Aboriginal Health Data for Our Region Newcastle/Hunter Aboriginal - - PowerPoint PPT Presentation

Aboriginal Health Data for Our Region

Newcastle/Hunter Aboriginal Partnership Forum Planning Day July 2017

• Aimed to identify local health priorities for action, and inform and guide
• ur activities in achieving better health outcomes for Aboriginal

communities across the region.

Aboriginal Health Needs Assessment

• A range of publicly available quantitative data was collated, along with

general practice and workforce data held internally.

• Key data sources:
• Australian Bureau of Statistics
• Australian Childhood Immunisation Register
• Australian Government Department of Human Services
• Australian Health Ministers’ Advisory Council
• Australian Indigenous HealthInfoNet
• Australian Institute of Health and Welfare
• Cancer Institute NSW
• Centre for Epidemiology and Evidence
• Public Health Information Development Unit

Aboriginal Health Needs Assessment

PEN CAT Data

• As at 31st July 2016, 117 General Practices had submitted data using the
• nline PAT CAT data tool, providing aggregated data for almost

1,000,000 patients across the region. This represented one quarter of general practices and did not include any Aboriginal Medical Services.

• Just under 4% of all data submitted was for patients identified as

Aboriginal and/or Torres Strait Islander. For Aboriginal and Torres Strait Islander patients, practice data submissions were evenly spread between major cities (50%) and inner regional areas (38%), with the remainder (12%) from outer regional and remote areas.

Aboriginal Health Needs Assessment

• Interviewed stakeholders from across the region between July and

September 2016. This information was integrated with quantitative data to supplement, support and build a deeper understanding of health needs and issues.

• Stakeholder groups represented included: Aboriginal consumers and

communities; Aboriginal Medical Services; General Practitioners and

• ther general practice staff; private health providers; non-government
• rganisations; and local, state and commonwealth government
• rganisations.
• Conducted a literature review examining the experience of health service

access for Aboriginal people.

Aboriginal Health Needs Assessment

Demographics

Age Distribution

Age Groups (%), Aboriginal Persons, 2016 ERP

Region 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+ Lake Macquarie LGA 13.1 10.8 10.7 10.7 9.7 7.5 6.1 5.0 5.2 5.2 4.4 4.0 2.9 4.7 Maitland LGA 13.5 11.6 10.8 10.3 10.4 7.4 6.0 5.6 5.1 4.9 4.3 3.3 2.9 3.8 Newcastle LGA 12.5 10.0 9.6 10.4 11.2 8.1 6.3 5.3 5.2 5.0 4.5 4.0 3.2 4.6 HNECC 12.3 11.6 11.0 10.8 9.8 7.2 6.0 4.9 5.1 5.1 4.6 4.0 2.9 4.7 NSW 12.0 11.2 10.7 10.7 9.7 7.7 6.2 5.0 5.3 5.3 4.6 4.0 2.9 4.7 Australia 11.8 11.1 10.7 10.5 9.7 8.2 6.7 5.4 5.5 5.3 4.5 3.7 2.7 4.2

• Percentage of the local Aboriginal population within each age group
• Note the young age profile, with the greatest proportions aged 24 years and

younger

Age Distribution

Age Groups (numbers), Aboriginal Persons, 2016 ERP

LGA 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+ Total Lake Macquarie 1,014 837 828 826 752 580 473 389 403 399 339 306 224 362 7,734 Maitland 475 410 382 364 365 260 211 198 180 173 150 117 103 133 3,521 Newcastle 697 558 539 583 626 454 355 294 293 281 251 222 180 259 5,593

• Number of Aboriginal people in each age group in the Lake Macquarie,

Maitland and Newcastle LGAs.

