Aboriginal #Rural and #Remote Health #ClosingTheGap #HaveYourSayCTG : New @AIHW Report says the mob living in remote and regional areas are dying preventable deaths from treatable conditions because of a lack of access to health services

 “Australians living in remote and regional areas are dying preventable deaths from treatable conditions because of a lack of access to health services.

The damning assessment is contained in a new Australian Institut­e of Health and Welfare report on rural and remote health, which finds that those in the bush rely heavily on general practitioners to provide primary healthcare services in the absence of specialist doctors.

But patients most in need of GPs often can’t access them, with those in remote areas six times as likely as those in metropolitan centres to report they had no access­ to one.”

From Natasha Robinson The Australian October 24 Continued Part 1 below

Aboriginal and Torres Strait Islander people are more likely to have higher rates of chronic conditions, hospitalisations and poorer health outcomes than non-Indigenous Australians

The differences in health outcomes in Remote and Very remote areas may be due to the characteristics of these populations.

The proportion of the population that is Indigenous, is much higher in more remote areas

However, more Indigenous Australians live in Major cities and Inner regional areas (61% of Indigenous Australians) compared with Remote and Very remote areas (19%) “

From the AIHW Report see Part 2 Below

Download full report HERE

Rural & remote health

Part 1 The Australian media report 

The report comes as The Australian revealed yesterday that the numbers of domestically trained doctors entering GP training had fallen for the third year in a row, with rural areas relying heavily on overseas-trained doctors to fill the workforce shortfall.

The AIHW report finds people in remote areas die five years before­ their city counterparts, with a life expectancy of 76 years.

More than 70 per cent of those living in regional areas are overweight or obese, less than one in 10 eat the recommended number of serves of vegetables per day, and one-quarter have high blood pressure or mental health problems.

Rural Australians are dying of diabetes at much higher rates than city dwellers, and many cancers­ go undetected because of a lack of acces­s to screening programs.

“The rate of potentially avoidable deaths increased as remote­ness increased,” the report says. “These are deaths among people aged 75 and under from conditions considered potentially preventable through individualised care, and/or treatment through existing primary or hospital care.”

The Australian College of Rural and Remote Medicine said the situation was a “tragedy”.

“We have a rural health crisis that extends right across from our Aboriginal and Torres Strait Island­er people to our rural communities,” said college president Ewen McPhee.

“I think it’s a tragedy that rural communities continue to be neglec­ted.”

In many tiny towns across the country, residents rely on the Royal Flying Doctor Service to provide access to a GP.

Yesterday in Stonehenge in remote­ central Queensland, doctor­ Arthur Beggs and nurse Jo Mahony­ flew in to provide the fortnightly mobile GP service for the town and surrounding areas of about 50 people.

“A lot of people don’t want to bother us unless they are really unwell and that’s really typical of the stoic, outback approach,” Dr Beggs said.

The RFDS has introduced a chronic disease management plan to the town, tracking baseline health measurements and flying specialist allied health practitioners in every few weeks to provide extra services.

Dr Beggs knows the challenges of being a rural GP, but says the difficulties are outweighed by the satisfaction of the work.

“I find rural and remote medicine fascinating and much more fulfilling than I do city-based medicine,” he said.

A recent report published by the Medical Deans of Australia found only 15 per cent of medical students in their final year of study said they were interested in becomin­g GPs, the lowest figure in five years.

Dr Beggs said attracting GPs to rural and remote areas was key to improving health outcomes in the bush.

“Modern medicine is all about specialties,” he said.

“The specialties can seem a more lucrative and controlled environm­ent than the realms of general practice, which is unfortun­ate because general practice­ gives you a much better overview of people and their health.”

Part 2

Profile of rural and remote Australians

See AIHW Online version HERE

For more information on Aboriginal and Torres Strait Islander health by remoteness see: The health and welfare of Australia’s Aboriginal and Torres Strait Islander peoples: 2015 and the Aboriginal and Torres Strait Islander Health Performance Framework (HPF) report

Overall, more Australians live in Major cities compared with rural and remote areas

. In 2017, the proportion of Australians by area of remoteness was:

72% in Major cities

18% in Inner regional areas 8.2% in Outer regional areas 1.2% in Remote areas

0.8% in Very remote areas (ABS 2019b).

On average, people living in Remote and very remote areas were younger than those living in Major cities ( gures 1a and 1c).

Australians aged 25–44 were more likely to live in Remote and very remote areas and Major cities compared with Inner regional and outer regional areas. However, a higher proportion of people aged 65 and over lived in Inner regional and outer regional areas and Major cities, compared with Remote and very remote areas ( gures 1a, 1b and 1c).

Rural and remote Australia encompasses many diverse locations and communities and people living in these areas face unique challenges due to their geographic isolation.

Those living outside metropolitan areas often have poorer health outcomes compared with those living in metropolitan areas. For example, data show that people living in rural and remote areas have higher rates of hospitalisations, mortality, injury and poorer access to, and use of, primary health care services, compared with those living in metropolitan areas.

Health inequalities in rural and remote areas may be due to factors, including:

  • challenges in accessing health care or health professionals, such as specialists social determinants such as income, education and employment opportunities higher rates of risky behaviours such as tobacco smoking and alcohol use
  • higher rates of occupational and physical risk, for example from farming or mining work and transport-related accidents.

Despite poorer health outcomes for some, the Household, Income and Labour Dynamics in Australia (HILDA) survey found that Australians living in small towns (fewer than 1,000 people) and non-urban areas generally experienced higher levels of life satisfaction compared with those in urban areas (Wilkins 2015).

Rural and remote Australians also report increased community interconnectedness and social cohesion, as well as higher levels of community participation, volunteering and informal support from their communities (Ziersch et al. 2009).

Part 3 National : Closing the Gap / Have your say CTG deadline extended to Friday, 8 November 2019.

 

The engagements are now in full swing across Australia and this is generating more interest than we had anticipated in our survey on Closing the Gap.

The Coalition of Peaks has had requests from a number of organisations across Australia seeking, some Coalition of Peak members and some governments for more time to promote and complete the survey.

We want to make sure everyone has the opportunity to have their say on what should be included in a new agreement on Closing the Gap so it is agreed to extend the deadline for the survey to Friday, 8 November 2019.

This will help build further understanding and support for the new agreement and will not impact our timeframes for negotiating with government as we were advised at the most recent Partnership Working Group meeting that COAG will not meet until early 2020.

There is a discussion booklet that has background information on Closing the Gap and sets out what will be talked about in the survey.

The survey will take a little bit of time to complete. It would be great if you can answer all the questions, but you can also just focus on the issues that you care about most.

To help you prepare your answers, you can look at a full copy here

The survey is open to everyone and can be accessed here:

https://www.naccho.org.au/programmes/coalition-of-peaks/have-your-say/

NACCHO Aboriginal Health and #SocialDeterminants : Download @AIHW Report : Indicators of socioeconomic inequalities in #cardiovascular disease #heartattack #stroke, #diabetes and chronic #kidney disease @ACDPAlliance

 ” Most apparent are inequalities in chronic disease among Aboriginal and Torres Strait Islander people and non-Indigenous Australians. Social and economic factors are estimated to account for slightly more than one-third (34%) of the ‘good health’ gap between the 2 groups, with health risk factors such as high blood pressure, smoking and risky alcohol consumption explaining another 19%, and 47% due to other, unexplained factors.

 An estimated 11% of the total health gap can be attributed to the overlap, or interactions between the social determinants and health risk factors (AIHW 2018a).

Download the AIHW Report HERE aihw-cdk-12

‘By better understanding the role social inequality plays in chronic disease, governments at all levels can develop stronger, evidence based policies and programs aimed at preventing and managing these diseases, leading to better health outcomes across our community,’

AIHW spokesperson Dr Lynelle Moonn noted that these three diseases are common in Australia and, in addition to the personal costs to an individual’s health and quality of life, they have a significant economic burden in terms of healthcare costs and lost productivity

AIHW Website for more info 

Government investment is essential to encourage health checks, improve understanding of the risk factors for chronic disease, and implement policies and programs to reduce chronic disease risk, particularly in areas of socioeconomic disadvantage,

Chair of the Australian Chronic Disease Prevention Alliance Sharon McGowan said that the data revealed stark inequities in health status amongst Australians.

Download Press Release Here : australianchronicdiseasepreventionalliance

The Australian Chronic Disease Prevention Alliance is calling on the Government to target these health disparities by increasing the focus on prevention and supporting targeted health checks to proactively manage risk.

