North Coast Primary Health Network 2016 Aboriginal Health Check · 2017. 11. 28. · north coast...

NORTH COAST PRIMARY HEALTH NETWORK | ncphn.org.au | Last Updated 7 February 2017

NSW ABORIGINAL LIFE EXPECTANCY FOR MALES IS 9.3 YEARS LESS THAN NON-ABORIGINAL

MALES IN NSW AT 70.5 YEARS1 NSW ABORIGINAL LIFE EXPECTANCY FOR FEMALES

IS 8.5 YEARS LESS THAN NON-ABORIGINAL WOMEN IN NSW AT 74.6 YEARS1 18.4% OF SERVICE PROVIDERS WHO WERE

SURVEYED REPORTED THAT CULTURAL AWARENESS TRAINING IS NOT PROVIDED TO

STAFF WHERE THEY WORK2

31.4% OF ABORIGINAL AND/OR TORRES STRAIT ISLANDER PEOPLE IN THE NCPHN REGION RATE

THEIR HEALTH AS FAIR OR POOR - ALMOST DOUBLE THE PROPORTION FOR ALL PEOPLE

IN THE NCPHN REGION (16.1%)3

ABORIGINAL AND / OR TORRES STRAIT ISLANDER POPULATION4

NCPHN NSW AUSTRALIA

21,468 (4.5%)

172,621 (2.5%)

548,369 (2.5%)

Population by Aboriginality, age and sex5, North Coast PHN, NSW 2015

Aboriginal population across the North Coast4

0-4

5-9

10-14

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65-69

70-74

75-79

80-84

85+

7 6 5 4 3 2 1 0 0 1 2 3 4 5 6 7

ABORIGINAL AGE (YEARS) NON-ABORIGINAL

PERCENT PERCENT

MALES FEMALES

Tweed 2942

Ballina 1224

Bellingen377

Byron515

Clarence Valley2845

Coffs Harbour2817

Kempsey3114

Kyogle487

Lismore 1918

Nambucca1358

Port Macquarie2418

Richmond Valley1453

North Coast Primary Health Network

2016 Aboriginal Health Check

Bundjalung

Githabul

Yaegl

Gumbayngirr

Dunghutti

Birpai

Lismore

Coffs Harbour

Port Macquarie

Kempsey

Arakwal

Tweed Heads


Aboriginal and/or Torres Strait Islander people as proportion of total population6

HOSPITALISATIONS8 NCPHN MNC NNSW NSW

Rate of dialysis36,421 41,148 23,927 20,338

4,239 4,468 4,070 4,081

Rate of infectious disease1,088 995 1,181 918

644 538 720 550

Rate of injury and poisoning4,553 3,733 5,333 3,871

2,979 2,596 3248 2,415

Rate of mental disorders2,479 2,590 2,367 2,909

1,276 1,692 985 1,680

Respiratory diseases3,855 4,029 3,764 3,511

1,725 1,669 1,763 1,676

Rate of musculoskeletal diseases1,812 1,719 1,865 1,606

1,781 2,233 1,454 1,703

Rate of skin disorders1,252 1,108 1,379 970

608 516 673 549

MBS ITEM 7159 North Coast Australia

Proportion receiving an Indigenous health check (MBS item 715) 24.8% 21.3%

Number of Aboriginal Medical Services (AMS)

11

AMS GP with Open Books FTE *

21.1

Open AMS GP FTE per 1000 population *

1.0

ABORIGINAL MEDICAL SERVICES (AMS)10

ABORIGINAL NON-ABORIGINAL

Aboriginal children who are fully immunised7, 2014-15

Hospitalisation by Aboriginality per 100,000 population, 2014-2015

* Please interpret FTE figures with caution due to some missing data

AUSTRALIA

NCPHN

5 year olds2 year olds1 year olds

90.3%

87.7%

88.3%

86.7%

95.1%

93.5%


Number of Aboriginal Medical Services (AMS)

11

AMS GP with Open Books FTE *

21.1

Open AMS GP FTE per 1000 population *

1.0

1,250 289 172 59 23service providers

completed the Primary Health Care Needs Assessment Survey

respondents worked in a Public Hospital,

196 in a Non-Government Organisation

respondents worked in a General Practice, 94 in an

Allied Health Private Practice

respondents worked in an Aboriginal Health

Service

respondents were Aboriginal Health

Workers

What our service providers think2… Anxiety about discrimination is rated by almost 1/3 of Service Providers as a barrier for local Aboriginal and/or Torres Strait Islander people to access health services...

