the original strep infection is accurately diagnosed and promptly treated with the antibiotic penicillin. But even if acute rheumatic fever occurs, it is not too late to intervene.

After even just a single episode of acute rheumatic fever, young people need monthly injections of penicillin for at least a decade, often longer. This protects them from further strep infections, subsequent episodes of rheumatic fever and further damage to the heart valves. Although this strategy works, it requires painful injections that need to be given on time, every month, for at least a decade.

In addition to these injections, people with rheumatic fever require long-term check-ups. If they have rheumatic heart disease, they require life-long clinical review, regular heart scans and long-term medication to treat heart failure or heart-rhythm abnormalities.

If the heart-valve damage is severe, surgery may be needed to repair or even replace the valve. This can only be done in major hospitals, often thousands of kilometres away from where the person lives. Surgery can be life-saving, although it doesn’t cure rheumatic heart disease.

RHD in Australia and the world

Rheumatic heart disease was common until the 1960s in wealthy populations, including major Australian cities.

Since then, improved living standards in high-income countries have reduced the transmission of the bacterial infection. A combination of less crowded housing, improved sanitation and better access to health services also resulted in a dramatic decrease in the incidence of acute rheumatic fever and resultant heart disease.

Penicillin has also had an added impact, both in preventing initial episodes of rheumatic fever by treating sore throat, and in preventing recurrences that enable slow disease progression.

Over the last few decades, however, an uncontrolled epidemic of rheumatic heart disease has been uncovered in developing countries and our own Indigenous populations, especially those living in rural and remote areas of northern and central Australia.

Today, rheumatic heart disease affects more than 32 million people worldwide and claims more than 275,000 lives each year. Almost all cases occur in low and middle-income countries, with the greatest burden being among some of the most disadvantaged populations.

Particular hotspots include sub-Saharan Africa, parts of South Asia and the South Pacific. However, the highest rates of rheumatic heart disease are in Australia.

The social, economic and human consequences of the disease are profound. Indigenous Western Australians with rheumatic heart disease die, on average, at 40 years old. Children must travel for heart surgery; young adults live with premature disability; and pregnant women face high-risk pregnancies.

Aug 22 2016

NACCHO #BlackLivesMatter : WALEED Aly dismay over Australia’s willingness to accept black deaths in custody

“Or maybe they’ve not even committed a crime at all. They’ve just been detained for their own safety. And this is a penalty we’ve administered almost 400 times in the last 25 years.”

Of those locked up in Australian prisons, 28 per cent are indigenous. That’s despite indigenous Australians making up only 2 per cent of the Australian population.

That means the likelihood of being locked up is 13 times higher for indigenous Australians than for non-indigenous Australians.

WALEED Aly has expressed dismay over Australia’s willingness to accept black deaths in custody. He says “Black Lives Matter” overseas, but Australia is “not at a point where we can fully accept that”.

See previous NACCHO News Alert

Royal Commission into Deaths in Custody 25th anniversary today : What’s changed

The Project host used Friday night’s editorial to tackle the huge number of Aboriginal and Torres Strait Islanders being locked up in Australian prisons and the tragic deaths we accept as a normal part of that process reports News Ltd

“I learned in school that the last person to receive the death penalty in Australia was Ronald Ryan, hanged in 1967,” Aly said.

“But the truth is, we still have the death penalty. Clearly death is still a penalty we’re OK with in this country. As long as, one, the person dying is indigenous, and two, their carers don’t illegally murder them outright.

“The difference is, we don’t even need their deaths to be signed off by a court anymore. And rather than their crimes being something serious like murder, sometimes the crime for which they’re dying is failing to pay some fines.

Aly said what happens when indigenous Australians are locked up is the real problem. Like what happened last month to NSW woman Rebecca Maher, who was walking home disoriented and possibly drunk when she was picked up by Maitland Police.

She was locked up and, less than six hours later, was found dead in her cell.

Ms Maher was the first indigenous woman to die in NSW police custody since 2000.

Aly said “there’s no suggestion that police are murdering indigenous Australians” but that a 1991 Royal Commission found about a quarter of indigenous deaths in custody were caused by “external trauma, meaning they died from injuries incurred before they were locked up or while in custody”.

Of all the deaths reviewed, Aly said more than a third were caused by disease, a third by suicide and 10 per cent by alcohol or drug use. But inherent racism played a big role, too.

“In other parts of the world right now, people are protesting that black lives matter. Clearly we’re not at a point where we can fully accept that.”

“But what I want to ask you is, now knowing everything I’ve just told you, do black deaths matter? I really hope the answer is yes.”

Aly is calling on the national rollout of a Custody Notification Service, otherwise known as the CNS. It is a notification service that alerts Aboriginal Legal Services that an Aboriginal person is in custody.

The service is used in NSW but, in Rebecca Maher’s case, was not used because she wasn’t officially arrested. She was held “for her own care”.

Tom Whitty, The Project’s supervising producer, co-wrote Friday night’s editorial.

Aug 17 2016

NACCHO Aboriginal Health Heart Map : Our Indigenous Community Hurting in the Heart

“Aboriginal and Torres Strait Islander peoples are two-and-a-half times more likely to be admitted to hospital for heart events than non-Indigenous Australians.

For both sexes, Aboriginal and Torres Strait Islander peoples are more likely to have high blood pressure, be obese, smoke and a poor diet.

“Many of the hospital admissions for Aboriginal and Torres Strait Islander peoples are preventable and the Heart Foundation is committed to closing the gap in health outcomes for Aboriginal and Torres Strait Islander peoples.”

Heart Foundation National Chief Executive Officer Adjunct Professor John Kelly said these maps brought together for the first time a national picture of hospital admission rates for heart-related conditions at a national, state and regional level.

Or Download report and press release

Australian Heart Maps Report 2016

Australia’s Indigenous Community Hurting in the Heart

Aboriginal and Torres Strait Islander peoples are two-and-a-half times more likely to be admitted to hospital for heart events than non-Indigenous Australians.