Total active patients at 25 July 2017 254,928 Total Aboriginal or Torres Strait Islander patients 8,437 Total Non-Indigenous patients 195,974 Total patients where Indigenous status was not recorded 50,517

General Practice Data

• Data extracted from PATCAT clinical data aggregation tool (25 July 2017)
• Includes only General Practices submitting data in Lake Macquarie,

Maitland and Newcastle LGAs – 60 out of a total 150 practices

• Data restricted to active patients (those seen 3 or more times within the

last 3 years as per RACGP definition)

General Practice Data

Socioeconomic Disadvantage

• There is strong evidence that socioeconomic disadvantage directly

correlates with poor health, higher incidence of risky health behaviours and reduced access to health care services.

• Stakeholders have identified that socioeconomic disadvantage is

contributing to poorer health outcomes for Aboriginal people across the region.

Newcastle (15), Maitland (28) and Lake Macquarie (28) have lower IRSEO values, so are among the least socioeconomic disadvantaged LGAs in our region, and are less disadvantaged than the averages for NSW (41) and Australia (46).

IRSEO values closer to 100 = most socioeconomically disadvantaged IRSEO values closer to 0 = least socioeconomically disadvantaged

• Life expectancy for the Aboriginal population is around 10 years less

than the non-Indigenous population due to higher rates of fertility and deaths occurring at younger ages

• The increased prevalence of health risk factors and chronic illness

contributes substantially to the shorter life expectancy

Life Expectancy

Chronic Disease

Chronic Disease

• Aboriginal people experience higher rates of chronic disease. In 2012-13, in the HNECC

PHN region, 73% of Aboriginal people reported having a long-term health condition, with 21.2% having one condition and 51.9% having two or more conditions

• Of particular

concern to stakeholders are diabetes, cancer and kidney disease

Chronic Disease

Based on PAT CAT data extracted 25.7.17, in Lake Macquarie, Maitland and Newcastle LGAs, higher proportions of Aboriginal patients had COPD, asthma, mental health, anxiety and depression compared to non- Indigenous patients.

Note: COPD and Mental Health figures include patients diagnosed with these diseases as well as patients whose profile indicates they have these diseases although it was not recorded in their medical record.

Diabetes

• In 2012-13, in Australia, 4.7% of Aboriginal adults were at a high risk of

developing diabetes

• Aboriginal adults are 1.8 times as likely to be at a high risk of diabetes

than non-Indigenous adults

• Aboriginal people are hospitalised for diabetes at 4 times the rate for

non-Indigenous people.

• In NSW in 2015, 17.2% of Aboriginal adults aged 16 years+ had diabetes
• r high blood glucose, more than two times the non-Indigenous rate

(8.5%)

• Health professionals in our region have identified diabetes as a health

need for Aboriginal people

Chronic Kidney Disease (CKD)

• In 2010-12, the rate of treated end stage kidney disease was over 6

times higher for Aboriginal people

• In 2012-13, 45% of hospitalisations of Aboriginal people were due to

CKD, with 99% of these being for dialysis, the leading cause of hospitalisation among Aboriginal people

• Over this period, Aboriginal people were 10 times as likely to be

hospitalised for CKD as non-Indigenous people

• Health professionals in our region have identified kidney disease as a

health need for Aboriginal people

Cancer and Smoking

Cancer

• Aboriginal communities have a higher incidence of cancer than non-

Indigenous communities (461 per 100,000 compared with 434 per 100,000)

• Aboriginal people are more likely to die from cancer than non-

Indigenous people (252 per 100,000 compared with 172 per 100,000)

• Lung cancer is the most commonly diagnosed cancer for Aboriginal

people followed by breast cancer for females, than colorectal cancer and prostate cancer

• Cervical cancer occurs in Aboriginal women at 4 times the rate of non-

Indigenous women

• Health professionals in our region have identified cancer as a health

need for Aboriginal people.

Breast Screening

• In 2014-15, the breast screening participation rate for all women aged 50-69

years in the HNECC region was 57.5% (NSW: 51.6%).

• Breast screening participation rates for Aboriginal women were lower, at 52%

for the HNECC region (NSW: 40.2%).