Other

Opening hours

Nothing

Time/budget pressures on staff

Limited Cultural Awareness

Concerns about confidentiality

Cost

Discomfort with look/feel/location

Shame/Stigma

Limited awareness about service/practice

Transport

Attitude of staff

Lack of Aboriginal/Torres Strait Islander workers

Anxiety about discrimination 31.1%

30.9%

30.9%

30.3%

30.2%

24.3%

18.4%

17.1%

15.8%

13.2%

10.2%

9.8%

5.7%

2.2%

Mental health counselling _____________________ 43.1%Drug & alcohol counselling ___________ 33.4%Educational programs _____________ 31.0%Mindfulness/wellness programs___ 27.1%Community support groups ___ 21.0%Child health services ______11.7%None _________________ 11.6%GPs ________________ 10.8%Maternal health services 8.5%Allied health services 8.0%Specialist services ___ 8.0%Other ____7.6%

Mental health counselling is rated by more than 40% of Service Providers as a health service which is hard for local Aboriginal and/or Torres Strait Islander people to access2...


18 ABORIGINAL AND/OR TORRES STRAIT ISLANDER PEOPLE PARTICIPATED IN

CONVERSATIONS WITH NCPHN ABOUT THEIR EXPERIENCE OF HEALTH SERVICES

306 ABORIGINAL AND/OR TORRES STRAIT ISLAND-

ER PEOPLE COMPLETED THE 2016 PRIMARY HEALTH NEEDS SURVEY (12.6% OF SURVEY

RESPONDENTS)

7.2% OF OLDER RESPONDENTS IDENTIFIED

AS OF ABORIGINAL AND/OR TORRES STRAIT ISLANDER ORIGIN

7.1% OF LESBIAN, GAY, BISEXUAL OR QUEER

RESPONDENTS IDENTIFIED AS ABORIGINAL AND/OR TORRES STRAIT ISLANDER

27.8% OF ABORIGINAL AND/OR

TORRES STRAIT ISLANDER RESPONDENTS HAD A HEALTH CARE CARD (COMPARED

TO 18.6 % OF RESPONDENTS WHO DID NOT IDENTIFY AS ABORIGINAL AND/OR

TORRES STRAIT ISLANDER)

6.5% OF ABORIGINAL AND/OR

TORRES STRAIT ISLANDER RESPONDENTS HAD PRIVATE HEALTH INSURANCE

(COMPARED TO 42.1% FOR PEOPLE WHO DID NOT IDENTIFY AS ABORIGINAL AND/OR TOR-

RES STRAIT ISLANDER)

What our Aboriginal and/or Torres Strait Islander community thinks3…

Alcohol and other drug services, and mental health services are rated as hard or very hard to access by more than half of the Aboriginal and/or Torres Strait Islander people who have tried to access them3

Aboriginal1 DRUG AND ALCOHOL MISUSE 59.8%

2 DIABETES 44.8%

3 FAMILY VIOLENCE 42.1%

4 MENTAL HEALTH ISSUES 31.6%

5 CANCER 32.8%

Non Aboriginal1 DRUG AND ALCOHOL MISUSE 55.4%

2 AGING ISSUES 54.3%

3 MENTAL HEALTH ISSUES 54.2%

4 FAMILY VIOLENCE 32.2%

5 CANCER 29.9%

Top 5 serious health concerns1. . .

20%

40%

60%

Non Aboriginal

Aboriginal

GPs

Allied Health

Professionals

Aged Care

Services

Specialist

s

Mental Health

Services

Alcohol and Other

Drug Services

54.6%

59.8%56.7%

47.4%

33.7%

25.3%

48.6%

31.4%

23.1%

56.8%54.6%

46.3%


Barriers to accessing a health service3. . .