AIHW Press Release

Social factors play an important role in a person’s likelihood of developing and dying from certain chronic diseases, according to a new report from the Australian Institute of Health and Welfare (AIHW).

The report, Indicators of socioeconomic inequalities in cardiovascular disease, diabetes and chronic kidney disease, examines the relationship between socioeconomic position, income, housing and education and the likelihood of developing and dying from several common chronic diseases—cardiovascular disease (which includes heart attack and stroke), diabetes and chronic kidney disease.

Above image NACCHO Library

The report reveals that social disadvantage in these areas is linked to higher rates of disease, as well as poorer outcomes, including a greater likelihood of dying.

‘Across the three chronic diseases we looked at—cardiovascular disease, diabetes and chronic kidney disease— we saw that people in the lowest of the 5 socioeconomic groups had, on average, higher rates of these diseases than those in the highest socioeconomic groups,’ said AIHW spokesperson Dr Lynelle Moon.

‘And unfortunately, we also found higher death rates from these diseases among people in the lowest socioeconomic groups.’

The greatest difference in death rates between socioeconomic groups was among people with diabetes.

‘For women in the lowest socioeconomic group, the rate of deaths in 2016 where diabetes was an underlying or associated cause of death was about 2.4 times as high as the rate for those in the highest socioeconomic group. For men, the death rate was 2.2 times as high,’ Dr Moon said.

‘Put another way, if everyone had the same chance of dying from these diseases as people in the highest socioeconomic group, in a one year period there would be 8,600 fewer deaths from cardiovascular disease, 6,900 fewer deaths from diabetes, and 4,800 fewer deaths from chronic kidney disease.’

Importantly, the report also suggests that in many instances the gap between those in the highest and lowest socioeconomic groups is growing.

‘For example, while the rate of death from cardiovascular disease has been falling across all socioeconomic groups, the rate has been falling more dramatically for men in the highest socioeconomic group—effectively widening the gap between groups,’ Dr Moon said.

The report also highlights the relationship between education and health, with higher levels of education linked to lower rates of disease and death.

‘If all Australians had the same rates of disease as those with a Bachelor’s degree or higher, there would have been 7,800 fewer deaths due to cardiovascular disease, 3,700 fewer deaths due to diabetes, and 2,000 fewer deaths due to chronic kidney disease in 2011–12,’ Dr Moon said.

Housing is another social factor where large inequalities are apparent. Data from 2011–12 shows that for women aged 25 and over, the rate of death from chronic kidney disease was 1.5 times as high for those living in rental properties compared with women living in properties they owned. For men, the rate was 1.4 times as high for those in rental properties.

Dr Moon noted that these three diseases are common in Australia and, in addition to the personal costs to an individual’s health and quality of life, they have a significant economic burden in terms of healthcare costs and lost productivity.

‘By better understanding the role social inequality plays in chronic disease, governments at all levels can develop stronger, evidence based policies and programs aimed at preventing and managing these diseases, leading to better health outcomes across our community,’ she said

Underlying causes of socioeconomic inequalities in health

There are various reasons why socioeconomically disadvantaged people experience poorer health. Evidence points to the close relationship between people’s health and the living and working conditions which form their social environment.

Factors such as socioeconomic position, early life, social exclusion, social capital, employment and work, housing and the residential environment— known collectively as the ‘social determinants of health’—can act to either strengthen or to undermine the health of individuals and communities (Wilkinson & Marmot 2003).

These social determinants play a key role in the incidence, treatment and outcomes of chronic diseases. Social determinants can be seen as ‘causes of the causes’—that is, as the foundational determinants which influence other health determinants such as individual lifestyles and exposure to behavioural and biological risk factors.

Socioeconomic factors influence chronic disease through multiple mechanisms. Socioeconomic disadvantage may adversely affect chronic disease risk through its impact on mental health, and in particular, on depression. Socioeconomic gradients exist for multiple health behaviours over the life course, including for smoking, overweight and obesity, and poor diet.

When combined, these unhealthy behaviours help explain much of the socioeconomic health gap. Current research also seeks to link social factors and biological processes which affect chronic disease. In CVD, for example, socioeconomic determinants of health have been associated with high blood pressure, high cholesterol, chronic stress responses and inflammation (Havranek et al. 2015).

The direction of causality of social determinants on health is not always one-way (Berkman et al. 2014). To illustrate, people with chronic conditions may have a reduced ability to earn an income; family members may reduce or cease employment to provide care for those who are ill; and people or families whose income is reduced may move to disadvantaged areas to access low-cost housing.

Action on social determinants is often seen as the most appropriate way to tackle unfair and avoidable socioeconomic inequalities. There are significant opportunities for reducing death and disability from CVD, diabetes and CKD through addressing their social determinants.

Summary

Australians as a whole enjoy good health, but the benefits are not shared equally by all. People who are socioeconomically disadvantaged have, on average, greater levels of cardiovascular disease (CVD), diabetes and chronic kidney disease (CKD).

This report uses latest available data to measure socioeconomic inequalities in the incidence, prevalence and mortality from these 3 diseases, and where possible, assess whether these inequalities are growing. Findings include that, in 2016:

  • males aged 25 and over living in the lowest socioeconomic areas of Australia had a heart attack rate 1.55 times as high as males in the highest socioeconomic areas. For females, the disparity was even greater, at 1.76 times as high
  • type 2 diabetes prevalence for females in the lowest socioeconomic areas was 2.07 times as high as for females in the highest socioeconomic areas. The prevalence for males was 1.70 times as high
  • the rate of treated end-stage kidney disease for males in the lowest socioeconomic areas was 1.52 times as high as for males in the highest socioeconomic areas. The rate for females was 1.75 times as high
  • the CVD death rate for males in the lowest socioeconomic areas was 1.52 times as high as for males in the highest socioeconomic areas. For females, the disparity was slightly less, at 1.33 times as high
  • if all Australians had the same CVD death rate as people in the highest socioeconomic areas in 2016, the total CVD death rate would have declined by 25%, and there would have been 8,600 fewer deaths.

CVD death rates have declined for both males and females in all socioeconomic areas since 2001— however there have been greater falls for males in higher socioeconomic areas, and as a result, inequalities in male CVD death rates have grown.

  • Both absolute and relative inequality in male CVD death rates increased—the rate difference increasing from 62 per 100,000 in 2001 to 78 per 100,000 in 2011, and the relative index of inequality (RII) from 0.25 in 2001 to 0.53 in 2016.

Often, the health outcomes affected by socioeconomic inequalities are greater when assessed by individual characteristics (such as income level or highest educational attainment), than by area.

  • Inequalities in CVD death rates by highest education level in 2011–12 (RII = 1.05 for males and 1.05 for females) were greater than by socioeconomic area in 2011 (0.50 for males and 0.41 for females).

The impact on death rates of socioeconomic inequality was generally greater for diabetes and CKD than for CVD.

  • In 2016, the diabetes death rate for females in the lowest socioeconomic areas was 2.39 times as high as for females in the highest socioeconomic areas. This compares to a ratio 1.75 times as high for CKD, and 1.33 for CVD. For males, the equivalent rate ratios were 2.18 (diabetes), 1.64 (CKD) and 1.52 (CVD).viii

Part 2

 

NACCHO Aboriginal Health #YouthJustice : Download @aihw report : Highlighting Aboriginal and/or Torres Strait Islander young people under youth justice supervision over-represented in treatment for alcohol and other drug use

” Aboriginal and/or Torres Strait Islander young people were over-represented among the study cohort. Of the just over 17,000 young people who received either an alcohol or other drug treatment episode or youth justice supervision, 3 in 10 were Indigenous.

In particular, Indigenous young people were over-represented among the ‘dual-service’ client population. During the 4-year period, Indigenous young people were 14 times as likely to experience both youth justice supervision and drug and alcohol services as their non-Indigenous counterparts.” 

Extract from AIHW Overlap between youth justice supervision and alcohol and other drug treatment services: 1 July 2012 to 30 June 2016

AIHW INFO PAGE and Data etc 

Download Copy HERE

aihw-youth justice system

1 in 3 young people under youth justice supervision receive treatment for alcohol and other drug use

Young people under youth justice supervision are 30 times as likely to receive an alcohol or other drug treatment service as young Australians generally, according to a new report from the Australian Institute of Health and Welfare (AIHW).

