There is evidence that deficit discourse has an impact on health itself — that it is a barrier to improving health outcomes. Accordingly, there are growing calls for alternative ways to think about and discuss Aboriginal and Torres Strait Islander health and wellbeing. This report builds on Deficit Discourse and Indigenous Health by reviewing and analysing a growing body of work from Australia and overseas that proposes ways to displace deficit discourse in health, or that provides examples of attempts to do so. The most widely accepted approaches to achieving this come under the umbrella term 'strengths-based', which seek to move away from the traditional problem-based paradigm and offer a different language and set of solutions to overcoming an issue.
Deficit discourse and strengths-based approaches: Changing the narrative of Aboriginal and Torres Strait Islander health and wellbeing
The term draws attention to the circulation of ideas, the processes by which these ideas shape conceptual and material realities, and the power inequalities that contribute to and result from these processes. 'Deficit discourse' refers to discourse that represents people or groups in terms of deficiency – absence, lack or failure.
It particularly denotes discourse that narrowly situates responsibility for problems with the affected individuals or communities, overlooking the larger socio-economic structures in which they are embedded. Understanding how deficit discourses are produced and reproduced is essential to challenging them. Thus, this report examines various aspects of deficit discourse in policy, but in particular considers deficit metrics: the ways in which Aboriginal and Torres Strait Islander Australians are homogenised and statistically compared to non-Indigenous Australians.
Researchers at the Murdoch Childrens Research Institute reviewed all admissions to the mental health unit at Royal Children's Hospital in Melbourne between October 2013 and September 2014.
In total, there were 271 adolescents admitted during the period, with 212 (78 per cent) due to suicidal behaviours.
Further analysis of clinical reports and past medical history found overwhelmingly the kids who were admitted to hospital for suicidal behaviour came from traumatic backgrounds.Three-in-five had been bullied, more than half reported significant family trauma, such as as witnessing a parent have a drug overdose or being incarcerated, said lead researcher Dr Rohan Borschmann.
Read more at: https://www.centralwesterndaily.com.au/story/5417653/suicidal-teens-suffer-poor-sleep-bullying/?cs=7
On 14 May, Murray was announced as the new CEO of Suicide Prevention Australia, a peak body for the suicide prevention sector. Murray, who is a member of the Australian Institute of Company Directors and fellow of the Australian Institute of Managers and Leaders, was named one of Australia’s 100 Most Influential Women by the Australian Financial Review in 2013.
In this week’s Changemaker, Murray discusses the leadership approach she intends to take at SPA, explains her immediate priorities as CEO and reveals her new passion for playing the harp.
Read more at: https://probonoaustralia.com.au/news/2018/05/new-leadership-suicide-prevention/
How primary health care staff working in rural and remote areas access skill development and expertise to support health promotion practice
For primary healthcare staff working in rural and remote locations, access to professional development can be limited by what is locally available and prohibitive in terms of cost for travel and accommodation. This study provides insight into how staff at a large north Queensland Aboriginal community controlled health service access skill development and health promotion expertise to support their work.
See more at: https://www.rrh.org.au/journal/article/4413
Advance care planning in aged care: a guide to support implementation in community and residential settings
Engaging in advance care planning helps people to determine their healthcare priorities, and thereby to align their health and care preferences with the actual care they receive.
Advance care planning is not a single event but an ongoing process, which should be revisited regularly. This is especially important when a person's health or social situation changes.
Key components of advance care planning are:
- having a conversation about the person's values, beliefs and goals and how these influence preferences for care – this may include specific care and treatment preferences
- selecting and appointing a substitute decision-maker
- documenting a person's preferences in an Advance Care Directive or Advance Care Plan
- regularly reviewing and updating the plan or directive.
Eye injuries in Australia 2010-11 to 201415 This report shows 51,778 people were hospitalised as a result of an eye injury in the 5-year period, 1 July 2010 to 30 June 2015; two-thirds of these were males. Falls (35%) and assaults (23%) were the most common causes of eye injuries. The most common type of eye injury was an open wound of the eyelid and periocular area (27%). Some 86,602 presentations were made to an emergency department due to an eye injury in the 2-year period, 1 July 2013 to 30 June 2015; 1% of these presentations were admitted to hospital.
Trends in hospitalised injury, Australia 1999-00 to 2014-15 This report shows that the rate of hospitalised injury cases in Australia rose between 1999-00 and 2014-15 by an average of 1% per year. In 2014-15, case numbers and rates were higher for males than females for all age groups up to 60-64, and higher for females for those aged 65-69 and older.
Spinal cord injury, Australia 2014-15In 2014-15, 264 newly incident cases of traumatic spinal cord injury (SCI) due to external causes were reported to the Australian Spinal Cord Injury Register. Males accounted for 4 in 5 (80%) of traumatic SCI cases. Land transport crashes(42%) were the leading mechanism of injury for cases of traumatic SCI sustained in 2014-15, followed by falls (40%). Around one-third (35%) were sustained during sports or leisure activities.