SEEING A GP

SEEING A SPECIALIST

SEEING AN ALLIED HEALTH PROFESSIONAL

ACCESSING MENTAL HEALTH SERVICES

36.4% 36.0% 16.9% 15.3% 14.4% 13.1% 13.1% 12.3%CAN’T GET AN APPOINTMENT

42.4%

TOO LONG TO WAIT FOR AN

APPOINTMENT 35.9%

IT COSTS TOO MUCH

31.4%

NOT SURE WHAT

SERVICES ARE AVAILABLE

5.6%

PUBLIC/COMMUNITY

TRANSPORT IS TOO LIMITED

10.5%

DON’T LIKE DOCTORS

7.4%

SHAME/ NERVOUS/

WORRY THAT OTHERS WILL

FIND OUT 5.5%

IT’S TOO FAR AWAY FROM

HOME 13.0%

OTHERS: Not open when I can go 10.2% 5.9% No-one to care for someone who depends on me 10.2% 4.3%

54.9% 52.4% 45.6% 37.9% 28.6% 17.5% 16.5% 14.6%COST57.3%

LONG WAIT TO SEE THE SPECIALIST

64.8%

DISTANCE OF TRAVEL

REQUIRED 45.3%

LACK OF SPECIALISTS IN

THE AREA 43.4%

TRANSPORT13.3%

LACK OF ACCOMMODA-TION DURING TREATMENT

9.8%

CAN’T GET REFERRAL TO

THE SPECIALIST 10.4%

NOT SURE WHAT IS

AVAILABLE 9.0%

OTHERS: Poor experience in the past 11.2% 8.2% 4.3% Not treated with respect 6.8% 4.5%

47.3% 40.7% 35.3% 30.7% 24.7% 19.3% 19.3% 14.7%COST53.8%

LONG WAIT TO SEE THE ALLIED

HEALTH PROFESSIONAL

37.6%

NOT ENOUGH SESSIONS

COVERED BY MEDICARE

49.2%

DISTANCE OF TRAVEL REQUIRED

20.9%

LACK OF ALLIED HEALTH

PROFESSIONALS IN THE AREA

18.8%

NOT SURE WHAT IS

AVAILABLE 11.7%

TRANSPORT 10.7%

CAN’T GET REFERRAL TO THE ALLIED

HEALTH PROFESSIONAL

10.2%

OTHERS: Opening times 8.7% 8.0% Poor experience in the past 8.7% 7.8%

42.4% 36.8% 31.3% 31.3% 29.9% 29.2% 27.8% 23.6%LACK OF

SERVICES42.0%

COST 45.3%

NOT SURE WHAT’S

AVAILABLE 24.2%

STIGMA/SHAME 23.2%

TRANSPORT12.7%

WORRY ABOUT LACK OF

CONFIDENTIALITY 17.5%

POOR EXPERIENCE IN THE PAST

31.0%

QUALITY OF THE SERVICES

AVAILABLE 29.4%

OTHERS: Lack of respect for my culture 21.5% 1.5% Existing services aren’t relevant 17.4% 20.0%

ABORIGINAL NON ABORIGINAL

Survey respondents who found it difficult to access a health service reported the following as barriers:


ACCESSING ALCOHOL AND/OR OTHER DRUG SERVICES

ACCESSING AGED CARE SERVICES

ACCESSING AGED CARE SERVICES ACCESSING AGED CARE SERVICES

48.5% 31.7% 27.7% 26.7% 25.7% 23.8% 22.8% 22.8%LACK OF

SERVICES44.4%

TRANSPORT 12.7%

COST 29.2%

NOT SURE WHAT’S

AVAILABLE 29.6%

LACK OF RESPECT FOR MY CULTURE

2.1%

STIGMA/SHAME 27.5%

EXISTING SERVICES AREN’T

RELEVANT 23.9%

WORRY ABOUT LACK OF


OTHERS: Poor experience in the past 20.8% 20.1% Quality of the services available 18.8% 24.6%

45.2% 41.9% 40.9% 31.2% 29.0% 29.0% 26.9% 15.1%COST45.4%

LACK OF SERVICES

39.6%

TRANSPORT 31.5%

NOT SURE WHAT’S

AVAILABLE 39.6%


RELEVANT15.3%


AVAILABLE 21.6%


1.4%

POOR EXPERIENCE IN

THE PAST 14.6%

OTHERS: Opening times 14.0% 5.6% Stigma/shame 8.6% 6.4%

CARDIOLOGISTS are rated as hard to access by almost 20% of the Aboriginal and/or Torres Strait Islander people who have tried to access them3...

