Leading health organisations, the Dietitians Association of Australia and the Public Health Association of Australia, have joined forces with Australian Red Cross to draw attention to the health gap between Aboriginal and Torres Strait Islander people and other Australians, due to food insecurity.
The three organisations are releasing their ‘Food Security for Aboriginal and Torres Strait Islander Peoples’ policy at Parliament House in Canberra today.
According to the organisations, one in four (24%) Aboriginal and Torres Strait Islander People report food insecurity, compared with just five per cent of non-Indigenous Australiansan issue they say is not getting any better and needs urgent attention.
Public Health Association of Australia CEO Michael Moore said: ‘We’re calling on all levels of Government to address food insecurity in Aboriginal and Torres Strait Islander people. Many in this population group do not have access to sufficient, safe and nutritious food to lead a healthy and active life.
‘Factors such as poverty, low or inadequate incomes, poor housing, including basic set-ups to store and prepare food, and less access to nutritious food place these Australians at higher risk.’
Claire Hewat, CEO of the Dietitians Association of Australia, said the result is that many Aboriginal and Torres Strait Islander families go hungry, and that diet-related diseases run rife in this population.
‘Sadly, in this group of Australians, we see high rates of preventable diet-related diseases like obesity, type 2 diabetes and heart disease,’ said Ms Hewat.
She said nutrition needs to be a priority if the health of Aboriginal and Torres Strait Islander people is to improve.
According to Jennifer Evans, National Coordinator, Families Children and Food Security at Australian Red Cross, Aboriginal and Torres Strait Islander people do not have an equal opportunity to be as healthy as non-Indigenous Australians, with poorer access to healthy food, primary health care and health infrastructure.
‘This is reflected in data showing life expectancy for Aboriginal and Torres Strait Islander people is 11.5 years shorter for males and almost 10 years shorter for females, compared with other Australians,’ said Ms Evans.
The ‘Food Security for Aboriginal and Torres Strait Islander Peoples’ policy highlights the need for all levels of government to take the lead in addressing food insecurity, working with non-government organisations and Aboriginal and Torres Strait Islander people.
ENDS
Media contacts:
Michael Moore, CEO, Public Health Association of Australia: 0417 249731
Emma Jones, Communications and Marketing Cadet Dietitian, Dietitians Association of Australia: 0409 661920.
Antony Balmain, Communications and Media Adviser, Australian Red Cross: 0408 018609
Background
Food insecurity includes periods of prolonged hunger, or anxiety about getting food or having to rely on food relief.
The ‘Food Security for Aboriginal and Torres Strait Islander Peoples’ policy highlights:
The unacceptable health gap between Aboriginal and Torres Strait Islander people and other Australians, related to food insecurity.
Government needs to take the primary role in developing targeted food and nutrition security policies and actions. A whole of government approach, linking in with relevant agencies and partners, is needed.
Mapping and reporting is needed on food and nutrition security in Australia, with a focus on Aboriginal and Torres Strait Islander people.
Future policies and policy actions to help achieve food and nutrition security need to involve Aboriginal and Torres Strait Islander people.
Picture above: Dea Delaney-Theile, third from left, rear, and her fellow graduates with Lisa Jackson Pulver, right.
NACCHO congratulates Sheila Hure, Elaine Lomas, Joanne Delaney, Jennifer King, Sethy Willie and Ms Delaney-Theile who all received their degrees while working full-time at the Aboriginal Medical Service in Mount Druitt – home to Australia’s largest urban Aboriginal population.
When her mother died of a heart attack aged only 44, Dea Delaney-Theile needed answers.
”She dropped dead on the streets of St Marys,” she said. ”At that moment I had to find out why my people were dying so young.”
Now, 30 years later, Ms Delaney-Theile is one of six Aboriginal women – all of them the first in their families to gain a university qualification – to graduate with public health degrees from the University of NSW this week.
It is the largest group of Aboriginal people to graduate from a university medical faculty at one time.
Sheila Hure, Elaine Lomas, Joanne Delaney, Jennifer King, Sethy Willie and Ms Delaney-Theile all received their degrees while working full-time at the Aboriginal Medical Service in Mount Druitt – home to Australia’s largest urban Aboriginal population.
”Twenty years ago it was a very rare thing to have an Aboriginal person studying medicine or public health,” said Lisa Jackson Pulver, professor of public health at UNSW. ”These women have worked incredibly hard.”
Ms Delaney-Theile, who has worked in Aboriginal health for 23 years, plans to ”overhaul” research to reduce the high incidence of chronic disease, including heart disease, diabetes, renal disease and mental health, in the western Sydney community. ”Incarceration rates are still really high and there is still a 10-year life expectancy gap,” she said.
