PDF printable version of NACCHO Ochre Day Men's Health Conference (PDF 294 KB)
4 October 2017
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Good morning everyone.
Before I begin I want to acknowledge the traditional owners of the land on which we meet, the Larrakia people, and pay my respects to Elders past and present.
I also acknowledge all Aboriginal and Torres Strait Islander people here this morning.
Thank you for your kind introduction, Matthew [Cooke, Chair, NACCHO]
I also acknowledge:
- John Patterson, [CEO, Aboriginal Medical Services Northern Territory]
- June Oscar, [Aboriginal and Torres Strait Islander Social Justice Commissioner]
- Dr Mark Wenitong, [Member, Implementation Plan Advisory Group]
We know that when people are empowered to take control of their own wellbeing, and take that responsibility seriously, we are on track for an improved future.
I’d like to begin by sharing a very sad story, from my own family.
Eight years ago, my nephew, Jason Bartlett was a much-loved musician. He’d made it to the Top 24 on TV’s Australian Idol and was recording albums and performing concerts with the popular Bartlett Brothers band.
But as his career went on, he found he struggled with his weight more and more and his health deteriorated significantly.
Earlier this year, he confided that he wished he had sought help much earlier and that he had listened to the medical professionals who tried to help him along the way.
Sadly, he passed away in June, aged just 35, after a battle with chronic kidney, diabetes and heart conditions.
His close family and friends are now working on a media project to fulfil his dying wishes – to get the word out to indigenous men in particular, to take their health seriously – to own it.
One of Jason’s killers was kidney failure, the same devastating condition that claimed the life of beloved musician, Dr G Yunipingu.
I would like to tell you now that turning around the tragedy of this disease is one of my top priorities.
Our men suffer kidney health problems at five times the rate of non-indigenous men and the onset of kidney disease is at a much earlier age in indigenous people. The rates of kidney disease steadily increase from 18 years as compared to 55 years for non-indigenous.
I will say much more about this in the coming months, but I am totally committed to working with communities and health practitioners across our nation to reduce the impact of renal failure and, even more importantly, to prevent it happening in the first place.
This means solutions that help people now, but also grassroots strategies that will help ensure our men, women and families continue reaping the benefits in five, 10 and 20 years – for the rest of their lives.
Owning our health and wellbeing links closely with the Prime Minister’s pledge to do things “with” Aboriginal people, not “to” them – because both commitments empower local community solutions, and personal choices.
This is about walking and working together, because indigenous health is everybody’s business.
The burden of disease in many of our communities is significant but it is not intractable – we’re here today because we know and believe this.
We understand the importance of Aboriginal community controlled health services because they are delivering many of what I like to call “jewels in the crown” of indigenous health improvement.
Recently, I was delighted to join Matthew to announce the expansion of one of the most successful of all programs– Deadly Choices – as it officially linked in with the Australian Kangaroos rugby league team.
Through sport and community activities, Deadly Choices has empowered thousands of people, especially younger men.
In South East Queensland, this has led to nearly 19,000 people having health check-ups each year, more than 1,100 households banning smoking, and active indigenous patient numbers tripling, to over 330,000.
I was also recently in Broken Hill, and saw firsthand some of the Maari Ma Health Corporation’s impressive results:
- People in their diabetes program now have blood sugar control significantly better than the national average.
- Those with diabetes or heart problems also have much better blood pressure and cholesterol control than the national average.
- The number of people having annual health checks is doubling almost every year.
- The number of specialist clinics operating that tackle everything from smoking to ear, nose and throat surgery, has jumped from under 100 to nearly 1000 a year.
- And Maari Ma has a rock-solid commitment to local decision-making and employment, with Aboriginal people now making up well over half of the staff.
Working with locals and the community, this helps ensure the “social and cultural determinants” of health are increasingly positive.
The Government’s 2017 Health Performance Framework estimates these factors contribute to more than one third of the health gap.
This figure rises to well over half, when combined with risk factors, such as heavy drinking, smoking and poor diet.
So half of the reason why Aboriginal and Torres Strait Islander men are dying too young, falling sick and getting injured lies largely outside the “traditional” health system.
This is a challenge, but understanding this fact is fundamental to us taking the next steps towards Closing the Gap in indigenous health outcomes .
It’s why the next Implementation Plan for the National Aboriginal and Torres Strait Islander Health Plan 2013 – 2023, due next year, will recognise that respect for culture, employment, living conditions, environmental health and education are ALL-IMPORTANT in the overall health of our people.
The Plan will identify opportunities to develop partnerships further – between communities, the health sector and the wide range of State and Commonwealth Government agencies working in Aboriginal and Torres Strait Islander affairs.
Working closely with local communities and tailor-making solutions, while thinking broadly, is the way forward.
In New South Wales, a program called “Driving Change” is helping indigenous people turn the corner on health and wellbeing, by getting their drivers’ licenses.
Already, its enabled an extra 400 people across a dozen communities to get on the road – and start changing their lives, through better self-esteem and improved employment prospects.
It’s recognised as a health program, because licensed driving means being able to hold down a job, which means having more money, better housing, better food on the table, more options for their children - the list goes on – but the bottom line is a far healthier future.
We have to look at how a wide range of government agencies, and the health sector, throw their weight behind Indigenous opportunity, and how we can do better.
