Source: https://nacchocommunique.com/category/close-the-gap/
Timestamp: 2018-07-18 12:54:58
Document Index: 500779985

Matched Legal Cases: ['art 2', 'art 1', 'art 2', 'art 2', 'art 2', 'art 1', 'art 1', 'art 2']

Close the Gap | NACCHO Aboriginal Health News Alerts
Category Close the Gap
” The National Congress of Australia’s First Peoples has also warned that a focus on “economic prosperity” in the current Close the Gap review “is misguided and should not serve as an overarching focus for government policy”.
The Lowitja Institute has called for “prosperity” to be ­removed as a criteria, saying it “has strong monetary connotations and does not adequately speak to the health and education sectors”, and warns that the ­review will fail “if effective partnerships and engagement, not consultation, with Aboriginal and Torres Strait Islander leaders and communities is not undertaken from the start to the end of the process”.
From the Australian 14 July see Part 2 Below
Part 1 : Download Aboriginal and Torres Strait Islander health organisations: Online Services Report—key results 2016–17
This ninth national report provides information on 266 organisations funded by the Australian Government to deliver health services to Aboriginal and Torres Strait Islander people. These organisations contributed to the 2016–17 Online Services Report. 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.
Some changes were made to the 2016–17 data collection, aimed at ensuring consistency in episode of care reporting between the different data collection systems. This resulted in a decrease in primary health episode of care counts in 2016–17. These are not comparable with previous collections, so comparisons are not presented in this report. See Chapter 2 for more information about the data collection, data quality and the impacts of these changes.
Download the full report 120 Page HERE
aihw-ihw-196
1.A range of services are provided to Aboriginal and Torres Strait Islander people
Of the 266 organisations in 2016–17:
196 (74%) provided a range of primary health-care services to around 444,700 clients through 3.2 million episodes of care. Just over two-thirds of these organisations (136) were Aboriginal Community Controlled Health Organisations. Services provided include: health promotion; clinical care; substance-use treatment and prevention; and social and emotional wellbeing support. These organisations also provided access to specialist, allied health and dental services, either on site or by facilitating off-site access. For example, most provided access to cardiologists (90%); renal specialists (87%); ophthalmologists (86%); paediatricians (90%); psychiatrists (87%); diabetes specialists (90%); and ear, nose and throat (ENT) specialists (88%). They also provided access to dental services (94%) and to allied health services such as physiotherapists (89%); psychologists (93%); dieticians (95%); podiatrists (96%); optometrists (94%); and audiologists (91%).
Around 7,600 full-time equivalent (FTE) staff were employed by organisations providing primary health-care services and just over half of all staff (53%) were Aboriginal and/or Torres Strait Islander (see Chapter 3).
213 (80%) provided maternal and/or child health services through their primary health and/or New Directions funding. Around 8,400 Indigenous women were seen through 42,200 antenatal visits—an average of 5 visits per client (see Chapter 4).
88 (33%) provided social and emotional wellbeing services. The 189 counsellors in these organisations saw around 16,300 clients, through 77,100 client contacts—an average of 5 contacts per client (see Chapter 5).
80 (30%) provided substance-use services to around 39,400 clients through 197,700 episodes of care. Most episodes of care (88%) were for non-residential or after-care services (see Chapter 6).
2.Many funded organisations provide services in Remote and Very remote areas
Nearly half (46%) of the organisations funded to provide primary health-care services to Aboriginal and Torres Strait Islander people did so in Remote or Very remote areas and they saw around 168,100 (38%) clients. Around 44% of employed staff (3,347 FTE) worked in Remote or Very remote areas, including a higher proportion of employed nurses and midwives (59% or 664 FTE) and a lower proportion ofemployed dental care staff (21% or 38 FTE).
There were more FTE nurses and midwives per 1,000 clients in Remote (3.5) and Very remote areas (4.4), compared with 2.6 per 1,000 clients overall. There were fewer doctors in Very remote areas (0.9 FTE doctors per 1,000 clients compared with 1.3 overall), perhaps reflecting a greater reliance on nurse-led clinics in these areas. Contacts by nurses and midwives represented half (51%) of all contacts in Very remote areas compared with 29% overall.