Of all the four heart events (STEMI and NSTEMI, unstable angina and heart failure), admission rates for Aboriginal and Torres Strait Islander peoples is at least double that of non-Indigenous Australians.

“For all separations, Aboriginal and Torres Strait Islander peoples have a rate of 117.9 compared to non-Indigenous of 48.9,” Adj Prof John Kelly said.

“If Aboriginal and Torres Strait Islander peoples had the same rate of admissions, there would be 2300 fewer hospital admissions each year including close to 900 fewer admitted for a heart attack.

“For both sexes, Aboriginal and Torres Strait Islander peoples are more likely to have high blood pressure, be obese, smoke and a poor diet.

“Adding to the risk is they’re more likely to have comorbidities, which is having at least two or more conditions/illnesses such as heart disease, respiratory disease and kidney disease.

For almost every social indicator (education, income, housing security etc) Aboriginal and Torres Strait Islander peoples fare worse than their non-indigenous counterparts.

“These poorer social and economic conditions lead to higher rates of smoking, hypertension, and obesity for Aboriginal and Torres Strait Islander peoples.

“Yet, for historical, geographic and cultural reasons, primary healthcare services remain under-used by Aboriginal and Torres Strait Islander peoples.

“As a result, poorer health and lower quality of life becomes the “norm” until a critical event like a heart attack happens.

Mapping Out Australia’s Heart Health

View and Engage with Heart Map Here

New heart-related hospital admissions data mapped by the Heart Foundation reveals disturbing gaps between those living in the city and those in regional Australia.

A concerning trend among the hotspots was the correlation between access to services, particularly for those considered disadvantaged, and the rates of heart-related hospital admissions.

Heart Foundation has launched Australian Heart Maps, which is an online service highlighting how indicators for heart disease are distributed throughout Australia’s hospital network.

Queensland dominates the list of hotspots with 12 regions included in the top 20.

This compared to four from New South Wales, two from Northern Territory and one each from Western Australia and Victoria.

“This contrasts to areas with the lowest rates – particularly the northern suburbs of Sydney, where there is little disadvantage of the community.

“There is a five-fold difference of hospital admissions between Northern Territory Outback and the region with the lowest admission rates North Sydney & Hornsby, which highlights the association between remoteness, disadvantage and our heart health.

“The lowest rate we see in the northern suburbs of Sydney tells us what is possible, what we should be striving for across the country.”

Adj Prof Kelly added that the Heart Maps would serve as a valuable tool for health professionals, health services, local governments, researchers and policy makers to be used to set strategy, plan services and target prevention initiatives to areas of greatest need.

“What we need is a greater focus on prevention and management of heart disease in rural and remote Australia and in areas of disadvantage,” he said.

“For those with established heart disease, we want to work with health planners to ensure everyone has good access to co-ordinated cardiac services to reduce hospital readmissions and the development of further chronic disease.”

The Heart Foundation Heart Maps display hospital admission rates for two years of hospital separation data, with a separation defined as a completed episode of patient care in hospital resulting in discharge, death, transfer or change in type of care (ie: acute to rehabilitation).

The Heart Maps display separations for four key heart diagnosis – NSTEMI, STEMI, Unstable Angina and Heart Failure, with data for all heart-related admissions presented.

The data is shown on interactive online maps that drill down into each region looking at the number of hospital admissions as well as identify the risk factors for heart problems by high blood pressure, high cholesterol, obesity, smoking and physical inactivity.

Further Away You’re Closer to a Heart Related Hospital Visit

Living in a very remote area, you’re nearly twice as likely to need to visit a hospital for a heart event.

In figures available as part of the Heart Foundation Australian Heart Maps, the further a person lives from a major city the greater the rate of heart related hospitalisations.

Those living in major cities had an ASR of 47.1, with rates increasing for people living in regional areas (inner regional 53.1; outer regional 57.6; remote 62.2; very remote 92.5).

“If Australians in outer regional and beyond had the same hospital admissions rate as those in major cities, there would be more than 3400 avoidable hospital visits for a serious heart event each year,” Adj Prof John Kelly said.

“That would mean 1700 fewer admissions for a heart attack, which is more than four a day.

“The Heart Foundation urges regional service providers and State and local governments to use this information to ensure all Australians have access to preventative health care and facilities to reduce the risk factors.”

“Along with higher rates of smoking, obesity and physical inactivity, remote Australia experiences higher levels of disadvantage, has poorer access to health services and the conditions needed for health such as an environment that supports physical activity, access to affordable healthy food, access to education and secure employment.”

see report in full Australian Heart Maps Report 2016

About the Maps

The Heart Foundation’s Australian Heart Maps bring together for the first time a national picture of hospital admission rates for heart-related conditions at a national, state, regional and where possible, at a local government level.

The Heart Maps show how rates of heart related admissions compare across Australia. Importantly, the Heart Maps also highlight the association between socioeconomic disadvantage and remoteness with heart health outcomes.

The Heart Maps can act as a valuable tool for health professionals, health services, local governments, researchers and policy makers. The Heart Maps can be used to establish health related strategies, to plan for health services and to develop/implement targeted prevention initiatives. Specifically, the Heart Maps show:

The rate of hospital admissions (per 10,000 people) for “All Heart Admissions” at a Local Government level. Local Governments can be compared against the national average and are ranked from highest to lowest admission rate across Australia.
The rate of admissions (per 10,000 people) for “All Heart Admissions”, Heart Attack (both STEMI and Non-STEMI), Heart Failure, and Unstable angina for states/territories and SA4 regions.
Australian Health Survey data (2011/12) for the prevalence of smoking, obesity, insufficient physical activity, hypertension and total high cholesterol for states/territories and SA4 regions.

The Heart Maps provide a national context for the more detailed state level maps available for Victoria and South Australia.