We must ask ourselves constantly: How well are we connecting, how many lives are being changed for the better by what we do?
If we don’t know the answer, then business as usual is not an option.
We clearly have much to do to get the broader health system where it needs to be.
I work with a range of Indigenous organisations, like NACCHO, across the country to put Indigenous families and communities at the centre of Indigenous health reform.
I remain deeply grateful and buoyed by every one of you here, who get up each day and go to work to improve people’s health.
I strongly believe that the key to closing the gap is for all of us to ‘opt-in’ – so there is even more Aboriginal and Torres Strait Islander leadership and participation in the health system.
Higher representation at all levels of the health system – as doctors, nurses, allied health professionals, in administration and management, in policy and planning, and research – will support our efforts to close the gap.
But the fact remains, Indigenous men have the poorest health of any group within the Australian population.
We are more reluctant to seek out help when we need it, we’re not good at recognising the early signs of disease and we don’t always think about what we can do right now – like quitting smoking – to prevent disease down the track.
This is reflected in a range of key health indicators so let’s look at the facts as I outline the Australian Government’s Indigenous men’s health agenda.
On average, we are dying more than 10 years younger than our non-Indigenous counterparts, with the majority of deaths occurring in our middle years.
The leading killers include circulatory failure, cancer, injury, diabetes and respiratory disease.
Infant Indigenous boys die at a rate almost double that of non-Indigenous boys.
This is why the Government has invested $94 million in the Better Start to Life initiative to support families.
This initiative will progressively increase the number of New Directions services from 85 to 136 sites and the Australian Nurse-Family Partnership Program from three sites to 13.
In addition, the Indigenous Australians’ Health Programme has allocated $12 million to support the implementation of better, more integrated early childhood services called Connected Beginnings.
A good foundation in health prevention and regular check-ups will help children do better at school which, in turn, gives them more choice in further education and work opportunities down the track.
Strong children. Strong teenagers. Strong adults. Strong communities.
While I want much work done to improve renal health, among my other top priorities are hearing, eyesight and preventable hospital admissions.
One area where I am also working hard with local communities, especially in the Territory and the Kimberley, is to reduce the wholly unacceptable rate of suicide.
I’ll talk more about mental health shortly, but figures from 2011–15 reveal that 71 per cent of Indigenous suicides were men.
Indigenous males are hospitalised for diagnoses related to alcohol at 4.2 times the rate of non-Indigenous males (July 2013 – June 2015).
Reducing alcohol abuse can result in fewer assaults and less disability and improve the health and wellbeing of the population.
The National Drug Strategy includes the National Aboriginal and Torres Strait Islander Peoples Drug Strategy to focus on this problem.
Importantly, this initiative has been informed by extensive community consultation.
Tobacco smoking is the most preventable cause of illness and early death among Indigenous men, with 45 per cent of males aged over 15 smoking.
The Government’s $116.8 million Tackling Indigenous Smoking program aims to reduce the uptake of smoking, and increase quit rates.
The successful Don’t Make Smokes Your Story campaign speaks directly to Indigenous smokers. There are encouraging signs, with smoking rates steadily declining every year, and I praise the efforts and commitment of the frontline tobacco workers who have contributed to this improvement.
The Australian Government’s health investments cover key areas of disease burden and risk factors across the entire population, but we give close consideration to what impacts, disproportionately, on Aboriginal and Torres Islander men.
For example, the new Council of Australian Governments National Strategic Framework for Chronic Conditions prioritises Aboriginal and Torres Strait Islander health.
The Government will also soon introduce a new National Male Health Initiative – a partnership with Andrology Australia, the Australian Men’s Health Forum, and the Men’s Health Information and Resource Centre.
This new collaboration will identify needs, and develop, disseminate and evaluate health promotion, education and clinical practice activities right across Australia.
Another priority is to increase Indigenous participation in the National Bowel Cancer Screening Program - so next year, a National Indigenous Bowel Screening Pilot will roll out in 50 Indigenous primary health care services.
Instead of receiving the bowel screening kit in the mail, the pilot will ensure general practitioners, nurses and Indigenous health workers directly offer the kits to people and provide follow up support.
The Government also doubled the number of Commonwealth-funded Prostate Cancer Nurses from 14 up to 28, with many of these working in rural and regional Australia.
The Men’s Sheds program is another mainstream program that helps to reduce the social isolation of men.
Priority is given to sheds in disadvantaged areas that focus on the needs of Aboriginal and Torres Strait Islander men, which leads me to the point I made earlier, about mental health.
Community-led solutions are the most effective, and although we need to work together nationally, each community will have its own response that will work best for them.
Funding of $85 million, over three years, aims to improve access to culturally sensitive, integrated mental health services for Aboriginal and Torres Strait Islander people.
These services will be commissioned locally by local Primary Health Networks, and I have made it clear that they must work closely with the Aboriginal Community Controlled Health Service sector to achieve the best possible outcomes.
I will continue to work with you to build on the reforms we have in place and ensure more responsibility for decision making rests as close to the community as possible.
Everything we do should be grounded in consultation and founded on evidence – using information and local input to understand where progress is slow, or results have flatlined.
Where we find that using the same old approaches is not making a real difference to people’s lives, I want to partner with local people and organisations like the ones you work for, to tackle these particular challenges head-on.
Together, we will build a better tomorrow – by helping our men own their future health.