The report, Overlap between youth justice supervision and alcohol and other drug treatment services, shows 1 in 3 young people aged 10–17 under youth justice supervision during the 4 years to June 2016 also received alcohol and other drug treatment services at some point during the same period.

‘Today’s report highlights the considerable overlap between young people under youth justice supervision and those receiving drug and alcohol treatment services. Through bringing together data on both services, we have been able to determine that there were just over 2,500 ‘dual service’ clients – that is, young people that accessed both youth justice supervision and drug and alcohol services within the study period’ said AIHW spokesperson Anna Ritson.

Nearly 1 in 4 (23%) young people under youth justice supervision received treatment for cannabis as their principal drug of concern, 1 in 12 (8%) for alcohol and 1 in 20 (5%) for amphetamines. Less than 1% of young Australians in the general population received treatment for each of these principal drugs of concern.

Dual-service clients were, overall, more likely than other young people in the study to receive multiple alcohol and other drug treatment services and have multiple drugs of concern.

‘For dual service clients, almost half (47%) received 2 or more alcohol or other drug treatment episodes over the 4-year study period. However, where the young person was not under youth justice supervision, this falls to just under 1 in 5 (19%),’ Ms Ritson said.

Today’s report builds on established evidence about the overlaps that exist among young people who experience child protection, youth justice supervision, homelessness, mental health disorders, and use of alcohol and other drugs.

The high level of overlap between clients of the youth justice and alcohol and other drug treatment service sectors indicates a need for more integrated services and person-centered service delivery, to reduce future reliance on health and welfare services and improve outcomes for young people.

Summary

Some young people are vulnerable and experience multiple levels of disadvantage. Evidence shows that overlaps exist among young people who experience child protection, youth justice supervision, homelessness, mental health disorders, and problematic use of alcohol and other drugs. Understanding the pathways and interactions with the health and welfare sectors for these young people is crucial for effective service delivery and targeted early intervention services.

Despite the relationship between youth offending and the use of alcohol and other drugs, data about the overlap between the services provided to young people by these 2 sectors in Australia has not been previously available.

This report presents information on young people aged 10–17 who were under youth justice supervision (both in the community, and in detention) and/or received an alcohol and other drug (AOD) treatment service between 1 July 2012 and 30 June 2016. Those who received both these services are referred to in this report as dual service clients.

Young people under youth justice supervision were 30 times as likely as the young Australian population to receive an alcohol and other drug treatment service

Of young people who were under youth justice supervision from 1 July 2012 to

30 June 2016, 1 in 3 (33%) also received an AOD treatment service at some point during the same 4-year period, compared with just over 1% of the general Australian population of the same age.

Nearly 1 in 4 (23%) young people under youth justice supervision received treatment for a principal drug of concern of cannabis, 1 in 12 (8%) for alcohol, and 1 in 20 (5%) for amphetamines. Less than 1% of young Australians in the general population of the same age received an AOD treatment for each of these principal drugs of concern. This means that compared with the Australian population, young people under youth justice supervision were 33 times as likely to receive an AOD treatment for cannabis, 27 times as likely to be treated for alcohol, and more than 50 times as likely to be treated for amphetamines.

Young people who received an alcohol and other drug treatment service were 30 times as likely as the Australian population to be under youth justice supervision

Of young people who received an AOD treatment service, 1 in 5 (21%) were also under youth justice supervision at some point during the same 4-year period, compared with 0.7% of the Australian population of the same age. About 1 in 4 (26%) young people who received an AOD treatment as a diversion (police and court referrals) in 2012–13 subsequently spent time under youth justice supervision within 3 years.

Young people who received an alcohol and other drug treatment service for volatile solvents or amphetamines were the most likely to also have youth justice supervision

Of the 11,981 young people who received an AOD treatment service, those whose principal drug of concern was volatile solvents or amphetamines were the most likely to have also been under youth justice supervision.

Dual service clients were more likely than those who only received alcohol and other drug treatment services to have multiple treatment episodes and drugs of concern

Nearly half (47%) of dual service clients received more than 1 AOD treatment episode in the 4-year period, compared with about 1 in 5 (19%) of those who received only an AOD treatment service. One in 5 (20%) dual service clients received services for multiple principal drugs of concern, compared with 4% of those who received only an AOD treatment service.

Young Indigenous Australians were 14 times as likely as their non-Indigenous counterparts to receive both services

Young Indigenous Australians were over-represented among the dual service clients—

2% of young Indigenous Australians had contact with both services during the 4-year period, compared with 0.1% of non-Indigenous young people.

NACCHO Aboriginal Health : Some big improvements but challenges remain says the @aihw 2018 Report : The report card is in—and here’s what we can learn

 ” There have been some big improvements in the health of Australia’s Aboriginal and Torres Strait Islander population—but challenges remain.

Life expectancy for Indigenous Australians has improved over time and with higher education attainment closely associated with better health outcomes, rising year 12 completion rates among Indigenous Australians are a positive sign.

There have also been reductions in smoking rates and alcohol use, as well as a significant improvement in child death rates.

While the improvements seen in recent years are positive, the report shows that social factors are key to making further progress—social factors such as employment, education and income are responsible for about one-third of the health gap between Indigenous and non-Indigenous Australians.

By comparison, health risk factors such as smoking and obesity account for one-fifth of the health gap.

In 2015–16, Indigenous primary health care services were delivered across nearly 370 sites, more than two-thirds of which were in Very remote (33%), Remote (13%) and Outer regional (23%) areas.”

From Executive summary see Part 1 Below

Or See Pages 305 -357 in report for more detail

Download Here

 ” Australia is generally a healthy nation but there are some key areas where we could do better, according to the latest report from the Australian Institute of Health and Welfare (AIHW).

The two-yearly report card, Australia’s health 2018, was launched today by the Hon. Greg Hunt MP, Minister for Health.”

See Part 2 Below

Download Brief aihw-aus-222.pdf

Part 1 Overview Indigenous Health

Aboriginal and Torres Strait Islander people are the Indigenous peoples of Australia. Indigenous Australians can be of Aboriginal origin, Torres Strait Islander origin, or both.

There were an estimated 787,000 Indigenous Australians in 2016—3.3% of the total Australian population, with an estimated growth in their population size of 19% since 2011.

This chapter presents information on the health status of the Indigenous population, as well as the determinants of health and access to health services that are specific to the Indigenous population.

For Indigenous Australians, good health is more than the absence of disease or illness; it is a holistic concept that includes physical, social, emotional, cultural, spiritual and ecological wellbeing, for both the individual and the community.

This concept of good health emphasises the connectedness of these factors and recognises how social and cultural determinants can affect health.

As a group, Indigenous Australians experience widespread disadvantage and health inequality. In 2014–15, Indigenous Australians were at almost half as likely as non-Indigenous Australians to rate their health as ‘fair’ or ‘poor’, and much less likely to rate their health as ‘excellent’ or ‘very good’.

Compared with non-Indigenous Australians, Indigenous Australians are 1.7 times as likely to have disability or a restrictive long-term health condition and 2.7 times as likely to experience high or very high levels of psychological distress.

The gap in life expectancy between Indigenous and non-Indigenous Australians in 2010–2012 was around 10.6 years for males and 9.5 years for females. Health inequality can start early for Indigenous people—reflected in infant and child mortality rates being generally higher in their communities.

Further, although rates have declined in recent years, Indigenous children are 2.1 times as likely as non-Indigenous children to die before the age of 5.

Indigenous children and adolescents are also far more likely than non-Indigenous children to be affected by ear infections and hearing loss. Although the proportion of Indigenous children with poor ear health and hearing loss has decreased in the last 15 years, the rate of long-term ear/hearing problems in children aged 0–14 is still almost 3 times that for non-Indigenous children (8.4% compared with 2.9%). Poor ear and hearing health can profoundly affect a child’s life, impeding cognitive development, auditory processing skills and speech and language development.

Hearing loss can lead to social isolation and problems with school attendance, which, in turn, can have life-long negative social consequences. For many Indigenous children, hearing loss and the associated aftermaths further compound many of the disadvantages already facing Indigenous Australians.

Much of the understanding of the ‘health gap’ between Indigenous and non-Indigenous Australians is based on factors generally recognised as contributing to good health, including:

  • differences in the social determinants of health—Indigenous Australians, on average, have lower levels of education, employment, income, and poorer quality housing than non-Indigenous Australians
  • differences in health risk factors—Indigenous Australians, on average, have higher rates of risk factors that can lead to adverse health outcomes, such as tobacco smoking, risky alcohol consumption and insufficient physical activity for good health
  • differences in access to appropriate health services—Indigenous Australians are more likely than non-Indigenous Australians to report greater difficulty in accessing affordable health services that are close by.