Over 800,000 episodes of care (25%) were provided to clients in Very remote areas. However, organisations in Very remote areas were still more likely to report staffing vacancies. Nearly one-third (31%) of reported health-staff vacancies were in organisations in Very remote areas. They also had more health-staff vacancies per 1,000 clients (1.0 compared with 0.7 overall). Organisations in Very remote areas were also more likely to report the recruitment, training and support of staff as one of the challenges they faced in providing quality care to clients (75% compared with 67% overall) as well as staff retention and turnover (75% compared with 57% overall).
3.Various group activities are run to promote health and wellbeing
Organisations delivered a range of group activities in 2016–17 to improve the health of the community:
Those funded to provide primary health-care services ran around 8,400 physical activity/healthy weight sessions; 4,300 chronic disease client support sessions; and 3,300 tobacco-use treatment and prevention sessions. Other common health promotion activities included campaigns to encourage immunisation services (in 81% of organisations), healthy lifestyle programs (75%) and sexual health/ education (71%).
With respect to maternal and child health services, around 20,300 home visits; 3,100 maternal and baby/child health group sessions; 2,100 parenting group sessions and 1,000 antenatal group sessions were provided.
In those funded to provide substance-use services, most (93%) provided community education, while 60% did school visits. Around 4 in 5 (80%) ran physical activity or healthy weight programs and around three-quarters ran tobacco-use treatment and prevention groups (76%), alcohol-misuse treatment and prevention groups (74%), living skills groups (75%), men’s groups (75%) and women’s groups (74%).
Most (94%) organisations funded to provide primary health care also provided social and emotional wellbeing or mental health or counselling services, and over half (57%) had mental health promotion activities in 2016–17; however, nearly two-thirds of organisations still reported mental health and social and emotional wellbeing services as a service gap (63%). This was even higher (78%) in organisations funded to provide substance-use services, but not primary health care.
Some organisations indicated that clients with high needs had to wait too long for some services, in particular to access dental services and mental health professionals. For example, 50 (27%) 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. This was higher in organisations in Remote (44%) and Very remote (34%) areas.
Part 2 Is the Closing the Gap ‘too focused on prosperity debate
The Closing the Gap program aimed at reducing indigenous disadvantage has hit stasis 10 years after it began, with four of its seven measures expired, a review of the scheme still months off being completed and warnings from a range of peak organisations that some proposed criteria for replacement targets are irrelevant or unhelpful.
Some fear the 11th annual Prime Minister’s report due in February might focus more on ­details of the review and launching a reboot, rather than accounting for any actual achievements in the scheme’s aims.
Submissions to the review warn of a “dire need for greater government accountability” and say “a myopic focus on national statistics” in the past has led to the needs of individual remote communities being unmet, as well as criticising the awarding of contracts to mainstream organisations which “frequently lack the capacity, knowledge and cultural competence required to effectively deliver services to our communities”.
The National Congress of Australia’s First Peoples has also warned that a focus on “economic prosperity” in the current review “is misguided … and should not serve as an overarching focus for government policy”.
It also warns of unhelpful uses of nationwide targets “which, due to data-collection protocols were unmeasurable, and secondly, did not seem to consider the distinct challenges faced at both the state and local levels”.
Of the four Closing the Gap targets that expired at the beginning of this month, just one — halving the gap in infant mortality rates — was said to be on track, ­although even that assessment has been questioned.
The other three — closing the gap on school attendance, halving the gap in reading and numeracy and halving the employment gap — expired without being on track.
Only two of the still active three targets are on track: getting 95 per cent of all indigenous four-year-olds enrolled in early childhood education by 2025 and halving the gap for Year 12 or equivalent attainment by 2020.
A third, closing the life expectancy gap by 2031, is not on track.
The Weekend Australian understands two review workshops are scheduled in Canberra for the end of this month, for peak groups in the sector and others who have made submissions.
The review, which is being conducted by the Department of Prime Minister and Cabinet as a Council of Australian Governments exercise, is then expected to report back by October 31 with a new “framework, targets and performance indicators”.
However congress co-chair Rod Little warned this might still be merely a report that requires further refining, with the outcome that by next February, when the Prime Minister’s annual report should be delivered, “that’s one year that’s gone into reshaping the framework rather than working on outcomes”.
But he said the October deadline opened the door for further consolidation.
NACCHO Aboriginal Heart Health : @ourANU @Mayi_Kuwayu Report high levels of risk of heart disease and #stroke for young and old #Indigenous Australians can be prevented : Plus @strokefdn Response
“Recognising the risk will help save and improve lives and contribute to Closing the Gap in life expectancy.