About the Data

Two years of hospital separation data (2012/13 and 2013/14) is presented in the Heart Maps. The separation (admission) data excludes admissions where a patient has been transferred from another hospital.

The admission data was accessed from State and Territory Health departments via the Australian Institute of Health and Welfare (AIHW). Suppression rules have been applied to the Heart Maps, in accordance with the State and Territory Conditions of Data Release. That is, admission rates are suppressed for any population smaller than 1,000 or where there are fewer than five admissions.

A full technical report describing the data and analysis is now available.

Acknowledgments

The Heart Foundation would like to acknowledge the following organisations:

The Australian Institute of Health and Welfare (AIHW): in seeking clearance from the State/Territory Data custodians and for undertaking the preliminary data analysis.
State/Territory Health departments: for providing initial feedback and recommendations relating to the project.
Statistical Consultant and Epidemiologist, Stephen Vander Hoorn: for undertaking comprehensive statistical analysis and for developing the online mapping tool.

Aug 3 2016

NACCHO Indigenous Health Research News: Tom Calma urges quarantining of Indigenous research funding

“The NHMRC has close to a 6 per cent target now for funding to go towards Aboriginal and Torres Strait Islander projects, We’re calling on the ARC to match it.”

While the ARC did have a dedicated stream of funding for Indigenous grants, it was a very small proportion of the overall pool. A quarantined funding would create a virtuous circle for Indigenous researchers starting with capacity building.

We have a recorded 10 years life expectancy gap between Indigenous and non-Indigenous peoples in Australia.

“When I wrote the Aboriginal and Torres Strait Islander Social Justice Report chapter on achieving health equality within a generation in 2005, the gap was 17 years. But there’s still a significant gap compared to our Indigenous brothers and sisters in New Zealand and Canada and the United States where they enjoy five to six years.”

Professor Calma, who is chairman of the Poche Centre for Indigenous Health Network and chancellor of the University of Canberra.

From The Australian

File Picture above NACCHO Chair Matthew Cooke with Former Rural Health Minister Fiona Nash and Professor Tom Calma at a recent Close the Gap event Parliament House Canberra

One of the country’s most senior Indigenous figures, Tom Calma, has called on the Australian Research Council to quarantine a proportion of its funding for research into indigenous matters.

Professor Calma said the ARC should match the proportion of designated funding for indigenous research as the National Health and Medical Research Council does.

See NACCHO Research News : Call for research priorities in Aboriginal and Torres Strait Islander health

“At Poche Melbourne we are trying to develop leadership among Indigenous people with a university qualification and also to get more Indigenous PhDs through,” Professor Calma said. “But this is coming out of philanthropic and university money.

“My belief is that philanthropic money should be used for the establishment of programs, not for keeping them going.”

An ARC spokeswoman said it “had no plans to quarantine a certain percentage of national competitive grants programs funding for Indigenous programs”. She said Indigenous research was supported across the range of NCGP areas, including in education, performing arts, health, policy, law, economic development, history and languages.

She said the dedicated scheme, Discovery Indigenous, funded research led by indigenous researchers, as well as higher degree and early career researchers.

The fund was valued at $4 million this year. The spokeswoman said a 2012 Indigenous research network initiative provided $3.2m across four years.

The Poche Indigenous Health Network is a made up of six research centres in five universities.

It was the result of a donation of more than $50m from philanthropists Greg and Kay van Norton Poche, who made their fortune by creating the courier and logistics company StarTrack Express, which was sold to Australia Post and Qantas for $750m in 2003.

Professor Calma is also chairman of the Co-operative Research Centre for Remote Economic Participation, or Ninti One. But he said a change in government focus was threatening public-good CRCs such as his.

Press Release

Poche Patron calls for increased funding for Aboriginal and Torres Strait Islander research projects

Professor Tom Calma AO has called on the Australian Research Council (ARC) to match the proportion of funding provided by the National Health and Medical Research Council (NHMRC) for Aboriginal and Torres Strait Islander research projects.

Addressing the Aboriginal and Torres Strait Islander Health Research Showcase, presented by The Poche Centre for Indigenous Health at the University of Sydney, the Chair and Patron of The Poche Indigenous Health Network said: “The NHMRC now has a target of between 5-6 percent for funding to go towards Aboriginal and Torres Strait Islander projects.”

“We’re calling on the ARC to match it. If we can expand the funding for research in this area, it’s better for all of us, particularly for the communities we’re doing our research for.

“I also strongly encourage senior public servants and policy makers to engage in the research, as research forums like today should be informing public policy,” Professor Calma added.

Speaking about the importance of research in this area, Professor Calma said: “We have a recorded 10 years life expectancy gap between Indigenous and non-Indigenous peoples in Australia.

“All of our research projects are looking at ways we can influence the way we close that gap.”

Professor Calma also thanked The Poche Centre at the University of Sydney for supporting the annual Health Research Showcase, the fifth since the centre was established in 2008.

“They’re an opportunity to bring together different research elements of the University, to be able to share experiences but also look at ways in which we can work better together,” he said.

“If we can encourage more targeted initiatives, we’ll always get better outcomes.”

The Poche Centre for Indigenous Health at the University of Sydney was established and funded by philanthropists Greg Poche AO and Kay Van Norton Poche, along with their friend and co-founder, Reg Richardson AM. They have gifted more than $50m in the past seven years to harness the skills, expertise and resources of the University of Sydney and four other universities to contribute towards Aboriginal health.

The centre draws upon a combination of Commonwealth, State and philanthropic funds and partners with Aboriginal Community Controlled and other organisations to provide specialist health services for Aboriginal people. They also build and support education and career pathways for Aboriginal people, and develop opportunities for students and graduates to participate in Aboriginal health service delivery.

Committed to the ongoing development of a strong research vision and strategy, the centre’s annual Aboriginal and Torres Strait Islander Health Research Showcase brings together an array of health researchers, scholars and community collaborators.