• The participation rates for

Newcastle (51.8%: N=313), Lake Macquarie (57.7%: N=390) and Maitland (61.5%: N=171) were higher than the NSW rate.

Cervical and Bowel Screening

• General practice data indicates that Aboriginal women across the

HNECC region are approximately 40% less likely than non-Indigenous women to participate in cervical screening

• Data on participation in Bowel Screening by Aboriginal people is of poor

quality, however the participation rates for the total population aged 50-74 years are low, in 2015:

• Lake Macquarie 41%
• Maitland 37%
• Newcastle 37.5%
• HNECC 38.1%

Current smoking by Aboriginality, persons aged 16 years and over, NSW 2015, (Centre for Epidemiology and Evidence, NSW Ministry of Health).

• In the HNECC region in 2012-13, 36.7%
• f Aboriginal people aged 15 years+

smoked daily

• In NSW in 2015, 34.9% of Aboriginal

adults aged 16 years and over were current smokers at more than two and a half times the non-Indigenous rate (12.9%)

• Smoking has been identified by health

professionals in HNECC region as an area

• f need for Aboriginal people

Smoking

Smoking Attributable Hospitalisations

Rates of smoking attributable hospitalisations by Aboriginality and sex, NSW 2001-02 to 2014-15, (Centre for Epidemiology and Evidence, NSW Ministry of Health).

From 2001-02 to 2014-15, the rate of smoking attributable hospitalisations in NSW increased for Aboriginal people and decreased for non- Indigenous people, increasing the rate difference between the two populations from 360.1 to 912 per 100,000.

Alcohol and Other Drug Misuse

Alcohol and Other Drug Misuse

• Alcohol and other drug misuse have been identified by health professionals

from across the HNECC region as particular area of need for Aboriginal people

Drug and Alcohol Misuse

Based on PAT CAT data extracted this week, Aboriginal patients of general practices in Lake Macquarie, Maitland and Newcastle LGAs were more likely to smoke daily and report drug misuse, but less likely to misuse alcohol when compared to non-Indigenous patients.

Alcohol Consumption

Centre for Epidemiology and Evidence, NSW Ministry of Health.

NSW 2015 – 16:

• 32.7% of Aboriginal adults and 31.6% of

non-Indigenous adults had never drunk alcohol

• 33.5% of Aboriginal adults and 25.2% of

non-Indigenous adults drank alcohol less than weekly

• 26.6% of Aboriginal adults and 35.7% of

non-Indigenous adults drank weekly

• 7.2% Aboriginal adults and 7.5% of non-

Indigenous adults drank daily

Alcohol Consumption

Centre for Epidemiology and Evidence, NSW Ministry of Health.

In NSW in 2016, 31.7% of Aboriginal adults and 27.7% of non-Indigenous adults drank alcohol at levels which posed an immediate risk to health

Alcohol Attributable Injury Hospitalisations

• From 2001-02 to 2013-14, the rate of

alcohol attributable injury hospitalisations in NSW increased in the Aboriginal population from 447.2 to 637.2 per 100,000.

• This increased the rate difference/

gap between Aboriginal people and non-Indigenous people from 160.5 to 321.4 per 100,000.

Centre for Epidemiology and Evidence, NSW Ministry of Health

Methamphetamine Hospitalisations

• In NSW, in 2014-15, Aboriginal

people aged 16 years+ accounted for 14% of all people with methamphetamine-related hospitalisations.

• The rate of hospitalisations

for Aboriginal people (431.9 per 100,000) was almost six times that of non-Indigenous people (72.8 per 100,000).

Centre for Epidemiology and Evidence, NSW Ministry of Health

Social and Emotional Wellbeing

Warrgi Djarii (South Taree) Dance Group

Social and Emotional Wellbeing

• Mental ill-health, including complex and enduring mental illness, grief and

loss, and youth mental health have been identified by health professionals across the HNECC region as a particular area of need for Aboriginal people.