Socioeconomic factors account for more than one-third (34%) of this health gap—household income is the largest individual contributor to the overall gap (14%), followed by employment status (12%).

Health risk factors contribute 19% of the gap—with differences in smoking rates between Indigenous and non-Indigenous Australians being the largest contributor, at 10%. While the Indigenous smoking rate has fallen substantially in recent years—from 51% in 2002 to 42% in 2014–15—it is still 2.7 times as high as that for non-Indigenous Australians.

Access to appropriate, high-quality and timely health care can help to improve health outcomes. Indigenous Australians can use mainstream or Indigenous-specific primaryhealth care services.

In 2015–16, Indigenous primary health care services were delivered across nearly 370 sites, more than two-thirds of which were in Very remote (33%), Remote (13%) and Outer regional (23%) areas.

The geographic distribution of the Indigenous population can pose substantial challenges for workforce recruitment and delivery of health services. For example, access to midwives is critical for the health of Indigenous women, who are less likely to attend antenatal care in the first trimester of pregnancy, and have higher levels of social disadvantage.

These factors contribute to the higher likelihood that babies born to Indigenous mothers will be premature, of low birthweight and/or will die before their first birthday. Looking at the supply of midwives across Australia, 15% of Indigenous women of child-bearing age live in areas likely to pose the highest challenges for supply of a midwife workforce.

This percentage is 8 times as high as that for non-Indigenous women of child-bearing age (1.8%).

Part 2 AIHW Press Release

Australia is generally a healthy nation but there are some key areas where we could do better, according to the latest report from the Australian Institute of Health and Welfare (AIHW).

The two-yearly report card, Australia’s health 2018, was launched today by the Hon. Greg Hunt MP, Minister for Health.

Download Brief aihw-aus-222.pdf

The report shows that Australia sits squarely in the best third of OECD countries when it comes to life expectancy, with girls born in 2016 likely to live 84.6 years, while boys can expect to live to 80.4 years.

Fewer of us are smoking or putting ourselves at risk from long-term alcohol use than in the past. More of our children have been immunised and we’re doing well in terms of preventing avoidable deaths.

At an individual level, we’re feeling the effects of these good results, with more than 4 in every 5 Australians grading their own health to be at least ‘good’—if not ‘very good’ or ‘excellent’.

But with a population that is living longer, we are now experiencing higher rates of chronic and age-related conditions. For example, we know that older Australians use a higher proportion of hospital and other health services and 75% of all PBS medicines were dispensed to people aged 50 and over.

And with health spending continuing to rise—reaching $170 billion in 2015–16 and outstripping population growth—we see the important role our health system plays in both prevention and treatment.

Long-term health conditions are common—often underpinned by lifestyle factors

Half of Australians have a common chronic health condition, such as diabetes, heart disease, a mental illness, or cancer. Importantly, almost a quarter of us have two or more of these conditions, often making our experiences of health and healthcare particularly complex.

Many chronic health conditions share common preventable risk factors, such as smoking, excessive alcohol consumption, and not getting enough exercise—in fact, around one-third of our nation’s ‘disease burden’ is due to preventable risk factors.

Our expanding waistlines are a notable example: about 6 in 10 adults—or 63%—are either overweight or obese, while carrying too much weight is responsible for 7% of our total disease burden.

Over the past two decades, the proportion of Australians who have a healthy body weight fell, while the proportion who are obese increased. Over the same period, the proportion who are ‘severely obese’ nearly doubled.

AIHW CEO Barry Sandison said that when it comes to obesity, it is not just a case of poor diet or exercise habits. Rather, a range of factors—biological, behavioural, social and environmental—contribute to our likelihood of becoming obese, including the walkability of our cities, rising work hours and increasingly sedentary jobs, larger portion sizes and food advertising.

‘Understanding why someone may be obese—or in good or poor health generally—is complex and it’s important to look at the raft of factors across a person’s life that may be at play,’ he said.

Tackling the ‘why’ of poor health

Mr Sandison said that through data, we are able to better understand how a diverse array of social and other factors contribute to our health.

For example, the report shows a clear connection between socioeconomic position and health—compared with people living in Australia’s highest socioeconomic areas, those in the lowest group are almost 3 times as likely to smoke or have diabetes and twice as likely to die of potentially avoidable causes.

Those in the lowest group are also more likely to have cost barriers preventing them from accessing health services—more than twice as likely to avoid seeing a dentist or filling a prescription due to the cost.

The impact of socioeconomic position on health can also be thought of in terms of disease burden, with those in the lowest socioeconomic group experiencing disease burden 1.5 times higher than those in the highest group.

Mr Sandison noted a similar pattern was seen among people living in remote areas, while certain groups—such as veterans—experience higher rates of mental health conditions such as depression. LGBTI Australians, people with a disability, prisoners and people of cultural and linguistically diverse backgrounds also experience specific health challenges.

As well as social factors, our natural environment is connected to our health and wellbeing—with air and water quality, exposure to extreme weather, and other events such as bushfires and drought all playing a role.

‘There is more to learn about the connections between health and the natural world—and in turn, the interplay between these and other risk factors,’ Mr Sandison said.

Employment and income key factors in improving Indigenous health

The value of data and looking forward

Mr Sandison noted that in a digital age, there is enormous potential to fill data gaps through new sources of health information.

‘Health data is collected for a variety of reasons—in hospitals, at our GP and through the prescriptions we receive, while new sources of information are emerging, such as through the Australian Government’s My Health Record.’

Despite the breadth of health and welfare information available, there are gaps in our knowledge and opportunities to make better use of existing data.

By bringing together data, we can gain important insights into people’s pathways through the health system and experiences of their own health, such as the relationship between different chronic conditions and the services and treatments yielding the greatest improvements in health outcomes and quality of life.

‘With a structured, strategic approach to health information and leadership from agencies like the AIHW, Australia’s health data assets can be built and improved to fill gaps in our knowledge and understanding—to drive better health outcomes for all Australians,’ Mr Sandison said.

Media coverage

Indigenous Australians are more than twice as likely to die before their fifth birthday than non-Indigenous Australians.

Australia’s Health 2018, a report released by the Australian Institute of Health and Welfare today , says Indigenous Australians have a shorter life expectancy than non-indigenous Australians and are at least twice as likely to rate their health as fair or poor.

On average, indigenous Australians have lower levels of education, employment and income and poorer quality housing than non-indigenous Australians.

However there have been improvements in child mortality rates, smoking rates and drinking rates for those over the age of 15.

Factors in the health gap include higher rates of smoking and risky alcohol consumption, less exercise, a greater risk of high blood pressure and difficulty accessing affordable health services.

The report states that if indigenous adults were to have the same household income, employment rates, hours worked and smoking rate as non-indigenous Australians, the health gap would be reduced by more than a third.

Levels of health vary within the indigenous population, with those employed in 2014-15 less likely to smoke and use illicit substances and more likely to have an adequate daily fruit intake.

IMPROVEMENTS IN INDIGENOUS HEALTH

– Child mortality rates (zero to four) decreased from 217 deaths per 100,000 in 1998 to 140 deaths per 100,000 in 2016

– Between 2005-2007 and 2010-2012, the gap in life expectancy at birth between indigenous and non-indigenous Australians decreased from 11.4 to 10.6 years for males and 9.6 to 9.5 years for females

– Smoking rates declined from 51 per cent in 2002 to 42 per cent in 2014-15, concentrated in non-remote areas.

– In 2014-15, 17 per cent of indigenous Australians aged between 15-17 smoked, compared to 30 per cent in 1994

INDIGENOUS HEALTH COMPARED TO NON-INDIGENOUS HEALTH

– 2.1 times as likely to die before their fifth birthday

– 2.7 times as likely to experience high or very high levels of psychological distress

(Source: Australia’s Health 2018, Australian Institute of Health and Welfare

NACCHO Aboriginal Health and #closingthegap Download @AIHW report summarises evidence on progress towards the seven #CTG targets . These include: child mortality, school attendance, literacy and numeracy, employment, and life expectancy.

 

” This report provides detailed information and analyses on the Closing the Gap targets, including the key drivers of change underpinning these targets.

This report provides context for policy debate and discussion for the Closing the Gap Refresh, a joint initiative of the Council of Australian Governments (COAG).

