Report card on Indigenous health: must do better

An extraordinary thing happened in North Queensland. Thanks to the Mums and Babies Project run by Townsville Aboriginal and Islander Health Services perinatal deaths fell from 58 to 22 per thousand, the number of premature births almost halved and birth weights increased.

What is truly extraordinary is that it happened against a backdrop of decades-long failure to improve Indigenous health and an overwhelming sense of pessimism about the chances of ever doing so.

We need to end the myth that the health crisis affecting Aboriginal and Torres Strait Islander people can’t be solved. If we believe it is impossible to fix Indigenous health problems then we cannot blame governments for failing - low expectations provide no impetus for success.

The fact is that we can fix Aboriginal health. As Indigenous Social Justice Commissioner Tom Calma said, the suggestion that a country as wealthy as ours can’t fix a health crisis affecting less than three per cent of our citizens is simply not credible.

What we need is a community commitment to getting results - we all need to make Indigenous health a national priority.

The Australian Future Directions Forum recently nominated the elimination of Indigenous disadvantage as the number one issue Australia needs to address. The key to success will be a community that believes that improvement is possible and demands results.

We can build that community commitment by drawing on the evidence of programs that work. In tackling Indigenous health, our starting point should be a focus on success.

There is a wealth of research about the health problems faced by Indigenous Australians. We have countless reports and reviews repeating the statistics of failure and telling us what is wrong.

We know that the life expectancy of Indigenous men is nearly two decades shorter than that of other Australian males and that Aboriginal babies in Western Australia and the Northern Territory are three times more likely to die before their first birthday than other Australian babies. Indigenous people are much more likely to die of cardiovascular disease than other Australians and evidence suggests they are between two and four times more likely to experience diabetes.

We cannot and we must not ignore these facts - but we also need to hear more about the research being done on proven solutions.

We need to make success the core of our activity - that means making evidence-based solutions the heart of our research and policy decisions.

If something works we need to find out why, to invest in it and to roll it out to other interested communities. We don’t have to keep re-inventing the wheel.

If an approach doesn’t work, we need to find out why and how it can be improved. If it continues to fail, then we should abandon it. We have to be flexible - we can’t blindly fund programs that continue to produce poor results.

Improving Indigenous health takes an effort that’s sustained, disciplined and transparent - and that builds on the evidence of programs that work.

Evidence tells us that a public health approach with a preventative focus that informs and empowers individuals and communities is the way forward. We need to tackle problems at source - not just respond to symptoms. And we need to set children up for life in the vital early years through a range of strategies to support early childhood development.

Townsville’s Mums and Babies Project is just such an approach. It increases access to, and take up of, health services; it’s preventative and it gets results. There are plenty of other programs which have demonstrated success.

In the WA Kimberley region a program delivered by local and state government, community organisations and NGOs has cut rates of trachoma in school-aged children.

Survival Tucker, a project led by the Northern Territory community of Minjilang, promoted better nutrition and led to a decreased consumption of saturated fat and sugar. Tests confirmed that community members experienced weight loss, lower cholesterol and blood pressure and improvements in other blood-health indicators.

Indigenous involvement and ownership of programs is vital for success. The ground-breaking rehabilitation program at Mount Theo station in the Northern Territory has helped the community of Yuendumu tackle petrol sniffing, in part through engagement with traditional culture and practice.

We need to recognise that up to 70 per cent of health problems stem from broader issues, such as poverty, unemployment and lack of education. Our investment and approach must respond to this evidence.

Research also shows that Indigenous-run services engage communities and produce the best results. The Australian Medical Association’s 2004 discussion paper Healing Hands noted that to create an equitable proportion of Indigenous health professionals we would need to train 928 doctors, 161 dentists and 2,570 nurses.

This means an investment in skills and training and building the capacity of the community sector. Such an investment now will pay dividends for generations.

We need to focus on the major health challenge facing our nation. The health of our Indigenous citizens can and must be improved. A national community commitment and evidence-based solutions are the keys to progress. It's time to focus on success and it’s time to demand results.