This year’s showcase covered three themes: evidence and discourse; meaningful collaboration in Indigenous health; and health, lifestyle and wellbeing. The University of Sydney faculties involved include the Faculty of Medicine, Faculty of Health Sciences, Faculty of Dentistry, Faculty of Pharmacy, School of Nursing and Midwifery as well as colleagues from The George Institute for Global Health.

Jul 20 2016

NACCHO #HIV #AIDS2016 : Fears for Indigenous HIV epidemic as diagnosis rates rise in Australia

” The potential exists for HIV to escalate rapidly in the Aboriginal and Torres Strait Islander population – as has been the experience in other Indigenous populations globally. This potential is due to three main issues:

very high rates of other sexually transmissible infections (STIs) exist in many communities, and the presence of these increases the chances that HIV can be transmitted
increasing rates of injecting drug use – including increasing rates of methamphetamine (ice) use in Aboriginal communities, and
the close proximity of Papua New Guinea (PNG) to the Torres Strait Islands, and the mobility and interaction of PNG nationals and Torres Strait Islanders. PNG has the highest recorded rates of HIV in the Asia-Pacific”

Associate Professor James Ward is Head, Infectious Diseases Research Aboriginal and Torres Strait Islander Health at South Australian Health and Medical Research Institute (SAHMRI) and a guest editor of HIV Australia.U And Me Can Stop HIV (article second)

“Public health authorities are warning that Australia could be on its way to an HIV epidemic in Indigenous communities.

We know that Indigenous Australians have poorer health overall and often have poorer access to health services, so just getting diagnosed can be a real problem, Support structures for HIV infection are not always in place in Indigenous communities.

The Aboriginal and Torres Strait Islander community traditionally hasn’t had high levels of HIV, so there’s still a lot of stigma and fear,

‘The young people we’ve diagnosed have known very little about HIV, so we have a lot of education to do for them, their sexual partners and sometimes their families if they’re willing to involve their families, which often they’re not.“

Cathy Van Extel reports on the latest figures from far north Queensland.

“Research into a cure for HIV has been gathering momentum. Global investment in cure research has more than doubled in the last four years, in contrast with investment in other HIV programs.

Given the effectiveness of antiretroviral drugs in both treating and preventing HIV infection, however, cure research raises a range of important questions about priority setting in global health.

Curing HIV – or at least achieving long-term remission – is possible, under the right circumstances.”

Author Bridget Haire Lecturer in ethics, HIV prevention, UNSW Australia: The Conversation Remind me again, how close are we to a cure for HIV?

Image above : To acknowledge #AIDS2016 Conference in South Africa NACCHO presents an update on Indigenous Australia : Today, there are 36.9 million people living with HIV/AIDS in the world and more than 95% of those living with HIV are in developing countries where access to effective health care is often challenging. SEE WEBSITE http://www.aids2016.org/

In the same week that Australia declared AIDS was no longer a public health issue, doctors have raised the alarm about a spike in new HIV cases involving Indigenous Australians in far north Queensland.

If we don’t act soon, there could be a whole lot of misery ahead for a lot of people.

Darren Russell, Cairns Base Hospital

Cairns normally records one or two new cases of HIV infection annually. This year, however, there have been nine diagnoses to date—and all have been Indigenous patients.

Dr Darren Russell, the director of sexual health at Cairns Base Hospital, says the spike comes on the back of a small increase in new cases in north Queensland last year.

‘We’re up to nine cases so far this year and we are only halfway through the year,’ he says.

‘We are concerned about it, and although we don’t think things are out of control, we are a bit worried.’

North Queensland a HIV hotspot

Nationally, homosexual men account for around 85 per cent of HIV cases, compared to 65 per cent among Indigenous people.

The new HIV infections in Cairns primarily involve younger gay or bisexual men, aged in their 20s and 30s.

While Cairns has emerged as a hotspot for new HIV infections, there is concern the virus could spread.

‘A lot of these people are very young and very mobile so there is the potential for spread to occur outside of Cairns,’ Russell says.

Health authorities are worried that Australia could follow Canada in experiencing an HIV epidemic in its indigenous population.

‘The Canadian epidemic came out of nowhere and has been a huge problem,’ Russell says.

‘If we don’t adequately address issues around Indigenous sexual health the same thing could happen here.

‘We don’t want to be too alarmist but at the same time if we don’t act soon there could be a whole lot of misery ahead for a lot of people.’

Indigenous access to services a factor

Russell says there are a range of challenges in managing HIV in Indigenous populations.

‘We know that Indigenous Australians have poorer health overall and often have poorer access to health services, so just getting diagnosed can be a real problem,’ he says.

He says support structures for HIV infection are not always in place in Indigenous communities.

‘The Aboriginal and Torres Strait Islander community traditionally hasn’t had high levels of HIV, so there’s still a lot of stigma and fear,’ he says.

‘In order to address those issues we need to reduce the stigma, get more people tested and diagnosed, and we need to enable them to stay on their medications.

‘They are all big challenges for anyone, let alone the Indigenous population.’

What’s behind the increase?

Doctors believe the increase in HIV infections in Cairns is linked to a syphilis epidemic, which has affected Indigenous communities across northern Australia for several years.

‘There are probably a few factors that are leading to this increase,’ Dr Russell says.

‘We have a syphilis epidemic across far north Queensland along with the Northern Territory and north-west Australia at the moment and we’re seeing a lot of syphilis where previously we had it almost under control.

‘Syphilis makes it much easier to acquire HIV so that could be one of the factors driving it.’

HIV infections by the numbers

The actual number of Indigenous HIV diagnoses each year remains small compared to the overall national figure.

In 2014, of the 1081 new cases of HIV around Australia, 33 involved Indigenous Australians.