Today’s report summarises evidence on progress towards the seven Closing the Gap targets. These targets include: child mortality, school attendance, literacy and numeracy, employment, and life expectancy. Read the full report:

Download the 300 Page report HERE

AIH W Closing the Gap Targets Report

Information on this COAG initiative, and additional resources with updated data on the COAG targets are available at the Department of Prime Minister and Cabinet website.

  • Contents
  • Acknowledgments
  • Abbreviations
  • Symbols
  • Chapter 1: Overview
    • 1.1 Closing the Gap targets and progress
    • 1.1.1 About the targets
    • 1.1.2 Current picture and progress
    • 1.2 Key drivers of change
    • 1.3 Key themes across the targets
      • 1.3.1 Social determinants are critical
      • 1.3.2 Remoteness has a relatively large impact
      • 1.3.3 Improved access to services is needed
      • 1.3.4 Investment is needed across the lifecourse
      • 1.3.5 Interactions between outcomes are important
      • 1.3.6 Need more evidence on ‘what works’
    • 1.4 Data limitations
    • 1.5 Future target setting
    • 1.6 References
  • Chapter 2: Child mortality target
    • Summary
    • 2.1 Background
    • 2.2 Current picture and progress
      • 2.2.1 National data on child mortality
      • 2.2.2 Child mortality by state and territory
      • 2.2.3 Age of childhood death
      • 2.2.4 Causes of death
    • 2.3 Key drivers of child mortality
      • 2.3.1 Evidence from the literature
      • 2.3.2 Evidence from new AIHW analyses
    • 2.4 Data limitations and measurement issues
      • 2.4.1 Child deaths data
      • 2.4.2 Population and births data
      • 2.4.3 Cause of death classifications
      • 2.4.4 Data on key determinants
    • 2.5 Bringing it together
      • 2.5.1 An overview
      • 2.5.2 Examples of opportunities for further progress
    • 2.6 References
  • Chapter 3: Early childhood education target
    • Summary
    • 3.1 Background
    • 3.2 Current picture and progress
      • 3.2.1 National data on enrolment and attendance
      • 3.2.2 Enrolment and attendance by state and territory
      • 3.2.3 Attendance by remoteness
    • 3.3 Key drivers of participation in ECE
      • 3.3.1 Evidence from the literature
      • 3.3.2 Evidence from AIHW analysis of the LSIC
    • 3.4 Data limitations and measurement issues
      • 3.4.1 Comparable enrolment and attendance rates
    • 3.5 Bringing it together
      • 3.5.1 An overview
      • 3.5.2 Examples of opportunities for further progress
    • 3.6 References
  • Chapter 4: School attendance target
    • Summary
    • 4.1 Background
    • 4.2 Current picture and progress
      • 4.2.1 National data on school attendance
      • 4.2.2 School attendance by state and territory
      • 4.2.3 School attendance by remoteness
      • 4.2.4 Patterns of student attendance
    • 4.3 Key drivers of school attendance
      • 4.3.1 Evidence from the literature
      • 4.3.2 Evidence from new AIHW analysis
    • 4.4 Data limitations and measurement issues
      • 4.4.1 Reporting on days of attendance
      • 4.4.2 Measuring student attendance rates
      • 4.4.3 Measuring students achieving 90% or more attendance
      • 4.4.4 Survey and longitudinal data sets
    • 4.5 Bringing it together
      • 4.5.1 An overview
      • 4.5.2 Examples of opportunities for further progress
    • 4.6 References
  • Chapter 5: Literacy and numeracy target
    • Summary
    • 5.1 Background
    • 5.2 Current picture and progress
      • 5.2.1 National data on literacy and numeracy
      • 5.2.2 Literacy and numeracy outcomes by state and territory
      • 5.2.3 Literacy and numeracy outcomes by remoteness
      • 5.2.4 Progress towards the literacy and numeracy target
      • 5.2.5 Improvements in mean NAPLAN scores
    • 5.3 Key drivers of literacy and numeracy
      • 5.3.1 Conceptual framework on influences on child development
      • 5.3.2 Drivers based on analysis of NAPLAN data
      • 5.3.3 Drivers based on other literature
      • 5.4 Data limitations and measurement issues
    • 5.4.1 Use of the NMS
      • 5.4.2 Participation in NAPLAN testing
    • 5.5 Bringing it together
      • 5.5.1 An overview
      • 5.5.2 Examples of opportunities for further progress
    • 5.6 References
  • Chapter 6: Year 12 or equivalent attainment target
    • Summary
    • 6.1 Background
    • 6.2 Current picture and progress
      • 6.2.1 National data on Year 12 or equivalent attainment
      • 6.2.2 Year 12 or equivalent attainment by geographic area
      • 6.2.3 Patterns of Year 12 or equivalent attainment
    • 6.3 Key drivers of Year 12 attainment
      • 6.3.1 Evidence from literature
      • 6.3.2 Evidence from new AIHW analysis of NATSISS data
    • 6.4 Data limitations and measurement issues
      • 6.4.1 Frequency of data
      • 6.4.2 Census data (main data source)
      • 6.4.3 Survey data (supplementary data source)
      • 6.4.4 Apparent retention rates
      • 6.4.5 Identifying drivers of Year 12 attainment
      • 6.4.6 Administrative data on educational attainment
      • 6.4.7 Components of Year 12 or equivalent attainment
    • 6.5 Bringing it together
      • 6.5.1 An overview
      • 6.5.2 Examples of opportunities for further progress
    • 6.6 References
  • Chapter 7: Employment target
    • Summary
    • 7.1 Background
    • 7.2 Current picture and progress
      • 7.2.1 National data on employment
      • 7.2.2 Patterns of employment
    • 7.3 Key drivers of Indigenous employment
      • 7.3.1 Key drivers in the literature
      • 7.3.2 Evidence from new AIHW analysis
      • 7.3.3 Trends in Indigenous employment drivers
    • 7.4 Data limitations and measurement issues
      • 7.4.1 Frequency of Indigenous employment data
      • 7.4.2 Use of employment rates
    • 7.5 Bringing it together
      • 7.5.1 An overview
      • 7.5.2 Examples of opportunities for further progress
    • 7.6 References
  • Chapter 8: Life expectancy target
    • Summary
    • 8.1 Background
    • 8.2 Current picture and progress
      • 8.2.1 National life expectancy
      • 8.2.2 Life expectancy by jurisdiction and remoteness
      • 8.2.3 Mortality patterns and trends
      • 8.2.4 Fatal burden of disease
    • 8.3 Key drivers of mortality and life expectancy
      • 8.3.1 Social determinants and risk factors
      • 8.3.2 Contribution of risk factors to the fatal burden
      • 8.3.3 Health system interventions
    • 8.4 Data limitations and measurement issues
      • 8.4.1 Deaths and population data
      • 8.4.2 Frequency of Indigenous life expectancy estimates
    • 8.5 Bringing it together
      • 8.5.1 An overview
      • 8.5.2 Examples of opportunities for further progress
    • 8.6 References

 

NACCHO Aboriginal Health : @AIHW Reports 1.#Indigenous life expectancy 2001-2015 and 2.Life expectancy varies by where you live

“The Australian Institute of Health and Welfare has released a new report : Trends in Indigenous mortality and life expectancy 2001-2015

This report examines Indigenous mortality and life expectancy during the period 2001 to 2015, based on evidence from the Enhanced Mortality Database.

The study observed increases in life expectancy during the study period for both Indigenous males and females across most jurisdictions. Life expectancy however increased faster among non-Indigenous than among Indigenous males and females.

 As a result, there was little change in the life expectancy gap

Are we Closing the Gap ? ”.

Download the AIHW report HERE and Summary Part 2 below

aihw-ihw-174.pdf

Report 2 Life expectancy varies by where you live

Healthy Communities: Life Expectancy and Potentially Avoidable Deaths in 2013–2015

This report provides updated information for life expectancy and potentially avoidable deaths in 2013–2015 across Australia, by Primary Health Network and smaller local areas.

Life expectancy at birth indicates the average number of years that a new born baby could expect to live, assuming that the current age-specific death rates are experienced throughout his/her life. It is a broad measure of population health.

Potentially avoidable deaths are deaths below the age of 75 from specific conditions that are potentially preventable through primary or hospital care. These conditions are classified using nationally agreed definitions. Rates of potentially avoidable deaths per head of population can be a useful indicator of how well health systems are performing.

Across PHN areas, the lowest average life expectancy for males and females was for those living in the Northern Territory–75.7 years and 78.5 years, respectively.”

