“Indigenous Health and Closing the Gap”

11th National Rural Health Conference Perth

14 March 2011

Dr Tom CalmaNational Coordinator Tackling Indigenous Smoking

andCo-chair CTG Steering Committee

Life-expectancy

Most Indigenous deaths occur in the middle adult ages

Source: Darren Benham analysis mortality data

Death Contributors

The campaign for health equality

OVERALL TARGET:

HEALTH STATUS EQUALITY WITHIN 25 YEARS

Targets and benchmarks as appropriate.

FOUNDATION TARGET:

EQUALITY OF OPPORTUNITY TO BE HEALTHY WITHIN 10 YEARS

Sub-target 1: Equality of access to primary health care within 10 years.

Sub-target 2: Equal standard of health infrastructure within 10 years

A human rights based approach

• All policies and programs relating to indigenous peoples must be based on the principles of non-discrimination and equality, which recognize the cultural distinctiveness and diversity of indigenous peoples.

• Indigenous peoples have the right to full and effective participation in decisions which directly or indirectly affect their lives.

• Capacity building always needs to be considered and resources made available to facilitate meaningful participation by indigenous peoples as equal partners in planning, design, negotiation, implementation, monitoring and evaluation of policies that affect them. .

Principle of Progressive Realisation

• Create a plan – ‘ambitious yet realistic time frame’, – set equality as a target, – set a time frame;

• Commit sufficient resources; and

• Be accountable to the plan by setting benchmarks

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Steering Committee members

• Dr Tom Calma, Co-chair, National Coordinator – Tackling Indigenous Smoking (campaign founder and former Aboriginal and Torres Strait Islander Social Justice Commissioner)

• Mr Mick Gooda, Co-chair, Aboriginal and Torres Strait Islander Social Justice Commissioner, Australian Human Rights Commission

• Australian Indigenous Doctors’ Association• Australian Indigenous Psychologists’ Association• Congress of Aboriginal and Torres Strait Islander Nurses• Indigenous Allied Health Australia Inc.• Indigenous Dentists’ Association of Australia• National Aboriginal Community Controlled Health Organisation• National Aboriginal and Torres Strait Islander Health Workers’

Association• National Indigenous Drug and Alcohol Committee• National Aboriginal and Torres Strait Islander Health Workers’

Association

Steering Committee members cont.

Building partnerships• Oxfam Australia• Australian General Practice Network• Aboriginal Health and Medical Research Council• Australian Human Rights Commission (Secretariat)• Australian Medical Association• Australians for Native Title and Reconciliation• Australian Peak Nursing and Midwifery Forum• Bullana - the Poche Centre for Indigenous Health• The Fred Hollows Foundation• Heart Foundation Australia• Menzies School of Health Research• Palliative Care Australia• Royal Australasian College of Physicians• Royal Australian College of General Practitioners• Professor Ian Ring, Wollongong University (expert adviser)

Council of Australian Governments December 2007

All Australian Governments have agreed to close the inequality gap in Indigenous health outcomes in a generation

Council of Australian Governments 29 November 2008 All Australian Governments have agreed to a $1.6 billion investment in Indigenous health over four years– $805.5 million Commonwealth commitment– $771.5 million State and Territory contribution

In excess of $5 billion of new money for Indigenous affairs since November 2008

Statement of Intent

• PM• Minister of Health and

Minister of Indigenous Affairs

• Opposition Leader• Every major

Indigenous and non Indigenous peak health and human rights body

• First and only bipartisan agreement

20 March 2008

Closing The Gap Targets

• The targets are to:• Close the life expectancy gap within a generation;• Halve the gap in mortality rates for Indigenous

children under five within a decade;• Ensure access to early childhood education for all

Indigenous four year olds in remote communities within five years;

• Halve the gap in reading, writing and numeracy achievements for children within a decade;

• Halve the gap for Indigenous students in year 12 attainment rates by 2020; and

• Halve the gap in employment outcomes between Indigenous and non-Indigenous Australians within a decade

CTG Campaign Targets

CTG Campaign Targets cont.

1. Partnership Targets

2. Health Status Targets(a) Maternal and Child HealthReduce low birth weight, control infections particularly gastroenteritis & respiratory infections, maternal education, dedicated services for mothers & babies.

 (b) Chronic disease–Secondary prevention of chronic disease – risk identification and management including health checks.–Acute care – reduce time to admission and implementation of care guidelines for CVD, diabetes, chronic kidney disease (CKD).–Tertiary prevention – services for cardiac rehabilitation, CKD, stroke.

(c) Mental health and emotional and social well-being–Reduce the impact of loss, grief and trauma.–Reduce the disparity in suicide rates and mental health disorders including depression, and psychosis.–Improve mental health outcomes and reduce adverse events for Indigenous patients including Indigenous people with chronic disease, substance abuse or in custody.

3. Primary Health Care and other Health Services Targets(a) A Capacity Building Plan

(b) Mainstream health services

(c) Specific Programs

CTG Campaign Targets cont.

4. Infrastructure Targets– (a) Workforce– (b) Capital works and equipment– (c) Engagement of Aboriginal and Torres Strait Islander communities– (d) Housing - Home maintenance, housing design.– (e) Environment– (f) Health information and data

5. Social Determinants Targets – (a) Education– (b) Community safety– (c) Employment– (d) Community development– (e) Culture/language– (f) Criminal justice system review and reform– (g) Other

Need to work together in partnership

“What can I do to achieve equality for all Australians?”