Worryingly, the rate of HIV diagnosis among Aboriginal and Torres Strait Islander people is now higher than the rate for non-Indigenous Australians. In 2014 it was 5.9 per cent compared to 3.7 per cent.

The Kirby Institute reported in its 2015 Annual Surveillance Report that the HIV diagnosis rate in Aboriginal and Torres Strait Islander people has increased in the past five years and ‘requires a strengthened focus on prevention in this vulnerable population’.

The Kirby Institute also found that the rate of syphilis infection in the Aboriginal and Torres Strait Islander population in 2014 was four times higher than the rate in the non-Indigenous population.

According to Russell, the number of syphilis infections appears to have plateaued or decreased in some areas such as Cape York and Torres Strait but continues to rise in other northern regions, particularly among younger Indigenous Australians.

Syphilis rates remain a concern in the Top End of the Northern Territory, and are increasing in the Kimberley region of Western Australia. There is also a danger of the syphilis epidemic spreading to Indigenous communities in Central Australia.

The role of government

The federal government is under pressure to act to prevent a sexual health crisis. Russell has described the federal response to date as disappointing.

‘We have a Closing the Gap scheme that is really silent on the issue of sexual health and sexually transmitted infections, and yet one of the health factors that could really cause a huge amount of damage to Indigenous Australians is poor sexual health including syphilis and HIV,’ he says.

‘They’re not getting the priority that they should.

‘I’m not suggesting we de-prioritise other chronic health conditions, but we do need to have more focus federally, and more funding and support when it comes to sexual health and HIV.’

U And Me Can Stop HIV December 2015

Aboriginal and Torres Strait Islander HIV Awareness Week (ATSIHAW) is an annual program of events that seeks to raise awareness about the impact of HIV among Aboriginal and Torres Strait Islander people.

Although the inaugural event was only held twelve months ago, it is already well recognised as key event for raising awareness and mobilising action to address HIV among Aboriginal and Torres Strait Islander communities.

HIV diagnoses among the Aboriginal and Torres Strait Islander population is increasing, yet for many years now there has been little or no investment by governments targeted at enhancing our communities’ knowledge and awareness of HIV.

While the number of annual HIV diagnoses for Aboriginal and Torres Strait Islander people is fairly low at present (around 30 new diagnoses per year), in 2014 the notification rate of newly diagnosed HIV infection was 1.6 times higher for the Aboriginal and Torres Strait Islander population compared to the non Indigenous population (5.9 vs 3.7 per 100,000 in 2014).

The potential exists for HIV to escalate rapidly in the Aboriginal and Torres Strait Islander population – as has been the experience in other Indigenous populations globally. This potential is due to three main issues:

very high rates of other sexually transmissible infections (STIs) exist in many communities, and the presence of these increases the chances that HIV can be transmitted
increasing rates of injecting drug use – including increasing rates of methamphetamine (ice) use in Aboriginal communities, and
the close proximity of Papua New Guinea (PNG) to the Torres Strait Islands, and the mobility and interaction of PNG nationals and Torres Strait Islanders. PNG has the highest recorded rates of HIV in the Asia-Pacific region.

In the five year period 2010–2014, when comparing rates of new HIV infection among the Aboriginal and Torres Strait Islander population with the non- Indigenous Australian born population, a higher proportion of notifications were attributed to injecting drug use (16% vs 3%); heterosexual sex (20% vs 13%); and 22% vs 5% of new HIV diagnoses were among females.

Based on CD4+ cell counts at diagnosis, in 2014 a third (30%) of the new HIV diagnoses among the Aboriginal and Torres Strait Islander population were determined to be late.

ATSIHAW events

The 2015 ATSIHAW launched at the Wuchopperen Aboriginal Health Service in Cairns on the 30 November.

Speakers included Assoc Professor James Ward, SAHMRI (South Australian Health and Medical Research Institute), Dr Mark Wenitong, Apunipima Cape York Aboriginal Health Council, HIV-positive speakers, and youth and elders from the Cairns region and community.

The launch was followed by a training day on Tuesday the 1 December for health service staff working in the Cairns region, to learn about updates on HIV diagnosis, risk factors, prevention strategies, treatment updates, care and management of people living with HIV and outbreak management – including privacy confidentiality stigma and discrimination.

On 2–3 December, ATSIHAW, in partnership with the HIV Foundation Queensland, ASHM (Australasian Society for HIV, Viral Hepatitis and Sexual Health Medicine) and the National Aboriginal Community Controlled Health Organisation, hosted a high level summit in Brisbane to discuss strategies and actions for moving forward an agenda that is urgently required.

The Summit, opened by the Queensland Health Minister, the Hon Cameron Dick MP, was held in recognition of the need to urgently address the fact that STIs and blood borne viruses are part of our communities’ overwhelming burden of disease, particularly:

for remote communities – STIs (chlamydia, gonorrhoea, syphilis and trichomonas), as well as hepatitis B
for urban and regional areas – hepatitis C and chlamydia
emerging HIV transmission risks from drugs such as methamphetamines (‘ice’) – both due to unsafe injecting and condomless sex.

During ATSIHAW, community events were held across Australia at over 30 Aboriginal Community Controlled Health Services in most jurisdictions and at other HIV organisations such as AIDS Councils, aimed at raising awareness of HIV in our communities.

ATSIHAW also recruited high profile Ambassadors to help spread the word about HIV in our communities and the roles all individuals can play in stopping HIV.

Our ATSIHAW Ambassadors include Prof Pat Anderson AM, Prof Kerry Arabena, Dr Marlene Kong, and Mr Dion Tatow, to name a few.

View profiles of some of our ATSIHAW Ambassadors

May 10 2016

NACCHO Aboriginal health #Stroke Stories : Written by the mob for the mob

“It’s very important that it belongs to the local community.And the community chose the stories, artwork and analogies that would be best to make it work.