Heart checks may need to start earlier in order to protect Aboriginal and Torres Strait Islander people but the good news is most heart attacks and strokes can be prevented.
Critical to this is knowing who is at risk and encouraging lifestyle changes, including quitting smoking, and lowering blood pressure and cholesterol levels.
The study also found that many people at high risk of heart attacks or strokes are not aware of it and most are not receiving currently recommended therapy to lower their cholesterol.”
Indigenous Health Minister Ken Wyatt releasing the study
Ken Wyatt Heart study press release
” Programs aimed at prevention should also be co-designed with Aboriginal and Torres Strait Islander peoples, taking into account social and cultural barriers that impact access and ongoing treatment.
Many people don’t receive a heart check and could be at high risk without knowing it. Prevention starts with getting a heart check and continuing to use any medications prescribed to you by your doctor to lower your risk ‘
Download the Report here Heart Stroke Report
ANU researchers have met with Minister for Indigenous Health Ken Wyatt, Aboriginal woman and heart health researcher Vicki Wade and @HeartAust to launch new study on First Nations people heart health.
” Aboriginal and Torres Strait Islander people were twice as likely to be hospitalised with stroke and 1.4 times as likely to die from stroke than non-indigenous Australians.
Stroke can be prevented, it can be treated and it can be beaten. We must act now to stem the tide of this devastating disease
Steps must be taken immediately to increase stroke awareness and access to health checks through targeted action. Federal and state government must come together to address this issue.”
Stroke Foundation Chief Executive Officer Sharon McGowan said the research results were frightening. See Full Press Release Part 2 below
” Australian’s national guidelines currently say heart health screening should begin at age 35 for Aboriginal and Torres Strait Islander people.
However, new research has found there’s a high risk of Indigenous people under 35 developing cardiovascular disease.
The study also shows Indigenous people have a higher risk of developing cardiovascular disease in older age.
Researchers say this information will be important to help identify risks earlier, and prevent disease from developing ”
Dr Norman Swan radio interview LISTEN HERE
Professor of Epidemiology and Public Health, National Centre for Epidemiology and Population Health, Australian National University, Canberra
Head of Aboriginal and Torres Strait Islander Health Program, National Centre for Epidemiology and Population Health, Australian National University, Canberra
Too few Indigenous peoples are having heart checks. from http://www.shutterstock.com
Part 2 Stroke Foundation Press Release
By nacchomedia  Posted in Close the Gap, Closing the Gap, Heart, Stroke and recovery	 Tagged Aboriginal Community Controlled Health Service
NACCHO Aboriginal Health : Download the ANAO Report : Primary Healthcare Grants under the IHAP Indigenous Australians’ Health Program : Effective high quality, comprehensive, culturally appropriate, primary healthcare services in urban, regional, rural and remote locations
” The bulk of IAHP expenditure is via grants. Since 2015, IAHP primary healthcare grants totalling approximately $1.44 billion have been awarded with 85 per cent of this funding going to Aboriginal Community Controlled Health Organisations.
The audit objective was to assess the effectiveness of the Department of Health’s design, implementation and administration of primary healthcare grants under the IAHP.”
ANAO Report PHC Grants Under IAHP – DoH
1. The Indigenous Australians’ Health Program (IAHP) was established in 2014 through the consolidation of four existing Indigenous health funding streams administered by the Department of Health (the department).
The IAHP aims to provide Aboriginal and Torres Strait Islander people with access to effective high quality, comprehensive, culturally appropriate, primary healthcare services in urban, regional, rural and remote locations across Australia.1
Primary healthcare services are usually the ‘entry point’ for persons into the broader health system and can be contrasted to services provided through hospitals or when people are referred to specialists.
The IAHP access to effective high quality, comprehensive, culturally appropriate, primary healthcare services in urban, regional, rural and remote locations
2. The bulk of IAHP expenditure is via grants. Since 2015, IAHP primary healthcare grants totalling approximately $1.44 billion have been awarded with 85 per cent of this funding going to Aboriginal Community Controlled Health Organisations.
3. As at March 2018, a total of 164 organisations are receiving IAHP primary healthcare grant funding. In 2016–17, IAHP-funded services provided primary healthcare services to an estimated 352,000 Indigenous Australians. This represents 54.2 per cent of the estimated total Indigenous population.