From My Healthy Communities Website

Download

AIHW_HC_Report_Avoidable_deaths_life_expectancy_November_2017

Report 1 Trends in Indigenous mortality and life expectancy 2001-2015

In 2008, the Council of Australian Governments (COAG) committed to six ‘Closing the Gap in Indigenous disadvantage’ targets (COAG 2008).

These were revised to seven targets with the addition of a school attendance target in 2014 and a further revision to the early childhood education target in 2015 (Commonwealth of Australia 2015, 2016).

Two key health targets within the COAG ‘Closing the Gap’ are:

  • closing the life expectancy gap within a generation (by 2031)
  • halving the gap in death rates for Indigenous children under 5 within a decade (by 2018).

Assessing progress against these two ‘Closing the Gap’ targets requires robust measures of mortality and life expectancy, in particular, the levels, patterns and trends of mortality to assess whether efforts are on track to meet the targets.

Official mortality and life expectancy estimates are produced by the ABS on a regular basis.

ABS estimates of life expectancy for Indigenous Australians are based on linking Census data with mortality records for the 13 months following the Census, and are produced at the national level as well as for four individual jurisdictions (New South Wales, Queensland, Western Australia and the Northern Territory).

In Australia, all deaths are likely to be registered, however not all Indigenous deaths are recorded as Indigenous during the registration process. Information on a deceased person’s Indigenous status is provided to jurisdictional registrars of births, deaths and marriages from a variety of sources, including the family and friends of the deceased person, the funeral director, the doctor certifying the death, the coroner or a health worker.

There is no consistency in how Indigenous status is reported by these sources.

The quality of Indigenous identification in death data therefore reflects the quality of the information provided by these various sources. The quality of Indigenous identification on death records often varies between jurisdictions, and can affect not only the reliable estimation of the true levels, patterns and trends in Indigenous mortality and life expectancy, but also the reliable estimation of the gap in mortality and life expectancy between Indigenous and non-Indigenous Australians.

Robust estimates of Indigenous mortality and life expectancy cannot therefore be reliably estimated without adjustments to Indigenous status information on the death data.

This means that the effectiveness of ‘Closing the Gap’ initiatives to improve Indigenous mortality and life expectancy cannot be reliably determined while there are inconsistencies in Indigenous identification in death data across jurisdictions.

To find solutions to meet these challenges, AIHW developed the EMD project which was later endorsed and supported by the COAG to add to similar efforts being made by Australian, state and territory statistical agencies and departments, and the research community.

The difference in life expectancy between two populations is the result of differences between the two populations in their age-specific death rates. Understanding the factors that contribute to Indigenous life expectancy is important in understanding the life expectancy gap.

These components include the levels, patterns and trends in Indigenous death rates, including the distribution of Indigenous deaths by age and sex.

Equally important is knowledge of the levels, trends and components of non-Indigenous life expectancy, including the levels, age-sex patterns and trends in non-Indigenous mortality, and how these components are changing in relation to Indigenous mortality.

The focus of this report is therefore not only on the levels, patterns, trends and the gap in mortality and life expectancy between Indigenous and non-Indigenous Australians, but also on the various contributors to the life expectancy gap.

1.2 Objectives

The aims of the EMD project are:

  1. to enhance the quality of Indigenous status information on death data by linking registered death data with comparative data sets that contain information on deaths and Indigenous identification, comparing Indigenous status information across the linked data sets, and using the result of the comparison to develop algorithms for enhancing Indigenous status on death data
  2. to use the enhanced death data to develop life tables for jurisdictions with small Indigenous populations for which official life expectancy estimates are currently unavailable
  3. to explore the mortality patterns underlying the trends and the gap in life expectancy between Indigenous and non-Indigenous Australians, to assist with monitoring the ‘Closing the Gap’ key health targets.

2.5 Conclusion

Enhancement of Indigenous identification in the Enhanced Mortality Database has enabled the estimation of alternative mortality measures for the six jurisdictions considered, as well as for Australia as a whole.

A number of mortality measures and indicators—namely, the median age at death, age-specific death rates, the cumulative proportions of deaths occurring by specified ages, and age-standardised death rates—have all shown that mortality has declined, if only slightly, in most age groups for both Indigenous males and females across the six jurisdictions considered.

The analysis also provides information on which areas of mortality must be further monitored and targeted. For instance, on average, death occurs much earlier for Indigenous males and females than non-Indigenous males and females. Some of the key findings from the study include the following:

  • Mortality appeared to have declined during the reference period for both Indigenousmales and females: the median age at death for both Indigenous males and femalesincreased during the period 2001–2005 to 2011–2015, while the age-standardised deathrates declined for both Indigenous males and females (tables 2.2 and 2.3).
  • In terms of absolute decline in mortality, non-Indigenous males experienced a muchbigger absolute decline in mortality than Indigenous males, while Indigenous femalesexperienced a much bigger absolute decline in mortality than non-Indigenous females:

–consequently, the rate difference between Indigenous and non-Indigenous malesincreased during the period 2001–2005 to 2011–2015 while the rate differencebetween Indigenous and Indigenous females decreased (Table 2.4).

  • In terms of relative decline in mortality, non-Indigenous females experienced a slightlyhigher percentage decline in mortality (13.5%) than that experienced by Indigenousfemales (12.9%). Non-Indigenous males, however, experienced both a bigger absolutedecline in mortality as well as a bigger percentage mortality decline (17.7%) compared toIndigenous males (4.3%):

–as a result, the rate ratio between Indigenous and non-Indigenous males increasedduring the period 2001–2005 to 2011–2015 while the rate ratio between Indigenousand Indigenous females remained stable (Table 2.4).

  • The age-standardised death rate declined marginally (4.3%) for Indigenous males, from13.8 per 1,000 population in 2001–2005 to 13.2 in 2011–2015 and more substantially forIndigenous females (12.1%) from 11.6 in 2001–2005 to 10.2 in 2011–2015.
  • On the other hand, the age-standardised death rate declined by 17.7 per cent fornon-Indigenous males, from 7.9 per 1,000 population in 2001–2005 to 6.5 in 2011–2015,and by 13.5 per cent for Indigenous females, from 5.2 in 2001–2005 to 4.5 in2011–2015.
  • The age-standardised death rate also declined for Indigenous males and females in alljurisdictions, except in Queensland and South Australia where the age-standardiseddeath rate increased for Indigenous males, and Victoria, where the age-standardiseddeath rate increased for Indigenous females.
  • The biggest gap in mortality between Indigenous males and females on the one hand,and non-Indigenous males and females on the other, occurred at two points along theage spectrum: at infancy and from about age 45 onwards.

Trends in Indigenous mortality and life expectancy 2001–2015

Life expectancy

Life expectancy is a statistical measure of how long a person can expect to live, depending on the age they have already reached. It is the number of years of life remaining to a person at a particular age if current death rates do not change. Life expectancy can be determined for any age.

Thus, life expectancy at age 20 or 65 refers to the probable years of life remaining for a group of people at age 20 or 65 if they experienced the prevailing mortality rates for the rest of their lives. The most commonly used estimate of life expectancy is life expectancy at birth. Life expectancy at birth reflects the mortality pattern that prevails across all age groups (Shryock & Siegel 1976).

Estimates of life expectancy are obtained from a life table. The life table is a summary measure of the age-specific death rates in a population. Because mortality differs between the two sexes, the life table is usually calculated for males and females separately. The quality of life table estimates is directly affected by the quality of the input death and population data.

The death data used to prepare the life tables in this report come from the Enhanced Mortality Database, created by linking the MED to comparative data sets that contain information on death and Indigenous status (see Appendix C on the methodology for enhancing the Indigenous status of death records).

Part 2

 

 

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%)

 DOWNLOAD THE FREE +NACCHO APP                                                        to find location of our ACCHOS

Here are the URL links to the App – alternatively you can type NACCHO into both stores and they come up!

iPhone/iPad

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Android

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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 Aboriginal Health @AIHW download 3 reports Alert : Obesity and smoking rates higher in regional Australia

obesity

 ” Australians living in regional areas are more likely to be overweight or obese, according to a report released by the Australian Institute of Health and Welfare (AIHW).

A second report reveals a similar pattern in relation to daily tobacco smoking with adults in regional areas more likely to smoke daily than their city counterparts.

These reports highlight local areas where efforts can be targeted to reduce rates of smoking, overweight and obesity.

The results are intended to assist local communities in defining their priorities for improvements in health care and to better target and drive health system improvements specific to their local community’s needs.”

