The Measure Up campaign has been extended until July 2013 as part of the National Partnership Agreement on Preventive Health. Lifescripts The Australian Government Lifescripts initiative provides general practices with tools and skills to help patients address the main lifestyle risk factors for chronic disease including poor nutrition, physical inactivity and unhealthy weight. The initiative assists with the provision of tailored advice to patients on modifying their lifestyles. This initiative aligns with the B3 and B4 measures of the ICDP, due to its focus on building GP capacity to provide Chronic Disease Management, and increasing the capacity for self management amongst individuals with, or at risk of, chronic disease. National healthy lifestyle websites The website contains information on the Australian Government’s Healthy Active initiatives including the Healthy Active Ambassadors, healthy weight, the Community and School Grants Program and the Get Moving and Go for 2&5® campaigns. Healthy Weight is a website developed to provide information on healthy weight, healthy eating and physical activity. It includes a sample daily kilojoule and nutrient calculator. National Healthy Lifestyle websites provide individuals with information about making healthy lifestyle choices, and strategies to address chronic disease risk factors, thus aligning with the A measures within the ICDP. Building Healthy Communities The publication Building Healthy Communities - A Guide for Community Projects is a guide for people in small rural communities who want to try new ways to make a difference to chronic disease at a local level. This is one of a number of resources available at the community level that support organisations to provide better information about chronic disease, provide CDM activities and programs and support patients in CD self management. Thus there is alignment between this and similar initiatives and the A, B3 and B4 measures of the ICDP. National Injury The National Injury Prevention and Safety In regards to the Aboriginal and Torres Strait Islander population,
partnerships between Aboriginal health organisations, and increase the capacity of the service system and workforce to respond to alcohol misuse. Family Nutrition Project (NT) The Family Nutrition Project (FNP); funded by the Australian Government through Red Cross Australia, involves providing information sessions focused on good nutrition for children aged 0-5 years. The program is being run in Palmerston and the Tiwi Islands at the communities of Nguiu, Pirlangimpi and Milikapiti. The FNP is focusing on preventing chronic disease and supporting healthy lifestyles for children, however, the involvement and exposure of parents and community members to healthy lifestyle messages makes this project relevant to the ICDP measures A1, A2 and - less directly - to A3. Improving care for people with advanced chronic kidney disease: I’m OK project (NT) The goal of this project is to reduce communication problems and enable access to specialist health care in regional community controlled IHSs in the Northern Territory. This project involves the allocation of disease management care coordinators to liaise with the various health professional/s that the patient is seeing, thus aligning with the ICDP B3b measure, and aims to support increased access to specialist services, thus aligning with the ICDP B5 measures. Aboriginal Health Worker telephone support cancer network (NT) This project involves a monthly telephone support network for Aboriginal Health Workers (AHWs) from health clinics within remote communities in the Northern Territory. The sessions will provide both learning and networking opportunities for AHWs that they may not otherwise have access to. This program aligns with the C1 measure of the ICDP as it focuses on increasing the knowledge and capability of the Aboriginal and Torres Strait Islander health workforce through training and professional learning opportunities. Know Your Heart Training Manual (NSW) The 'Know Your Heart' training manual is a resource to assist health workers in delivering training, health education/ health promotion to other Aboriginal workers and their communities. This manual supports increasing the capacity of Aboriginal and Torres Strait Islander health workers in chronic disease management via provision of information and education, aligning with the ICDP C1 measure. The community teaching and health promotion components
control strategies 2010-2014. South Australian Tobacco Control Strategy NT Alcohol and Other Drugs Information. Tasmanian Tobacco Action Plan 2011-2015. aligning with the ICDP A1 measure. Table 15: State/territory Aboriginal and Torres Strait Islander workforce programs, strategies and initiatives which are relevant to the ICDP. Program, strategy or initiative Overview Alignment with ICDP State and territory Aboriginal and Torres Strait Islander health workforce programs, strategies and initiatives New South Wales Health Aboriginal Workforce Strategic Framework 2011- 2015. Queensland Health Indigenous Workforce Strategy. South Australian Health Aboriginal Workforce Reform Strategy 2009-2013. Western Australian Aboriginal and Torres Strait Islander Employment Framework. Victorian Aboriginal Health Workforce Plan. New South Wales Health Aboriginal Workforce Strategic Framework 2011 – aims to increase the representation of Aboriginal and Torres Strait Islander employees in health professions (relevant to the ICDP C4 measure) as well as providing culturally safe and competent health services (aligned with the ICDP C1 measure). Queensland Health Indigenous Workforce Strategy – focuses on encouraging Aboriginal and Torres Strait Islander people to work in health careers (relevant to the C4 measure). Also aligns with the ICDP C1 measure through its activities to support and develop Aboriginal and Torres Strait Islander staff. South Australian Health Aboriginal Workforce Reform Strategy – focuses on recruitment and retention of Aboriginal and Torres Strait Islander people into health professions (relevant to the ICDP C1 and C4 measures).