Ms Delaney-Theile said the role of education – particularly in urban areas – was crucial to improving health outcomes. Often boarding school scholarships only help kids from rural communities.
”But we have big Aboriginal populations in the cities and you don’t hear about many kids who get the opportunity to go to Joey’s or Saint Ignatius,” she said.
Professor Jackson Pulver estimates there are about 100 Aboriginal and Torres Strait Islander students studying public health in Australia – a number that is on the rise.
But university is still out of the ”reality” for many young Aboriginal people, she said. ”Universities are normally in very expensive cities and most Aboriginal families don’t have the financial resources behind them to support their children,” she said.
School guidance councillors often discourage children from entering health, she said. Despite this, there are 260 indigenous students studying medicine in Australia and 56 of those are studying at UNSW.
“We’ve come great strides and we have a lot to shout about,” Professor Jackson Pulver said.
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Are you interested in working in Aboriginal health?
Are you interested in working in Aboriginal health?
NACCHO is the national authority in comprehensive Aboriginal primary health care currently has a wide range of job opportunities in the pipeline.
“This is a good example of “the 3 C’s” as this event is not government funded but has been self-funded by our sector showing how NACCHO, affiliates and member services continue to support each other. The summit themes of governance, workforce and comprehensive primary health care will show the diversity amongst the membership. ” Lisa Briggs
In the conference preview below, Lisa Briggs, CEO of NACCHO, has an online chat with Croakey about the “bang for the buck” provided by the Aboriginal community controlled health sector.She also reveals her dream panel for ABC TV’s Q and A program, her enthusiasm for the power of social media, and her hopes that more young Aboriginal and Torres Strait Islander people will choose careers in health.Lisa is a Gunditjmara Aboriginal woman from the western district of Victoria, and an Aboriginal Health Worker who has worked in the health field for the past 25 years, mainly within the Aboriginal community controlled health sector.***Q: A Twitter campaign is pushing for the ABC program Q and A to have an all-Indigenous panel. Who is your dream Q and A panel?
Lisa Briggs:
Justin Mohamed, Chair of NACCHO – to highlight the importance of Aboriginal health and how the Aboriginal Community Controlled Health model is contributing to Closing the Gap.
Warren Mundine – who would Chair the Prime Minister’s Indigenous Advisory Council should the Coalition win the election.
Marion Scrymgour, CEO of our member service Wurli-Wurlinjang Health Service in Katherine. Marion understands the political and health system and would be able to provide another opinion and challenge ideas, as well as provide gender balance.
Shane Houston from Sydney University – his extensive knowledge of Aboriginal affairs is impressive and he would provide a sense of the vision and systematic changes required.
Professor Patrick Dodson – his extensive knowledge on current issues such as Constitutional reform and land rights.
Pat Turner – Former Deputy Secretary of the Prime Ministers Department – has extensive experience in government and Aboriginal affairs.
I wanted to put Marcia Langton and Noel Pearson in there too, as I think they all have something to contribute on how policy is being formed for Aboriginal people and the impacts that it has on us and our environments of urban, regional and remote…I think people expect Marcia, Noel and Warren to all be part of this should the Coalition win the election, so I thought what other Aboriginal leaders have equal experience but are not always heard and these are the ones I came up with my shortlist.
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Q: You tweeted from a recent AHMRC meeting that the three C’s of the Aboriginal community control philosophy are “Community-initiated”, “Community-driven”, “Community-owned”. Could you explain why each of these C’s matter?
Lisa Briggs: It’s about self-determination of Aboriginal and Torres Strait Islander people and their fundamental right of being part of all processes that have impacts on us. Aboriginal Community Controlled Health Services are founded on this basis.
Q: The NACCHO Summit aims to profile innovation and best practice in the community controlled sector. Can you give us one of your favourite examples of this?
Lisa Briggs: It wouldn’t be fair for me to pick one over the other. However, I can say this – how very pleased I am to see the Aboriginal Community Controlled Health Services put in so many conference abstracts to this weeks summit that will show innovation and best practice from all over the country. With over 300 delegates registered, over 85 presentations and over 100 speakers and exhibitors, it is going to be a great event.
This is a good example of “the 3 C’s” as this event is not government funded but has been self-funded by our sector showing how NACCHO, affiliates and member services continue to support each other. The summit themes of governance, workforce and comprehensive primary health care will show the diversity amongst the membership.
There will be common things we can all relate to, however it will be innovation at its best that the members can take back to their community organisations.
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Q: What are the barriers within government & government policy to the community controlled sector achieving its potential?