4. The IAHP was selected for audit because it is intended to contribute towards achieving the Indigenous health-related ‘Closing the Gap’ targets regarding life expectancy and infant mortality. The program represents the Australian Government’s largest direct expenditure on Indigenous primary healthcare.
5. The audit objective was to assess the effectiveness of the Department of Health’s design, implementation and administration of primary healthcare grants under the IAHP.
6. To form a conclusion against this objective, the ANAO adopted the following high-level criteria:
Did the department design the IAHP primary healthcare components consistent with the Government’s objectives in establishing the IAHP?
Has implementation of the IAHP primary healthcare components been supported through effective coordination with key Government and non-Government stakeholders?
Has the department’s approach to assessing primary healthcare funding applications and negotiating funding agreements been consistent with the Commonwealth Grant Rules and Guidelines?
7. The department’s design and implementation of the primary healthcare component of the IAHP was partially effective as it has not yet achieved all of the Australian Government’s objectives in establishing the program. The department has not implemented the planned funding allocation model and there are shortcomings in performance monitoring and reporting arrangements. However, the department has consolidated the program, supported it through coordination and information-sharing activities and continued grant funding.
8. The Government’s original objectives in establishing the IAHP are due to be fully achieved in 2019–20, four years later than originally planned. The majority of IAHP primary healthcare grant funding to date has been allocated in essentially the same manner as previous arrangements rather than the originally intended needs based model. Program implementation has been supported through appropriately aligning funding streams to intended outcomes and coordination and information-sharing with relevant stakeholders.
9. Most aspects of the department’s assessment of IAHP primary healthcare funding applications and negotiation of funding agreements were consistent with the Commonwealth Grants Rules and Guidelines (CGRGs). The exception to this was the poor assessment of value for money regarding the majority of grant funds. The grant funding agreements were fit for purpose, but the department has not established service-related performance benchmarks for funded organisations that were provided for in most of the agreements.
10. The department has not developed a performance framework for the Indigenous Australians’ Health Program. Extensive public reporting on Indigenous health provides a high level of transparency on the extent to which the Australian Government’s objectives in Indigenous health are being achieved. However, this reporting includes organisations not funded under the IAHP and, as such, it is not specific enough to measure the extent to which IAHP funded services are contributing to achieving program outcomes.
11. In managing IAHP primary healthcare grants, the department has not used the available provisions in the funding agreements to set quantitative benchmarks for grant recipients. This limits its ability to effectively use available performance data for monitoring and continuous quality improvement. Systems are in place to collect performance data, but systems for collecting quantitative performance data have not been effective. Issues with performance data collection limit its usefulness for longitudinal analysis.
12. The design of the IAHP was consistent with the Government’s objectives of achieving budget savings and reducing administrative complexity through consolidation of existing grant programs. The objective of allocating primary healthcare grant funding on a more transparent needs basis will not be achieved until 2019–20, four years behind the timetable agreed by Government in establishing the IAHP.
13. Three outcomes were established for the program and set out in published IAHP grant guidelines. One of the outcomes does not clearly identify the desired end result. IAHP funding, including the primary healthcare component, are appropriately aligned to the outcomes.
14. The department uses a wide variety of forums and networks to share information and seek feedback about its current and planned Indigenous health activities, including the IAHP. Some coordination and joint planning activities relating to primary healthcare have also been undertaken through the Aboriginal Health Partnership Forums.
15. Ninety eight per cent of IAHP primary healthcare grant funding has been provided through non-competitive processes. The department obtained Ministerial agreement for these processes.
16. Most aspects of the assessment of funding proposals were undertaken consistently with the CGRGs and IAHP guidelines. The exception was assessment of value for money. Assessment records for some funding rounds, including the $1.23 billion ‘bulk’ round undertaken in 2015, lacked evidence of substantive analysis of value of money considerations. The department was also unable to provide evidence it had undertaken a value for money assessment regarding the $114 million grant to the Northern Territory Government. In virtually all cases, risk assessments formed part of the assessment process.
17. Departmental delegates were provided with sufficient advice to enable them to discharge their obligations under the Public Governance, Performance and Accountability Act 2014 in approving IAHP grant proposals. The timeliness of the advice varied, but was provided relatively quickly for the larger 2015 funding rounds.