Table 16: Selected summary statistics for Volume 1 indicators. Indicators (HPF indicator number) Statistic Baseline ref. year(s) Aboriginal and Torres Strait Islanders - Male Aboriginal and Torres Strait Islanders - Female Aboriginal and Torres Strait Islanders - Total and Torres Strait Islanders - Male and Torres Strait Islanders - Female and Torres Strait Islanders - Total Commentary Life expectancy at birth (HPF# 1.17) Years 67.2 72.9 n/a 78.7 82.6 n/a In 2005-2007, life expectancy for Aboriginal and Torres Strait Islander people was shorter by 11.5 years for males and 9.7 years for females, compared with the total population. An annual increase in life expectancy of 0.8 years for Indigenous males and 0.6 years for females is needed to close the gap in life expectancy within a generation (i.e., by 2031). All-cause mortality (HPF#1.22) Age mortality rate per 1,278.4 954.6 1,101.6 705.9 521.9 607.2 Between 1991 and 2008, there has been a downward trend in all-cause mortality for Aboriginal and Torres Strait Island people (in WA,
100,000 SA and NT), which indicates an improvement in health status for the Indigenous population overall. Circulatory disease: Aboriginal and Torres Strait Islander people reporting heart and circulatory conditions (by age, sex and remoteness) crude rate Persons reporting heart and circulatory conditions, age proportion n/a n/a 23 n/a n/a 20 Deaths caused by circulatory disease the most common cause of death for Aboriginal and Torres Strait Islander people declined by 29% between1997 and 2008 (in WA, SA and NT). Current trends (2001-08) show a decline in death rates due to circulatory disease for both Indigenous and non-Indigenous Australians, so while death due to circulatory disease has declined for Indigenous
(HPF#1.05 and 1.23) Australians, it has also declined for non-Indigenous Australians, there is no further closing of the gap (NSW, Qld, WA, SA and NT). Diabetes: Prevalence of diabetes for Aboriginal and Torres Strait Islander people– by age, sex, remoteness, population and particular health Proportion (%) of persons reporting diabetes /high sugar levels 11.0 13.0 12.0 4.0 3.0 4.0 After accounting for age differences between the two populations, Aboriginal and Torres Strait Islander people were more than three times as likely as non-Indigenous Australians to report some form of diabetes. For Aboriginal and Torres Strait Islander people, diabetes problems start in younger age groups with higher rates of self-reported diabetes emerging from 25 years of age onwards.
conditions, crude rate (HPF#1.08) End-stage renal disease (ESRD): Incidence of end-stage renal disease by remoteness, crude rate, incidence of mortality related to end-stage renal disease, crude rate (HPF#1.09) Incidence of renal disease per 100,000 77.5 83.0 80.4 13.2 7.2 10.1 Between 2006 and 2008, there were 696 new Aboriginal and Torres Strait Islander patients registered as commencing ESRD treatment, accounting for 10% of all new registrations. The age-adjusted incidence rate of treated ESRD was 8 times as high for Aboriginal and Torres Strait Islander people as non-Indigenous people.