Lisa Briggs: The barriers are to do with lack of action on the following:
• Engagement and cultural consultation processes with Aboriginal and Torres Strait Islander people
• Government understanding the role and importance of Aboriginal Community Controlled Health Services as part of the overall Australian health system
• Government Policies are piloted in Aboriginal and Torres Strait Islander communities before being rolled out nationally. Aboriginal specific policies such as the NT Intervention imply institutional racism, and then these policies affect the ideas of government workers and others
• Aboriginal history embedded into the Australian education system so that wider Australia can feel proud of it First Nations peoples
• Constitutional recognition that Australia’s first people are Aboriginal and Torres Strait Islander people who are rich in culture and knowledge – something all Australia should be proud of.
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Q: What are the barriers within the community controlled sector to the sector achieving its potential?
Lisa Briggs:
• A lack of appropriate funding to enable the ACCHS to meet the needs of communities.
• Government policies that are not targeted to the needs of that community.
• Workforce recruitment, retention and capacity – particularly GPs, nurses and allied health workers.
• Lack of genuine partnerships.
• Lack of scholarships that support and meet the demand required for Aboriginal and Torres Strait Islander people to join the health workforce.
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Q: What are the barriers within the wider health system to the community controlled sector achieving its potential?
Lisa Briggs:
• A lack of understanding of ACCHSs, their role and mechanism
• Lack of genuine partnerships
• Lack of coordination
• Institutional racism
• Policies which impact access such as affordability, access,
• A lack of cultural understanding
• A lack of capacity to meet the needs of Aboriginal organisations and Aboriginal & Torres Strait Islander people.
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Q: What are the barriers within Aboriginal and Torres Strait Islander communities to the community controlled sector achieving its potential?
Lisa Briggs: The Social and Cultural Determinants of Health are important, and these are a few underpinning examples:
• Employment – meaningful career pathways
• Education – meaningful and supported such as scholarships programs that enable participation, and being open to all age groups
• Accessibility – having the means to be able to access services no matter where they are located and in an environment that meets their needs
• Housing – having the same level of opportunity as other Australians to either purchase or rent.
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Q: What are the enablers within government and government policy and the wider health system to the community controlled sector achieving its potential?
Lisa Briggs:
• Genuine engagement and consultation and being heard and listened to.
• Working alongside Aboriginal leadership at all levels for development, implementation and evaluation.
• Genuine partnership, opportunity and investment in what works for Aboriginal and Torres Strait Islander people.
• Close the Gap Statement of Intent is a good example of what can happen when this above process is followed. However, there is always room for improvement.
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Q: What are the enablers within the sector to the community controlled sector achieving its potential?
Lisa Briggs:
• Genuine engagement and consultation with local community members, and hearing their needs
• Appropriately resourced to be able to meet the targeted needs of the local community
• Funding mechanism that allows for innovation and investment
• Appropriate workforce capacity and investment in new workforce innovation
• Investing in Aboriginal leadership as part of professional development.
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Q: You’ve been known to say that the community controlled sector offers “the best bang for the buck”. Can you quantify this?
Lisa Briggs: Aboriginal Community Controlled Health Services are not funded to the same level as other primary health care services across Australia.
However, they are the only services that demonstrate and are targeted towards health gains – not throughput. This is why the Aboriginal Community Controlled Health Services Report Card is so significant, as we now have an evidence base that can be showcased.
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Q: How would you advise community members to evaluate the quality of their community controlled service? What are the signs of a healthy service? And what are the signs of a service that needs support to improve?
Lisa Briggs: All of our Aboriginal Community Controlled Health Services are accredited and meet the Australian Standards and part of the process is to receive feedback from the clients you service to measure quality. This has now been embedded as custom and practice, and allows the ACCHS’s to work on a continuous quality improvement model.
A healthy service in my opinion is one that follows “the 3 Cs” (ie “Community-initiated”, “Community-driven”, “Community-owned”).
The issues that services face vary: it might be a small service needing more capacity and expansion, it might be a large service needed to review its strategic direction, it might be a young community needing guidance.
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Q: In a recent speech on the social determinants of health, AMA president Dr Steve Hambleton acknowledged the impact of institutionalised racism. The vision of the new national plan for Aboriginal and Torres Strait Islander health (which recently had a positive wrap in The Lancet)is for a health system free of racism. For health services and health professionals that want to address this problem, how would you advise them?
Lisa Briggs: Engage with their local Aboriginal Community Controlled Health Service and learn about what the communities’ needs are, ask how they can assist in a genuine partnership and coordination model – it will take shape from there over a period of time.
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Q: What is your vision for Aboriginal and Torres Strait Islander health in 10 years time?