The river is compared to the blood flow through the body,” says Rachel. “If it’s dammed with silt and trees then nothing gets past, like when an artery gets blocked. Or if the river floods it kills the land it goes over, which can be like a bleed in the brain.”

Rachel Peake, Stroke Care Coordinator in from Hunter New England Health.

A book of personal stroke stories from Aboriginal community members is proving effective at getting authentic, relatable information across to others in the community and raising stroke awareness.

All the words in Stroke: Written by the Mob for the Mob come from the Aboriginal people of the Kamilaroi/Gomeroi/Gamilaraay/Gamilaroi nations. The booklet was published by the Hunter New England Local Health District of NSW.

Download Stroke: Written by the Mob for the Mob (PDF, 12 MB)

“It’s very important that it belongs to the local community,” says Rachel Peake, Stroke Care Coordinator in from Hunter New England Health. “And the community chose the stories, artwork and analogies that would be best to make it work.”

The stories were gathered through a series of yarning sessions, which let people direct the conversation themselves. This makes sure that nothing important is missed, and that the authentic voices of the participants come through.

The result is a relaxed mix of humour and art. This includes the painting on the booklet’s cover, a representation of stroke and the brain created by students from the Peel High School. This picture also demonstrates the analogy of the river, which is central to the booklet’s message.

“The river is compared to the blood flow through the body,” says Rachel. “If it’s dammed with silt and trees then nothing gets past, like when an artery gets blocked. Or if the river floods it kills the land it goes over, which can be like a bleed in the brain.”

Since its publication the booklet has taken on a life of its own, with hardly any copies left from the original print run of 2000. This is partly due to people’s pride in their own family members, demonstrating that the booklet is reaching the community it was created for.

As Rachel says, “This is the message the community wanted: if they’re given a voice, they can educate their own people.”

You can find the Stroke: Written by the Mob for the Mob booklet on enableme and InformMe, as well as a series of videos of respected community members telling their own stories.

Download Stroke: Written by the Mob for the Mob (PDF, 12 MB)

Declaration: Colin Cowell editor of NACCHO Aboriginal Health News Alerts is stroke survivor and was recently elected to the board of Stroke Foundation as a Consumer director

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Apr 21 2016

NACCHO Aboriginal #Healthelection16 : Croakey Profiling diversity and innovation in Indigenous smoking programs

“The initiative, launched in 2010, has helped to reduce Indigenous smoking rates, that have been falling at a faster rate than was seen in the general population, and he expects the 2016 national census to confirm anecdotal expectations of more success.

If we have consistent government policies instead of the ‘stop start’ (approach) we’ve seen, the vulnerability of funding, and the demoralising of the community….then we will see even faster gains,” he told Croakey.

“When you start to engage with people, they need to know there’s a future. Our people have too often invested a lot of time and effort into initiatives of government, just get excited about it, and then there’s a change of direction, change of Minister, change of government. It’s got to stop.”

Professor Tom Calma, Chancellor of the University of Canberra and a founder of the Close the Gap Campaign, is ever optimistic about the success of the Tackling Indigenous Smoking initiative, after the Federal Government last year committed funding and resources to a redesigned program

Our thanks to Editor: Melissa Sweet Author: Marie McInerney and the team at Croakey for permission to publish : Please support /Donate /subscribe

Around the world, diverse and innovative programs are tackling high smoking rates among Indigenous communities, according to presentations at the World Indigenous Cancer Conference in Brisbane last week.

Some of these are big and nationwide like the Tackling Indigenous Smoking program led by Professor Tom Calma in Australia.

Others are small, innovative and targeted, from efforts to “Keep it Sacred” among the Navajo tribes in the United States, through to a board game developed to help Maori Aunties to discourage smoking among young pregnant women.

The conference also heard of the profound impacts of tobacco upon Indigenous communities.

Lung cancer is one of the most common cancers in Indigenous populations, according to the first ever comparative population-based study of cancer incidence in Indigenous people in Australia, New Zealand, Canada, and the United States.

Led by Australian researcher Dr Suzanne Moore, of the Menzies School of Health Research, it also found that smoking is more common in Indigenous communities in all four countries than in their non-Indigenous counterparts.

Another key message from the conference was the impact of “stop start” government policies and a failure to address the social determinants of health that lead to high smoking rates in Indigenous communities.

Harvard Public Health Professor David Williams, who presented a keynote address on the role of race and racism in health, said one important way to address tobacco-related cancers in Indigenous communities is to “address stressors in smokers that drive them to smoke”.

It was also important to focus on the equity impact of anti-smoking policies, he said, where tobacco taxes have a bigger effect on poorer people.

One media campaign that he said had worked better with minority young people in the United States focused on the deceptive practices of the tobacco industry rather than on the health impacts of smoking.

***

Tackling Indigenous Smoking

He told that conference that the initiative, launched in 2010, has helped to reduce Indigenous smoking rates, that have been falling at a faster rate than was seen in the general population, and he expects the 2016 national census to confirm anecdotal expectations of more success.

Part of its power, he said, is to not focus on the perils of smoking – “that’s known” – but to talk about the benefits of non-smoking – “not blaming, but empowering”.

It’s targeted big sporting activities, like the popular Murri Rugby League carnival, which is smoke and drink free and requires all players to complete a ‘Health Check’ in order to participate, the Nuff of the Puff program aimed at young people, and the successful Break the Chain promotion which is also being used in mainstream campaigns.

But, he said, it had suffered from the “wax and wane” approach of governments – notably from a $30 million a year cut in funding under the Abbott Government and disruption of its work while a review of its operations was carried out by Assistant Health Minister Fiona Nash (see more detail in this previous Croakey story).

That had created workforce instability in the Tackling Smoking and Healthy Lifestyle Teams across the country, and disrupted goodwill that had been built up in communities and organisations since 2010.

As a result, he said, Australia is not going to meet its target of halving 2008 Indigenous smoking results by 2008.

“We have to rebuild all that now,” he said.