• There is a need for greater integration between mental health and drug and

alcohol services, for more flexibility in treatment approaches, and for an increased emphasis on culturally appropriate mental health treatment.

• There is concern amongst health professionals that the physical health

needs of Aboriginal people experiencing mental illness, particularly severe and complex mental illness, are being overlooked.

• Health professionals have identified a need for youth programs, including

leadership and mentoring, for Aboriginal people in the HNECC region.

Social and Emotional Wellbeing

Proportion of people experiencing psychological distress by Aboriginality, persons aged 16 years and over, NSW 2003 to 2015 (Centre for Epidemiology and Evidence, NSW Ministry of Health).

• In NSW in 2015, 21.7% of

Aboriginal people aged 16 years and over reported experiencing psychological distress, almost twice that of non-Indigenous people (11.6%).

• This proportion has varied over

time since 2003 for Aboriginal people, whilst that of non- Indigenous people has remained relatively stable.

NSW, 2013-15:

• 10.7% of Aboriginal people

and 7% of non-Indigenous people aged 16 years and

• ver+ reported high levels of

psychological distress

• 8.1% of Aboriginal people

and 3.7% of non-Indigenous people aged 16 years and

• ver reported very high levels
• f psychological distress

Social and Emotional Wellbeing

Centre for Epidemiology and Evidence, NSW Ministry of Health

Intentional self-harm hospitalisations

Centre for Epidemiology and Evidence, NSW Ministry of Health

NSW, 2015-16:

• The rate of intentional self-

harm hospitalisations for Aboriginal females aged 15- 24 years was 1009.2 per 100,000 and 510.2 per 100,000 for males.

• The hospitalisation rate for

non-Indigenous females aged 15-24 years was 460.7 per 100,000 and 176.2 per 100,000 for males.

Intentional self-harm hospitalisations

Centre for Epidemiology and Evidence, NSW Ministry of Health

NSW 2001-02 to 2015-16: Rates of intentional self-harm hospitalisations for young Aboriginal people has increased since 2001-02, particularly for females which has increased from 317.3 to 1009.2 per 100,000.

• Data provided by the National Coronial Information System

indicated that between 2000 and 2013 in the HNECC region, there were 1,337 deaths recorded as intentional self-harm fatalities.

• Of these, 38 (2.8%) were deaths of Aboriginal people, and

135 (10.1%) were deaths where Indigenous status was recorded as unlikely to be known (NCIS, 2016).

Suicide

Suicide

NSW 2011-15:

• The rate of suicide amongst

males was 22.3 per 100,000 for Aboriginal people and 14.5 per 100,000 for non- Indigenous people.

• The rate of suicide for

females was 6.3 per 100,000 for Aboriginal people and 4.8 per 100,000 for non- Indigenous people.

Centre for Epidemiology and Evidence, NSW Ministry of Health

NSW 2011-15: The suicide rate amongst 15-24 year olds was 15.3 per 100,000 for Aboriginal people and 8.1 per 100,000 for non- Indigenous people.

Suicide

Centre for Epidemiology and Evidence, NSW Ministry of Health

Child and Family Health

Health professionals in the HNECC region have identified maternal health as an area

• f concern for Aboriginal people, and

have highlighted a need for improved coordination of prenatal care between services.

Smoking During Pregnancy

Centre for Epidemiology and Evidence, NSW Ministry of Health.

• In 2015, in Hunter New

England LHD, 44.5% of Aboriginal mothers and 12.2%

• f non-Indigenous mothers

smoked during pregnancy.

• The averages for NSW were

45% and 7.4%.

Smoking During Pregnancy and Low Birth Weight Babies

PHIDU, 2017.

Region % Low Birth Weight Babies Born to Aboriginal Mothers 2012 - 2014 % Aboriginal Mothers Smoking During Pregnancy 2012 - 2014 Lake Macquarie Indigenous Area 9.6 37.6 Maitland Indigenous Area 6.6 41.3 Newcastle Indigenous Area 9.9 46.1 NSW 9.1 47.2 Australia 11.5 47.3

Antenatal Visits

Centre for Epidemiology and Evidence, NSW Ministry of Health

• In Hunter New England LHD

in 2015, 68.3% of Aboriginal mothers and 80.6% of non- Indigenous mothers attended their first antenatal visit before 14 weeks gestation.