(HPF#1.07) Leading causes of mortality (by Indigenous status); crude rate, longer term mortality trend data (only available in three jurisdictions) – including respiratory, diabetes, renal and circulatory diseases Age mortality rate from circulatory diseases per 100,000 426.7 332.1 376.6 237.1 195.4 213.0 During the period 2004-08, the most common cause of death among Indigenous Australians was circulatory diseases (27% of all deaths), followed by cancer (18%) and external causes (15%). After adjusting for age, mortality rates for endocrine, metabolic and nutritional disorders (which includes diabetes) were around six times as high for Aboriginal and Torres Strait Islander peoples as for other Australians.
(HPF#1.23) Leading causes of mortality (by Indigenous status); crude rate, longer term mortality trend data (only available in three jurisdictions) – including respiratory, diabetes, renal and circulatory Age mortality rate from respiratory diseases per 100,000 143.8 94.8 115.5 62.5 43.1 50.9 During the period 2004-08, the most common cause of death among Indigenous Australians was circulatory diseases (27% of all deaths), followed by cancer (18%) and external causes (15%). After adjusting for age, mortality rates for endocrine, metabolic and nutritional disorders (which includes diabetes) were around six times as high for Aboriginal and Torres Strait Islander peoples as for other Australians.
diseases (HPF#1.23) Leading causes of mortality (by Indigenous status); crude rate, longer term mortality trend data (only available in three jurisdictions) – including respiratory, diabetes, renal and Age mortality rate from diabetes per 100,000 n/a n/a 103.4 n/a n/a 15.0 During the period 2004-08, the most common cause of death among Indigenous Australians was circulatory diseases (27% of all deaths), followed by cancer (18%) and external causes (15%). After adjusting for age, mortality rates for endocrine, metabolic and nutritional disorders (which includes diabetes) were around six times as high for Aboriginal and Torres Strait Islander peoples as for other Australians.
renal and circulatory diseases (HPF#1.23) Most common reasons for Hospital admissions for the leading of Diseases – version 10 Rate of for diseases of the circulatory system per 1,000 n/a n/a 33.4 n/a n/a 21 The Indigenous hospitalisation rate has increased significantly over the last few years and the gap between Indigenous and non-Indigenous rates has widened. Admission for dialysis was the main reason for this difference. However, once dialysis is excluded, the gap is still widening. Admissions to hospital are higher for Aboriginal and Torres Strait Islander people across all age groups below
Hospital admissions for the leading of Diseases – version 10 Australian categories by Indigenous status expressed as a diseases of the respiratory system per 1,000 the last few years and the gap between Indigenous and non-Indigenous rates has widened. Admission for dialysis was the main reason for this difference. However, once dialysis is excluded, the gap is still widening. Admissions to hospital are higher for Aboriginal and Torres Strait Islander people across all age groups below 65 years, although the differences are less pronounced for children aged 5–14 years.
of Diseases – version 10 Australian categories by Indigenous status expressed as a percentage, rate, rate ratio and rate differences (HPF#1.02) Admissions to hospital are higher for Aboriginal and Torres Strait Islander people across all age groups below 65 years, although the differences are less pronounced for children aged 5–14 years.
Most common reasons for Hospital admissions for the leading of Diseases – version 10 Australian Rate of for care involving dialysis per 1,000 n/a n/a 421.3 n/a n/a 39.1 The Indigenous hospitalisation rate has increased significantly over the last few years and the gap between Indigenous and non-Indigenous rates has widened. Admission for dialysis was the main reason for this difference. However, once dialysis is excluded, the gap is still widening. Admissions to hospital are higher for Aboriginal and Torres Strait Islander people across all age groups below 65 years, although the differences are less
heart and circulatory conditions by Indigenous status, age rate, rate ratio and rate differences, time series (HPF#1.05) heart /circulatory problems, aged Strait Islander people between 2001 and 2004–05. Self-reported data prevalence as not everyone who has the condition will have been diagnosed. End-stage renal disease (ESRD): Incidence of end-stage renal disease by Indigenous Incidence of renal disease per 100,000 77.5 83.0 80.4 13.2 7.2 10.1 Aboriginal and Torres Strait Islander people are commencing ESRD treatment are much younger than non-Indigenous Australians commencing ESRD treatment, with almost two-thirds aged under 55
status, age rate, rate ratio and rate differences, time series (HPF#1.09) years compared with of other Australians commencing ESRD treatment. High blood pressure: Persons reporting high blood pressure by Indigenous status, age rate, rate ratio and rate Proportion of persons reporting high blood pressure, age 14.0 16.0 15.0 10.0 10.0 10.0 Compared with other Australians, Aboriginal and Torres Strait Islander people have similar GP attendance rates for high blood pressure. High blood pressure was a reason for consultation in 4% of GP consultations for Aboriginal and Torres Strait Islander patients.
