1. WHAT ARE THE PRIORITY ISSUES FOR IMPROVING AUSTRALIA’S HEALTH? Groups Experiencing Health Inequities Generally speaking Australians health status is improving. However, this is not shared Australia-wide. There are fundamental differences in the level of health for particular groups. Groups within Australia experience inequities (unfair differences in levels of health status). Aboriginal and Torres Strait Islanders Socio-economically disadvantaged People living in rural and remote areas Australians born overseas Elderly People with disabilities

3. Reduced quality of life

5. Infant mortality is 3 times higher than the national average. However, the gap is closing due to better maternal and infant health care.

6. Poorer mental health

7. Higher hospitalisations

8. Poorer sexual health

9. Higher incidence of diabetes

11. The Roles of Individuals, Communities and Governments in Addressing the Health Inequities Modern approaches to healthcare and health promotion acknowledge the fact that Indigenous health status results from the interaction of multiple determinants. An “inter-sectoral” approach is required based on partnerships between people and agencies at many levels and in a variety of sectors. Government The Office of Aboriginal and Torres Strait Islander Health (OATSIH) www.health.gov.au/oatsih The National Aboriginal Community Controlled Health Organisation (NACCHO) www.naccho.org.au The Aboriginal Health and Medical Research Council of NSW (AH&MRC) www.ahmrc.org.au Government agencies aim to improve the access of Indigenous people to primary health care services. Communities Aboriginal Community Controlled Health Services (ACCHSs) and Aboriginal Medical Services (AMSs) are primary healthcare services initiated and operated by local Aboriginal communities (clinical care, health education, promotion, screening, immunisation, counselling, trasnport to medical appointments, hearing health, sexual health, substance use and mental health).

12. Individuals There is a strong focus in many Aboriginal Health Services on providing education and support for Indigenous mothers and children, on increasing the number of Aboriginal health workers, community support workers and medically trained staff and on increasing capacity by empowering individuals. www.health.gov.au/internet/h4l/publishing.nsf/Content/respack-exemplarsite

14. Low income

15. Poor housing

16. Unskilled work

18. Lower life expectancy

19. More likely to die from cardiovascular disease, respiratory disease and lung cancer

20. Higher levels of blood pressure

21. Higher body-mass index for males and females (overweight)

22. More likely to smoke

23. More likely to suffer from mental health problems, diabetes and circulatory diseases

24. Less likely to engage in preventative health behaviours e.g. dental checks, “pap” smears, immunisation, family planning

25. Sick more often

26. Less informed about health

29. Childhood services

30. Parenting and maternity services

31. Community language services

32. Housing assistance

33. Employment training

34. Home care

35. Meals

36. Migrant services

38. more likely to drink to hazardous levels

39. More likely to be overweight

40. Lower levels of education

41. Engage in more sedentary behaviour

42. Engage in risky occupations

43. Lower life expectancy (decreasing life expectancy with remoteness)

44. High death rates for coronary heart disease, other circulatory diseases and motor vehicle accidents

45. Higher deaths rates for injury (motor vehicle accidents and suicide) mostly in males

46. Higher levels of depression or psychological distress in males

47. Females have higher levels of diabetes and arthritis

49. Provide sustainable quality health services

50. Make health services more accessible via initiatives such as “Telehealth”, a visualtelecommunications system for clinicians and patients. Examples: Medical Specialist Outreach Assistance Program and Multi Purpose Service (MPS) Program

51. Communities Multipurpose services running in NSW rural communities. Aim to integrate services, better match services to community needs, achieve gains in productivity, reduce administration and share resources.

53. poor language skills

55. More likely to be overweight

56. Less likely to report medical conditions

58. Communities and Individuals The critical role of communities is to provide support for their members by advocating, promoting and engaging in the use and delivery of culturally appropriate health services. Training and education of CALD community members to support and work with health care professionals is very important.