Lisa Briggs: I believe if we currently keep tracking with our original health targets, then life expectancy should increase. However, some areas need urgent attention now, such as diabetes, renal disease and cancer.
We are moving into a world where everything will be more telecommunication-based with telehealth and ehealth. With workforce shortages and population growth, models of services will also need to adapt, to continue meeting the needs of the community.
Since we are a young population compared to the rest of Australia, I hope to see more of our young people complete their studies, and find their career pathway into the health system.
Economic constraints will create challenges and opportunities. The challenges include that NACCHO, affiliates and members are not funded at parity as the rest of the health system. A potential opportunity is that Government may choose to invest at a higher level or to buy more services from ACCHSs given the good value they provide.
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Q: What is your vision for the community controlled sector in ten years time?
Lisa Briggs: Aboriginal Community Controlled Health Services are viable and sustainable, and their model of services adapts to suit the changing needs. This vision is outlined by the NACCHO 10 point plan, which gives focus and direction to us, our affiliates and member services.
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Q: What is your top tip to those working in the community controlled sector for looking after their own health?
Lisa Briggs: Ensure that you have an annual health check, take regular holidays and spend quality time with the ones you love, take the time to sit back and reflect on how your contribution has made a difference – you can’t look after other people if you don’t look after yourself!
It’s work and life balance.
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Q: NACCHO (@NACCHOAustralia has over 4,000 followers) has been at the forefront of the health sector in using Twitter and other social media channels such as blogsto communicate with its stakeholders and to build influence. Would you like to see more people in the community controlled sector using social media as a health communications channel? If so, what might help them to get on board?
Lisa Briggs: This is absolutely essential, people need to be informed of the power and traction social media has – generally teaching people how to use social media or be involved is the key.
We are encouraging all our member services and staff to utilise social media and can provide them with information on establishing a corporate social media policy. Once you start, you just can’t stop engaging with our community, partners, and stakeholders, sharing the issues and good news stories about the successes in our Aboriginal community controlled health sector.
• An Australian Centre for Health Services Innovation forum, “Fixing Healthcare”, in Brisbane, August 29. Mardi Chapman (@mardidiane), a health journalist and writer based in Brisbane, will cover the forum.
Check #12Bhealthfix.
@WePublicHealth is a new rotated Twitter account that is something of an experiment in public health/citizen journalism. Every week, a different person – including community members and public health professionals – will be asked to tweet-report and investigate public health matters.
Their focus might be local – for example, documenting the cost of fresh foods in remote communities via tweet-photos – national or global (for example, reporting from international conferences and events).
Gavin Mooney believed passionately in social justice and taught thousands of students in the ”caring discipline” of health economics. The real power of health economics, he said, was to be found in asking the right questions: ”What does the community want from their health system?”, ”How can we improve health unless we achieve greater equity?” and ”What does equity mean anyway?”
Not one for convention, Mooney instilled in all of his many PhD students the obligation to question the status quo and to propel new ideas and methods into the discipline of health economics.
Gavin Hunter Mooney was born on October 30, 1943, son of Hendry Mooney and his wife, Mary (nee Hunter), who inculcated the ideas of social justice into their children. He grew up in Glasgow, graduated from Edinburgh University in economics and became a trainee actuary. He did a short stint in the civil service but his true calling was to the academic world.
In 1977, despite not having a PhD, Mooney was appointed Professor of Health Economics at the University of Aberdeen and founded the Health Economics Research Unit (HERU). To this day HERU remains one of the leading health economics teaching and research centres in the world.
Mooney moved to Denmark in the mid-1980s, married Anita Alban and was Professor of Health Economics at Copenhagen University. He made a valiant attempt to learn Danish and his students made a valiant attempt to understand his Danish delivered with a strong Glaswegian accent. He also took up a part-time position at the University of Tromso in Norway, the world’s northern most university, and developed an influential correspondence course there for health professionals.
In 1987 Mooney made his first visit to Sydney, as a keynote speaker at the annual conference of the Australian and New Zealand Public Health Association. In his opening lines, he said that Australians were a kind and friendly bunch. Then came the challenge – if we are concerned about equality in our society, particularly in relation to health, then we had better consider what we mean by equality and do something about it.
And in time Australia did so. In 1993, the University of Sydney appointed Mooney as the Foundation Professor of Health Economics and it wasn’t long before he helped to establish the Centre for Health Economics Research and Evaluation, based at Westmead Hospital, where he met and later married Jackie Dettman.
He later also established the Social and Public Health Economics Group (SPHERe) in the School of Public Health at the University of Sydney and it was here that he pursued his communitarian ideology and abiding passion for Aboriginal health.