“If we have consistent government policies instead of the ‘stop start’ (approach) we’ve seen, the vulnerability of funding, and the demoralising of the community….then we will see even faster gains,” he told Croakey.

There’s hope that the new national Aboriginal and Torres Strait Islander Cancer Framework developed by Cancer Australia in partnership with Menzies School of Health Research will help to bring consistency and broader population based approaches.

Calma said it’s an easy-to-read document that is the result of extensive consultation with the Indigenous community, and “that everybody needs to sign up to”.

Prevention is Priority 2 – see the image below.

Keep it Sacred

Tobacco has been used by the Navajo, along with most other American Indian nations, for centuries as a medicine with cultural and spiritual importance, said Scott Leischow from the Mayo Clinic in the US.

Traditionally the Navajo healers would go into the mountains and collect what they call ‘mountain smoke’ that grew naturally, to use in their ceremonies. But over the decades, he said, it’s become more common to just go to the local store and buy commercial tobacco instead, helping to further normalise the use of tobacco and continue to grow high rates of smoking.

Leischow told Croakey the Mayo Clinic has been working to support tribal organisations that have started the “Keep it Sacred” movement to reduce commercial tobacco-related illnesses and cancer disparities among American Indian and Alaska Native populations.

“So some of the tribal organisations are now working to create a policy within healing communities to only use mountain smoke,” he told Croakey. The Mayo Clinic has helped by making videos where healers talk about the role of commercial tobacco and how it has impacted on traditional ways, which will then be disseminated to schools and communities.

Leischow is also working with tribal organisations that are trying to promote smokefree workplaces and public places. This is a complex and contentious policy area, he said, with many American Indian communities fearful that smoking bans in casinos, which have become an economic lifeline for many, will impact on business.

(Check here to see success stories from Keep it Sacred).

Tradition and innovations

Conference keynote speaker Dr Linda Burhansstipanov, director of the Native American Cancer Research Corporation director, talked about another pilot intervention among around 250 Native Americans living in the Rosebud and Pine Ridge Indian reservations and Rapid City in South Dakota.

One-quarter were cancer survivors, she said, in an area where the majority of people with tobacco-related cancer were back smoking within two years of ceasing treatment.

The project used a combination of motivational support and nicotine replacement therapy (NRT).

A big feature was that participants were given a mobile phone, so they could receive tailored text messages each day: a traditional Indian quote and/or personal messages such as: “I am quitting smoking so I can watch my granddaughter go through ceremony”.

The cultural and ceremonial use of tobacco was an issue too with the community, although the novelty of the phones was a big one, with many participants having never had one before. In fact, Burhansstipanov said, some non-smokers had gone to the local casino, where smoking is permitted, to try to build up the carbon monoxide levels in their blood so they could qualify for the program. Others built up pretty high phone bills, just calling information lines.

But, she said, “that’s why they call it research” and while results are still unofficial it is showing great promise. Burhansstipanov said the norm for stop smoking interventions was to get a quit attempt rate of about 7 per cent, and up to 12 per cent in very effective interventions.

As of October 2015, she said, 45 per cent of study participants had attempted to quit. They expect a lot of relapses, but also attempts to try again. “The number of times people restart makes it more likely they will quit in future.”

Game time

Burhansstipanov was speaking at an early morning symposium on traditional and innovative arts and media-based research to prevent smoking and cancer.

The forum also heard about the ‘Talking about Smoking’ project among the Yolngu people of East Arnhem Land. You can read more and watch a video about it here.

Researcher Moana Tane said the Yolngu were introduced to tobacco by Macassan traders and “traditional and culural factors have contributed to normalisation of smoking”. Narali (tobacco) is celebrated and viewed as an essential part of culture, although interestingly most in the community are happy to have smoke-free homes.

There was a need to consider “very carefully” how to intervene, not wanting to offend and denigrate a cultural relationship built up over hundreds of years, but also to be confident offering support because it is what the community want.

And then it was game time. Maori Public Health Professor Marewa Glover explained she wanted to find a way for Aunties to support young pregnant Maori smokers to quit, so she developed a board game to help them deliver essential messages on smoking, nutrition and antenatal care.

Like a Snakes and Ladders game, it’s based, she said, on Robert West’s theory of addiction, where quitting smoking is not a straightforward journey. It has ‘low dice’ cards to connect with low motivation days, and ‘high dice’ cards when smokers are more likely to listen to quit messages. The snakes represent relapse.

“The Aunties were much more interested in playing a game than having me stand and lecture,” she said.

• The feature image is from the Keep it Sacred website.

• Watch Professor Tom Calma talking about the harmful impacts of “stop start” government policies for the health of Aboriginal and Torres Strait Islander people.

• Marie McInerney is covering #WICC2016 for the Croakey Conference News Service. Track the conference coverage here.

Apr 5 2016

NACCHO #HealthElection16 , it’s time to encourage all political parties to focus on Aboriginal health

With an early Federal Election looking likely, it’s time to encourage all political parties to focus on Aboriginal health and the critical role of the community controlled sector in improving services and health outcomes for Aboriginal and Torres Strait Islander people.

The Turnbull Government has flagged it will call a Double Dissolution Election on July 2 if the Senate refuses to pass the Australian Building and Construction Commission (ABCC) Bill, targeting unions. The Prime Minister has until May 11 to call the poll.

NACCHO Aboriginal Health Newspaper available as a FREE lift out in Koori Mail 6 April or as Download HERE or on the Koori Mail APP (see below)

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A decade after governments agreed to bipartisan support for the Close the Gap agreement, the National Aboriginal Community Controlled Health Organisation (NACCHO) Chairperson, Matthew Cooke, said long term commitment from politicians to strengthen and grow the community controlled sector, through partnership with it, must be a priority for all political parties.

“One of the principles that is espoused by all levels of government on Aboriginal issues is that engagement with Aboriginal communities and organisations is the only way to successfully close the gap,” Mr. Cooke said.