Please click on the link below to download a free PDF copy of the reports
Around 55% of women in the target age group of 20-69 took part in the National Cervical Screening Program in 2015 and 2016, with more than 3.8 million women screening.Cervical cancer incidence and mortality have both decreased since the National Cervical Screening Program began in 1991-incidence from 17 to 10 new cases per 100,000 women aged 20-69 and mortality from 4 to 2 deaths per 100,000 women aged 20-69.
1. In 2015-2016, more than 3.8 million women participated in cervical screening. This was 55% of women aged 20-69
2. 10% of women with a negative screen in 2015 rescreened earlier than the recommended 2 years, continuing a downward trend
3. In 2016, for every 1,000 women screened, 7 women had a high-grade abnormality detected by histology
4. In 2015, 143 women aged 20-69 died from cervical cancer.
This report presents statistics on the National Bowel Cancer Screening Program using key performance indicators. Of those who were invited to participate in the program between 1 January 2015 and 31 December 2016, 41% were screened. Of those, 8% had a positive result warranting further assessment, and 1 in 26 participants who had a follow-up diagnostic assessment was diagnosed with a confirmed or suspected cancer.
1. Of the 3.2 million people invited between January 2015 and December 2016, 41% participated in the National Bowel Cancer Screening Program
2. The recurring participation rate in 2015-2016 for people who had taken part in an earlier invitation round and were receiving a subsequent screening invitation was 77%
3. Of participants assessed in 2016 after a positive screening test, 1 in 26 were diagnosed with a confirmed or suspected cancer
4. Since the program began in August 2006, about 4.4 million NBCSP screening tests have been completed
5. The median time from positive screening test result to diagnostic assessment was 54 days.
Download report: Cervical screening in Australia 2018
Download report: National Bowel Cancer Screening Program: monitoring report 2018
The Australian Institute of Health and Welfare has released a new web update:
Mental health services in Australia-Emergency department 2016-17:
- 276,954 presentations to Australian EDs in 2016-17 were mental health-related, which was 3.6% of all presentations.
- 79.2% of these mental health-related ED presentations were classified with a triage status of either Semi-urgent (patient should be seen within 60 minutes) or Urgent (seen within 30 minutes).
- 68.0% of mental health-related ED presentations were seen on time (based on triage status) compared with 73.0% of all ED presentations
- More than half (53.5%) of mental health-related ED presentations had a principal diagnosis of either Neurotic, stress-related and somatoform disorders or Mental and behavioural disorders due to psychoactive substance use.
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"Growing up strong Buraay" is a book full of games and ideas for Wiradjuri parents on ways to interact with their toddlers (Buraay). Available in PDF from : http://www.community.nsw.gov.au/__data/assets/pdf_file/0010/319807/par_buraay.pdf
This is one of a number of Indigenous parenting resources sponsored by the Department of Family and Community services. See: http://www.community.nsw.gov.au/parents,-carers-and-families/parenting/for-aboriginal-parents-and-carers
Two further versions of interest are:
Kiilalaana marta-marri – Growing up really big in Barkindji – resource for Aboriginal and Family Workers in the Far West region of NSW: Broken Hill and surrounding region.
1. In 2010-2014, 4,843 new cases of cancer were diagnosed in adolescents and young adults.2. In 2011-2015, 499 adolescents and young adults died from cancer.
3. In 2010-2014, 5-year relative survival from all cancers combined for adolescents and young adults was 89%.
4. Adolescent and young adult cancer survivors had a 1.9 times increased risk of developing a second cancer
The site is part of a 3-year project funded by the Australian Government Department of Health which aims to improve the care of older Australians through advance care planning activities and palliative care connections.
AHHA is a member of the ELDAC consortium led by the Queensland University of Technology, Flinders University and the University of Technology Sydney, and including Palliative Care Australia, Aged and Community Services Australia, Leading Age Services Australia, and Catholic Health Australia.
'As an ELDAC project partner we are proud to have been involved in the development of this website, where health professionals and aged care workers can access information, guidance, and resources to support palliative care and advance care planning for older people and their families', Ms Verhoeven said.
'One of the features of the site is a set of 5 online toolkits developed by palliative care, aged care, primary care and legal experts covering Residential Aged Care, Home Care, Primary Care, Working Together, and Legal matters.
'For example, the Primary Care toolkit, which was developed by AHHA, leads healthcare workers and primary care teams through the various steps involved in supporting advance care planning with patients and their families, including considerations for people of various religious and cultural backgrounds. There are links to fact sheets, guides, discussion starters, patient resources and podcasts.
'Users can also access materials on assessing palliative care needs, providing palliative care, managing dying, and bereavement', Ms Verhoeven said.
So, how do we combat this? How do we lower the risks or delay the development of dementia, and design care and treatment interventions that reduce the personal and economic costs of the disease?