differences, time series (HPF#1.07) Perceived health status: health status (by Indigenous status, age and sex) (HPF#1.15) Proportion of persons aged 15 years and over with poor health status, 2008 11.4 9.2 10.2 4.0 3.9 3.9 After adjusting for differences in age structure, Aboriginal and Torres Strait Islander people were twice as likely as non-Indigenous Australians to report their health as fair or poor. Social and emotional wellbeing: Levels of distress Proportion of people aged 18 years and over who reported n/a n/a 26.6 n/a n/a 13.1 Those who reported excellent/very good health in 2008 were less likely than those who reported fair/poor health to also report high levels of
by Indigenous status, age rate, rate ratio and rate differences. (HPF#1.16) high or very high levels of distress, psychological distress (20% and 52%, respectively). After adjusting for age differences between the Indigenous and non-Indigenous populations, Indigenous Australians were twice as likely as Australians to report high or very high levels of psychological distress. Tobacco use: Proportion of adults who smoke regularly, aged 15 or more: smoking Proportion of current smokers aged 15 years and over, 2008 47.4 43.1 45.1 22.2 18.0 20.1 In 2008, 45% of Indigenous Australians aged 15 years and over were current smokers, a significant reduction from an estimated 51% in 2002 and 52% in 1994. Aboriginal and Torres Strait
status (by age, sex, state /territory, remoteness, selected population and trends over time) (HPF#2.18) Islander smoking rates were highest in the 25-34 year age group (56%) and lowest in the 55 years and over age group (32%). Compared to other age groups, smoking rates were relatively low among older Aboriginal and Torres Strait Islander people (32% of those aged 55 years and over) and young Aboriginal and Torres Strait Islander people aged 15–17 years (22%) Tobacco smoking during pregnancy: Proportion of women Proportion of mothers who smoked during pregnancy, n/a 50.5 n/a n/a 14.8 n/a Of the Aboriginal and Torres Strait Islander mothers who reported smoking during pregnancy, 47% smoked up to 10 cigarettes per day, 43% smoked 10 or more cigarettes per day and
regular smoker, and proportion that live with someone who smokes indoors, by state /territory and remoteness (HPF#2.03) Prevalence of overweight and obesity: prevalence of overweight and obesity among Indigenous Proportion of adults who are age 35.5 25.6 30.5 43.0 27.8 35.5 After adjusting for differences in the age structure of the two populations, Indigenous Australian adults were twice as likely to be obese as Australian adults.
and obesity by Indigenous status, age rates, rate ratios and rate differences (HPF#2.26) who are obese, age Islander males were overweight (34%) compared with Aboriginal and Torres Strait Islander females (24%), however, Aboriginal and Torres Strait Islander females were more likely to be obese than Aboriginal and Torres Strait Islander males (34% compared with 28%). Level of physical activity: proportion of Indigenous Australian adult population classified as having Proportion of persons whose level of physical activity is low in areas, age 24.0 30.0 27.0 33.0 39.0 36.0 The proportion of sedentary Aboriginal and Torres Strait Islander people aged 15 years and over increased between 2001 and from 37% to 47%. The proportion reporting a high level of physical activity remained unchanged over
rate ratios and rate differences (HPF#2.22) in areas, age areas. After adjusting for differences in age structure, Aboriginal and Torres Strait Islander people in areas were times as likely as other Australians to be classified as sedentary in 2004–05. Dietary behaviour: Dietary habits of Aboriginal and Torres Strait Islander people. (HPF#2.23) Age proportion of persons aged 12 years and over reporting no usual daily n/a n/a 5.3 n/a n/a 0.8 After adjusting for differences in age structure, Aboriginal and Torres Strait Islander people aged 12 years and over were twice as likely as non-Indigenous Australians to report no usual daily fruit intake, and 7 times as likely to report no daily vegetable intake.