The Healthy Communities reports look at local-level variation in obesity and smoking rates across Australia’s Primary Health Network (PHN) areas.

 ” The release of the Australian Institute of Health and Welfare report on overweight and obesity rates should serve as a shocking wake up call for the Turnbull Government – stop sitting on your hands and start acting on this critical public health issue by putting a National Physical Activity Strategy in place

The Abbott-Turnbull Government has gutted preventative health programs and cut $368 million out of prevention.

This forced the closure of successful health promotion programs including the Healthy Children program which provided funding to states and territories to run physical activity and healthy eating programs for children in schools, early childhood centres and preschools.”

CATHERINE KING MP SHADOW MINISTER FOR HEALTH AND MEDICARE ( see full press release below )

Image above : Please note for specific data from our NACCHO 302 Clinics

Download NACCHO Healthy Futures

reportcard-1

MyHealthyCommunities

MyHealthyCommunities is an interactive site that lets you see how your local health area is performing and how it compares against other similar areas.

The website is managed by the Australian Institute of Health and Welfare, 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. We provide nationally consistent, locally relevant and comparable information about health care services in Australia.

The aim of this website is to provide information in a way that helps you to make informed decisions. By publicly reporting in this way we also aim to empower clinicians and service providers to drive improvements, and increase transparency and accountability within the health system.

http://www.myhealthycommunities.gov.au/

The first report, Healthy Communities: Overweight and obesity rates across Australia, 2014–15,

DOWNLOAD report Here

aihw_hc_report_overweight_and_obesity_report_december_2016

shows that the highest rate of overweight and obesity in adults was 73% in Country South Australia, while Northern Sydney had the lowest rate at 53% – still over half the adult population in that area who were overweight or obese.

When looking at just obesity (a body mass index of 30 and above) a wider variation was seen in adults across PHN areas.

‘With obesity we see even wider variation with 16% of adults who were shown to be obese in Central and Eastern Sydney, compared with 38% in Country South Australia. Again, the highest obesity rates were recorded in regional areas,’ said AIHW spokesperson Michael Frost.

Today’s second report, Healthy Communities: Tobacco smoking rates across Australia, 2014–15

smokes-1smokes-2

Image above :

Please note for specific data from our NACCHO 302 Clinics

Download NACCHO Healthy Futures

For AIHW DOWNLOAD report here

aihw_hc_report_tobacco_smoking_rates_report_december_2016

shows that while daily smoking rates in Australia have continued to fall, they remain relatively high in some PHN areas – particularly regional areas.

‘Northern Sydney had the lowest rate of daily smoking at around 5%, while Western NSW had the highest rate of 23%,’ Mr Frost said.

‘Overall, regional PHN areas had higher smoking rates than city-based PHNs.’

Both reports are available on the MyHealthyCommunities website (http://www.myhealthycommunities.gov.au).

Opposition Response AUSTRALIA PAYING A HEAVY PRICE WHILE TURNBULL GOVERNMENT FAILS TO ACT ON OBESITY

Today’s release of the Australian Institute of Health and Welfare report on overweight and obesity rates should serve as a shocking wake up call for the Turnbull Government – stop sitting on your hands and start acting on this critical public health issue by putting a National Physical Activity Strategy in place.

The AIHW’s Healthy Communities report illustrates why overweight and obesity rates are a serious problem for the future of our health system, finding that around 64 per cent of Australian adults – 11.2 million – are now overweight or obese.

The Government needs to get serious and start putting in place serious strategies to combat this epidemic. We don’t need more inquiries – Australia needs action.

The Global Burden of Disease study identified dietary risk and high body mass index as the top two contributors to burden of disease – even higher than smoking – linked to conditions such as cardiovascular disease, diabetes and cancer.

That’s why during the election, Labor committed to developing Australia’s first National Physical Activity Strategy.

Australia is falling behind the pack when it comes to tackling obesity – more than a dozen countries already have strategies in place to increase activity and reduce obesity.

We also committed to introduce a National Nutrition Framework, to work with food producers and retailers to expand the utilisation of the Health Star Rating system, something Labor developed in Government.

In contrast, the Abbott-Turnbull Government has gutted preventative health programs and cut $368 million out of prevention. This forced the closure of successful health promotion programs including the Healthy Children program which provided funding to states and territories to run physical activity and healthy eating programs for children in schools, early childhood centres and preschools.

Australia needs a Government prepared to take action in recognition of the cost of obesity and associated co-morbidities, and actively help Australians to change their behaviour. The Turnbull Government either doesn’t care, or isn’t up to the task.

NACCHO Aboriginal Health Alert : #AIHW and Minister Sussan Ley launch #AustraliasHealth2016 report

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 ” A new snapshot of Australia’s health has found we are living longer than ever before, but the rise of chronic disease still presents challenges in achieving equal health outcomes for Indigenous Australians and people living outside metropolitan areas.

Minister for Health Sussan Ley pictured above with Dr Mukesh Haikerwal

Download the Report Here

australias-health-2016

As well as looking at factors influencing individuals’ health, today’s report also examines the health of particular population groups, and shows considerable disparities.

‘For example, while there have been some improvements overall in the health of Aboriginal and Torres Strait Islander Australians—including falls in smoking rates and infant mortality—Indigenous Australians continue to have a lower life expectancy than non-Indigenous.

Indigenous Australians, at 69.1 years for males and 73.7 for females, more than 10 years shorter than for non-Indigenous Australians,’

Indigenous Australians also continue to have higher rates of many diseases, such as diabetes, end-stage kidney disease and coronary heart disease.”

AIHW Director and CEO Barry Sandison

                     AIHW website Australia’s Health 2016

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The Minister today launched the Australian Institute of Health and Welfare’s (AIHW) publication Australia’s health 2016, which provides an update on the health of Australians and the performance of Australia’s health system.

“Australia’s health 2016 shows us that about 85 per cent of Australians rate their health as good, very good or excellent, which is a testament to the significant investment of the Turnbull Government into the health of our nation, with about one-quarter of total government revenue attributed to health spending,” Minister Ley said.

“Our Government’s priority is to ensure the high performance and sustainability of our health system over the long term. This is why the Turnbull Government is working closely with stakeholders to progress a range of health system reforms.”

Total Commonwealth investment in health will grow to more than $71 billion in 2015-16 and this will increase to $79 billion within four years. The Turnbull Government’s investment in Medicare is at $23 billion per year and this will increase by $4 billion over the next four years.

“The report indicates that health outcomes for Australians have improved over time with life expectancy at an all-time high of 80.3 years for males, while a baby girl could expect to live for 84.4 years. Survival rates for cancer are also improving,” Minister Ley said

Minister Ley said that despite plenty of good news on health in the report, managing chronic conditions and their impact on Australia’s health system remained one of our greatest health challenges.

“The report shows that half of Australians have a chronic disease – such as cardiovascular disease, arthritis, diabetes or a mental health disorder – and one-in four have two or more of these conditions,” Minister Ley said.

“This is why our initial investment of almost $120 million in the Health Care Homes initiative is so important. It will help to keep those with chronic conditions healthier and out of hospital. It will give GPs the flexibility and tools they need to design individual care plans for patients with chronic conditions and coordinate care services to support them.

“We recently announced the 10 geographic regions that will deliver Stage One of this important initiative from 1 July next year, and we hope the results will lead more broadly to a better, consumer-focused approach to health care.”

Australia’s health 2016 is available on the Australian Institute of Health and Welfare’s website.

85 out of 100 Australians say they’re healthy—but are we really? AIHW Press Release

Most Australians consider themselves to be in good health, according to the latest two-yearly report card from the Australian Institute of Health and Welfare (AIHW).

The report, Australia’s health 2016 is a key information resource, and was launched today byfederal Health Minister, the Hon. Sussan Ley.

AIHW Director and CEO Barry Sandison said the report provided new insights and new ways of understanding the health of Australians.

‘The report shows that Australia has much to be proud of in terms of health,’ he said.

‘We are living longer than ever before, death rates continue to fall, and most of us consider ourselves to be in good health.’

If Australia had a population of just 100 people, 56 would rate their health as ‘excellent’, or ‘very good’ and 29 as ‘good’.

‘However, 19 of us would have a disability, 20 a mental health disorder in the last 12 months, and 50 at least one chronic disease.’

Mr Sandison said the influence of lifestyle factors on a person’s health was a recurring theme of the report. ‘13 out of 100 of us smoke daily, 18 drink alcohol at risky levels, and 95 do not eat the recommended servings of fruit and vegetables.