Aboriginal &/ or Torres Strait

Islander

Not Aboriginal &/or Torres Strait Islander

Cardiologist 22.3% 17.1%

Psychiatrist 21.4% 19.5%

Paediatrician 18.4% 11.6%

General Surgeon 17.0% 14.8%

Gynaecologist 17.0% 14.8%

Endocrinologist 16.5% 8.5%

Opthamologist 15.5% 9.6%

Orthopod 13.1% 10.9%

Radiologist 10.7% 5.8%

Neurologist 9.7% 11.8%

Respiratory Physician 9.7% 4.7%

Oncologist 7.3% 6.3%

Renal Specialist 6.8% 3.7%

Other 5.8% 7.9%

Geriatrician 4.4% 4.2%

Palliative Care Specialist 4.4% 2.4%

DENTISTS are rated as hard to access by almost 30% of the Aboriginal and/or Torres Strait Islander people who have tried to access them3...


Islander


Dentist 46.7% 28.9%

Psychologist 24.0% 32.6%

Aboriginal Health Worker

20.0% 0.9%

Physiotherpist 19.3% 24.8%

Social Worker 18.7% 11.3%

Exercise Physiologist 18.0% 10.7%

Speech Pathologist 17.3% 10.8%

Dietician/Nutritionist 16.7% 14.5%

Occupational Therapist 16.0% 11.8%

Podiatrist 15.3% 11.4%

Optometrist 12.7% 7.0%

Chiropractor 10.0% 8.2%

Audiologist 8.0% 8.0%

Nurse 6.0% 2.5%

Pharmacist 2.7% 2.0%



48.5% 31.7% 27.7% 26.7% 25.7% 23.8% 22.8% 22.8%LACK OF

SERVICES44.4%

TRANSPORT 12.7%

COST 29.2%

NOT SURE WHAT’S

AVAILABLE 29.6%


2.1%

STIGMA/SHAME 27.5%


RELEVANT 23.9%

WORRY ABOUT LACK OF


OTHERS: Poor experience in the past 20.8% 20.1% Quality of the services available 18.8% 24.6%

45.2% 41.9% 40.9% 31.2% 29.0% 29.0% 26.9% 15.1%COST45.4%

LACK OF SERVICES

39.6%

TRANSPORT 31.5%

NOT SURE WHAT’S

AVAILABLE 39.6%


RELEVANT15.3%


AVAILABLE 21.6%


1.4%

POOR EXPERIENCE IN

THE PAST 14.6%

OTHERS: Opening times 14.0% 5.6% Stigma/shame 8.6% 6.4%



ACCESSING AGED CARE SERVICESCOUNSELLING AND COMMUNITY-BASED MENTAL HEALTH SERVICES are rated as hard to access by more than ¼ of the Aboriginal and/or Torres Strait Islander people who have tried to access them to assist with their mental health3


Islander


Counselling 42.4% 48.3%

Community-based mental health programs

41.7% 37.3%

GP with knowledge in mental health

29.9% 38.8%

Hospital 25.0% 14.0%

Psychiatry 19.4% 29.6%

Consumer support groups

18.8% 10.8%

Mental Health Access Line

17.4% 11.2%

Mental health nursing 16.0% 12.3%

Youth-specific services 14.6% 17.5%

Residential Support 13.9% 11.0%

Respite for carers 13.2% 12.9%

Online mental health support/app

11.1% 8.0%

Other helplines, e.g. Lifeline

6.9% 5.6%

IN-HOME DOMESTIC SUPPORT is rated as hard to access by 16.9% of the Aboriginal and/or Torres Strait Islander people who have tried to access it for aged care support3


Islander


In-home domestic support

43.0% 37.3%

General wellness sup-port

39.8% 24.7%

Respite support for carers

34.4% 29.3%

Family violence support 31.2% 6.6%

In-home medical care 29.0% 30.7%

GP with knowledge and skills in aged care

28.0% 27.2%

Nursing home 15.1% 18.6%

Myagedcare.gov.au 12.9% 17.3%

Aboriginal and Torres Strait Islander people in the NCPHN region would prefer to receive their health information from...