18. Funding agreements are fit for purpose, using a grant head agreement and an IAHP-specific schedule. The specific services to be provided by each funded organisation are set out in separate Action Plans, which are appropriately referenced in the agreement schedule. The agreements with Aboriginal Community Controlled Health Organisations allow for the setting of individual performance targets, but no targets have been set. All agreements also clearly set out reporting requirements.
19. The department has not established a performance framework for the primary healthcare component of the IAHP.
20. Systems are in place to collect performance data, but systems to collect quantitative performance data have not been effective. Several changes to data collection processes have resulted in an increased reporting burden on IAHP grant recipients and two six-monthly data collections being discarded or uncollected. These breaks in the data series limit its usefulness for longitudinal analysis of performance trends. The department has commenced projects to improve the quality of data, but has limited assurance over the quality of data collected before 2017 as it has not been validated.
21. The department relies on public reporting of a range of Indigenous health indicators to monitor achievement of program outcomes. The reporting includes data about services not funded under the IAHP. As such, it is not specific enough to measure the extent to which IAHP funded services are contributing to achieving program outcomes. The department was also unable to demonstrate how it used the data to inform relevant policy advice and program administration.
22. The department is not effectively using available performance data to monitor IAHP grant recipient performance and has not set quantitative national key performance indicator (nKPI) based benchmarks for grant recipients. The department’s ability to set performance expectations and assess actual performance is limited by the currency of data and variability in the content of Action Plans.
23. The Department of Health (‘the Department’) notes the findings of the report and agrees with the recommendations.
It is pleasing that the report finds: the program has been consolidated and supported through coordination and information sharing activities; programme implementation has appropriately aligned funding streams to intended outcomes; and the objective of reducing administrative complexity has been achieved.
Work is already underway within the Department which aligns with the report’s recommendations, and the report provides a platform to continue these efforts. In particular, the Department has introduced more robust assessment processes for primary health care grants under the Indigenous Australians’ Health Programme and has also commenced development of enhanced performance measurements of program outcomes, supported by an outcomes-focussed policy framework. The Department’s responses to the individual recommendations provide further detail.
The report identifies that the introduction of a new funding allocation model for the distribution of primary health care funding as announced in the 2014–15 Budget is yet to be completed and finds that this deferral has contributed to a partially effective implementation of the Australian Government’s objectives in establishing the programme. The Government announced in the 2018–19 Budget that the model will be implemented from 1 July 2019 and the Department will continue to work closely with Aboriginal Community Controlled Health Services to deliver this important initiative. The Department notes that this deferral occurred in the context of extensive stakeholder engagement together with significant data improvement activities designed to support a robust and well-developed funding model.
Whilst the Department is committed to continuous improvement of the administration of the Indigenous Australians’ Health Programme, the Department wishes to acknowledge and recognise the significant contribution our network of Aboriginal Community Controlled Health Services are making to improve the health of their communities under the Australian Government’s Closing the Gap agenda
Indigenous health and government funding
1.1 In 2008, the Council of Australian Governments set targets aimed at reducing or eliminating differences in specific outcomes between Indigenous and non-Indigenous Australians. These Closing the Gap targets covered three broad areas, of which health was one. In 2013, the Australian Government released the National Aboriginal and Torres Strait Islander Health Plan 2013–23, which set out a 10 year plan for the direction of Australian Government Indigenous health policy. This was followed in 2015 by an Implementation Plan for the Health Plan. The Implementation Plan outlines the actions to be taken by the Australian Government, the Aboriginal community controlled health sector, and other key stakeholders to give effect to the Health Plan. Progress under the Implementation Plan is measured against 20 goals and 106 deliverables that were developed to complement the existing Closing the Gap targets.
1.2 While the 2018 Prime Minister’s Closing the Gap report and the 2017 Aboriginal and Torres Strait Islander Health Performance Framework report show gains have been made in some areas, Indigenous Australians continue to experience significantly poorer health outcomes than the general population.2 Life expectancy is about 10 years lower. Rates of chronic disease are higher, with some tending to occur at a younger age in Indigenous Australians compared to the general population. The overall burden of disease3 for Indigenous Australians is also 2.3 times higher. Some factors potentially impacting on health, such as smoking and obesity, are higher: the overall smoking rate is 2.7 times higher and Indigenous Australians are 1.6 times as likely to be obese as the general population. Some health interventions can have a long lead time before measurable impacts are seen across the target population—for example, up to three decades in the case of many smoking-related diseases.