‘And while 55 do enough physical activity, 63 of us are overweight or obese.’

Mr Sandison said that while lifestyle choices were a major contributor to the development of many chronic diseases, other factors such as our income, education and whether we had a job—known as ‘social determinants’—all affected our health, for better or worse.

‘As a general rule, every step up the socioeconomic ladder is accompanied by an increase in health.

‘Compared with people living in the highest socioeconomic areas, people living in the lowest socioeconomic areas generally live about 3 years less, are 1.6 times as likely to have more than one chronic health condition, and are 3 times as likely to smoke daily.’

As well as looking at factors influencing individuals’ health, today’s report also examines the health of particular population groups, and shows considerable disparities.

‘For example, while there have been some improvements overall in the health of Aboriginal and Torres Strait Islander Australians—including falls in smoking rates and infant mortality—Indigenous Australians continue to have a lower life expectancy than non-

Indigenous Australians, at 69.1 years for males and 73.7 for females, more than 10 years shorter than for non-Indigenous Australians,’ Mr Sandison said.

Indigenous Australians also continue to have higher rates of many diseases, such as diabetes, end-stage kidney disease and coronary heart disease.

For people living in rural and remote areas, where accessing services can be more difficult, lower life expectancy and higher rates of disease and injury—particularly road accidents— are of concern.

In Australia, health services are delivered by a mix of public and private providers that includes more than 1,300 hospitals and about 385,000 nurses, midwives and medical practitioners.

Of the $155 billion spent on health in 2013–14, $145 billion was recurrent expenditure. Hospitals accounted for 40% of recurrent expenditure ($59 billion), primary health care 38% ($55 billion), with the remaining 22% spent on other health goods and services.

For the first time, the report examines how spending by age for people admitted to hospital has changed over time.

Mr Sandison said the analysis showed that the largest increase in spending between 2004–05 and 2012–13 was for Australians aged 50 and over.

‘This was due to more being spent per person in the population as well as the increased number of people in these age groups.’

Mr Sandison also said that while Australia’s health 2016 provides an excellent overview of Australia’s health at a point in time, there is still scope to expand on the analysis.

New to this edition is information on the changing nature of services provided by publicand private hospitals over the last 10 years; information about how geography affects

Indigenous women’s access to maternal health services; and about the increasing role ofinstitutions such as hospitals and residential aged care in end-of-life care.

‘Good data is essential to inform debate and policy and service delivery decision-making— and improving its quality and availability is at the core of the AIHW’s work.

‘We’re committed to providing meaningful, comprehensive information about Australia’s health and wellbeing—to help create a healthier Australia.’

  • Preliminary material
    • Title and verso pages
    • Contents
    • Preface
    • Acknowledgments
    • Terminology
  • Body section
    • Chapter 1 An overview of Australia’s health
      • Introduction
      • What is health?
      • Australians: who we are
      • How healthy are Australians?
    • Chapter 2 Australia’s health system
      • Introduction
      • How does Australia’s health system work?
      • How much does Australia spend on health care?
      • Who is in the health workforce?
    • Chapter 3 Leading causes of ill health
      • Introduction
      • Burden of disease and injury in Australia
      • Premature mortality
      • Chronic disease and comorbidities
      • Cancer
      • Coronary heart disease
      • Stroke
      • Diabetes
      • Kidney disease
      • Arthritis and other musculoskeletal conditions
      • Chronic respiratory conditions
      • Mental health
      • Dementia
      • Injury
      • Oral health
      • Vision and hearing disorders
      • Incontinence
      • Vaccine preventable disease
    • Chapter 4 Determinants of health
      • Introduction
      • Social determinants of health
      • Social determinants of Indigenous health
      • Biomedical risk factors
      • Overweight and obesity
      • Illicit drug use
      • Alcohol risk and harm
      • Tobacco smoking
      • Health behaviours and biomedical risks of Indigenous Australians
    • Chapter 5 Health of population groups
      • Introduction
      • Health across socioeconomic groups
      • Trends and patterns in maternal and perinatal
      • health
      • How healthy are Australia’s children?
      • Health of young Australians
      • Mental health of Australia’s young people and adolescents
      • Health of the very old
      • How healthy are Indigenous Australians?
      • Main contributors to the Indigenous life expectancy gap
      • Health of Australians with disability
      • Health of prisoners in Australia
      • Rural and remote health
    • Chapter 6 Preventing and treating ill health
      • Introduction
      • Prevention and health promotion
      • Cancer screening
      • Primary health care
      • Medicines in the health system
      • Using data to improve the quality of Indigenous health care
      • Indigenous Australians’ access to health services
      • Spatial variation in Indigenous women’s access to maternal health services
      • Overview of hospitals
      • Changes in the provision of hospital care
      • Elective surgery
      • Emergency department care
      • Radiotherapy
      • Organ and tissue donation
      • Safety and quality in Australian hospitals
      • Specialised alcohol and other drug treatment services
      • Mental health services
      • Health care use by older Australians
      • End-of-life care
    • Chapter 7 Indicators of Australia’s health
      • Introduction
      • Indicators of Australia’s health
  • End matter
    • Methods and conventions
    • Symbols
    • Acronyms and abbreviations
    • Glossary
    • Index

 

 

NACCHO #Aboriginal Health : #AIHW releases specific Measures tool Item 715 MBS Health checks

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All Aboriginal and Torres Strait Islander people are eligible for an annual Indigenous-specific health check: item 715 on the Medicare Benefits Schedule (MBS).

AIHW Press Release 21 July 2016

Medicare Health Assessment for Aboriginal and Torres Strait Islander People (MBS Item 715) – PDF 322 KB

See update 22 July For Aboriginal Health Workers
The aim of this MBS health assessment item is to help ensure that Aboriginal and Torres Strait Islander people receive primary health care matched to their needs, by encouraging early detection, diagnosis and intervention for common and treatable conditions that cause morbidity and early mortality.

For the purpose of this item, a person is an Aboriginal or Torres Strait Islander person if they, or their parent or carer, identify them as being of Aboriginal or Torres Strait Islander descent.

The MBS health assessment for Aboriginal and Torres Strait Islander people covers the full age spectrum, and should be used for health assessments for the following age groups:

  • Aboriginal and Torres Strait Islander children who are less than 15 years old
  • Aboriginal and Torres Strait Islander adults who are aged fifteen years and over but under the age of 55 years
  • Aboriginal and Torres Strait Islander older people who are aged 55 years and over

Indigenous specific measures tool 5th release (dynamic data display)

This tool shows numbers and usage rates of the checks at various geographic areas. Charts and tables in the tool can be customised to show different time periods and, where possible, disaggregations by age and sex.

The Australian Institute of Health and Welfare has released a new web product on 21 July, 2016:

Indigenous specific measures tool 5th release (dynamic data display)

1.The Indigenous health check (MBS 715) data tool provides information on use of MBS-rebated health checks for Aboriginal and Torres Strait Islander people displayed using SAS Visual Analytics.

2 The tool shows; numbers and rates of health check uptake at national, jurisdiction, Medicare Local and peer group, and Primary Health Network levels.

3 .This update adds national and jurisdiction data up to December 2015, updated from 30 June 2014.

The page can be viewed at this link: http://www.aihw.gov.au/indigenous-australians/indigenous-health-check-data-tool/

Source data: Excel download (1.5MB XLS)

Helpline: 1800 223 919 or nidisc@aihw.gov.au.

Components of the Health Assessment

The health assessment includes an assessment of the patient’s health, including their physical, psychological and social wellbeing. It also assesses what preventive health care, education and other assistance should be offered to the patient to improve their health and wellbeing. It complements existing services already undertaken by a range of health care providers. This health assessment must include:

  • information collection, including taking a patient history and undertaking examinations and investigations as required;
  • making an overall assessment of the patient;
  • recommending appropriate interventions;
  • providing advice and information to the patient;
  • keeping a record of the health assessment, and offering the patient a written report about the health assessment, with recommendations about matters covered by the health assessment; and
  • offering the patient’s carer (if any, and if the medical practitioner considers it appropriate and the patient agrees) a copy of the report or extracts of the report relevant to the carer.

As part of a health assessment, a medical practitioner may develop a simple strategy for the good health of the patient. The strategy should identify any services the patient needs and the actions the patient, or parent or carer, should take. It should be developed in collaboration with the patient, or parent or carer, and documented in the written report on the assessment that is offered to the patient, and/or patient’s carer.