Islander


Doctor/health care provider

16.0% 20.2%

Community events 15.2% 6.5%

Community support groups

13.5% 6.0%

Family or friends 11.8% 5.8%

Hospital 8.7% 7.3%

Website 7.3% 14.4%

Newspaper 5.3% 8.9%

Facebook 5.0% 5.5%

Other medical practice staff

5.0% 7.8%

Email 4.7% 6.8%

Smartphone and tablet app

4.7% 6.1%

Radio 2.7% 4.5%

COUNSELLING is rated as hard to access by almost ¼ of the Aboriginal and/or Torres Strait Islander people who have tried to access it to assist with their alcohol and/or other drug use3


Islander


Counselling 54.5% 45.1%

Detox 46.5% 47.2%

Rehab 44.6% 43.3%

Community support groups

40.6% 24.6%

GP with knowledge of alcohol and other drugs

29.7% 36.6%

Hospital 27.7% 18.7%

Youth-specific services 20.8% 19.4%

Respite support for carers

16.8% 16.5%

Psychiatrist 14.9% 29.9%

Methadone Clinic 12.9% 9.9%

Other helplines, e.g. Lifeline

6.9% 6.7%



REFERENCES1 Northern NSW Local Health District, 2015. Northern NSW Integrated Aboriginal Health and Wellbeing Plan 2015-2020 Vol. 1 & 2 [Online]. Available at: http://nnswlhd.health.nsw.gov.au/blog/2015/07/30/northern-nsw-integrated-aboriginal-health-wellbeing-plan-2015-2020/ [Accessed January 2016].2 North Coast Primary Health Network, 2016. Results from the 2016 NCPHN Primary Health Needs Service Providers Survey, document in preparation.3 North Coast Primary Health Network, 2016. Results from the 2016 NCPHN Primary Health Needs Community Members Survey, document in preparation.4 Australian Bureau of Statistics, 2011. Census of Population and Housing: QuickStats, [Online] Available at: http://www.abs.gov.au/websit-edbs/censushome.nsf/home/quickstats?opendocument&navpos=220 [Accessed March 2016].5 Centre for Epidemiology and Evidence, 2014. Health Statistics New South Wales: Population by Aboriginality. [Online] Available at: http://www.healthstats.nsw.gov.au/Indicator/dem_pop_atsi/dem_pop_atsi_phn_snap?&topic=Population&topic1=topic_pop&code=dem_pop [Accessed November 2015].6 University Centre for Rural Health North Coast, 2016. Population Health Maps using data from the Australian Bureau of Statistics, 2011. Census of Population and Housing, Not available online. [Accessed March 2016]. 7 National Health Performance Authority, 2016. North Coast Primary Health Network, Primary: Immunisation Rates for Indigenous 1,2 and 5 year olds. [Online[ Available at: http://www.myhealthycommunities.gov.au/primary-health-network/phn109 [Accessed March 2016].8 Centre for Epidemiology and Evidence (x), 2014. Health Statistics New South Wales: Hospitalisations by cause and Aboriginality, by LHD [Online] Available at: http://www.healthstats.nsw.gov.au/Indicator/bod_hos_cat/atsi_hos_lhn_cat [Accessed August 2016].9 Australian Institute of Health and Welfare, 2016. Indigenous health check (MBS 715) data tool [Online] Available at: http://www.aihw.gov.au/indigenous-australians/indigenous-health-check-data-tool/ [Accessed March 2016].10 North Coast Primary Health Network, 2016. Regional Service Mapping Project.

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