1.3 The Australian and state and territory governments all fund Indigenous health. Estimated total direct funding on Indigenous health4 has increased since the setting of the Closing the Gap targets: from $4.76 billion in 2008–09 to $6.30 billion in 2015–16.5 Of this, expenditure specifically targeted at Indigenous Australians was $1.44 billion in 2015–16. The remainder is expenditure on ‘mainstream’ services used by Indigenous Australians, notably hospitals, and the cost of various Australian Government subsidies, including the Medicare Benefits Scheme and the Pharmaceutical Benefits Scheme. Indigenous-related expenditure on public and community health services6 in 2015–16 is estimated at $1.73 billion. The Australian Government contributes 59 per cent of the total 2015–16 government expenditure on the Indigenous public and community health services category.
1.4 Measured on a per-person basis, total direct health funding on Indigenous Australians in 2015–16 by all Governments in Australia is 1.83 times greater than the direct health funding on non-Indigenous Australians. Funding on the public and community health services category of Indigenous health is 3.59 times higher.
1.5 The Department of Health (the department) has had primary responsibility for Commonwealth Indigenous health policy and funding since 1995. Since that time, the department’s role has been to improve both Indigenous Australians’ access to mainstream primary healthcare and increase the capacity of the Indigenous-specific sector to provide comprehensive primary healthcare.7
1.6 In the May 2014 Budget, the Australian Government announced the establishment of the Indigenous Australians’ Health Programme (IAHP). It was formed by consolidating four existing funding streams administered by the department, which between them included around 30 discrete funding components.8 The consolidation was intended to reduce administrative complexity and enable an improved focus on basic health needs (including clinical primary healthcare) at a local level to improve health outcomes. The stated high-level objective for the IAHP is:
to provide Aboriginal and Torres Strait Islander people with access to effective high quality, comprehensive, culturally appropriate, primary health care services in urban, regional, rural and remote locations across Australia.
1.7 A new primary healthcare grant funding allocation model was also to be developed for implementation from 2015–16. As discussed in Chapter 2, development and implementation of the new allocation model has been delayed.
1.8 With the exception of ‘social and emotional wellbeing’ activities being transferred to the Department of Prime Minister and Cabinet9, the range of activities funded by the department under IAHP are broadly similar to those under the pre-IAHP arrangements and funding levels have increased. In 2013–14, funding under predecessor grant programs was $682.3 million (excluding social and emotional wellbeing activities). The budget allocation for IAHP funding in 2017–18 is $856.1 million.
1.9 The bulk of IAHP expenditure is via grants. As at March 2018, $743.5 million of 2017–18 grant funds had been expended or committed.10 The largest component is grants to provide primary healthcare services to Indigenous Australians, which account for $461.5 million (62 per cent) of total IAHP 2017–18 expended and committed grant funding.11 Other significant grant funding areas under the IAHP relate to activities intended to increase Indigenous Australians’ access to mainstream services12 ($108 million, or 15 per cent) and funding for various maternal/early childhood health and anti-smoking activities (about five per cent each).
1.10 As at March 2018, 164 organisations are receiving IAHP primary healthcare grant funding. Around 140 of these organisations are Aboriginal Community Controlled Health Organisations (ACCHOs), which collectively account for 85 per cent of total IAHP core primary healthcare grant funding in 2017–18. The remaining primary healthcare grant recipients include the Northern Territory Government, various public sector regional health bodies across several states, and a small number of private sector providers and non-government organisations.
1.11 The geographical distribution of the healthcare facilities receiving IAHP primary healthcare funding is shown in Figure 1.1.
Figure 1.1: Distribution of IAHP primary healthcare funded facilities
1.12 The 2017–18 primary healthcare grant funding amounts according to jurisdiction and remoteness index is shown in Table 1.1.
By nacchomedia  Posted in Close the Gap, Closing the Gap, Federal Government News	 Tagged Aboriginal, Aboriginal Community Controlled Health Service, Aboriginal Health, ANAO, IHAP
” 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
” 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
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.
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.
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.
(Source: Australia’s Health 2018, Australian Institute of Health and Welfare
By nacchomedia  Posted in Close the Gap, Closing the Gap	 Tagged Aboriginal Community Controlled Health Service, Australian Institute of Health and Welfare (AIHW)
By nacchomedia  Posted in Close the Gap, Closing the Gap, Deadly Choices, Nutrition Healthy foods, Obesity, Prevention	 Tagged Obesity