vegetable Dietary behaviour by Indigenous status, age rates, rate ratios and rate differences (HPF#2.23) Proportion of persons aged 15 years and over who ran out of food and couldn't afford to buy more at some time over previous 12 months 21.0 27.0 24.0 4.0 5.0 5.0 Aboriginal and Torres Strait Islander people aged 15 years and over in the lowest quintile (20%) of income were much more likely than Aboriginal and Torres Strait Islander people in the two highest quintiles of household income to report no usual daily fruit intake (17% compared with 8%) and no usual daily vegetable intake (8% compared with 0.8%). Self reported access to Problems accessing 2008 27.1 32.5 29.9 n/a n/a n/a A higher percentage of Aboriginal and Torres Strait
health services and change over time (HPF#3.12) services, Indige-nous persons aged 15 years and over Islander people in areas reported not accessing doctors, dentists and other health professionals when needed, compared with those living in remote areas. Proportion of Aboriginal and Torres Strait Islander people with Type 2 Diabetes to receive care (HPF#3.04) Aboriginal and Torres Strait Islander regular clients with Type 2 Diabetes and had an HbA1c test in the last 6 months 1 January – 30 June 2009 n/a n/a 50.1 n/a n/a n/a The proportion of Indigenous regular clients with Type 2 Diabetes and that had an HbA1c test in the last 6 months is higher in remote and regional areas than urban areas. Ambulatory 194.3 229.0 212.3 46.1 39.0 42.2 For Aboriginal and Torres
care sensitive hospital admissions (HPF#3.06) care sensitive hospital admis-sions per 1,000 (in NSW, Vic, Qld, WA, SA and NT) Strait Islander people, vaccine-preventable conditions account for around 2% of all ambulatory care sensitive hospital admissions, acute conditions for 23% of admissions, and chronic conditions for 79% of admissions. Total size of IHSs workforce Number of full time equivalent staff within Aboriginal and Torres Strait Islander primary health care services funded by 2009-10 n/a n/a 2,745 n/a n/a 2,090 In the six years to June 2009, there has been an increase of 60% in the workforce of Aboriginal and Torres Strait Islander primary health care services funded by the Australian Government.
the Australian Number of Aboriginal and Torres Strait Islander people in the health workforce (noting that they will not all be serving Aboriginal and Torres Strait Islander people, and that there Number employed persons in health related 2006 1,401 4,082 5,483 125,491 404,844 530,335 While the Indigenous health workforce has grown between 1996 and 2006, the non-Indigenous health workforce has grown at a faster rate and there has been a 20% increase in the gap between them. In 2006, the health occupation with the largest number of Indigenous Australians was nursing (1,449) followed by nursing support and personal care workers (974), and Aboriginal and Torres Strait Islander Health
are and Torres Strait Islander people working in Indigenous health) (HPF#3.10) Workers (966). Enrolments (Aboriginal and Torres Strait Islander people) in higher education Number of students enrolled in health disciplines in higher education 2010 n/a n/a 2,119 n/a n/a 164,012 The most common course for Aboriginal and Torres Strait Islander undergraduate students in 2008 was nursing (582 enrolments, and 71 completions). In the same year, there were 298 Indigenous student enrolments in public health
courses / vocational education and training (VET) courses courses. Enrolments (Aboriginal and Torres Strait Islander people) in higher education courses / vocational education and training Number of students enrolled in health disciplines in vocational education 2010 n/a n/a 3,932 n/a n/a 93,540 Aboriginal and Torres Strait Islander student rates in health-related courses were higher than non-Indigenous student rates for both enrolments (194 per 10,000 compared to 65 per 10,000) and completions (13 per 10,000 compared to 7 per 10,000).