“Time and again we see evidence that supports that principle.

“Our own sector, managed by Aboriginal people for Aboriginal people, is making the biggest in-roads against the Closing the Gap health targets.

“Our services provide over two million episodes of care nationally each year and have made the biggest gains against the targets to halve child mortality and improve maternal health. “

“Indeed, our services have successfully contributed to the Close the Gap targets that have reduced child mortality rates by 66% and overall mortality rates of Aboriginal and Torres Strait Islander people by 33% over the last two decades.

The Australian Institute of Health and Welfare’s Healthy Futures Report Card (2015) also highlights ACCHOs’ continued improvement in other areas that measure good practice in primary health care.

Those improvements include increasing the proportion of regular patients who are recorded as having an MBS health assessment; patients with existing conditions who are immunised against influenza; and, patients with Type 2 Diabetes receiving MBS General Practice Management Plans and MBS Team Care Arrangements.

“The fact is, Aboriginal people prefer health care that is holistic and provided in a culturally sensitive environment and that’s why our service delivery model works,” Mr Cooke said.

“Too many Aboriginal people have experienced racism and judgement in the mainstream health system, along with a very clinical approach to health care that doesn’t recognise connections to community and country.

“The holistic approach to health that operates in the Aboriginal Community Controlled sector takes a broader look, considers the range of complex issues affecting health and includes educating patients and preventative measures.

“And it works.”

Mr Cooke said he’d like all parties to commit to a roadmap to extend the reach of Aboriginal health services to ensure more Aboriginal people in more areas can access Aboriginal Community Controlled health care.

“Our services are struggling to meet the demand,’ Mr Cooke said.

“We know many Aboriginal people are driving many kilometers, often past several mainstream service providers, to access the culturally safe care offered by our services.

“Many miss out altogether as they don’t have access to a service where they live.

“Expanding the Aboriginal community controlled network would help improve the health outcomes for Aboriginal people.

“It would mean refocusing the heath system a bit – and a better allocation of the funding pie, ensuring long-term funding certainty, fairer tendering processes and faster decision making by government departments.”

“I believe there’d be real rewards in terms of better health outcomes for Aboriginal people for that effort. ”

Mr Cooke said that approach is confirmed by the Productivity Commission Report released at the end of last year on the National Indigenous Reform Agreement Performance Assessment 2013-14.

“That Report showed mainstream services have not proved they can deliver better outcomes than our sector,” he said.

Mr Cooke said Aboriginal people would also be looking closely at commitments around the Government’s controversial Indigenous Advancement Strategy, which saw the transfer of important Aboriginal health programs to the Department of Prime Minister and Cabinet.

See story Page 4 :Indigenous Advancement Strategy report: Abbott-era indigenous cuts went too far, Senate inquiry

That Strategy’s tendering process drew heavy criticism from respondents to a recent Senate Inquiry.

“The Aboriginal controlled health sector is not afraid of contestability, in fact it welcomes it,” Mr Cooke said. “Yet that was a patently unfair process that didn’t consider results on the ground.”

Mr Cooke said overall he was optimistic about the possible outcomes an election could bring.

“There is a real opportunity in an election campaign to hear the commitments of future governments to Aboriginal people.

“We are hopeful all parties will make Aboriginal health a priority and work with us toward reducing the persistent health gaps between Aboriginal and non-Aboriginal people.”

NACCHO Aboriginal Health Newspaper available as a FREE lift out in Koori Mail 6 April or as Download HERE or on the Koori Mail APP

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*The National Diabetes Scheme is an initiative of the Australian Government administered by Diabetes Australia.

NACCHO chair encourages our award winning health services

Youngsters at the Indigenous Governance Awards winning Institute for Urban Indigenous Health: Photo Wayne Quilliam

National Aboriginal Community Controlled Health Organisation Chair Matthew Cooke is encouraging all of its 150 member services to enter this year’s Indigenous Governance Awards (IGA).

This year the awards will celebrate organisations that are developing local solutions to local problems with culture as a source of strength and innovation and no one does it better than our Aboriginal community controlled health services said Mr Cooke.

One of the NACCHO/QAIHC members, the Institute for Urban Indigenous Health in Brisbane, became a finalist last year for its ‘Work it Out’ and ‘Deadly Choices’ programs, which was a major achievement giving they were only in their fifth year of operation. This recognised how the programs impacted on the health and wellbeing of Aboriginal and Torres Strait Islanders in South-East Queensland,” he said.

This is only one of many potential award winning health services that should be encouraged to enter these prestigious awards “ Mr Cooke said : Applications for the Awards close on May 20 : visit www.reconciliation.org.au/iga/ for more information

NACCHO Aboriginal Health News Alerts

The national authority in Aboriginal primary health care – Aboriginal health in Aboriginal hands

Tag Archives: Australian Indigenous

NACCHO #NNW2016 Aboriginal Health and Nutrition : What works to keep our mob healthy and strong?

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NACCHO Aboriginal #Heart Health : Why are Aboriginal children still dying from rheumatic heart disease?

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NACCHO Indigenous Health Research News: Tom Calma urges quarantining of Indigenous research funding

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NACCHO #HIV #AIDS2016 : Fears for Indigenous HIV epidemic as diagnosis rates rise in Australia

Author Bridget Haire Lecturer in ethics, HIV prevention, UNSW Australia: The Conversation Remind me again, how close are we to a cure for HIV?

U And Me Can Stop HIV December 2015

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Australia’s Indigenous Community Hurting in the Heart

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Author Bridget Haire Lecturer in ethics, HIV prevention, UNSW Australia: The Conversation Remind me again, how close are we to a cure for HIV?

U And Me Can Stop HIV December 2015

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Tackling Indigenous Smoking

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*The National Diabetes Scheme is an initiative of the Australian Government administered by Diabetes Australia.

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