This research brief explores the impacts of cognitive ageing and decline on individuals, as well as on the wider Australian economy. The brief emphasises how cognitive impairment is a significant barrier to those over sixty staying in the workforce and managing their finances properly. The brief also discusses the current and proposed future ways to diagnose and prevent cognitive impairment before it becomes severe.
Among Australians 45 and over who visited a GP in the past year, those living in rural and remote areas were less likely than others to have a usual GP or place of care. Not having facilities nearby was a barrier to seeing a specialist and having a medical test.
Key findings: * 3 in 5 people in Remote/Very remote areas said not having a specialist nearby stopped them from seeing one. * People in Remote/Very remote areas were the most likely to report going to an ED because no GP was available. * People reported decreasing information sharing between health providers as remoteness increased. * People in Outer regional and Remote/Very remote areas were the least likely to have a usual GP.
- An average of 112 patients per week or 16 patients per day were transported for CVD;
- On average, per day, 10.1 (63%) were male and 5.9 (37%) were female, a ratio of 1.7 males for every female;
- All age groups were represented; the mean age group was 55–59 years, more than one-third (35.3%) were aged 60–74 years, and 1% were children under the age of 5 years.
More than half (52.5%) of all CVD transports were for CHD. The two main CHDs that lead to a patient requiring an aeromedical transport were 'acute myocardial infarction' (heart attack) (38.9%) and 'angina pectoris' (angina) (9.4%). Almost one-quarter (22.2%) of CVD transports were for patients experiencing other forms of heart disease; the two main other forms of heart disease were 'heart failure' (4.6%) and 'atrial fibrillation and flutter' (4.0%).
This report's purpose is to detail the CVD burden on remote and rural Australia, and to propose action to ameliorate CVD impacts. Many CVD events are preventable. Increased investment in, and access to, evidence-based, culturally appropriate prevention and early intervention for people at increased risk of CVD, and those who have experienced a CVD event, is required.
Similarly, better treatment options for remote and rural Australians are also required. For example, between 2001 and 2008 the South Australian integrated Cardiovascular Clinical Network (iCCNet) established a support program for remote and rural primary care services to manage heart attacks by providing expert risk stratification, point-of-care troponin testing and cardiologist-supported decision making. The program's evaluation demonstrated a 22% improvement in 30-day survival rates for remote and rural patients, which closed the mortality disparity that had previously existed between city and country hospitals.
This paper uses the latest 2016 Census figures to provide a snapshot of how the ATSI peoples of NSW compare with non-Indigenous residents across a range of key indicators, including population, age, education, income and employment. The paper also provides a comparative analysis of these indicators over three Censuses (2006, 2011 and 2016) for both NSW as a whole and for three custom NSW regions that incorporate different State Electorates based on their location. These geographies were selected to not only to provide an indication as to how location affects the wellbeing of the State's Indigenous peoples, but to also help Members of the NSW Parliament gain greater insight into the Indigenous peoples residing in or around their electorates.
Impact of alcohol and illicit drug use on the burden of disease and injury in Australia: Australian Burden of Disease Study 2011 [AIHW]
The report highlights that health inequalities exist, with lower socioeconomic groups and more remote areas generally experiencing higher rates of disease burden due to alcohol and illicit drug use.
* Nearly 1 in every 20 deaths in 2011 were from alcohol and illicit drug use, equating to 6,660 deaths.* 6.7% of all disease burden in Australia was from alcohol and illicit drug use in 2011 (9% for males and 4% for females).* 4.6% of all disease burden in Australia was from alcohol use alone, of which one-third was due to alcohol dependence.* On its own, illicit drug use was responsible for 2.3% of Australia's disease burden.* 41% of the illicit drug use burden was from opioids, followed by amphetamines (18%), cocaine (8%) and cannabis (7%).* Alcohol use was responsible for around one-third of the burden of road traffic injuries. * The rate of burden from alcohol use fell slightly between 2003 and 2011 and further reductions are expected by 2020.* The rate of burden due to amphetamine use is projected to rise by 14% between 2011 and 2020.
Download report: Impact of alcohol and illicit drug use on the burden of disease and injury in Australia: Australian Burden of Disease Study 2011
Media release:1 in 20 Australian deaths caused by alcohol and illicit drugs.
- equips primary healthcare providers and their teams with a comprehensive and concise set of recommendations for Aboriginal and Torres Strait Islander patients, with additional information about tailoring advice depending on risk and need
- advises on activities that can help prevent disease, detect early and unrecognised disease, and promote health in Aboriginal and Torres Strait Islander communities, while allowing for local and regional variations.
- encourages clinicians to consider the social determinants of health when providing preventive healthcare
- Includes the following new topics and features:
- Fetal alcohol spectrum disorder
- Preventing child maltreatment – supporting families to optimise child safety and wellbeing
- Family abuse and violence
- Prevention of lung cancer
- Young person lifecycle summary wall chart