• The NSW averages were

55.6% and 64.7%.

Antenatal Visits

Centre for Epidemiology and Evidence, NSW Ministry of Health.

The proportion of Aboriginal mothers in Hunter New England LHD who had their first antenatal visit prior to 14 weeks has increased from 50% in 2001 to 68.3% in 2015.

Childhood Immunisation

Percentage of Aboriginal Children Fully Immunised 2015-16 Region 1 year 2 years 5 years Newcastle & Lake Macquarie SA4 94.8 93.5 96.2 Hunter Valley (excluding Newcastle) SA4 93.7 91.8 97.7 HNECC PHN 93.8 91.3 96.5 Australia 89.8 87.7 94.6

AIHW, 2017.

Childhood Immunisation

Note: Childhood immunisation rates reflect the National KPI for immunisation, ie numbers of children aged 1, 2, and 5 who had essential immunisations at last birthday.

Based on PATCAT data extracted this week, Lake Macquarie, Maitland and Newcastle LGAs had lower childhood immunisation rates for Aboriginal patients compared to non- Indigenous patients.

Perinatal Mortality

Centre for Epidemiology and Evidence, NSW Ministry of Health.

In NSW in 2015, the perinatal mortality rate for Aboriginal babies was 10.7 per 1,000 births compared to 8.0 per 1,000 births for non- Indigenous babies.

Infant Mortality

Centre for Epidemiology and Evidence, NSW Ministry of Health

The Aboriginal infant mortality rate in NSW has decreased from 11.8 deaths per 1,000 live births in 1998- 2000 to 4.4 deaths per 1,000 live births in 2012-2014.

Access to Services

Access to Services

• A key factor to the disproportionate burden of disease experienced by

Aboriginal people is reduced access to services.

• In 2012, 18% of Aboriginal people in NSW aged 16 years and over

reported having difficulty accessing health care.

• GPs in the HNECC region have asked for more education on the services

available for their Aboriginal patients.

• Stakeholders across the region have identified a need for increased

disease prevention and health promotion and education activities for Aboriginal people.

Access to Services

Barriers identified by stakeholders as reducing health service access for Aboriginal people in the HNECC region:

• Transport
• Cost
• Low motivation
• Competing family and work commitments
• Low levels of health literacy

Access to Services

Barriers identified by health professionals as reducing mental health service access for Aboriginal people in the HNECC region:

• Competing family and cultural priorities
• A lack of Aboriginal staff or staff of the appropriate gender
• A history of service mistrust and disengagement
• Limited awareness of services
• Doubts related to confidentiality
• Concerns that the service may not be culturally sensitive

Stakeholders identified these factors as contributing to poorer health

• utcomes for Aboriginal people in our region:

reduced compliance; poor attendance at appointments; not bringing

• r not having a Medicare card; the inability to effect the social

determinants within the primary care setting; patient discomfort in waiting rooms and consulting rooms; difficulty contacting transient community members; limited support navigating the health system; misunderstandings between clients and health professionals; a lack of Aboriginal Health Workers; difficulty for health professionals in remaining aware of the different services and programs available to their patients; and case complexity.

Access to Services

• Aboriginal community members from across the HNECC region suggest that

a great health service is one that provides a holistic health care program, and one that provides support for social issues as well as health conditions

• There is a need for increased integration, flexibility and cultural

appropriateness of mental health and drug and alcohol services.

• There is fragmented care and lack of integration and coordination of health

services for Aboriginal people

• Health professionals and Aboriginal community members have highlighted

a need more holistic care for Aboriginal people taking into consideration mental health, physical health, disability, and social issues

Access to Services

healthplanning@hneccphn.com.au