In 2000, Mooney moved to Western Australia and led the SPHERe group at Curtin University and established the WA social justice network. An outspoken critic of institutions, governments and some professional bodies, Mooney ruffled feathers and mobilised action for social justice. He also met and fell in love with Del Weston.
During his time at Curtin, Mooney trained five Aboriginal health economists – a remarkable achievement and a reflection of his commitment to Aboriginal health.
His life was run in the pursuit of social justice for people everywhere. He forged an enduring relationship with the health economics group at Capetown University and was a regular visitor to South Africa. At 67, he ran a marathon to raise money to support education for orphaned African kids. His friends and colleagues supported him with sponsorship and he raised a considerable sum of money. He was delighted when, in 2009, the University of Capetown awarded him an Honorary Doctorate as ”one of the founding fathers of health economics”.
No matter what the language, the culture or country, Mooney had what his colleague Steve Leeder described as a ”challenging, clarifying and provocative style”. He also wrote more than 20 books and more than 200 publications and held honorary positions at Aarhus University in Denmark, Victoria University in New Zealand and the University of NSW.
Gavin Mooney is survived by his family in Scotland: sister Helen, brother Grant and four nieces. Del died with him.
In 2009, the federal government’s preventive health taskforce proposed measures to combat obesity, including increased taxes on unhealthy food, a ban on junk food marketing to children, exercise programs in schools and workplaces and an urban planning overhaul to boost physical activity.
With obesity, we are where we were with tobacco about 50 years ago.
In a speech to be delivered at a health summit in Canberra on Monday 3 December , Professor Zimmet, director emeritus at Melbourne’s Baker IDI Heart and Diabetes Institute, argued there is no political will to reduce obesity.
THE political response to Australia’s obesity epidemic has been a ”failure”, and $49 million spent on healthy lifestyle advertising campaigns was a ”waste of taxpayers’ money”, a key government adviser claims.
Professor Paul Zimmet, a member of former prime minister Kevin Rudd’s preventive health taskforce, says the government’s strategy to fight the fat is ”weak and fragmented”.
He says he would not have agreed to be on the taskforce – set up to find ways to reduce the burden of alcohol, tobacco and obesity – if he had known most of its obesity recommendations would be ignored.
In a speech to be delivered at a health summit in Canberra on Monday 3 December , Professor Zimmet, director emeritus at Melbourne’s Baker IDI Heart and Diabetes Institute, will argue there is no political will to reduce obesity.
While congratulating the government for its action on tobacco control, he claims it has taken the ”easy option” on obesity, with ineffective social marketing campaigns.
”The government seems to not have the stomach for obesity prevention. What is being done at present is fragmented and weak and does not constitute a serious attempt to tackle the problem,” Professor Zimmet said.
”This is one of the biggest drivers of disease – it drives type two diabetes, arthritis, heart disease and certain cancers. It’s a huge load on the community so it’s very disappointing there is no national effective strategy, despite the taskforce making it very clear that it was the whole package that was important, not isolated bits and pieces.”
In 2009, the federal government’s preventive health taskforce proposed measures to combat obesity, including increased taxes on unhealthy food, a ban on junk food marketing to children, exercise programs in schools and workplaces and an urban planning overhaul to boost physical activity.
But Professor Zimmet said the measures had not been adopted and money had been squandered on social marketing campaigns such as the ”Swap It, Don’t Stop It” and ”Measure Up” healthy lifestyle campaigns.
”To spend more than $40 million on social marketing campaigns without having an integrated strategy is a waste of money. It’s achieved very little because campaigns like that can’t be done in isolation without addressing better parks, … improved food access, addressing indigenous diabetes and heart disease rates. So really the whole approach to the problem has been a failure.”
Fellow preventive health taskforce member Mike Daube, director of the Public Health Advocacy Institute, is also disappointed by the government’s lack of action on obesity.
”With obesity, we are where we were with tobacco about 50 years ago. We’re fat, we’re getting fatter and the junk food industry is immensely powerful, so strong public education needs to be allied with tough measures, such as dealing with food advertising or food formulation,” Professor Daube said. ”Having said that, the government has been sensational on tobacco and you can understand them not wanting to take on every major industry at once.”
Professor Zimmet will be among a range of speakers at Monday’s summit, ”Obesity: Changing the Rhetoric, Solutions for the Future”, organised by newly formed public health lobby group Obesity Australia.
A spokesman for the Department of Health said figures show childhood obesity rates have stabilised.
”The success Australia has experienced in reducing tobacco has been the result of 30 years of co-ordinated effort. A similar long-term view is required to address obesity,” he said.
